Theses and Dissertations at Montana State University (MSU)
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Item Inpatient intravenous chemotherapy administration : nursing competence and confidence(Montana State University - Bozeman, College of Nursing, 2016) Anderson, Kristi Lynn; Chairperson, Graduate Committee: Sandra KuntzAn estimated 40% of people in the United States will receive a cancer diagnosis in their lifetime. This illness may be managed with intravenous (IV) chemotherapy, which requires specialized training and expertise for staff nurses. A microsystem assessment was completed on an inpatient medical, surgical, oncology unit at a northwest Montana hospital. Nurses in the microsystem expressed the inability to maintain competency standards and expertise with infrequent IV chemotherapy administration. A review of the literature was conducted to identify best practices in competence and confidence in nursing IV chemotherapy administration. A root cause analysis was conducted to discover factors contributing to low levels of competency and confidence in IV chemotherapy administration. Comparisons were made between the standards, guidelines, and policies, and themes were analyzed. Solutions were identified and prioritized. A protocol utilizing just-in-time training was developed along with an implementation plan and an evaluation plan. Just-in-time training utilizes checklists, demonstration, peer review feedback, and self-assessment as a measure of competence and confidence assessment. Feedback about the protocol, implementation plan, and evaluation plan was solicited from a key administrator and stakeholders. The Clinical Nurse Leader (CNL) is well suited to implement this protocol due to their ability to integrate care with an interdisciplinary team to identify, develop, implement, and evaluate care practices.Item Environmental health clinical competencies for family nurse practitioners(Montana State University - Bozeman, College of Nursing, 2001) Stager, Valli Evenstar; Chairperson, Graduate Committee: Patricia G. ButterfieldItem Acute care nurses' self-reported competence in palliative care(Montana State University - Bozeman, College of Nursing, 2016) Hayter, Chelsi Rae; Chairperson, Graduate Committee: M. Jean Shreffler-GrantPalliative care is a health care specialty that can provide patients and their families relief from burdensome symptoms and improve quality of life when faced with a life-limiting illness. Researchers have documented that nurses' knowledge and competence in palliative care results in more timely referrals for palliative care, which can promote comfort and increase the quality of care patients receive with life-limiting illnesses. Despite the known benefits of nurses' competence in providing palliative care, there is a need for more studies to further quantify nurses' self-competence in palliative care in the United States. The purpose of this study was to examine acute care nurses' self-reported competence in providing palliative care services. A non-experimental descriptive research design was utilized in this study to better understand acute care nurses' self-reported competence in palliative care services in one urban hospital in South Central Montana. All registered acute care nurses were eligible and invited to participate in an anonymous online survey. Nurse participants completed the online survey containing standard demographic questions and an instrument that examined their self-competence in 8 domains of palliative care. Mean scores of the instrument showed that nurses in this particular acute care hospital felt they are more than moderately capable in providing palliative care services to patients and their families. Despite this finding, some nurses indicated that they did not feel at all capable in performing some domains of palliative care. Implications for nursing include further education for acute care nurses' to increase self-competence in providing palliative care services to ensure quality care is delivered to patients and their families.