Nursing Commons^™

The Effect Of Cultural Literacy, Ethnocentrism And Xenophobia On Intercultural Sensitivity In Intern Nurses In Türkiye, Yasemin Gümüş Şekerci, Beyza Gül Yıldırım

Makara Journal of Health Research

Background: With rising migration and multicultural patient populations, understanding the factors that shape intercultural sensitivity among healthcare workers has become essential. This study aims to determine the effect of cultural literacy, ethnocentrism, and xenophobia on intercultural sensitivity in nurse interns.

Methods: This cross-sectional study was conducted with 206 intern nurses from three universities in a province of Türkiye. A simple random sampling method is used. Data are collected by using the Introductory Information Form, Intercultural Sensitivity Scale, Cultural Literacy Scale, Ethnocentrism Scale, and Xenophobia Scale. Multiple regression is used for data analysis.

Results: Cultural literacy (β = …

Patient Education On Conversion From Oral Art/Prep To Long-Acting Injectable (Lai) To Improve Patient Treatment Adherence, Marnel Reina Mae M. Hernandez

Doctor of Nursing Practice Final Manuscripts

Patient Education on conversion from oral ART/PrEP to Long-Acting Injectable (LAI) improves patient adherence.

Marnel Reina Mae Hernandez, MSN, RN

Joseph, F. Burkard, DNSc, CRNA, EBP-C

Background: Long-acting injectables (LAI) have been shown to be equally effective in viral load suppression. Implementing nurse led educational interventions in the use of oral treatment to LAI will address if LAI prescriptions can improve adherence and patient retention. Despite the availability of LAI for ART (antiretroviral treatment) and PrEP (pre-exposure prophylaxis for HIV) patients continue to have a low appointment adherence which can impact adherence and overall viral detectability. LAIs will continue to …

Raising Provider Awareness Of Fluid Status In Women Undergoing Elective Cesarean Section Through The Use Of A Preoperative Checklist To Assess Fluid Status: A Quality Improvement Project, Marcus Miller, Michael Sorge

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract

Maternal hypotension following neuraxial anesthesia during cesarean section is a common and potentially harmful complication. While vasopressors are often used for this issue, they carry risks to fetal well-being. Goal-directed fluid therapy (GDFT) provides an individualized approach that may improve outcomes by optimizing fluid status perioperatively. This quality improvement project aimed to increase provider awareness of fluid status through the implementation of a preoperative checklist that assessed fluid status in women undergoing cesarean section. A preoperative fluid assessment checklist was developed using evidence-based predictors of fluid status and integrated into anesthesia workflow. The project followed the Plan-Do-Study-Act cycle and …

Implementation Of An Epidural Catheter Assessment Tool To Reduce The Risk Of Racial And Ethnic Disparities Associated With The Conversion To General Anesthesia In Cesarean Deliveries: A Quality Improvement Project, Marjani A. Saunders, Tyler-Nicole Pannell

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Neuraxial anesthesia has significantly reduced anesthesia-related maternal morbidity during the peri-partum period. Despite these advancements, racial disparities persist in obstetric anesthesia care and Black women continue to experience disproportionately higher rates of general anesthesia (GA) for cesarean delivery when compared to non-Hispanic White patients. This quality improvement (QI) project sought to decrease the conversion from epidural anesthesia to GA for cesarean sections in laboring women by creating an epidural catheter assessment tool. The epidural catheter assessment tool provided uniform assessment and documentation of labor epidurals by anesthesia providers to reduce the use of general anesthesia for unplanned cesarean section deliveries. …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

"Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project", Amber M. Woodring, Samantha Kalkstein

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Quality Improvement Initiative For Emergency Cesarean Delivery: Implementation Of Rapid Sequence Spinal Anesthesia, Hunter L. Baselj, Joseph A. Gabster

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract

Background: General anesthesia (GA) for emergency cesarean sections (EmCS) poses potential risks Rapid Sequence Spinal Anesthesia (RSSA) offers a promising alternative that preserves benefits of neuraxial anesthesia while accommodating the urgency of EmCS. This quality improvement (QI) project aimed to implement and evaluate the use of RSSA at a teaching hospital, utilizing a decision-tree tool to enhance clinical efficiency and assess provider perceptions regarding its impact on airway complications and post-operative pain outcomes. Methods: A RSSA decision-making chart was developed and introduced to anesthesia providers at a teaching hospital. A total of 16 providers, including CRNAs, SRNAs, and anesthesiologists, …

Utilizing Simulation Training To Understand Maternal Cardiac Arrest Precipitated By Amniotic Fluid Embolism: A Quality Improvement Project, Erica L. Wright, Megan L. Tiernan, Michael W. Neft, Paige Spagiare, Erica Coffin

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Background and Problem: Maternal cardiac arrest precipitated by amniotic fluid embolism is among the leading direct causes of death among laboring women (Enomoto et al., 2022). Because it presents suddenly without any immediate apparent cause and lacks specific diagnostic tests, frontline obstetric caregivers must be vigilant, competent, and prepared to handle this potentially catastrophic emergency. Coordination among multiple disciplines is paramount since two lives, not just one, are at risk. Unfortunately, the rarity of maternal cardiac arrest significantly limits opportunities for staff to learn how to identify and manage these events successfully. Method: This quality improvement project established a simulation-based …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Psychometric Properties Of The Turkish Version Of The Palliative Care Attitude Scale (T-Pcas-9) In Cancer Patients, Sevgi Demir Çam, Neşe İşcan Ayyildiz, Hasan Evcimen, Timüçin Çil, Berna Bozkurt Duman

Makara Journal of Health Research

Background: A reliable, validated Turkish measurement tool will allow researchers to measure the impact of attitudes towards palliative care on other health outcomes in individuals with chronic and critical illness. This study aimed to examine the Turkish psychometric properties of the Palliative Care Attitude Scale (PCAS-9) for individuals with cancer.

Methods: The Turkish adaptation of the PCAS-9 (T-PCAS-9) included 505 cancer patients, who were aged >18 years, had a diagnosis of cancer, and no mental problems. The factor structure of the T-PCAS-9 was examined using exploratory factor analysis, confirmatory factor analysis, convergent-divergent validity, and measurement invariance analysis.

Results: The three-factor …

Evaluation Of Palliative Care Awareness Among Hospitalized Patients And Their Relatives In Türkiye, Füsun Uzgör, Ayşe Özkaraman, Hülya Özen

Makara Journal of Health Research

Background: Today, with the advances in medical knowledge and technology, chronic diseases have increased worldwide in parallel with the prolonging life expectancy and the aging of the population. This has increased the need for palliative care in the delivery of medical services. This study aimed to evaluate the palliative care awareness and level of knowledge of inpatients receiving health services in a university hospital and their relatives in Türkiye.

Methods: This cross-sectional study was carried out with 360 patients and their relatives who volunteered to participate in the research. The study data were collected in face-to-face interviews using …

Improving Perioperative Nursing Residency Student Retention: Identifying And Mitigating Factors Causing Attrition In A Nursing Residency Program, Bridgette D. Mangan

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: The nursing workforce decreased by 100,000 nurses from 2021 to 2022. Such a drop has not been seen in the last 40 years of the nursing profession. The frequency of job turnover among newly hired nurse graduates is troublesome. Research reveals 30% to 69% of new graduate nurses voluntarily leave their positions within a year of employment. Nurse residency programs help new graduate nurses’ transition from advanced beginners to competent professionals and focus on areas critical to new graduate success. The cost of training a new graduate nurse to be a competent perioperative nurse may be upwards of …

Safe Steps: Protecting Pediatric Patients From Falls, Sydney Richter, Generra Okello, Adaeze Ndulue, Megan Bauman, Robert Riegler

2024

No abstract provided.

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …

Staff Education To Reduce Alarm Fatigue And Enhance Patient Safety Through Nurse Education On Telemetry Optimization, Casey Alan Metcalf

Walden Dissertations and Doctoral Studies

Summary This project was an evidence-based staff education initiative to reduce alarm fatigue and enhance patient safety through telemetry optimization in an acute care setting. The core issue involved the overuse of continuous cardiac monitoring, which contributed to nonactionable alarms, alarm fatigue, workflow inefficiencies, delayed throughput, and increased costs. The project was a structured intervention delivered to 171 telemetry nurses across three inpatient units. Pretests and posttests measured changes in knowledge, intent, and practice. Results showed a 22.9% increase in knowledge, a 92% agreement regarding intention to follow discontinuation protocols, and a 10% overall reduction in practice of telemetry use …

Need A Buddy? A Mentorship Program For New Graduate Nurses, Makenzie Smith, Clarissa Leal, Danae Jones, Tram Anh Tran, Serenity Helaire

2024

No abstract provided.

Staff Education On The Abbreviated Teachers’ Rating Scale (Atrs) Tool As A Screening Tool For Attention Deficit Hyperactivity Disorder (Adhd)., Tena E. Currie

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education program to enhance the treatment and diagnosis of attention-deficit hyperactivity disorder (ADHD) at a mental healthcare facility. The identified practice problem was the lack of knowledge about the Abbreviated Teacher Rating Scale (ATRS) used in ADHD testing, which may result in inaccuracies and underutilization of the tool. To bridge this gap is essential in nursing practice as clinicians should be competent in performing standard assessment, which is indispensable for patient with ADHD. Staff education with the ATRS was the practice-directed question for the project: Does staff education with the ATRS increase knowledge for …

Decreasing The Incidence Of Healthcare Associated Presure Injuries In The Acute Care Setting, Amanda R. Nichols

Doctoral Dissertations and Projects

Healthcare-associated pressure injuries (HAPIs) can cause great harm to vulnerable patients. Acquiring a HAPI during hospitalization can result in delayed wound treatment, prolonged hospitalization, risk for infection, reimbursement issues for the facility, and delayed patient discharge. Avoiding these injuries is essential to improve patient outcomes. Research reveals that the implementation of nurse education and two registered nurse skin assessments on admission, instead of one nurse skin assessment, can decrease the incidence of healthcare-associated pressure injuries. Using the Iowa model, the goal of this scholarly project is to implement evidence-based research to change the current process and decrease the incidence of …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray-Johnson

Doctoral Dissertations and Projects

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to teenagers aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was used as a framework for implementing this study. The quasi-experimental …

Passing The Torch: Evaluating Documentation Quality And Its Impact On Nurses’ Perceptions Of Communication Across Va Care Transitions, Shannon Collier Baker

Doctoral Dissertations and Projects

Effective communication during transitions of care is crucial to ensuring patient safety and optimizing outcomes. However, current practices may fall short in supporting clear and comprehensive communication among healthcare providers, particularly during complex care transitions involving Veterans who have received targeted care coordination intervention outside of their primary Patient Aligned Care Team. The absence of standardized tools for handoff documentation exacerbates fragmented communication and ambiguity about the transfer of care management responsibilities, potentially leading to avoidable errors and care coordination failures. This project aimed to investigate nurses' perceptions of the adequacy of communication during the transition of moderate to complex …