Other Nursing Commons^™

What The Heck Is Value-Based Purchasing??, Centracare Health

Nursing Posters

Medicare has changed the way hospitals get paid. The new payment program is called Value-Based Payments (VBP). VBP is made up of two parts: incentives & penalities.

Utilizing A Protocol To Reduce Post-Operative Urinary Retention In Total Joint Arthroplasty, Gina Anderson-Malum, Naomi Schneider

Nursing Posters

Foley catheters have not routinely been used for our total joint patients for many years, leading staff to bladder scan and straight catheterize patients postoperatively. Bladder scanning and catheterization were identified as an inconsistent practice. Patients were commonly straight catheterized when nurses determind bladder scan volume and time of last void; yet the amounts for both and decision to catheterize were inconsistent. Also, the clinical evaluation and treatment was inconsistent among physicians. Variations in practice included rationale for a urology consult, use of medications for urinary retention, and documentation. Baseline urinary retention condition codes ranged from 8-18%, which led our …

Expanding The Practice Of Caring In The Peri-Anesthesia Unit, Jacqueline J. Meyer-Rostad

Theses and Graduate Projects

Caring is a central theme of the nursing profession; the essence of nursing. The preoperative and postoperative surgical settings at a large Midwestern Hospital are extremely busy and very demanding, which can affect patient care. It is essential for Patient Care Assistants (PCAs) to identify caring actions and to provide authentic caring for patients and families. Themes of witnessed uncaring behavior include: rough handling, loud and inappropriate conversations, ignoring the patient or family, abrupt answers to questions, and negative non-verbal body language. Conversations with several patient care assistants (PCAs) revealed they feel 'too busy' during their work day or are …

Evaluation Of A Rheumatology Patient Prioritization Triage System, Katharine R. Layton

DNP Projects

The United States health care system is currently experiencing an increase in demand for services due to an aging population. Rheumatology, an Internal Medicine sub-specialty, treats those patients with arthritic conditions as well as other autoimmune and inflammatory conditions. A shortage of rheumatologists is projected by 2025, adding additional stress to an already burdened clinical area.This means patients can face substantial wait times when requesting consultation with a rheumatology provider.This capstone project will present three manuscripts that explore the referral process from primary to specialty care and strategies to reduce wait times. The first manuscript is a literature review that …

An Assessment Of Knowledge And Attitude Towards Stock Epinephrine Among Kentucky School Nurses, Brandi M. Duran

DNP Projects

This cross-sectional, pre-post intervention study was designed to gather information on Kentucky School Nurses attitude and knowledge toward non-prescribed epinephrine auto injectors in Kentucky Schools. All 500 members of the Kentucky Schools Nurses Association received a link to the pretest, educational intervention and posttest via email. Of those, 75 nurses responded and 72 were eligible to participate in the study. The data was analyzed through a paired t-test using SPSS. The results showed an increase in level of comfort with epinephrine, although it was not statistically significant. There was a statistical significance between the pretest and posttest when school nurses …

Munchausen By Internet And Nursing Practice : An Ethnonetnographic Case Study, Cynthia Witney, Joyce M. Hendricks Phd, Vicki C. Cope Ms

Research outputs 2014 to 2021

This paper used Feldman’s clues to factitious illness behavior on the Internet (FIBI), to determine whether the online behaviour of one member of an online breast cancer support community www. breastcancerclick.com , moderated by a specialist breast cancer nurse (SBCN), could be Munchausen by Internet (MBI) and why identification of this behaviour is important for online nursing practice. This was a focused ethnonetnographic and qualitative research study whereby the online behaviour of one member was observed and compared with Feldman’s clues to factitious behaviour on the Internet. The online data showed that nine out of ten of Feldman’s clues were …

The Health And Health Behaviours Of Australian Metropolitan Nurses: An Exploratory Study, L. Perry, R. Gallagher, Christine Duffield

Research outputs 2014 to 2021

Background: Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses' overall health and the presence of chronic disease; to describe nurses' health-related behaviours and to compare them to those of the general population, with both groups matched by …

The Effect Of Personal Contact On Attitudes Toward Mental Illness In Baccalaureate Nursing Students, Jessica Ashe

Williams Honors College, Honors Research Projects

Many people who suffer from serious mental illness also suffer from the stigma associated with such illness. Because nurses frequently come into contact with the mentally ill, it is important that they do not stigmatize these individuals. The purpose of this study is to determine the effect of a guest lecture by an individual with a serious mental illness on attitudes about mental illness in a sample of baccalaureate nursing students. The theoretical framework that guides this study is Goffman’s (1963) theory of social stigma. The sample used for this research is a convenience sample of 50 junior level nursing …

A Systematic Review: Immediate And Maintenance Effects Of Interventions On Handwashing Compliance In Healthcare Workers, Brent E. Gibson, Dajana Markovic

Williams Honors College, Honors Research Projects

There has been a drastic rise in the number of nosocomial infections of patients in intensive care units. Handwashing is generally accepted as an effective and inexpensive method that healthcare providers in hospital settings can use to decrease the likelihood of nosocomial infections, however, studies have shown that healthcare providers are often not compliant with handwashing protocol. The purpose of this systematic review of literature is to not only obtain information on handwashing compliance and non-compliance among different healthcare providers, but also to identify, describe, and evaluate evidence about the effect of various interventions on handwashing compliance in healthcare providers. …

A Comparison Of Empathy In Sophomore And Senior Baccalaureate Nursing Students, Alexandra I. Woods, Stephanie Malachin

Williams Honors College, Honors Research Projects

Empathy is a cognitive process rather than an emotional and is often learned through life. Hildegard Peplau’s theory of interpersonal relations explains the importance of the nurse having a shared experience with the patient. Empathy is a crucial skill for nursing students to develop because it is shown that nurses showing empathy is directly related to improved patient satisfaction. Empathy levels tend to decrease as students progress throughout nursing school. The purpose of this study is to examine the empathy levels in sophomore baccalaureate nursing students compared to senior baccalaureate nursing students. Using a descriptive comparison design and a cross-sectional …

Assertiveness In Nursing Students, Kaitlin F. Amicone, Rachel Miller

Williams Honors College, Honors Research Projects

The problem that this study focused on was that there was minimal evidence on whether or not nursing students become more assertive throughout their academic education. The purpose of this study was to compare the assertiveness scores of sophomore level nursing students and senior level-nursing students. The study was guided by Hildegard Peplau’s theory of interpersonal relations in nursing, which focuses on the therapeutic process between nurses and patients, rather than on internal patient pathology. The descriptive, comparative study used a 15-question survey design and a convenience sample of sophomore and senior level nursing students at a large urban Midwest …

A Systematic Review: Non-Pharmacological Interventions For Chemotherapy-Induced Nausea And Vomiting, Miranda L. Ayers, Olateju F. Olowe

Williams Honors College, Honors Research Projects

Around 70-80% of patients receiving chemotherapy are at risk of chemotherapy-induced nausea and vomiting (CINV), which can interfere with appetite and the ability to perform normal activities for daily living. When CINV is severe, psychological distress, depression, and physiological impairment occur. Patients may also stop chemotherapy treatments, which can lead to untimely deaths. The aim of this systematic review was to identify, describe, and evaluate the evidence about the use and effectiveness of non-pharmacological interventions, compared to no use of non-pharmacological interventions, on self-reported episodes of CINV among the cancer patients. Twenty articles were reviewed on the use of acupressure, …

Nursing Students' Concerns And Experiences Toward End-Of-Life Care: A Mixed Methods Study Using Simulation, Patricia Cosby

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Identification Of Effective Disinfectants On Bacterial Growth, Linda A. Hanson

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Relational Coordination: An Exploration Of Nursing Units, An Emergency Department And In-Patient Transfers, Mary Coffey

Theses and Dissertations

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to …

Just Sit For A Bit: A Moment Of Caring, Gabrielle M. Malouf

Master's Projects and Capstones

Background: Research shows that time spent sitting at the bedside promotes trust, which ultimately improves nurse satisfaction, patient satisfaction and patient outcomes. Patient satisfaction scores have been below benchmark for several months on an adult medical unit at an academic medical center.

Overview: The purpose of this project was to improve patient satisfaction in the areas of nursing courtesy, friendliness, and listening. Nurses were asked to sit down for at least 5 minutes per shift with each patient, engaging in a “moment of caring”. Nurse surveys were given and both pre and post implementation. These surveys assessed whether or not …

Outpatient Medication Error Improvement, Savannah M. Klinginsmith

Master's Projects and Capstones

Patient Safety Initiative -Improving Medication Administration (Outpatient Care)

SPECIFIC AIM: We aim to Improve the medication administration process and involve all staff within 6 months

In the microsystem consisting of 14 family practice and urgent care clinics, there is not a standard process based on evidence based practices for medication administration. With and estimated of 400-600 medications (immunizations included) being administered per day, without a standard of care protocol, the risk for medication errors is evident.

Objectives and changes anticipated based on implementation of the project is to engage staff in support for improving medication administration standard of care based …

Narrowing The Qsen Competency Gap In New Graduate Registered Nurses, Marty Mayhew

Doctor of Nursing Practice (DNP) Projects

This intervention is an evidence based, change of practice, quality improvement project that evaluates achievement of the six Quality and Safety Education for Nurses (QSEN) competencies of new registered nurse graduates. No intervention with a similar focus was found in an extensive review of the literature. The participants included 16 new graduate registered nurse hires enrolled in a new graduate RN residency program at Tucson Medical Center located in southern Arizona. The Nursing Quality and Safety Self Inventory^© (NQSSI^©) was used to identify practice gaps perceived by the new RN graduates related to the six QSEN competencies. …

Transitional Care Services: A Nurse-Led Quality Improvement Project, Debra Conroy-Mccue

Doctor of Nursing Practice (DNP) Projects

With the implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA) and a national requirement for health care providers and systems to deliver care that is safe, outcome driven, and cost effective, Dignity Health (DH) as part of the hospital engagement network (HEN) launched an initiative called the “No Harm” campaign to reduce all-cause avoidable hospital readmissions. The project, led by a Doctorate of Nursing Practice (DNP) student and readmission team, sought to achieve a 20% reduction in preventable readmissions by December 2014. After having achieved initial success in implementing transitional care services for patients with heart …

Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice project was to provide nurses with an experiential learning opportunity, using simulation, to identify and report near miss events during the medication administration process related to patient-controlled analgesia (PCA) usage. Despite extensive in-service training on a Medical/Surgical (Med/Surg) floor in an acute care hospital, inconsistent, inaccurate and incomplete documentation with use of the new PCA pumps continued to be problematic. A conceptual framework of just culture was used with the quality improvement method of the Plan-Do-Study-Act (PDSA) cycle for testing change. Medication safety education was a valid andragogical strategy to decrease rates …

The Creation And Implementation Of A Transgender Cultural Competence Nursing Education Toolkit, James Bl Donovan

Doctor of Nursing Practice (DNP) Projects

Healthcare disparities in the transgender populations have been linked to lack of healthcare provider cultural competence (IOM, 2011; Bradford et al., Harbin et al., 2012; Eliason, Dibble, & DeJoseph, 2010; Lim, Brown, & Jones, 2013). Prior research has identified that healthcare providers receive little, if any, transgender cultural competence training during their formal education. A survey of nursing educators at the University of San Francisco School (USF) of Nursing and Health Professions suggested that few educators are providing transgender content or understand the unique healthcare needs of that population. A literature review concluded that little is known about the best …

Emergency Preparedness On An Inpatient Hospital Unit, Hailee Marie Barnes

Master's Projects and Capstones

This paper will discuss the implementation of an emergency preparedness quality improvement project conducted by a University of San Francisco Clinical Nurse Leader (CNL) student on an inpatient cardiac unit, Unit H, at an urban teaching hospital in Northern California, Hospital B. An assessment of the current state of emergency preparedness, a diagnosis of Unit H’s area of greatest needs, the details of planning and implementing the quality improvement as well as the final evaluation will be discussed. The nursing process will be used for the structure of this paper as it was used as the structure of this project. …

Increasing Patient Participation In The Medication Reconciliation Process, Andrea Idudhe

Master's Projects and Capstones

It is estimated, that ambulatory care settings have a 25% adverse drug events (ADEs) rate, and 39% of those event were preventable errors (Taché, Sönnichsen, and Ashcroft, 2011). Considering many adverse drug events are related to medication errors, preventing medication errors is fundamental to improving patient safety and outcomes. Medication reconciliation is the process of identifying and resolving medication discrepancies that occur, during transitions in care. Patient participation is a key component to the medication reconciliation process. With the intent to improve patient participation, a patient awareness intervention was implemented in the cardiology outpatient clinic. Data was collected using microsystem …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Collaborating With The Unit Clerk To Decrease Avoidable Interruptions During Medication Administration On A Medical Surgical Unit, Christine Dimaano

Master's Projects and Capstones

Medical errors are the third leading cause of death in the United States. Medical errors also incur significant cost ramifications due to increased hospital length of stay and fines. Medication errors, a type of medical error, are one of the most common types of inpatient errors. Nurses are most often are responsible for medication administration, but safety during medication administration should be a priority of all hospital personnel. Avoidable interruptions during medication administration contribute to medical errors. Decreasing interruptions require increased nurse assertiveness during medication administration, interdisciplinary cooperation and unit culture change. This project identified that educating the unit clerk …

Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang

Master's Projects and Capstones

The purpose of this project was to develop a video simulation exercise to enhance communication between Registered Nurses (RNs) and Patient Care Assistants (PCAs). From a general microsystem assessment initially performed on an urban hospital medical-surgical unit, 75% of respondents noted that the most pertinent issue to address was improving communication between RNs and PCAs. Literature review of evidence-based practices found several studies that support the use of human clinical simulation to promote teamwork and interdisciplinary communication. RNs (n = 24) and PCAs (n = 9) were then individually interviewed with surveys and responses scored based on the …

Ent Educational Patient Bedside Tool, Alina M. Toma

Master's Projects and Capstones

Early educational and discharge preparations are an advantage to patients, the interdisciplinary team, and hospital. It was determined that lack in communication and coordination among staff members led to inadequate patient teaching, therefore an educational tool that is kept at the bedside may facilitate accountability and smoother transition to home.

The aim of the project is to improve the education of patients with tracheostomies and laryngectomies, and enhance staff communication and coordination by December 2014.

Analysis methods used included Failure Mode Effects Analysis (FMEA), fishbone diagram, process map, and SWOT analysis. The social learning theory is the framework chosen for …