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- Diane Kay Boyle PhD, RN, FAAN (1)
Articles 211 - 240 of 241
Full-Text Articles in Medicine and Health Sciences
Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli
Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli
DNP Projects
Problem: The CDC estimates one person every 20 minutes every day acquires an HPV-related cancer. Kentucky’s HPV associated cancer burden is among the highest in the nation. Adolescent HPV vaccination rates in Kentucky are far below HealthyPeople 2020 goals. Barriers are multifaceted and include provider, patient and system barriers. The AFIX model is an evidenced based quality improvement program that addresses key provider barriers. The USPSTF findings identify a gap in the literature related to AFIX methods to improve rates of adolescent vaccines.
Objectives: The purpose of this study was to evaluate the effects of an intervention using the AFIX …
Implementing & Evaluating A Nurse-Led Educational Intervention For Bone Marrow Transplant Patients In The Acute Care Setting, Tia T. Wheatley
Implementing & Evaluating A Nurse-Led Educational Intervention For Bone Marrow Transplant Patients In The Acute Care Setting, Tia T. Wheatley
DNP Projects
Objective: The Bone Marrow Transplant (BMT) Basics Class is a nurse-led educational program dedicated to preparing patients and their caregivers of the treatment outline and self-care behaviors associated with receiving a BMT. The purpose of this project is to evaluate the effectiveness of this intervention in order to support the needs of the BMT patient and promote patient-centered care.
Study Design: Retrospective review to evaluate a quality improvement project.
Participants & Methods: As of July 2016, the BMT Basics Class became a standard of care at an NCI-designated academic cancer center in the southeastern United States. Between July 20, 2016 …
Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube
Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube
Walden Dissertations and Doctoral Studies
Postpartum depression (PPD) is a mood disorder affecting approximately 20% of women within 6 months of delivery. Untreated PPD diminishes a woman's functioning and may result in short and long-term consequences for her infant. Screening with evidence-based tools can identify prenatal and postpartum women at risk for PPD, ensure early treatment, and limit adverse maternal and infant effects. Using Rosswurm and Larrabee's evidence-based practice model, a multidisciplinary team of 7 key stakeholders, including directors and a nurse from the departments of OB/GYN, Pediatrics, and Primary Care, a psychiatrist specializing in women's health, and a member of nursing leadership, formed to …
Organizational Improvement Readiness Assessment (Oira) Tool Evaluation, Leslie Hough Falk
Organizational Improvement Readiness Assessment (Oira) Tool Evaluation, Leslie Hough Falk
Doctor of Nursing Practice Projects
Background: Research shows that despite an increase in the number of organizational improvement initiatives there is a lack of consistent, sustained outcomes. Organizations struggle with how to reliably and accurately measure their readiness to drive and sustain outcomes. A search of the literature failed to identify a comprehensive, evidence-based tool that has been developed or evaluated to assess organizational improvement readiness. The objective of this project was to evaluate a newly developed Organizational Improvement Readiness Assessment (OIRA) Tool.
Project Design: Guided by two theoretical models, Delphi-Based Systems Architecting Framework (DB-SAF) and the Rogers Diffusion of Innovation Model, a 3-round, modified …
Improving Quality And Efficient Communication Between Providers And Nursing - A Psychiatric Sbar Tool (Psych), Karen Lee Richards
Improving Quality And Efficient Communication Between Providers And Nursing - A Psychiatric Sbar Tool (Psych), Karen Lee Richards
Master's Projects and Capstones
IMPROVING QUALITY AND EFFICIENT COMMUNICATION BETWEEN
PROVIDERS AND NURSING - A PSYCHIATRIC SBAR TOOL (PSYCH)
Karen Richards
University of San Francisco
Abstract
Effective communication is the cornerstone of providing safety and quality healthcare. However, nursing and providers often share information inequitably, as these disciplines are trained differently regarding communication. Providers are taught to be brief, accurate and focused while nurses are taught to be descriptive and holistic. These differences have led to disparity in the sharing of valuable patient information, subsequently leading to increased frustration, inefficiency, and medical errors. Multiple studies provide evidence that poor communication is a major contributor …
Evaluation Of The Nursing Handoff Process From Emergency Department To In-Patient Unit, Yana Marutyan
Evaluation Of The Nursing Handoff Process From Emergency Department To In-Patient Unit, Yana Marutyan
Master's Projects and Capstones
Handoff, or transition in care, is known to be a danger point in the patient care process for a long time. Ineffective communication during handoff is one of the most common identified cause of catastrophic or sentinel events in hospitals (The Joint Commission, 2015). Emergency department (ED) to in-patient unit handoff is particularly vulnerable to medical errors due to high workload, time constraints, different approaches to patient care, and lack of established relationships between care providers (Ong & Coiera, 2011; Hilligoss & Cohen, 2012).
The purpose of this project was to examine and review a current process of ED to …
Evidence Based Protocol: Improving Depression Assessments In Primary Care, Katherine E. Hoffhines
Evidence Based Protocol: Improving Depression Assessments In Primary Care, Katherine E. Hoffhines
Master's Projects
Depression is a destructive condition that can have a profoundly negative impact on quality of life, wellbeing, and health (Thase, Stowell, Berry, Mencia & Blum, 2014). Worldwide, depression is the leading cause of medical disability costing the health care system over $210 billion annually (World Health Organization, 2014; Greenberg, Fournier, Sisitsky, Pike & Kessler, 2015). The World Health Organization (2016) estimates depression affects 350 million people of all ages globally. One and three adults in the U.S. will experience a major depressive episode during their lifetime (Kessler, Petukhova, Sampson, Zaslavsky & Wittchen, 2012; Rubin, Ciechanowski, Egede, Lin & Lustman, 2004). …
A Pressure Ulcer And Fall Rate Quality Composite Index For Acute Care Units: A Measure Development Study., Diane K. Boyle, Ananda Jayawardhana, Mary E. Burman, Nancy E. Dunton, Vincent S. Staggs, Sandra Bergquist-Beringer, Byron J. Gajewski
A Pressure Ulcer And Fall Rate Quality Composite Index For Acute Care Units: A Measure Development Study., Diane K. Boyle, Ananda Jayawardhana, Mary E. Burman, Nancy E. Dunton, Vincent S. Staggs, Sandra Bergquist-Beringer, Byron J. Gajewski
Manuscripts, Articles, Book Chapters and Other Papers
Background: Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement.
Objective: The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index.
Design: Two-phase measure development study.
Settings: 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013.
Methods: The Pressure Ulcer and Fall Rate Quality Composite Index was developed …
Quality Improvement And Safety In Healthcare: Reflections On Essential Frameworks To Guide Applied Scholarship That Promotes Transformation And Innovation, Angelo P. Giardino Md, Phd, Mph
Quality Improvement And Safety In Healthcare: Reflections On Essential Frameworks To Guide Applied Scholarship That Promotes Transformation And Innovation, Angelo P. Giardino Md, Phd, Mph
Journal of Nursing & Interprofessional Leadership in Quality & Safety
The publication of the inaugural issue of the Journal of Nursing and Interprofessional Leadership in Quality and Safety (JONILQS) is a unique milestone that is the culmination of visionary leadership, scholarly effort, and keen attention to the many tasks necessary to launch a journal. The University of Texas Health Science Center at Houston’s School of Nursing launches this journal to address the focus on quality and safety initiatives and research that helps to make the health care we provide safer and better. This journal seeks to highlight practical work from the field that will change things for the better for …
Quality Improvement Initiative In Transplant Diabetes Care: Needs Assessment And Protocol Development, Dawn Korson
Quality Improvement Initiative In Transplant Diabetes Care: Needs Assessment And Protocol Development, Dawn Korson
Doctoral Projects
Over 30,000 people receive a solid organ transplant each year, with 5-30% developing post-transplant diabetes mellitus (PTDM) (United Networking for Organ Sharing, 2015). At a Midwestern transplantation center, over 22% of patients with a history of diabetes were not consulted to endocrinology after kidney and liver transplantation. With poor glycemic control, there is an increased risk of developing PTDM leading to poor outcomes. Utilizing the Donabedian model and the Six Sigma’s Define, Measure, Analyze, Improve, and Control (DMAIC) as guides for implementation, the purpose of this project was to address the process measures of increasing appropriate consultations for evaluation and …
Heart Huddle: Increasing Cohesiveness In Ccu And Cvtu, Ashley Douvier
Heart Huddle: Increasing Cohesiveness In Ccu And Cvtu, Ashley Douvier
Nursing Posters
The American Association of Critical Care Nurses identifies six standards for a healthy work environment, two of which are skilled communication and true collaboration. CCU and CVTU are two separate units staffed by one Charge RN. A need to improve communication and collaboration has existed throughout both units. Thus, Heart Huddle has been developed. The objective of Heart Huddle is to bring cohesiveness to CCU and CVTU through improving communication and collaboration, which is imperative to a healthy work environment.
Reducing Overnight Vital Signs, Jill Libbesmeier
Reducing Overnight Vital Signs, Jill Libbesmeier
Nursing Posters
As delirium has been identified to increase functional decline, cost per patient day of hospitalization, and length of stay, previous delirium work has been completed at St. Cloud Hospital. Changes in sleep pattern and sleep environment have been identified as a cause of delirium. The purpose of this project is to change frequency of vital signs on Med 1, Med 2, and Medical and Oncology, allowing for increased uninterrupted periods of sleep to help reduce delirium rates; in turn reducing average length and cost of stay.
Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter
Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter
DNP Projects
Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.
Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.
Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …
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
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
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
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 …
Engaging Patients To Improve Documentation Of Oral Intake On A Cardiac Telemetry Unit: A Quality Improvement Initiative, Timiny A. Mosher
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 …
Contributing To A “Culture Of Safety” By Increasing Usage Of The Drug Library On Smart Infusion Pumps: A Quality Improvement Project, Heidi Armstrong
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 …
The Design And Implementation Of A Relationship-Based Care Delivery Model On A Medical- Surgical Unit, Paula Ann Rodney
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 …
Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham
Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham
Doctor of Nursing Practice (DNP) Projects
The purpose of this evidence-based change in practice project was to provide nurses with an experiential learning opportunity, using simulation, to identify and report near miss events during the medication administration process related to patient-controlled analgesia (PCA) usage. Despite extensive in-service training on a Medical/Surgical (Med/Surg) floor in an acute care hospital, inconsistent, inaccurate and incomplete documentation with use of the new PCA pumps continued to be problematic. A conceptual framework of just culture was used with the quality improvement method of the Plan-Do-Study-Act (PDSA) cycle for testing change. Medication safety education was a valid andragogical strategy to decrease rates …
Improving Discharge Planning And Education Of Nursing Students: A Collaborative Approach, Lea Dodge
Improving Discharge Planning And Education Of Nursing Students: A Collaborative Approach, Lea Dodge
Doctor of Nursing Practice (DNP) Projects
Nurses require training to provide discharge teaching yet nursing students are often not assigned the task of discharge teaching and are overwhelmed by the task once they enter the workforce (London, 2004). Few nursing programs provide opportunities for nursing students to participate in quality improvement projects. In an attempt to decrease post-discharge adverse events (AE) and increase exposure to discharge teaching and quality improvement by nursing students, 13 nursing students in a baccalaureate undergraduate nursing program assigned to a DEU in a sub-acute rehabilitation facility were provided with instruction utilizing the evidenced-based teach-back method. The nursing students conducted the discharge …
Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement
Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement
DNP Projects
Background: Pediatric obesity has reached epidemic levels in the United States and the burden of early identification and prevention lies with Primary Care Providers. With this burden comes the responsibility of increased documentation in order for patients to obtain the appropriate counseling, treatment, and referrals.
Objective: The objective of this study is to identify missed opportunities to identify pediatric patients that meet the criteria for overweight or obesity during well-child visits within a primary care practice.
Method: A retrospective chart review of 100 randomly selected patients born between 9/1/2001 and 9/1/2010 that have received a well-child visit between 1/1/2010 and …
Preoperative Education Needs In Ear, Nose, & Throat Clinic: A Patient Perspective, Jonathan Edmun Ramos
Preoperative Education Needs In Ear, Nose, & Throat Clinic: A Patient Perspective, Jonathan Edmun Ramos
Walden Dissertations and Doctoral Studies
A medical center specializing in ear, nose, and throat (ENT) services noted an increase in the number of postoperative ENT complications compared to the national average. The purpose of this mixed-methods project study was to examine ENT patients' preoperative patient education (PPE) needs regarding postoperative care. Grounded in Knowles's model of learning, core adult learning principles were applied as guidelines in facilitating patients' PPE learning. Data were collected from 58 ENT patients who were selected using a convenience sampling method and who responded to a PPE survey using a 5-point Likert scale and open-ended questions. Quantitative data were analyzed using …
Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock
Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock
Doctor of Nursing Practice (DNP) Projects
The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical …
Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort
Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort
UNLV Theses, Dissertations, Professional Papers, and Capstones
Despite the overwhelming evidence that sudden cardiac death is the most frequent cause of firefighter fatalities, many fire departments do not have a program to measure or maintain basic firefighter fitness and health. This project evaluated and compared medical screening outcomes of four industrial fire brigades within a multinational oil and gas corporation and introduced a quality improvement plan. The goal of this project was to apply the evidence and measure outcomes to determine the most effective way to ensure that firefighters in a corporate setting are healthy. This was accomplished by utilizing established guidelines in developing an educational program …
Improving Evidence Based Asthma Management In An Urban University Student Health Center, Hedian Cho Swanson
Improving Evidence Based Asthma Management In An Urban University Student Health Center, Hedian Cho Swanson
UNLV Theses, Dissertations, Professional Papers, and Capstones
The purpose of this project was to improve asthma management through focused staff education and training on national asthma guideline recommendations. The Student Health Center (SHC), located in a university in the southwest United States, performed annual reviews of asthma-related electronic medical records (EMR) in an effort to provide quality health care. These reviews used 23 quality improvement (QI) parameters extracted from the 2007 National Asthma Education and Preventive Program Expert Panel Report 3 (NAEPP EPR 3). The SHC QI findings were consistent with current asthma management literature indicating asthma control is often overestimated and undertreated. This project (a) provided …
Hospital Nursing Research Program: Partnership Of Service And Academia, Patricia Ravert, Katreena Collette Merrill
Hospital Nursing Research Program: Partnership Of Service And Academia, Patricia Ravert, Katreena Collette Merrill
Faculty Publications
Hospitals in a nonprofit mountain west corporation conducted a gap analysis to determine readiness for Magnet Recognition. Major gaps included nursing research and availability of consultation and resources for research. Based on the findings, the development of a dynamic research program promoting nursing research and evidence-based practice within hospitals was undertaken. A nursing research council was reestablished with representatives from service and academia. A literature review and analysis of corporate/academia resources were completed. The plan called for a nursing research coordinator position and development of a research budget. Academia continues to be represented on the hospital institutional review board. A …
Utilising The Clinical Excellence Commission’S Performance Indicators For Quality Use Of Medicines, Jed S. Duff
Utilising The Clinical Excellence Commission’S Performance Indicators For Quality Use Of Medicines, Jed S. Duff
Nursing Conference Papers
Like other aspects of health care, Quality Use of Medicine (QUM) can be considered in terms of structures, processes and outcomes. These components of QUM can be measured with performance indicators. This poster describes the Clinical Excellence Commissions (CEC) new performance indicators and their use in a warfarin practice improvement project.
Aim: - To measure performance indicators in order to; Comprehensively audit warfarin therapy.
- Benchmarking current practices.
- Identify opportunities for practice improvement.
- Measure practice change>
Method: Auditing structures, processes, and outcomes requires different tools and methods. For this project, the following tools were utilised;
- The CEC …
Quality And Safety Education For Nurses, Linda Cronenwett, Gwen Sherwood, Jane Barnsteiner, Joanne Disch, Jean Johnson, Pamela Mitchell, Dori Taylor Sullivan, Judith Warren
Quality And Safety Education For Nurses, Linda Cronenwett, Gwen Sherwood, Jane Barnsteiner, Joanne Disch, Jean Johnson, Pamela Mitchell, Dori Taylor Sullivan, Judith Warren
Nursing Faculty Publications
Quality and Safety Education for Nurses (QSEN) addresses the challenge of preparing nurses with the competencies necessary to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine competencies for nursing (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), proposing definitions that could describe essential features of what it means to be a competent and respected nurse. Using the competency definitions, the authors propose statements of the knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing …