Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Facilitating Communication With Diverse Teams, Maryjane Lewitt

Academic Chairpersons Conference Proceedings

Non- hierarchical communication structures are associated with greater clarity across all levels. These structures can be implemented in a variety of ways under different circumstances. A variety of communication processes should be implemented to improve communication with individualizing the technique to the type of information being communicated.

Evaluation Of An Advanced Quality Improvement Program, Arjun M. Dangre Bds Mph, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Texas Children’s Hospital implemented the Advanced Quality Improvement and Patient Safety Program (AQI) in 2009, designed to train clinicians and staff to develop leaders in quality improvement to improve patient care, lower costs, change culture, and lead improvement initiatives at the organization. Evaluations of the AQI programs measured the program’s effectiveness in achieving its goals and objectives. This paper describes the Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety program (AQI,) the program’s evaluation processes, and show the results of the evaluation of the AQI programs using evaluation surveys completed by QI participants over the span of 13 successful …

Learning Lean To Lead, Krystle Irene Guenther

Doctoral Projects

This project sought to see if training frontline nurses and physicians together in Lean methodology improved collaboration between the two disciplines while giving them the tools they need to lead change at the bedside and in their practice. A quasi-experimental pre- and post-intervention methodology was used. The intervention was six, four-hour in-person modules on performance improvement (PI). Respondents completed two surveys, the performance improvement instrument and the Professional Practice Environment Assessment Scale (PPEAS). Surveys were paired for analysis. There was a statistically significant median increase in participants confidence for all questions on the PI instrument post-intervention. Results for the PPEAS …

Implementation Strategies To Reduce Hospital Readmission Rates In Adults With Sepsis: A Quality Improvement Project, Erin Kucharek

Doctoral Projects

Background: Sepsis is a concern in healthcare, as patients are 2 to 3 times more likely to be readmitted to the hospital than those with other illnesses. Readmitted patient with sepsis costs the healthcare system $3.5 billion dollars per year. Effective care coordination is a tool that decreases readmission rates in other illnesses and is likely applicable to those with sepsis. The purpose of this quality improvement project was to determine if primary care provider follow-up appointments, increased home care utilization, and patient education would reduce sepsis readmissions.

Methods: The Transitional Care Model guided project design and The Kotter Model …

Utilization Of Patient Toolkit And Discharge Algorithm For Providers To Reduce Readmission Due To Repeat Ground Level Fall, Sara Karl

Doctoral Projects

Introduction. Falls are the leading cause of injury and injury death in adults over the age of 65. A retrospective examination at Level 1 trauma center in the Midwest found that 19.4% (118/605) of older adults admitted with a ground level fall were readmitted with a subsequent fall and injury. The aim of this quality improvement initiative is to determine if the implementation of an evidenced based patient toolkit and a discharge algorithm for providers will reduce outpatient falls. The objective was to reduce hospital readmission due to repeat fall.

Methods: The design of this project was mixed methods, observational, …

Increasing Annual Retinal Exams Among Patients With Type 2 Diabetes, Afokoghene H. Odhu

Doctoral Projects

The Center for Disease Control and Prevention (CDC, 2017) reports that approximately 30 million people in the United States (US) have diabetes. Approximately 8 million have diabetes retinopathy (DR) (CDC, 2018). DR is the leading cause of vision impairment in type 2 diabetes patients. Left untreated, DR can result in loss of vision and blindness (Hernández, Simó-Servat, Bogdanov, & Simó, 2017). The US spends approximately $500 million dollars annually in the treatment of diabetes-related blindness (CDC, n.d.). Early detection and management of DR through tight glycemic control, aggressive blood pressure and lipid management is essential to preventing complications of the …

A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel

Doctoral Projects

Background and Objectives: Home palliative care services are challenging to bill due to the complexity of services and competing time demands. Objectives and protocol were developed to guide coding and billing to increase Relative Value Unit generation and improve financial sustainability.

Design: A quality improvement project.

Setting: A home-based palliative care program in one health system in the Midwest.

Participants: Participants included 7 nurse practitioners.

Intervention: Coding protocol were developed, providers were educated, electronic health record audits were conducted to collect data on improvement, and feedback provided to prompt improvement.

Measurement and Analysis: Documentation of advanced care planning and billing, …

Pulmonary Rehabilitation Initial Education, Allison Vititoe

Scholars Week

Abstract

Pulmonary rehabilitation has been proven successful among those with chronic pulmonary diseases. However, there is a low rate of involvement and a lower rate of completion for these patients.

One of the major underlying factors contributing to this problem is patients’ lack of motivation. If the patients can be given information on the benefits of this program that align with what they hold as important there will be increased level of motivation and subsequently completion of pulmonary rehabilitation.

How Do Nurse-To-Patient Ratios In The Emergency Department Impact Patient Experience?, Jessica L. Marcoux

Electronic Theses and Dissertations

There is a lack of consensus about the staffing matrix across nursing and especially in emergency

nursing, where variations in arrival patterns, acuity, social determinants of health, and length of stay all impact the workload of emergency nurses. The objective of this paper was to determine if government-mandated staffing ratios had a greater impact on patient experience at hospitals in California than staffing based on hours per patient visit at hospitals in Massachusetts. Seven hospitals from the state of California with government-mandated nurse-to-patient ratios were compared to 7 hospitals from Massachusetts that did not have mandated staffing ratios to determine …

Disruptive Innovation: Impact For Practice, Policy, And Academia, Heather V. Nelson-Brantley, K. David Bailey, Joyce Batcheller, Laura Caramanica, Bret Lyman, Francine Snow

Faculty Publications

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US States, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

Leader Empowering Behaviour As A Predictor Of Nurse And Patient Outcomes, Karen Cziraki

Electronic Thesis and Dissertation Repository

Nursing leadership remains a critical factor during healthcare transformation. Nurse leaders who promote healthy working conditions have been associated with positive nurse and unit outcomes. However, mechanisms to explain how they influence outcomes are not understood (Cummings et al., 2018). Conger and Kanungo’s (1988) Process Model of Empowerment provided a framework to examine how leader empowering behaviour (LEB) influenced experienced nurses’ self-efficacy (SE), interprofessional collaboration (IPC), job turnover intentions (JTI) and nurse-assessed adverse patient outcomes (NAAE).

A non-experimental predictive design and structural equation modelling techniques in Mplus were used to conduct a secondary analysis of experienced registered nurses’ data ( …

Creating Restful Environments: Applying Evidenced-Based Interventions To Increase The Patients Perceptions Of Room Quietness At Night, Timothy Marks

West Chester University Doctoral Projects

Florence Nightingale first described the detrimental effects of noise on patients as an element nurses could control. Hospitalized patients who sleep in the hospital are at risk for poor periods of rest from unwanted noise in the care environment. This Doctor of Nursing Practice Project will assess interventions aimed at increasing the patient’s perception of quietness around the care environment at night for a pilot population. Swanson’s Theory of Caring will be utilized as a framework for the project. Outcomes of nursing interventions were reviewed for the improved patient perception of the care environment at night and resultant health outcomes. …

Development Of Hospital-Wide Policy For Pediatric Needle Procedures At An Academic Medical Center, Katherine J. Rose

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Needle procedures are traumatic experiences for pediatric patients, and have been linked to formation of phobias and lifelong decreased healthcare utilization.^1,2 Pain management during needle procedures and hospital wide standardization of needle procedures are known to increase patient satisfaction, while decreasing long-term adverse outcomes related to seeking health care.^3,4 The purpose of this project was to develop a hospital-wide standardized policy for pediatric needle procedures at an academic medical center.

Methods: Those performing pediatric needle procedures were electronically surveyed to identify full spectrum issues regarding adoption of a pediatric needle policy. Based on survey findings …

Crowded Er Waiting Rooms – Are Freestanding Ers The Way To Go?, Jesse Keats

Student Research Poster Presentations 2020

This poster discusses the differences in freestanding and hospital emergency departments. My position on this topic focuses on the idea that free standing ERs do not reduce overcrowding in an emergency room.

Are Healthcare Workers In The Hospital Ready For Disasters In The Community?, Nicholas Hromek

Student Research Poster Presentations 2020

This poster presents the idea that healthcare workers in hospitals are not equipped for disasters in the community. During such a vulnerable and relevant time such as the COVID-19 pandemic, this poster focuses on the pitfalls of the healthcare and hospital system.

Safety Promotion Via A Just Culture, Eric Gurzynski

Student Research Poster Presentations 2020

No abstract provided.

Nursing Annual Report: 2020, Centracare Health

Nursing Annual Report

Message from the CNO

St. Cloud Hospital Statistics

Message from Craig Broman, St. Cloud Hospital President/CEO

Nursing Strategic Plan FY 2020

Message from Tom Schrup, MD/CPO

Education & Certification

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Gratitude Journaling As Intervention To Combat Nurse Burnout In Cardiac Surgery Intensive Care Nurses, Melinda Simpson

Master of Science in Nursing Theses and Projects

As a practicing registered nurse in the intensive care setting, this researcher witnessed an episode of burnout characterized by a public meltdown, crying, and yelling. This sparked an interest in an intervention to combat nurse burnout. Literature was found on gratitude which has been found to increase resiliency. An increase in resiliency, in various populations, has been found to decrease perceived stress and feelings of burnout. This researcher investigated the use of gratitude journaling for 21 days as means to decrease perceived stress and feelings of burnout while increasing gratitude and resiliency. The PSS, GQ, BRS, & BBI tools were …

Front-Line Nurse Manager Succession Planning: Building And Promoting Strong Nurse Leaders Through Implementation Of A Nurse Manager Development Program, Melany Boyd

Master of Science in Nursing Theses and Projects

Succession planning plays a pivotal role in the infrastructure of any company. Succession planning is designed to identify individuals with potential and prepare them as successors when the current leader vacates their position. With the ageing nurse population, increased role demand, and lack of interest from incoming nurses there is an increase in nurse leader (particularly nurse managers) vacancies. Through the implementation of a Nurse Manager Development Program, executives have the opportunity to strengthen the nurse manager pipeline and promote succession planning through early identification of potential leaders and placing those individuals through a 3-month program that focuses on the …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Using The Bedside Care Conference To Improve The Patient Experience, Eileen Keefe

DNP Scholarly Projects

Abstract

Improving the patient experience of hospital care is a priority for nursing leaders. The terms patient satisfaction and patient experience have been used interchangeably to define the patient’s unique perspective on care quality and the impact of patient engagement on health outcomes. Patients and families experience suffering when their expectations are not congruent with their care in the hospital setting, and there are significant cost and financial implications for organizations that do not reach performance thresholds. Communication with nurses is highly correlated to overall patientsatisfaction in the Center for Medicare and Medicaid (CMS) Hospital Consumer Assessment of Providers and …

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

Uninsured/Underinsured: Who's Problem Is It?, Manpreet Kaur

Student Research Poster Presentations 2020

The problem of uninsured and underinsured in terms of health care was implored in the population of the United States of America. Other developed nations have implemented universal health care whereas the United States have fallen behind. It is an ongoing problem in the nation, and it is not only the problem of the people who face being uninsured and underinsured. It is everyone’s problem because it affects the economy as a whole and every person is affected by the way the country decides to treat health care. Nurses, as health care professionals, have the opportunity to help patients access …

Promoting A Culture Of Civility Among Oncology Nurses In The Ambulatory Care Setting To Improve Patient Safety And Nurse Retention, Sheila Evans

DNP Scholarly Projects

INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations.

AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association …

The Effect Of Acuity-Based Nurse Staffing On Nursing Medication Errors, Egidius Maria Eugene Waterval

Electronic Theses and Dissertations, 2020-

Nurses spend on average one third of their time on direct patient care, and most on indirect care in hospital settings. However, nursing workload is challenging to measure in a systemized, accurate, and timely way. Patient classification systems are designed to capture information about nursing workload based on the illness severity of the patient (acuity) to determine staffing resources and balance nursing workload. These systems are instruments that group nursing care activities in different categories to determine patient acuity. Electronic health records provide opportunities to use available data sets to accurately, and in real-time, document many direct and indirect patient …

The Effects Of Mindfulness Practices On Nurse Leader Resiliency, Kimberly Blanton

DNP Projects

Background: The purpose of this study was to evaluate if brief Mindfulness Based Stress Reduction (MBSR) sessions can improve nurse leader resilience and overall mindfulness.

Conceptual Framework: Two different conceptual frameworks, Jean Watson’s theory of caring and Albert Bandura’s theory of self-efficacy, were used to guide this project. Watson’s theory of caring is defined as healing of the mind, body, and spirit. This theory supports caring for oneself while caring for others. Bandura’s theory focuses on the belief that individuals can influence their own lives.

Methodology: This study employed a descriptive, pretest-posttest single site comparative design. Sixty-six nursing leaders from …

Patient Satisfaction With Nurse Versus Non-Nurse Post-Discharge Outreach, Iyore Adonri

West Chester University Doctoral Projects

In today’s current healthcare environment, there has been an extensive focus on patient satisfaction, and healthcare leaders struggle with the options of utilizing a registered nurse or a non-nurse when making outreach follow-up calls to recently discharged patients. Healthcare leaders find that designing, implementing and managing an efficient telephone outreach program can be challenging, however, this has become a necessary aspect of the patient continuum of care plan. Studies demonstrate that patient follow-up post-discharge increases patient satisfaction and their compliance with post-discharge instructions, thereby reducing readmission rates and emergency room visits (Meek, Williams, & Unterschuetz (2018). This quality improvement project …

Preparing Ambulatory Care Leaders For Service: Onboarding To Mentorship, Kara Simpson

Doctor of Nursing Practice Projects

At a large academic medical center in the Southeastern United States, a gap was identified in the process for onboarding and mentorship new leaders in the ambulatory care setting. Based on the evidence in the literature, a standardized onboarding and mentorship program can improve job satisfaction and retention of leaders. A program was developed to bridge this gap and provide educational support for new leaders. Participants completed surveys at the onset and conclusion of the program with a validated survey tool. While the quantitative results were not statistically significant, the feedback from the participants indicated the time spent in the …