Nursing Administration Commons^™

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec

Doctor of Nursing Practice Scholarly Projects

Background: Every day, nurses are faced with making decisions for patient care and may come across complicated ethical decisions. Ethical practice is essential in every health care organization in providing care and how they conduct themselves (ANA, 2015). Nurse managers are responsible for ensuring ethical standards are met by nursing staff.

Problem: Nurse managers are faced with ethical problems more than fifty percent of their work time (Aitamaa, 2019). There are studies that show nurse managers and nurses have difficulty solving ethical problems because they lack understanding of ethical principles (Huang, et al., 2020). Evidence shows nurses are deficient in …

Referral Triage To Improve Neurology Access, Melinda Mata

Doctor of Nursing Practice Scholarly Projects

The demand for neurology consultation far outweighs the number of specialists, thus causing long wait-times for consultation. Other contributing factors to obtaining timely consultation include, quality of information sent with the referral, insurance authorization, triage process, and appointment availability. This retrospective quality improvement study explored the effects of a referral triage process on reducing appointment wait time. All referrals were sent to one fax number and a new standard referral and triage process was implemented with specific operators with defined roles and responsibilities. The initial results following intervention implementation did not show improvement in wait times. Comparing the new triage …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Implementation Of A Peer Mentoring-Network Initiative In Outpatient Psychiatry To Improve Psychiatric Advanced Practice Nurses' Job Satisfaction, Maria Romanoff Rand

Doctor of Nursing Practice Scholarly Projects

Background: Post-pandemic rates of mental illness have increased, resulting in a rise in demand for psychiatric services. At the same time, a growing shortage of psychiatric providers is occurring. This combination has given rise to an expanding mental health crisis where strengthening and stabilizing the psychiatric workforce is paramount. Psychiatric Advanced Practice Nurses are uniquely qualified to staff this shortage. Therefore, positive job satisfaction for Psychiatric Advanced Practice Nurses is vital to increase and retain psychiatric healthcare providers available to address this critical need for mental health services.

Methods: At the project site, the shift to telehealth, changing leadership, and …

Just Culture In Undergraduate Nursing Academia, Marcie Leonard

Doctor of Nursing Practice Projects

Understanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data …

Experiences Of Transitioning Medics And Hospital Corpsman, David Renfro

Doctoral Projects

Approximately 2,000 medics transition from military service to civilian jobs annually, and the civilian workforce currently does not have a mechanism to utilize the skills of these transitioning veterans. Medics and Hospital Corpsmen are not licensed or certified, making transferring into employment in the community difficult. The Veterans Affairs (VA) has an intermediate care technician (ICT) program that provides employment for previous active-duty medics and hospital corpsmen. Understanding the transition of medics and hospital corpsmen better positions the Department of Defense and the VA leadership to support the transitioning veteran.
This DNP project used a quality improvement framework, and a …

An Integrative Review: Best Practices For Educating And Engaging Care Partners Of Patients With New Ostomies, Lauren Flook Brown

Master of Science in Nursing Final Projects

PURPOSE: The purpose of this integrative review was to identify and synthesize the best practices of engagement and education for care partners of patients with new ostomies to support adaptation.

METHODS: Five-stage integrative review process: (1) problem identification, (2) systematic literature search, (3) data evaluation, (4) data analysis, and (5) presentation.

RESULTS: Four themes with sub-themes emerged to understand effective engagement and education of care partners: (1) care partner influences on patient outcomes; (2) care partner needs; (3) barriers to care partner adaptation; and (4) diverse engagement strategies. Each theme and sub-themes related to care partners could not be separated …

Suicide Screening Among Adolescents With A History Of Mental Or Physical Abuse- Evaluating The Effectiveness Of Suicide Screening: A Scoping Review, Tiffany Nicole Jackson Bsn, Rn, Cody Tyler Cottrell Bsn, Rn, Allison Tucker Mcculley Bsn, Rn, Cen, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review is to gather evidence on best practice for the administration of pediatric suicide screening in a variety of healthcare settings.

Understanding The Experiences Lived By Nurses Caring For Patients With Covid-19: A Hermeneutic Approach, Awatif Mansoor Alrasheeday, Ma. Venus Borja, Eddieson Pasay-An, Farhan Alshammari

Makara Journal of Health Research

Background: Nursing is highlighted among professions that value caring and is perceived as the profession’s heart and soul because of its critical role in providing and delivering high-quality patient care, especially during this coronavirus disease 2019 (COVID-19) pandemic. However, little is understood about the experiences of the frontline workers in caring for persons diagnosed with COVID-19. This study aimed to explore the experiences of nurses in caring for persons diagnosed with COVID-19 inspired by the four lived worlds of van Manen.

Methods: The hermeneutic phenomenology was used in nine nurses working in hospitals of Hail region. This study …

Enhanced Recovery After Surgery (Eras) For Cardiothoracic Surgery, Emile Shaw, Samantha Schultz, Taylor Woods, Emma Zollmann, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Background/Purpose

Enhanced Recovery After Surgery (ERAS) protocols are multi-disciplinary approaches that optimize recovery and reduce surgical outcome variability. This scoping review compares surgical outcomes associated with traditional perioperative care to outcomes associated with an ERAS protocol for patients undergoing cardiothoracic surgery.

Methods

A literature review evaluating traditional perioperative care versus ERAS protocols in cardiothoracic surgical patients was performed to set inclusion and exclusion criteria based on current peer-reviewed journal articles for qualitative data. Group members selected 14 articles based on inclusion criteria and relevance to the PICOT question for review and placed findings in a synthesis table. Findings included compliance …

A Systematic Record Review Of A Local Quality Improvement Impacts On Anesthesia Provider Knowledge And Attitudes Following A Presentation Of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use In Total Joint Arthroplasty Surgical Patients, Kevin Mcclellan

Doctor of Nursing Practice Scholarly Projects

Abstract Patients undergoing spinal anesthesia for total joint arthroplasty (TJA) must urinate and ambulate within 1-hour before discharge from the post-anesthesia care unit to indicate a healthy return of lower body neuro-function after spinal administration. The most common spinal medication used is bupivacaine which has complications including postoperative urinary retention (POUR), altered proprioception, delayed ambulation, and prolonged motor block, resulting in increased cost and length of stay. One alternative solution is mepivacaine, an intermediate local anesthetic lasting 1.5 to 2.5 hours with comparative surgical blockade but a quicker motor and sensory function return. Research suggests mepivacaine is just as safe …

Hospital Acquired Pressure Injury (Hapi)– Related To Bilevel Positive Airway Pressure (Bipap) In Definitive Stepdown Unit (Dsu)​, Carmyle Seville, Bsn, Rn, Pccn, Angelica Taneca, Bsn, Rn, Pccn

Articles, Abstracts, and Reports

2023 Western Institute of Nursing Research (WIN)

Leveraging Technology to Advance Nursing and Equity in Research, Practice, and Education

HAPI-Related to BIPAP in DSU

Carmyle Seville, BSN, RN, PCCN

Angelica C. Taneca, BSN, RN, PCCN

Background: Most Medical-Device Related Pressure Injuries develop when skin or underlying tissues are subjected to a sustained pressure or shear from medical devices. Dressings have shown substantial biomechanical effectiveness in alleviating facial tissue deformations and stresses by providing localized cushioning to the tissue at risk. Our units (DSU and SDU) provides for the monitoring and care of patients with moderate or potentially severe physiologic instability …

Type 2 Diabetes Treatment Plan, Kylie N. Laird

MSN Capstone Projects

Diabetes affects more than 34 million Americans, with approximately 90-95 percent of them having type 2 diabetes. Diabetes is primarily managed by the patient with assistance from their healthcare team (Centers for Disease Control and Prevention, 2021). Diabetes is a costly disease that affects individuals, healthcare systems, economies, and entire societies globally. Based on the knowledge, lifestyle interventions have shown to be effective in the management of type 2 diabetes (Garcia, 2020), a more holistic approach to disease management was pursued. Garcia (2020) conducted a study in which lifestyle intervention data for treatment of diabetes was compared to pharmaceutical management …

Evidence Based Change To Improve Outcomes In Cardiac Patients, Amy L. Callahan

MSN Capstone Projects

According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.

Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need …

Mitigating Fatigue In The Triage Process: A Creative Solution To Shorter Shifts, Rebecca J. Arismendi

MSN Capstone Projects

Triage is a critical assessment process performed by a registered nurse by which Emergency Rooms (ERs) sort patients who present for a medical evaluation. With ER visits increasing, pressure on staff to move patients through the department is often palpable. Whether a patient decides to walk in, or come in by ambulance, the first person to assess the patient is the triage nurse. They determine the appropriate level of care needed for the presenting complaint.

After a review of literature, it was found that fatigue is correlated with shift length in triage with the highest level of fatigue being at …

Implementation Of Purposeful Hourly Rounding To Decrease Fall Rates, Dannette Kizy

Student Scholarly Projects

Practice Problem: Patient falls can lead to an increased length of stay and potentially reduce the quality of life. In addition to serious injury, the patient and the hospital have a significant financial burden. PICOT: On a medical-surgical unit, does incorporating purposeful hourly rounding in the patient care routine compared to no purposeful rounding decrease patient fall rates over eight weeks?

Evidence: Of the 35 articles related to fall prevention and PHR, a final selection of eight articles met the criteria and were of high quality and evidence levels.

Intervention: PHR was implemented to decrease falls over …

The Introduction Of A Family Advisory Council In A Neonatal Icu, Jennifer Streelman

MSN Capstone Projects

Having a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a …

The Implementation Of A Nurse Residency Program, Jessica Conrad

MSN Capstone Projects

Implementing a nurse residency program in a hospital can be a successful plan to improve nurse retention and the quality of patient care. Nurse residency programs allow new graduate nurses to transition into professional practice and gain skills for safe and effective care. Components of the programs include preceptorship, educational seminars, shadowing days, and support from preceptors, educators, and other leadership members. The program also may provide benefits to hospitals, including improved patient outcomes, nurse job satisfaction, and decreased costs associated with reduced turnover. Successful implementation needs leadership, collaboration, and communication among all stakeholders, including the staff nurses, preceptors, educators, …