Digital Commons Network^™

Enhancing Nursing Perspectives And Support Of Stroke Patient Satisfaction Survey, Vanessa Li

Master's Projects and Capstones

Problem A stroke diagnosis is associated with high mortality and increased morbidity that affect the quality of life of both patients and caregivers. Higher satisfaction with stroke care could alleviate both patient and caregiver stress, thereby positively affecting their quality of life. Regulatory guidelines underscore the need for a stroke-specific patient satisfaction survey (SPSS). Context Hospital X houses one of the few comprehensive stroke centers (CSC) in the San Francisco Bay Area, serving patients with various stroke etiologies and complexities. Its Neuro Observation Unit (NOU) currently does not administer a SPSS. Intervention An educational presentation using literature evidence in support …

Increasing Adherence To A Nurse-Driven Removal Protocol To Reduce Indwelling Urinary Catheter Days, Hannah K. Brosnan

Master's Projects and Capstones

Problem

Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs.

Context

The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area.

Interventions

Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Enhancing Nurse Awareness Of A Stroke Patient Satisfaction Survey And Their Significance In Practice, Amanda Dao

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. InterventionTo address this gap in care, an educational presentation using literature evidence in support …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Reducing Barriers To Timely Indwelling Urinary Catheter Removal, Huyen T. Nguyen

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Game-Based Learning: A Handbook For Chilean Elementary Efl Educators, Bernardita Maria Ramirez Larrain

Master's Projects and Capstones

English language learning in Chilean elementary schools presents a significant challenge. Despite mandatory English education since fifth grade, many students struggle to achieve high proficiency, highlighting the need for transformative interventions. The presented curricular design addresses this problem by integrating game-based activities to enhance listening and speaking skills in Chilean elementary schools. Titled "Level Up Language Learning: Transforming Chilean Elementary EFL Instruction with Game-Based Learning," the handbook offers customizable games aligned with the Chilean proposed curriculum, catering to individual learner needs and diverse learning styles. This approach aims to bridge the gap between theory and practice, empowering educators and improving …

“We Have To Fight For Change”: Intersecting And Ongoing Crises Amongst Farmworker Families Along The Monterey Bay Central Coast, Mikayla S. Feliciano

Master's Projects and Capstones

This study examines the crises farmworkers are experiencing along the Monterey Bay Central Coast. It analyzes and reviews housing insecurity, deficit to basic needs, and the environmental impact of storms and pesticides exposure. In January of 2023, the central coast experienced an immense amount of rain, atmospheric rivers, and a levee break that the Salinas and Pajaro Valley communities' infrastructure could not handle. These storms caused even more financial and economic peril for the already struggling farmworkers and their children. This research aims to highlight the importance of farmworking families in the community and what social barriers they face. Information …

An Examination Of Contemporary Fundraising Trends And Support For A Sustainable Shift To Full-Cost Funding, Alison Scott

Master's Projects and Capstones

For decades, nonprofit organizations have faced immense challenges securing adequate funding that will not only run their programs, but cover all operational and overhead costs. Traditional funding models often restrict funds to specific projects or services, leaving nonprofits with financial instability, and potentially hindering their ability to fully deliver on their missions. Recently, there has been a shift in the philanthropic landscape that challenges these more restrictive fundraising models. As this conversation has grown, the concept of “Full Cost Funding” has gained traction, which calls for a more comprehensive funding approach that covers the full costs of running an organization, …

Improvement Of Medication Compliance By Adding A Weekly Medication Planner, Jeramie Muya Laurio

Master's Projects and Capstones

Abstract

This quality improvement project aimed to use a weekly medication planner to enhance medication adherence in a home health setting to help improve patient healthcare outcomes. A weekly medication planner helps patients manage their medications. Systematic reviews and meta-analyses show medication planners increase adherence. Morisky 4-item survey assessed patient opinions pre and post intervention.

Problem:. Medication adherence is an important part of home health patient care that affects health outcomes and safety. The problem is patients received an abundance of discharge medications and do not have enough time with a Registered Nurse discharge planner to go over their …

Toxic Fashion: Evaluation Of Chemicals In Clothing And Recommendations For The Amended Tsca, Gregory Zajac

Master's Projects and Capstones

The fashion industry is one of the largest polluting industries in the world and its rising environmental impact is partly due to the dominance of fast fashion business models. Recently researchers and advocates have found that large amounts of chemicals are used by textile manufacturers to produce clothing, some proven to be toxic in other applications. The risk of exposure to these classes of chemicals is a growing concern. With the risk management model, a qualitative examination was conducted on existing policies in the United States that regulate chemicals used by the industry. Despite some policy changes regarding chemical exposure …

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Data Quality: Integral To Cauti Surveillance And Improvement In Non-Critical Care Units, Mary Grace Daria

Master's Projects and Capstones

Background: Urinary tract infections (UTIs) are the most common type of healthcare-acquired infection (HAI), with 75% approximately associated with urinary catheter use. The key to preventing UTIs is to avoid the use of indwelling urinary catheters (IUCs). This study explores denominator data extract logic modifications to increase IUC data capture and accuracy. It is set in a 249-bed acute care, teaching hospital in the Diablo Service Area in Northern California.

Problem: The electronic system used to extract the CAUTI denominator data is inconsistently capturing the IUC device days from the electronic medical record (EMR). This has regulatory reporting ramifications and …

Give Love With Lovenox: Reducing Pulmonary Embolism Risk In The Postpartum Unit Through Lovenox Prophylaxis Nursing Education, Guadalupe Sierra Arroyo

Master's Projects and Capstones

Problem: This quality improvement project aims to improve nurse education on Lovenox prophylaxis to reduce pulmonary embolism occurrence post-discharge amongst high-risk postpartum women who underwent vaginal/cesarean deliveries and to increase patient medication compliance in the Family Baby Unit (FBU) at Hospital X.

Context: The quality improvement project occurred on the Family Baby Unit (FBU) at Hospital X. This 25-bed unit has recently had an increased rate of pulmonary embolisms post-discharge due to poor Lovenox medication adherence amongst patients and lack of education among nurses.

Intervention: Data was collected in the microsystem. This data was collected through questionnaires to assess nurses' …

Dodge The Fall: A Newborn Fall Prevention Initiative, Linda Nguyen

Master's Projects and Capstones

Problem: In the past year, three separate newborn fall incidents occurred on the postpartum unit at Hospital X. This project aims to increase nurse-to-patient education on newborn fall prevention, thereby reducing the number of newborn falls on the unit.

Context: This quality improvement project was implemented on the postpartum unit at a hospital located in San Francisco County. At this hospital, the postpartum unit consists of 10 beds in postpartum and 11 beds in antepartum. Currently, there is no standardized method used by registered nurses to prevent newborn falls.

Intervention: The requirement for mothers to sign the Pledge Form for …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Andrea Garcia

Master's Projects and Capstones

Problem: Compliance and timeliness with the sepsis bundle protocol are continuously increasing, resulting in poor patient outcomes. This quality improvement project aims to increase sepsis bundle compliance and earlier sepsis management in the Emergency Department (ED) to reduce sepsis mortality rates and length of hospital stay.

Context: Hospital A’s emergency department is a level II adult trauma center located in the Greater Bay Area that treats a range of patients presenting with life-threatening diagnoses such as sepsis, traumatic injuries, and electrolyte imbalances.

Interventions: The sepsis committee team was provided recommendations to implement post-data analysis. Interventions recommended included standardizing and increasing …

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Monica P. Rabago Moreno

Master's Projects and Capstones

Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths as well as hospital length of stays.

Context: A microsystem assessment, in the emergency department (ED) unit, was performed in Hospital A located in the Greater San Francisco Bay area by Clinical Nurse Leader (CNL) students. This ED unit cares for a variety of critical care patients ranging from urgent to life-threatening conditions.

Intervention: An intervention was not implemented in the ED unit due to time constraints and limitations; however, CNL students provided recommendations …

Improving Triage Accuracy In The Emergency Department, Joselyn Silverman

Master's Projects and Capstones

Problem: High rates of patients being mis-triaged was occurring at Hospital X leading to poor patient outcomes and incorrect staffing levels.

Context: This quality improvement project took place at Hospital X’s emergency department. A stakeholder analysis and a microsystem assessment along with a staff survey was created in order to determine areas of improvement and staff responsiveness.

Interventions: Eight educational seminars were conducted along with Hospital X leadership and students created supplemental materials for the staff to use on a daily basis.

Measures: Two data pulls were conducted over the course of the quality improvement project; one prior to the …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Camila Sanchez

Master's Projects and Capstones

Problem: The purpose of this quality improvement (QI) project revolves around increasing overall staff nurse compliance, enhancing their sepsis education resources, and usage of their provided education and bundle. This goal was created to produce more positive patient outcomes at Hospital X, along with its improved management of sepsis. Hospital X is an acute care facility located in the San Francisco Bay Area.

Context: The unit that was studied during this QI project was the emergency department of Hospital X. This unit provides level I trauma services in addition to other types of emergency care and contains 44 beds. Not …

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Resocialization Of An Inpatient Handoff Sepsis Bundle Checklist On A Medical-Surgical Unit, Sophia Kawada

Master's Projects and Capstones

Problem: In September 2023, it was found that only 25% of nurses were familiar with an inpatient handoff sepsis bundle checklist (IHSBC) on a Medical-Surgical Unit in Hospital A. This evidence-based project aimed to improve resocialization of the IHSBC such that compliance to the bundle continues to be maintained well above the benchmark of 75%. Context: Clinical Nurse Leader (CNL) students at the University of San Francisco conducted a microsystem assessment of the Medical-Surgical Unit at Hospital A. This hospital aimed to maintain high rates of compliance with the IHSBC. Interventions: Resocialization of the IHSBC was completed in October, and …

Assessing Wastewater Treatment In Yopal Colombia Using Gis, Leydi P. Puerto Bohorquez

Master's Projects and Capstones

The amount of wastewater has surged alongside population growth, urbanization, and economic development, which can influence the wastewater treatment process, especially in the treatment capacity, particularly in developing countries. In Colombia, the low coverage of Wastewater Treatment Plants (WWTP) leads to a complex environmental issue. This has threatened water quality and aquatic ecosystems of waterbodies that receive this type of water by increasing disease prevalence and creating hypoxic conditions. To determine how a WWTP could impact water quality, it was necessary to understand the treatment process and the physicochemical parameters being monitored. The focus is to answer the central research …

Improving Triage Accuracy In The Emergency Department, Vince Harrington

Master's Projects and Capstones

Problem: Mistriage was occurring at higher than acceptable rates. In turn, this caused poor staffing levels and patient outcomes. This project seeks to improve triage accuracy according to the Emergency Nurses Association’s (ENA) Emergency Severity Index (ESI) algorithm.

Context: The Emergency Department in a prominent bay area hospital that was experiencing high rates of mistriage.

Interventions: The staff nurses were required to attend a retraining on the Emergency Nurses Association (ENA) Emergency Severity Index (ESI) algorithm. Following the retraining, a follow up online exam with sample patients must be passed at 100%. Furthermore, badge buddies containing the ESI algorithm will …

Solar-Powered Microgrids In Northern California: An Opportunity For Resilience, Marina Riddle

Master's Projects and Capstones

Planned and unplanned power outages have been increasing in frequency and duration, negatively impacting all public sectors, and threatening public safety. These outages are deadly to those who rely on medical devices. As climate change-fueled extreme weather events (wildfires, earthquakes, storms, etc.) also increase in frequency, our electrical grid must be prepared to bounce back. Microgrids provide necessary redundancy and reliability. Through a novel GIS suitability analysis, based on solar radiation, land use type, local energy demand, distance to transmission lines, distance to roads, and slope, optimal locations for solar-powered microgrids throughout Northern California were determined. The counties of Fresno, …

Addressing Linguistic Isolation Through Community Based Esl And Emergency Preparedness, Lisa Guay

Master's Projects and Capstones

Linguistic isolation acts as a barrier to the well-being and social integration of Limited English Proficient (LEP) adults. Community-based English as a Second Language (ESL) classes, designed with learner-centric curricula, may help LEPs gain access to social and navigational capital in the form of English proficiency, confidence and social integration. Community-based ESL programs provide adult English Language Learners (ELLs) with a path to English proficiency and social integration, but curricula should be geared toward ELLs’ needs. There is a need for ESL curricula focused on emergency and disaster preparedness, curricula which may contribute positively to adult ELLs’ speaking skills and …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Emily Beck

Master's Projects and Capstones

Problem: With a recent influx of sepsis cases, hospital stakeholders identified gaps between sepsis protocol and practice. This quality improvement project aimed to increase sepsis bundle compliance and utilization among registered nursing staff in the emergency department to improve sepsis management and patient outcomes ultimately.

Context: The microsystem assessed is a 44-bed emergency department at Hospital A, a level II adult trauma center within the greater San Francisco Bay Area. The current registered nurse roster within this department, excluding four on leave, is 115 individuals and represents the target population for this change project.

Interventions: Interventions were not implemented due …

Resocializing Medical-Surgical Nurses On The Inpatient Handoff Sepsis Bundle Checklist, Maram Abuzahriyeh

Master's Projects and Capstones

Abstract

Problem: In September 2023, Hospital X identified a lack of utilization of the Inpatient Handoff Sepsis Bundle Checklist (IHSBC) in the medical-surgical unit with only 25% of nurses being familiar with it. This project aimed to improve the use of the IHSBC to maintain compliance of the sepsis bundle above the benchmark of 75%.

Context: A microsystem assessment was completed in a medical-surgical unit by CNL students at Hospital X. The students collaborated with Hospital X and identified the need to improve the socialization of the IHSBC in the medical-surgical unit.

Interventions: The intervention included resocializing the IHSBC on …

Improving Preeclampsia Education And Assessment Frequency Among Nurses In The Postpartum Unit, Jazmin Garduno

Master's Projects and Capstones

Problem: This study aims to improve maternal-child health education and assessment among the multidisciplinary staff in a postpartum unit. Pre-assessment questionnaires and data will be collected over one month, and will guide the changes that need to be implemented.

Context: Clinical Nurse Leader students conducted a microsystem assessment in the Postpartum Unit of a hospital in the Bay Area, conducive to improving preeclampsia education and the frequency of assessment for patients with preeclampsia without severe features.

Intervention: We implemented supplemental Preeclampsia education for the nurses on the Maternal-Child Postpartum Unit. In addition to the education, we used pre- and post- …

Improving Triage Accuracy In The Emergency Department, Maia E. Baglin

Master's Projects and Capstones

A Northern California emergency department (ED) faced increased triage inaccuracy. An analysis of 400 random ED visits from January to April 2023 discovered a 23% mistriage rate, with under- and over-triage rates at 16.25% and 6.75%, respectively. Mistriage creates an imbalance in unit acuity, leading to inappropriate staffing levels. Potential breaks in the triage process, include inaccurate triaging by the screener or triage nurses, as well as delays in the providers inputting initial orders, leaving patients waiting without appropriate care orders. An educational training focusing on the updated Emergency Nurses Association Emergency Severity Index (ESI) algorithm version 5 was mandated. …