Medicine and Health Sciences Commons^™

Ultrasound Guided Piv Insertion Implementation, Blake Hotchkiss, Beth O'Donnell, Miles Merwin, Billie Jo Senecal, Ronica Smith, Eric Alan, Bryan Tavary, Chelsea Harkins, Taylor Archard, Leslie Geissinger, Lauren Remington

Operations Transformation

Observed high number of unsuccessful peripheral IV insertion attempts. This increases waste (cost and time) and decreases patient satisfaction.

An Integrated Review: Outpatient Care And Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

DNP Qualifying Manuscripts

Abstract

In the pediatric population, comprehensive cancer treatment and its associated side effects significantly impact their physical and emotional well-being. Though chemotherapy drugs are valuable agents against cancer cells, they also damage healthy dividing cells, such as bone marrow, thus weakening the immune system. Febrile neutropenia (FN) and associated infections remain the most critical complications of the extensive chemotherapy regimen and can threaten life if not appropriately addressed. Appropriate primary evaluation and treatment of FN in children with cancer includes administering proper broad-spectrum antibiotics. Ongoing research has focused on improving quality of life (QoL); yet, FN has persisted as the …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Enhancing Nurse Awareness Of A Stroke Patient Satisfaction Survey And Their Significance In Practice, Amanda Dao

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. InterventionTo address this gap in care, an educational presentation using literature evidence in support …

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

A Structured Handoff Report And Its Impact On Patient Experience, Gary N. Hicks

Doctoral Dissertations and Projects

Over the past decade, a fast-moving industry has challenged hospital health systems. Today, hospitals are measured on the effectiveness of healthcare delivery ensuring efficiency, quality, and safety. In addition to the delivery of effective healthcare, hospitals are now accountable for the overall patient experience, a system known as value-based purchasing. Value-based purchasing directly impacts the overall financial status of any healthcare organization and is based on data collected from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Nursing practice can significantly influence the overall impact and outcomes of value-based purchasing by helping with an improvement of HCAHPS. One …

Correlation Between Purposeful Patient Medication Education And Patient Experience Scores, Paula Shredl

Doctoral Dissertations and Projects

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national grading system that is used by payors to determine patients’ perception of their hospital stay. This public benchmarking system is tied to reimbursements and encompasses several domain areas. The medication and nursing domain questions revolve around how the nursing staff explained the purpose and possible side effects of patient medication. This project targeted a medical-surgical unit in a suburban faith-based hospital that was not meeting the national benchmarks in the nursing domain. The purpose of this evidence-based practice project, which was conducted using the Iowa Model of …

Seeking Patient-Centered Care Through Bedside Handoff In The Postpartum Unit, Evelyn Ndaki

Master's Projects and Capstones

Problem: Patient discontent with nurse compassion and attentiveness prompted the implementation of standardized bedside shift handoff (BSH) for nurses in the postpartum unit of a Northern California teaching hospital.

Context: Pandemic stressors led to nurse practices not reflecting patient-centered care. Bedside handoff offers an opportunity to improve patient-centered nurse behaviors.

Intervention: To standardize BSH, a modified SBAR (Situation, Background, Assessment, Recommendation) tool was implemented.

Measures: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question on “Nurses kept you informed” was tracked, and nurse satisfaction with the handoff process was measured with a pre- and post-implementation survey.

Results: Final …

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …

Benchmark Study: Impact Of Electronic Health Records Vs. Paper-Based Records, Erin Emmerich

MSN Capstone Projects

Medical documentation is an essential part of healthcare and conducted at the highest standard; documentation ensures the delivery of safe and high-quality healthcare services (Noureldin et al., 2014). Performance Improvement team reports the same poor outcomes each quarter that may be a result of the paper-based documentation system. These outcomes include patient safety, patient satisfaction and cost-effectiveness. This narrative review’s purpose is to determine whether the implementation of an electronic health record (EHR) system could improve outcomes. Evidence-based guidelines for the implementation of an EHR need special consideration to have a successful transition. Further studies may need to be reviewed …

Impacts Of Emotional Intelligence Skill Development Training On Nurse Leaders, Denise A. Holyoak Dnp, Rn, Ccrn-K, Nea-Bc

Doctor of Nursing Practice Projects

Background: Emotional intelligence (EI) skills are recognized as an essential tool for leaders’ success in their organization. Research shows that an EI skill development training program is effective at improving this skill set of nurse leaders and thus positively influence individual and organizational outcomes.

Aims: The purpose of this evidence-based practice (EBP) project was to design an EI skill development curriculum for frontline inpatient nurse managers and to evaluate its impact on three aims: EI skill scores of nurse managers, patient satisfaction scores related to nurse communication and nurse manager leadership communication scores.

Methods: Eleven inpatient nurse managers from a …

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews Protocol, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Abby Kra-Friedman, Reneé Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Nursing Faculty Publications

Introduction

In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A …

The Effects Of Nursing Bedside Shift Report On Patient Safety And Satisfaction: A Systematic Review Of The Literature, Alyssa Wong

Master's Projects

Introduction: Nursing bedside shift report is a recommended strategy to promote the effective exchange of accurate patient information during the handoff process with the goal of decreasing communication errors and adverse patient events. However, adopting this handoff method into nursing practice has been challenging in the clinical setting. This systematic review aims to understand the rationale behind nursing bedside handoff by identifying the advantages and barriers to implementation and exploring how this affects patient safety and experience.
Methods: A systematic review was conducted by searching through electronic databases and Google Scholar to identify English-language peer-reviewed journal articles published between 2012 …

Dedicated Vascular Access Team Benchmark Study, Rachel Davis

MSN Capstone Projects

Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages …

From The First Encounter: A Communication Program For High Volume, High Acuity Patient Care Locations, Shazam Bacchus

Student Scholarly Projects

Effective communication is a true value to healthcare organizations. Far too many communication sessions are detrimental to patient health outcomes. National data and hospital records are proven information to suggest communication is a major barrier to overall patient satisfaction. Organizations struggle to increase market share and patient satisfaction with a likelihood to recommend because of poor communication by physician and nurses. The use of a strategic communication tool like AIDET plus the Promise can influence the improvement of an organization’s quality of care.

This paper examines the use of AIDET plus the Promise as a strategic communication tool. High volume, …

Take A Seat To Improve Patient-Centered Communication, Emma E. El-Shami

Doctor of Nursing Practice Scholarly Projects

Problem Statement: At a hospital in Upstate South Carolina, the patient experience surveys identify nurse-patient communication on the post-operative unit needs improving. Over three months of Summer 2021, 83.5% of patients reported that their nurses listened carefully, 82.4% stated there was comfort with talking with nurses, and 80.8% of patients reported that nurses explained things in a way they could understand. Purpose: This project aims to determine if the "Commit to Sit" Initiative compared to usual practice will affect patient satisfaction scores. Methods: Nurse-patient communication components of the patient satisfaction survey were assessed before and after the "Commit to Sit" …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Patient And Provider Experiences With Virtual Care During The Covid-19 Pandemic: A Mixed Methods Study, Mars Zhao, Hisham Elshoni, Jennifer O'Brien, Erin Barbour-Tuck, Mary Ellen Walker, Heather Dyck, Andrea Vasquez, Eric Sy, Angela Baerwald, Clara Michaels, Rejina Kamrul, Olivia Reis, Brenda Schuster, Barb Beaurivage, Adam Clay, Mark Lees, Jonathan Gamble

Patient Experience Journal

The COVID-19 pandemic prompted the rapid uptake of Virtual Care (VC). Positive patient outcomes with VC are previously reported but little is known about the experiences of patients and providers using VC during the pandemic. We aimed to describe patient and primary care provider experiences, satisfaction, perceptions, and attitudes to VC during the COVID-19 pandemic that might explain adoption of VC across the continuum of care and inform sustained uptake. We conducted a sequential explanatory mixed methods study using online surveys and virtual interviews with a convenience sample of primary care providers and patients in a Canadian province (July – …

Revising An Order Set To Standardize The Workflow For The Outpatient Intravenous Diuretic Therapy Clinic In The Cardiac Cath Lab Holding Area, Mackenzie Trent Rasnake

Doctoral Dissertations and Projects

Heart failure (HF) is the leading cause of hospital admissions and readmissions. This produces costly hospital bills and detrimental effects on healthcare systems (Babar et al., 2020). It has been shown that intravenous (IV) diuretic therapy in the outpatient setting will reduce HF-related hospital readmissions (Abougergi et al., 2021). Outpatient IV diuretic therapy clinics are crucial for this reason. Revising an order set for the outpatient IV diuretic therapy clinic in the Cardiac Cath Lab holding area will reduce patient length of stay, improve nurse-provider communication, and increase patient and nurse satisfaction. Utilizing the Secure Chat feature within the electronic …

Improving Patient Satisfaction And Preventative Health Service Utilization For Limited English Proficiency Immigrants At Pearl Medical Centr, Chioma Holland

Graduate Theses, Dissertations, and Capstones

Background: Despite research efforts to address health disparities within immigrant communities, immigrant health continues to lack the attention from healthcare stakeholders it needs. Many immigrants already face dire health threats like extreme poverty, political unrest, and mental health concerns in their countries of origin, making them even more vulnerable to poor physical, mental, and social health outcomes upon arrival to the United States (U.S.). The purpose of this project was to improve patient satisfaction and increase immigrant use of preventative care by utilizing appropriate interpreter services. Method: The Quality improvement (QI) project involved surveying limited English proficiency (LEP) immigrants older …

Positively Waiting: Technology As The Preferred Distractor In A Pediatric Outpatient Setting, Timothy Ernest, Victoria Maddex, Arnaldo Mejias, Lindy Davidson, Donna Ettel-Gambino

Patient Experience Journal

Visiting any pediatric outpatient clinic as a child may be considered a stressful and anxiety-inducing experience. The literature suggests that positive distractions, such as pet therapy and single-user electronic devices, may aid in reducing anxiety and maximizing patient satisfaction throughout the patient’s experience at a pediatric outpatient clinic. The aim of this pilot quality improvement project was to determine which positive distractions patients experienced and whether single-user electronic loaner devices should be provided to patients at pediatric outpatient facilities. A quantitative causal comparative approach was utilized in identifying patient exposure to key positive distraction techniques that may significantly decrease anxiety. …

Reduction Of Order-To-Scan Times To Increase Patient Throughput And Improve Patient Outcomes: A Quality Improvement Project, Jason Harrington

Master's Theses and Capstones

Background: Throughput is a key metric for both the emergency department and the hospital system. Diagnostic tests, such as CT scans, can lead to a large delay in patient throughput which can negatively impact patient satisfaction and patient outcomes. Finding ways to reduce delays in CT scan acquisition can positively impact patient satisfaction and patient outcomes.

Aim: The specific aim of this quality improvement project was to decrease the amount of time it takes to complete abdominal CT scans with IV contrast once ordered from 61 minutes to below 35 minutes by July 1^st, 2022

Methods: Plan was …

Patient Satisfaction, Amber Bowman

Master of Science in Nursing Theses and Projects

This thesis project reviews how nursing care, specifically that of nursing assistance, impacts patient satisfaction. Care provided to patients during hospitalization is scored by post-discharge surveys. For this project, the HCAHP survey is specifically referred to and discussed. The survey data obtained from the HCAHP survey is available to the public for review. This data can affect the population's outlook on healthcare organizations. Research has found that care provided by nursing assistants has an impact on the satisfaction of patients. Research in the area of improving patient satisfaction is lacking in data and tools for improvement.

Bedside Reporting, Morgan Sanford

Master of Science in Nursing Theses and Projects

Bedside reporting can directly correlate with preventing errors in the healthcare setting. The three main errors that occur are falls, medication errors, and sentinel events. These errors have a vast number of different outcomes, even resulting in death in some cases. Despite The Joint Commission directly stating that bedside reporting is best practice, this is not always what is conducted in many hospital organizations. Literature has suggested the problem that exists with implementation is the longevity of the implementation from staff. Identifying a feasible and conducive way to implement bedside reporting that is both favorable for the patient and staff …

Implementation Of Oncology Standardized Scheduling Bundle Impacting Staff Productivity And Patient Satisfaction, Carolyn Brausch

DNP Scholarly Projects

BACKGROUND: Patients having timelyaccess to healthcare services is the entryway to quality of care and patient safety. Timely access is essential in cancer treatment and often requires complex scheduling requiring multiple, highly coordinated, time sensitive appointments. To facilitate optimal clinical care, timely appointment scheduling must be patient-centered. With the heavy scheduling workload growing at the the Cancer Network at Froedtert & the Medical College of Wisconsin and recognition of timely scheduling as a quality indicator, the need to examine the workflow and improve the process became apparent.

METHODS: The goal of the quality improvement project was to provide patients with …

Reducing Observation Unit Length Of Stay Hours: A Quality Improvement Project, Rena D. Cantrell

Master of Science in Nursing Theses and Projects

An acute care observation unit provides care for patients admitted via Emergency Center (EC) or direct admission from a healthcare provider’s office who do not yet require inpatient status. The goal length of stay (LOS) for these patients should be less than or equal to 24-48 hours. This project is being developed for a 22-bed observation unit in the Southeastern United States to decrease current LOS hours. Currently, the goal LOS for this unit is 24 hours, not to exceed 48 hours, and for patients admitted with a chest pain diagnosis, no longer than 19 hours. A plan to expand …

Increasing Patient Satisfaction With Noise Reduction On Medical Surgical Units: A Quality Improvement Project, Chennah Sharpe

Master's Theses and Capstones

Background: Noise has been linked to negative impacts on patient’s rest, length of stay (LOS), the immune system’s ability to fight infections, pain and anxiety levels, and readmission rates. Quality improvement projects in non-intensive care units are needed to determine major causes of noise and factors which impact patients’ rest, perception of noise, and satisfaction with medical-surgical unit care.

Aim: The global aim of this quality improvement project was to increase medical-surgical patients’ satisfaction by reducing the impact of noise in their inpatient stay. The specific aim was to increase the percent of patients, who responded Always to the Hospital …

Telehealth Appointments To Increase Therapy Compliance In Patients With Mosa, Tracy J. Partington

Doctor of Nursing Practice (DNP) Projects

Background: At the VA Puget Sound Healthcare System, care as usual for patients with a new diagnosis of mild obstructive sleep apnea (MOSA) is a letter directing the patient to call the continuous positive airway pressure (CPAP) clinic to establish ongoing care.

Local Problem: This model has resulted in low therapy compliance and does not afford patients the ability to discuss their diagnosis and treatment options with a licensed healthcare provider. A literature review showed telemedicine interventions increase therapy compliance in patients with MOSA.

Context: The Doctor of Nursing Practice project implemented an evidence-based practice change to improve therapy compliance …

Increasing Lactation Consultant Support To The Mch Unit, Daniella Grace Mcclendon

Master's Projects and Capstones

Problem: Breastfeeding is the most beneficial feeding choice for newborns and one of the best ways for mothers to bond with their newborns. In the current Maternal Child Health (MCH) unit, exclusive breastfeeding rates have fallen lower than the unit’s goal of 82%.

Context: Exclusive breastfeeding, when a newborn consumes only human breastmilk, is not always an easy process to initiate immediately after birth and in the early postpartum period. On this specific unit, there is not enough lactation consultant support to provide all patients on the unit.

Interventions: This project considers adding additional lactation consultants to support the MCH …