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A Clinical Nurse Leader Initiative: Promoting Mobility Among Long-Term Care Facility Residents, Ulyses Reamico 2017 The University of San Francisco

A Clinical Nurse Leader Initiative: Promoting Mobility Among Long-Term Care Facility Residents, Ulyses Reamico

Master's Projects and Capstones

Maintenance of mobility during hospitalization or stay in long-term care facility result in improved patient outcomes including but not limited to decreased incidence of falls, non-pharmacological pain intervention, and prevention of further functional decline. In a 45-bed rehabilitation unit of a Veterans Affairs (VA) health care facility, a clinical nurse leader (CNL) initiative was done to promote mobility among the patients to mitigate functional decline. The patients, also referred to as clients or residents in long-term care facilities, were aged between 20s and 90s. The resident population consisted of patients admitted for physical rehabilitation after a stroke or surgical procedure ...


Reframing The Conceptual Model Of Telehealth Nursing For Community-Dwelling Older Adults, Luz Rivera 2017 DePaul University

Reframing The Conceptual Model Of Telehealth Nursing For Community-Dwelling Older Adults, Luz Rivera

Grace Peterson Nursing Research Colloquium

Background: Of the huge influx of retirees expected in the next 10 years, the vast majority prefers aging in place; a concept commonly used to refer to the practice of remaining in a community-based setting as the changes of life unfold with age. Extant health systems currently fail to provide the structure to promote staying at home when increasing health care assistance or monitoring is needed. Clinical pilot studies using telehealth are providing evidence for improving patient healthcare provision and outcomes from the setting of the patient’s choice. As the landscape of healthcare changes with technological advances, nursing practice ...


Delirium Rates Increasing In Elderly Hospitalized Patients, Sarah Jane Soffel 2017 DePaul University

Delirium Rates Increasing In Elderly Hospitalized Patients, Sarah Jane Soffel

Grace Peterson Nursing Research Colloquium

Delirium commonly affects hospitalized elderly patients, and is associated with increased mortality and morbidity, among other detrimental outcomes. Delirium is increasing in prevalence, yet remains under detected. Many of the negative effects of hospitalization, such as immobility, dehydration, and polypharmacy, increase the risk for developing delirium. Early detection of delirium remains an important factor for treatment and reversal. The aim of the integrative literature review was to determine whether delirium rates are increasing among elderly hospitalized patients, as well as to identify risk factors associated with delirium and nursing interventions that may prevent the increasing prevalence of delirium. The study ...


Fall Prevention In The Inpatient Setting, Verna Bautista 2017 The University of San Francisco

Fall Prevention In The Inpatient Setting, Verna Bautista

Master's Projects and Capstones

Fall Prevention in the Inpatient Setting Abstract

This project focuses on patient and family fall prevention education through an educational brochure. 4South is a mixed medical/surgical and medical/surgical-telemetry unit, specializing in dialysis and stroke patients. Since January 2017, there has been eight falls on the unit. The project’s objective is to decrease the number of falls in 4South by 50% by the end of the 4th quarter 2017.

An identified weakness was inconsistent patient and family education. The CNL roles of data analyst and clinician were utilized. With the feedback from the Fall Task Force committee ...


Alzheimer's Disease, Kirstin Fortune 2017 Otterbein University

Alzheimer's Disease, Kirstin Fortune

Master of Science in Nursing (MSN) Student Scholarship

This presentation is an overview on Alzheimer's disease. Signs, symptoms, pathophysiology and pharmaceuticals are all incorporated in this poster. The United States is planning to address the possible crisis of Alzheimer's with many initiatives.


Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner 2017 The New Jewish Home

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing ...


Asthma Chronic Obstructive Pulmonary Disease Overlap Syndrome, Kimberly A. Babich-Speck 2017 Otterbein University

Asthma Chronic Obstructive Pulmonary Disease Overlap Syndrome, Kimberly A. Babich-Speck

Master of Science in Nursing (MSN) Student Scholarship

Asthma and COPD often have symptoms that overlap. The area of overlap is known as asthma COPD overlap syndrome.


A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot 2017 California State University - San Bernardino

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a ...


I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam 2017 University of San Francisco

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that ...


Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno 2017 University of San Francisco

Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno

Master's Projects and Capstones

The focus of this CNL project is quality improvement using high quality hourly rounds to achieve improved patient satisfaction and communication with nurses. It was determined by reviewing survey results that patient satisfaction and nurse communication is below National levels. Data shows that rounds are not being done well on a medical unit before the improvement project. It is proven that patients receive and perceive higher quality care and communication with increased nurse presence at the bedside. The population of the medical unit has high numbers of confused/dementia, and dual-diagnosis patients. It was determined that the unit would benefit ...


Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas 2017 University of San Francisco

Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas

Master's Projects and Capstones

Bedside shift report is a complex process, which involves the transition of care from one clinician to another. The Agency for Healthcare Research and Quality (AHRQ) (2013) reported that approximately 70% of patient adverse events are attributed to communication failures between healthcare providers. Nurses remain inconsistent with information sharing during bedside shift report leading to communication gaps. The object of the clinical nurse leader (CNL) internship project is to provide true patient-centered by standardizing bedside shift report by implementing a nursing report sheet and addressing patient needs. The project was conducted in a level-one trauma center in San Diego, CA ...


Treatment-Related Decisional Conflict, Quality Of Life, And Comorbid Illness In Older Adults With Cancer, Jeannette Kates, PhD, MSN, GNP-BC 2017 Thomas Jefferson University, College of Nursing

Treatment-Related Decisional Conflict, Quality Of Life, And Comorbid Illness In Older Adults With Cancer, Jeannette Kates, Phd, Msn, Gnp-Bc

Department of Nursing Posters

As the aging population in the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults are confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. In their current research agenda, the Oncology Nursing Society identified the need for research related to multiple comorbidities in older adults with cancer. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional ...


Antimicrobial Stewardship: Incentives And Barriers To Implementation In Skilled Nursing Facilities, Gloria M. Escalona 2017 California State University, Northern California Consortium Doctor of Nursing Practice

Antimicrobial Stewardship: Incentives And Barriers To Implementation In Skilled Nursing Facilities, Gloria M. Escalona

Doctoral Projects

This study was part of a quality improvement effort of a Skilled Nursing Facility (SNF) to develop and establish an antimicrobial stewardship program to comply with recently enacted California State Senate Bill 361 (SB 361), which went into effect January l, 2017 (Skilled nursing facilities, 2015). The division of the facility into two sections, one staffed largely by Licensed Vocational Nurses (L VNs) and another staffed largely by Registered Nurses (RNs) provided an study opportunity that easily differentiated the licensed nurses. This study used three methods: 1) an educational intervention to licensed nurses, 2) a post-educational intervention survey of licensed ...


Preserving Dignity In The Long Term Care Of Actively Dying Residents, Libby-Rose Cronican 2017 College of Saint Benedict and Saint John's University

Preserving Dignity In The Long Term Care Of Actively Dying Residents, Libby-Rose Cronican

All College Thesis Program

As one goes through the process of aging and approaches death, they experience a series of losses: from the loss of physical or mental ability to the ultimate loss of life. These losses make the individual vulnerable to harms that can come from a variety of sources. One source is found within the everyday interactions of long-term care nurses and aides with their elderly, dying residents. Creating this harm stems from a poor nursing practice where the nurse or aide fails to recognize and promote the resident’s dignity and autonomy. The normal notion of dignity and autonomy does not ...


Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis 2017 University of Arkansas

Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication regimens ...


Linking Key Factors Of Quality Dementia Care: Knowledge And Self-Efficacy, Sophie Miller 2017 Dominican University of California

Linking Key Factors Of Quality Dementia Care: Knowledge And Self-Efficacy, Sophie Miller

Honors Theses and Capstone Projects

Dementia-related changes in cognition, memory, and personality can have wide-ranging impacts on individuals, families, and healthcare systems (Plassman et al., 2007); including caregiver burnout, disruption of family life, and costly care requirements (Graneheim, Johansson, & Lindgren, 2014). Dementia has become a global issue; 46 million people worldwide have dementia and $600 billion are spent on dementia-related care every year (Farina al., 2016). Certified nursing assistants (CNAs) generally assume the majority of day-to-day care and are a vital component of providing quality, person-centered services to patients with dementia in residential care (Burke & Orlowski, 2015). The purpose of this study was to explore the relationship between knowledge and self-efficacy in CNA ...


Older Adults’ Response To Adverse Opioid Related Events: A Secondary Analysis, Sarah R. Coughlin 2017 University of Connecticut - Storrs

Older Adults’ Response To Adverse Opioid Related Events: A Secondary Analysis, Sarah R. Coughlin

Honors Scholar Theses

Background: Many older adults suffer from chronic pain, a disease treated with opioids. Older adults are also highly susceptible to opioid ADEs. Research addressing older adults’ self-management of opioid ADEs is lacking.

Objectives: This study compared the opioid ADE profile found by the present research to those previously reported in the literature for older adults. It also described how older adults respond to opioid ADEs and the resulting outcomes.

Method: The study utilized a secondary analysis design to examine 15 opioid ADE cases from a pilot study that described older adults’ responses to analgesic ADEs.

Results: Neurological ADEs, including dizziness ...


Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver 2017 Mount Royal University

Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver

The Qualitative Report

The issue of the literature review remains a conundrum and a controversy within the discourse on grounded theory methodology. Grounded theory researchers are expected to minimize preconceptions to ensure the concept of interest is grounded in data, yet at the same time are required to evaluate existing literature to support institutional ethics and scientific review of the research proposal. In addressing this dilemma, we espouse that literature review in grounded theory should comprise a multistage nonlinear approach to the literature and introduce a framework for novice grounded theory researchers. This framework offers a reflexive, dynamic and integrative process for conducting ...


Fall Prevention In An Acute Care Hospital: The Challenges Encountered By Patients, Staff And Administrators, Barbara J. Watson 2017 The University of Western Ontario

Fall Prevention In An Acute Care Hospital: The Challenges Encountered By Patients, Staff And Administrators, Barbara J. Watson

Electronic Thesis and Dissertation Repository

Abstract

Falls are frequent and often serious events that take place in hospitals. Healthcare providers find it challenging to minimize fall risk factors. In fact, just being in a hospital is a risk factor in itself! The aim of this thesis was to investigate the reasons behind patient falls, identify gaps in prevention strategies and suggest additional recommendations to improve patient safety. A mixed method approach was used to interpret the data and uncover the reasons for falls.

The first study was a secondary data analysis where 7,721 patient falls were examined. The data were taken from the hospital ...


Quantitative Or Qualitative? Chossing The Best Fit Method For Gaining New Insight About What Matters To Residents In Nursing Homes, Nila Reimer 2017 Indiana University - Purdue University Fort Wayne

Quantitative Or Qualitative? Chossing The Best Fit Method For Gaining New Insight About What Matters To Residents In Nursing Homes, Nila Reimer

Nursing Faculty Presentations

Although a shift in culture is occurring in many nursing homes, things that matter from residents' perspectives need investigation. The purpose of this study was to describe things that matter to residents while living in nursing homes. The shift from a quantitative to qualitative method expounded on concepts of empathy, consistency, and reliability from perspectives of residents who lived in the long-term care section of nursing homes. An iterative process using conventional content analysis revealed findings of residents' positive and negative experiences that provided ideas for expanding on current person-centered care strategies used in nursing homes.


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