Other Nursing Commons^™

Interdisciplinary Team Approach In Fall Prevention: Physician Perspective Focus, Anna Gryn

Master's Projects and Capstones

An in-hospital fall is a devastating event for patients and care providers resulting in injuries, physiological and psychological patient declines, and sometimes deaths. Furthermore, fall related costs greatly increase hospitals’ expenses and cause massive distress to caregivers and health providers. Many patient-specific, organizational, and seemingly erratic factors contribute to the occurrence of in-hospital falls. Despite this, hospitals must undertake consistent evidence-based measures to prevent fall occurrences as much as possible.

The traditional nursing approach to falls prevention is not sufficient to control fall rates because the issue is too complex and must be approached from multiple perspectives rather than just …

Fall Prevention Protocol In Acute Care Setting, Allie Di Angelo

Master's Projects and Capstones

Purpose:

Purpose: The purpose of this quality improvement project is to implement a falls intervention to improve falls on the Medical Telemetry unit in the large metropolitan hospital.

Background: Between 700,000 and 1,000,000 falls occur in hospitals every year. Furthermore, approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls harm patients, families, and providers. They are also a high cost, as many insurance companies will not reimburse care when a patient falls. As a hospital organization it is important to ensure funds are going to the appropriate places. …

Improving Early Sepsis Identification On Inpatient Units, Yee Yang

Master's Projects and Capstones

Sepsis is a serious complication caused by an overwhelming immune response to infection that affect millions of people worldwide each year. Sepsis is a time sensitive illness that requires early identification and quick interventions to improve patient outcomes. This quality improvement project includes a team of clinical nurse leader (CNL) students and gathering information on the nursing compliance of the sepsis protocol at a large metropolitan hospital. The observations on different inpatient units and chart review conducted at the large metropolitan hospital led to increased awareness of gaps that prolong the identification of sepsis among patients; also to the creation …

Clinical Practice Update On A Temperature Guideline To Decrease Intraoperative Hypothermia In Patients Undergoing General Anesthesia, Ashley Rigdon

Doctoral Projects

Intraoperative hypothermia is a common problem within the operating room. Anesthesia inhibits the body’s normal thermoregulatory response to hypothermia, redistributing heat from the core to the periphery (Brandt et al., 2009). In the event of hypothermia, the incidence of infection triples as there is an increased risk for blood loss, increased risk for cardiac complications, and the thermal discomfort of patients (Brandt et al., 2009). Following a recent clinical practice guideline can help prevent hypothermia.

A descriptive project was organized utilizing current literature. The sample for this study is 45 CRNAs practicing at a multiple system healthcare facility in the …

Individualized Glycemic Targets For The Elderly Residing In Long Term Care Facilities, Abegail Hubberd

Doctor of Nursing Practice

Of people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Implementing Nerve Blocks For Patients Undergoing A Bilateral Mastectomy With Immediate Reconstruction: A Practice Change, Corey Beene Auerswald

Doctoral Projects

Breast cancer is one of the most commonly diagnosed cancers in women. A mastectomy is one of the first line treatments for breast cancer, but it is associated with considerable postoperative pain. Literature suggests current methods of pain management are ineffective and regional anesthesia can help reduce postoperative complications following a bilateral mastectomy with immediate reconstruction. Information from the literature review was used to inform five anesthesia providers at a rural hospital in Mississippi about the benefits of regional anesthesia for patients having a mastectomy. A presentation was given to anesthesia providers regarding the benefits of paravertebral blocks (PVB) for …

Nurse Perspectives On The Work Impacts Of Decentralized Nursing Unit Design, Susan Mcdevitt

Electronic Theses and Dissertations

This study investigated nurse perspectives on the work impacts of a decentralized inpatient unit model. The study involved two rural acute-care hospitals in rural Nebraska that moved from a centralized to a decentralized inpatient unit design. The researcher conducted focus group discussions with staff and nursing management at both facilities with a total of 28 participants. In addition, the participants completed a 12-item questionnaire using a five-point Likert scale for responding. Focus group discussion and questionnaire were designed to investigate the areas of quality of care, communication, documentation, stress and wellbeing, and transition. Data gathered revealed that on all survey …

A Clinical Nurse Leader Initiative: Promoting Mobility Among Long-Term Care Facility Residents, Ulyses Reamico

Master's Projects and Capstones

Maintenance of mobility during hospitalization or stay in long-term care facility result in improved patient outcomes including but not limited to decreased incidence of falls, non-pharmacological pain intervention, and prevention of further functional decline. In a 45-bed rehabilitation unit of a Veterans Affairs (VA) health care facility, a clinical nurse leader (CNL) initiative was done to promote mobility among the patients to mitigate functional decline. The patients, also referred to as clients or residents in long-term care facilities, were aged between 20s and 90s. The resident population consisted of patients admitted for physical rehabilitation after a stroke or surgical procedure, …

Impact Of A Mastectomy On Female Body Image And Sexuality, Hilary Tingley

Grace Peterson Nursing Research Colloquium

Impact of a Mastectomy on Female Sexual Expression: An Integrative Literature Review

Hilary Tingley

Nursing Student, DePaul University, School of Nursing

Background: Women diagnosed with breast cancer are often treated with a combination of therapies, one of which may be a mastectomy. There are an increasing number of women who are undergoing preventative mastectomies, many as a result of BRCA gene testing.

Objective: The purpose of this literature review was to examine the impact of a mastectomy on female sexual expression and body image.

Method: An integrative literature review design was used with research articles pulled from search engines such …

Organizational Learning In A College Of Nursing: A Learning History, Bret Lyman, Lisa A. Cowan, Hannah C. Hoyt

Faculty Publications

Background: College of nursing leaders can foster organizational learning as a means of achieving their desired organizational outcomes. Organizational learning has not previously been studied in colleges of nursing, leaving college administrators and faculty little guidance as they strive to improve outcomes in their own colleges.

Objectives: The purpose of this study was to discover new insights related to organizational learning in a college of nursing.

Design: The learning history method was used to document and describe organizational learning in a college of nursing.

Setting: This study was conducted with a college of nursing situated in a private, religious-based university …

Turning A Blind Eye: How Lack Of Communication With Er Nurses Nearly Cost A Patient Permanent Vision Loss, Kenneth Royal, April Kedrowicz

Patient Experience Journal

This narrative presents a case in which a patient was treated for conjunctivitis, but a breakdown in several layers of communication (between the hospital and the patient, and between hospital personnel) resulted in multiple medical errors that nearly costs the patient permanent vision loss. This real-life case underscores how simple communication errors may lead to life-altering consequences. Recommendations for improving communication to ensure similar errors do not happen to others are provided.

Antibiotic Stewardship: The Role Of Clinical Nurses And Nurse Educators, Sharon Sumner, Sandra Forsyth, Katreena Collette Merrill, Caroline Taylor, Todd Vento, John Veillette, Brandon Webb

Faculty Publications

Within 10 years of the breakthrough development of Penicillin, antibiotic resistance was reported. According to the Centers for Disease Control (CDC) and Prevention (CDC, 2017), each year 2 million cases of antibiotic resistant bacteria occur resulting in approximately 23,000 deaths in the United States. The World Health Organization (WHO) also reports that approximately 25,000 people die from antibiotic resistant organisms annually in the European Union (WHO, 2014). To combat these alarming trends, antibiotic stewardship (AS) programs have been strongly recommended by the WHO, the National Institute for Health and Care Excellence (NICE) Centers for Disease Control and Prevention (CDC), the …

Teach-Back Methodology To Improve Patient Satisfaction In An Urgent Care Setting, Candi Payne

Doctoral Dissertations and Scholarly Projects

The project used teach-back methodology to provide an evidence-based approach to improve patient satisfaction scores in an urgent care clinic. The teaching plan should include evaluation of patient teaching to determine effectiveness and patient understanding per The Joint Commission (TJC) for Ambulatory Care Center standards. The project was developed to assist nurses (N=12) with an evidence-based method to improve patient understanding and provide an opportunity to ensure comprehension to increase patient satisfaction scores from a one or two to a level three at the end of 30 days following implementation of teach-back. The scores revealed an increase of patient satisfaction …

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

The Effects Of In-Service Education On Workplace Incivility For Crnas, Tran King

Doctoral Projects

Workplace incivility (WPI) affects many healthcare providers, including Certified Registered Nurse Anesthetists. This project was an exploration of the prevalence, nature, and sources of WPI affecting CRNAs. The project’s intervention was an in-service education on WPI for CRNAs. The purposes of the project were to measure the effectiveness of the in-service education in increasing awareness of CRNAs about WPI; and to offer a practice change proposal in terms of a policy against WPI in the anesthesia department.

A Needs Assessment Survey and Demographic Data Information form were distributed from Survey Monkey to participants’ email by way of blind copy. Data …

Loma Linda Nurse - Vol. 25, No. 01, Loma Linda University School Of Nursing

Loma Linda Nurse

Contents

FEATURES

4 | Full Circle – Dexter Emoto and Mao Kimura

6 | Mentorship

8 | A Place for Excellence

10 | New Scholarships at the School of Nursing

LLUSN HIGHLIGHTS

12-17 | ALUMNI NEWS

18-23 | HOMECOMING

24-27 | COMMENCEMENT

28-32 | ACADEMICS

33-35 | FACULTY UPDATES

Implementing The Use Of Intracuff Alkalinized Lidocaine Among Certified Registered Nurse Anesthetists: A Practice Change Proposal, Shawn Taylor

Doctoral Projects

Patients today are experiencing comorbidities predisposing them to increased risk under general anesthesia. Emergence cough reflex is a response that can lead to hemodynamic alterations occurring during emergence and the postoperative period for many patients requiring general endotracheal tube anesthesia (GETA). It is proposed that 38% to 96% of patients receiving GETA will experience coughing during emergence (As, Iqbal, & Ali, 2009; Watkins, Lee, White Jr, & Mundy, 2012).

The use of intracuff alkalinized lidocaine is an intervention shown to be effective in previous studies at blunting this response during anesthesia emergence. Through verbal communication with CRNAs, it was discovered …

Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann

Doctoral Dissertations and Scholarly Projects

Nurses are at the forefront in the care of patient pain management; however, many nurses do not possess the knowledge, skills, and attitudes required for best pain management outcomes. Adequate pain management education is often infrequent in academic settings and in post-graduate health care environments. That shortcoming suggests a need to improve pain management education as advocated by The Joint Commission and U.S. Department of Health and Human Services. The purpose of this study is to measure 20 nurses’ knowledge and attitudes regarding pain and pain management while working in an orthopedic setting. It was an evidence-based practice project utilizing …

A Whooping Cough Education Module For Wic Clients In Utah, Karlen E. Luthy, Alicia Anderson, Janelle L. B. Macintosh, Renea L. Beckstrand, Lacey M. Eden, Ryan Amy, Christopher I. Macintosh

Faculty Publications

Background: Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. Problem: A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included …