Nursing Commons^™

A Provider In Triage To Decrease “Left Without Being Seen”: A Benchmark Project, Taylor B. Weathers

MSN Capstone Projects

As Emergency Departments (ED) continue to fill and become crowed, the attention to care of each patient can be delayed or missed. Back flow into the ED can cause a bottleneck effect for patients coming in, which can lead to an increase in the number of patients who leave without being seen (LWBS). In order to combat the challenges of patient throughput that result in patients leaving prior to care, I am proposing the implementation of a provider in triage (PIT). By placing a provider, either physician or mid-level practitioner, in the triage area will allow patients to been seen …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

Perceptions And Awareness Of Operating Room Staff Regarding Surgical Smoke: Implications For Safety And Health, Karla Flores

MSN Capstone Projects

In the ever-evolving landscape of modern medicine, surgical procedures have become increasingly complex and reliant on energy-based devices, leading to the ubiquitous presence of surgical smoke in ORs. This phenomenon, while a byproduct of technological advancement, poses significant concerns regarding the health and safety of OR personnel, including surgeons, nurses, anesthesiologists, surgical technicians, and ancillary staff. This paper presents a meticulous examination of the multifaceted impacts of surgical smoke, emphasizing the urgency for comprehensive intervention and systemic change.

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …

The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson

MSN Capstone Projects

Influenza is a viral illness that occurs internationally and peaks in prevalence during the months of October to May. There are several types of influenza viruses: Influenza A, B, C, and D (CDC, 2023). Vaccines are available in the United States as early as the start of the flu season to those who wish to receive it. The influenza virus types covered by the annual flu vaccine include Influenzas A and B types (CDC, 2023). The influenza vaccine is recommended by the CDC with the intent to limit the occurrence and spread of influenza each year. Symptoms of influenza consist …

America Heart Association Guidelines On Telemetry Monitoring To Reduce Alarm Fatigue And Improve Patient Outcomes, Rekike Aster Ehrenberg

MSN Capstone Projects

The excessive use of telemetry monitoring in healthcare has become a widespread concern, leading to increased healthcare costs and alarm fatigue among providers. These issues threaten patient safety and negatively impact patient outcomes. To address these issues, the American Heart Association (AHA) has published guidelines for telemetry monitoring to reduce alarm fatigue and improve patient outcomes.

A three-month benchmark project was conducted using evidence-based methods to implement the AHA guidelines for telemetry monitoring in a medical-surgical unit. The project aimed to serve as a model for others with similar issues. By following the AHA guidelines, patient safety can be enhanced, …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Empowering New Ob Nurses To Combat Racial Disparities Through Education, Tabitha Poole

Doctor of Nursing Practice Projects

Minority patients are experiencing maternal morbidity and mortality at rates three to four times higher than white patients in America (Valerio et al., 2023). The project aims to measure the impact of anti-racism training on new OB nurses' understanding of racial disparities and their impact on maternal health outcomes. A three-hour educational course, in alignment with evidence-based practices, was provided to the participants. Utilizing a Likert Scale, pre- and post-intervention assessments were administered via Microsoft Forms to measure participants' perception of knowledge of implicit bias and structural racism. Gender, age range, and race/ethnicity were also collected to allow for further …

The Effects Of Diet And Exercise On Menopause Symptoms And Symptom Severity, Nicole Crowder

Doctor of Nursing Practice Projects

Menopause is a phase of life that occurs between the ages of 45-50 years and can last from 7-10 years or longer. The purpose of this quality improvement project was to develop a clinical protocol of assessments not currently completed to decrease the common symptoms of menopause such as hot flashes by implementing dietary changes and exercise as a weekly routine to decrease menopause symptoms. Participation was solicited at a private primary care clinic to women aged 40 and older over a 6-week period. BMI was calculated, documented, and completed surveys were retuned at check-out, with no identifiers and deposited …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Advance Care Planning: Best Practice Toolkit For Improving Access To Advance Care Planning Using Telehealth Visits, Jae Jackson

Student Scholarly Projects

Advance care planning (ACP) predominately occurs during a life-threatening crisis or during an inpatient admission. The primary care provider (PCP) is generally not the healthcare provider addressing ACP at the time of a crisis or during an inpatient admission. Being proactive in limiting ACP decisions with unfamiliar providers, uncomfortable environments, and increasing access to ACP discussions with PCPs are supportive reasons to utilize an ACP telehealth toolkit in primary care. Patients risk having ACP discussions with random providers, environments that don’t provide comfort when having such personal discussions, or not having the peaceful death they deserve without having an ACP …

Analysis Of Phlebotomy Training Implementation To Reduce Lab Errors In The Clinical Setting, Sandy King

Doctor of Nursing Practice Projects

The primary responsibility of a laboratory technician is to obtain patient blood samples through venipuncture as well as collect, transport, and store other clinical specimens. Poor blood collection can lead to erroneous and misleading results for the provider in addition to the annoyance of repeat testing for the patient. The lack of formal phlebotomy training provided to nurses could be contributing to laboratory rejections. For patients receiving lab services, how effective is an implementation of formal phlebotomy training for nurses compared to non-formal phlebotomy-trained nurses, in reducing failed lab results? The purpose and aim of this quality improvement project are …

Palliative Care And Quality Of Life Improvement: A Benchmark Study, Rebecca Daniels

MSN Capstone Projects

This project provides an overview of the standard and regular implementation of palliative care versus early implementation of palliative care in patients with chronic or terminal illnesses. Palliative care is an essential component of healthcare that focuses on improving the quality of life and providing support to patients through holistic elements to patients and their families facing chronic and terminal illnesses. With evidence-based research, many articles have been published with implementation of early palliative care showing improvement in patient and even caregiver quality of life. This project includes evidence gathered from mixed methods of systematic review of existing literature, randomized …

Fostering Critical Thinking Through Simulation: An Integrative Review, Sarah Knapp, Raymonta Green

Master of Science in Nursing Final Projects

Over the past decade simulation has become a staple of nursing education with increasing use during the COVID-19 pandemic. Both manikin-based and virtual simulation are used to increase the preparedness of nursing students for their roles at the bedside. With the increasing experience-complexity gap, it is important that students enter the workforce prepared to effectively care for patients. Simulation allows students to work with a patient scenario without the possibility of injury; in simulation, mistakes are opportunities instead of harm. This integrative review searched the literature questioning if in pre-licensure Bachelor of Science in Nursing students, do virtual simulation and …

Medication Overrides In Emergency Departments Defy Safety Culture, Jennifer Holt

Doctor of Nursing Practice Projects

Medication errors are a growing problem in healthcare systems. Emergency Departments (ED) are especially susceptible to this. Automated dispensing cabinets (ADC) help promote patient safety, but ED nurses commonly override the safety steps built into that workflow. This quality improvement project aims to reduce the number of medication overrides in three rural emergency departments. Data was compiled for the six months before the education and then for the four-week time frame post-education. Education was developed concerning the effects of medication override and errors were presented to all ED nursing staff at the three facilities. Implementation occurred over four weeks and …

Recommendation Of Intermittent Fasting In The Treatment Of Chronic Musculoskeletal Pain: Evaluating Healthcare Provider Behavior And Patient Fasting Behavior., Melissa Humphreys, Melissa Humphreys

Doctor of Nursing Practice Papers

Abstract

Background: Chronic musculoskeletal pain was a significant problem in this primary care clinic. A total of 75% of the primary care providers (PCPs) agreed to consider an alternative treatment for chronic pain and Intermittent fasting (IF) was introduced as an option.

Purpose: Quality improvement project to introduce IF as an adjunct to traditional pain management for chronic musculoskeletal pain, evaluate PCPs’ application, and patient response to provider recommendation of IF.

Methods: A virtual continuing education (CE) program on IF was presented to PCPs in family medicine to establish baseline competency. For two months, 29 patients were recommended IF who …

Perceived Power By Nurse Managers In Dialysis Units: A Qualitative Case Study, Janie Griner

Dissertations

Nurses comprise the largest workforce in health care but lack power despite their numbers. Nurses have suffered short-staffing, burnout, job dissatisfaction, unsafe work settings, and cumbersome technology for decades. The dialysis nurse manager is an important component of the dialysis unit and plays a role in the retention and recruitment of nurses. Using a case study approach this qualitative, thematic analysis described dialysis nurse managers’ perception of power in dialysis units. A review of the current research revealed a gap involving dialysis nurse managers’ perception of power in the dialysis unit. The following research question was developed: • How do …

The Role Of Safety Interventions In Decreasing Unplanned Extubations In Pediatrics: A Benchmark Study, Wesley Bray

MSN Capstone Projects

Unplanned extubation (UE) is the removal of an endotracheal tube from a patient any time before their planned extubation. In layman’s terms it is when a patient loses their airway before they were ready. These events lead to longer hospital stays, cost hospitals thousands of dollars for each case and can cause severe complications for the patient including death. Pediatric patients are a population that are at risk of UEs more so than the general population due to their inability to understand what is going on in the hospital due to their age and development, as well as their ability …