Other Nursing Commons^™

Health Literacy Among Chronic Kidney Disease Patients: Disparities In Information Seeking, Educational Needs, And The Role Of Healthcare Professionals, Fitri Mailani, Rahmi Muthia, Emil Huriani, Rika Sarfika

The Qualitative Report

Chronic kidney disease (CKD) is a complex disease that poses various challenges to patients. Health Literacy (HL) is considered essential for the effective management of CKD. This phenomenological study explored health literacy in 12 patients with chronic kidney disease undergoing hemodialysis in Padang, Indonesia. Semi-structured individual interviews were conducted, and the data were analysed and interpreted using the hermeneutical phenomenological approach of Diekelmann. We found six themes: sources of information and knowledge, differences in patient attitudes and behaviors as health information seekers, learning needs for successful treatment and care, effective learning and education methods, experiences with alternative treatments, and positive …

Evaluation Of An Advanced Practice Clinician Onboarding Program, Sophia Robinson

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of a mentorship-based onboarding program versus a standard program without mentorship.

PICOT: The PICOT question that guided this project was (P), In newly hired APCs did the inclusion of mentorship in the onboarding process (I) lead to higher levels of general self-efficacy compared to standard orientation practices lacking mentorship (C), within an 8-week timeframe (T)?

Evidence: Nine articles were reviewed, revealing that standardized mentorship, structured orientation, and tailored support for professional development are critical strategies to boost confidence and retention among healthcare professionals.

Intervention: A standardized onboarding program that incorporated …

Decreasing Inappropriate Wound Consults, Arpita Hinton

Master's Projects and Capstones

Abstract

Background: This project was centered around the wound nurses and their workload. It also highlighted the opportunity for education for frontline staff. The wound nurses at this northern California hospital are a group of five nurses that support the whole hospital. Usually there are two staffed per day to support a facility that continues to have three to four overflow areas open to accommodate its high census.

Problem: My project focused on decreasing inappropriate wound consults. There are many consults places that do not need the intervention of a skilled wound nurse. These consults lead to time that is …

Increasing Resiliency In Front-Line Nurse Managers, Adrianne N. Bunyard-Fallquist

Master's Projects and Capstones

Problem

According to Membrive-Jimenez et al. (2020), 29% of nursing managers experience emotional exhaustion due to work overload, conflict mediation, and a lack of support from senior leadership. In a central California hospital, front-line nurse managers struggle to meet organizational goals and support their teams, with 64% indicating dissatisfaction in their roles in fall 2023. This highlights the need to improve job satisfaction and retention.

Context

A large healthcare system in Northern California has implemented Caring Science (Foss et al., 2015) and HeartMath® (HeartMath, 2023) techniques in a rural hospital to improve nurse manager retention and job satisfaction. The project …

Decreasing Incivility Through Improved Communication And Teamwork, Marvin Ernest Tamayo

Master's Projects and Capstones

Problem: Workplace incivility (WI), lateral violence (LV), and bullying in healthcare settings are pervasive issues negatively impacting staff morale, turnover rates, and patient care outcomes. High turnover and low employee satisfaction scores from a September 2023 culture of safety survey signaled a toxic work environment characterized by ineffective communication and unprofessional behavior. Context: A 24-bed telemetry-stroke unit at a 172-bed acute care facility in the North Bay area of San Francisco.

Interventions: The Transtheoretical Model (TTM) of behavior change and the Crucial Conversation frameworks were used to improve staff communication and reduce incivility.

Measures: September 2023 and March …

Preventing Hospitalization-Associated Disability, Elizabeth M. White

Master's Projects and Capstones

Problem: Hospital-associated disability (HAD) affects one-third of hospitalized adults, diminishing post-discharge independence and contributing to high mortality rates. Identifying at-risk patients through early assessment of nutritional and functional status upon admission is critical to personalizing care and improving discharge outcomes.

Context: A 24-bed adult medical-surgical unit in a 173-bed suburban hospital in Northern California is part of a large not-for-profit healthcare organization. Interventions: Nursing staff received education on the Enhanced Recovery Medicine (ERM) pathway designed to prevent HAD. A visual display board, maintained and updated by unit champions, gave staff performance feedback. Nursing leadership reviewed admission assessments and addressed barriers …

Improving Stroke Education Scores At A Primary Stroke Center, Jesse J. Young

Master's Projects and Capstones

Abstract

Problem: The COVID-19 pandemic precipitated a significant departure from the nursing profession, leaving healthcare organizations grappling with critical staffing shortages and compromising patient care standards. In 2023, an advanced Primary Stroke Center in a Northern California hospital’s STK-8 scores fluctuated between 80-100%, with an average annual score of 92.8%, putting the facility's primary stroke certification and long-term patient outcomes at risk.

Context: A 24-bed acute stroke and telemetry unit in a Northern California hospital and designated primary stroke center.

Interventions: The following measures were implemented to improve the quality of stroke care and enhance STK-8 compliance, including …

Reducing Hapi On A Medical Surgical Telemetry Unit, Emily Nicole Johansen

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired pressure injuries (HAPI) are a global issue that harms patients, prolongs lengths of stay, and increases hospital costs and financial burdens. Because HAPIs are preventable, hospital organizations worldwide are implementing prevention strategies to improve the quality of care and quality of life and decrease costs associated with them.

Context: The 24-bed medical-surgical telemetry unit is one of five adult inpatient units within a Northern California hospital. The patient population includes an increased number of patients who are at risk of HAPI. The unit struggles with HAPI prevention, and the staff is challenged with implementing proper HAPI prevention …

Enhancing Patient Throughput From Emergency Department To Inpatient Unit With Electronic Handoff Implementation, George Hanania

Master's Projects and Capstones

Background: This evidence-based improvement project aimed to address communication issues during information exchange among healthcare professionals and the operational impacts of ineffective nurse-to-nurse reports among the emergency department (ED) to the inpatient units at a northern California hospital-based system hospital in San Leandro. The impacts of miscommunication and ineffective ways of giving nurse-to-nurse reports over the phone can result in delays in treatment and diagnosis, leading to ED overcrowding and decreased throughput.

Problem: Communication issues during information exchange, specifically operational impacts of ineffective nurse-to-nurse report/handoff between the ED and inpatient units.

Interventions: This project aimed to implement an electronic handoff …

Investigating Nature-Based Mindfulness In Nurse Anesthesia Students: A Pilot Study, Douglas Lovern

Dissertations

Across the country, the mental health crisis continues to rage. Varying degrees of depression, stress, and anxiety are commonly found in college-age students. The COVID-19 pandemic augmented this crisis, but the pandemic is not the sole culprit for the escalation of mental health disorders in the United States. Students across the globe suffer mental health disorders that include depression, anxiety, and stress. Research has shown that graduate students are six times more likely to develop anxiety and depression than the general population. Student registered nurse anesthetists (SRNAs) are vulnerable to mental health disorders. SRNAs enter labor-intensive doctoral programs fraught with …

Implementation Of Synchronous And Asynchronous Car-T Education For Emergency Room And Intensive Care Unit Nurses In Non-Oncology Units, Kylie Kuck

Doctor of Nursing Practice Scholarly Projects

Background: Chimeric antigen receptor T cell (CAR-T) therapy is a novel and promising cancer treatment for hematologic malignancies. This treatment is highly regulated by the Food and Drug Administration (FDA) and The Foundation for the Accreditation of Cellular Therapy (FACT) because of the known toxicities associated with treatment.

Local problem: In 2022, FACT published guidelines requiring formal education for both oncology and non-oncology nurses who care for these patients, including emergency room and intensive care unit nurses.

Methods: This quality improvement project provided education to emergency room and intensive care unit care nurses who are caring for CAR-T cell therapy …

A Quality Improvement Project On The Evaluation Of A Community Gastroenterology Advanced Practice Providers’ Update On The Utilization Of The American College Of Gastroenterology (Acg) Recommendation For Annual Depression Screening In Patients With Inflammatory Bowel Disease, Yolanda Levy Dnp, Fnp-Bc

All Dissertations

Inflammatory bowel disease (IBD) is an autoimmune disease that can result in chronic inflammation in the gastrointestinal tract (Farbod et al., 2021). The two most common types of IBD are called Crohn’s disease and Ulcerative Colitis. There have been several studies that have shown how the psychological disorders, including depression, can be associated with flares of IBD (Farraye et al., 2017). The American College of Gastroenterology (ACG) published clinical practice guidelines in 2017, which recommended gastroenterology (GI) healthcare providers screen for depression in all patients with IBD at least once annually (Farraye et al., 2017). This quality improvement did show …

Exploring The Relationship Of The Noncognitive Variables Of Grit And Mindset In Baccalaureate Nursing Students And Their Impact On Academic Success, Alecia Hollis

Dissertations

The study aimed to evaluate how the noncognitive variables of grit and mindset could impact the academic success of baccalaureate nursing students. With the present and growing shortage of nurses, attrition within nursing programs is cause for concern. Attrition is a multifaceted problem; however, academic failure is one contributing factor. While cognitive factors, such as the standardized aptitude test (SAT), pre-nursing science GPA, pre-nursing GPA, and standardized entrance exams (Al-Alawi et al., 2020; Chisholm-Burns et al., 2021), have traditionally been used for admission criteria, increasing evidence suggests that noncognitive factors, like grit and mindset, play a crucial role in academic …

Unlocking Icu Barriers: Investigating The Challenges Of Early Progressive Mobility, Leslie S. Bigler

Doctoral Projects

Approximately 800,000 patients in the United States annually are admitted to the Intensive Care Unit (ICU) due to critical illnesses and prolonged immobility contributes to poor patient outcomes. While existing data demonstrates early and progressive mobility helps improve outcomes, adherence remains inconsistent for a variety of reasons such as safety concerns, staffing, and lack of knowledge and confidence of mobilization techniques. This quality improvement project, conducted in a 20-bed Medical Intensive Care Unit, asked staff to identify barriers to adherence to mobility protocols. Nurse managers and clinical educators play a crucial role in addressing these issues using strategies such as …

Moral Disengagement And The Tendency To Engage In Academic Dishonesty In Prelicensure Nursing Students, Sarah Guimaraes

Electronic Theses and Dissertations

Despite decades of research, academic dishonesty remains a significant concern in nursing education. The connection of academic dishonesty to dishonest clinical practice presents a moral imperative for nurse researchers to find new facets of understanding these phenomena. Literature regarding moral disengagement in health care is minimal and is even less prevalent in the context of nursing education. The purpose of this study was to determine the effects of moral disengagement on prelicensure nursing students’ tendencies to engage in academic dishonesty in their last or next to last semester of a nursing program. A correlational design via survey method was used. …

Implementation Of An Evidence-Based Hospital Acquired Pressure Injury Strategy In The Intensive Care Unit, Tonya C.W. Brigman

Student Scholarly Projects

Practice Problem: Hospital-acquired pressure injuries (HAPI) are a significant concern in healthcare with the most vulnerable group being the adult patients in ICUs leading to increased morbidity, longer hospital stays, and higher healthcare costs.

PICOT: In adult ICU patients (P) does the implementation of daily chlorhexidine gluconate (CHG) baths with post bath barrier cream combined with intentional turning every 2-hours (I) compared to standard skin care practices and nonintentional turning (C) reduce the incidence of hospital-acquired pressure injuries (HAPI) (O) within 10-weeks (T)?

Evidence: The project was based on the analysis of the literature published in the …

Empowering Patient Care Technicians To Reduce Non-Ventilated Hospital-Acquired Pneumonia In An Acute Care Hospital In Northern California, Barbra Pacatang

Master's Projects and Capstones

Abstract

Problem: Non-ventilator hospital-acquired pneumonia (nv-HAP) is increasingly becoming a significant concern in healthcare settings. Studies have indicated that nv-HAP accounts for a substantial portion of hospital-acquired pneumonia cases, with a high associated mortality rate. The prevalence of nv-HAP underscores the importance of implementing robust HAP prevention bundles. Prevention, early recognition, and appropriate management of nv-HAP are essential to improve patient outcomes and reduce the burden on healthcare facilities.

Context: A 28-bed capacity Stroke Telemetry Unit incurred six nv-HAP incidents in 2023. Patients needed to be more compliant with the nv-HAP prevention bundles. Patient care technicians (PCTs) are instrumental nurses’ …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Using Home Telehealth To Reduce Hospital Readmission Rates In Heart Failure Patients In The Emergency Room, Margaret Ashby

Student Scholarly Projects

Practice Problem: In one hospital, the readmission rates and emergency room visit for patients who are diagnosed with heart failure (HF) was increasing.

PICOT: Among veterans who are hospitalized for HF (P) does the enrollment into a care coordination program for these veterans (I) compared to current practices (C), reduce the hospital readmission rates and emergency department visits (O) within 10-weeks (T)?

Evidence: The literature supports the idea that home telehealth as a home monitoring program for patients who have chronic diseases such as heart failure (HF) and has had success in patients with hypertension amongst patients. Transition strategies from …

Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi

Student Scholarly Projects

Practice Problem: The project targeted low job satisfaction and high nurse turnover in a Central Florida bone marrow transplant unit, impacting patient care and costs.

PICOT: (P) For registered nurses (RNs) on the bone marrow transplant unit, (I) does implementing an evidence-based practice employee recognition program (C) compared to no employee recognition program, (O) lead to an increase in job satisfaction (T) over 10 weeks?

Evidence: The evidence supported the effectiveness of meaningful recognition programs, such as personalized verbal acknowledgment from leadership, in boosting job satisfaction among nurses.

Intervention: The intervention involved nurse managers using a weekly employee recognition …