Other Nursing Commons^™

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias

Master's Projects and Capstones

Purpose: The aim of the study was to identify barriers encountered by registered nurses (RNs) and nursing assistants (NAs) that prevent purposeful (hourly) rounding.

Background: The literature has shown that purposeful rounding improves patient outcomes and safety. However, few studies show the barriers encountered by nursing staff that hinder the purposeful rounding process.

Methods: A pre-post test design was implemented on a 25-bed oncology, urology medical surgical unit with a staff of 38 RNs, 9 NAs, and 4 Unit Secretaries (US). A pre-implementation needs assessment survey was completed by 55% (21/38) of RNs, 33% (3/9) of NAs, and 100% (4/4) …

Handoff Communication In The Emergency Department, Kristen Matichko

DNP Forum

The communication of patient information through use of handoff ensures continuity of care and patient safety. A study of hand-off reports between pre-hospital personnel and staff in the emergency department revealed a lack of complete or formal information dialogue. Nurses play a vital role in the process of communication and information exchange through the use of handoff despite minimal guidelines for that exchange in current nursing practice. The pre-hospital hand-off informational exchange impacts patient safety as well as the planning and implementation of nursing care based upon that information.

The sample used was from a convenience sampling of patients arriving …

The Relationships Between Patients’ Perceptions Of Nurse Caring Behaviors, Nurses’ Perceptions Of Nurse Caring Behaviors And Patient Satisfaction In The Emergency Department, Theresa Bucco

Seton Hall University Dissertations and Theses (ETDs)

Background: Approximately 100 million people seek care in Emergency Departments yearly, which can be overwhelming for many Emergency Department (ED) nurses. Thus, caring for these patients and meeting their needs is challenging for ED nurses. It is the patients’ perceptions of the first caring encounters in the ED that can have a significant impact on patient satisfaction.

Objective: The purpose of the study was to examine the relationships between patients’ perceptions of nurse caring behaviors, nurses’ perceptions of nurse caring behaviors, and patient satisfaction in the ED.

Methods: This was a descriptive cross-sectional study that examined the …

Improving Patient Satisfaction After Primary Total Knee Arthroplasty Using Nurse Practitioner-Driven Preoperative Education, Jennifer A. White

Doctor of Nursing Practice Scholarly Projects

Total joint arthroplasty is an undisputed option for relieving pain and improving the function of an arthritic joint. The number of patients undergoing total knee arthroplasty (TKA) annually is expected to increase by 600% in the next two decades (Lau, Gandhi, Mahomed, & Mahomed, 2012).

Current research shows that while 81-89% of patients who have had a TKA are satisfied postoperatively, there is room to improve patient satisfaction by providing further education preoperatively. While research cannot agree on a single, specific variable that influences patient dissatisfaction, a review of the literature shows that patients repeatedly note their “unmet expectations” as …

Multimodal Secondary Prevention Behavioral Interventions For Tia And Stroke: A Systematic Review And Meta-Analysis., Maggie Lawrence

Dr. Maggie Lawrence

Background Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions.

Strategy Searches were conducted in 14 databases, including MEDLINE (1980-January 2014). We included randomized controlled trials (RCTs) testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines.

Results Twenty-three papers reporting 20 RCTs (6,373 participants) of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

A Systematic Review: Non-Pharmacological Interventions For Chemotherapy-Induced Nausea And Vomiting, Miranda L. Ayers, Olateju F. Olowe

Williams Honors College, Honors Research Projects

Around 70-80% of patients receiving chemotherapy are at risk of chemotherapy-induced nausea and vomiting (CINV), which can interfere with appetite and the ability to perform normal activities for daily living. When CINV is severe, psychological distress, depression, and physiological impairment occur. Patients may also stop chemotherapy treatments, which can lead to untimely deaths. The aim of this systematic review was to identify, describe, and evaluate the evidence about the use and effectiveness of non-pharmacological interventions, compared to no use of non-pharmacological interventions, on self-reported episodes of CINV among the cancer patients. Twenty articles were reviewed on the use of acupressure, …