Implementation Of Purposeful Hourly Rounding To Decrease Fall Rates, Dannette Kizy

Student Scholarly Projects

Practice Problem: Patient falls can lead to an increased length of stay and potentially reduce the quality of life. In addition to serious injury, the patient and the hospital have a significant financial burden. PICOT: On a medical-surgical unit, does incorporating purposeful hourly rounding in the patient care routine compared to no purposeful rounding decrease patient fall rates over eight weeks?

Evidence: Of the 35 articles related to fall prevention and PHR, a final selection of eight articles met the criteria and were of high quality and evidence levels.

Intervention: PHR was implemented to decrease falls over …

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Culminating Experience Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Nursing Care Of Family Caregivers: Interventions And Considerations Regarding Current Issues Facing Family Caregivers Of Persons With Dementia Relevant To Nursing Practice, Alayna Kent

Senior Honors Theses

There are an estimated 6.5 million Americans age 65 and older who are currently living with Alzheimer’s dementia. A large majority of these individuals receive care from a nonprofessional family caregiver, typically in the home setting. It is well documented that family caregivers of dementia patients experience many unique challenges. These challenges provide valuable opportunities for nurses to provide helpful interventions to aid this vulnerable population. An integrated review of the recent literature was conducted, and articles were chosen by a method modeled after the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowsheet. The research was then analyzed …

Benchmark: Impact Of Weight Loss Education On Obese Patients, Tabitha A. Moorehead

MSN Capstone Projects

Objective: With an epidemic as severe as obesity, it is paramount that healthcare professionals be aware of the overarching negative effects the disease can contribute to the human body. If constructive dialogue can be achieved between patient and provider without suspicion of bias or judgment, we would potentially experience an elevated willingness of patients to follow treatment steps.

Background: According to the World Health Organization (WHO), worldwide obesity has nearly tripled since 1975. “Most of the world's population live in countries where overweight and obesity kills more people than underweight” (WHO, 2021). “More than 4 in 10 Americans are …

Benefits Of Minimizing Foley Catheterization Time In Nursing Homes, Carly Robertson, Laney Farmer

Scholars Week

Foley catheterization is a commonality seen in various healthcare settings. There is a high risk of infection, trauma, and dependence associated with indwelling urinary devices. This research project addresses the benefits of decreasing foley catheterization time, specifically in nursing home patients. Previous research has deemed foley catheters as dangerous, invasive, and in some cases unnecessary. Foley’s are accompanied by many complications, trauma to urinary structures, as well as a major source of infection. This project used meta-analysis nursing journals to support the importance of decreasing catheterization time. This evidence-based practice project has discovered many risks associated with foley catheters and …

Implementing A Pressure Ulcer Bundle, Amy D. Johnson, Pamela Hardesty, Janice Zimmer, Patricia Moore

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: A quality improvement DNP project in a rural southern hospital was implemented to improve hospital-acquired pressure ulcers by implementing an evidence-based pressure ulcer prevention policy and education. Framework: The Evidence-Based Practice framework utilized in the project's development, implementation, and evaluation was the John Hopkins Evidence-based Practice Model. Local Problem: The hospital had no pressure ulcer bundle in place. Design: Quality improvement project utilizing the plan-do-study-act cycle. Methods: An educational presentation on pressure ulcers and the steps to implement a bundle. A pre-and post-test using Pieper's Pressure Ulcer Knowledge Test, modified from Agency for Healthcare Research and Quality (AHRQ) website. …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Resilience As A Moderator Of Role Overload And Sleep Disturbance Among Caregivers Of Persons With Dementia, Elliane Irani, Fei Wang, Stephanie Griggs, Ronald L. Hickman

Faculty Scholarship

The purpose of this study was to examine if resilience moderates the association between role overload and sleep disturbance among caregivers of persons with dementia. This was a secondary analysis of data on 437 informal caregivers (mean age=61.77 years, SD=13.69) of persons with dementia in the United States. Data from the 2017 wave of the National Study of Caregiving were analyzed using multiple regression with interaction terms to evaluate the moderation effect of resilience, while controlling for caregivers’ age, race, gender, education, self-rated health, caregiving hours, and primary caregiving status. Higher role overload was associated with greater sleep disturbance and …

Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse

Management Faculty Research

Long-Term Care (LTCs) facilities and nursing homes have been an essential part of the healthcare industry to meet the needs of older adults. However, Electronic Medical Records (EMRs/ EHR within LTC facilities and nursing homes have lagged more than in other healthcare sectors. This research analyzed the impact of implementing EMR/EHR and Computerized Decision Support Systems within LTC facilities and nursing homes. In nursing homes and LTC facilities where EMR/EHR has been implemented, patient outcomes improved by reduced pressure ulcers and increased identification of patients at risk for malnutrition and falls. Integration of CDSSs with EMR/EHR improved documentation and prescribing …

Effects Of Hope Intervention On Hope And Quality Of Life In Senior People Who Live Alone, Sophia Abraham

Doctor of Nursing Practice Projects

Background

In the United States, there is a growing number of seniors who frequently present with increased risk for reduced hope and quality of life (QOL). Quality of life in the senior population is a world-wide concern and it is believed to be directly associated with their well-being. Senior people living alone experience a higher degree of depression, reduced hope, isolation, falls, and increased mortality. The literature indicates that there is a significant relationship between the level of hope and QOL. Hope is an inner source that plays a vital part in how an individual think and behaves. Hope shapes …

Family Caregivers Of Older Adults With Physical Disabilities In Rural Thailand, Denis Tuttle, Jiranan Griffiths, Anuchart Kaunnil

The Qualitative Report

Thailand is one of many countries experiencing changes in the demographics of its population. People are living longer and having fewer children resulting in an increasing percentage of older adults in the general population. This presents a challenge in providing care for older adults, especially in countries where there is a culture of family caregiving. This study aims to investigate the experience of family caregivers, exploring the problems of caring for older people with physical disabilities and the needs of family caregivers. This is done to better understand ways to support caregivers. Using a descriptive qualitative approach, 15 family caregivers …

Factors Associated With Technology Adoption By Community-Dwelling Older Adults During The Covid-19 Pandemic, Elizabeth A. Sutton

Dissertations, Theses, and Capstone Projects

The COVID-19 pandemic brought to the forefront the disparity between older and younger Americans in the utilization of information and communication technologies (ICT) when measures such as the COVID vaccine rollout were dependent on technology use. Technology adoption has implications for overall health and the continuation of disparities in technology adoption is associated with poor aging outcomes. The aim of this study was to understand factors associated with technology adoption by community-dwelling older adults during the COVID-19 pandemic. A nationally representative sample of 2,954 community-dwelling older adults who completed the National Health and Aging Trends Study (NHATS) COVID-19 Questionnaire was …

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Therapeutic Gardening And Its Effects On Depressive Symptoms In Dementia Care, Shannon E. Norton

Honors Undergraduate Theses

Aim: To present a literature review of the positive effects and overall reduction of depressive symptoms that an intervention such as therapeutic gardening has on individuals living within memory care facilities.

Background: As most humans age, they often lose abilities or skills that they have had for their entire lives (e.g. driving, grooming, toileting, seeing and/or hearing). By implementing programs that involve therapeutic garden therapy, individuals with dementia who are at greater risk for clinical depressive symptoms may find that this alternative approach improves their symptoms.

Methods: A comprehensive, electronic, literature search in the CINAHL database was completed and included …

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, …

Gender Differences In Administration Of Tpa In Treatment Of Ischemic Stroke, Christina Annerino

CURE Proceedings

As medicine and pharmacology advance through the years, new life-saving treatments are studied or discovered every day, and a medical emergency is no longer a death sentence. Even with conditions as serious as ischemic stroke, there is hope for survival and rehabilitation with the ‘clot-busting’ drug, tissue plasminogen activator, colloquially known as ‘tPA’. tPA is a thrombolytic agent, a substance that acts on fibrin in clots to dissolve them so they can no longer cause ischemia in blood vessels that results in a stroke. (Vega, 2022). tPA is an extremely effective treatment for ischemic stroke, demonstrated in 2013 by a …

Polypharmacy: Increasing Medication Adherence, James C. Kelly

Nursing | Student Research Posters

Polypharmacy is a common problem among older adults where they take multiple medications concurrently, leading to negative health outcomes such as adverse drug reactions, drug-drug interactions, and non-adherence to medications. To address this issue, a randomized controlled trial (RCT) is proposed that will involve elderly patients (aged 65 years or older) who are taking five or more medications. Participants will be randomly assigned to either the intervention or control group, with the intervention group receiving nurse-led medication therapy management (MTM) and patient education to improve medication adherence. The Health Belief Model can be used to educate and empower older adults …

Heart Smart Holidays: Coping With Stress, Staying Active, And Healthy Cooking Strategies For Seniors In Cleveland County, Lauren Ridgeway

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice Project assessed whether attending community group meetings focusing on stress, staying active, and healthy eating during the holidays, could influence cardiovascular disease awareness, mental health awareness, and quality of life of senior citizens in Cleveland County. A convenience sample of 6 participants attended the Coping with Stress and Staying Active event while 10 participants attended the Healthy Cooking Strategies event. The objectives were measured using a pretest posttest design before and after the presentations. There was strong evidence (t(9) = -13.597, p < .05) that the group seminar on managing stress and staying active during the holiday season improved the mental health awareness of participants. Data also showed a significant increase in Cardiovascular Disease Awareness from pretest to posttest (t(5) = 3.246, p < .05) after the seminar on healthy cooking strategies. The project raised community awareness to the importance of managing stress, staying active, and making small nutritional changes to positively impact the cardiovascular health of Seniors.

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Addressing The Inpatient Penicillin Allergy And Antibiotic Stewardship: The Effect Of Education On Compliance Rates Of The Nurse Driven Penicillin Allergy Assessment Tool, Alexandria Bassler

DNP Projects

Background: Penicillin allergies are the most frequently reported drug allergy but less than 1% of the total population has a true immune-mediated allergy. Patients who are labeled as having a penicillin allergy may receive drugs that are less effective, more costly, and more toxic. The nurse driven penicillin allergy assessment tool strives to increase penicillin allergy de-labeling rates by pharmacists and providers.

Objective: The purposes of this study were to (1) perform a retrospective and prospective chart review to determine compliance rates with the nurse driven penicillin allergy assessment tool, (2) provide an education module on antibiotic stewardship …

Relationship Between Residential Aged Care Facility Characteristics And Breaches Of The Australian Aged Care Regulatory Standards: Non-Compliance Notices And Sanctions, Janine Alan, Sean Randall, Anna Ferrante, Davina Porock

Research outputs 2022 to 2026

Objectives

To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards.

Methods

Facility-level analysis of audits, sanctions and non-compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks.

Results

Non-compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non-compliance notices were less likely in …

Comparing Clinico-Demographics And Neuropsychiatric Symptoms For Immigrant And Non-Immigrant Aged Care Residents Living With Dementia: A Retrospective Cross-Sectional Study From An Australian Dementia-Specific Support Service, Pelden Chejor, Mustafa Atee, Patricia Cain, Daniel Whiting, Thomas Morris, Davina Porock

Research outputs 2022 to 2026

Background:

Neuropsychiatric symptoms of dementia such as agitation and aggression are common in people living with dementia. The presentation of neuropsychiatric symptoms is influenced by the cultural background of people living with dementia. Further, identifying factors contributing to neuropsychiatric symptoms may be complicated if people living with dementia are immigrants or from non-English-speaking backgrounds. Most of what is known about differences in neuropsychiatric symptoms between racial and ethnic groups living with dementia come from community-based samples. This study investigated differences in clinico-demographics and neuropsychiatric symptoms between immigrants and non-immigrants living with dementia in residential aged care homes who were referred …

Investigating The Perspectives Of Older Adults In Residential Aged Care On Oral Health-Related Quality Of Life, Parisa Malekpour, Amanda Devine, Julie Dare, Leesa Costello

Research outputs 2022 to 2026

Objective

The objective of the study was to explore how older people living in a residential aged care facility perceived that their oral health influenced their food preferences and attitudes towards food, their social interactions and their self-esteem.

Background

Poor oral health can have biological, behavioural and social impacts on quality of life among older adults (aged 65+ years). In terms of biological impacts, oral health impairments may cause older adults to avoid many types of foods. This shift in dietary pattern can lead to malnutrition among older people, undermine general health and negatively impact quality of life (QOL).

Materials …

The Use Of Paxlovid Amongst The Elderly & Reduced Hospital Stays, Maria M. Gichana, Kate Ames, Nicole Chandler, Madeline Gill

Non-Thesis Student Work

Coronaviruses are a large family of viruses infecting many species and cause a variety of illnesses. COVID-19 is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2). Understanding that COVID-19 can cause severe disease in vulnerable populations has launched the development of viral treatments. Nirmatrelvir-ritonavir (Paxlovid) is an oral antiviral treatment authorized for adults with mild to moderate symptoms who are at an increased risk for severe disease. These authors pose the question: For older adults over the age of 65 who have had COVID-19, does the use of Paxlovid reduce hospitalizations, compared to those not treated with Paxlovid? …

Effectiveness Of Non-Pharmacological Interventions In Managing Inpatient Dementia, Jester West, Maddie Faulkner

Non-Thesis Student Work

When caring for dementia patients as inpatients at the hospital, the methods by which you treat the patient and manage their symptoms are varied. Often there are two methods of treating exacerbations and agitation: pharmacological and non-pharmacological. This literature review sought to examine the effect of including supplemental non-pharmacological techniques in managing inpatient dementia related behaviors. A literature search was conducted using CINAHL and NRCP using the following terms: inpait*, dement*, alzehei*, nonpharm*, interventions. Initial results resulted in 15 articles. After review, results were filtered to be within the past six years and a total of 12 articles met inclusion …

Implementing Gerontological Education Into Undergraduate Nursing Curricula, Amanda Gleason

Non-Thesis Student Work

The United States has an ever-increasing older adult population, with nearly one-fifth of US citizens over the age of 65 (United States Census Bureau, 2022). America is already in need of nurses trained to work with aging patients and that need is only expected to grow. Many registered nurses (RNs) choose specialties other than gerontological care, with only approximately four percent of RNs currently working in long-term care facilities or retirement or nursing homes (Smiley et al., 2021). Nursing students often, knowingly or unknowingly, have preconceived notions of older adults or older patients that can affect their interest, or lack …

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 …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …