No Full Text- In Process--Nursing 2024

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Accreditation of a Nurse Residency Program
(Montana State University - Bozeman, College of Nursing, 2024-05) Belt, Jennifer
Background. This quality improvement project proposal focuses on creating a pathway to ANCC PTAP accreditation for the nurse residency program at a 99-bed hospital in Montana. The proposal aims to gain key stakeholder engagement and support for anticipated program changes. Local Problem. Following the COVID-19 pandemic, high turnover among nursing staff highlights the need for quality onboarding and retention of newly graduated nurses. Addressing this problem requires the implementation of a standardized and evidence-based nurse residency program to improve nurse satisfaction and decrease 1-year nurse turnover. Methods. A nurse residency program steering committee, stakeholder survey, and gap analysis tool were utilized to evaluate the current state of the program and inform change satisfactory of ANCC-PTAP accreditation requirements. SMART goals were implemented to establish baseline outcome data, set outcome goals, and track program progress over time. Interventions. Anticipated program changes were addressed including, but not limited to, the revision of the preceptor program, the creation of a mentorship program, the development of a content revision policy, additional NPD practitioner training, the inclusion of more competency-based learning activities, and the creation of a newly licensed nurse onboarding pathway.
Indigenizing the National Parks Service-Unlearning Settler Colonial History on Native Lands
(Montana State University - Bozeman, College of Letters & Science, 2024-05) Dugan-Kimball, Amy Jo
Each year, millions of people retreat to what are now known as (WANKA) America’s national parks and their units. This escape from the settler-colonial lives of our capitalistic economy and imperialistic mindset is often touted as a much-needed respite for overworked, stressed-out adults and technology-addicted youth- a result of our “more is better” lifestyle and demand for instant gratification. The learning opportunity afforded, although unconventional, provides space with which to bring the voice of Indigenous Peoples to the forefront of the narrative of national parks’ history and the legacy of displacement.
Peripheral Intravenous Catheter Compliance in the Acute Care Setting
(Montana State University - Bozeman, College of Nursing, 2024-05) Lee, Mandilynn Renee
The intent of this quality improvement clinical project aimed to improve peripheral intravenous catheter (PIV) compliance and reduce poor patient outcomes on Unit B. Currently, there is a lack of compliance with PIV standards, poor documentation, and no data collection for closer monitoring. The Model of Improvement and establishing SMART goals, with subsequent PDSA cycles was used as the premise framework for this quality improvement project. To establish PIV knowledge of the initial PDSA cycle, the use of a single page questionnaire and education sessions interventions was proposed. In the acute care population, reducing PIV complications and maintaining continual focus on improvement measures, can directly impact a patient’s length of stay, and be a cost saving measure for the facility.
Something in the Water: On the Minneapolis Music Scene
(Montana State University - Bozeman, College of Letters & Science, 2024-05) Kennedy, Jonathan
Minneapolis is a paradoxical place. Despite its rich and vibrant arts community, the city has some of the worst racial disparities in the country. It’s also cold and it’s isolated, and an unlikely location for one of the best music scenes in the United States. My claim is that the tension between the city’s forward-seeming politics and its conservative reality helps to foster new and eclectic music scenes in Minneapolis year after year. I also argue that its music community remains one of the only threads keeping the city together, especially as it still recovers from the protests after George Floyd’s murder. Studying the history and the impact of Minneapolis’s music through its artists, songs, and venues reveals a traceable lineage from one music scene to the next. This reciprocity helps to explain Minneapolis’s improbable place in the larger history of modern music. I will incorporate my own experiences, living as a musician in Minneapolis from 2002-2018, alongside the experiences and the songs of other Minneapolis musicians including Bob Dylan, Prince, The Replacements for an exploration that’s both introspective and retrospective. This reveals how the indefinable “sound” of Minneapolis continues to evolve through its fluid movements and scenes, rather any stagnant periods in its history.
Nurse Residency Program: Road to Accreditation with Distinction
(Montana State University - Bozeman, College of Nursing, 2024-05) Leese, Miranda
The purpose of this project was to help Hospital Z’s nurse residency program meet the American Nurses Credentialing Center (ANCC) practice transition accreditation program (PTAP) with distinction criteria by earning ANCC nursing continuing professional development (NCPD) contact hours for the didactic curriculum classes. Hospital Z’s entire nurse residency program was ANCC PTAP accredited, but the program must reapply for this accreditation in 2024. This project aimed to help the residency program earn ANCC PTAP accreditation with distinction, showing a commitment to excellence, evidence-based practice, and quality improvement initiatives by updating the didactic curriculum to meet ANCC NCPD criteria. Without reevaluating the program, Hospital Z risked decreased nurse recruitment into the program and increased nurse turnover due to difficulties transitioning into professional nursing practice. Utilizing the Donabedian Quality Improvement Framework, the current residency program’s structure, processes, and outcomes were assessed to identify areas that prevented the program from meeting ANCC NCPD criteria. Following the direction of this author and the ANCC NCPD expert at Hospital Z, the residency coordinators started process changes to move toward ANCC NCPD accreditation. The residency coordinators planned to assess resident confidence, competence, and retention after implementation of the new program. Once the didactic curriculum meets ANCC NCPD criteria for contact hours, the residency program coordinators could highlight this achievement in their 2024 application for PTAP accreditation with distinction. Earning ANCC PTAP accreditation with distinction is the highest honor for a residency program and could increase national recognition of the program, draw more qualified applicants, and increase funding for the program.
From Surviving to Thriving: Exploring the Experiences of LGBTQ+ Adolescents and Engaging Teacher Allies in Rural Montana Schools
(Montana State University - Bozeman, College of Letters & Science, 2024-05) MacAlister, Emma
Written by an educator for educators, this qualitative research study explores two questions: (1) What are the lived experiences of LGBTQ+ adolescents residing in rural Montana? (2) How can rural educators become LGBTQ+ allies in their schools and communities? Relying on the voices of five participants, this case study examines queer adolescents’ lived experiences within their family units, rural high school, and local community. The research study also explores ways rural educators can become teacher allies by creating more inclusive, equitable classrooms and communities for rural-living LGBTQ+ youth. Existing research analyzes queer adolescents’ lived experiences in the rural Southeast, Midwest, and Pacific Northwest United States, yet much of this research adheres to a deficit narrative; in essence, what rural places lack. Existing research also depicts high rates of school victimization among LGBTQ+ youth, mental health and behavioral issues, and a lack of queer representation in the rural classroom. This study’s data derives from semi-structured interviews and sheds light on participants’ experiences (both positive and negative) in one rural Montana community, and its findings are broken into seven themes: (1) Outsider Status: Lacking a Rural Sense of Belonging; (2) Conflicting Familial Support; (3) School Victimization & Subsequent Anxiety; (4) Catching a “Vibe” About Teacher Allies; (5) Lack of LGBTQ+ Representation in School; (6) Resilience & Western Toughness; (7) Heightened Sense of Empathy & Advocacy. With Critical Rural English Pedagogy (CREP) (Petrone & Wynhoff Olsen, 2021) as its theoretical framework, the research study further examines the complex intersection between queerness and rurality and provides ways rural educators can LGBTQ: Listen to queer students, Give queer students support, foster queer students’ rural sense of Belonging, Transform rural classrooms and communities, and Question damaging beliefs about gender and sexuality—with the goals of not only engaging queer students in the classroom but empowering them to enact positive social change in rural America.
Use of Information Dispensing in the Emergency Department to Improve Patient Satisfaction and Reduce Leave-Without-Treatment Rates: A Quality Improvement Project
(Montana State University - Bozeman, College of Nursing, 2024-05) McIntosh, Delaney M.
Ineffective communication between healthcare professionals and patients results in decreased patient perceptions regarding the quality of care received and contributes to reduced patient satisfaction, negative patient care outcomes, and decreased compliance with treatment recommendations. A microsystem assessment completed within a rural region trauma transfer facility identified a need for improved communication between clinicians and patients to improve patient satisfaction. Information dispensing is a form of intentional knowledge sharing between healthcare professionals and patients used to proactively engage patients and improve patient satisfaction. Review of the literature identified contributing factors to patients who sought care in the emergency department (ED) and reported low patient satisfaction or left-without-treatment (LWOT) such as inadequate communication, unmet expectations, and negative patient-clinician interactions. The literature supported the use of a patient-information-leaflet (PIL) in the ED as a sustainable and cost-effective method to communicate commonly sought information requested by patients to improve patient satisfaction and reduce LWOT rates.
Nursing Mentorship in an Associate of Science Registered Nursing Program
(Montana State University - Bozeman, College of Nursing, 2024-05) Senn, Laura
Rigorous nursing school programs and the transition to nursing practice can be difficult for nursing students leading to attrition from nursing school and rapid burnout in the field of nursing. Mentorship programs have been proven to increase student abilities and confidence leading to successful nursing careers. This quality improvement project proposes to use the Plan Do Study Act framework to research and design a nurse-to-student mentorship program for associate registered nursing students. Nursing school mentorship programs have demonstrated a wide variety of benefits for all participants and involvement in these programs leads to future success as a nurse. This mentorship program aims to establish a supportive nursing community to increase nursing school retention as well as job satisfaction and longevity for recently graduated nursing students.
Integration of a Perinatal Specialty Curriculum into a PTAP Accredited Nurse Residency Program
(Montana State University - Bozeman, College of Nursing, 2024-05) Sweet, Teresa
Background. Nurse residency programs including the one at a regional Montana healthcare system play a crucial role in supporting new graduate nurses during transition to independent practice, enhancing retention rates, and fostering organizational commitment. The predominant focus of these programs lies in medical/surgical inpatient nursing. While this approach is justifiable due to the substantial representation of med/surg nurses in the workforce, it often neglects the unique needs of specialty nurses working in pediatrics, NICU, and perinatal services. Local Problem. Despite the documented success of nurse residency programs, one-year turnover rates persistently outpace other categories. RN turnover rates within the first year remain stagnant. At this facility, this turnover disproportionately impacts perinatal specialty nurses, constituting up to 83.3% of their turnover. Methods. This quality improvement project proposes the integration of perinatal specialty curriculum into an existing PTAP (Practice Transition Accreditation Program) accredited nurse residency program. By incorporating evidence-based practices, tailored content, and specialized training modules, we aim to address the unique challenges faced by perinatal nurses. Interventions. Interventions will include curriculum enhancement and simulation training. We will develop and incorporate perinatal-specific modules within the existing nurse residency curriculum. These modules will cover topics such as neonatal care, maternal health, and perinatal complications. High-fidelity simulations will allow nurses to practice critical scenarios encountered in perinatal care, enhancing their confidence and competence. Results. We anticipate that the integration of perinatal specialty curriculum will lead to improved job satisfaction, reduced turnover rates, and enhanced patient outcomes. By addressing the unique needs of perinatal nurses, we aim to create a more resilient and committed nursing workforce. Conclusion. The proposed integration represents a strategic investment in the professional development of perinatal nurses. By fostering their expertise and confidence, we contribute to better patient care and organizational stability.
Addressing Communication Challenges Related to Nursing Unit Design
(Montana State University - Bozeman, College of Nursing, 2024-05) Thorson, Hannah L.
When nurses transition from a centralized nursing unit to a decentralized nursing unit, significant workflow changes can occur. A literature review identified four significant themes related to the transition to a decentralized unit. These themes are challenges with collaboration and teamwork, decreased nurse work efficiency, improvement to patient outcomes, and the importance of nurses’ role in departmental design. Additionally, literature related to the efficacy of electronic communication systems for bedside nursing staff was reviewed. The aim of this scholarly project is to propose a quality improvement intervention to increase nurse usage of clinical phones in an intermediate care unit (IMCU) to help with communication challenges caused by the transition to a decentralized nursing unit. By improving communication through use of the phones, nurses will be able to deliver care more efficiently and enhance communication with other members of the multidisciplinary care team. This quality improvement project falls within the scope of the Clinical Nurse Leader, and has the potential to improve job satisfaction for nurses, as well as provide a safer care environment for patients.
Chronic Pain Management, Opioid Tapering Guideline
(Montana State University - Bozeman, College of Nursing, 2024-05) Wheeler, Madisen M.
Chronic pain is an ongoing issue facing many Americans and individuals globally. Patients have historically been prescribed opiates and narcotics as a common care plan to help manage the chronic pain that they are experiencing. Recent guideline changes to the CDC’s recommendation on opioid prescribing, has had a monumental impact on chronic pain and chronic care management patients. Many patients in a rural access facility in the United States, are discontinued from their opioid pain medications, with no taper, leading to negative and poor health outcomes not only for the patient, but for the community.

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