Master of Science in Nursing

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    Years of Nursing Experience and Resiliency During a Pandemic
    (Bryan College of Health Sciences, 2020-12-09) Martin, Ginnie ; Townsley, Karen
    Purpose: This quality improvement project was conducted to understand resiliency of new nurses during the COVID19 pandemic. What is the self-reported resiliency of newly graduated nurses with 0-3 years of experience during the COVID19 pandemic? Literature Review: Nursing is a rewarding, often challenging, and at times emotionally draining profession. Stress in nursing can lead to burnout, nurse turnover, and potentially contribute to poor patient outcomes. Providing care within a pandemic can increase the stress. Literature shows the first year of practice is the most stressful in a nurse’s career, and nurse residency programs (NRP) are beneficial with the transition. Resiliency, defined as the “ability to thrive in the face of adversity”, is teachable and can provide nurses with emotional adaptability. Patricia Benner’s Novice to Expert Theory provides a theoretical framework which can be utilized to understand the nurse’s growth and development. Methods: NRP co-coordinators, as the stakeholders, provided permission to conduct this project within the NRP. The Connor-Davidson Resilience Scale (CD-RISC) was used. The CD-RISC assessed resiliency differences of nurses with less than one-year experience and nurses with 1-3 years of experience. After IRB review, data were collected and analyzed for 62 valid responses. Results: Nurses completed the survey with n=23 reporting having less than one-year experience and 39 reporting having 1-3 years of experience. The mean resiliency scores for nurses with less than one-year experience was 26.83 and nurses with 1-3 years of experience was 28.31. The results did not show a statistically significant difference. Conclusion: This data suggests that utilizing a resiliency scale and providing training to all nurses in the organization would be beneficial. This allows the individual the opportunity to see how they score regarding resiliency to identify areas of strength and potential areas for improvement.
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    Troubleshooting Vascular Access Device Selection
    (Bryan College of Health Sciences, 2020-12-09) Badura, Nicole ; Beil, Lindsay
    Purpose: To educate registered nurses (RN) regarding the necessity for pre-assessment of risk factors, and importance of vascular access device (VAD) selection. Will providing this education to RNs, improve understanding of appropriate VAD selection? Literature Review: Identified knowledge gaps and patients presenting with co-morbidities and associated risk factors are affecting VAD selection, leading to inappropriate prescriptions from providers. Central lines (CL) are associated with central line associated bloodstream infections (CLABSI), leading to increased morbidity/mortality rates. Even with national initiatives created to improve safety and education regarding VAD selection, CLABSIs are still occurring. Three factors leading to complications with VADs (host factors, device factors, and provider factors) have been identified. Mandatory annual training on maintenance of VAD improves confidence and competence. The Plan, Do, Study, Act (PDSA) cycle provides a framework for developing, testing, implementing change and improvement in VAD selection. Methods: The setting for the QI project was general/progressive/critical care areas in an urban hospital. Project stakeholders were a Clinical Educator, and a Clinical Nurse Specialist. The RNs on selected units were given comprehensive VAD education on pre-assessment of risk factors, and importance of appropriate VAD selection. The participants completed a pre-test, and then completed a post-test following education, to determine understanding. The data were reviewed and analyzed. IRB reviewed the project and deemed it a quality improvement project. Results: The project question was supported by the outcomes, as evidence by, improved post education scores. It was determined that the location of the education session can be detrimental to the learning outcomes. Future testing considerations would include review of test question verbiage to be more succinct and unit directed. Conclusion: VAD selection education improved the knowledge of the RNs regarding appropriate VAD selection. Plan to disseminate education to all units, and commit to implementing annual education.
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    Workplace Attributes Leading to Job Satisfaction of the Bedside Nurse
    (Bryan College of Health Sciences, 2020-12-09) Johnson, Stephanie ; Speer, Katie
    Purpose: The purpose of this quality improvement project is to better understand workplace attributes of selected units within an acute care hospital to provide recommended strategies for improving the workplace attributes as a way to promote nurses’ job satisfaction. The guiding question was “What are the attributes that promote nurses’ job satisfaction within the workplace?” Literature Review: Communication, relationships with physicians, and nursing involvement in decision making are workplace attributes discussed in the literature leading to job satisfaction. Nurses having autonomy and control over their work environment are also strong factors for satisfaction with the work environment. Methods: The project took place on both intensive care and progressive care units. The stakeholders were the nurse managers and directors of these units and the CNO of the organization. A Google Form was developed to administer the questionnaire and participants were invited via email. SMART objectives were created, partially met, with one being delayed. The PDSA framework relates to change theory in planning, implementing, and evaluating the project. Data were collected via the NWI-R as the instrument. The capstone project was reviewed by the IRB and deemed as a quality improvement project. Results: The outcome of this quality improvement project was to identify strategies as recommendations, which included implementing task forces for nurse's involvement in controlling costs, employee forums increased to bi-monthly, twice monthly informal CNO rounding, maintaining a culture of safety, and professional/career development opportunities with improved marketing. Recommendations were given via a flyer and presentation. Conclusion: The project's outcomes supported the guiding question, in that we learned work attributes that scored higher on job satisfaction, which were also supported in the literature. Initially, stakeholders should focus on the most influential recommendations provided and create SMART goals as a framework to implement strategies going forward.
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    Generational Diversity Among Registered Nurses in the Workplace: A Quality Improvement Project for Enhancing Communication and Collaboration
    (Bryan College of Health Sciences, 2020-12-09) Weise, Jackie ; Bernecker, Whitney
    Purpose: The purpose of this quality improvement project was to enhance intergenerational communication and collaboration among staff RNs in the workplace. What are the strategies to enhance communication and collaboration among generationally diverse RNs? Literature Review: The RN workforce is currently comprised of three generational cohorts including baby boomers, millennials, and generation X. RNs from generation Z will soon be entering the workforce. Generational diversity influences many workplace outcomes including morale, commitment, and patient care. Generational diversity among RNs effects communication and collaboration in the workplace. The Dynamic Social-Ecological Model of Generational Identity in the Workplace identifies how differences in generational diversity can negatively impact workplace outcomes. Methods: A comparative correlation design was used to analyze three generational cohorts on six acute care hospital units. The units’ nursing directors served as stakeholders. The SMART objective was to identify ten strategies to improve communication and collaboration among staff RNs to foster an inclusive, intergenerational work environment. The Workplace Intergenerational Climate Scale (WICS) was utilized to collect data. Data were analyzed using descriptive and inferential statistics. The IRB determined this to be a quality improvement project. Results: The results guided the identification of strategies which included generational competence and sensitivity education, team building, reverse mentoring, embracing generational strengths, and building a culture supportive of generational diversity. The strategies were shared with the stakeholders and unit staff via posters. Conclusion: An implementation plan and timeline are necessary to incorporate the recommended strategies within the project’s setting.
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    Using a Checklist as a Strategy to Reduce Errors During the Administration of High Alert Continuous Intravenous Medications
    (Bryan College of Health Sciences, 2020-12-09) Gowan, Christine ; Schwartz, Lindsay ; Buchholtz, Abbi
    Purpose: The purpose of this quality improvement project was to create a medication safety checklist for high alert medications (HAMs) to be used by nurses during any patient handoff, and to evaluate its effectiveness. Will the implementation of a checklist, to be completed at all nurse to nurse handoffs, improve patient safety by decreasing the risk of HAM errors compared to not using a checklist or other double check processes? Literature Review: Reason’s Swiss cheese model of accident causation likens failures that occur on human and systematic levels to a stack of Swiss cheese slices. Research supports that when nurses do not utilize double check systems to their full potential, errors occur and negatively impact patients. Utilizing a medication safety checklist can aid in the reduction of errors by adding an additional layer of defense. Methods: After IRB review of the quality improvement (QI) project the stakeholders granted permission to begin the project. The stakeholders were managers of two ICUs in the Midwest. A checklist and survey were provided to bedside nurses. The checklist was utilized for HAMs at all nurse handoffs. Nurses also answered a short survey regarding their experience with the checklist. Completed forms were kept in a secure folder. Results: Three errors were identified by the checklist. Results showed that 81.5% of participants felt that the checklist helped improve patient safety. In total, 96.2% of participants felt that the checklist was easy to use. Some felt that the checklist added to their workload. We recommend stakeholders implement the checklist into the current workflow. Stakeholders received results via email along with a visual aid for them to use at their discretion. Conclusions: The utilization of a checklist as a double check is a valuable tool to help reduce or prevent patient harm and aids in positive patient outcomes.