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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 ...


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.


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 ...


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.


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 ...


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.


Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock 2020 University of Texas at Tyler

Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock

MSN Capstone Projects

Diabetes is a disease that affects millions of people from children to older adults. There is no cure, although it can be managed to prevent complications. Education of student nurses is where they are born and raised to become nurses who save and change lives. Teaching student nurses in depth about diabetes as a disease and the treatments that best fit their specific needs is where educating patients begins. Learning about a secondary option for blood glucose checks can make all the difference for several patients. Multiple finger sticks daily has been the leading way to check blood sugar for ...


Supporting Older Adults Through Aging In Place And Capable Programs, Laura Compton 2020 Belmont University

Supporting Older Adults Through Aging In Place And Capable Programs, Laura Compton

OTD Capstone Projects

This experiential component or doctoral capstone project involved a partnership with Habitat for Humanity of Greater Memphis. Through this agency, projects were completed based on identified needs of the Aging in Place and CAPABLE programs. The Aging in Place (AIP) program provides critical home repairs to low-income adults aged 60 years and older. The CAPABLE program provides the same critical home repairs along with a select number of visits from a registered nurse and an occupational therapist to help the older adults age in place safely.


Feasibility Of An Online Cognitive Behavioral Therapy Program To Improve Insomnia, Mood, And Quality Of Life In Bereaved Adults Ages 55 And Older, Cassandra Godzik 2020 University of Massachusetts Medical School

Feasibility Of An Online Cognitive Behavioral Therapy Program To Improve Insomnia, Mood, And Quality Of Life In Bereaved Adults Ages 55 And Older, Cassandra Godzik

Graduate School of Nursing Dissertations

Objective: To determine the feasibility of an online cognitive behavioral therapy for insomnia (CBT-I) in bereaved older adults.

Participants: The study participants include adults aged 55 and older (N = 30) that lost a loved one within the past five years and are currently experiencing symptoms of insomnia.

Methods: This study used an experimental design and was guided by the Transitions Theory developed by Meleis. Descriptive statistics and t-tests were used to measure changes within and between groups. Experimental arm had the CBT-I online treatment and the control arm had attention controlled online tasks. Intervention fidelity was measured.

Results: The ...


Humna Elahi's Portfolio, Humna Elahi 2020 Duquesne University

Humna Elahi's Portfolio, Humna Elahi

Honors College Portfolios

As a student in the four-year Registered Nurse-Bachelor of Science in Nursing (RN-BSN) program, you are immersed in an education beyond the vital scientific facts and nursing skills. Throughout the undergraduate studies, one is challenged to rise to the skills of thorough assessments, critical thinking, and evaluations. Not only are you prepared for the clinical setting, you are given the tools to go above and beyond with your career. Your time and efforts as a nursing student creates a pathway to success and leadership.

A major goal in nursing is to practice cultural competence and provide holistic care to those ...


Caregiver Burden From Caring For Dependent Elderly In Yangon, The Republic Of The Union Of Myanmar, May Zun Naing, Sein Yaw May, Min Htike Aung 2020 Department of Community Health Nursing, University of Nursing, Yangon 11131, Myanmar

Caregiver Burden From Caring For Dependent Elderly In Yangon, The Republic Of The Union Of Myanmar, May Zun Naing, Sein Yaw May, Min Htike Aung

Makara Journal of Health Research

Background: Elderly population and well-being of those are emerging as major challenges for families and communities. This study aimed to identify caregiving burden among caregivers who care for dependent elderly.

Methods: A cross sectional descriptive study was conducted in Tharkayta Township, Yangon, Myanmar. Total 200 caregivers were selected applying multi-stage sampling method and structured questionnaires were used to collect data. Dependent score of elderly was assessed by using Barthel Index of activities of daily living (ADL) and assessment of caregiver burden through Zarit Burden Interview.

Results: The results showed that over one fifth of caregivers 21.5% had experienced severe ...


Utilization Of Patient Toolkit And Discharge Algorithm For Providers To Reduce Readmission Due To Repeat Ground Level Fall, Sara Karl 2020 Grand Valley State University

Utilization Of Patient Toolkit And Discharge Algorithm For Providers To Reduce Readmission Due To Repeat Ground Level Fall, Sara Karl

Doctoral Projects

Introduction. Falls are the leading cause of injury and injury death in adults over the age of 65. A retrospective examination at Level 1 trauma center in the Midwest found that 19.4% (118/605) of older adults admitted with a ground level fall were readmitted with a subsequent fall and injury. The aim of this quality improvement initiative is to determine if the implementation of an evidenced based patient toolkit and a discharge algorithm for providers will reduce outpatient falls. The objective was to reduce hospital readmission due to repeat fall.

Methods: The design of this project was mixed ...


An Actigraphy-Based Validation Study Of The Sleep Disorder Inventory In The Nursing Home, Gunnhild J. Hjetland, Inger Hilde Nordhus, Ståle Pallesen, Jeffrey Cummings, Rochelle E. Tractenberg, Eirunn Thun, Eirin Kolberg, Elisabeth Flo 2020 University of Bergen

An Actigraphy-Based Validation Study Of The Sleep Disorder Inventory In The Nursing Home, Gunnhild J. Hjetland, Inger Hilde Nordhus, Ståle Pallesen, Jeffrey Cummings, Rochelle E. Tractenberg, Eirunn Thun, Eirin Kolberg, Elisabeth Flo

School of Medicine Faculty Publications

Background: Disrupted sleep is common among nursing home patients with dementia and is associated with increased agitation, depression, and cognitive impairment. Detecting and treating sleep problems in this population are therefore of great importance, albeit challenging. Systematic observation and objective recordings of sleep are time-consuming and resource intensive and self-report is often unreliable. Commonly used proxy-rated scales contain few sleep items, which affects the reliability of the raters' reports. The present study aimed to adapt the proxy-rated Sleep Disorder Inventory (SDI) to a nursing home context and validate it against actigraphy. Methods: Cross-sectional study of 69 nursing home patients, 68 ...


Ethical Considerations When Conducting Research With Older Adults, Karen Arrant 2020 University of Louisiana Monroe

Ethical Considerations When Conducting Research With Older Adults, Karen Arrant

Online Journal of Interprofessional Health Promotion

The ethical issue exists between the researcher’s passion for the study focus and the human rights of the participant. This manuscript provides a case study, an actual illustration, but names were changed to protect anonymity. Objectives include examining the researcher’s perspective and personal beliefs, identifying the process to recruit participants, the ethical manner to disseminate information, and identifying ethical principles during the study process.It is mandatory that minute attention is given to the details of caring for the safety and welfare of study participants.


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