Other Nursing Commons^™

Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata

Doctor of Nursing Practice (DNP) Projects

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …

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 …

Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez

Doctor of Nursing Practice (DNP) Projects

Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …

Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley

Master's Projects and Capstones

Patient satisfaction scores regarding how effectively staff educates patients about possible side effects of new medications are not consistently above the national average at a large metropolitan hospital in California (MHC). The results of these patient satisfaction scores shed light on the need for evidence-based strategies to improve a patient’s perception of the medication education provided to them. The basis of the incentive to improve care is ultimately increased safety and better patient outcomes. From the Root Cause Analysis, it became apparent that a few common barriers need to be addressed, but the one most frequently reported by everyone that …

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 …

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …

Fall Reduction With Nursing Interventions, Sin Ting Chan

Master's Projects and Capstones

The aim of the project is to reduce the patient’s fall rate in the medical surgical unit at an acute care hospital through improving the fall precaution process. The unit consists of 37 bed with a population of stroke, medical, and surgical patients. The focus of the nursing staff education using handouts, brochures, and poster will be based on the results from pre and post intervention audits. The goal of this fall reduction project is to have the nursing staff learn, review, and apply fall prevention interventions for fall risk patients in order to help reduce fall rate by 50 …

Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens

Master's Projects and Capstones

The congestive heart failure patient faces many challenges after discharge from the hospital. Learning how to manage diet, medications, and other lifestyle changes needed for symptom management can lead to multiple readmissions and rapid progression of condition. Many patients feel overwhelmed at time of discharge from the hospital, and many miss key components in discharge instructions and education. The main objective of the organizations Heart Failure program is to educate patients who have been admitted into the hospital with systolic or diastolic heart failure. Within our team we set out to educate our patients and their families on reducing incidents …

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …

N653 Fall Prevention Final Project, Sam Clark

Master's Projects and Capstones

N653 Fall Prevention Final Project

by Samuel K. Clark, RN

This project was done with patient safety in mind through the use of the most current EBP available.

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) …

Videoconferencing For Improved Access To Care, Alana L. Hernandez

Master's Projects and Capstones

The aim of this project is to increase the amount of education visits completed by pharmacy nurses in an outpatient infusion clinic for patients receiving 5-fluoracil chemotherapy. Two approaches have been applied: securing additional nursing staff; and implementing a telehealth delivery system that utilizes asynchronous video and videoconferencing. The intervention will employ an internet-based application to secure a videoconferencing session between patients and nurses that are 25 miles apart; and offer a patient education video that will be used and an adjunct to videoconferencing. Microsystem data obtained by auditing schedules and patient charts showed pharmacy nurses completed 0% of pharmacy-patient …

Improving Management Of Inpatient Blood Glucose, Rachael K. Misitano

Master's Projects and Capstones

Epidemiologic studies indicate blood glucose management in the hospitalized patient population is not adequate; with approximately 30% of patients reporting values >180mg/dl. Patients with increased blood glucose levels pose a higher mortality risk as well as increased risks for dehydration, hypotension, renal injury, decreased wound healing, immunosuppression, and an overall increase in hospital length of stay (AACE, 2015). This project aims to improve inpatient management of blood glucose levels by facilitating MD-RN communication through a reduction in the current reportable blood glucose level. This project took place on a 17 bed adult medical-surgical unit at a large academic hospital in …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

Improving Patient Satisfaction Through Reducing Nurse Overtime And Redesigning Nurse Staffing And Scheduling, Abby Romme

Master's Projects and Capstones

Increasing cardiac device patient demands within a large Midwest healthcare institution resulted in significant increases in staff shift requirements and corresponding patient complaints. The quality improvement project aimed to decrease patient complaints by executing a standard baseline daily full time equivalent (FTE) staffing strategy for future schedules, increasing nursing FTE, and maintaining institutional staffing standards. Standard calculated daily nursing requirements targeted 17.0 FTE. Implementation occurred over a three month period including schedule reprocessing, a pending incremental nursing FTE request, and a restructuring of unit based scheduling and paid time off guidelines. The completed schedule accurately captured staffing requirements for 100% …

Monitoring Non Compliant Diabetic A1c Levels, Laura J. Tracy

Master's Projects and Capstones

The AIM of this CNL project is to identify and connect with, those diabetic patients within the out-patient clinic that are not in compliance with their A1C laboratory values. Contacting these patients to schedule follow up and re-engagement in their health care plan, may improve their overall health care outcomes and decrease their risk of more frequent or prolonged hospitalization and increased use of medications. There are over 25.6 million adult diabetic people living in the United States as of 2010. The total cost of direct and indirect medical care is 174 billion dollars as of 2007. With over 3.9 …

Improving Nurse-Patient Communication About New Medicines, Srimala Thinsan

Master's Projects and Capstones

Improving Nurse-patient Communication about New Medicines

Abstract

The project aimed at improving nursing communication with patients and families about medication in order to increase patient satisfaction in terms of safety, quality of care, and patient-centeredness in an acute care setting. The selected patient cohort was at a 42-bed medical-surgical unit in a trauma center in Oakland, California. The gap of nurse-patent communication about medicines was identified based on the HCAHPs scores that had been found to be lower than average (44.1% in March 2015; 40.9% in April 2015). The visibility board was provided to show the staff the HCAHPS scores, …

Pre-Exposure Prophylaxis (Prep) Education Improvement Project, Reginald M. Hilarie

Master's Projects and Capstones

In 2012, the US Food and Drug Administration approved the pill Truvada for use as pre-exposure prophylaxis or PrEP. Its purpose is to help prevent HIV infection by taking one pill every day. This project aims to improve PrEP patient education provided by the multi-disciplinary team and to decrease new HIV infection and sexually transmitted infections (STIs) to zero. The focus of the study is patients on PrEP at the Infectious Disease and HIV Clinic in San Francisco Veterans Administration Medical Center. The Clinical Nurse Leader, in collaboration with the multidisciplinary team, incorporated Pender’s Health Promotion Model Theory in developing …