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Workplace Violence (Wpv) Prevention Training Program For A Healthcare Organization, Hsing-Wen (Jill) Wang 2022 Seattle Pacific University

Workplace Violence (Wpv) Prevention Training Program For A Healthcare Organization, Hsing-Wen (Jill) Wang

Doctor of Nursing Practice (DNP) Scholarly Projects

Executive Summary

Background and Significance

Compared to all other industries in the United States, healthcare professionals are at the greatest risk for experiencing work-related violence (Cafaro et al., 2020; U.S. Bureau of Labor Statistics, 2020). Moreover, patient-to-staff violence, also known as Type Two Workplace Violence (Type 2 WPV), has the highest prevalence to healthcare employees in the past decades (Nowrouzi-Kia et al., 2019). Increasing incidence of Type 2 WPV impacts the health status of medical workers mentally and physically and generates substantial costs to organizations and the society (ILO/ICN/WHO/PSI Joint Program on WPV in the Health ...


Raising Awareness Of Second Victim Phenomenon And Supportingyou: A Quality And Safety Initiative, Megan Renee Bryant 2022 West Virginia University

Raising Awareness Of Second Victim Phenomenon And Supportingyou: A Quality And Safety Initiative, Megan Renee Bryant

Graduate Theses, Dissertations, and Problem Reports

Current literature has established a need for practice change in management of healthcare-related critical incidents. Peer-support programs have been cited as the most impactful resource healthcare professionals request following a critical incident (Daniels & McCorkle, 2016). SupportingYOU, a peer-support program, is in the process of expansion at a large academic children’s hospital in northern West Virginia in anticipation for the opening of a new facility. The specific aim of this project was to raise awareness of second victim phenomenon (SVP), SupportingYOU, and perception of awareness of resiliency. Interventions included multi-formatted educational sessions on SVP and SupportingYOU via PowerPoints, brochures, flyers ...


Implementation Of A Training Program To Improve The Crna Precepting Experience At An Academic Medical Center, Megan Jean Gillespie 2022 West Virginia University

Implementation Of A Training Program To Improve The Crna Precepting Experience At An Academic Medical Center, Megan Jean Gillespie

Graduate Theses, Dissertations, and Problem Reports

Formal preceptorship training has been shown to improve the comfort and confidence with precepting across many disciplines. Currently, there is no training program in place for the Certified Registered Nurse Anesthetist (CRNA) preceptors at a large academic medical center in West Virginia. The overarching goal of this quality improvement (QI) project was to implement a formal preceptorship training for the CRNAs at the facility of interest. The training, or intervention, was the Preceptor Essentials Parts I and II on NetLearning. This project followed the pre-intervention-post-survey design. The participants were self-selected CRNAs. The survey results were analyzed using the Mann-Whitney U ...


Implementation Of Standardized Handoff Reporting To Improve Communication Among Certified Registered Nurse Anesthetists And Postanesthesia Care Unit Nurses In The Postanesthesia Care Unit, Lauryn G. MacFawn 2022 West Virginia University

Implementation Of Standardized Handoff Reporting To Improve Communication Among Certified Registered Nurse Anesthetists And Postanesthesia Care Unit Nurses In The Postanesthesia Care Unit, Lauryn G. Macfawn

Graduate Theses, Dissertations, and Problem Reports

Standardization of handoff reporting has been proven to increase the quality of information being transferred and improve patient safety. Poor quality handoff between providers increases morbidity and mortality, hospital length of stay, healthcare costs, as well as decreases patient satisfaction The aim of this Doctor of Nursing Practice quality improvement (QI) project was to implement the situation, background, assessment, recommendation (SBAR) handoff reporting tool in the postanesthesia care unit (PACU) at a hospital in Western Maryland. There was no standardized handoff process in place between certified registered nurse anesthetists (CRNAs) and PACU registered nurses (RNs) at the facility. The participants ...


Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington 2021 The University of San Francisco

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and ...


Discharge Process Optimization, Erin M. O’Neal 2021 Southern Illinois University Edwardsville

Discharge Process Optimization, Erin M. O’Neal

Doctor of Nursing Practice Projects

As the demands of the nurse become increased with higher acuity and documentation requirements, the delivery of discharge instructions is often one of the most, and at times, only, formal education opportunities between the nurse and the patient. It is imperative to modify the discharge process to ensure patients have the ability to confidently care for themselves after they leave the hospital. The aim of this project was to create a nursing discharge workflow that meets the educational needs of the patients. This project was a quality improvement project designed to change the nursing workflow to provide a better discharge ...


Evaluating The Impact Of Nursing Assistant Employment On New Graduate Nurse Practice In The Acute Care Setting, Amy Bliemeister 2021 University of Nebraska Medical Center

Evaluating The Impact Of Nursing Assistant Employment On New Graduate Nurse Practice In The Acute Care Setting, Amy Bliemeister

Doctor of Nursing Practice Projects: College of Nursing

Background: New graduate nurses (NGNs) are expected to enter the acute care setting ready to provide safe and quality care in a fast-paced environment filled with high acuity patients, shortened lengths of stay, and difficult nurse to patient ratios (Clark & Springer, 2012). Employers, nursing students, and consumers are setting high expectations all nursing graduates will possess specific skills, knowledge, and competencies upon entry into practice (American Association of Colleges of Nursing, 2020).

Purpose: The purpose of this project was to determine the impact of NA program completion and employment on the NGN during the first year of nursing practice. The ...


Barriers To Discharge: A Retrospective Medical Record Review Examining Potential Barriers To Patient Discharge At The End-Of-Life, Pauline Felker, Kelly Purdy 2021 University of Nebraska Medical Center

Barriers To Discharge: A Retrospective Medical Record Review Examining Potential Barriers To Patient Discharge At The End-Of-Life, Pauline Felker, Kelly Purdy

Doctor of Nursing Practice Projects: College of Nursing

It is estimated that 70% of Americans would prefer to die at home, but less than one-quarter do so. Patients near the end of life often face several barriers that prevent them from successfully transitioning from an acute care setting to their preferred place of death. These barriers include but are not limited to a lack of trust between facilities and community care providers, ineffective communication, delayed discharge planning, difficulty accessing medications and supplies, lack of control, feelings of uncertainty, and feelings of burden. This study utilized a survey of 102 medical records of patients who died in the hospital ...


Implementation Of Maternal Fetal Triage Index To Improve Nurse Knowledge And Timeliness In Obstetric Triage: A Pilot Project, Emilie Long 2021 University of Nebraska Medical Center

Implementation Of Maternal Fetal Triage Index To Improve Nurse Knowledge And Timeliness In Obstetric Triage: A Pilot Project, Emilie Long

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to implement an obstetric triage acuity scale in a labor and delivery setting and study the effect on nurse knowledge and timeliness of care.

Design: A quasi-experimental pre and post-test design was used for this pilot project.

Setting: This project was conducted in an obstetric triage unit located within a fourteen-bed labor and delivery unit in the Midwest.

Methods: This pilot project was conducted over a two-month time period. Fifteen registered nurses qualified to care for obstetric triage patients were given education on the chosen triage acuity scale. A pre-test was administered before ...


Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan 2021 University of San Francisco

Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan

Master's Projects and Capstones

Section I: Abstract

Problem: January and February 2021 data showed a rise in readmissions for the NSTEMI population. This is significant as 2020 had a readmission rate of 5.6% and 7.3% in 2019. This sudden increase in readmissions within the first two months of the year is a cause for concern and immediate action is needed.

Context: 2020 had a reduction in cardiac catheterizations due to the multiple canceled cases during the COVID 19 pandemic. As the cases were being rescheduled along with new cases in 2021, the institution experienced an uptake in readmissions.

Interventions: The staff of ...


Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog 2021 University of San Francisco

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads ...


Implementation Of An Agitation Scale In Three Emergency Departments In An Urban Area Of Northern California, Adam Pelzl 2021 The University of San Francisco

Implementation Of An Agitation Scale In Three Emergency Departments In An Urban Area Of Northern California, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Background. Behavioral health patients in the emergency department are customarily treated without an objective assessment of agitation at presentation and throughout their hospital stay.

Local Problem. Behavioral health patients presenting with agitation in three emergency departments in Northern California are customarily treated with activation of a Code Grey emergency alert, use of physical restraints, or emergent sedation medication administration to manage the situation, prevent escalation, and protect the staff.

Context. Agitation in patients that is not recognized can lead to emergent sedation medication administration, physical restraints placed, and Code Greys activated to support the clinical staff.

Interventions. An evidenced-based agitation ...


Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl 2021 The University of San Francisco

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral ...


Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya 2021 The University of San Francisco

Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya

Master's Projects and Capstones

Abstract

Problem: Falls are considered never events, yet continuously occur in the inpatient setting. Falls,

especially falls with injuries, impact the patients, the staff, and the hospital. Falls cause extended lengths of stay, affect the morale of the patients and the staff, and are non-reimbursable events.

Context: There have been an increased rate of falls within a medical/surgical/telemetry unit

microsystem at a Northern California hospital despite standardized screening and prevention tools. The unit can house up to 52 patients and is the designated Covid unit of the hospital at the time of this project.

Interventions: The interventions include ...


Improving First Case Starts For A Neurosurgery Or, Tara L. Goodall 2021 University of San Francisco

Improving First Case Starts For A Neurosurgery Or, Tara L. Goodall

Master's Projects and Capstones

Problem: On-time first cases for operating rooms (OR) is a worldwide focus for improvement. OR delays have many adverse effects, including economic costs and patient and facility staff satisfaction.

Context: The site for this improvement project is a medium-sized hospital in Northern California. There are 12 ORs, with an average of 600-700 cases. Neurosurgery was the chosen specialty due to low on-time starts and long delay minutes. The focus was working with one OR to improve first case on-time starts by 20%.

Interventions: A worksheet was created to track room setup, delay reasons, and delay minutes. A visual setup guide ...


Preparing Nurses In Management Positions For Bedside Care During Times Of Crisis, Trevor Murray 2021 The University of San Francisco

Preparing Nurses In Management Positions For Bedside Care During Times Of Crisis, Trevor Murray

Doctor of Nursing Practice (DNP) Projects

Background

The purpose of this quality improvement project was to increase perceived self-efficacy in performing bedside skills among nurse leaders. As the demand for nurses increased, these leaders anticipated a direct role in providing patient care in the event of a patient surge due to COVID-19.

Problem

Due to the COVID-19 pandemic and Delta variant, hospital nursing leaders were and still are concerned with the challenge of providing enough competent nurses to deliver care. The DNP project prepared nurses who work in leadership roles to take or assist in taking a patient assignment.

Methods

Nurse leaders attended a skills lab ...


Streamlining Care For Children With Autism Spectrum Disorder, Siavash Rostami Jafarabad 2021 The University of San Francisco

Streamlining Care For Children With Autism Spectrum Disorder, Siavash Rostami Jafarabad

Doctor of Nursing Practice (DNP) Projects

Background: Autism spectrum disorder (ASD) is a chronic and developmental disorder that affects about one out of every 65 children in California, and one in 59 children in the United States. Children with ASD have difficulty communicating and interacting with others, and experience oversensitivity to new stimuli and environments.

Problem: In healthcare settings, children with ASD experience numerous challenges related to lack of adequate knowledge and education of staff regarding ASD, and lack of appropriate environmental and sensory resources which reduce quality of care provided to this population.

Methods: The project took place in a Psychiatric Emergency Services (PES) Unit ...


Transcatheter Aortic Valve Replacement: Implementation Of Shared Decision-Making, LIESEL BUCHNER 2021 The University of San Francisco

Transcatheter Aortic Valve Replacement: Implementation Of Shared Decision-Making, Liesel Buchner

Doctor of Nursing Practice (DNP) Projects

Background: The setting for this study is the structural heart program of a large healthcare organization in the Greater Sacramento area in California. Aortic stenosis (AS) is the most common cardiovascular valvular disease in the elderly. The treatment of AS is complex and over the last decade, the transcatheter aortic valve replacement (TAVR) procedure has changed the management of this high-risk group and has become the standard of care.

Problem: The structural heart team performs an average of 170 TAVR procedures annually. The program is relatively new, and although it is performing above the national averages for specific program outcome ...


Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa 2021 The University of San Francisco

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention ...


Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli 2021 University of San Francisco

Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli

Doctor of Nursing Practice (DNP) Projects

Background: “Baby boomers” (born between 1946 and 1964) represent 15% of the total population of the United States (Population Reference Bureau, 2019), but 50% of its total healthcare expenses (Mattison, 2021). Growth of this population will have a corresponding rise in demand on healthcare resources. Replication of a geriatric inpatient care model (Palmer et al., 1994) was introduced in a large geographically and ethnically diverse integrated care delivery system.

Problem: The demographic for this small community hospital located in Northern California has a larger percentage of patients over the age of 65 compared to other facilities within this delivery system ...


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