Scholarship & Research
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Item Fostering nursing student resilience(Montana State University - Bozeman, College of Nursing, 2023) Marquardt, Gina Nicole; Chairperson, Graduate Committee: Sandra KuntzThe purpose of this quality improvement project was to identify components of resiliency and create a solution to develop senior-level nursing student resilience. Assessment of Location X nursing school highlighted the need to identify components, tools, and measures of seniorlevel nursing student resiliency. The American Association of Colleges of Nursing (AACN) cites the importance of the development of nursing student wellbeing and resilience in the 2021 Essentials Domain 10 titled Personal, Professional and Leadership Development. The AACN further advocated for resiliency development during a 2020 Call to Action of United States nursing programs to promote and create a culture of wellness and resiliency among nursing students. The "Thriving in Nursing School" workshop was developed as a solution to equip students with the necessary tools, practices, and skills to develop resilience. The workshop consists of five evidence-based components: relaxation strategies, coping techniques, communication skills for problem solving, community and university resources available, and faculty mentorship. Formal focus and education about resilience has the potential to increase resiliency skills and was measured using the Connor-Davidson Resilience Scale (CD-RISC-10). It was hypothesized that resiliency-development quality improvement implementation will contribute to further development of nursing students' resiliency skills to meet the demands of the nursing profession. Through a focus on student wellbeing and resiliency, this project has the potential to increase student success and improve skills to thrive in a rigorous education program. This quality improvement project was implemented to gather data and analyze workshop efficacy.Item Improving preeclampsia outcomes: a high-fidelity simulation for undergraduate nursing students(Montana State University - Bozeman, College of Nursing, 2023) Tonkin, Katlin Rose; Chairperson, Graduate Committee: Sandra KuntzPreeclampsia, a hypertensive disorder of pregnancy, commonly affects women and fetuses/neonates, significantly increasing the risk for morbidity and mortality. Underutilization of evidence-based practice standards intensifies complications. Montana has limited resources to care for high-risk pregnancies, especially in rural areas of the state. However, patient outcomes can be improved with standardized care and collaboration. Therefore, it is imperative that all hospitals in the state join forces to improve evidence-based practices for obstetric patients. This quality improvement (QI) teaching project aimed to inform future advocates, nursing students, of the evidence-based guidelines and collaborative tools available in Montana to care for maternal-fetal patients with preeclampsia. The QI project adapted a preeclampsia-focused high-fidelity simulation (HFS) scenario in collaboration with a school of nursing in Montana. The purpose of the HFS scenario was to aid undergraduate nursing students in developing knowledge, psychomotor (technical), and affective (values) skills to manage intrapartum care for a patient with preeclampsia. Senior-level nursing students participated in the simulation process including preparation, pre-briefing, scenario, and debriefing. The students were evaluated on meeting the safe-care measures for an HFS patient with preeclampsia while monitoring for fetal intolerance to labor. Qualitative data were collected based on Kirkpatrick's Four Levels of Training Evaluation tool. The data revealed the students' reactions to the simulation process, plans to apply what was learned, and how the teaching modality helped achieve the learning objectives. The QI teaching project subjectively and objectively improved the students' knowledge, psychomotor skills, and values in caring for a maternal-fetal patient with preeclampsia. Students were also provided with reference materials to use as registered nurses in the event of caring for patients who develop preeclampsia in healthcare facilities throughout Montana.Item The evidence-based benefits of a dedicated simulation lab coordinator for a rural nursing program(Montana State University - Bozeman, College of Nursing, 2023) Garcia (Valdez), Jamie Michelle; Chairperson, Graduate Committee: Sandra KuntzProblem/Purpose: The pandemic created extreme challenges for the healthcare workforce and impacted the availability of clinical placement sites for students. Student nurses accustomed to direct patient care experiences at a hospital or clinic site were barred from these settings and redirected to learn skills exclusively in simulation labs and online environments. Initially unprepared to educate and account for all required clinical hours for multiple cohorts of students, faculty were forced to take stock of their resources, keep students safe, and prepare for the unpredictable and lengthy COVID-19 event. This project aimed to establish the evidence-based benefits of a dedicated sim lab coordinator/educator and describe the role and expectations of a dedicated sim lab coordinator for a rural-based nursing program. Procedure: A microsystem assessment of the Community College Nursing Program (CCNP) and a review of pertinent literature identified the value of a dynamic, well-managed, and expertly staffed clinical simulation lab as a possible solution. Results: This project addressed the need for simulation preparation training and implementation among faculty by utilizing the education outlined in the simulation handbook. This education provides a foundation for simulation implementation for faculty. In addition, the implementation of simulation with the National League for Nursing (NLN) simulation template is utilized by all faculty to provide consistent simulation methods for students at the CCNP. By using a standardized template and having faculty educated in the development and implementation of simulation, the nursing students will gain clarity regarding what to expect and how to prepare for the simulation. Ongoing assessments of the simulation program are conducted using faculty and student evaluations, thus allowing the CCNP to facilitate changes and improvements as deemed necessary. Conclusions: Expected outcomes include consistency in simulation education and implementation. A well-prepared simulation coordinator manages the lab, educates faculty and students, and creates an environment where academic and clinical learning confidence is nurtured. A coordinator guided by evidence-based best practices provides controlled, managed, and consistent clinical learning experiences for students and fosters readiness for practice as registered nurses.Item Program evaluation of a nurse-residency program(Montana State University - Bozeman, College of Nursing, 2018) Hastings, Deanna Dawn; Chairperson, Graduate Committee: Susan LuparellWhile the number of graduates from schools of nursing is increasing, there is a national trend that shows they are leaving the profession at alarming rates. This problem could potentially contribute to decreased patient outcomes and increased costs to facilities as they are continuously recruiting and training new nurses. Furthermore, research suggests that the transition to practice is a stressful period, and new graduates who receive support and guidance through nurse-residency programs tend to have higher satisfaction rates, deliver better patient care, and have lower turnover rates. Therefore, the purpose of this project was to evaluate the nurse-residency program in a local, level-two trauma center in rural central Montana that can serve up to 34,000 patients a year. A convenience sample of 13 registered nurses who completed the nurse-residency program or who were currently enrolled in the program and graduated within a year of beginning the residency program were surveyed using the Casey-Fink Graduate Nurse Experience Survey (New Graduate Survey). Also, a convenience sample of 41 staff members of the local emergency department, which included registered nursing staff who didn't participate in the nurse-residency program, operations specialists, physicians, and paramedics, were given an adapted Casey-Fink Graduate Nurse Experience Survey to evaluate their perception of the new graduates' readiness to practice. Project results indicate that new graduates who participated in the program tend to be more confident, the nurse-residency program is meeting the needs of the new graduates, and retention rates of the new graduates has increased since the inception of the program. Facilities and management can incorporate these findings into developing and maintaining nurse-residency programs in order to improve patient outcomes and new-graduate satisfaction and retention rates.Item Best practice components for nursing new graduate residency programs: an integrative review of the literature(Montana State University - Bozeman, College of Nursing, 2018) Wacker Happel, Amanda May; Chairperson, Graduate Committee: Susan LuparellThe need for an effective transition to practice program, such as nurse residency programs (NRPs), has been documented for over 80 years (Townsend, 1931 as cited in Spector et al., 2015). Anderson, Hair, and Todero (2012) stress how new graduate registered nurses (RNs) face high patient acuity and complex situations, nursing shortages, high turnover, burnout, excessive overtime demands, reduced new RN orientations, and heavy use of agency/traveling nurses to fill gaps (Joint Commission on Accreditation of Healthcare Organization, 2002; Jones & Gates, 2007 as cited by Anderson et al., 2012). Not only does this turnover negatively affect morale and job satisfaction, it's also very expensive with the estimated cost to replace these nurses ranging from $49,000 to $92,000 per nurse (Kram & Wilson, 2016). NRPs have been recommended to combat turnover and provide support during the transition into professional practice (Benner, Sutphen, Leonard, & Day, 2010; IOM 2011; The Joint Commission, 2002 as cited by Spector et al., 2015; Cochran, 2017). However, despite these recommendations, there continues to be a lack of comprehensive, evidence-based NRPs offered by employers (Spector, et al., 2015). The purpose of this integrative review of literature was to explore the best practice components of NRPs. This integrative review was performed by mining relevant literature from predetermined databases and all reference lists of the selected literature. A total of 13 publications met the predetermined inclusion criteria. After reviewing how different factors affect the transition of new graduates, it was concluded that an NRP that was based on a national model or developed internally in congruence with national models would provide best chance for a successful transition for new graduates. This model would include an adaptive, evidence-based curriculum that is customized to the patient populations and unit specifics, a program length of at least 12 months, and training and careful selection of preceptors and mentors. Additionally, it is recommended to that NRP staff have an awareness of differences in new graduate ADN and BSN preparedness and skill sets and adapt the NRP as needed to accommodate both cohorts.Item Cardiac services nurse residency(Montana State University - Bozeman, College of Nursing, 2016) Kennedy-Collins, Kamera Machel; Chairperson, Graduate Committee: Alice RunningThis professional project was born out of a specific need within the cardiac services department at Kalispell Regional Medical Center. In order to describe, and best determine the exact needs of the cardiac services department, a clinical microsystem assessment was completed for the department focusing on the 'five P's' of the assessment process; Purpose, Patients, Processes, Professionals, Patterns. Information obtained from the microsystem assessment highlighted the need for additional staffing. Factors such as retirement, department growth, and turnover have left the department chronically short staffed. Chronic short staffing has resulted in long work hours and routine overtime. Attempts at hiring experienced nurses have not been successful enough to meet the department demand. Evidence would support nursing residency programs as one solution to staffing shortages. Therefore, a literature review was completed regarding the design and success of nurse residency programs. Given the issues of persistent short staffing, and the subsequent increased work load for staff, a proposal for the development of a unit specific nurse residency program was made. This professional project proposes a 16 week unit specific nurse residency program designed to be integrated into the existing organizational program. The programs includes components of preceptorship, mentoring, and didactics. The goal of the proposed nurse residency program would be to provide education, professional support, and mentoring to new graduate nurses interested in cardiac care in order to satisfy long term staffing needs within the department.Item Sex knowledge of freshmen and senior nursing students(Montana State University - Bozeman, College of Professional Schools, 1970) Wheeler, Lois Mary KocherItem A survey of career motivational factors which influence nursing students in Montana(Montana State University - Bozeman, College of Professional Schools, 1972) Sokoloski, James LeRoy; Chairperson, Graduate Committee: Virginia Ellen FeltonItem Institutional support of on-campus and off-campus nursing students(Montana State University - Bozeman, College of Nursing, 1995) Wankel, Kathleen KarenItem Learning strategies utilized by Montana nursing students(Montana State University - Bozeman, College of Education, Health & Human Development, 1997) Lockwood, Suzanne Frank