Medicine and Health Sciences Commons^™

The Effect Of Longitudinal Changes In Rn Specialty Certification Rates On Total Patient Fall Rates In Acute Care Hospitals, Diane Kay Boyle Phd, Rn, Faan

Diane Kay Boyle PhD, RN, FAAN

Background: Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification.

Objective: To examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level.

Method: We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators®. The sample consisted of 7,583 units in …

Implementation Of Motivational Interviewing In A Multidisciplinary Hiv Clinic In An Academic Medical Setting, Lucy Ledesma

Doctoral Dissertations

Purpose: People living with HIV (PLWH) struggle with medication adherence. Antiretroviral therapy (ART) requires greater than 95% adherence to prevent HIV drug resistance and treatment failure. Motivational interviewing (MI) is an effective counseling method designed to enhance health behavior change. This project determined the effectiveness of a two-day introductory MI training course on participant MI knowledge, perception of MI effectiveness, perception of client behavior change, and likelihood of MI use in a Midwest outpatient HIV clinic.

Participants: Seven clinical and non-clinical members of the multidisciplinary care team completed the two-day MI training course. Approximately 82% of the participants had never …

Be Seen And Heard Being Clean: A Patient-Centered Approach To Hand Hygiene At Concord Hospital, Ashley Pinkham

Master's Theses and Capstones

Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using …

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 …

Contributing To A “Culture Of Safety” By Increasing Usage Of The Drug Library On Smart Infusion Pumps: A Quality Improvement Project, Heidi Armstrong

Master's Theses and Capstones

Background: Computerized infusion devices called smart infusion pumps or smart pumps are clinical tools capable of decreasing IV medication infusion calculation errors through the use of embedded drug libraries. These devices are now important tools contributing to a “culture of safety” defined by the Joint Commission. Reports from April 2015 indicated a 22% occurrence rate in which the devices were not correctly programmed before infusion.

AIM Statement: The global aim of this quality improvement project was to improve usage of the IV pump drug library by ensuring medication is correctly labeled before infusion. The specific aim was to increase the …

Engaging Patients To Improve Documentation Of Oral Intake On A Cardiac Telemetry Unit: A Quality Improvement Initiative, Timiny A. Mosher

Master's Theses and Capstones

Background Information
It is important for patients with heart failure to have awareness of their intake & output to effectively manage their disease. There is evidence that tracking intake & output is a component of missed nursing care resulting in discrepancies between the actual patient intake and what is documented in the patient’s electronic health record (EHR).

Aim

The aim of this quality improvement project was to engage patients in monitoring their intake by using teach-back and patient engagement techniques to track their own oral fluid intake throughout the day.

Methods
The Plan-Do-Study-Act (PDSA) model was used as the framework …

Implementing A Checklist & Hourly Huddles To Increase Situational Awareness During The Second Stage Of Labor-A Perinatal Quality Improvement Project, Kelly Knowles

Master's Theses and Capstones

Background: Current management of the second stage of labor often follows tradition-based routines rather than evidence-based practices. A lack of situational awareness and tunnel vision can limit medical decision-making. Northern New England Perinatal Quality Improvement Network (NNEPQIN) has listed Second Stage Situational Awareness as a priority initiative. Standardized checklists are useful for maintaining situational awareness. Regular debriefings using a standardized tool have been shown to improve communication and team based care, which generally leads to improved patient outcomes. Based on this evidence, developing a standardized checklist including regular hourly care team “huddles” is valuable and could result in improved birth …