Bundle For Left Ventricular Assist Device (Lvad) In The Ed, Tina Morris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff …

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

Relationships Among The Concepts Of Organizational Theory And Nurse Burnout Before And After Covid-19, Bridget M. Webb

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nurse burnout is a global health priority that has been compounded by Coronavirus 2019 (COVID-19). Organizational theory states that nurse burnout is directly impacted by operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. The purpose of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination), operant mechanisms (nurse characteristics, nurse specialization), and outcomes (nurse burnout) before and after COVID-19.

Research Question: The specific aim of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination) and operant mechanisms (nurse …

A Quality Improvement Initiative To Reduce Preanalytical Blood Gas Errors, Layla Haver Newbrough

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Introduction: Laboratory testing is one of the most commonly performed procedures in healthcare and resulting data are paramount to clinical decision making. Background: Preanalytical blood gas laboratory errors often stem from the incorrect recording of a patient’s fraction of inspired oxygen (FiO2) within the laboratory collection application. Incorrect FiO2 may cause erroneous results or delays in reporting results that have the potential to negatively impact patient safety and medical management.

Purpose: The purpose of this quality improvement initiative was to reduce the occurrence of preanalytical blood gas laboratory errors. Methods/Interventions: This initiative combined modification of the laboratory collection application …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Establishing Guidelines For Implementing Electronic Hand Hygiene Monitoring Systems, Olaoti Opaleye

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Healthcare-associated infections (HAIs) in hospitals threaten patient safety and quality of care, which leads to increased healthcare costs. Despite national and state-level progress in hand hygiene compliance (HHC), the 2022 CDC annual report on HAIs highlighted ongoing concerns for standard infection ratios (SIRs) and called for improved HHC to reduce HAIs. Many hospitals use trained observers to collate HHC data; their audits are limited and often skewed by the Hawthorne Effect (HE) and observer bias, resulting in inaccurate HHC data. This project aimed to create guidelines for implementing electronic hand hygiene monitoring systems (EHHMSs) to help hospital inpatient units adopt …

Project Quiet: A Quality Improvement Initiative To Reduce Noise Pollution During Anesthesia Induction And Emergence, James Christopher Woods

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: Excessive intraoperative noise puts anesthesia providers at risk for errors that could negatively impact patient morbidity and mortality. Distractions from excessive noise experienced during the “critical phases” of anesthesia present a risk to patient safety and need to be reduced or eliminated. Anecdotally, reports from anesthesia staff at a large academic medical center confirmed that noise pollution during induction and emergence significantly impacted the performance of critical anesthesia tasks. Objective: The goal of this quality improvement (QI) project was to implement a series of interventions designed to reduce noise pollution during induction and emergence, and to reduce …

Benefits And Barriers Of Using Prefilled Precedex Syringes In The Operating Room: A Cost Comparison, Ashley White

Graduate Theses, Dissertations, and Problem Reports (ETD)

According to a report published by the Institute of Medicine, at least 44,000 and possibly up to 98,000 Americans die each year because of medical errors in hospitals. More than 7,000 of those deaths are from medication errors alone (Stucki et al., 2013). Anesthesia providers in the operating room (OR) are at even greater risk to commit medication errors due to their easy access to medications and their autonomy to make independent choices for medication administration. A small rural community hospital in Pennsylvania lacks a protocol for Precedex preparation. Evidence-based research show the benefit of prefilled ready-to-administer syringes, but the …

A Structured Diabetes Continuous Glucose Monitor Education Program To Improve Patient Knowledge And Self-Efficacy, Krystal Abucevicz-Swick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/background: Continuous glucose monitor (CGM) is a recommended method of glucose monitoring for patients living with diabetes who are on insulin or experience documented hypoglycemia. CGM is a tool that can improve patient management of diabetes but works best when paired with education to achieve the maximum therapeutic benefits.

Purpose: The purpose of this project was (1) to develop an evidence-based structured CGM education program toolkit for people with diabetes who are ordered CGM, (2) to implement the CGM education toolkit into the Diabetes Self-Management and Education Services (DSMES) program at the project site, (3) to improve patient knowledge about …

Enhancing Inpatient Sleep Quality In Patients On An Intermediate Care Unit Through Healthcare Staff Education: A Quality Improvement Project, Avery B. Drouin

Master's Theses and Capstones

Background

In the Intermediate Care Unit (IMCU), patients often suffer from poor sleep quality due to continuous overnight care and inherent hospital environment noise. Poor sleep can adversely affect recovery, especially for cardiac patients, who constitute a significant portion of the IMCU population. Improving sleep quality in these patients is essential for their recovery and overall well-being.

Local Problem

Despite the importance of adequate sleep, only 47% of patients in the hospital that houses the microsystem reported a quiet environment at night using the Hospital Compare online survey platform. Disruptions from alarms, phones, and care activities significantly impact sleep quality, …

Nursing Students’ Comfort In The Nursing Program, Camella Bloom, Rebecca Karr, Makenzie Menard

Williams Honors College, Honors Research Projects

This research project’s purpose is to investigate student nurses’ comfort levels within the nursing program. The project focuses on how interactions with RNs impact comfort levels of nursing students. These interactions take place within the student nurses’ clinical experiences or their experiences at their healthcare jobs. The sample was sophomore, junior, and senior-level undergraduate BSN students at The University of Akron, which is about 434 students. The number of participants that completed the survey was 57 nursing students. The independent variables were student level in the BSN program and current employment status in a patient care role. The dependent variable …

Exploring Nurses' Perspectives Of The Use Of Hospital Interpretation Technologies Versus Other Methods For Communicating With Non-English Language Preference (Nelp) Patients: A Literature Review, Natalie Moreira-Rivera

Honors Undergraduate Theses

Nurses' perspectives on the use of interpretation technologies compared to other methods for communicating with NELP patients when providing treatment in a hospital setting was explored utilizing a literature review. The literature search was conducted using CINHAL, APA PsychInfo, Medline, and Applied Science & Technology Source databases. The search resulted in 84 articles, of which 6 were eligible to be included in the narrative review. Three themes emerged that helped explain nurses’ perspectives: preferred technology, facilitators/benefits, and barriers/concerns. Interpretation technologies were preferred over in-person translators in most cases. Nurses and other healthcare providers perceived technologies as convenient, flexible, versatile, and …

The Effect Of An Intervention To Improve Screening For Opioid Use In Patients With Post Traumatic Stress Disorder, Tammy Swartz

DNP Projects

Background: Rates of post-traumatic stress disorder (PTSD) were reported to be higher during COVID-19 than during any other epidemic in history. Patients diagnosed with PTSD are at an increased risk of experiencing opioid use disorder (OUD). Early detection, prevention, and treatment are essential to prevent OUD.

Purpose: The purpose of this project was to determine if education aimed at increasing nurses’ knowledge increased patient screenings for OUD.

Methodology: A baseline chart audit was performed to determine the number of patients seen in the emergency department with PTSD who also were evaluated for OUD. Two hundred and forty emergency department registered …

Enhancing Communication Between Nurses And First Call Providers Using A Secure Chat Algorithm, Karen Hilt

DNP Projects

BACKGROUND: Healthcare requires quality multidisciplinary communication for patient care. Secure Chat is a feature within the Epic electronic health record to facilitate communication without violating Health Insurance Portability and Accountability Act (HIPPA). An algorithm to streamline communication utilizing this feature is needed to improve patient care.

PURPOSE: The purpose of this study was to determine, develop, implement, and evaluate a communication protocol between nurses and first call providers. The overall goal was to improve the knowledge, attitudes, efficacy, and address barriers with communication of nursing staff and providers through efficient messaging embedded within Epic, electronic health record

CONCEPTUAL MODEL: …

Nurse Management Competency Training For Frontline Nurse Leaders, Travis Drake

DNP Projects

Background: Growing evidence shows that front line nurse leaders take on their role with minimal education and training. Healthcare facilities are pressed for resources and time to allow for proper development of these leaders.

Purpose: The purpose of this project was to provide novice nurse leaders with a condensed management development program utilizing key American Organization of Nurse Leaders (AONL) nurse manager competencies. This abbreviated program was developed focusing on three key competencies of finance, innovation, and human resources. The impact of the program was measured by comparing self-assessment prior to any of the education and after the entire program …

Sleep Quantity And Quality: Impact On Nursing Students' Gpa At Georgia Southern University, Jennifer K. Arlow

Honors College Theses

Introduction: Nursing school is a physically and mentally challenging commitment that can result in students sacrificing sleep and compromised sleep quality.

Methodology: A cross-sectional mixed methodology research study of Georgia Southern University’s nursing students was conducted to gauge students' self-perceived sleep habits and current and past academic performance quantified by GPA. Five respondents (whose results were excluded from the data analysis) confirmed the questions were clear and relevant.

Results and Discussion: Thirty-two (n=32) questionnaires were received, of which four were excluded from the final analysis as some questions were not answered. More than 50% of respondents said their GPA decreased …

Hack24f: Ai Conversations In Healthcare, Patrick Finger, Hannah Neale, Anthony Ferreira, Ayaz Mohammed

Paul English Applied Artificial Intelligence (AI) Institute Publications

Nursing students often complete clinical hours under the supervision of instructors in traditional hospital settings. However, obtaining individualized, consistent feedback from patients about their interactions with nursing students is often not feasible. This limits students' ability to fully understand how their communication skills are perceived and how they can improve. Currently, there are no models that represent realistic real life conversations with patients. Most virtual simulation models used for nursing students provide scripted responses that do not feel genuine.

Electronic Symptom Management Using Pros In A Rural, Appalachian Medical Oncologic Population, Andrea Ray Bailey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Systemic chemotherapy is a cornerstone of cancer treatment, but it often leads to significant side effects, which may impact patients' quality of life and lead to increased acute healthcare utilization. Although patients are typically informed of potential symptoms and advised to seek care as needed, many struggle to understand and manage symptoms effectively. Patient-reported outcomes (PROs) have been shown to improve symptom monitoring, decrease symptom burden, and reduce emergency department visits and hospital admissions. Electronic patient-reported outcomes (ePROs), in particular, offer timely and accessible symptom tracking, though their effectiveness has largely been evaluated within urban clinical trial settings and …

Implementation Of A Targeted “Micro-Learning” Inpatient Diabetes Education Program In A Rural Hospital Setting, Melissa Lynn Fannon-Wisner

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Diabetes affects a large portion of Americans and West Virginians annually. Inpatient hospitalization provides an opportunity to provide evidence-based diabetes education to patients. A lack of access to diabetes education at rural hospitals across the United States exists, creating a need for patients who require education while hospitalized. An intervention needs to be explored to bridge the gap for patients that need education when the diabetes educator is not available.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to create and implement a video micro-learning diabetic education series that can be utilized for diabetes self-management …

Power Safety Plan Checklist As An Intervention In The Operating Room, Scott John Fankhauser

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Power Safety Plan Checklist as an Intervention in the Operating Room

Scott J. Fankhauser

Background: Intraoperative power failures (IOPF) force anesthesia providers to quickly make decisions to prevent patient harm when equipment does not operate as designed. Familiarity with alternative methods is critical during this decision process to deliver high-quality care during IOPF events. Purpose: The purpose of this project was to assess the impact of a checklist on anesthesia providers’ perceptions regarding continuation of care during an IOPF. Interventions: Pre- and post-intervention surveys were conducted during a simulation and education setting for annual competencies. Methods: The study …

Self-Care And Quality Of Life Of Remotely Monitored Appalachians With Heart Failure, Patrick Rexrode Murphy

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Self-Care and Quality of Life of Remotely Monitored Appalachians with Heart Failure

Patrick R. Murphy

Background: About 6.2 million persons are living with heart failure in the United States and over 960,000 new cases are diagnosed annually. The cost to provide care to this population exceeds $30 billion per year. Rates of heart failure are higher in the Appalachian region where persons are more likely to experience poverty, lack resources, and be geographically isolated. Heart failure coupled with these unique challenges can negatively impact self-care and quality of life. Numerous interventions have been attempted to support this population, but …

Associated Factors Related To Self-Management Behaviors Among People With Type 2 Diabetes In Myanmar, Aye Nyein Oo, Jiraporn Lininger, Sirirat Leelacharas

Makara Journal of Health Research

Background: Diabetes is a global health concern that affects individuals and the healthcare system. This study aimed to describe the relationships between personal and environmental factors and self-management behaviors in individuals with type 2 diabetes mellitus (T2DM).

Methods: This research included 100 individuals with T2DM who were recruited through convenient sampling from three government hospitals in Myanmar. Data collection was fulfilled using a standardized interviewer-administered questionnaire consisting of demographic information, the Diabetes Management Self-Efficacy Scale, the New Short-Form Health Literacy Instrument, the 24-item version of the Diabetes Knowledge Questionnaire, the Social Support Questionnaire, and the Summary of Diabetes …

Relationships Between Nursing Students’ Attitudes Toward The Nursing Profession, Fear Of Covid-19, And Intolerance Of Uncertainty: A Cross-Sectional Study, Banu Terzi, Fatma Azizoğlu, Çağla Seven

Makara Journal of Health Research

Background: Nursing students were caught unprepared for the COVID-19 pandemic. Both the inability to control the epidemic and the interruption of education caused students to experience fear, anxiety, and uncertainty. This study investigates the relationships between nursing students’ attitudes toward the nursing profession and their fear of COVID-19 and intolerance of uncertainty.

Methods: This cross-sectional study included 727 nursing students who were members of the Student Nurses Association and who volunteered to participate in the research. Research data were collected using the Student Information Form, The Fear of COVID-19 Scale, the Intolerance of Uncertainty Scale (IUS-12), and the …

Diabetes Health Coaching Program In An Eastern Virginia Health Center: A Retrospective Program Evaluation, Moniqueia Flint

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The primary goal of diabetes management is to assist patients in controlling their diabetes and minimizing complications. Diabetic patients require continuous medical care that encompasses medication management, multifactorial risk-reduction strategies, and a multidisciplinary team. Health coaching is an emerging tool used to provide education and motivational techniques to individuals for better self-management of their chronic condition. Health coaching is a proven strategy with favorable effects on hemoglobinA1c (HgbA1c), blood pressure, weight, and health behaviors. A diabetes health coaching program (DHCP) was implemented at an eastern Virginia healthcare center (EVHC). The DHCP’s objective was to assist patients in meeting their individualized …

Medical Device Cybersecurity Risk Assessments: Engaging Clinicians To Mitigate Threat, Nicole A. Mohiuddin

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Much of healthcare practice relies on computers, data and the Internet. This is especially true in the use of medical devices which are connected to the Internet and require strong cybersecurity protocols to ensure their data is secure. Technical advances have resulted in transformations to health care delivery, which have the capacity and capability to improve patient care. A prime example is the increase in interconnectivity between medical devices and other clinical systems. This interconnectivity leaves medical devices vulnerable to security breaches in the same way other networked computing systems are vulnerable (Williams and Woodward, 2015). However, unlike other networked …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri

Doctor of Nursing Practice (DNP) Projects

Background

Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central …

Patient Education Improvement Initiative For Self-Management Of Congestive Heart Failure Among Senior Residents Of A Long-Term Care Facility, Abigail A. Abella, Brooke Sheck, Daniela Ramos, Ivy H. Nguyen, Mary Tran, Roshni Nagarajan

Master's Projects and Capstones

The purpose of this quality improvement project was to use evidence-based practices to determine if personalized education on disease self-management would lead to improved treatment adherence in a residential facility. The target population consisted of four elderly female patients who had been diagnosed with congestive heart failure (CHF) and were struggling with the self-management of their disease. Contributing barriers to effective CHF self-management were determined using a root cause analysis, and included a lack of educational templates, declining cognitive ability of the residents, and no electronic health record (EHR). Using the Self-Determination theory, the interventions were implemented. Phase one was …

Using Clinical Staff-Initiated Protocols In The Urgent Care Setting To Improve Throughput, Holly S. Mason

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

One of the goals and purposes of the urgent care setting is to provide quality patient care within a timely fashion. This process improvement project was designed to improve patient visit times in the urgent care setting, thus improving throughput. In this project, testing/imaging protocols were developed, agreed upon by the office healthcare providers, and utilized by clinical staff for patients who presented with complaints of 1) dysuria, 2) sore throat with an accompanying fever, 3) upper respiratory symptoms without an accompanying fever, 4) upper respiratory symptoms with an accompanying fever, and 5) an orthopedic injury known as a FOOSH …