Capstones: Master of Science in Nursing: 2020

KRAMER, Julianne, MORAVEK, Kristen, & RAILE, Brittany. (2020). The purpose of this evidence-based project was to search the literature to see if educating adolescents regarding the risks associated with vaping would aid in the solution for this epidemic. This resulted in the PICO question: in adolescents (ages 13-18), how does education on the dangers of vaping, compared with no education, affect the likelihood of vaping? As this is a new trend, two descriptive studies and one uncontrolled cohort pilot study were used to assess the best methods to educate today’s youth.

ALLEN, Cassie, GRYZWA, Kiley, & Junck, Jill. (2020). In registered nurses in their second year of practice, how does a supportive mentor program affect job retention? Although some research has established that mentoring programs such as nurse residencies have a positive impact on new graduate nurses, little is known about the impact mentorships programs have on second-year practicing nurses.

NOVOTNY, Chelsea, PHILLIPS, Carrie, & ROBISON, Jori. (2020). The PICOT question for this project was: In hospitalized patients (P), how does scheduled interdisciplinary rounding with the physician (I) compared to rounding without the physician (C) affect patient satisfaction (0) during an inpatient stay? (T). Currently there is no best practice standard related to interdisciplinary round attendees, nor has collaboration during rounds been thoroughly explored regarding influencing patient satisfaction.

DOYLE, Chelsey & ENENBACH, Catherine. (2020). The purpose of this evidence-based project was to explore the effect of the newborn rooming-in during traditional nighttime hours on maternal fatigue through the course of the hospital stay for postpartum cesarean mothers. The research was centered around the PICO(T) question: In postpartum cesarean mothers, what is the effect of rooming-in during nighttime hours versus utilization of the newborn nursery on maternal fatigue during the postpartum hospital stay?

HAGEWOOD, Heather, MOORE, Alexandra, & PARYS, Kayleen. (2020). This was an evidence-based project to determine in oncology nurses who handle hazardous medications, does formal peer evaluation monitoring for required PPE use with an audit tool compared to no formal peer evaluation monitoring increase nurse compliance with personal protective equipment?

HARTY, Jerica & MEYERPETER, Tricia. (2020). The aim of this evidence-based practice is to review the literature to determine if Code Lavender
improved staff support during stressful events in the workplace. The PICOT question used in this research project was: In-hospital registered nurses, how does Code Lavender compare to no formal intervention, affect staff support, following stressful or traumatic events? Nurses frequently experience stressful events while providing care. Code Lavender is designed to increase compassion for the nurse’s emotional state after stressful events or traumatic events. Quality improvement and evidence-based practice in nursing were addressed on the topic of Code Lavender. A search of the Academic Search Elite, CINAHL Complete, and Medline Complete databases was conducted. The search yielded four articles using specific exclusion and inclusion criteria. The evidence endorses the use of Code Lavender as a form of staff support. The intervention of Code Lavender, along with peer to peer support, has a positive effect on staff support during stressful and traumatic events. Future recommendations for nursing include continued research on the topic and definition of Code Lavender, staff education, compliance of staff, and administrative cognizance and support. A change in policy is needed to support nurses when they experience stressful or traumatic events.

OMOTO, Leslie, OWEN, Nicole, & SMITH, Melanie. (2020). In the older patient who is hospitalized in the ICU (P), does the use of evidenced-based pharmacologic and nonpharmacological interventions for delirium (I) affect cognitive impairment after discharge (O)? Delirium is a significant predictor of cognitive impairment following a critical illness. Delirium affects 60-80% of mechanically ventilated patients and approximately 50-75% of hospitalized older patients. Approximately $164 billion a year is spent in the United States combating the effects of delirium. A search was performed in the following databases: CINAHL, Medline, ProQuest, and PubMed, resulting in nine quality evidence-based articles. Cognitive deficits can negatively affect quality of life, basic daily life activities, the ability to return to the workplace, and financial stability; relatives who may help care for the patient after discharge also experience additional stress. Methods for preventing, screening, and treating delirium could diminish or prevent cognitive deficits following a critical illness. Prevention of delirium outweighs treatment options and should be taken seriously in hospitalized older adults to improve quality of care and overall outcomes. Nurses and providers who are prepared to utilize an individualized approach for management of symptoms using both non-pharmacological and pharmacological treatments to combat delirium can effectively improve outcomes.

BURESH, Dana, D'ELIA, Francesca, GALLES, Jessica, & PIEPER, Timothy. (2020). Post-operative delirium is a concern for the geriatric population, as it leads to an increase in cognitive impairment and mortality. Most cases of post-operative delirium are undiagnosed due to the lack of screening tools or instances where screening tools are improperly utilized. The purpose of this evidence-based research project was to determine if screening and the introduction of preventative measures affects the frequency and prevalence of post-operative delirium in geriatric patients. The PICOT question was, “in geriatric surgical patients, how do screening and preventative measures compared to no screening and preventative measures affect the prevalence of hospital delirium?” The search plan method literature search resulted in three evidence-based research articles related to the use of screening tools and prevention measures to identify the risk of post-operative delirium in the geriatric population. Research suggests that post-operative delirium can be reduced by up to 33% when patients are prescribed a prehabilitation program prior to their procedure. Future recommendations include the development of tools which are easy to understand and implement, instrument education for pre- and postoperative nursing staff, and the modification of nursing policies to reduce or eliminate the occurrences of post-operative delirium. It was concluded that with the introduction of screening and interventions, the occurrence of post-operative delirium can be significantly reduced, however, further research is necessary.

BEDEL, Amanda, MCCLUSKY, Megan, & PATSIOS, Heidi. (2020). Healthcare-associated infections (HAIs) continue to be a problem for hospitals and patients around the world. However, there is little to no focus on the day-to-day transmission of the organisms that cause these types of infections. Supplies used by healthcare professionals such as stethoscopes, phones, and tablet computers can serve as a vehicle of transmission for bacteria that cause HAIs, yet few healthcare facilities have policies addressing the routine cleaning of these supplies. The purpose of this paper is to explore the evidence related to the cleaning of supplies and its effect on the rate of HAIs. The following PICO question was used to guide the research: In hospitalized patients, does sanitizing of supplies used by nurses between each patient compared to no sanitizing (or inconsistent sanitizing) affect healthcare-associated infections? Six articles were reviewed to determine whether a relationship between cleaning supplies and HAIs exists. Studies examined the frequency in which supplies were cleaned, the types of disinfecting solutions used, and common bacteria found on a variety of supplies. Bacteria capable of producing different types of HAIs were found on all supplies used by healthcare workers. Disinfecting supplies even once a shift reduces the number of bacteria found. Results suggest that policies directed toward routinely disinfecting supplies should be enforced in all healthcare facilities as a measure to improve patient safety. Routinely disinfecting supplies can reduce the number of bacteria capable of producing HAIs and prevent the transfer between healthcare workers’ supplies and patients

DEIDA, Beth, ESCHMANN, Darbi, & SCHMAD, Lynsey. (2020). “In perioperative patients (P), how does using a standardized handoff report tool during transfers from perioperative areas to inpatient areas (I) compared to not using a standardized handoff report tool (C) affect nursing medication errors (O)?” The literature search strategy included three search engines, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline Complete, and ProQuest Nursing & Allied Health. Selected articles met certain criteria including: published within the last five years, addresses the PICO question, peer reviewed, and was focused on perioperative handoffs, not handoff at shift change. The search yielded five articles for further critical analysis. Findings demonstrated that using a standardized handoff tool after surgery improved interdisciplinary satisfaction and increased perceived effectiveness of the handoff process. Improved satisfaction among staff members inadvertently lead to improved patient outcomes. Future research should focus specifically on medication errors and include other stakeholders. In conclusion, the main theme throughout these studies was satisfied nurses resulted in better patient outcomes. Nursing involvement is important to the success of the implementation of this new process with the help of a multidisciplinary team

FREAR, Melanie, OSBORN, Patricia, & PRIBNOW, Jennalee. (2020). The purpose of this evidence-based project was to evaluate the efficacy of 24% sucrose in the management of pain in term newborns. Newborns are exposed to a variety of potentially painful procedures during their inpatient stay. The use of prophylactic treatment options, including sucrose for newborn pain, is inconsistent and is a concern for those caring for this vulnerable population. A comprehensive literature search in the CINAHL, Medline, and PubMed databases was conducted to gather studies that contained pertinent, valid, and reliable data on the efficacy of sucrose to treat term newborn pain. Four articles were identified and systematically reviewed for quality of evidence, reliability of the statistical findings, the validity of the scientific methodology, and applicability in clinical practice. There was strong evidence to support the use of sucrose in term newborns as a nonpharmacological treatment method for minor painful procedures, including heel lances and venipuncture. Evidence also indicated that the concurrent use of non-nutritive sucking or swaddling and sucrose can improve the analgesic effects. The recommendations for further research include the use of sucrose for specific painful procedures in term newborns, concurrent nonpharmacological therapies, and identification of the most effective concentration and dosage of sucrose. This evidenced-based project concluded that 24% sucrose is an effective treatment option for painful procedures in term newborns