Medicine and Health Sciences Commons^™

Assessment Of Organizational Readiness Towards Electronic Health Records In A Tertiary Care Hospital, Karachi, Pakistan, A Quantitative Analytical Cross-Sectional Study, Muhammad Javeed

Theses & Dissertations

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital …

Reducing The No Show Rates For Mental Health Appointments Among Young Adults, Johnnie Carrico

Student Scholarly Projects

Practice Problem: Missed patient appointments have become an increasingly significant issue for healthcare organizations, private practices, and clinics. No show appointments can negatively impact the operational functions of these organizations including lost revenue. The clinical practice site’s pre-intervention no-show rate for young adult mental health appointments was 21%. The high percentage of missed mental health visits has resulted in both lost revenue for the clinic and disruptions in patient care.

PICOT: The PICOT question that guided this project was: In young adults 18-25 years with mental health appointments (P) how does patient preferred appointment reminders (I) compared to …

Predictors Of Presenteeism Among Nurses Working At A Tertiary Care Hospital In Karachi, Pakistan: A Cross-Sectional Analytical Study, Farhan Shahzad

Theses & Dissertations

Background: Nurses are considered the backbone of hospitals who provide care for their patients despite being ill. This phenomenon of working while ill or suffering from a health condition is called presenteeism. Presenteeism is becoming a more prominent problem among healthcare providers, especially nurses. It has a variety of negative effects, including stress and burnout, decline in productivity and performance, and ultimately results in decreased quality of care.
Objective: The objective of this study was to compute the presenteeism score and predict its associated factors among nurses working at a tertiary care hospital in Karachi, Pakistan.
Methodology: A cross-sectional analytical …

Nurses' Compliance With Central Line Maintenance (Handling) Guidelines At A Tertiary Care Setting In Karachi, Pakistan- A Descriptive Cross-Sectional Study, Alina Amir Ali

Theses & Dissertations

Background: Central venous catheters (CVCs) are integral to modern healthcare, facilitating critical treatments. However, the risk of complications, particularly infections, necessitates strict adherence to central line maintenance protocols. This study explores the compliance of nurses in executing these protocols.
Purpose: In a tertiary care facility in Karachi, Pakistan, this study sought to evaluate nurses' adherence to each item on the central line management checklist as well as the checklist's total adherence in the Special Care Units.
Method: A total of 119 registered nurses were assessed, using a quantitative structured observational design for central line handling in adult medical surgical special …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

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 …

Evaluation Of A Blood Pressure Education Program On Knowledge And Self-Efficacy In Patient Care Associates ., Casey Prestigiacomo

Doctor of Nursing Practice Papers

The American College of Cardiology (ACC) and American Heart Association (AHA) revealed common errors made by healthcare professionals when measuring blood pressure (BP) in adult inpatients. These errors include using incorrectly sized cuffs, improper cuff placement, and inappropriate patient positioning. Inconsistent cuff sizes and position lead to underestimated and overestimated results, directly impacting patient care and outcomes. Additionally, the ACC/AHA identified patient position and talking during assessments as factors that directly impact the accuracy of the results. At Norton Healthcare facilities, a majority of BPs are obtained by patient care associates (PCAs). The purpose of this quality improvement project was …

Fighting Fatigue With Caffeine: Exploring Perceptions On Patient Safety, Camille Quitangon

Honors Theses

Objective: To examine the association between fatigue and caffeine consumption, and explore nurses’ perceptions of the impact of these factors on patient safety.

Background: Many people consume caffeine for its benefits, such as stimulating the central nervous system to feel more awake. Health professionals, such as nurses, commonly experience fatigue and often will drink coffee to get through their long shifts.

Methods: A comprehensive literature review was conducted. Studies were split into two categories – fatigue and patient safety or caffeine's effect on human performance.

Results: Fatigue causes nurses to be impaired; it affects their ability to be alert, vigilant, …

Nursing Students' Attitude And Commitment Toward Substance-Abusing Patients, Amy L. O'Conner

Honors Undergraduate Theses

The topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared nursing students are to care for patients with drug abuse or addiction. Specifically, the project explores student nurses' attitudes and commitment toward …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

The Effects Of Implementing Best Practices On 30-Day Readmission Rates In Adults Following Cabg Surgery, Linda Elaine Kline

Evidence-Based Practice Project Reports

Coronary artery bypass graft (CABG) surgery is one of the most frequent and expensive cardiac surgical procedures in the U.S. today. Complications from CABG surgery are one of the top causes of 30-day hospital readmissions. Readmissions after CABG surgery are often preventable and add to health care costs. Recent government legislation mandates penalties for hospitals with excess readmission rates. The purpose of this evidence-based practice project was to determine if implementation of best practice recommendations effected 30-day readmission rates following CABG surgery. A critical appraisal of the literature was conducted to identify best practice recommendations. The Iowa model and Lewin’s …

The Effects Of An Evidence-Based Food Allergy Management Plan To Keep Children With Food Allergies Safe At School, Scarlet R. Spain

Evidence-Based Practice Project Reports

The prevalence of food allergies in children has increased 18% between 1997 and 2007 (CDC, 2013). Furthermore, 84% of food allergic children will experience a reaction at school (Powers, Bergren, & Finnegan, 2007). An exposure in a sensitive child may progress quickly into potentially life threatening symptoms and death if not treated. The purpose of this evidence based practice (EBP) project was to determine if implementation of a food allergy management policy in a school setting reduced overall incidence rates of food allergy reactions in school children and to examine compliance to policy guidelines. The project encompassed implementation of a …

Best Practice For A Standardized And Safe Registered Nurse Shift Handoff, Nancy Rankin Ewing

Theses and Dissertations

One of the most important times for the delivery of patient care occurs during the change of shift handoff between professional nurses. This complex interchange of information and responsibility carries with it distinct possibilities for error that can adversely affect a patient’s hospitalization, safety, and the quality of patient care outcomes (Blouin, 2011; Hilligoss & Cohen, 2011). Communication errors, including errors during shift handoff, account for more than 70% of sentinel events that occur in the provision of healthcare in the acute care setting (Federwisch, 2007; Streeter, 2010). Poorly conducted and unstructured shift handoffs are known to result in delayed …

Relationship Between Horizontal Violence Among Registered Nurses And Falls, Elizabeth Densford Rocha Phd

Dissertations

Background: Horizontal violence is a manifestation of oppressed group behavior leading to low self-esteem and feelings of worthlessness among nurses. Horizontal violence leads to the creation of a hostile, unsafe work environment preventing nurses from performing at their highest potentials. A hostile work environment leads to a culture of unsafe patient care which may result in increased harm to patients. An understanding of why horizontal violence occurs and the implications of this phenomenon are the first steps in addressing this destructive behavior as well as protecting patients from harm. Health care environments must support nurses to perform at their best …

Nursing Informatics Competencies: Implications For Safe And Effective Practice, Hayes Greer

Honors Theses

The purpose of this thesis is to examine the implications and availability of nursing informatics competencies, and to address the current state of informatics competency guidelines and assessment tools. To possess competence in nursing informatics, one must possess the ability to obtain, store, retrieve, and communicate data, information, knowledge, and wisdom, which is essential to nursing practice. Nurses must be educated and competent in nursing informatics in order to exhibit safe and effective nursing practice. Many various lists and guidelines exist to address the distinct competencies that nurses must possess; however, very few resources are available to assess the degree …

Managing Patient Care: A Substantive Theory Of Clinical Decision Making In Home Health Care Nursing, Felicitas A. Dela Cruz Dnsc, Ma, Rn

Dissertations

This study investigates the phenomenon of clinical decision making, deriving a grounded substantive theory to explain how home health care nurses make patient care decisions. Despite the continuing shift of health care from acute care settings to the patient's home, little is known about home health care nurses' clinical decision making processes and the factors influencing them. The study employs a field research design using grounded theory based on symbolic interactionism. Data collection at two Visiting Nurse Associations includes participant observation and open-ended interviews of 21 nurses, and document analysis of patients' records and home care nursing practice policies. The …