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Geriatric Nursing Commons

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Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr 2016 University of San Francisco

Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr

Master's Projects

Patient safety is one of the major concern of any healthcare provider during their patient’s hospital stay. This project addressed the steady trend of fall incidences compared to last fiscal years’ data of an average of 4 falls per month. This trend created urgency to envisioned a plan for solutions to prevent this circumstance from happening. This Clinical Nurse Leader led a project in creating a process in identifying all patients that are high risk to fall (HRTF) prior to their admittance or transfer to Medical Surgical/Intermediate Care Unit and throughout their hospital stay until they are discharged ...


Ihss: Repackaging Consumer Information, Deloras N. Puran 2016 University of San Francisco

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed ...


Strategies To Prevent Hospital Transfers In The Snf Environment, Vinai P. Decena 2016 University of San Francisco

Strategies To Prevent Hospital Transfers In The Snf Environment, Vinai P. Decena

Master's Projects

This project focuses on the CNL curriculum element of Care Environment Management. The purpose of this project is to reduce hospital readmissions in geriatric patients who are currently having any changes of medical condition within the SNF microsystem. In this project, the CNL functions as the team manager and care coordinator. The CNL facilitated, and utilized patients’ outcome data to make changes in care processes to reduce acute hospital transfers in the skilled nursing facility. The CNL lead the interdisciplinary team and was resource or point of contact for this project. The CNL educated nurses to utilize (Interventions to Reduce ...


Standardized Blood Transfusion Documentation, Kelly A. Hill 2016 University of San Francisco

Standardized Blood Transfusion Documentation, Kelly A. Hill

Master's Projects

The aim of this project was to improve nurse satisfaction through the use of a standardized blood administration documentation template. The goal was to reduce the time that nurses spend charting by offering a structured documentation template and to ensure that the procedure is correctly recorded in the patient’s electronic record. The leadership theme that supported this project is Information Manager, as the clinical nurse leader (CNL) uses information systems and technology at the point of care to improve health care outcomes. The selected microsystem is a medical/surgical/telemetry unit, which has 38 beds with 38 registered nurses ...


Artificial Nutrition, Advance Directives And End Of Life In Nursing Homes, Cheryl Ann Monturo 2016 West Chester University of Pennsylvania

Artificial Nutrition, Advance Directives And End Of Life In Nursing Homes, Cheryl Ann Monturo

Cheryl Monturo

No abstract provided.


A Systematic Review Of Recruitment For Older Chinese Immigrants Into Clinical Trials, Wen-Wen Li, Yuaner Wu, Angela Chia-Chen Chen 2016 University of Nevada, Las Vegas

A Systematic Review Of Recruitment For Older Chinese Immigrants Into Clinical Trials, Wen-Wen Li, Yuaner Wu, Angela Chia-Chen Chen

Asian/Pacific Island Nursing Journal

Purpose: To identify barriers and discuss strategies for recruitment of older Chinese immigrants into clinical research studies.

Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). PubMed, WEB of Science, CINAHL Plus, and the Cochrane Central Register of Controlled Trials were searched from 2001 to 2014. Empirical studies with Chinese immigrants aged 60 or older were identified and analyzed. Numerical analysis, such as calculation of response rates as indexes for recruitment outcomes, was conducted. Content analyses for recruitment barriers were abstracted.

Results: Thirteen studies of 4753 subjects were analyzed. Response rates ranged from ...


A New Look At Successful Aging : Exploring A Mid-Range Nursing Theory Among Older Adults In A Low-Income Retirement Community., Valerie Lander McCarthy 2016 University of Louisville

A New Look At Successful Aging : Exploring A Mid-Range Nursing Theory Among Older Adults In A Low-Income Retirement Community., Valerie Lander Mccarthy

Valerie L. McCarthy

The current view of successful aging excludes elders with disease or disability, limits the potential for success among disadvantaged populations, and fails to consider older adults’ own criteria for success, especially in the existential or spiritual domain. This cross-sectional study was a preliminary investigation of a mid-range nursing theory (Flood, 2005) of successful aging. A random, stratified sample (N= 112) was used. Questionnaires were administered to small groups of non-demented older adults. Relationships among study variables were examined using hierarchical multiple regression. Adaptation and transcendence explained 45.4% of the variance in successful aging, independent of age, income, function, and ...


The Role Of Transcendence In A Holistic View Of Successful Aging : A Concept Analysis And Model Of Transcendence In Maturation And Aging., Valerie Lander McCarthy, Amanda Bockweg 2016 University of Louisville

The Role Of Transcendence In A Holistic View Of Successful Aging : A Concept Analysis And Model Of Transcendence In Maturation And Aging., Valerie Lander Mccarthy, Amanda Bockweg

Valerie L. McCarthy

BACKGROUND: Although successful aging is most often defined by the absence of disease and disability, older adults consistently report aging successfully even in the presence of chronic illness and functional limitations. A more holistic way of looking at old age suggests transcendence may be an important missing criterion for successful aging.

AIM: Transcendence, a late life developmental process, appears to have a profound effect within the spiritual domain, but is an abstract, complex and unfamiliar concept. A clear understanding of the meaning of transcendence is necessary to explore the concept’s usefulness as a potential basis for future interventions to ...


Promoting Self-Transcendence And Well-Being In Community-Dwelling Older Adults : A Pilot Study Of A Psychoeducational Intervention., Valerie Lander McCarthy, Jiying Ling, Sharon Bowland, Lynne A. Hall, Jennifer Connelly 2016 University of Louisville

Promoting Self-Transcendence And Well-Being In Community-Dwelling Older Adults : A Pilot Study Of A Psychoeducational Intervention., Valerie Lander Mccarthy, Jiying Ling, Sharon Bowland, Lynne A. Hall, Jennifer Connelly

Valerie McCarthy

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being of older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility ...


Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi 2016 West Chester University of Pennsylvania

Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi

Chris Moriconi

No abstract provided.


Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi 2016 West Chester University of Pennsylvania

Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi

Cheryl Schlamb

No abstract provided.


Hope And Health Related Quality Of Life Of Older Women Who Have Had Heart Attacks, Alice Mary Kelly-Tobin 2016 Graduate Center, City University of New York

Hope And Health Related Quality Of Life Of Older Women Who Have Had Heart Attacks, Alice Mary Kelly-Tobin

All Graduate Works by Year: Dissertations, Theses, and Capstone Projects

Background: Heart disease is the number one cause of death and leading cause of disability in adults in the United States. Coronary heart disease (CHD) is the most common form of heart disease with heart attack as its acute manifestation. Health Related Quality of Life (HRQoL) is a multidimensional concept of self-perception of physical, emotional health, and overall sense of well-being. Hope, an inner process focusing on maintaining physical and mental well-being, is considered necessary for survival of chronic illnesses, such as CHD.

Method: Women age 65 and older who have had heart attacks (N=91) volunteered to participate in ...


A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson 2016 University of San Diego

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Projects

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy ...


Implementing Ways To Reduce Catheter-Associated Urinary Infections (Cautis), Maryam Keyhani 2016 University of San Francisco

Implementing Ways To Reduce Catheter-Associated Urinary Infections (Cautis), Maryam Keyhani

Master's Projects

Abstract

Center for Control and Disease Prevention (CDC), estimates that 40% of all Urinary Tract Infections (UTIs) are related to Hospital-acquired Infections (HAIs) (CDC, 2013). The Facility where the project was done consists of oncology, orthopedic, medical-surgical, telemetry, incentive care, and step-down units. This hospital with 242 licensed beds has approximately 51,571 ER visits and a total of 10,606 admissions per year.The prevalence of Cather-associated Urinary Tract Infections (CAUTIs) on the 4th floor, the medical-surgical unit with 42 beds was significantly higher than other units. The hospital goal is to increase patient safety and satisfaction as well ...


Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur 2016 Bellarmine University

Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Heart failure readmissions are a common and costly issue. Poor transitions of care as patients move from one setting to another are thought to be a major contributor to this growing problem. For those patients discharged to skilled nursing facilities (SNFs), poor transitions can be especially problematic. Telephone follow-up by nurses is a cost effective intervention commonly used to improve communication and coordination of care, thought little is known about interventions directed at patients discharged to SNFs. The purpose of this review is to evaluate the evidence regarding nurse led telephone follow-up in the transition of care process and ...


Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur 2016 Bellarmine University

Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Reducing hospital readmissions has become a national priority for health care institutions. Telephone follow-up, a cost-effective intervention, has been used with varying degrees of success in reducing 30-day readmissions for heart failure (HF) patients. However, little is known about interventions directed toward HF patients discharged to skilled nursing facilities (SNFs). The purpose of this project was to test the effect of telephone follow-up with SNF staff by an advanced practice nurse (APN) on 30-day readmission rates. A one-time call to SNF staff was made by the APN to review key components of HF management. Readmission rates for the intervention ...


The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden 2016 Valparaiso University

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority of these readmissions were unplanned (Mor, Intrator, Feng, & Grabowski, 2010). The role of nursing homes has changed from tertiary care settings to post-acute care facilities providing skilled nursing services (Mor et al., 2010). The purpose of the Evidence Based Practice (EBP) project was to determine if the implementation of a standardized education intervention to patients admitted to a SNF with a primary or secondary diagnosis of Heart Failure will reduce hospital readmission rates and improve patient knowledge. The theoretical framework used to guide this EBP project was the Situation-specific Theory of Heart Failure Self-care, and the Stetler model was used to implement the project. The Knowledge Acquisition Questionnaire (KAQ), developed by London Health Sciences Center, was used to measure patient and caregiver knowledge pre and post educational intervention. Staff members were also provided HF specific education and were given a questionnaire adapted from the KAQ to measure pre and post education knowledge. Paired-samples t-tests were conducted to analyze mean pre-test (M = 12.1; SD = 2.07) and post-test (M = 11.7; SD = 2.58) scores and did not show a statistically significant change in knowledge (t(9) = .524, p > .05). Hospital readmission rates were also compared to readmission rates for the same time period the prior year. The intervention group had a 0% hospital readmission rate compared to a 20% readmission rate for the comparison group. The results of this EBP indicate that incorporation of evidence-based interventions can reduce ...


Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy 2016 California State University, Northern California Consortium Doctor of Nursing Practice

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly individuals ...


The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel 2016 California State University, Northern California Consortium Doctor of Nursing Practice

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 ...


The Effect Of Music Intervention On Cam Scores Of Hospitalized Older Adults Experiencing Delirium, Mae Lavente Dizon 2016 California State University, Northern California Consortium Doctor of Nursing Practice

The Effect Of Music Intervention On Cam Scores Of Hospitalized Older Adults Experiencing Delirium, Mae Lavente Dizon

Doctoral Projects

Older adults are vulnerable to developing while hospitalized is delirium. Research has shown that non-pharmacological interventions are effective in managing delirium and should be the first-line of treatment; however despite this, nurses fmd it difficult to address delirium. The purpose of this research study is to examine the effectiveness of classical music intervention in hospitalized older adults experiencing delirium by evaluating their Confusion Assessment Method (CAM) scores. A pre-and-post study design to compare the CAM scores of patients before and after music intervention was implemented. Study participants were patients 65 years and older identified to be experiencing delirium by a ...


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