Scholarship & Research
Permanent URI for this communityhttps://scholarworks.montana.edu/handle/1/1
Browse
7 results
Search Results
Item Implementing the American Heart Association 2020 guidelines for cardiac arrest in an urgent care setting(Montana State University - Bozeman, College of Nursing, 2022) Freeborn, Heidi Jo; Chairperson, Graduate Committee: Christina BorstThis quality improvement project seeks to match a clinic's preparedness for cardiac resuscitation with current American Heart Association standards. Through a review of current literature, this project describes several key actions in the management of cardiac arrest, which include having an emergency preparedness plan, staff competency and trainings, the provision of rapid defibrillation, the administration of resuscitation medications, and the importance of data registry for continuous improvement to processes. Recommendations for the clinic have been developed based on the literature review and an analysis of the setting. Recommendations will be shared with the clinic's leadership and advise the development of detailed Standard Operating Procedures which translate the American Heart Association guidelines into this practice setting. Recommended actions include staff BLS and ACLS trainings, continuous short interval trainings, and the acquisition of useful, non-expired equipment. Data collection consists of an auditing of staff certifications and available resuscitation equipment and medications, as well as protocols in place. Results: 100% of medical staff were BLS trained, and 100% of providers were ACLS trained. 100% of resuscitation medications and crash cart equipment was updated, with exception of the defibrillator. 0% of SOPs were adopted into practice. Conclusion: The declination of SOPs is predicted to greatly affect the sustainability of outcomes related to this project. Although there is value in the AHA BLS and ACLS trainings, without continued short interval trainings these skills are likely to decay in a matter of months. Further, there is no policy to direct staff to be retrained again in two years when certifications expire. Although an updated checklist for equipment was provided to the clinic manager, no policy is in place for routinely outdating medications and replacing them or ensuring that equipment is in a functional state. Use of motivational interviewing with key stakeholders may encourage behavioral changes to improve health outcomes, and thus further the outreach of a quality improvement endeavor.Item Development and implementation of a policy to reduce urinary catheter days(Montana State University - Bozeman, College of Nursing, 2022) Trystianson, Bowen Austin Stephen; Chairperson, Graduate Committee: Yoshiko Yamashita ColcloughUrinary catheters are useful medical tools for draining urine. These devices are often used for patients whose medical conditions make urination difficult or may limit their mobility, making toileting challenging. The use of urinary catheters is associated with risks such as trauma or infection. Therefore, medical research aims to limit the usage of urinary catheters only for patients who need intervention and also to reduce the duration of catheter usage. A hospital in central Montana had noted an increase in their overall urinary catheter use. To address this increase a project was started with the goal of revising an existing catheter policy and adding in the authorization for registered nurses to remove catheters when appropriate. To help guide the project, a literature review was undertaken. Research was sought out in the areas of urinary catheter guidelines, utilization of policies, implementation of policies, and sustaining change. Once the literature review was completed, an existing policy was checked against existing guidelines and a point was added to this policy to permit registered nurses to remove urinary catheters when deemed appropriate. Further, this policy was adopted by the facility. Training presentations were then developed and recorded to familiarize nurses with the new policy and the new nurse-driven urinary catheter removal process. An algorithm was developed to aid nurses' decision-making process for the removal of catheters. As there was considerable delay in the project implementation due to various factors, the end goal of achieving a reduction in urinary catheter days was not determined. Despite not achieving the ultimate goal within the specified time, this project is still of value to future quality improvement initiatives. The project identifies a number of potential pitfalls and recommends ways to overcome these obstacles. It also highlights the value of persevering the implementation process despite the associated difficulties and delays.Item Mandatory influenza vaccination of staff in long term care and assisted living facilities(Montana State University - Bozeman, College of Nursing, 2020) Kearns, Heidi King; Chairperson, Graduate Committee: Laura LarssonInfluenza vaccination rates of healthcare personnel in long-term care facilities continue to lag behind rates in other healthcare facilities. Long-term care facility residents are at particularly high risk of influenza-related complications and death, and the low vaccination rates of workers in this setting puts residents at even greater risk. Mandatory influenza vaccination policies have been shown to be the most effective means of increasing healthcare personnel influenza vaccination rates. Despite this, long-term care facility staff are the least likely to report working in an environment that requires them to receive influenza vaccination on an annual basis. The purpose of this project was to explore the current policies in place at long-term care and assisted living facilities within Flathead County, Montana, with the hope of continuing to bring awareness to effective means of increasing influenza vaccination rates. This project's secondary goals were to continue cultivating a relationship between the local health department and the facilities and work toward creating sustainability in the annual collection of this data. The results of the surveys conducted showed that facilities with the strongest policy components achieved the highest vaccination rates. Continued support is necessary to assist facilities in strengthening their policies in order to achieve the desired healthcare personnel influenza vaccination rates.Item An assessment of nurse confidence, perception of individual impact, and view of professional responsibility to influence policy(Montana State University - Bozeman, College of Nursing, 2019) Chovanak, Lori Anne; Chairperson, Graduate Committee: Laura LarssonProfessional governing organizations call all registered nurses to engage in political advocacy to improve the delivery of care as well as to promote positive change in the health care system. Little is known about the confidence of nurses towards engaging this mandate as well as their attitudes regarding the impact on patient care. This project outlined the impact of educational content in a nurse's confidence level to engage political advocacy, perception of ability to impact health policy, and perception on professional responsibility to engage political advocacy. It includes a literature review on nurse views regarding their ability to address practice and health care issues, explore what inspires nurses to engage in professional advocacy, research nurse' attitudes regarding how political action affects them professionally, and a review of existing research regarding the impact of education on an individual nurse's confidence. Two state nursing associations developed continuing education activities which they provide regularly to nurses with content aimed specifically at increasing participation in political advocacy. The content of these events included information regarding historical political efforts that have advanced the nursing profession, updates of current issues, instruction on legislative process engagement and strategies for success, and information on resources and support that are available for engagement in political advocacy. Participants at these state events were surveyed before and after the educational event to learn if nurses' knowledge, confidence, perceptions, and disposition towards engaging political advocacy increased with receipt of educational content on the topic. The dependent samples t-test demonstrated significant difference (t(47) = -7.99, p < .001 ) between the scores before (M = 80.2, sd = 14.67) and after the intervention (M = 89.9, sd = 14.82) supporting the hypothesis that participant scores would positively change on engaging political advocacy.Item The role of the doctorate prepared nurse practitioner in medical surge policy development and revision(Montana State University - Bozeman, College of Nursing, 2020) Dunshee, Chelsea Jean; Chairperson, Graduate Committee: Casey ColeDisasters and mass casualty events pose significant challenges to healthcare facilities. It is imperative as an organization to have a medical surge policy in place should a sudden influx in patients occur. Proper policy planning is required to ensure the policy in place works sufficiently to meet the healthcare organization's needs. The purpose of this project was to define the role of the Doctorate prepared Nurse Practitioner (DNP) in the medical surge policy development and revision process. This was accomplished by leading a quality and performance improvement project workgroup after performing a review of current literature and a Root Cause Analysis of a recent mass casualty patient surge incident at the organization. The results show that the role of the DNP as it relates to medical surge policy revision are to: (a) analyze policy processes and lead development and implementation of policies, (b) influence policy making process through participation on committees and educating policymakers on nursing processes, policy, and patient outcomes, and (c) act as a change agent and stakeholder. All recommendations made to improve the medical surge policy by the DNP student were accepted and utilized in the acting organizational EOP.Item The views of Montana State legislators on nurses, nursing, and health care(Montana State University - Bozeman, College of Nursing, 1985) Adkins, Linda KayItem Public health policy for testing of radon in Montana schools(Montana State University - Bozeman, College of Nursing, 2014) Champer, Veronica Jean; Chairperson, Graduate Committee: Laura LarssonRadon as a human carcinogen has been clearly documented (NTP, 2011; NCI, 2011; ATSDR, 2013; EPA, 2013). Radon is the second leading cause of lung cancer after smoking (NCI, 2011) and is found in every state in the U.S. (DEQ, 2013). As Hill, Butterfield, & Larsson (2006) have stated, children are a vulnerable population with consideration to radon exposure due to biophysical characteristics and duration and levels of exposure over time. As a nation responsible for its vulnerable youth, further investigation is necessary to determine that health policies exist to protect school children from this known carcinogen. This study inventoried the public health policies that exist at a federal, state, and local level and then compared and contrasted those policies for best practices. Results of the policy inventory were that nine states had state laws mandating radon testing in the schools. The Environmental Protection Agency zone risk designation demonstrated that 36 states had greater than 50% of counties in zones 1 and 2 (moderate to high risk for radon exposure) but only eight of those states had health policies for testing radon in schools. An analysis of the policies was conducted to identify best practices and a recommendation for a public health policy governing the testing of radon in Montana schools was developed. Research implications are that radon is a public health threat for which the regulatory environment to protect vulnerable children is lacking. The need for well written policy is evident and as states consider public health initiatives, radon testing in schools should be included in that discussion.