Other Nursing Commons^™

Reducing Falls In Adults On A Neurology Unit: An Evidence Based Quality Improvement Project, Kari Congenie, Sandra Scheidenhelm, Rachel Zastrow

DNP Scholarly Projects

BACKGROUND: Falls are a common concern in hospitalized adult patients affecting quality of life, length of stay, and cost.

LOCAL PROBLEM: A quality audit at a community hospital identified increased falls/falls with injury rates on a medical-surgical unit.

METHODS: A quality improvement initiative was implemented using a fall prevention toolkit to understand its effect on total fall/fall with injury rates, nursing knowledge, and nurse perceived efficacy.

INTERVENTIONS: The Fall Tailoring Interventions for Patient Safety (TIPS), an evidence-based toolkit, was implemented over five months.

RESULTS: Knowledge quiz scores were similar pre- and post-education. Fall rates and calls to 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 …

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 …

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 …

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 …

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.

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 …

Effectiveness Of Diversion Tube On Peripheral Blood Culture Contamination Rates From Intravenous Catheters In A Community Hospital Emergency Department, Anne Meginniss

DNP Scholarly Projects

BACKGROUND: Obtaining blood cultures is routine care for patients who are suspected to have sepsis. Contaminated blood cultures can lead to increased healthcare costs for patients suspected of sepsis. Reducing contaminated specimens could improve the quality of care delivered as well as increase patient satisfaction.

AIM: This quality improvement project aimed to reduce the number of contaminated blood cultures in a community hospital emergency department by using an initial specimen diversion tube to meet the new national benchmark of below 1% contamination rate.

METHODS: Twenty-seven diversion specimens were collected over an eight-week period via initial intravenous catheter insertion in a …

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 …

Data Quality: Integral To Cauti Surveillance And Improvement In Non-Critical Care Units, Mary Grace Daria

Master's Projects and Capstones

Background: Urinary tract infections (UTIs) are the most common type of healthcare-acquired infection (HAI), with 75% approximately associated with urinary catheter use. The key to preventing UTIs is to avoid the use of indwelling urinary catheters (IUCs). This study explores denominator data extract logic modifications to increase IUC data capture and accuracy. It is set in a 249-bed acute care, teaching hospital in the Diablo Service Area in Northern California.

Problem: The electronic system used to extract the CAUTI denominator data is inconsistently capturing the IUC device days from the electronic medical record (EMR). This has regulatory reporting ramifications and …

Give Love With Lovenox: Reducing Pulmonary Embolism Risk In The Postpartum Unit Through Lovenox Prophylaxis Nursing Education, Guadalupe Sierra Arroyo

Master's Projects and Capstones

Problem: This quality improvement project aims to improve nurse education on Lovenox prophylaxis to reduce pulmonary embolism occurrence post-discharge amongst high-risk postpartum women who underwent vaginal/cesarean deliveries and to increase patient medication compliance in the Family Baby Unit (FBU) at Hospital X.

Context: The quality improvement project occurred on the Family Baby Unit (FBU) at Hospital X. This 25-bed unit has recently had an increased rate of pulmonary embolisms post-discharge due to poor Lovenox medication adherence amongst patients and lack of education among nurses.

Intervention: Data was collected in the microsystem. This data was collected through questionnaires to assess nurses' …

Lovenox Prophylaxis: Improving Lovenox Nurse Education In A Postpartum Unit, Amy T. Nguyen

Master's Projects and Capstones

Problem: This quality improvement project aimed to increase nurse education about Lovenox

prophylaxis within the postpartum unit to reduce risks of pulmonary embolism among high-risk postpartum women in the postpartum unit. Context: A microsystem assessment was completed by Clinical Nurse Leader (CNL) students in the postpartum unit at Hospital X located in the southern Bay Area. This unit accommodates 25 beds and provides care for postpartum mothers after both cesarean section and vaginal births. Intervention: An anonymous pre-intervention survey was distributed to the registered nurses on the unit. Educational handouts were created and distributed to the nurses on the unit. …

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Improving Triage Accuracy In The Emergency Department, Maia E. Baglin

Master's Projects and Capstones

A Northern California emergency department (ED) faced increased triage inaccuracy. An analysis of 400 random ED visits from January to April 2023 discovered a 23% mistriage rate, with under- and over-triage rates at 16.25% and 6.75%, respectively. Mistriage creates an imbalance in unit acuity, leading to inappropriate staffing levels. Potential breaks in the triage process, include inaccurate triaging by the screener or triage nurses, as well as delays in the providers inputting initial orders, leaving patients waiting without appropriate care orders. An educational training focusing on the updated Emergency Nurses Association Emergency Severity Index (ESI) algorithm version 5 was mandated. …

Improving Triage Accuracy In The Emergency Department, Vince Harrington

Master's Projects and Capstones

Problem: Mistriage was occurring at higher than acceptable rates. In turn, this caused poor staffing levels and patient outcomes. This project seeks to improve triage accuracy according to the Emergency Nurses Association’s (ENA) Emergency Severity Index (ESI) algorithm.

Context: The Emergency Department in a prominent bay area hospital that was experiencing high rates of mistriage.

Interventions: The staff nurses were required to attend a retraining on the Emergency Nurses Association (ENA) Emergency Severity Index (ESI) algorithm. Following the retraining, a follow up online exam with sample patients must be passed at 100%. Furthermore, badge buddies containing the ESI algorithm will …

Resocialization Of An Inpatient Handoff Sepsis Bundle Checklist On A Medical-Surgical Unit, Sophia Kawada

Master's Projects and Capstones

Problem: In September 2023, it was found that only 25% of nurses were familiar with an inpatient handoff sepsis bundle checklist (IHSBC) on a Medical-Surgical Unit in Hospital A. This evidence-based project aimed to improve resocialization of the IHSBC such that compliance to the bundle continues to be maintained well above the benchmark of 75%. Context: Clinical Nurse Leader (CNL) students at the University of San Francisco conducted a microsystem assessment of the Medical-Surgical Unit at Hospital A. This hospital aimed to maintain high rates of compliance with the IHSBC. Interventions: Resocialization of the IHSBC was completed in October, and …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …