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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 …

The Lived Experience Of Feeling Disrespected, Nadine Donahue

Dissertations, Theses, and Capstone Projects

The purpose of this study is to explore the lived experience of feeling disrespected. The participants were registered professional nurses, with at least two years of clinical experience. A phenomenological approach utilizing Giorgi’s method was used to analyze the data and interpret the findings for this study. New knowledge about feeling disrespected contributes to nursing science and may help nurses and organizations that employ them, provide a healthy work environment that supports and retain them. The experience of feeling disrespected was illuminated by the following themes; “Powerless, feeling like a “nobody,” treated like you are “stupid,” utter discouragement and broken …

Exploration And Description Of Faith Community Nurses’ Documentation Practices And Perceived Documentation Barriers., Susan M. Dyess, Donna M. Callaghan, Andra S. Opalinski Dr.

International Journal of Faith Community Nursing

Purpose: Documentation within Faith Community Nursing is an expected aspect of the professional specialty but is under-studied. Findings in previously published studies suggest there is a lack of consistent documentation practices among FCNs. Therefore, the aim of this research study was to explore and describe documentation practices of FCNs, and identify the perceived barriers to documentation.

Methodology: This mixed methods research had both qualitative and quantitative components. The qualitative inquiry involved three live focus groups and three telephonic key informant interviews (n = 28). Conventional content analysis was used to examine all qualitative data. The quantitative inquiry involved a survey …

Reflection On Retention: An Evaluation Study On Minority Students’ Success In An Online Nursing Program, Amanda Hawkins, Elizabeth Frander, Melissa Young, Kaylen Deal

Perspectives In Learning

The United States nursing workforce faces a health care challenge for providing culturally competent care to the growing number of racial and ethnic minority groups. According to Gertner et al (2010), cultural competency in health care is defined as providing care to patients with diverse backgrounds to meet the social, cultural and linguistic needs. Research has shown that patients receive a higher level of culturally competent care from nurses who are from their own cultural background. Administrators and faculty working in Schools of Nursing must recognize this important fact and take action to ensure the admissions, progression, and graduation of …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Rates Of Autoimmune Disease Increasing In Women, Rosa De La Cotera

Grace Peterson Nursing Research Colloquium

Abstract

Autoimmune disorders (AD) are a group of highly disabling pathological conditions that are growing at an alarming rate affecting approximately 8% of the population. These disorders occur more frequently in women, as 78% of those diagnosed are women. Little conclusive research has been conducted as to determine why there is a tremendous sex disparity when looking at the rates. Due to the overall poor health that results from these disorders, there is an increase in the societal burden in terms of health care costs, loss of work productivity and reduced quality of life. The aim of this integrative literature …

Identifying The Factors For Acute Cardiac Arrest For Establishing A New Recognition Protocol In Detecting Pre-Arrest Symptoms, Sarah Power

Grace Peterson Nursing Research Colloquium

Abstract

Background: Worsening physiological symptoms can easily go overlooked or unmanaged. The early detection of clinical signs that precede cardiac arrest can reduce the risk of worsening condition or death. Determining a nursing protocol to recognize pre-arrests symptoms would allow a systematic way to evaluate patients and their health status before adverse events occur.

Objectives: The purpose of an integrative literature review was to identify signs and symptoms that precede cardiac arrest, and to specify a recognition protocol that ameliorates patient care outcomes.

Method: An integrative literature review was conducted undergoing an extensive search to identify acute cardiac arrest and …