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A Checklist To Design And Evaluate Systems-Informed Wellbeing Initiatives: A Mixed Methods Validation Study, Jaclyn Gaffaney

CGU Theses & Dissertations

The COVID-19 pandemic shed light on global mental health struggles, underscoring the need to prioritize wellbeing. Many disciplines currently research aspects of wellbeing, ranging from psychology, behavioral economics, public health, and public policy, to prevention, evaluation, and education. However, researchers have rarely integrated insights across disciplines or extracted meaningful nuance from real-world applications. Many wellbeing interventions can also fall short due to poor design and execution as well as inadequate application of systems thinking and culturally responsive lenses. This dissertation addressed these gaps by creating a structured framework for crafting and assessing systems-informed wellbeing initiatives in the form of the …

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 …

Nurses’ Compliance With Handover Practices In Adult Medical Surgical Units At A Tertiary Care Hospital In Karachi, Pakistan, Amber Qasim Ali

Theses & Dissertations

Background: The exchange of the shift changeover report of patient, from nurse to nurse at the patient's bedside is known as "bedside handover." Although this method is becoming more and more popular in the nursing sector, not many people genuinely practice it.
Purpose: To determine the different factors impacting nurses' compliance and to evaluate the compliance rate of nurses to comply with bedside handover guidelines.
Methods: A cross-sectional observational study was conducted in the medical surgical ward at the Aga Khan University Hospital, Karachi. During the study, the structured bedside handover technique known as "kardex," which adheres to SBAR (Situation, …

Implementing A Bedside Rounding Tool To Reduce Inpatient Falls, Steven W. Garcia

Master's Projects and Capstones

Problem: Each year, thousands of patients sustain falls while hospitalized, resulting in an increase in serious injuries or death. In a Neuroscience Step Down Unit (NSDU), fall rates in 2022 were higher than the NDNQI benchmark. Despite a thorough fall prevention policy, nurses inconsistently implemented preventative interventions, resulting in increased falls.

Context: The NSDU is a 15-bed inpatient unit providing intermediate-level care for patients with neurological and neurosurgical diagnoses. The unit is part of a 459-bed academic medical center and safety net hospital providing tertiary and quaternary care in southern California.

Interventions: A bedside safety rounds checklist for charge nurses …

An Emergency Department Resource Nurse Checklist, Aaron Tucker

Doctor of Nursing Practice Scholarly Project

Introduction: Like many hospitals across the country, a Southwest Missouri hospital emergency department (ED) is frequently crowded with patients. The resource nurse role is one method EDs use to help manage surges in patient care. A resource nurse is a registered nurse whose dedicated role it to help other nurses in the unit. Unfortunately, there are no specific written expectations to guide the resource nurse. The nurse often waits to be needed and productivity and dependability are highly variable. Purpose: Implementation of a checklist could prompt the resource nurse to be more productive, will provide written expectations for the role, …

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Culminating Experience Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

Evaluating Providers’ Knowledge, Attitudes, And Intentions Toward Utilizing First Post-Discharge Visit Checklist In Primary Care To Reduce Readmissions In Heart Failure Patients, Binu Bashyal

DNP Projects

Background and Significance: Heart failure (HF) affects approximately 6.2 million adults in the United States and 40 million people globally. HF is one of the leading causes of emergency department (ED) visits and hospitalizations in adults. Twenty percent of patients admitted for HF are readmitted within thirty days, and up to fifty percent are readmitted by six months. A First Post-Discharge Visit checklist could help mitigate the problem of readmission.

Purpose: The purpose of this DNP project was to evaluate primary care providers’ knowledge, attitudes, and intentions towards utilizing the First Post-Discharge Visit checklist to reduce hospital readmissions among …

Use Of A Nurse-Led Daily Goals Checklist To Improve Multidisciplinary Rounds In The Icu, Marissa Riley

DNP Projects

Research has shown a multidisciplinary rounding approach can improve patient care outcomes in the intensive care unit (ICU). Due to the complexity and wide range of the healthcare team, many patient details and treatment goals may be overlooked during daily patient rounds without a daily goals checklist to help ensure collaboration and communication of the multidisciplinary team. A nurse led daily goals checklist could be useful for framing nurse-provider conversations to promote comprehensive communication and collaboration. The purpose of this project was to improve adherence to a nurse-led daily goals checklist to improve communication and collaboration between the nurses and …

Reducing Physical Restraints And Emergency Psychiatric Medications On An Inpatient Psychiatric Unit With The Broset Violence Checklist, Victoria Hernandez

Doctor of Nursing Practice

Background: Physical restraint and psychiatric emergency medication use, especially psychotropic medications, is problematic, negatively impacting patient safety on psychiatric units (Ambwani et al., 2021; Iuppa et al., 2013; Rahman, 2021). The Bröset Violence Checklist (Woods & Almvik, 2002), a short-term violence-predicting tool, has been used in the inpatient setting to predict violent outbursts and determine when high-level violence interventions are needed.

Purpose: The purpose of this project was to recognize signs and symptoms of aggression and agitation early and intervene to reduce the use of physical restraints and emergency restraint medications on an inpatient psychiatric unit, thereby improving patient safety. …

Use Of A Checklist As A Decision Support Aid For Heart Failure Assessment And Management, Maryann Hogan

Doctoral Dissertations

Heart failure is a serious chronic health problem requiring ongoing management to control disease progression. Consequences of inadequate heart failure management include acute exacerbation, worsening baseline status, and possibly death. Nurses play a key role in surveillance of patients with heart failure and in management of their condition as part of the interprofessional health care team. During episodes of acute decompensation of heart failure, nurses must be able to detect onset of signs and symptoms, initiate appropriate nursing interventions promptly, and communicate with the provider and other team members as needed. Although heart failure is a common health problem in …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

Implementation And Evaluation Of A Post-Op Coronary Artery Bypass Graft Extubation Checklist To Reduce Prolonged Intubation In The Intensive Care Unit, Melissa Bailey

Doctor of Nursing Practice Projects

Background: Total intubation time of post-op coronary artery bypass graft (CABG) patients is set by the Society of Thoracic Surgeons (STS) guidelines. STS states that post-op CABG patients need to be extubated within twelve hours of end anesthesia time with a recommendation of fewer than six hours. The project site had a total intubation time of greater than seventeen hours before removing the outliers. The current process does not result in a total intubation time of fewer than six hours. Implementation of an extubation checklist was chosen as the intervention for this DNP project.

Purpose: This DNP project aims to …

Family Centered Care In The Neonatal Intensive Care Unit: A Standard Checklist For Nurses And Parents, Tori C. Williams

Honors Theses

Neonatal Intensive Care Units (NICUs) care for critically ill newborn babies. Family Centered Care (FCC) is a relatively new standard of NICU care that allows for caregivers to be as much of a part of the NICU experience as health care providers. This thesis utilized a review of literature to identify research that shows that FCC is an effective way to improve outcomes for neonates and their caregivers. Many sources did provide evidence for this. Some evidence shows that FCC can lead to shorter length of stay, increased rates of breastfeeding, and increased weight gain for the neonates, while parents/caregivers …

Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash

Master's Projects and Capstones

Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.

Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.

Intervention: This project implemented an Add-On Communication Tool for …

The Effects Of Real-Time Computerized Needle Tip Location Feedback On State Anxiety And Immediate Performance Of Simulated Ultrasound-Guided Regional Anesthesia, Joseph Janakes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Complications of ultrasound-guided regional anesthesia (UGRA) in the clinical setting are severe and frequently related to improper needle tip placement, which is a challenging skill for novice student learners. Accordingly, anesthesia education programs are incorporating simulation-based teaching methods that use expensive procedural task trainers to aid in UGRA training. However, it was unknown if the task trainers with real-time computerized needle tip location feedback affect student anxiety and immediate simulated UGRA performance, leaving educators wondering if the cost was justified.Aims: The purpose of the study was to examine the effects of real-time computerized needle tip location feedback on students’ …

Efficacy Of Handoff Education For Icu Nurses When Transferring Patients To The Operating Room, Sandra Ruth Horace

Doctor of Nursing Practice Projects

Background: The transition of care from the Surgical Intensive Care Unit (SICU) to the Anesthesia team in the Operating Room (OR) is a vulnerable time for patients. There is currently no formal process for the patient transitioning from the Surgical ICU to the OR. The disarray of this transition can lead to serious omissions in communication and be harmful to the patient.

Purpose: Currently, there is no formalized or universal process for handoff communication between the SICU team and the Anesthesia team. This project aimed to provide handoff education for SICU nurses when sending a patient from the OR. This …

A Management Checklist For Primary Care Practice Mergers, Expansions, Or Acquisitions – Critical Components For Financial Planning, Space And Staffing Management, Training And Start-Up, Tamara El-Amoor

MUSC Theses and Dissertations

No abstract provided.

Comprehensive Survey Of Butterflies At The Sam D. Hamilton Noxubee National Wildlife Refuge, Jordan Gesell

Theses and Dissertations

In collaboration with the Sam D. Hamilton Noxubee National Wildlife Refuge, I collected detailed information on the butterflies (Lepidoptera: Papilionoidea Latreille, 1802) of the refuge. I produced a comprehensive checklist of butterflies and skippers numbering 60 species. In addition, I collected data on flight periods as well as local plant community associations. Butterfly abundance surveys were conducted to assess seasonal habitat use across six site classes. Special emphasis was placed on pine forest at various stages of management for the endangered red-cockaded woodpecker (Picoides borealis). An exploratory analysis of butterfly diversity and abundance was conducted using non-metric multidimensional scaling (NMDS). …

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

Student Scholarly Projects

Practice Problem:There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

PICOT: This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Evidence: Thirteen pertinent studies recommended the use of …

Crna To Cvicu Rn: Implementation Of A Standardized Patient Handoff Checklist For Post-Surgical Heart Patients, Ashley Mcgrath

Doctor of Nursing Practice Projects

Patient handoffs occur when the information and responsibility of the patient is transferred from one health professional to another. Ineffective communication during the critical postoperative phase of the transfer of care (TOC) has been associated with extended hospital stays, increased healthcare costs and patient dissatisfaction. In 2007, the Joint Commission National Patient Safety Goals proclaimed the importance of a standardized handoff process for effective handoffs. The purpose of this quality improvement doctoral project was to assess if the utilization of a standardized TOC checklist from the operating room to the cardiac intensive care unit (CVICU) for post-heart patients improved communication …

Checklist Utilization To Reduce Cauti Rates: A Dnp Project, Christina Jah

Doctor of Nursing Practice Projects

Catheter-associated urinary tract infections (CAUTIs) are preventable events with significant ramifications for both patients and hospitals. Proper training on evidence-based practices for catheter management is a vital component of preventing and decreasing CAUTIs. Following a review of the literature, evidence supports that CAUTI education with the use of a standard urinary catheter checklist for registered nurses (RNs) has the potential to ensure that knowledge is applied, thus decrease CAUTIs. This doctoral project developed, implemented, and evaluated an educational program and checklist to reduce CAUTI among patients at a Veterans Administration (VA) hospital. This project utilized a mixed-method data collection with …

Pautas Para La Elaboración De Una Herramienta De Mitigación Para Los Efectos De Los Sesgos Cognitivos En La Gestión De Innovación En Colombia, Diego Alejandro Gómez Sánchez, Juan David Pabón Vargas

Finanzas y Comercio Internacional

En la investigación se diseñó una herramienta para mitigar los sesgos cognitivos en la gestión de innovación en las empresas. Con el fin de mejorar el desempeño frente a los procesos de innovación. Si bien, los efectos psicológicos causados por juicios inexactos, interpretaciones ilógicas o irracionalidad, son conocidos como sesgos cognitivos, los cuales afectan de manera directa la toma de decisiones de los gerentes creando una distorsión o juicio errado. Con este proyecto se da una solución a partir de una nueva herramienta, que ayude a mitigar el efecto de los sesgos en la gestión de innovación empresarial, seleccionando los …

Drivers Of Start-Up Delays In Global Randomized Clinical Trials, Jennifer Lai

MUSC Theses and Dissertations

Background: Global, randomized clinical trials are extremely complex. Trial start-up is a critical phase and has many opportunities for delay which adversely impact the study timelines and budget. Understanding factors that contribute to delay may help clinical trial managers to work more efficiently, hastening patient access to potential new therapies. Methods: We reviewed the available literature related to start-up of global, Phase III clinical trials and then created a fishbone diagram detailing drivers contributing to start-up delays. The issues identified were used to craft a checklist to assist clinical trial managers in more efficient trial start-up. Results: We identified key …

Mojave Desert Plant Community Long-Term Response To Disturbance, Dominic M. Gentilcore

UNLV Theses, Dissertations, Professional Papers, and Capstones

All vegetation communities have been shaped by disturbances. This dissertation consists of three separate chapters: Blackbrush (Coleogyne ramosissima) natural regeneration in the Great Basin-Mojave Desert Transition Zone on two fires, Long-term Response to Fire in Eastern Mojave Desert semi-arid shrubland communities, and an Annotated Checklist of Gold Butte National Monument in the Mojave-Colorado Plateau Transition Zone. The section on blackbrush natural regeneration was a long-term dataset from two fires in Basin and Range National Monument that burned in 2008 with monitoring events in 2009, 2010, 2011, 2018 and 2019. The monitoring documented some of the strongest post-fire regeneration for the …

An Evaluation Of A Culture Interview Checklist For Behaviorally-Oriented Clinicians, Joshua Hursel Addington

Theses and Dissertations

In recent years, there have been calls from within the field for behavior analysts to develop awareness of the impact of client culture on treatment. The purpose of this study was to develop and evaluate a checklist as a tool for increasing the frequency of questions about client culture asked by behavioral clinicians during mock intake interviews. A multiple baseline across question types (diet, communication and reward/discipline) was used to evaluate the effects of a vague prompt and the Culture Interview Checklist (CIC). When instructed to ask questions about culture, none of the participants increased the number of questions asked …

Use Of A Checklist To Facilitate The Recognition Of A Transfusion Associated Adverse Event, Susan Scott

Doctoral Dissertations

Transfusions are the most common procedure that hospitalized patients undergo. One of the risks associated with a transfusion is a transfusion related adverse event (TAAE). Transfusion associated adverse events can occur in any patient receiving a transfusion. Some patients are at risk of certain TAAEs (e.g., heart failure patients at risk of transfusion associated circulatory overload) while other events (e.g., allergic reactions) cannot always be anticipated. The severity of a TAAE can range from mildly uncomfortable to life threatening. Nurses need to be able to identify the signs and symptoms of a possible TAAE and intervene immediately by stopping the …

A Quality Improvement Project To Increase Eye Care Screenings And Recommendations For Patients With Type Ii Diabetes Mellitus, Amber Ojeda

Doctor of Nursing Practice

Type 2 diabetes affects more than 90 million people and is a major cause of reduced vision and blindness in the United States (Lu et al., 2016). Without proper preventative measures, T2D damages the microvascular within the retina causing diabetic retinopathy (Lima, Cavalieri, Lima, Nazorio, & Lim, 2016). Despite the success of early detection and the availability of diabetic retinopathy screenings, many people diagnosed with T2D do not complete the recommended routine eye exam (Lu et al., 2016). Healthy People 2020’s (HP2020) (2016) target goal for annual dilated eye exams for patients with T2D is 58%. At baseline, only 2% …

Use Of A Handoff Communication Tool Between Certified Registered Nurse Anesthetists, Anesthesiologists, And Post Anesthesia Care Unit Nurses, Rachel Louise Johnson

Doctoral Projects

Ineffective communication in the post-anesthesia care unit (PACU) is considered to have incidences of increased error, mortality, morbidity, which leads to decrease patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the …

Improve Intra-Operative Nurse-To-Nurse Communication Using A Safety Checklist, Silvinita Tadeo Rowe

Doctoral Projects

Poor and inadequate handoff, or transfer of care of the surgical patient care from the primary to the relief operating room registered nurse circulators, can result in irreversible patient harm, or sentinel events, such as retained foreign items. In this study, Rogers' diffusion of innovation theory was the framework for implementing the handoff safety checklist. Also, Donabedian's structure process and outcome was the model to investigate the feasibility, acceptability, and improvement in the quality of patient handoff communication and improvement of nurse satisfaction over time. Nineteen-statement surveys, conducted at multiple timeframes, were completed by volunteer operating room nurse participants. In …

The Effect Of Job Performance Aids On Quality Assurance, Erik David Fosshage

Open Access Theses

Job performance aids (JPAs) have been studied for many decades in a variety of disciplines and for many different types of tasks, yet this is the first known research experiment using JPAs in a quality assurance (QA) context. The objective of this thesis was to assess whether a JPA has an effect on the performance of a QA observer performing the concurrent dual verification technique for a basic assembly task. The JPA used in this study was a simple checklist, and the design borrows heavily from prior research on task analysis and other human factors principles. The assembly task and …