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Articles 1 - 23 of 23
Full-Text Articles in Medicine and Health Sciences
Just Sit For A Bit: A Moment Of Caring, Gabrielle M. Malouf
Just Sit For A Bit: A Moment Of Caring, Gabrielle M. Malouf
Master's Projects and Capstones
Background: Research shows that time spent sitting at the bedside promotes trust, which ultimately improves nurse satisfaction, patient satisfaction and patient outcomes. Patient satisfaction scores have been below benchmark for several months on an adult medical unit at an academic medical center.
Overview: The purpose of this project was to improve patient satisfaction in the areas of nursing courtesy, friendliness, and listening. Nurses were asked to sit down for at least 5 minutes per shift with each patient, engaging in a “moment of caring”. Nurse surveys were given and both pre and post implementation. These surveys assessed whether or not …
Fall Prevention Through Proactive Toileting, Kristin Smith
Fall Prevention Through Proactive Toileting, Kristin Smith
Master's Projects and Capstones
This paper will summarize the quality improvement falls prevention project conducted by a University of San Francisco Clinical Nurse Leader student. Falls in the hospital setting are an ongoing problem in our healthcare system as they have great physical and financial impacts (Salamon, Victory, & Bobay, 2012). Hospital A, an urban teaching hospital, uses the Schmid scale for determining if a patient is a fall risk which includes the assessment of need for ambulatory aids, history of falls, and impaired cognition among other criteria (Schmid,1990). Fall rates are climbing in the United States and the trend is similar on Hospital …
Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang
Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang
Master's Projects and Capstones
The purpose of this project was to develop a video simulation exercise to enhance communication between Registered Nurses (RNs) and Patient Care Assistants (PCAs). From a general microsystem assessment initially performed on an urban hospital medical-surgical unit, 75% of respondents noted that the most pertinent issue to address was improving communication between RNs and PCAs. Literature review of evidence-based practices found several studies that support the use of human clinical simulation to promote teamwork and interdisciplinary communication. RNs (n = 24) and PCAs (n = 9) were then individually interviewed with surveys and responses scored based on the …
Collaborating With The Unit Clerk To Decrease Avoidable Interruptions During Medication Administration On A Medical Surgical Unit, Christine Dimaano
Collaborating With The Unit Clerk To Decrease Avoidable Interruptions During Medication Administration On A Medical Surgical Unit, Christine Dimaano
Master's Projects and Capstones
Medical errors are the third leading cause of death in the United States. Medical errors also incur significant cost ramifications due to increased hospital length of stay and fines. Medication errors, a type of medical error, are one of the most common types of inpatient errors. Nurses are most often are responsible for medication administration, but safety during medication administration should be a priority of all hospital personnel. Avoidable interruptions during medication administration contribute to medical errors. Decreasing interruptions require increased nurse assertiveness during medication administration, interdisciplinary cooperation and unit culture change. This project identified that educating the unit clerk …
Improving Influenza Vaccination Rates Through Nursing Journal Clubs, Lily Yan
Improving Influenza Vaccination Rates Through Nursing Journal Clubs, Lily Yan
Master's Projects and Capstones
The objective of this CNL Internship Project is to improve patient compliance with the flu vaccine for the 2015 fiscal year. Currently the project is set at a teaching hospital in Northern California on the Abdominal Transplant Unit. Participants include six staff nurses who care for End Stage Renal Disease (ESRD), End Stage Liver Disease (ESLD) and abdominal transplant patients. To address the barriers to vaccination, specifically patients’ fear of adverse effects, nursing journal clubs (NJC) were implemented on the unit to educate nurses about the current research on flu vaccination for this patient population. As the facilitator, the CNL …
Ent Educational Patient Bedside Tool, Alina M. Toma
Ent Educational Patient Bedside Tool, Alina M. Toma
Master's Projects and Capstones
Early educational and discharge preparations are an advantage to patients, the interdisciplinary team, and hospital. It was determined that lack in communication and coordination among staff members led to inadequate patient teaching, therefore an educational tool that is kept at the bedside may facilitate accountability and smoother transition to home.
The aim of the project is to improve the education of patients with tracheostomies and laryngectomies, and enhance staff communication and coordination by December 2014.
Analysis methods used included Failure Mode Effects Analysis (FMEA), fishbone diagram, process map, and SWOT analysis. The social learning theory is the framework chosen for …
Emergency Preparedness On An Inpatient Hospital Unit, Hailee Marie Barnes
Emergency Preparedness On An Inpatient Hospital Unit, Hailee Marie Barnes
Master's Projects and Capstones
This paper will discuss the implementation of an emergency preparedness quality improvement project conducted by a University of San Francisco Clinical Nurse Leader (CNL) student on an inpatient cardiac unit, Unit H, at an urban teaching hospital in Northern California, Hospital B. An assessment of the current state of emergency preparedness, a diagnosis of Unit H’s area of greatest needs, the details of planning and implementing the quality improvement as well as the final evaluation will be discussed. The nursing process will be used for the structure of this paper as it was used as the structure of this project. …
Improving Patient Outcomes And Nurse Satisfaction By Reducing Avoidable Interruptions During Medication Administrations, Roberta Howard
Improving Patient Outcomes And Nurse Satisfaction By Reducing Avoidable Interruptions During Medication Administrations, Roberta Howard
Master's Projects and Capstones
Medication administration is an important part of nursing duties in acute-care settings. The nurse is responsible for prioritizing safe quality care when administering medications but errors do occur. This project addressed interruptions as one of the challenges of safe medication administration. The aims of this project are 1) to determine a standardized medication administration process 2) to identify perceived and actual interruptions on the unit and 3) to address and reduce the avoidable interruptions of calls, pages and call lights at the nurse station. The purpose of this project is to improve patient outcomes, nurse satisfaction and nurse workflow by …
Improving Staff Responsiveness To Patient-Initiated Call Lights, Doshia B. Williams
Improving Staff Responsiveness To Patient-Initiated Call Lights, Doshia B. Williams
Master's Projects and Capstones
This Clinical Nurse Leader (CNL) project involves the nursing staff and patients of a 23-bed post-surgical medical-surgical nursing unit at a Bay Area community hospital. The goal of this project was to improve patient care, patient satisfaction and staff workflow. Assessment of the microsytem revealed that from July 2013 through July 2014, the nursing unit scored below the unit’s goal 10 out of the 12 months for the HCAHPS question related to patient’s receiving help as soon as they pressed their call button. The unit’s goal is 64%; however, the 12-month average was 50%, with one month as low as …
Development And Implementation Of A Patient Education Tool To Increase Fall Risk Awareness, Natalie Ybarra
Development And Implementation Of A Patient Education Tool To Increase Fall Risk Awareness, Natalie Ybarra
Master's Projects and Capstones
The Clinical Nurse Leader (CNL) project is intended to identify a problem and implement an intervention that will change the current problem in a hospital setting. This project explores the reasons for patient falls on an inpatient unit at an urban hospital, referred to as Unit A and Hospital Y. Unit A is a 45-bed cardiac floor where patients are at high risk for falls due to diagnosis, medications, and treatment. Development and implementation of a patient education tool was conducted through an assessment of the microsystem and evaluation of the patient education tool. The foundation for this project is …
Patient Satisfaction Related To Noise In The Coronary Care Unit, Anjanette S. Dominguez
Patient Satisfaction Related To Noise In The Coronary Care Unit, Anjanette S. Dominguez
Master's Projects and Capstones
Background The CCU staff recognized a department trend for low patient-satisfaction score related to environmental noise levels. Based on the Press Ganey score, the patient-satisfaction score plummeted in relation to noise level beginning in March 2014.
Purpose To improve patient satisfaction regarding noise level in the CCU to 100% by November 21, 2014.
Methods Senior & Fleming’s Hard System Model of Change guided this literature search of CINAHL and Fusion for articles published from 2009 to 2014. Specific terms used were noise, critical care, and sleep promotion. From September to November 2014, earplugs were offered to all alert/oriented patients entering …
Minimizing Avoidable Interruptions During Medication Administration, Jaleel Anne Arnado
Minimizing Avoidable Interruptions During Medication Administration, Jaleel Anne Arnado
Master's Projects and Capstones
The objective of this CNL Internship Project is to improve patient outcomes and nurse satisfaction by minimizing the avoidable interruptions that occur during medication administration. The microsystem is a pediatric and adult medical-surgical overflow unit at a large, urban teaching hospital in Northern California. A series of surveys for nurses and patients and observations of medication administrations were conducted to assess barriers during mediation administration. It was determined phone calls interrupt a nurse the most during medication administration. Interruptions leave the medication administration process vulnerable to errors because it disrupts the nurse’s workflow and thought process. Because most pediatric medication …
Relocation Of Orc To Or2, Svetlana N. Schopp
Relocation Of Orc To Or2, Svetlana N. Schopp
Master's Projects and Capstones
The goal of this Clinical Nurse Leader (CNL) internship project was to maintain safety and quality of care of obstetric (OB) patients undergoing Cesarean Sections (C/S) after operating room for cesarean sections (ORC) is relocated from obstetric unit to the main operating room (OR). The microsystem will accomplish this through effective teamwork, clear interdisciplinary communication, collaboration, and standardization of processes involved. The institution is a not for profit rural health care facility and is a designated Critical Access Hospital; it is located in Northern California. A general obligation bond was passed in 2007 to fund seismic upgrades. Old OB unit …
The Significance Of Timing Of Patient Daily Weights And The Barriers, Ann Pan
The Significance Of Timing Of Patient Daily Weights And The Barriers, Ann Pan
Master's Projects and Capstones
Background. Current unit practice is that patient daily weights are obtained in the afternoon or evenings. However, patient weights in the afternoon and evenings are not accurate dry weights. According to evidenced based research, to obtain an accurate patient daily weight, patients should be weighed every morning, after their first void and before they eat breakfast.
Purpose. The focus of the study was to compare the current practices of obtaining daily weights in the afternoon and evenings, compared to the evidenced based practice recommended in the literature.
Method. Through interviews and surveys with staff, the barriers to obtaining patient weights …
Improving Patient Outcomes Through Use Of The Teach-Back Method In The Post Anesthesia Care Unit, Kathleen Osullivan
Improving Patient Outcomes Through Use Of The Teach-Back Method In The Post Anesthesia Care Unit, Kathleen Osullivan
Master's Projects and Capstones
The setting for this Clinical Nurse Leader (CNL) project was the Post Anesthesia Care Unit (PACU) at a level I trauma center in the Bay Area. The goal was to improve the discharge education performed by the PACU nurses to improve patient safety and decrease the chance of complications or readmissions to this hospital. With no clear instructions for how discharge teaching should be done, the nurses have many differing styles which leaves room for gaps in discharge planning. This influenced the implementation of the teach-back method during discharge planning in order to ensure proper education and increased patient understanding. …
Reducing Avoidable Interruptions During The Medication Administration Process, Lindsay A. Umeda
Reducing Avoidable Interruptions During The Medication Administration Process, Lindsay A. Umeda
Master's Projects and Capstones
Background: Medication safety and preventing medication errors continues to be a high priority for hospitals and clinics, as medication errors are the most common and most costly errors in U.S. hospitals (Kliger, 2010, p. 690). Kliger (2010) reported that 450,000 medication errors occur annually, costing hospitals approximately $3.5 to 29 billion dollars a year. Furthermore, Ching, Long, Williams & Blackmore (2013) estimated that 770,000 injuries and deaths occur each year as a result of medication errors.
Purpose: To decrease medication errors by reducing the number of phone call and call light interruptions during the medication administration process.
Methods: Lippitt’s Change …
Improving Nurse Education On Research Informed Consent, Tina Rasooli
Improving Nurse Education On Research Informed Consent, Tina Rasooli
Master's Projects and Capstones
As the number of human participants in clinical trials continues to grow, it is increasingly imperative that research nurses are educated about valid research informed consent to improve patient outcomes. As patient advocates, nurses must be aware of the components and principles of valid informed consent in order to protect the rights, safety, and wellbeing of their patients as human subjects. The research nurse must also be aware of their available resources and who to contact if they suspect a problem or a lack of patient comprehension of the study. In order to address these needs, an evidence-based performance improvement …
Increasing Patient Participation In The Medication Reconciliation Process, Andrea Idudhe
Increasing Patient Participation In The Medication Reconciliation Process, Andrea Idudhe
Master's Projects and Capstones
It is estimated, that ambulatory care settings have a 25% adverse drug events (ADEs) rate, and 39% of those event were preventable errors (Taché, Sönnichsen, and Ashcroft, 2011). Considering many adverse drug events are related to medication errors, preventing medication errors is fundamental to improving patient safety and outcomes. Medication reconciliation is the process of identifying and resolving medication discrepancies that occur, during transitions in care. Patient participation is a key component to the medication reconciliation process. With the intent to improve patient participation, a patient awareness intervention was implemented in the cardiology outpatient clinic. Data was collected using microsystem …
Employee Engagement In The Pacu, Michelle Spadaro
Employee Engagement In The Pacu, Michelle Spadaro
Master's Projects and Capstones
A clear vision is a powerful tool that can help advance employee engagement within nursing units. There is a great need for a compelling vision for the operation of a safe, efficient, equitable, effective, and patient centered healthcare delivery system. It is crucial to identify what actions are needed to achieve this vision and what realistic strategies are necessary for success. The purpose of this vision statement is to achieve excellence in nursing by establishing a common identity and direction that responds to an ever-changing healthcare environment. The project was conducted on a 25 bed peri-operative and post anesthesia care …
Cardiovascular Intensive Care Unit Patient Transition, Jenna-Lynn Stewrat
Cardiovascular Intensive Care Unit Patient Transition, Jenna-Lynn Stewrat
Master's Projects and Capstones
With no designated cardiovascular step-down unit at Phoenix Children’s Hospital, patient transitions to acute care are inconsistent following admission to the Cardiovascular Intensive Care Unit (CVICU). We aim to improve CVICU patient continuum of care through transferring patients to a step-down telemetry unit starting October 13th, 2014 exemplified by a 95% patient satisfaction of care provided by January 1st, 2015. The progression of the project was influenced by Lippitt’s theory, which includes seven phases in the change process. To accommodate post CVICU patients, the acute care unit was transformed to include cardiac monitors, telepacks, a central …
Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer
Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer
Master's Projects and Capstones
Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.
Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …
Improving Medication Administration And Patient Outcomes By Decreasing Avoidable Interruptions, Polly Nghiem
Improving Medication Administration And Patient Outcomes By Decreasing Avoidable Interruptions, Polly Nghiem
Master's Projects and Capstones
This Clinical Nurse Leader (CNL) project took place at a level I trauma center in the San Francisco Bay Area, on a 34-bed Medical Surgical, Behavioral Medicine and Acute Care for the Elderly (ACE) Specialty Unit. The goal was to improve the adverse events made during medication administration, which in turn reduces medical error costs and improves patient outcomes and patient safety. A review of the literature revealed several key points: (1) Medication errors are increasingly recognized as a significant, but preventable problem in our health care system, (2) Interruptions are implicated as a cause of clinical error, (3) Medication …
Prevention Of Hiv Mother-To-Child-Transmission In Sub-Saharan Africa, Sidik Abdul-Mumuni
Prevention Of Hiv Mother-To-Child-Transmission In Sub-Saharan Africa, Sidik Abdul-Mumuni
Master's Projects and Capstones
The transmission of HIV infection from an HIV-positive mother to her child during labor, pregnancy, breastfeeding or delivery is termed as mother-to-child HIV transmission (WHO, 2013 report on HIV). A range of 15-45% infection transmissions are possible when no intervention strategies are put into place. Globally, goals and initiatives have been set to combat this issue as well as speeding up the interventions and achieve possible transmission rates of levels less than 5% and total elimination of new infant HIV infections by 2015 (WHO, 2013 report on HIV). In 2011, 57% of pregnant women living with HIV in low and …