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Articles 1 - 30 of 48
Full-Text Articles in Medicine and Health Sciences
Implementing The "Baby Drop Bundle", Natalie Aguirre
Implementing The "Baby Drop Bundle", Natalie Aguirre
Master's Projects and Capstones
Problem: Falls are a preventable type of trauma that may lead to serious injury, prolonged hospital stays, and non-reimbursable costs to the organization. While there are established fall prevention policies for ambulatory patients, infants dropped by their caregivers are largely excluded.
Context: This quality improvement project aims to decrease newborn drops by implementing the “Baby Drop Bundle”. The bundle allows caregivers and bedside providers to partner in creating a safe environment for the patient.
Interventions: The Clinical Nurse Leader (CNL) will provide a brief in-service during the morning safety huddle to introduce the bundle to staff. The bundle includes educational …
Improving Prolonged Antibiotics Education In A Pediatric Unit, Zerena S. Silva Villamonte
Improving Prolonged Antibiotics Education In A Pediatric Unit, Zerena S. Silva Villamonte
Master's Projects and Capstones
Problem Children’s Hospital A's incidence report tool, iCares, demonstrates that 50% of the issues related to prolonged intravenous (IV) antibiotics are categorized as administration issues. This leads to the medication being delivered at the wrong time or rate. Having these issues increases patient length of stay, increasing hospital costs. Context The microsystems for this quality improvement project include inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s Hospital A is a 361-bed San Francisco Bay Area hospital. Interventions The Clinical Nurse Leader students implemented a presentation defining prolonged IV antibiotics, their rationale, and a video demonstrating the correct …
Educating Pediatric Registered Nurses On The Administration Of Prolonged Intravenous Antibiotics, Kasandra Rezler
Educating Pediatric Registered Nurses On The Administration Of Prolonged Intravenous Antibiotics, Kasandra Rezler
Master's Projects and Capstones
Abstract
Problem According to Children’s Hospital A's incident reporting system, 50% of problems related to prolonged intravenous antibiotics were classified as administration issues. When mistakes are made in this process, the antibiotic is then delivered at the wrong rate or the wrong time, which is problematic. Additionally, findings from a needs assessment survey highlight a critical need for targeted interventions, such as an educational video, to reduce administration errors associated with prolonged IV antibiotics. Context Within Children’s Hospital A, the microsystems targeted by this quality improvement project consist of inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s …
Educating Inpatient Pediatric Registered Nurses On The Setup And Administration Of Prolonged Intravenous Antibiotics And The Reduction Of Medication Errors, Kiara Hayden
Master's Projects and Capstones
Problem The acute care unit microsystem of a California children’s hospital encounters issues involving the incorrect set up and administration of prolonged intravenous (IV) antibiotics and medication errors, such as delivery at the wrong rate or time. These problems can result in negative patient health outcomes, delayed healing, antibiotic resistance, and increased length of hospital stay and costs. Context A collaborative quality improvement (QI) project was launched to target the pediatric population of this particular microsystem. The aim of this project was to standardize prolonged IV antibiotic practices, disseminate knowledge while using evidence-based practice (EBP), and improve patient outcomes. Interventions …
Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez
Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez
Master's Projects and Capstones
Abstract
Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …
Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone
Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone
Master's Projects and Capstones
Problem
One million hospitalized people fall annually in the United States, and up to a third are preventable.
Context
Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.
Interventions
A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.
Measures
Outcome measures observe for total fall count and the …
Improving Quality Of Communication In Pediatric Perioperative Outpatient Setting Using Aidet And Commit To Sit, Hyo Ryung Kim
Improving Quality Of Communication In Pediatric Perioperative Outpatient Setting Using Aidet And Commit To Sit, Hyo Ryung Kim
Master's Projects and Capstones
Abstract
Problem: Effective and therapeutic communication in the health care setting is multidisciplinary,
complex, and has unique challenges for each microsystem. The perioperative setting is an
especially challenging environment for healthcare workers to provide therapeutic
communication, as uniquely high-risk and time-sensitive information must be disseminated in a
language that is understandable for the patient(Osborne-Smith & Kyle Hodgen, 2017). A
microsystem assessment of an outpatient pediatric perioperative setting reflected some of the
challenges the healthcare workers were facing when communicating with their patients and
family members. Upon evaluation of the monthly NRC (National Research Corporation) score
prior to implementation of two …
Implementation Of Aidet, Commit To Sit, And Culturally-Competent Care In Pediatric Outpatient Setting, Melanie T. Wine
Implementation Of Aidet, Commit To Sit, And Culturally-Competent Care In Pediatric Outpatient Setting, Melanie T. Wine
Master's Projects and Capstones
Problem: This quality improvement project implements AIDET, Commit to Sit, and culturally-competent care to improve patient satisfaction and communication between providers and patients in a diverse pediatric outpatient surgery microsystem setting. The microsystem’s NRC patient satisfaction scores from September to September is below the 85th percentile, and there is an immense desire to improve the overall scores by the staff. The detractors of the overall performance derived from the patients feeling that the staff needs to work together to meet patients’ needs, care providers not taking enough time to explain and listen, wanting to trust providers with care, procedures …
Increasing Patient Satisfaction In A Pediatric Perioperative Outpatient Setting, Ailen Revuelta
Increasing Patient Satisfaction In A Pediatric Perioperative Outpatient Setting, Ailen Revuelta
Master's Projects and Capstones
Problem: Effective and therapeutic communication in the healthcare setting is multidisciplinary, complex, and has its unique challenges for each microsystem. This quality improvement project implements two communication tools AIDET and Commit to Sit and incorporates cultural competency to improve communication and increase patient satisfaction in a pediatric outpatient perioperative microsystem. A microsystem assessment reflected some challenges that staff were facing when communicating with their patients and family members. A patient satisfaction assessment revealed that the microsystem is scoring below the target goal of the 85th percentile.
Context: The microsystem being addressed by this quality improvement project is an outpatient perioperative …
Implementation Of Aidet And Commit To Sit In Pediatric Outpatient Setting, Shibani Dhir
Implementation Of Aidet And Commit To Sit In Pediatric Outpatient Setting, Shibani Dhir
Master's Projects and Capstones
Problem: This quality improvement project implements AIDET (Acknowledge, Introduce, Duration, Explain, and Thank You), Commit to Sit, and cultural-competent care to improve patient satisfaction and communication between multidisciplinary health care team members and patients in a microsystem of a pediatric outpatient setting. The National Research Company (NRC) scores from the microsystem are below the 85th percentile, and this microsystem strives for excellence in the care provided to patients. The detractors from the patient satisfaction scores include patients scoring low on staff needing to work together, care providers not taking enough time to explain and listen, wanting to trust providers with …
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
Master's Projects and Capstones
Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.
This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …
Optimizing Mri Experience For Children Living With Autism Spectrum Disorder, Lyn Tran
Optimizing Mri Experience For Children Living With Autism Spectrum Disorder, Lyn Tran
Master's Theses
Magnetic Resonance Imaging (MRI) in pediatric patients living with Autism Spectrum Disorder (ASD) is often complicated by challenges. The child perceives the MRI environment as abnormal and uncertain of the implications of the procedure. The child may exhibit distress becoming anxious and frightened, reluctant to enter the scanner, and unable to remain still throughout the duration of the procedure. The issue lies within the child’s mental and behavioral challenges to understand and follow the task demands to ensure safety and accurate acquisition of image artifacts. After reviewing literature, observing MRI protocol for pediatric patients, and conducting multiple nursing staff surveys …
Prevention Of Abusive Head Trauma Using An Educational Program For Parents/Caregivers, Camile Williams
Prevention Of Abusive Head Trauma Using An Educational Program For Parents/Caregivers, Camile Williams
Doctor of Nursing Practice (DNP) Projects
Problem: The National Center on Shaken Baby Syndrome reports that 1,300 abusive head trauma (AHT) cases occur in the USA each year, a quarter of which are fatal. Injuries are caused by impact, shaking, or both and result in intracranial and spinal damage, retinal hemorrhages, fractures of the ribs and other bones. AHT case rates in the community involved in this project had a 22% increase of AHT from 2018 to 2019.
Context: A practice improvement project involved the implementation of an AHT educational program targeted at parents/caregiversreceiving care services at a children’s hospital pediatric well-child clinic located in …
Optimizing Pediatric Preoperative Experiences In The Mri, Ryan Jann
Optimizing Pediatric Preoperative Experiences In The Mri, Ryan Jann
Master's Projects and Capstones
Problem: Over the past decade, the prevalence of children with sensory processing disorders has had a steep upward trend. Youth with hyposensitivity and hypersensitivity conditions often develop enhanced stress and anxiety during the pre-operative admission process in preparation for MRI procedures.
Context: Specialized interventions and accommodations are a necessity for this population however, no preventative measures have been utilized within the outpatient surgical center.
Interventions: Resources were created to better prepare patients and guardians for their MRI visits including: a Social Story Video, Picture & Activity Book, as well as an MRI Toolkit. In addition, a one …
Optimizing Pediatric Experiences In Mri, Ryan Jann
Optimizing Pediatric Experiences In Mri, Ryan Jann
Master's Projects and Capstones
Problem: Over the past decade, the prevalence of children with sensory processing disorders has had a steep upward trend. Youth with hyposensitivity and hypersensitivity conditions often develop enhanced stress and anxiety during the pre-operative admission process in preparation for MRI procedures.
Context: Specialized interventions and accommodations are a necessity for this population however, no preventative measures have been utilized within the outpatient surgical center.
Interventions: Resources were created to better prepare patients and guardians for their MRI visits including: a Social Story Video, Picture & Activity Book, as well as an MRI Toolkit. In addition, a one hour staff inservice …
Standardizing Patient Handoffs In The Icu – Implementing The “I Put Patients First” Tool., Wislande Joseph
Standardizing Patient Handoffs In The Icu – Implementing The “I Put Patients First” Tool., Wislande Joseph
Master's Projects and Capstones
Abstract
Background. Ineffective patient handoff can result in poor nurse communication, increasing the likelihood of adverse events including medication and documentation errors.
Context/Problem. In one 20-bed ICU unit in a northern California community hospital, 48 patient handoffs were observed over 2 weeks. Only 29% occurred at the patient’s bedside; 39.5% used a standardized handoff tool; and 54% included the patient and/or family. These findings indicate significant quality gaps in the unit’s ICU patient handoff processes.
Intervention. The educational intervention consisted of one introductory and two follow-up teaching sessions related to best practices for handoff processes followed by implementation …
Type 2 Diabetes Mellitus In The Pediatric Population, Lorna Santiago
Type 2 Diabetes Mellitus In The Pediatric Population, Lorna Santiago
DNP Qualifying Manuscripts
The incidence and prevalence of diabetes in youth in the United States is increasing. In particular, type 2 diabetes mellitus (T2DM) is becoming more common in individuals younger than 20 years. Nurse practitioners and other primary care providers that see children should be knowledgeable about the condition and confident in participating in multidisciplinary management. Screening should begin at age 10 or at puberty, whichever comes first. Providers should screen all children who are overweight or obese or of Native American, African American, Latino, Asian American, or Pacific Islander race or ethnicity. Children of these ethnicities have a greater risk for …
Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Amanda Dailor, Macy Therese G. Andrada, Julie C. Barragan, Samantha T. Gerber, Mercedes S. Greenberg, Tatyana Grib
Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Amanda Dailor, Macy Therese G. Andrada, Julie C. Barragan, Samantha T. Gerber, Mercedes S. Greenberg, Tatyana Grib
Master's Projects and Capstones
At a large, community-based pediatric hospital in Southern California, a quality improvement project commenced with a goal to improve patient outcomes by decreasing length of stay and pain levels, while increasing toleration of feeds. Implementing a standardized guideline would ensure safe practice across the continuum and allow providers to use a systematic tool for postoperative care, including nursing care interventions and medications. The Root-Cause-Analysis tool was used to assess the microsystem and determine the contributing factors to the identified problem. A SWOT analysis was then performed, followed by a plan to collect data from all pediatric cleft palate procedures performed …
Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Julie Barragan, Macy Andrada, Mercedes Greenberg, Tatiana Grib, Samantha Gerber, Amanda Dailor
Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Julie Barragan, Macy Andrada, Mercedes Greenberg, Tatiana Grib, Samantha Gerber, Amanda Dailor
Master's Projects and Capstones
At a large, community-based pediatric hospital in Southern California, a quality improvement project commenced with a goal to improve patient outcomes by decreasing length of stay and pain levels, while increasing toleration of feeds. Implementing a standardized guideline would ensure safe practice across the continuum and allow providers to use a systematic tool for postoperative care, including nursing care interventions and medications. The Root-Cause-Analysis tool was used to assess the microsystem and determine the contributing factors to the identified problem. A SWOT analysis was then performed, followed by a plan to collect data from all pediatric cleft palate procedures performed …
Implementation Of A Mentor Program To Support Nurse Retention: A Pilot Project, Lucy Camarena
Implementation Of A Mentor Program To Support Nurse Retention: A Pilot Project, Lucy Camarena
Doctor of Nursing Practice (DNP) Projects
Abstract
Problem: Primary factors affecting nurses’ decisions to stay at an organization include nurse self-concept, job satisfaction, and professional growth. A high turnover rate of nurses poses a risk to patients’ safety and healthcare outcomes. The implementation of mentor programs in institutions that employ new nurses has been shown to reduce turnover rates, increase the quality of patient care, and empower nurses in professional development. The existing literature supports the use of mentor programs and encourages their implementation in healthcare institutions.
Interventions: The DNP project’s goal was to identify effective methods of promoting positive nurse self-concept and increasing job satisfaction …
Childhood Obesity: Getting Back To The Basics, Fanny Powell
Childhood Obesity: Getting Back To The Basics, Fanny Powell
DNP Qualifying Manuscripts
Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …
Implementation Of A Pediatric Post-Operative Hand-Off Tool: A Patient Safety Project, Kaye Remo
Implementation Of A Pediatric Post-Operative Hand-Off Tool: A Patient Safety Project, Kaye Remo
Master's Projects and Capstones
Abstract
Problem: The clinical nurse leader (CNL) performed a microsystem assessment using the Dartmouth assessment tool to evaluate the microsystem’s readiness to provide safe care for pediatric post-operative cardiovascular patients. The microsystem is a 12-bed unit caring for critically ill pediatric patients requiring intensive monitoring and therapy. The microsystem’s interdisciplinary team is comprised of medical doctors, nurses, respiratory therapists, social workers, nutritionists, child life specialists, and pharmacists. During assessment and gap analysis, the CNL identified gaps in nursing knowledge and skills to deliver safe care for this patient population during the immediate post-operative phase of recovery. There is a …
Improving Analgesia Administration For Pediatric Patients In A Rural Emergency Department, Alvin R. Walters
Improving Analgesia Administration For Pediatric Patients In A Rural Emergency Department, Alvin R. Walters
DNP Qualifying Manuscripts
When a child is in pain, parents often seek out treatment at an emergency department. After a detailed chart review it was determined that only 32.53% of the pediatric patients who present to a rural, northern California, ED in pain receive any documented form of analgesia during their time in the ED. A review of the literature revealed that triage nurse-initiated protocols can successfully manage to provide consistent and efficient analgesia to patients who present to an ED with pain. Therefore, a practice improvement project was undertaken to increase of the consistency and efficiency of analgesia administration for pediatric patients …
Benefits Of Interprofessional Education Between Advanced Practice Nurse Practitioner And Dentistry Students, Oksana Prodan
Benefits Of Interprofessional Education Between Advanced Practice Nurse Practitioner And Dentistry Students, Oksana Prodan
DNP Qualifying Manuscripts
Background: Interprofessional Education (IPE) is mandated for accreditation in health professional schools. IPE between Advanced Practice Registered Nurse (APRN) and dentistry students have been developed to improve health oral systemic health outcomes and improve inter-professional practice competencies.
Method: Literature on APRN dental IPE was searched was searched via CINAHL Complete from 2007-2018, looking for scholarly journals, English language. The search was narrowed from 55 to three relevant, data-based studies.
Results: Review of literature produced one study demonstrating benefits of IPE for both APRN and dentistry students, one study only focused on benefits for APRN students, and another IPE article was …
Educational Prevention Program Of Surgical Site Infections At A Metropolitan Pediatric Hospital, Myra Hasan
Educational Prevention Program Of Surgical Site Infections At A Metropolitan Pediatric Hospital, Myra Hasan
Master's Theses
Surgical site infections (SSI) are a common cause of healthcare-associated infections (HAI). They remain a significant problem, as they are associated with increased morbidity and mortality and cause an increase in demand for several healthcare resources. In order to address this problem, hospitals have implemented several protocols and polices that are aimed to reduce these infections. However, the rates of SSIs continue to rise. Healthcare team members have found that while it is their responsibility to enforce preventative measures to the patient in the preoperative and surgical room, patient compliance to preventive measures at home also plays a role.
At …
Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung
Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung
Master's Projects and Capstones
Surgical site infections (SSI) cause negative health care effects to patients and hospitals. SSI is one of the most common types of healthcare-associated infections (HAI) accounting for 31% among hospitalized patients (Centers for Disease Control and Prevention [CDC], 2012). It is associated with prolonged length of stays (LOS), higher morbidity and mortality, and increased healthcare costs. The purpose of this quality improvement project is to decrease SSI rates by enhancing patient education and engagement in preoperative care and hygiene before surgery. In a metropolitan pediatric hospital, a microsystem analysis of the preoperative unit was conducted before generating the SSI Prevention …
Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan
Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan
Doctor of Nursing Practice (DNP) Projects
Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …
Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters
Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters
DNP Qualifying Manuscripts
Only 50% of pediatric patients presenting with significant pain receive any form of analgesia while in the emergency department (ED). The American College of Emergency Physicians endorses the use of triage protocols to improve the speed and consistency of analgesia in the ED. However, given the unique needs of the pediatric population insufficient evidence exists, if any, to support the use of triage protocols for their treatment in the ED. After a review of the literature it is concluded that triage pain protocols are a safe and effective method for providing pediatric analgesia in the ED. However, the variability in …
Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller
Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller
Master's Theses
This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …
Admission Criteria For The Pediatric Acute Care Unit To Reduce Length Of Stay In The Emergency Department, Peter G. Campbell
Admission Criteria For The Pediatric Acute Care Unit To Reduce Length Of Stay In The Emergency Department, Peter G. Campbell
Master's Projects and Capstones
Abstract
The primary objective as outlined in this prospectus is to develop pediatric admission criteria to reduce length of stay (LOS) in the emergency department for patients being admitted to the pediatric acute care unit. The pediatric acute care unit is a 25-bed licensed bed at a tertiary hospital in San Francisco serving patients from 1 day to 21 years of age. Methods included both qualitative and quantitative data to determine relevance of quality improvement project related to LOS, patient safety, patient satisfaction, and nurse to physician communication. Data collected indicated that average LOS in the ED was significantly higher …