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Full-Text Articles in Medicine and Health Sciences

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs Dec 2022

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in ...


How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez Dec 2022

How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez

Nursing | Senior Theses

Background

Language barriers cause a disconnect between patients and health care workers. What further causes a disconnect is when patients have a lower level of education in addition to having a language barrier. I will be focusing on Latin immigrant individuals in the United States for my research. Many Latin immigrant patients may not have gone to school in their native countries, so their education level is lower making it harder to understand discharge information or patient teaching. When patients are unable to have that health literacy it may lead to negative patient outcomes due to not adhering to medication ...


Podium Presentation: Racial Inequities And Breastfeeding In A Nicu: A Quality Improvement Project, Emilia C. Garcia Jun 2022

Podium Presentation: Racial Inequities And Breastfeeding In A Nicu: A Quality Improvement Project, Emilia C. Garcia

Providence Nurse Research Conference (2022 - present)

No abstract provided.


High Reliability Through Charge Nurse Huddles: Improving Communication To Decrease Absenteeism, Audra Ellis Overman Jun 2022

High Reliability Through Charge Nurse Huddles: Improving Communication To Decrease Absenteeism, Audra Ellis Overman

Providence Nurse Research Conference (2022 - present)

Abstract:

It is important we show staff we as leaders are listening to their concerns and frustrations. Lack of communication with immediate supervisor is a cause of absenteeism among nurses, and that absenteeism leads to decreased quality of care, disrupted work routines, and increased workload for staff that are present. Communication is a proven tool to help develop teamwork, reduce absenteeism, and manage conflicts. Staff commitment to the workplace can be increased by management working toward a democratic style of supervision with increased open communication to decrease staff absenteeism. Absence of or poor communication creates a negative work environment and ...


Optimization Of Transfusion Administration Process: A Quality Improvement Project, Nannette Berg, Jennifer Togioka Jun 2022

Optimization Of Transfusion Administration Process: A Quality Improvement Project, Nannette Berg, Jennifer Togioka

Providence Nurse Research Conference (2022 - present)

BACKGROUND:

Transfusion of blood products (transfusion) occurs infrequently for most nurses yet is a high-risk procedure for patients. To ensure patient safety, Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC) created regulatory standards for transfusion administration and documentation. To meet regulatory standards, transfusion events require documentation of all six critical steps and nurse leaders must monitor compliance with regulatory transfusion documentation, taking action when rates are suboptimal. Yet, transfusion documentation in the electronic health record (EHR) has been described as fragmented, confusing, and devoid of built-in prompts to facilitate completion. Checklists can organize tasks with multiple ...


Employing Strategies To Increase Ebp Competency In Frontline Nurses While Aligning Nursing Skills With Current Evidence: A Quality Improvement Project, Stacey Spradling, Jamie Roney Jun 2022

Employing Strategies To Increase Ebp Competency In Frontline Nurses While Aligning Nursing Skills With Current Evidence: A Quality Improvement Project, Stacey Spradling, Jamie Roney

Providence Nurse Research Conference (2022 - present)

Background: Clinical nurses are required to demonstrate expertise for diverse patient conditions while balancing efforts to improve both staff satisfaction and clinical outcomes. Nurse leaders must implement and measure the effectiveness of strategies to empower nurses to maintain clinical competence for themselves and their peers to ensure the highest quality of evidence-based care is delivered at the earliest patient touchpoints reliably and consistently.

Purpose: The purpose of this quality improvement project was to engage direct care nurses as skills “champions” to improve the clinical skills of nurses working in a resource pool in a large urban hospital.

Methods/Approach: Clinical ...


Converting Clinical Orientation Materials From Paper To Electronic: A Quality Improvement Project, Megan Bowles, Abby Lust, Teresa Bigand Jun 2022

Converting Clinical Orientation Materials From Paper To Electronic: A Quality Improvement Project, Megan Bowles, Abby Lust, Teresa Bigand

Providence Nurse Research Conference (2022 - present)

Background:

In one region including 4 hospitals, acute care nurses historically met with professional development practitioners (PDP) and received binders containing printed, specialty-specific policies and a competency checklist (required to be signed and returned to the nurse leader) upon new hire or transfer. Creating physical orientation packets is costly, time-consuming, and restricts the ability to share appropriate orientation materials in the event of a PDP sick call. Real-time communication between the orientee, preceptor, PDP, and nurse leader regarding status of the competency checklist cannot occur with a physical binder. Providing electronic onboarding materials is a potential solution.

Purpose:

To describe ...


Quality Improvement In A Hospital Setting: Central Line-Associated Bloodstream Infections At An Acute Care Hospital In South Texas, Hoang Anh T. Nguyen, Jose E. Campo Maldonado Jun 2022

Quality Improvement In A Hospital Setting: Central Line-Associated Bloodstream Infections At An Acute Care Hospital In South Texas, Hoang Anh T. Nguyen, Jose E. Campo Maldonado

MEDI 9331 Scholarly Activities Clinical Years

Background: Central line-associated infections (CLABSI) are life-threatening nosocomial infections that are associated with significant increase in healthcare expenditure, prolonged stays, and risk of mortality.

Objective: To identify outcome trends and risk factors that contribute to incidence of CLABSI at an 866-bed acute care hospital in South Texas.

Methods: A retrospective chart review was conducted on 38 patients who met the National Healthcare Safety Network criteria for CLABSI during the period of January 2021 to March 2022

Results: There was a total of thirty-two CLABSIs in 2021. Hospital-wide CLABSI rate was 1.76 hospital-wide per 1,000-line days. Half of cases ...


Changes In Cognitive Control Following A Novel Resilience-Focused Nursing Educational Program: An Exploratory Study, Shannon Dames, Wendy Young, Olave Krigolson, Kelly Zhang, Lincoln Stoller, Robyn Bartle Jun 2022

Changes In Cognitive Control Following A Novel Resilience-Focused Nursing Educational Program: An Exploratory Study, Shannon Dames, Wendy Young, Olave Krigolson, Kelly Zhang, Lincoln Stoller, Robyn Bartle

Quality Advancement in Nursing Education - Avancées en formation infirmière

Patient care is currently challenged by various factors including stress and nurse fatigue that can negatively impact nurses’ health and patient safety. Emotional exhaustion and burnout among nurses are at an all-time high. Canadian nurses are reporting clinical rates of depression, anxiety, and panic at disproportionately higher rates than other public safety personnel. Innovative educational programs are desperately needed to mitigate stress and relieve distress, which will ultimately promote a healthier and more productive workforce. Little is known about the effectiveness of research informed cognitive control education within a community of practice (COP) to help nurses and nursing students process ...


Organizational Compassion: Ameliorating Healthcare Worker’S Suffering And Burnout, Rachel Thienprayoon, Shane Sinclair, Beth A. Lown, Teresa Pestian, Eli Awtrey, Naomi Winick, Jason Kanov Jun 2022

Organizational Compassion: Ameliorating Healthcare Worker’S Suffering And Burnout, Rachel Thienprayoon, Shane Sinclair, Beth A. Lown, Teresa Pestian, Eli Awtrey, Naomi Winick, Jason Kanov

Journal of Wellness

No abstract provided.


Improving Satisfaction Of Patients Living With Hidradenitis Suppurativa Through Administration Of An Intake Form, Emilia M. Clementi, Steven Daveluy Jun 2022

Improving Satisfaction Of Patients Living With Hidradenitis Suppurativa Through Administration Of An Intake Form, Emilia M. Clementi, Steven Daveluy

Medical Student Research Symposium

Background

Hidradenitis suppurativa (HS) is an incurable, chronic inflammatory skin that is caused by follicular occlusion and affects around 1% of people in the United States 1. Because of its chronic, grave nature, patients may be dissatisfied with their care. Improving the fecundity of HS patients’ interaction with their physicians may be an important step towards improving patient outcomes. Currently, there is no standardized patient intake form for HS patients at Wayne Health. The intake form describes key patient details, such as their current treatments, pain level, and associated symptoms. This project measures the efficacy of this tool after its ...


Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins Jun 2022

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up ...


Do Orthopedic Surgeons Follow Through On Verbal Commitments To Participate In Deficit Recovery Efforts?, Maxwell T. Yoshida, Wendy Jin, Joseph S. Files, Austin M. Meadows, Charles S. Day M.D. Mba Jun 2022

Do Orthopedic Surgeons Follow Through On Verbal Commitments To Participate In Deficit Recovery Efforts?, Maxwell T. Yoshida, Wendy Jin, Joseph S. Files, Austin M. Meadows, Charles S. Day M.D. Mba

Medical Student Research Symposium

No abstract provided.


The Short-Term Effects Of Fine Airborne Particulate Matter And Climate On Covid-19 Disease Dynamics, El Hussain Shamsa, Kezhong Zhang Jun 2022

The Short-Term Effects Of Fine Airborne Particulate Matter And Climate On Covid-19 Disease Dynamics, El Hussain Shamsa, Kezhong Zhang

Medical Student Research Symposium

Background: Despite more than 60% of the United States population being fully vaccinated, COVID-19 cases continue to spike in a temporal pattern. These patterns in COVID-19 incidence and mortality may be linked to short-term changes in environmental factors.

Methods: Nationwide, county-wise measurements for COVID-19 cases and deaths, fine-airborne particulate matter (PM2.5), and maximum temperature were obtained from March 20, 2020 to March 20, 2021. Multivariate Linear Regression was used to analyze the association between environmental factors and COVID-19 incidence and mortality rates in each season. Negative Binomial Regression was used to analyze daily fluctuations of COVID-19 cases and ...


Pediatric Palliative Care Training To Advance Nurses’ Knowledge And Increase Patient Referrals, Whitney Lynn Stone, Lisa Merritt, Tammy Childers Jun 2022

Pediatric Palliative Care Training To Advance Nurses’ Knowledge And Increase Patient Referrals, Whitney Lynn Stone, Lisa Merritt, Tammy Childers

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: The purpose of this evidence-based practice quality improvement project was to implement an educational intervention to improve pediatric palliative care services in a Pediatric Intensive Care Unit (PICU). The goal was to improve nurses’ knowledge of palliative care and increase the number of palliative care consults.

Methods: Educational sessions were created using the End-of-Life Nursing Education Consortium (ELNEC) Pediatric Curriculum. Participants included 46 PICU nurses. Knowledge of palliative care was measured at three timepoints; pre-, immediately post- and four weeks post-intervention. The number of palliative care referrals were measured at two timepoints; three months pre- and three months post-intervention ...


The Experiences Of Collegiality By Early-Career Counselor Educators, Jessica M. Tyler, Malti Tuttle, Marina Naviaux, Sara Ellison Jun 2022

The Experiences Of Collegiality By Early-Career Counselor Educators, Jessica M. Tyler, Malti Tuttle, Marina Naviaux, Sara Ellison

Journal of Counselor Preparation and Supervision

It is essential to develop a work culture that supports faculty needs, be it professional for promotion and tenure, or personal. This phenomenological study examined the lived experiences of collegiality by early-career counselor educator faculty members (CES) working in a CACREP institution. Relational support, expectations, administration, and doctoral experiences emerged as themes from these narratives. Implications for the field are discussed to address these experiences and provide recommendations to counselor education faculty and departments.


Eagle Medical Tray Denesting & Debris Removal Process, Nicholas Allen Ungefug, Noah Chavez, Susana Shu-Lin Okhuysen, Michael Augustine Pennington Jun 2022

Eagle Medical Tray Denesting & Debris Removal Process, Nicholas Allen Ungefug, Noah Chavez, Susana Shu-Lin Okhuysen, Michael Augustine Pennington

Industrial and Manufacturing Engineering

Eagle Medical Incorporated is a contract medical device packaging and sterilization company. The company purchases thermoformed medical packaging trays, which maintain the sterility of medical devices, from various manufacturers. To ensure packaging quality and to prevent cleanroom contamination, Eagle Medical inspects and sterilizes each blister tray that they order. This process is an essential non-value-added activity that creates a bottleneck. Cleanroom employees must stop packaging medical devices and attend to the processing of blister trays and packaging solutions. The blister trays arrive at Eagle’s facility in nested stacks. Vibration and movement during shipping further compresses the stacks, which makes ...


Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar May 2022

Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic is the first of its kind to hit the world in the modern information age. People working in healthcare across the globe have harnessed technological advances and modern digital tools in innovative new ways. This has brought specific, more recent trends in healthcare delivery to the forefront. In this review, we present a collection of articles that highlight some of the emerging trends in healthcare driven by the COVID-19 pandemic and that have the potential to transform healthcare in the coming decades. We provide a brief commentary on the opportunities and challenges for each trend.


Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini May 2022

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people ...


Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston May 2022

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using ...


Skin Response: A Multidisciplinary Approach To Pressure Injury Prevention, Shannon E. Jagger Msn, Rn-Bc, Ne-Bc, Cpps, Deborah A. Saber Ph.D.. Rn, Ccrn-K, Patricia Poirier Ph.D., Rn May 2022

Skin Response: A Multidisciplinary Approach To Pressure Injury Prevention, Shannon E. Jagger Msn, Rn-Bc, Ne-Bc, Cpps, Deborah A. Saber Ph.D.. Rn, Ccrn-K, Patricia Poirier Ph.D., Rn

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Hospital acquired pressure injuries (HAPIs) are listed as serious reportable events and classified as “never events.” Nevertheless, more than 2.5 million people develop HAPIs in the United States every year with 60,000 dying from associated complications. HAPI rates at the site of this quality improvement initiative were high and required intervention. As a result, the Skin Response (SR) initiative was developed to bring a multidisciplinary team to the bedside within 20 minutes of an identified skin concern. This team consisted of the bedside registered nurse (RN), RN leader, physician, facilitator, nutritionist, and wound RN. Through a team approach ...


Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S May 2022

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.


Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith May 2022

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.


Pressure Injury Prevention: A Quality Improvement Project Utilizing Incontinence Care Education, Laura Renner May 2022

Pressure Injury Prevention: A Quality Improvement Project Utilizing Incontinence Care Education, Laura Renner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: Evaluate whether the initiation of incontinence care education can improve pressure injury knowledge by an average of 5% in post-test scores over 1 month. Design: Theoretical Framework: Lewin’s Three-Step Model for Planned Change and Evidence-Based Practice Improvement Model. Setting/Local Problem: A 20-bed acute care geriatric unit in a large metropolitan hospital in middle Tennessee with inappropriate use of incontinence management products. Participants: Nurses and nursing assistants employed at the project site. Intervention/Measurements: An educational tool was developed to improve knowledge on pressure injury prevention through incontinence management. A pre-test and post-test were conducted immediately before and ...


How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan May 2022

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors ...


Implementation Of An Educational Guide To Improve Icu Delirium Awareness And Detection, Samantha Payne, Samereh Abdoli May 2022

Implementation Of An Educational Guide To Improve Icu Delirium Awareness And Detection, Samantha Payne, Samereh Abdoli

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Intensive care unit (ICU) delirium is a prevalent condition that can occur in up to 80% of critical care patients. It can increase hospital length of stay, morbidity rates, and recovery time. It can also demand higher costs for care and long-term effects on the patient. A good practice statement, issued by the Society of Critical Care Medicine, acknowledges the importance of delirium awareness (Devlin, 2018). For ICU nurses, educational approaches of ICU delirium have shown significant increases in delirium awareness and detection. The purpose of this project was to determine if an evidenced-based education program on delirium would improve ...


Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance May 2022

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC ...


Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad May 2022

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused on hand hygiene compliance among staff members involved in the C-section procedure. Staff members were observed entering and exiting the operating room to determine if they performed hand hygiene upon entry or exit. Hand hygiene compliance increased by 8.8% among all staff members. Obstetric (OB) nurse hand hygiene compliance increased by 28.6%. While overall hand hygiene compliance increased, it was not statistically significant; however, the increase in OB nurse compliance is statistically significant. Implementation of educating the OB nurses proved to be successful, and future interventions were recommended to continue to monitor and improve hand hygiene compliance.


Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le May 2022

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically past the initial measuring in L&D – using the Triton Scale and proper documentation of QBL onto EPIC, the hospital’s electronic patient record system (EPIC). This included creating an instructional video for the Triton Scale, flyers on how to document QBL, emails of changes and implementation, and surveys on nurses’ feedback for QBL implementation. Data collection focused on daily auditing of the nurses’ QBL documentation for the first two voids of a vaginal delivery, QBL for the first four hours of enhanced recovery after surgery (ERAS), and the first eight hours ERAS with ambulation. If a patient hemorrhages, the focus shifts to determine when the nurse notified the Medical Doctor (MD) or Obstetric (OB) rapid response. QBL compliance increased by 96% among all nurses in the PP unit. While QBL compliance increased, it was not statistically significant; however, important steps towards attaining this goal were found. Nurses have demonstrated significant improvements in the ability to use the Triton scale and the ability to properly document their ...


Utilization Of A Drug Use Screening Assessment: A Quantitative Study To Reduce Benzodiazepines In Inpatient Detoxification, Malerie Lazar Bolinsky, Mary Johnson, Sarah Devault May 2022

Utilization Of A Drug Use Screening Assessment: A Quantitative Study To Reduce Benzodiazepines In Inpatient Detoxification, Malerie Lazar Bolinsky, Mary Johnson, Sarah Devault

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

The use of benzodiazepines in the inpatient psychiatric setting is common for patients undergoing drug and alcohol detoxification but does not come without risks. Too high of a dose of benzodiazepines are often administered during detoxification when patients are not adequately assessed on admission. Current literature supports utilization of a screening tool for drug use can reduce unnecessary benzodiazepine use. This study implemented the Drug Use Screening Tool in a drug and alcohol detoxification unit of inpatient psychiatric hospital to evaluate severity of drug use on admission and established a statistically significant reduction in the use of as-needed benzodiazepines prescribe.