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The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon 2020 University of St. Augustine for Health Sciences

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

Student Scholarly Projects

Practice Problem:There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

PICOT: This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Evidence: Thirteen pertinent studies recommended the use ...


A Policy Change To Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project, Nia Hidalgo 2020 University of St. Augustine for Health Sciences

A Policy Change To Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project, Nia Hidalgo

Student Scholarly Projects

Practice Problem: At a small community facility in Los Angeles County, there was a reporting rate of hospital-acquired Clostridium difficile cases that was higher than both state and national benchmarks.

PICOT: The PICOT question that guided this project was: In acute care patients aged 18-90, does not retesting for CDI for at least seven days compared to retesting in less than seven days reduce the incidence of false positive CDI tests during the first seven days of the hospital stay?

Evidence: The evidence demonstrates that if patients are tested initially for Clostridium difficile and then retested seven days after, the ...


“Elderly” Seniors Vs. “Youthful” Seniors: Attributions And Reshaping Of Aging Expectations, Johnny Julvesano Yao Jr 2020 Cebu Normal University

“Elderly” Seniors Vs. “Youthful” Seniors: Attributions And Reshaping Of Aging Expectations, Johnny Julvesano Yao Jr

The Qualitative Report

People’s expectations of aging are shaped by various sources and experiences. These aging expectations subsequently influence a person’s overall health and well-being. I intended to gain a deeper understanding of the various sources by which Filipino older adults attribute and reshape negative and positive expectations regarding aging. I used a multiple case study (Creswell, 2013) and enlisted eight participants who are 60 years old and older in a large metropolitan area in the Philippines and interviewed them regarding their aging expectations. I analyzed the data using cross-case analysis for comparison of commonalities and differences in the events, activities ...


Dnr No Polst Project, Reanda Scherson 2020 University of San Francisco

Dnr No Polst Project, Reanda Scherson

Master's Projects and Capstones

Problem: The DNR No POLST project aims to increase the number of physician orders for life-sustaining treatment (POLST) forms completed on hospitalized patients who are designated DNR status. Currently, there is no process for ensuring completion of advanced care planning (ACP) materials, including the POLST form, on designated DNR patients throughout the hospital. Ensuring patients receive a complete and accurate POLST prior to discharge decreases the chance of unwanted overtreatment.

Context: This quality improvement project utilizes regionally trained life care plan (LCP) facilitators to initiate and assist patients and families in the completion of the POLST form. Approximately 70% of ...


Pressure Injury Documentation And Reporting: A Quality Gap, Mary Ann Laslo 2020 The University of San Francisco

Pressure Injury Documentation And Reporting: A Quality Gap, Mary Ann Laslo

Master's Projects and Capstones

Abstract

Problem: Inaccurate and incomplete pressure injury (PrI) assessment and documentation leads to inaccurate reporting of PrI quality reporting measures to the Centers for Medicare and Medicaid Services. Inaccurate, incomplete documentation of pressure injuries and wounds adversely affects the quality of care, financial reimbursement, and hospital reputation as well as increasing the risk of litigation to medical providers. Barriers to accurate and complete documentation by the nurses were inaccuracy in identification of PrIs Stage 1 or greater and knowing what and where to document the information in the electronic medical record.

Context: This quality improvement project attempted to improve nurse ...


Pre-Discharge Bnp: A Policy Change To Reduce Hospital Readmission, Melissa Duckett 2020 Jacksonville State University

Pre-Discharge Bnp: A Policy Change To Reduce Hospital Readmission, Melissa Duckett

Doctor of Nursing Practice Projects

Heart Failure (HF) is the leading cause of hospital readmission for patients 65 years of age and older. A pre-discharge B-type natriuretic peptide is a strong predictor of hospital readmission and mortality. The annual cost for admission of patients with HF is greater than $17 billion. Diagnosed heart failure patients continue to be discharged without the physician knowing their current BNP levels. The Affordable Care Act established the Hospital Readmissions Reduction Program (HRRP) requiring the Center for Medicare and Medicaid Services (CMS) to reduce reimbursement to hospitals with high readmission rates. A change in policy should be initiated to include ...


A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula 2020 Winona State University

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers ...


Quantifying Differences In Pill Swallow Patterns In Adults, Catherine A. Sullivan, Luis F. Riquelme 2020 New York Medical College

Quantifying Differences In Pill Swallow Patterns In Adults, Catherine A. Sullivan, Luis F. Riquelme

Annual SHSP Student Research and Scholarship Day

Difficulty swallowing pills has become an increasing complaint among patients visiting swallow evaluation centers across the globe. Deficits are reported in healthy individuals as well as in clinical populations. In the USA, 40% of 679 persons responding to a survey reported difficulty swallowing pills (Business Wire, 2009). In an effort to facilitate pill intake, several modifications have been reported: use of liquid formulations, crushing tablet, opening capsule, whole pill mixed with food or via feeding tube (Cornish, 2005). A survey of 40 nurses revealed the most common modification was to use apple sauce (Riquelme et al., 2009). Current literature on ...


Insulin Injection Re-Education For Improved Glycemic Control, Daniela Shon 2020 University of San Diego

Insulin Injection Re-Education For Improved Glycemic Control, Daniela Shon

Doctor of Nursing Practice Final Manuscripts

Title: Insulin Injection Re-education for Improved Glycemic Control

Background: Patients on insulin therapy often continue to show suboptimal glycemic control. Data from adult patients with T2DM have demonstrated that 56.1% had poor control, despite adherence to treatment, oral and injectable. Poor glycemic control stems from many sources, including poor self-efficacy regarding insulin dosage adjustment, inaccurate insulin dosing, expired insulin, lipohypertrophy of the injection site and technique, and equipment issues.

Purpose: This project aimed to implement and assess the efficacy of re-education in the insulin injection technique for improved glycemic control.

Methods: This project was conducted based on the John ...


Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez BSN, RN, DNP - FNP/AGNP Student 2020 University of San Diego

Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez Bsn, Rn, Dnp - Fnp/Agnp Student

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led standardized dry skin protocol for outpatient geriatric patients to promote overall well-being and improve quality of life.

Background: Current literature supports using the dry skin protocol to help primary care teams identify patients that require xerosis cutis skin care, particularly of the lower extremities. The primary focus of this project will be timely detection of patients with the dry skin condition that will be identified with the standardized Overall Dry Skin (ODS) scale. When the patient meets the ODS criteria, a timely discussion will be ...


Increasing Access To Medicare Annual Wellness Visits In Primary Care; Utilizing Registered Nurses As Part Of An Interdisciplinary Team Based Approach, Iyo Kubota 2020 The University of San Francisco

Increasing Access To Medicare Annual Wellness Visits In Primary Care; Utilizing Registered Nurses As Part Of An Interdisciplinary Team Based Approach, Iyo Kubota

Doctor of Nursing Practice (DNP) Projects

Background: In order to provide evidence-based preventive care to the aging population, Medicare began providing free annual wellness visits (AWVs) to its beneficiaries in 2011. The AWVs are a great opportunity for primary care providers to develop personalized preventive care as well as health promotion. However, many primary care practices especially those with limited resources struggle to incorporate AWVs into their busy primary care practice. Centers for Medicare and Medicaid Services allows other providers than physicians, NPs and PAs to perform those visits including registered nurses, health educators, and registered dietitians.

Methods: A pilot project was conducted with 12 patients ...


Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax 2020 Valparaiso University

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this ...


Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber 2020 University of Texas at Tyler

Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber

MSN Capstone Projects

With rising healthcare costs and increasing demands placed on healthcare workers, it is no wonder that decreasing hospital length of stay for patients is high priority for hospitals today. Hospital acquired infections are one of the culprits keeping so many patients hospitalized. Specifically, in intensive care units (ICU) and intermediate care (IMC) units that care for mechanically ventilated patients, ventilator associated pneumonia secondary to intubation is a complication and cost that is being sought to be avoided. Hospitals have been pro-active to prevent ventilator associated pneumonia from occurring by placing oral care bundles or protocols in place to care for ...


Those Who Can Pay: The Impact Of Socioeconomic Status In Long Term Care, Desiree Schippers 2020 Kansas State University

Those Who Can Pay: The Impact Of Socioeconomic Status In Long Term Care, Desiree Schippers

Crossing Borders: A Multidisciplinary Journal of Undergraduate Scholarship

In this personal essay I explore the disparities between two different state funded long term care facilities. After completing four months of field work living in a nursing home, I synthesize my experiences both as a long term care resident and employee into a work of creative nonfiction. I include information from interviews with experts on long term care funding, finance officers at the facilities, and refer to state long term care laws.


Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell 2020 Winona State University

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so ...


Long-Term Care Policy After Covid-19 — Solving The Nursing Home Crisis, Rachel M. Werner, Allison K. Hoffman, Norma B. Coe 2020 University of Pennsylvania Perelman School of Medicine

Long-Term Care Policy After Covid-19 — Solving The Nursing Home Crisis, Rachel M. Werner, Allison K. Hoffman, Norma B. Coe

Faculty Scholarship at Penn Law

Nursing homes have been caught in the crosshairs of the coronavirus pandemic. As of early May 2020, Covid-19 had claimed the lives of more than 28,000 nursing home residents and staff in the United States. But U.S. nursing homes were unstable even before Covid-19 hit. The tragedy unfolding in nursing homes is the result of decades of neglect of long-term care policy.

Beyond the pandemic, we will have to transform the way we pay for and provide long-term care. First, Medicaid programs need to invest considerably more in care in all settings, including home-based settings as Medicaid shifts ...


Patient-Centered Emr Communication, Christi Lynn Camarena 2020 California State University, Northern California Consortium Doctor of Nursing Practice

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in ...


Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba 2020 Dominican University of California

Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba

Nursing | Senior Theses

When caring for people with severe dementia, the concept of the person being central is increasingly advocated in clinical practice. Person-centered care acknowledges autonomy in all facets of care. Recent studies examine behavioral changes in individuals with dementia and how health care teams address these alterations. Health care providers are vital for effective holistic management. Therefore, this review focuses on the current knowledge regarding care goals, practices, and perceptions of the client battling with cognitive decline. A literature review ascertains that clients with dementia respond to interventions and have decreased negative health outcomes, when providers ensure values and needs are ...


A Compilation Of Written Instructional Practice Reflections On The Acue (Association Of College And University Educators) Course In Effective Teaching Practices, Sheryll Go 2020 California State University, San Bernardino

A Compilation Of Written Instructional Practice Reflections On The Acue (Association Of College And University Educators) Course In Effective Teaching Practices, Sheryll Go

Q2S Enhancing Pedagogy

This is a compilation of written instructional practice reflections on The ACUE (Association of College and University Educators) Course in Effective Teaching Practices, from January – April 2020. This online course has prepared Nurse Educators like me in gaining a foundation in evidence-based teaching practices that increase student motivation, engagement, and learning. The attached assignment include reflections from completed modules.


Fear Not...No Falls, Jennifer A. Rabenold MSN, RN, CDN 2020 Lehigh Valley Health Network

Fear Not...No Falls, Jennifer A. Rabenold Msn, Rn, Cdn

Patient Care Services / Nursing

No abstract provided.


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