Medicine and Health Sciences Commons^™

Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter

Master's Projects and Capstones

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …

Ed To Telemetry Bed: Optimizing Nurse Communication & Decreasing Team Frustration, Harmandeep (Harm) S. Madra

Master's Projects and Capstones

PROBLEM: According to the Institute of Medicine, boarding inpatients in the emergency department (ED) can result in an increased risk for medical errors, delay in treatments, and decreased quality of care. The goal is to move the patient to the hospital bed within 60 minutes from when an order is written for admission. The current average monthly compliance for ED throughput and admission to the inpatient bed is at 45% compared to the target of 70%. Lack of standardization during handoff can lead to delays, miscommunication and causes team frustration.

CONTEXT: In 2022, this community hospital’s ED microsystem had limited …

Introducing A New 12 Week Education & Simulation Program To Optimize Financial Performance Of Nurse Managers, Melissa Hathcoat

Master's Projects and Capstones

Problem: Several nurse executives (Waxman 2018; Massarweh, 2017; Hunt, 2018) agree that in today's increasingly complex health care environment, the reality of decreasing reimbursements and increasing focus on value-based metrics reflects a crucial knowledge base for nurse managers. Therefore, it is imperative for unit-based nurse leaders to receive education and support to attain and maintain the requisite business competencies to achieve both fiscal and quality targets in their microsystem (McFarlan, 2020). In an integrated managed care delivery system in northern California, no education curriculum exists for nurse managers and assistant nurse managers that addresses gaps in financial knowledge, skills, and …

Defying The Gravity Of Falls On Msu, Alvin Joseph Abad

Master's Projects and Capstones

Falls are a leading cause of injury and death for adult males in the United States and have been an ongoing problem on the Medical Surgical Unit (MSU). Therefore, the aim of this project is to increase fall prevention education and communication on MSU in order to ultimately improve fall rates. Although there are currently fall prevention processes already in place, these may not be sufficient as demonstrated by recent fall metrics. Many RNs on MSU are fairly new nurses; and their enthusiasm and adaptability may be an advantage for this evidence-based project. Furthermore, the management team seems to be …

Leadership Rounding In The Intensive Care Unit To Improve Satisfaction, Stephanie Laborde

Master's Projects and Capstones

A mid-sized hospital in Alameda County would like to increase its Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) scores by improving the patient care experience. The specific aim for this project is that by August 2018, the implementation of daily leadership rounding in the ICU will result in an increase of patient satisfaction HCAHPS scores by 5%. The project team used the Plan-Do-Study-Act cycle to guide the implementation of leadership rounding. Leadership rounding was conducted daily over a 10-week period by the project team, which consisted of the floor manager and clinical nurse leader (CNL) student. The project …

The Clinical Nurse Leader: Improving Early Sepsis Identification On Inpatient Units, Denise G. Lopez

Master's Projects and Capstones

CNL students were invited to a large metropolitan hospital in an effort to create a quality improvement project related to sepsis in order to decrease cost, the length of stay, and improve patient outcomes. CNL students shadowed nurses in order to better un derstand the nursing culture and assess the microsystem. Chart audits were reviewed to determine whether nurses at the assigned units were completing sepsis screenings on time and used the appropriate vital signs and labs. Nurses’ questionnaires were provi ded to assess sepsis knowledge and their understanding of sepsis. Results showed a lack in compliance in completing sepsis …

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects and Capstones

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL …

Reducing Clabsi In The Nicu With Iv Tubing Competency, Tessa A. Toscano Ms

Master's Projects and Capstones

Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to …