Nursing Administration Commons^™

Bolstering Moral Courage And Ethical Decision-Making Confidence To Moderate Nurse Leader Moral Distress, Lisa Krening

Central Division Nurse Clinical Inquiry Conference

Abstract:

Bolstering Moral Distress Knowledge, Ethical Decision-Making Confidence, and Moral Courage Among Nurse Leaders

Background

Nurse leaders report low confidence navigating ethical dilemmas. Ethical dilemmas arise when ethical values are challenged, causing uncertainty about how to proceed. Left unresolved, ethical dilemmas impact ethical decision-making and can lead to moral distress. Moral distress is the anguish that occurs when there is recognition of an ethical dilemma necessitating a professional obligation to act, yet barriers exist to taking the ethically correct course of action.

To reduce moral distress, nurse leaders not only need to be able to identify an ethical dilemma, know …

Implementing In-Room Recycling On A Family Medical Center, Sarah Johnson

Central Division Nurse Clinical Inquiry Conference

Abstract:

Title: Implementing In-Room Recycling on a Family Medical Center

Background:

Healthcare operations are estimated to generate up to 29lbs of waste per patient per day (Practice Greenhealth, 2022). Waste contributes significantly to healthcare’s carbon emissions, which in turn contributes to the growing climate crisis (Karliner et al., 2019, Healthcare Without Harm, 2019; World Health Organization, 2018). Diverting recyclable waste from healthcare operations will reduce healthcare’s total waste to landfill and waste related carbon emissions.

Recycling bin placement and contamination rates (the amount of items in recycling that should go to another waste stream) can impact recycling levels. Staff at …

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

Results Of Nursing Training Reforms: Estimating The Scope Of Nursing Practice, Marat Serikbayev, Saltanat Mamyrbekova, Ainur B. Kumar, Lyazzat Kosherbayeva, Akmaral Abikulova, Laura Seiduanova, Elmira Serikbayeva

Journal of Health Research

Background: With the adoption of the Astana Declaration on primary health care, modern approaches are being introduced in the Republic of Kazakhstan. The created national foundations of the nursing management system in Kazakhstan are a visible manifestation of a new organizational culture. In connection with the large-scale reform of nursing and the creation of a new position of nurses that meets modern social challenges and international requirements, the role of nurses in healthcare has increased significantly. In this study, we measured the actual scope of nursing practice among nurses in the medical organizations in the Republic of Kazakhstan.

Methods: …

Nursing Leadership Panel: Evaluating An Alternative Day Work Week For Nurse Leaders : A Pilot Study, Stephanie Nolan (Presenting Author), Trisha Saul (Presenting Author), Candice Washilewski

2023 South Division Nursing Research Conference

No abstract provided.

Nursing Leadership Panel: Achieving Nurse Leader Respite Through Implementation Of A Nurse Leader Cross-Coverage Program, Kathryn Webster

2023 South Division Nursing Research Conference

No abstract provided.

Nursing Leadership Panel: The Relationship Between Moral Injury, Moral Resilience, And The Healthy Work Environment Among Icu Nurses: Implications For Nurse Leaders, Sarah Sumner

2023 South Division Nursing Research Conference

No abstract provided.

Effect Of Resilience Training Program For Nurse Interns On Their Work Engagement, Yaldez K. Zein Eldin Prof, Ahmed Ragab Elwany Mr., Neamat Mohamed El Sayed Prof, Mayada Hassan El Zoheiry Dr

Nursing

Background: Resilience in nurses enables them to use positive adaptive skills in coping with stress and helps them keep up with the stressful environment of their work settings and it was proven that resilience was the most significant positive factor contributing to work engagement. It is difficult to accomplish high-quality patient care without nurse work engagement (WE), and in the current complex healthcare environment, the engagement of the nursing workforce is essential for delivering quality patient care and overcoming current challenges in healthcare. Objective: Determine the effect of resilience training program for nurse interns on their work engagement at their …

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …

Emergency Department To Medical Telemetry Bed Flow Optimization, Anne Rochelle P. Taco

Master's Projects and Capstones

Abstract

Background: The setting for this quality improvement project is a 22-bed medical telemetry unit that receives approximately 85% of ED admissions. The capacity challenges are one of the major causes of ED admissions beyond the 60-minute benchmark. To create capacity, discharges should happen earlier on the day or before 1:00 p.m. to be able to admit patients within 60 minutes from when the physician writes an order to patient transfer to the telemetry unit.

Problem: Patients are being boarded in the ED for extended times while waiting for an inpatient bed assignment. Longer boarding time in the ED is …

Reducing Hospital-Acquired Clostridium Difficile, Tracy Esposo

Master's Projects and Capstones

Background: This project focused on implementation of clostridium difficile (C. diff) education sessions at Hospital A, a not-for-profit, short-term, acute care hospital serving the Greater Sacramento community. It comprises of 241 staffed beds in the medical-surgical, telemetry, and intensive care units.

Problem: My Clinical Nurse Leader project focused on preventing hospital-acquired C. diff. At Hospital A, there were 19 hospital-acquired C. diff cases for the 2022 performance year. Of the 19 clostridium difficile cases, 12 were related to C. diff testing criteria fall-outs.

Despite huddling with staff on opportunities and providing education through health stream modules, Hospital A continues to …

Implementation Of A Wellness Program For Nurse Leaders, Ericson A. Fernando

Master's Projects and Capstones

Background: The setting for this study is the implementation of a wellness program for nurse leaders at Hospital A, a healthcare organization servicing the South Sacramento area in California. Healthcare is a challenging and high-demand profession, and the COVID-19 pandemic has exacerbated an issue of burnout and unwavering job-related stress for physicians and employees. This remains true for nurse leader professionals who take on the responsibility to ensure safety and quality always remains at ideal measures for any facility.

Problem: During the past several years of the pandemic, the nurse leader role has had to endure several unknowns, placing significant …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Safe Staffing, Safe Patients Benchmark Project, Sarah Barton

MSN Capstone Projects

With the most recent pandemic, nurses have been overworked, overwhelmed, and understaffed at dangerous levels. Nurses are leaving full time employment at this facility in droves to seek better wages through traveling. In turn, our patient outcomes have taken a large hit, with an increase in falls, pressure ulcers, and catheter-acquired urinary tract infections, to name a few. This is costly for the hospital, not to mention the damper it puts on the hospital’s vision and goals. With the implementation of a nursing incentive program, the hospital could cut overall spending in half within 2 years with an investment of …

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Implementation Of A Nursing Peer Mentorship Program To Improve Nursing Retention And Job Satisfaction In An Acute Care Hospital: A Quality Improvement Project, Rebecca Cassel

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Currently staffing shortages are impacting patients and communities nationwide. This problem has been on the rise since the before the pandemic. COVID-19 has certainly increased the rate of nursing turnover, and vacancy, especially in acute care (Krofft & Stewart, 2021). Many factors contribute to nursing turnover, including nursing satisfaction, interprofessional relationships, and organizational support, and it is apparent that swift and effective action is needed, to ensure that safe, skilled nursing professionals are available to provide the necessary treatment that those seeking healthcare need. Nursing Mentorship programs have been shown to improve retention of nursing staff, …

A Practice-Based Inquiry Into The Correlation Between Nursing Retention Rates And Resiliency, Kelly J. Watson

Electronic Theses and Dissertations

Nurses are the frontline in the security of the United States. Their wellbeing and retention in the workforce is of the utmost of importance. Nurses are leaving at increasing levels with just over 27% turnover rates across the nation in 2021. Organizations are experiencing increasing fiscal losses and the average loss for a nurse leaving is just over $46,000. The prioritization of nurses’ wellbeing and taking steps to address policy that promotes the sustainability of this very valuable workforce has the potential to pay high dividends for nurses individually, the security of the nation, and the good of the organization. …

The Transformation: Teaching Critical Thinking And Clinical Decision Making In Nursing Education, Winifred Ferguson Adams

Electronic Theses and Dissertations

Abstract

The profession of nursing has recognized in the past 20 years the need for graduate nurses to enter the profession prepared to care for complex medical patients in an ever-changing healthcare environment. It has become a major challenge for nurse educators to provide students with adequate didactic and clinical education in nursing. The overall purpose of this project was to help nurse educators accept the challenge required to make the radical transformation in education. Faculty participated in the measurement of self-efficacy pre and post-exposure to teaching strategies related to (1) critical thinking, (2) clinical judgment, and (3) clinical reasoning …

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …