Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Cultural Education Interventions Impact On Cultural Competence, Kaylie V. Griffin Ms

ONU Student Research Colloquium

Problem: In the United States, there is a substantial increase in diversity. This increase in diversity poses multiple challenges for healthcare workers and healthcare systems. Because nurses care for patients with various cultural backgrounds, health beliefs and practices, and languages, cultural competency plays a pivotal role in providing patient-centered care. There is a need to enhance cultural education for healthcare workers to ensure that healthcare workers have the skills and knowledge to effectively engage with all patient populations. Implementing cultural education interventions seeks to increase healthcare workers' competency, communication, and patient outcomes. Purpose: The purpose of this research question is …

Maggot Debridement Therapy Vs. Negative Pressure Wound Therapy And Their Effectiveness On Tissue Healing On Older Adults, Angelica L. Funes

Soaring: A Journal of Undergraduate Research

Chronic ulcers, particularly prevalent in older adults, significantly impact patients' quality of life, leading to prolonged hospital stays and increased healthcare costs. This study explores the efficacy of two common therapies, Negative Pressure Wound Therapy (NPWT) and Maggot Debridement Therapy (MDT), in promoting tissue healing for chronic ulcers in adults aged 60 and older. A methodical search was conducted using databases such as CINAHL, PubMed, EBSCO, and ProQuest, employing specific search strategies and inclusion/exclusion criteria. Four high-quality Level 1 randomized controlled trials were selected for analysis, comparing NPWT and MDT in various settings. The results indicate that MDT exhibits superior …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Patient Education Improvement Initiative For Self-Management Of Congestive Heart Failure Among Senior Residents Of A Long-Term Care Facility, Abigail A. Abella, Brooke Sheck, Daniela Ramos, Ivy H. Nguyen, Mary Tran, Roshni Nagarajan

Master's Projects and Capstones

The purpose of this quality improvement project was to use evidence-based practices to determine if personalized education on disease self-management would lead to improved treatment adherence in a residential facility. The target population consisted of four elderly female patients who had been diagnosed with congestive heart failure (CHF) and were struggling with the self-management of their disease. Contributing barriers to effective CHF self-management were determined using a root cause analysis, and included a lack of educational templates, declining cognitive ability of the residents, and no electronic health record (EHR). Using the Self-Determination theory, the interventions were implemented. Phase one was …

Benefits Of Bedside Report, Konner Spalding, Hannah Mattingly

Scholars Week

No abstract provided.

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

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 …

Educating Novice Nurses And Nurse Practitioners About Military Sexual Trauma Screening, Alyssa D. Freeman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Military sexual trauma prevalence has continually increased over the past 25 years. Exposure to sexual trauma, violence, and abuse result in notable health consequences. The Veterans Health Administration has led the integration of universal Military Sexual Trauma (MST) screening and training. Purpose: The purposes of this project were to educate novice nurses and nurse practitioners about MST and to increase their knowledge and comfort in MST screening techniques. Methods: Following an educational session, a pre- and post-study design was used to evaluate improvement in knowledge and comfort screening for MST. Thirty-two participants including PBRNR Nurse Residents, …

Delirium And Staff Injury, John Olague Jr

Master's Projects and Capstones

Abstract

Problem: From April 2021 to January 2022 there were 17 cases of reported patient aggression and staff injury due to patients in the hyperactive state of delirium. In a stroke/tele unit, diagnosis of delirium was delayed due to subjective assessment from the confusion assessment method (CAM) tool. This delay allowed patients to reach the hyperactive state of delirium which poses a threat to patient and staff safety. An objective form of assessment for delirium was needed on this stroke/tele unit.

Context: Through a microsystem assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis, stakeholders in this performance improvement plan …

Evidence-Based Selection Of A Fall Risk Assessment Tool: A Program Evaluation Review, Lindsey Adams

Student Scholarly Projects

Fall prevention strategies are a consistent topic of discussion for healthcare regarding patient safety, as patient falls are costly to the patient and the organization. This project uses the CDC Framework for Program Evaluation to assess the fall prevention policy of a local hospital system, with particular emphasis on the fall risk assessment tool, Hester Davis. This project also explores the risks and benefits of adopting an alternative fall risk assessment tool, predictive analytics. Predictive analytics uses electronic health record (EHR) data analysis to provide a highly individualized patient fall risk score based on a large variety of patient and …

Reducing Readmission (And Mortality) For Older Patients & Survivors Of Life-Threatening Conditions: A Study Using The Staarr Protocol, Akhenaten Amun

Symposium of Student Scholars

Readmission rates for patients admitted for heart failure, pneumonia, chronic obstructive pulmonary disorder, a myocardial infarction, a hip or knee arthroplasty, or coronary artery bypass surgery tend to have high readmission and mortality rates within 30 days of their discharge from a hospital. Starting in October 2012, the Healthcare Reimbursement Reduction Program enforced penalties on Medicare reimbursements for hospitals with readmission rates, for patients with the conditions above, were higher than averages based on facilities with similar characteristics and patient populations. Teach-back and verify (Klingbeil & Gibson, 2018), interdisciplinary teams that engage in patient care and support (Reiter-Palmon et al., …

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 …

Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White

Patient Experience Journal

During the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve the …

Educational Plan For Certified Nursing Assistants In Long-Term Care Facilities On Assessing Pain Of Residents With Dementia, Rachel Lynn Spoon

DNP Scholarly Projects

Certified nursing assistants employed in long-term care agencies may have little education on the assessment of pain experienced by residents with dementia. The purpose of the Doctor of Nursing Practice Project was to develop an evidenced-based teaching plan for certified nursing assistants caring for residents with dementia in long-term care settings. The plan includes content on dementia, dementia symptoms, pain indicators, and pain assessment in residents with dementia, non-medicinal management strategies, and communication strategies for referring assessment findings to licensed practical and registered nurses. Supplemental PowerPoint™ slides were developed that match the teaching plan. The draft teaching plan was judged …

Addressing Anxiety In Hospitalized Adults Using A Music Intervention, Raina M. Rochon

Student Scholarly Projects

Practice Problem: The practice problem is anxiety related to hospitalization among adults in an acute care setting. Increased anxiety can lead to other issues while hospitalized including disruptive behaviors.

PICOT: The PICOT question that guided this project was: In hospitalized medical-surgical adults (P), how does the implementation of a music intervention as an adjunct to standard distraction techniques (I) compared to standard care (C) affect symptoms of anxiety as observed by the rate of behavior de-escalation team calls (O) within eight weeks (T)?

Evidence: There were five systematic reviews, four systematic reviews with meta-analysis with high level of …

Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare

Dissertations

Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …

Phenomenological Study Of The Lived Experience Of New Graduate Nurses Caring For Hospitalized Patients Living With Dementia, Geline Buenconsejo

Dissertations

Title. Phenomenological Study of the Lived Experience of New Graduate Nurses Caring for Hospitalized Patients Living with Dementia.

Purpose. This study explored new graduate nurses’ lived experiences in caring for hospitalized patients living with dementia.

Background. The first twelve months of transitioning from student to professional nurse in acute care settings are the most stressful, emotionally challenging, and mentally exhausting for new nurses striving to apply newly acquired skills into practice. Some of the most challenging patients for nurses to care for are hospitalized patients living with dementia (PtLWD). With the projected increase in the number of patients with dementia …

Dnp Final Report: Skilled Nursing Facility Readmissions: An Evidence-Based Telemedicine Innovation Project, Debra B. Graham

DNP Final Reports

Background: Nationally, 20% of patient readmissions occur within the first 48 hours after arrival to a skilled nurse facility (SNF), and 40-68% of these readmissions are potentially avoidable. Since 2016, the Centers for Medicare and Medicaid penalized SNFs when their return to hospital (RTH) percentages was above national benchmarks. The four SNFs in this project experienced rising transfer rates and diminished RTH percentages since 2017, despite using in-house providers Monday through Friday. Furthermore, there was no provision to address patients’ changes in conditions after hours.

Purpose: This evidence-based practice (EBP) project aimed to standardize the care provided to …

Implementing Systematic Sexual Orientation And Gender Identity (Sogi Data) Collection At An Inpatient Hospital Located In The Southern Region Of The United States, Shawn Malugin

Epsilon Sigma at-Large Research Conference

Purpose

LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge.

Aims

The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization.

Processes

To understand how to provide high-quality care to LGBTQ patients, providers receive instruction …

Sleep Deprivation And Delirium Development In The Icu, Cynthia Howell Msn Fnp-Bc, Stacy Murillo Msn Fnp-Bc, Amy Wilson Msn Fnp-Bc, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Delirium is an acute syndrome characterized by disturbances in cognition occurring in critically ill patients, particularly those over 65 in the intensive care unit (ICU). Numerous risk factors are associated with delirium development, with sleep being a modifiable factor. This review explores existing literature regarding the relationship between sleep deprivation and delirium development while evaluating the effectiveness of a sleep promotion protocol to decrease the incident of delirium in those ICU patients 65 years or older.

Method A literature review of peer-reviewed studies from PubMed and additional search engines was completed. Articles reviewed were published within the last five …

Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

Clinical Nurse Specialist Job Description Assignment, Diane R. Maydick Youngberg

Open Educational Resources

The Clinical Nurse Specialist (CNS) is an advanced practice registered nurse with expertise in assessment, diagnosis, and treatment of specialty patient populations. In addition to direct care, the CNS role expands to other areas including research, education, quality improvement, and inter professional teamwork. Creating a detailed CNS Job description helps to clarify the role.

Improving Telehealth Knowledge And Comfort In An Older Adult Population, Carolyn J. Jones

Doctor of Nursing Practice (DNP) Projects

Background: Telehealth usage is increasing a means of providing healthcare in a more efficient and cost-effective way. Older adults have been left behind from the telehealth movement and this can negatively impact their access to the healthcare system.

Purpose: An educational workshop was offered in a local older adult community with the goal of increasing their knowledge, literacy, motivation, and usage of telehealth.

Methods: The participants completed a pre-assessment survey to determine their baseline knowledge, experience, and perceptions about telehealth. They then participated in an educational workshop, which consisted of a 45-minute presentation given via Zoom with a 15-minute …

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 …

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

Master of Science in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judy E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.