Other Nursing Commons^™

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Relationship Of Undergraduate Nursing Students' Emotional Intelligence And Other Factors To Ati-Nclex-Rn Comprehensive Predictor Examination Performance, Sarah Y. Jimenez

Nursing Theses and Dissertations

Background/Problem: Nursing schools prepare nursing students to provide competent and safe nursing care and to pass NCLEX-RN for professional licensure. The ATI-NCLEX-RN Comprehensive Predictor Examination from Assessment Technologies Institute (ATI) has been used to predict the likelihood of passing NCLEX-RN on the first attempt. Emotional intelligence (EI), critical thinking (CT), and resilience contribute to academic performance and may influence test performance.

Purpose: The purpose of this study was to determine significant predictors of ATI-NCLEX-RN Comprehensive Predictor Examination test performance among the variables of EI, CT, and resilience among undergraduate senior nursing students.

Hypothesis: There will be an association between …

Dnp Final Report: Cultivating A Culture Of Civility In A Baccalaureate Nursing Program: A Doctor Of Nursing Practice Evidencebased Practice Project, Monica Sowell

DNP Final Reports

Incivility is a well-known issue in nursing, negatively impacting every aspect of the profession. In response to high incivility levels within a baccalaureate nursing program in central Texas, an incivility education module was created for use in adult medical-surgical courses. The module incorporated online preparatory learning followed by active classroom learning, roleplay practice, and faculty modeling to teach students to define, identify, and respond to incivility using evidence-based cognitive-behavioral strategies. Data was collected pre-education implementation and at three post-education time points to evaluate student self-efficacy changes in recognizing and responding to incivility. The COVID-19 pandemic necessitated changing the education delivery …

Increasing Adherence Of Pump Integration With Electronic Medical Record Through Simulation, Judi Reeves

Dissertations

Problem: Intravenous (IV) medication errors account for one-third of the medication errors made by nurses in the United States. A measure to combat medication errors is the development of IV pump integration where the IV pump is electronically connected to the electronic medical record (EMR). With IV pump integration, the nurse is responsible for turning on the pump, scanning the medication and the IV pump, and confirming in the EMR. Human error is removed when the IV pump integration system automatically programs and starts the IV pump. This is a technical system which requires the nurse to have expertise in …

Dnp Final Report: The Impact Of Mindfulness Training On Stress, Burnout, And Mindfulness, Denise Mcnulty

DNP Final Reports

Stress and burnout are endemic in the health care profession, and the transition to practice is associated with even more stress and anxiety for new graduate nurses (Boehm & Tse, 2013). Researchers have demonstrated that mindfulness-based interventions mitigate stress and burnout and improve the workplace environment and patient outcomes (Perla et al., 2017; van den Riet et al., 2018). This scholarly evidence-based practice project assessed the impact of integrating mindfulness training into an existing nurse residency program. The team measured burnout, stress, and mindfulness via an online survey at the beginning of the February 2020 residency cohort with repeat measures …

Emergency Department Staffing And Overcrowding, Royce Hudgins

MSN Capstone Projects

Overcrowding in the emergency room (ER) is a decades old problem that can be caused by factors both internal and external to the (ER). The ripple effects from this problem can be seen throughout the hospital.

This change project seeks to identify and find solutions to patient flow problems that occur in the emergency room (ER) in order to: decrease patient wait times, reduce ER overcrowding, reduce costs, and to increase patient satisfaction and overall outcomes.

Suicide Mortality Of Emergency Department Patients, Briony Marie Dubose Mhi, Rn, Lss, Bb

Dissertations

Purpose The purpose of this retrospective comparative study is to describe relationships among biological, psychological, sociocultural factors and emergency department (ED) care among discharged ED patients and describe the association of these variables with subsequent suicide mortality.

Rationale Identifying patients who are most at risk of suicide mortality post ED discharge can focus resources, refine interventions, and prevent suicide. Additionally, recognizing patterns of ED care including ordering of a psychiatric evaluation and disposition status can provide data for potential practice changes.

Background Suicide is the 10th leading cause of death in the United States and has been since 2008. Suicide …

Exploring The Lived Experience Of Adolescent Caregivers, Abbigale Laurentius

Honors Theses

In today’s society, the population is aging, and any member of the family could find themselves in the role as an informal caregiver. Adolescents between the ages of 12 and 18 years old may have these caregiving responsibilities, and it is imperative that healthcare professionals recognize and support this change of roles. A literature review revealed a general lack of research from within the last five years regarding adolescent caregivers. Those studies that were analyzed in the review presented themes of depression, anxiety, lack of education, and insufficient social supports for the adolescent. An unfolding case study was then designed …

Indwelling Urinary Catheter Removal Houdini Protocol, Fatima Villacruz

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) in spinal cord injury (SCI) patients have many negative health consequences, including increased cost, increased length of hospital stays, delay in bladder training, increased associated infections, and mortality.

PICOT: The PICOT question that guided this project was: In adult SCI patients (P), does the implementation of a nurse-driven indwelling urinary catheter removal protocol (I), compared to without a nurse-driven protocol (C), decrease the indwelling urinary catheter days and the occurrence of CAUTIs (O) within six weeks (T)? Evidence: Nurse-driven discontinuation protocols are an effective method of decreasing indwelling urinary catheter (IUC) days and …

Evidence-Based End-Of-Life Comfort Care Guidelines, Myla Maranan

Student Scholarly Projects

Practice Problem: In the absence of end-of-life (EOL) comfort care guidelines, the nurses in a medical-surgical unit are apprehensive about caring for patients in their active stage of dying, which leads to abandoning the values of holistic and patient-centered care.

PICOT: The PICOT question that guided this project was: "How do acute care bedside nurses (P) who utilize the evidence-based comfort care guidelines (I) compare to not using the evidence-based guidelines (C) perceive their confidence in their capability to provide holistic and patient-centered care (O) during the active onset of the patient's end-of-life stage (T)?"

Evidence: The literature indicated …

Improving The Nurse Patient Assignment Process On A Medical Surgical Unit, Kevin K. Mcewan

Doctor of Nursing Practice Projects

Background: Nurse patient assignments on an adult medical surgical unit at a community hospital are often accomplished with inconsistent processes and rationales. Each charge nurse utilizes individualized processes to determine which patients will be best teamed-up and assigned to the available nurses. There are frequently no acuity measurements system or set criteria by which the number or types of patients can or should be assigned to any given nurse, nor are staff skill or competency considered in the assignment process.

Project Design: A pilot project was conducted on a medical/surgical unit. The project utilized the American Association of Critical Care …

Neuropathic Pain Management Of Adult Males A Quality Improvement Project In A Correctional Facility, George Egesi

Cohort IX

Disease or a lesion of the somatosensory system can cause neuropathic pain, a common condition seen in most primary care settings, including my adult correctional setting. I became aware of this fact after completing a 10-day Reflective Practice Log (RPL). After a literature review, the recommended intervention, Duloxetine 30 mg daily for seven days with follow-up in seven days. In my practice, I prescribed Cymbalta 30 mg daily for 30 days. I used self-reporting as the neuropathic signs and symptoms along with pain severity. The literature recommended the use of a numeric rating scale of 0-10 for pain assessment and …

Nurse Educators Influence On Student Success, Callie Whittington

Doctor of Nursing Practice Scholarly Projects

Passing nursing licensure exams is important to promising nurses. The number of times a graduating nursing student must take The National Council Licensure Examination-Registered Nurse (NCLEX-RN), reflects upon the institution of higher education as a gauge of the quality of their training programs and preparation. Student outcomes are very important to overall standing of the nursing programs, as the first attempt NCLEX-RN pass rates affect status of the nursing program. The nurse educator’s role in student success is vital and the level of education for the nurse educator can play a valuable part in this as well.

The researcher of …

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Increasing Comfort Of Mychart Patient Messaging In An Outpatient Oncology Clinic, Katherine Herdzik

Master of Science in Nursing Scholarly Project

Increasing Comfort of MyChart Patient Messaging in an Outpatient Oncology Clinic

Katherine Herdzik, BSN, RN

Abstract

Electronic patient portals have provided increased access to the electronic health record and patient information. A feature within the portal is a messaging system, creating a secure method of communication between and patient/family member and their care team. Scholarly literature has suggested that this method of communication helps to increase trust between the patient and providers, enhancing the healthcare experience. This study focuses on educational review to increase comfort with the MyChart messaging portal for care managers and nurse practitioners in an outpatient pediatric …

Nursing Fatigue In Intensive Care Units: A Clinical Inquiry, Elizabeth A. Gambill

The Eleanor Mann School of Nursing DNP Capstone Projects

Registered Nurses (RN) working in Intensive Care Units (ICU) report increased physical and emotional fatigue from a combination of various environmental factors. Fatigue is suspected as contributing to low retention rates of ICU RNs. A meeting was arranged with an ICU nursing director in an acute care facility in Northern Arkansas revealing the need for a clinical inquiry into the prevalence of fatigue. A review of literature further analyzed the impact of fatigue, management practices, safety culture in the workplace, the Occupational Fatigue/Exhaustion and Recovery (OFER) scale, the Copenhagen Burnout Inventory (CBI), and the Moral Distress Scale- Revised (MDS-R). The …

Promoting Civility In The Workplace: Addressing Bullying In New Graduate Nurses Using Simulation And Cognitive Rehearsal, Sandy Phan

Doctoral Projects

Bullying continues to be a widespread, devastating problem in nursing. Research indicates that bullying has a negative, rippling impact on nurses, organizations, and patient care. This evidence-based practice project aimed to enhance new graduate nurses’ abilities to identify and respond to bullying behaviors. The intervention used a mixed educational methodology of didactic, simulation role-play, and cognitive rehearsal. The project was implemented at a large academic healthcare system in Northern California. Outcomes were evaluated using Kirkpatrick levels 1-4 and the Clark Workplace Civility Index (CWCI). Participants reported that the educational intervention met intended learning objectives, enabled them to apply learned behaviors …

The Effects Of Virtual Reality On Symptom Distress In Patients Undergoing Hematopoietic Stem Cell Transplant, Colleen Vega, Robin Whitney, Josef Hannah, Grant Smith

Doctoral Projects

The purpose of this QI project was to evaluate the effects of virtual reality (VR) on symptom distress experienced by individuals receiving an allogenic stem cell transplant. Allogenic transplants are associated with a moderate to high risk for distressing symptoms such as depression, anxiety, and pain. VR targets multiple sensory modalities, including auditory, visual or haptic experiences, by using computer-generated scenarios, which can interact with an individual and possibly diminish unpleasant symptoms. Twenty individuals aged 19 to 70 years (median age of 56.5 years) who were hospitalized in an academic setting received VR up to two sessions a week for …

To Implement Or Not To Implement: Safe Opioid Injection Sites As A Solution To The Opioid Crisis, Kayla Keister

Senior Honors Theses

The opioid epidemic has been a crisis in the United States for the last 30-40 years but is just now being popularized by the American public. One potential up-and-coming solution to the opioid crisis is the implementation of safe opioid injection sites, which are locations where individuals may bring drugs to inject under the supervised care of medical professionals. They are currently being used in Canada as well as several Western European countries. The question remains, however, as to whether or not the United States is ready for the implementation sites in regard to public opinion, finances, and ethics.

Development And Implementation Of Computer-Based Learning Modules On Alternative Communication For Pediatric Nurses And Nursing Students, Amanda Kaye Simmons

Theses and Dissertations (ETD)

Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The …