Nursing Administration Commons^™

Care Transitions: A Mixed Methods Study Using A Complexity Science Lens, Carol Geary

Theses & Dissertations

Research studies on care transitions from hospital to nursing home are few and heterogeneous, offering an inadequate characterization to support practice. The purpose of this study was to characterize multiple care transitions among hospitalized older adults with advanced chronic disease who were discharged to a nursing home. This prospective, mixed methods study used multiple case studies with an embedded quantitative strand and multiple sources of information.

Four cases included an index patient (an older hospitalized adult with advanced chronic illness), his or her informal caregiver, if available, and healthcare providers involved in the index patient’s care. Two hospitals and two …

Operating Room Nurse To Post Anesthesia Care Unit Nurse Handoff: Implementation Of A Written Sbar Intervention, Erin Long

Evidence-Based Practice Project Reports

The lack of standardized handoff from the operating room (OR) nurse to the post anesthesia care unit (PACU) nurse may result in the miscommunication or omission of patient information, which increases the risk of patient safety events. The goal of this EBP project was to standardize OR to PACU nurse handoff in order to reduce risks to patient safety. A literature review revealed guidelines for handoff which included implementing a standardized protocol and using a mnemonic phrase. The Iowa Model of Evidence-Based Practice and Lewin’s Model of Change guided the EBP project. Handoff quality was evaluated by OR and PACU …

Pre-Employment Testing To Improve Nurse Retention, Jonathan Brandon

Nursing Theses and Capstone Projects

Nurse retention is an issue healthcare organizations cannot afford to ignore. The nursing shortage continues to impact healthcare in this country which increases the importance and urgency of retaining nurses. Job success, also referred as job satisfaction, is a key indicator of a nurse’s intent to stay. There are pre-employment tests that were designed specifically for healthcare organizations to help them choose applicants that are most likely to be successful resulting in better patient outcomes and improved nurse retention. The purpose of this study was to compare the perceived job satisfaction and intent to stay of nurses that completed pre-employment …

An Exploration Of Social Capital Among Nurses In The Ambulatory Setting, Anna Lutz, Tamara Mckinnon

Doctoral Projects

Bullying and lateral violence are a sadly, common phenomena among nurses. While this issue has been examined within the inpatient, acute setting, it has not been widely researched in the ambulatory setting. This concept is usually looked at from a negative standpoint, looking at the levels of lateral violence. The purpose of this research study was done to explore the levels of social capital, also known as positive peer support, among nurses in the ambulatory setting. The participants of the study were 39 registered nurses from a public health department and an embedded care management department. The tool used was …

Barriers To Preoperative Teaching In A Culturally Diverse Healthcare Environment, Rancelle Ablan

Doctoral Projects

The role of the professional nurse is integral in educating and ensuring that patients understand essential components of their plan of care. This is especially true for patients who are to undergo surgical interventions; evidence has demonstrated that preoperative education provided to patients is linked with positive patient outcomes and a decrease in post-operative complications (Blackstone, Garrett, & Hasselkus, 2011). This qualitative study investigated the barriers that nurses experience in providing preoperative education to diverse patients in a multicultural healthcare environment. Ten registered nurses at a private community hospital in the San Francisco Bay Area participated in an hour long …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

The Effects Of Education On Compassion Fatigue Experienced By Oncology Nurses, Ina Wilson

Evidence-Based Practice Project Reports

Oncology nursing is widely viewed as a rewarding and emotional challenging specialty. Oncology nurses witness terminal illness, death, physical, and emotional suffering which increases their risk of developing compassion fatigue. The purpose of this evidence-based practice (EBP) project was to increase awareness of compassion fatigue among oncology nurses by providing them with knowledge, effective coping skills, and self-care management skills. The Theory of Human Caring was used as the theoretical framework to support this EBP project and the intervention was guided by The Iowa Model of Research-Based Practice to Promote Quality Care. The project used a pre-test and post-test design. …

Patient Complexity Factors And Their Influence On Nurses' Perception Of Staffing Adequacy, Margaret M. Duffy

Theses & Dissertations

Nurse leaders must consider the influence of nurse-specific and patient-specific factors on nursing workload and nurses’ perception of staffing adequacy when developing nurse staffing plans. All of the factors that influence individual nurses’ perception of staffing adequacy are not known. Using a synthesis of the Roy Adaptation Model (RAM) and economic theory as a guiding model, the purpose of the current study was to determine if selected patient complexity factors that are not consistently captured in the measurement of patient acuity by an automated workforce management system influence nurses’ perception of staffing adequacy. The current study employed a complex predictive …

The Evolution Of The U.S. Catholic Hospital: From Sisters In Habits To Men In Suits, Michael Greenstein

Celebrating Scholarship & Creativity Day (2011-2017)

In today’s ever-changing healthcare landscape, Catholic U.S. hospitals have undergone a change in their mission and thus their identity. This paper argues that Catholic hospitals need to rediscover the origins of their ministry. This can be accomplished by refocusing their efforts away from mergers with secular entities that deal strictly with life and death issues to mergers that more fully engage the care for the poor and vulnerable. To provide the context for this paper, Part One will present an overview of Jesus’ ministry, which is the foundation for Catholic health care. Part Two will address the history of the …

Enhancing Nurse-Physician Communication And Collaboration, Pamela D. Missi

Graduate Theses, Dissertations, and Capstones

In healthcare organizations today, creating a culture of safety is critically important. Communication failures among healthcare providers have been linked to 70% of annual sentinel events. Seventy-six percent of individuals experiencing a sentinel event die (Joint Commission, 2009). Lack of good communication behavior between nurses and physicians has been recognized as a cause of preventable harm to patients (Institute of Medicine, 2004; Zwarenstein & Reeves, 2006). In hospital settings, communication failures are linked to increases in length of stay, patient harm, resource utilization, more rapid turnover, and caregiver dissatisfaction (Dingley et al., 2008). Numerous national organizations and commissions have officially …

Ua61/1 Nursing Spirit, Volume 1, Neal Chambler, Dean, Mary Bennett, Director, Susan Megahee, Editor, Creative, Wku School Of Nursing

School of Nursing Publications

No abstract provided.

The Effect Of A Multifaceted Reminder Intervention On Nursing Documentation Completeness, Meredith A. White

Evidence-Based Practice Project Reports

Nationwide, nurses must withstand growing patient assignments and increased workloads. The consistency between nursing documentation and technical nursing interventions performed indicates that registered nurses provide much more care than they record. This incongruence has the potential to impact patient safety, but also has significant financial implications, since reimbursement is linked to documented services. The purpose of this EBP project was to implement a multifaceted reminder intervention (including a 10-minute PowerPoint and visual reminder) in an IMCU setting to assist the nursing staff (n = 38) in completing the HAPU documentation components. John Kotter’s Eight-Stage Process and the Iowa Model of …

A Causal-Comparative Inquiry Into The Significance Of Implementing A Flipped Classroom Strategy In Nursing Education, Rhonda Faretta

Doctoral Dissertations and Projects

The purpose of this causal-comparative design study was to examine the application of the theory of Vygotsky’s social constructivism (1978) and McMillan and Chavis’s (1986) definition of sense of classroom community in the context of a flipped classroom. The researcher aimed to determine if a pathophysiology course taught with the flipped classroom method would result in a statistically-significant difference in nursing students’ academic performance and sense of classroom community when compared to a pathophysiology course taught with the lecture classroom method. Two questions were addressed during this study: (a) Is there a statistically-significant difference in nursing students’ academic performance (as …

Flight Nurses’ Narratives Of Traumatic Patient Care Events: Why Do They Stay?, Joanne Booth Newton

Graduate Dissertations and Theses

As frontline providers of care, flight nurses are continuously exposed to traumatic patient care events; they are, accordingly, highly vulnerable to the injurious effects of compassion fatigue. Flight nursing is an exclusive nursing specialty in which highly trained registered nurses provide comprehensive pre-hospital, emergency, and critical care to patients with urgent or life-threatening conditions aboard helicopter or fixed wing aircraft or, when necessary due to unfavorable weather conditions, by ground ambulance. The purpose of this study was to explore the lived experiences of five flight nurses; to better understand the factors they perceived to be contributors or barriers to compassion …

Sustainable Cost Models For Mhealth At Scale: Modeling Program Data From M4rh Tanzania, Emily R. Mangone, Smisha Agarwal, Kelly L'Engle, Christine Lasway, Trinity Zan, Hajo Van Beijma, Jennifer Orkis, Robert Karam

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania.

METHODS: We delineated 2014 m4RH program costs and considered three …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …