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Geriatric Nursing Commons

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Health-Services Utilisation Amongst Older Persons During The Last Year Of Life: A Population-Based Study, Danielle Ní Chróinín, David E. Goldsbury, Alexander Beveridge, Patricia M. Davidson, Afaf Girgis, Nicholas Ingham, Jane L. Phillips, Anne M. Wilkinson, Jane M. Ingham, Dianne L. O'Connell 2018 Edith Cowan University

Health-Services Utilisation Amongst Older Persons During The Last Year Of Life: A Population-Based Study, Danielle Ní Chróinín, David E. Goldsbury, Alexander Beveridge, Patricia M. Davidson, Afaf Girgis, Nicholas Ingham, Jane L. Phillips, Anne M. Wilkinson, Jane M. Ingham, Dianne L. O'Connell

ECU Publications Post 2013

BACKGROUND: Accurate population-based data regarding hospital-based care utilisation by older persons during their last year of life are important in health services planning. We investigated patterns of acute hospital-based service use at the end of life, amongst older decedents in New South Wales (NSW), Australia.

METHODS: Data from all persons aged ≥70 years who died in the state of NSW Australia in 2007 were included. Several measures of hospital-based service utilisation during the last year of life were assessed from retrospectively linked data comprising data for all registered deaths, cause of death, hospital care during the last year of life ...


Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson 2018 University of San Francisco

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted ...


Identification Of Perioperative Barriers To Enhanced Recovery After Surgery In Colorectal Surgical Populations, Leah Marshall 2018 The University of San Francisco

Identification Of Perioperative Barriers To Enhanced Recovery After Surgery In Colorectal Surgical Populations, Leah Marshall

Master's Projects and Capstones

Enhanced recovery after surgery (ERAS) has evolved over the past 30 years through evidence-based interventions. Enhanced recovery after surgery uses a multidisciplinary and multimodal evidence-based approach to maximize patient recovery. Perianesthesia nurses are critical to its success and have an obligation to understand and participate in the process to optimize patient outcomes. Despite proving to decrease complications and duration of stay in colorectal surgery patients without following colorectal surgery, the implementation of ERAS in colorectal pathways have been met with barriers (Alawadi et al., 2015). Subramaniam & Horgan (2016) describe ERAS pathways as evidence-based interventions that eliminate dated practices based in ...


Defying The Gravity Of Falls On Msu, Alvin Joseph Abad 2018 The University of San Francisco

Defying The Gravity Of Falls On Msu, Alvin Joseph Abad

Master's Projects and Capstones

Falls are a leading cause of injury and death for adult males in the United States and have been an ongoing problem on the Medical Surgical Unit (MSU). Therefore, the aim of this project is to increase fall prevention education and communication on MSU in order to ultimately improve fall rates. Although there are currently fall prevention processes already in place, these may not be sufficient as demonstrated by recent fall metrics. Many RNs on MSU are fairly new nurses; and their enthusiasm and adaptability may be an advantage for this evidence-based project. Furthermore, the management team seems to be ...


Nurse Practitioner Students: Providing Wellness Screenings To Underserved Older Adults, Rexanna Tatlock 2018 Purdue University

Nurse Practitioner Students: Providing Wellness Screenings To Underserved Older Adults, Rexanna Tatlock

Purdue Journal of Service-Learning and International Engagement

Rexanna Tatlock (BSN, RN, CCRN) received a BSN from Saint Francis College in 2003. As a registered nurse, she specialized in critical care nursing and eventually enrolled in the Adult Gerontology Nurse Practitioner master’s program in Purdue University’s School of Nursing in 2016. Upon graduation in May 2018, Rexanna has planned to focus on primary health care. The service-learning project provided primary care clinical experience, while meeting the needs of an underserved older adult population. This article will discuss the community partnership, a needs assessment, and a wellness screening offered to Fairington Apartments (FA) residents.


Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella 2018 The University of San Francisco

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital ...


Consistently Using A Transportation Department For Patient Discharge To Sustain Nursing Staffing Levels, Victoria Boutin, Joseph East, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks 2018 Maine Medical Center

Consistently Using A Transportation Department For Patient Discharge To Sustain Nursing Staffing Levels, Victoria Boutin, Joseph East, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Excellence

IMPROVING PATIENT FLOW BY UTILIZING A HOSPITAL TRANSPORTATION DEPARTMENT FOR DISCHARGES

Using a transportation department for transporting patients for discharge is the industry standard. At a large urban hospital, inconsistent use of this department has resulted in frontline caregivers (RNs) having to pick up this function, resulting in potentially unsafe staffing levels on the floor.

The goal of this quality improvement project was to improve the percent of discharges with the transport department from ≤10% to 70% by the end is fiscal year 2018 in an academic tertiary medical center.

Baseline metrics demonstrated the current state and a root cause ...


Knowledge And Attitude Of Nurses In A New Rn Graduate Residency Program Regarding Pain Management, Kathryn Lee Wampole 2018 Liberty University

Knowledge And Attitude Of Nurses In A New Rn Graduate Residency Program Regarding Pain Management, Kathryn Lee Wampole

Doctoral Dissertations and Projects

Most people have encountered pain at some point in their lives. It is a very common complaint nurses hear from patients. When assessing patients, nurses are taught to take what the patient says as his or her pain level as fact. Pain is not a vital sign that can be measured with medical equipment like temperature or blood pressure. Therefore, many nurses find assessing pain challenging. Adding to the complexity of pain management is the current opioid crisis. To help combat some of these issues, the project leader worked with healthcare administrators at a regional teaching hospital in the southeastern ...


Conflicts, Concerns And Family Circumstances In Custodial Grandmothers Over 8 Years, Cristina Noriega, Carol Musil, Jaclene Zauszniewski, Camille Warner 2018 Department of Psychology and Pedagogy, School of Medicine, CEU San Pablo University

Conflicts, Concerns And Family Circumstances In Custodial Grandmothers Over 8 Years, Cristina Noriega, Carol Musil, Jaclene Zauszniewski, Camille Warner

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Although many grandmothers raising grandchildren experience transitions in their roles as family strains and circumstances change, little longitudinal data has been examined. This qualitative study assessed the relationships between custodial grandmothers’ appraisals of their family conflicts and concerns and family circumstances across eight years. Participants were thirty-five Ohio grandmothers who were raising their grandchildren in 2006-2007 and provided additional self-report survey data in 2008-2009 and 2014-2015. Data were gathered from open-ended questions that were analyzed through conventional content analysis. The reported concerns were financial and emotional difficulties, grandchildren outcomes, mental and physical health of the grandchild and other family members ...


Nutrition Education To Improve Health Outcomes In Community Dwelling Older Adults, Sara Giessinger 2018 University of San Francisco

Nutrition Education To Improve Health Outcomes In Community Dwelling Older Adults, Sara Giessinger

Master's Projects and Capstones

Abstract

The proportion of people age 60 and over is growing faster than other age group, and will double by 2050 from approximately 605 million to 2 billion worldwide, in addition to the 80 and over population quadrupling by the same time. Non-communicable diseases such as obesity, cancer, coronary heart and lung disease, diabetes, hypertension, insulin resistance, and hyperlipidemia,represent 63% of deaths annually worldwide. Due to the immense contact nurses have with clients, they play a key role in screening, referrals and education to guide this demographic to improved health outcomes through nutrition and physical activity interventions (Xiaoyue, Parker ...


Effectiveness Of Bed Alarms On Falls, Maegan Karlin, Jennifer Schoenecker 2018 Fort Hays State University

Effectiveness Of Bed Alarms On Falls, Maegan Karlin, Jennifer Schoenecker

John Heinrichs Scholarly and Creative Activities Day (SACAD)

No abstract provided.


Prospectus For Improving Measure Ii Scores Of Hospice Visits When Death Is Imminent In The Hospice Item Set, David Ainsworth 2018 The University of San Francisco

Prospectus For Improving Measure Ii Scores Of Hospice Visits When Death Is Imminent In The Hospice Item Set, David Ainsworth

Master's Projects and Capstones

Abstract


Problem: Center for Medicare Services (CMS) created a new quality measure pair to collect data on hospice visit patterns by a registered nurse in the last three days of life (Measure I), and at least two visits by a social worker, home health aide, licensed vocational nurse or spiritual counselor in the last seven days of life (Measure II). A hospital-based hospice organization created a quality improvement project to address this problem and improve both parts of the measure pair, but special emphasis was placed on improving Measure II, as initial data revealed the team met the goal only ...


Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia 2018 University of San Francisco

Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia

Master's Projects and Capstones

Standardizing the Palliative Care Referral Process

Problem: Heart failure (HF) is one of the most common causes of hospital admissions and emergency department visits in the United States. HF patients are at high risk for hospital readmission: 25% of HF patients discharged from the hospital are readmitted within 30 days of discharge, and 50% are readmitted within 6 months (Vedel & Khanossov, 2015).

Context: Palliative Care (PC) has been shown to be an effective way of managing distressing HF symptoms and thus of reducing hospital readmissions, yet patients are infrequently referred to PC services during their transition from hospital to home (Lowey & Liebel, 2016). Currently, there is no standardized referral process for patient care coordinators (PCCs) to refer HF patients to PC services.

Interventions: Standardized scripting was developed and implemented as a tool for PCCs to educate patients about the benefits of PC. Four PCCs implemented the intervention over the course of 30 days, and together, they identified 26 HF patients appropriate for PC referral.

Measures: Process measures include: the development and implementation of the standardized PC referral process; the number of completed PC referrals after utilization of the standardized PC referral process.

Results: Among the 26 patients identified, 22 (85%) received the PC standardized scripting, and of those 22 patients, 12 (43%) provided verbal consent to the PC ...


Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery 2018 University of Missouri, St. Louis

Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery

Dissertations

ABSTRACT

Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)

Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.

Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as ...


Education On Fall Prevention To Improve Self-Efficacy Of Nursing Staff In Long Term Care: A Pilot Study, Mark D. Leverenz, Jennifer Lape 2018 Chatham University

Education On Fall Prevention To Improve Self-Efficacy Of Nursing Staff In Long Term Care: A Pilot Study, Mark D. Leverenz, Jennifer Lape

Internet Journal of Allied Health Sciences and Practice

Purpose: Fall prevention is an ongoing concern in long-term care. Self-efficacy of nursing staff affects their performance levels related to fall prevention. Research concerning falls in the elderly is plentiful but there are no published studies addressing self-efficacy of nursing staff for implementation of fall prevention strategies in long-term care. The authors hypothesize that fall prevention education by an occupational therapist would be effective to improve the self-efficacy of nursing staff for implementation of fall prevention strategies and self-efficacy to prevent resident falls.

Method: A pre-test post-test pilot study implementing a five-week, multifaceted, fall prevention education course was conducted by ...


Improving Hand-Off Communication Between The Skilled Nursing Facility And The Emergency Department, Dubravka Labovic 2018 The University of San Francisco

Improving Hand-Off Communication Between The Skilled Nursing Facility And The Emergency Department, Dubravka Labovic

Master's Projects and Capstones

Abstract

The purpose of this project is to improve hand-off procedure between Skilled Nursing Facility (SNF) and Emergency Department (ED). Patient population consists of all retired veterans who currently reside in California Department of Veterans Affairs, Veterans Home of California (CalVet) – the state long-term care facility for elderly. The problem occurs when continuation of care is compromised due to poor exchange of information at the time of transfer to ED. Nurses in SNF need a step-by-step procedure that will improve the process of transfer and the intention of this project is to create a process that will become daily nursing ...


Reduing Hospital Readmissions: Ideal Discharge Planning For Heart Failure Management, Chun Mei Chen, Chun Mei Chen 2018 The University of San Francisco

Reduing Hospital Readmissions: Ideal Discharge Planning For Heart Failure Management, Chun Mei Chen, Chun Mei Chen

Master's Projects and Capstones

Abstract

The objectives during this project were to achieve by the end of 2018 an overall reduction of 25% in HF readmissions within 30 days. By identifying root causes of readmissions and using needs assessment within the microsystem, literature highlights the elements defining interventions that can be used to improve transitions of care and reduce avoidable HF hospital readmissions. A plan was developed for integrating an evidence-based practice, IDEAL Discharge Planning, along with engaging patients and families at bedside from the first day of admission until discharge to more effectively assist staff in providing patient-centered education and self-care skills. The ...


Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi 2018 Kennesaw State University

Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi

Bachelor of Architecture Theses - 5th Year

This thesis intends to address the increasing challenges the Alzheimer’s disease poses for our growing American population. The research begins by looking at the brain as a combination of components which make up the individual. Following this, the research compiles information on the Alzheimer’s disease and its symptoms, followed by an analysis of the built environments effects on the condition.

Through analysis of precedent cases and the combined Alzheimer’s research, I chose to propose an experimental community in which those with Alzheimer’s can live a life with greater autonomy while simultaneously slowing the progression of the ...


Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller 2018 Dominican University of California

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Master's Theses and Capstone Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained ...


Relationship Between Toileting Programs And Geriatric Falls In Long-Term Care Facilities, Klarissa Pomajevich, Brianna Denning 2018 Carroll College

Relationship Between Toileting Programs And Geriatric Falls In Long-Term Care Facilities, Klarissa Pomajevich, Brianna Denning

Carroll College Student Undergraduate Research Festival

Toileting programs, such as two hour continence checks and bringing patients to the bathroom have become a standard in most nursing home facilities. Nursing Homes and Assisted Living Facilities are defined as institutions that offer medical, personal, and supportive care for individuals who are unable to care for themselves in the community (United States Department of Health and Human Services, 2016). Falls are a common cause of injury, hospitalization and even death in the Geriatric population, with at least one-third of persons 65 years and older experiencing a fall (Al-Aama, 2011). The purpose of this Evidence Based Practice Brief is ...


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