Other Nursing Commons^™

Implementation Of A Code Lobby Surge And The Impact On Left Without Being Seen Rates, Nicole Plouffe

Student Scholarly Projects

Practice Problem: Crowding of emergency departments contribute to higher-than-average left without being seen (LWBS) rates. LWBS patients pose risks to the hospital as well as to one’s own health.

PICOT: The PICOT question that guided this project was in a pediatric emergency department (P), does implementation of a “Code Lobby Surge” (I), compared to standard care (C), decrease left without being seen rates (O) within eight weeks (T)?

Evidence: Surge interventions and decreasing the visual of crowding have shown to decrease LWBS rates.

Intervention: “Code Lobby Surge” was implemented to decrease LWBS rates and improve throughput within the …

Sustainability Of An Outpatient Antibiotic Stewardship Program, Kristin Smith

Dissertations

Abstract

Problem: Antibiotic stewardship is an effort to evaluate and improve the use of antibiotics by providers and patients. Antibiotic stewardship programs (ASPs) promote the appropriate use of antibiotics. There is increasing evidence that supports the use of antibiotic stewardship programs in reducing antibiotic prescribing rates while continuing to maintain safe patient care. Research supports approaches with multiple interventions and ongoing commitment to antibiotic stewardship. However, information regarding long-term sustainability of antibiotic stewardship programs is lacking. The purpose of this quality assurance project was to assess long-term sustainability of a previously implemented ASP promoting appropriate prescribing of antibiotics for the …

Qualifications Of Executive Nurses For Service On Hospital Boards, Michelle Lee Foxx

Electronic Theses and Dissertations

Abstract Healthcare governing boards have responsibility for the legal and financial stability of the organization. They are assuming more responsibility for quality care and outcomes. Nurse leaders have valuable insights into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. Yet, only 5% of the 3.2 million nurses in the U.S. health workforce hold a seat on hospital governing boards in the United States. The purpose of this study was to explore how nurses with executive experience perceive their own leadership qualities in the context of established requirements for executive hospital boards. Fifty …

Adults On The Autism Spectrum: A Quality Improvement Project To Develop A Patient-Centered Nursing Care Guideline For The Acute Care Setting, Elizabeth Cirelli

DNP Scholarly Projects

Abstract

Background: Incidence of autism spectrum disorder is increasing. Current prevalence rate is 1 in 59 people, which translates to roughly 1% of the U.S. population. These adults have higher rates of epilepsy, gastrointestinal disorders, obesity, cardiac dysfunction, and mental health disorders. Healthcare system utilization is resultantly greater than their neurotypical counterparts, coupled with longer lengths of stay and decreased patient satisfaction reports.

Purpose: Most nurses report little to no formal training about the disorder or how to develop interventions sensitive to the needs of this population yet are crucial care givers to ensure patient-centeredness. A guideline to …

Diabetes Shared Medical Appointment: An Evidence-Based Innovation Project, Mohamed Bojang

DNP Final Reports

The purpose of the evidence-based practice innovation project (EPIP) is to address uncontrolled diabetes by implementing an evidence-based shared medical appointment (SMA) intervention which based on the body of the evidence will help improve diabetes outcomes. A pilot implementation and retrospective chart review were conducted. Data was collected on outcome indicators such as blood pressure, lipid values, body mass index, A1C, and knowledge. The results of a pilot SMA implementation revealed that patients who participated in the weekly SMA saw an improvement in post-mean values compared to pre-mean values. Mean A1c dropped to 7.0% from 7.11%; systolic blood pressure improved …

What? Not Another Fall!: Reducing Falls In The Neuroscience Patient Population, Elizabeth Plante

Nursing Posters

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.

Reducing Falls In The Neuroscience Patient Population, Elizabeth Plante

Nursing Posters

Purpose Statement:

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Evaluation Of Educating Registered Nurses Prior To Implementing New Evidence-Based Protocol: Enhanced Recovery After Surgery (Eras), Lisa Brooks

Dissertations

Evidence-based protocols promote standardization of care and patient safety. The inclusion of major stakeholders is imperative to the success of implementation of a new protocol. The “Enhanced Recovery After Surgery” (ERAS) protocol was implemented at the Veterans Administration Medical Center – St. Louis prior to formal education of direct-care registered nurses (RNs), a major stakeholder group. Due to the lack of knowledge, the RNs who were expected to implement and adhere to the ERAS protocol were not prepared and displayed a lack of confidence. Subsequently, an educational training intervention was designed and executed with thirty-five RN participants. Prior to this …

Assessment Of Fall Protocol Use On A Medical-Telemetry Unit, Ashia Mar

Master's Projects and Capstones

Purpose: This quality improvement project serves to implement a fall prevention plan to decrease patient falls on the medical-telemetry unit of a large metropolitan hospital.

Background: Patient falls are a persistent nationwide problem in the acute care setting. Between 700,000 and 1,000,000 falls occur in hospital every year and approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls always cause harm to the patient, whether it is emotional or physical; but, falls can also cause harm to the providers, family, and organization. Patient injury, additional hospital expenses, and …

Improving Bedside Ecg Monitoring In Telemetry, Teresa Jahn, Jennifer Lang, Jaclyn Hoppe

Nursing Posters

To improve accuracy of bedside ECG (EASI lead) monitoring through accurate placement of electrodes and proper skin preparation.

Inpatient Rehabilitation Performance Improvement: Skin Care And Guidelines, Golden Fisk

Nursing Posters

To improve skin integrity care as well as use of hospital policies and guidelines within Inpatient Rehabilitation.

Reduction Of Cesarean Section Surgical Site Infections (Ssi): Progression And Implementation Of Evidence Based Practice, Patricia Dumonceaux, Melissa Erickson, Kim Schuster, Elizabeth Kiffmeyer

Nursing Posters

To improve cesarean section patient experience by reduction of postoperative SSI.

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) …

Evidence To Measure And Implement Patient Satisfaction In Fbc Patients, Meredith Wells

Nursing Posters

Purpose Statement: The purpose of this project is to increase Family Birthing Center patient Press Ganey satisfaction scores by focusing on communication with nurses, implementing communication guidelines and nurse accountability for compliance.

Evidence To Support Standardized End Of Life Care Utilizing Evidence-Based Training, Education, And Protocol/Order Sets, Sara S. Revier

Nursing Posters

Purpose Statement: Develop and implement evidence based standardized end of life care through education, case identification, and care delivery tools for adult med/surgical patients transitioned to comfort care as compared to current, non-standardized care for patients transitioned to comfort care.

Giving Time Back: Implementing A Electronic Nursing Protocol For Skin Care, Amy Gorecki, Sue Omann, Kim Schuster

Nursing Posters

Purpose Statement: To improve the accessibility of evidence based skin care interventions for the clinical nurse without the need of a CWOCN consult.

Treating Early Sepsis Outside Of The Icu Using A Bundle Of Interventions, Jennifer Burris

Nursing Posters

To decrease cost and length of stay for sepsis patients by standardizing treatment in the progressive care units (PCUs).

Sustaining Pressure Ulcer Prevention: Implementing A Skin Champion Model, Jennifer Burris

Nursing Posters

Purpose Question: Will an evidence-based skin champion model in the ICU improve nursing knowledge and perceptions about pressure ulcer prevention and reduce hospital acquired pressure ulcers?

Prevention Of Unplanned Extubations, Melissa Fradette, Donna Kamps

Nursing Posters

Background: The trend of unplanned extubations is rising. Unplanned extubations are a safety concern for patients. A ventilator bundle is in place to guide nurses and respiratory therapists for weaning and extubating patients who meet criteria; it is not always being used. This concern has been discussed at the ICU safety team, ICU NP, ICU ROE, and ICU leadership meetings.

Nursing Skin Integrity Guidelines: A New Approach To Skin Care, Kim Schuster, Amy Gorecki, Jennifer Burris

Nursing Posters

What is nursing skin integrity guidelines: a nursing driven order to provide evidence based skin integrity interventions; provides a streamlined process for immediate application of best practice interventions for identified skin impairments; the interventions can be implemented based on assessment findings and clinical judgment; and provides a guideline for consulting the WOC Nurse, including when wounds are not healing, all pressure ulcers, and ostomy needs.

Impact Of Tranexamic Acid (Txa) On Hemoglobin Levels In Elective Total Knee Arthroplasty Patients, Gina Anderson-Malum

Nursing Posters

Over the last 2 years, the Bone and Joint Center has focused on blood utilization for total knee and total hip arthroplasty. With the use of a blood transfusion protocol, we significantly reduced blood transfusion rates and standardized the approach to care. As an expansion of this work, other ideas to further decrease blood utilization were considered. The purpose of the data collection of preoperative and postoperative Hemoglobin (HGB) levels was to evaluate the effect of Tranexamic Acid (TXA) on the average change in Hgb levels compared to Hgb levels of patients that did not receive the medication. In addition, …

Sitter Observation, Lisa Kilgard, Elizabeth Schuler

Nursing Posters

To implement a practice change at St. Cloud Hospital which reduces one to one observation in medical and behavioral patients as compared to current routine practice of one to one sitter use as a common intervention used.

Advancing Employee Engagement Through The Development And Responsible Use Of An Internal Social Media Wiki, Marci Timlin

Nursing Posters

The purpose of this Evidence-based practice project is to increase employee engagement on the Surgical Care Unit through the use of social media. The fundamental reason for the project is to increase cohesion among employees by increasing communication, team building, and personal relationships.

Wiki's And Ebp: Linking Academia And Practice, Susan Schleper, Joyce Simones, Rachelle Larsen, Judy Gilsdorf-Gracie

Nursing Posters

To evaluate the advantages and disadvantages of using a Wiki to develop an evidence-based practice research project.

Hospital Nursing Research Program: Partnership Of Service And Academia, Patricia Ravert, Katreena Collette Merrill

Faculty Publications

Hospitals in a nonprofit mountain west corporation conducted a gap analysis to determine readiness for Magnet Recognition. Major gaps included nursing research and availability of consultation and resources for research. Based on the findings, the development of a dynamic research program promoting nursing research and evidence-based practice within hospitals was undertaken. A nursing research council was reestablished with representatives from service and academia. A literature review and analysis of corporate/academia resources were completed. The plan called for a nursing research coordinator position and development of a research budget. Academia continues to be represented on the hospital institutional review board. A …