Nursing Commons^™

Conceptual Considerations For Understanding Resilience In Healthcare Students, Claire Donnellan, Deepthi Chakkittakandy, Christina Lydon

Research outputs 2022 to 2026

Aims: Increasing attention has been given to the concept resilience in the context of healthcare especially during and post the COVID pandemic. Much of the inquiry and evidence reported has focused on promoting or enhancing resilience in healthcare for improving the quality of care and reducing medical negligence. This discursive paper aims to highlight how resilience is conceptualised and identify any potential limitations or gaps in the context of healthcare students, acknowledging considerations for further development and research into this topic. Design and Methods: This discursive discussion draws on relevant theoretical underpinnings from the fields of adjustment and coping psychology, …

Prazosin As An Adjuvant To Increase Effectiveness Of Duloxetine In A Rat Model Of Oxaliplatin-Induced Peripheral Neuropathy, Monica A. Wagner, Naji Ayyash

Faculty Scholarship

Objectives: Duloxetine, the only American Society of Clinical Oncology (ASCO) treatment recommended for chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors, is not effective for 40% of survivors. This study examined the ability of a duloxetine-prazosin combination to prevent the development of allodynia and hyperalgesia in a rat model of oxaliplatin-induced peripheral neuropathy (OPIN). Methods: Female (n = 24) and male (n = 41) rats were started on duloxetine (15 mg), prazosin (2 mg), or a duloxetine-prazosin combination one week prior to administration of the chemotherapy drug, oxaliplatin, and continued the duloxetine-prazosin combination for 32 days. Behavioral testing for mechanical allodynia …

Reimagining Supportive Approaches At The Intersection Of Mandatory Reporting Policies For The Mother–Infant Dyad Affected By Substance Use, Kelly Mcglothen-Bell, Diana Cartagena, Kathryn J. Malin, Dorothy Vittner, Jacqueline M. Mcgrath, Rebecca Koerner, Ashlee J. Vance, Allison Crawford

College of Nursing Faculty Research and Publications

Background: As rates of substance use during pregnancy persist, the health and optimal development of infants with prenatal substance exposure remain a key priority. Nurses are tasked with identifying and reporting suspected cases of child maltreatment, including abuse and neglect, which is often assumed to be synonymous with substance use during pregnancy. While policies aimed at protecting infants from child abuse and neglect are well intentioned, literature regarding the short- and long-term social and legal implications of mandatory reporting policies is emerging.

Purpose: In this article, we explore the intersections between the condition of substance use in pregnancy and policies …

Examining Relationships Among Nursing Students’ Views Of Suffering, Positive Thinking, And Professional Quality Of Life, Ruth A. Engbers, Abir K. Bekhet, Teresa Jerofke-Owen, Norah L. Johnson, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Exposure to suffering can lead to compassion fatigue in undergraduate nursing students.

Objective:

Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction.

Results:

In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F11,145 = 4.121, P <  .001), and 21.9% of the variance in burnout (F11,144 = 3.786, P <  .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P = .025; and β = 0.309, P <  .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = −0.280, P <  .001; β = −0.392, P = .014; and β = −0.206, P = .014, …

Using Screen-Based Simulation In Family Nurse Practitioner Education, Angela M. Mcnelis, Kristina Thomas Dreifuerst, Sarah L. Beebe, Majeda El-Banna, Mary S. Dietrich

College of Nursing Faculty Research and Publications

Background

Innovations in nursing education are crucial for developing new learning approaches to ensure quality preparation and an adequate number of nurse practitioners (NPs). This necessity prompts exploration and implementation of alternative clinical educational approaches, such as screen-based simulation (SBS), to address challenges posed by limited clinical sites and preceptors.

Purpose

The study aim was to compare the effectiveness of SBS with that of traditional precepted clinical experiences in students’ attainment of mastery of knowledge in the domains of assessment, diagnosis, treatment, and evaluation across the pediatric, adolescent, adult, and geriatric populations.

Methods

A quasi-experimental, pretest/posttest design was employed. Family …

Impact Of Social Risk Screening On Discharge Care Processes And Postdischarge Outcomes A Pragmatic Mixed-Methods Clinical Trial During The Covid-19 Pandemic, Andrea S. Wallace, Alycia A. Bristol, Erin Phinney Johnson, Catherine E. Elmore, Sonja E. Raaum, Angela Presson, Kaleb Eppich, Mackenzie Elliott, Sumin Park, Benjamin S. Brooke, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background: 

Social risk screening during inpatient care is required in new CMS regulations, yet its impact on inpatient care and patient outcomes is unknown.

Objectives: 

To evaluate whether implementing a social risk screening protocol improves discharge processes, patient-reported outcomes, and 30-day service use.

Research Design: 

Pragmatic mixed-methods clinical trial.

Subjects: 

Overall, 4130 patient discharges (2383 preimplementation and 1747 postimplementation) from general medicine and surgical services at a 528-bed academic medical center in the Intermountain United States and 15 attending physicians.

Measures: 

Documented family interaction, late discharge, patient-reported readiness for hospital discharge and postdischarge coping difficulties, readmission and emergency department visits …

Vaccine Decision-Making Among Pregnant Women: A Protocol For A Cross-Sectional Mixed-Method Study In Brazil, Ghana, Kenya And Pakistan, Jessica Schue, Prachi Singh, Berhaun Fesshaye, Emily Miller, Shanelle Quinn, Ruth Karron, Renato Souza, Maria Laura Costa, Ferdinand Okwaro, Marleen Temmerman

Centre of Excellence in Women and Child Health

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

Little Lungs, Big Care: Prevent Unplanned Extubation, Leslie Huntington, Emily Jordan Ressman, Carmen Yearego

2024

QUALITY

Background: The pediatric critical care unit in a large medical center benchmarks a variety of quality metrics to ensure we are providing our patients with the best care. At the end of 2023, the unit rate of 0.58 was higher than the national benchmark rate of 0.33 for unplanned extubation (UE). Additionally, the unit was lower for failed extubation rate than the national benchmark which led to questioning if the unit was too conservative with when patients are deemed ready to extubate.

Objectives: The primary goal is to lower the rate of UE while maintaining a failed extubation rate …

Exploring Parent/Child Peri-Anesthesia Anxiety And Anesthesia Effects On Children, Ann Johnson, Alejandra Lozano, Pauline Chen

2024

RESEARCH

Approximately four million children undergo procedures with anesthesia yearly. For children and parents, this can be anxiety-provoking. In extant literature, level and timing of pre-anesthesia anxiety in children are not adequately studied; associated factors are largely unknown in humans. Preparing for anesthesia and its effects may cause parental worry, and little is known about these effects on school-age children in the weeks following a procedure. The purpose of this study was to explore longitudinal peri-anesthesia factors of anxiety and behavior in children ages 7 through 12. Spanish and English-speaking dyads consented to four data collection points beginning at the …

Nurse Manager Hiring Practices And The Experience Of New Graduate Nurses, Tiffany Montgomery, Zara Sajwani-Merchant

2024

RESEARCH

Purpose
/="/">Hiring decisions have implications for the hiring unit and the healthcare organization, including nursing retention, orientation costs, and organizational culture. Despite available literature, hiring practices, and diversity, equity, and inclusion practices are unknown within nurse residency programs. This study explores the experiences of nursing hiring managers and newly hired nurse candidates with the interview and hiring process into residency programs within the DFW metroplex.
/="/">Methods
/="/">A qualitative phenomenological study was conducted to describe the nursing manager experiences and thoughts through the hiring process and how they compare to nurse candidate’s perspective hired into an established …

Reducing The Burden Of Tracking Age Of Majority (Aom) Research Participant Consents, Beena Pappen, Lindsay Therrian, Bobby Lawrence

2024

QUALITY

Background
/="/">Reconsenting research participants when they reach Age of Majority (AOM) – age 18 in the state of Texas – is a vital responsibility of the pediatric research world. It requires tracking and planning for an activity that may not happen until months, years, or over a decade later. Not obtaining AOM consent may violate the rights of the research participant, as well as impede the ongoing collection and usage of their research data. At the Center for Cancer and Blood Disorders (CCBD) Clinical Research Office (CRO), a very manual process was being used to identify and notify …

Preventing Patient Deterioration By Creating A Reassessment And Escalation Process For The Ed Waiting Room, Virginia Elizondo, Amanda Caipo, Cory Carlos

2024

EBP

Practice Problem:

Long wait times in the emergency department (ED) waiting room significantly impact patient outcomes. Waiting times increase the risk of deterioration, the number of patients leaving without being seen (LWBS), and lead to dissatisfaction with care. 1,2,3 The urgency and significance of early recognition of abnormal vital signs and the appropriate responses cannot be overstated.3 Current ED practices lack a structured process for regular reassessment and escalation in the waiting room.

Literature/Evidence:

A comprehensive literature search was conducted, utilizing EBSCOhost, PubMed, and Ovid. The literature supports continuous reassessment to enhance safety and satisfaction in the waiting room. …

A Transformative Leadership Approach To Reducing Nursing Turnover In A Pediatric Cardiac Intensive Care Unit, Deniro Brown, Lindsey Daigle, Brandi Brown, Julia Gerstmann, Emily Hernandez, Delaney O’Brien, Casey Conrad, Christina Whittington, Lindsey Wren, Gustavo Barbero

2024

INNOVATION

Introduction/Objective:
Retention of nurses in the pediatric cardiac intensive care unit (CICU) is essential for optimal patient outcomes, as nurse experience significantly impacts patient mortality and hospital-acquired conditions. In April 2022, our CICU faced high voluntary turnover among direct bedside nurses. Our immediate goal was to reduce this turnover, with a longer-term objective of improving overall nurse retention.

Methods:|
We established global and SMART aims by comparing organizational benchmarks for nurse turnover with unit-specific data from human resources. Co-managers and eight nurse team leaders conducted stay interviews with direct bedside nurses during the first half of 2022. These …

Improving Sepsis Response, Awareness, And Engagement In The Emergency Department, Virginia Elizondo, Nicole Bizzack, Amber Dayton, Angie Rodick, Ashley Collins, Georgina Hernandez, Amber Albiar

2024

QUALITY

Sepsis background:
Sepsis is the leading cause of death in children² and a global health problem³. The primary source of infection is often not apparent¹, making early patient identification, initiation of sepsis protocols, and continued awareness crucial to improve outcomes and prevent mortality in patients at risk for sepsis.

Purpose:
An emergency department (ED) Sepsis Response Team (SRT) and other initiatives were designed to enhance workflow efficiency, improve time to antibiotic administration (TTA) tominutes, improve sepsis recognition, and uphold standards by maintaining staff engagement.

Implementations:
Once a patient screens positive for sepsis risk, an …

Bridging The Gap: Leveraging Cnap To Enhance Professional Development, Align With Organization Goals And Create A Culture Of Safety, Marissa Crosley, Brooke Harris, Gwenetta Hicks, Cornelius Metili

2024

INNOVATION

Abstract: As our organization strives for its fifth Magnet designation, enhancing nurse professional development has become a clear priority. Currently, only half of our nursing staff participate in the Clinical Nurse Achievement Program (CNAP), highlighting a need for increased engagement. Additionally, feedback from the latest Experience, Inclusion, and Engagement (EIE) Survey identified an opportunity to improve nurse recognition within our department. These insights prompted an exploration of how the Team Lead role, uniquely positioned between frontline nurses and leadership, could be more effectively utilized.

A key challenge identified is the time-consuming process of documenting CNAP achievements. Nurses often defer …

Closing The Gap For Psychiatric Resource Nurse Orientation, Kelly Bonilla, Madison Mcqueen, Cornelius Metili, Annietra Udoh

2024

EBP

A nursing orientation program can positively impact new nurses that are joining the organization (Nobles, 2022). The implementation of a new psychiatric nurse role within the hospital system developed the necessity for an orientation program that would provide quality, safe, and positive outcomes. Psychiatric Resource Nurse roles were created within the organization to provide support and education to staff regarding patients with behavioral or mental health needs. An orientation program was created to support the specific role of the Psychiatric Resource Nurse role to fulfill the need for patient centered care.

A need for an orientation program for Psychiatric …

Fall Prevention Strategies In A Pediatric Epilepsy Monitoring Unit, Bailey Cochrum

2024

EBP

Practice Problem: In 2023, our Epilepsy Monitoring Unit (EMU) had 8 falls, 5 with injuries, up from zero falls with injury in 2022. Enhancing patient and family education on fall risks and prevention is crucial for improving safety and reducing falls.

Literature: Falls in an EMU are common adverse events. Patients with epilepsy are at increased risk of falls due to seizures. In the EMU, seizures are provoked by changing medications, sleep patterns, and stimulation, increasing fall risk and possible injury.

Practice Change(s): For planned EMU admissions, we developed additional seizure-specific education for patients and families, sent prior …

Improving The Lactation Journey: Empowering Moms’ Utilization Of Breast Milk From Admission To Discharge In A Level Iv Neonatal Intensive Care Unit, Rebecca Palmer, Jerithea Tidwell, Traci Hankins, Sharetha Hollier, Nicole Jenkins, Dawn Schindler, Jeanne Gaines

2024

INNOVATION

Background
The benefits of MBM is well-known in literature, especially for infants admitted to the NICU. There is difficulty in engaging and empowering NICU mothers due to multiple barriers including holding limitations, inability to feed orally, and separation of mother and infant for extended periods. Opportunities for improving MBM utilization throughout admission include oral immune therapy (OIT) and/or oral care with MBM, skin to skin (STS), and non-nutritive attempts at breast. Access to lactation education, support, and resources throughout admission is imperative.

Methodology
Utilization of the plan-do-study-act (PDSA) cycle of quality improvement (QI) has improved our overall lactation processes …

Emergent Medication Labels In The Pediatric Intensive Care Unit, Christine Hajovsky

2024

EBP

PICOT: In emergent situations in a pediatric ICU requiring nurses to draw up emergent doses of medication, is it safer to use color coded, pre-printed fill-in-the-dose medication labels vs. our current practice of white handwritten labels? In our pediatric ICUs, nurses use handwritten labels for emergent drug administration, which can lead to illegibility and increased risks of adverse events. This project assessed whether pre-printed, color-coded, fill-in-the-blank labels enhance nurse confidence and nurses’ perceptions of patient safety during emergent drug procedures.

Literature/Evidence: Search strategy in the CINAHL (EBSCOhost) database used MeSH headings and keywords, including English articles published within the …