Medicine and Health Sciences Commons^™

Reducing Hospital Noise Levels Through Nursing Staff Education, Althea Sanders

Walden Dissertations and Doctoral Studies

AbstractNoise levels can negatively affect a patient’s hospital experience. Increased noise levels in the hospital can trigger sleep disturbance and affect the length of recovery for patients; the increased noise levels can also cause increased anxiety and exhaustion for nursing staff members. Due to a gap in nursing practice related to nurses’ knowledge to safely reduce noise levels, this project addressed if nursing staff education on noise reduction could increase the knowledge among nursing staff members to use specific strategies to reduce noise levels in an intensive care unit (ICU) setting. The purpose of this project was to educate eight …

Improving The Patient Experience With Case Management Follow Up Phone Calls: A Quality Improvement Project Evaluation, Karen Jarrell

Walden Dissertations and Doctoral Studies

In January of 2020, a follow-up phone call quality improvement initiative was implemented by the case management department of an acute care facility located in the Mid-Atlantic region of the United States, to improve the patients’ healthcare experience. The intent was to improve the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. This quality improvement (QI) project was conducted using the Plan-Do-Check-Act Cycle along with the Kotter’s 8-step change model. The purpose of the QI project evaluation was to determine if a QI initiative using follow up phone calls had a positive effect on increasing CAHPS survey scores. The …

Implementation Of A Fall Prevention Program For The Elderly In A Long-Term Care Facility, Maureen Orobosa Igharosa

Walden Dissertations and Doctoral Studies

One out of 4 older people fall each year. By the year 2030, it is estimated that 49 million older adults will fall and that 12 million will incur injuries as a result. A rise in the trend in falls among older adults represents a growing burden; the cost for falls billed to Medicare in the year 2015 was an aggregate of over $31 billion. The purpose of this quality improvement evaluation project was to assess the effectiveness of a fall preventative pilot program to reduce the number of falls among the residents of a rehabilitation and long-term care facility …

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was …

Evaluating An Incentive Program To Improve Teamwork And Productivity In The Operating Room, Christopher Bejil

Walden Dissertations and Doctoral Studies

The operating room (OR) is a complex system that must run efficiently to remain profitable and of value to its multiple stakeholders who include the patient, surgeon, OR staff member, and hospital administration. The OR at the practice site struggled with teamwork and efficiency in the areas of first-case on-time starts, turnover time, and last-case out times, resulting in a less than favorable impact on the organizational bottom line. The practice-focused question asked if a performance-based incentive bonus program can improve OR efficiency in the department’s three major problem areas. Using Gittell’s relational coordination theory as a framework, the practice …

Staff Education On American Diabetes Association Standards Of Medical Care For Diabetes, Christine Nsubuga

Walden Dissertations and Doctoral Studies

Diabetes is a commonly encountered chronic illness that leads to other lifelong comorbidities if left uncontrolled. Ranked as the seventh leading cause of death in the United States, diabetes affects over 29 million Americans. Although 90%-95% of all diabetes cases are preventable with proper planning and management, clinicians continue to be challenged as they strive to achieve the desired patient care goals. This Doctor of Nursing Practice (DNP) staff education project addressed the lack of standard evidence-based care for diabetic patients in the federally qualified health center look-alike practice for which this project was developed. Guided by the practice-focused questions …

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …

Cesarean Births Rates After Implementation Of Labor Management Guidelines, Margie Allyn Bridges

Walden Dissertations and Doctoral Studies

Cesarean birth rates are associated with increased maternal morbidity. This project evaluated a quality improvement (QI) initiative implemented to reduce cesarean births among Nulliparous Term Singleton Vertex (NTSV) obstetric populations, the largest contributor to cesarean births. Variations in labor management practice contribute to cesarean birth rate; implementation of labor management bundles have been endorsed to influence practice- and system-level changes in the promotion of vaginal births. The problem addressed in this project was an organizational NTSV cesarean section rate of 30%. The purpose of the project was to use secondary data to evaluate a previously implemented labor management bundle at …

Increasing Medication Adherence In Hypertensive Patients With Million Hearts® Health Literacy Program, Tammy Ross

Walden Dissertations and Doctoral Studies

Healthy People 2020 identified hypertension (HTN) as a controllable risk factor to prevent cardiovascular disease and stroke. Adhering to regular antihypertensive (AHT) medications improves outcomes in patients diagnosed with HTN by controlling blood pressure, reducing hospital visits, and promoting patient wellness. Medication adherence occurs when prescribed medicine regimens are utilized by the patient as directed to manage illness or disease, as evidenced by patients receiving medications at their pharmacy. The practice-focused question for this quality improvement project asked whether implementation of health literacy tools from Million Hearts® HTN Control: Action Steps for Clinicians, increased medication adherence as evidenced by regular …

Using A Quality Workbook Committee To Improve Nurse-Sensitive Patient Indicator Scores, Nicole Robinson

Walden Dissertations and Doctoral Studies

Health care providers gather and track quality patient indicator scores to monitor patients' safety and outcomes and decrease the number of adverse events. Nursing leaders implemented a Quality Workbook Committee (QWC) within a hospital setting to improve patient outcomes and the facility's reported scores for nurse-sensitive patient indicators. The practice-focused question for this quality improvement evaluation project examined whether the implementation of the QWC improved nurse-sensitive patient indicator scores. Watson's theory of human caring was used to evaluate the gap in practice, and Rosswurm and Larabee's model for evidence-based practice change provided guidance for planning the project. Sources of evidence …

An Assessment Of Heart Failure Screening Tools For An Outpatient Arrhythmia Devices Clinic, Lucy Joanne Paul

Walden Dissertations and Doctoral Studies

People living with heart failure (PLHF) should be screened for symptoms at every

healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires …

Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is a mood disorder affecting approximately 20% of women within 6 months of delivery. Untreated PPD diminishes a woman's functioning and may result in short and long-term consequences for her infant. Screening with evidence-based tools can identify prenatal and postpartum women at risk for PPD, ensure early treatment, and limit adverse maternal and infant effects. Using Rosswurm and Larrabee's evidence-based practice model, a multidisciplinary team of 7 key stakeholders, including directors and a nurse from the departments of OB/GYN, Pediatrics, and Primary Care, a psychiatrist specializing in women's health, and a member of nursing leadership, formed to …

The Design And Implementation Of A Relationship-Based Care Delivery Model On A Medical- Surgical Unit, Paula Ann Rodney

Walden Dissertations and Doctoral Studies

The Design and Implementation of a Relationship-Based Care Delivery Model on a Medical- Surgical Unit

by

Paula A. Rodney

MSN, California University of Pennsylvania, 2011

BSN, University of Virginia, 1979

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

April 2015

Patient satisfaction and clinical outcomes have become important issues in healthcare since the introduction of the Value Based Purchasing Program. Patient satisfaction, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, was declining and hospital-acquired pressure ulcers (HAPU), falls, and catheter-associated urinary tract infections (CAUTI) were …

Preoperative Education Needs In Ear, Nose, & Throat Clinic: A Patient Perspective, Jonathan Edmun Ramos

Walden Dissertations and Doctoral Studies

A medical center specializing in ear, nose, and throat (ENT) services noted an increase in the number of postoperative ENT complications compared to the national average. The purpose of this mixed-methods project study was to examine ENT patients' preoperative patient education (PPE) needs regarding postoperative care. Grounded in Knowles's model of learning, core adult learning principles were applied as guidelines in facilitating patients' PPE learning. Data were collected from 58 ENT patients who were selected using a convenience sampling method and who responded to a PPE survey using a 5-point Likert scale and open-ended questions. Quantitative data were analyzed using …