Geriatric Nursing Commons^™

Implementation Of A Primary Care Toolkit To Improve Dementia Diagnosis And Management In A Rural Setting, Meredith George-Wieland

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: There are six million people with dementia living in the United States and this number is expected to rise exponentially due to the aging population. In the United States, it is estimated that only two thirds of dementia cases are recorded during primary care visits and an estimated, one third of cases have been either missed or disregarded.

LOCAL PROBLEM: In a remote primary care clinic on Kodiak Island, off the southeastern coast of Alaska, there is a lack of dementia and related cognitive diagnoses in the primary care setting due to patients’ and families lack access to the …

Increasing Advance Directive Rates In Primary Care: Implementation Of A Redesigned Form, Abbie Cheatham, Samereh Abdoli

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Less than half of individuals 65 and older have completed an advance directive despite evidence to their benefit. Lack of advance directives can have emotional and financial consequences for the family and individual. A major barrier to advance directive completion is the high literacy level most state sponsored forms are written at, with the average form written at a high school level. Methods: This quality improvement project was a three-month trial to increase the number of advance directive rates at a primary care clinic in the Knoxville area. Five Wishes, written at an 8th grade reading level was …

Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis

Evidence-Based Practice Project Reports

Osteoporosis is caused by caused by low bone mass, microarchitecture disruption and increase in skeletal fragility (Rosen & Drezner, 2021). This disease presents as a silent disease without any clinical manifestations and increases risk for bone fracture. The purpose of this Evidence-Based Practice (EBP) project was to increase screening rates for osteoporosis in the female population by mailing a patient reminder letter to the home of qualifying patients in the primary care setting and to determine if mailing a patient reminder letter would increase screening rates. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare professionals (JHEBP) model was used …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

Factors Affecting Quality Of Life And Asthma Control In Older Adults With Asthma., Karen Schuckmann

Electronic Theses and Dissertations

Introduction: Approximately 7.7 percent of adults over the age of 65 have asthma in the United States (U.S), further, the population of older adults in the U.S. will increase to 20% by 2030. Health Related Quality of Life is low for this age group and asthma is often misdiagnosed and undertreated creating a need for research to improve factors that influence Asthma Quality of Life. Aims: This study explored two aims. The first aim evaluates the relationship between medication numeracy and asthma self-management knowledge with asthma self-efficacy. The second aim evaluates medication numeracy, asthma self-management knowledge, asthma self-efficacy, and asthma …

Implementing Systematic Sexual Orientation And Gender Identity (Sogi Data) Collection At An Inpatient Hospital Located In The Southern Region Of The United States, Shawn Malugin

Epsilon Sigma at-Large Research Conference

Purpose

LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge.

Aims

The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization.

Processes

To understand how to provide high-quality care to LGBTQ patients, providers receive instruction …

Caring For The Caregiver: Improving Screening For Caregiver Presence During The Inpatient Stay., Brittany Mendo, Florence Weierbach Phd

Epsilon Sigma at-Large Research Conference

Informal caregiver burden and burnout can cause worsened outcomes of care for both the recipient of care and the caregiver’s overall health. Experiencing increased levels of distress by the caregiver may be the deciding factor for the elder remaining in the home or being placed in a long-term facility for care. Thus, healthcare professionals must be diligent in assessment for presence of a caregiver on admission, as well as identifying needs and providing education of resources within the community upon discharge. The purpose of this project is to implement admission screening for caregiver presence during the inpatient stay, with the …

Lgbt Community And Mental Health, Danielle Schleeter

Epsilon Sigma at-Large Research Conference

Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities.

Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health.

Literature Review: This literature review utilized search engines …

Limiting Potentially Inappropriate Medications In Long-Term Care, Clare M. Ironside

Doctor of Nursing Practice Scholarly Projects

Aim: This project aimed to assess the effectiveness of the STOPP/START tool in identifying and reducing potentially inappropriate medications among multi-morbid, older, long-term care residents in a metropolitan area of a Southwestern state.

Design: In this quality improvement project, seven prescribers working within four long-term care facilities were trained to assess for potentially inappropriate medications using the STOPP/START tool. The medication lists for long-term care residents (n =45) over age 65 were collected at baseline and again at three months post-intervention and assessed for overall medication use, psychotropics, and proton pump inhibitors. The project also assessed prescribers’ comfort and …

Sleep Deprivation And Delirium Development In The Icu, Cynthia Howell Msn Fnp-Bc, Stacy Murillo Msn Fnp-Bc, Amy Wilson Msn Fnp-Bc, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Delirium is an acute syndrome characterized by disturbances in cognition occurring in critically ill patients, particularly those over 65 in the intensive care unit (ICU). Numerous risk factors are associated with delirium development, with sleep being a modifiable factor. This review explores existing literature regarding the relationship between sleep deprivation and delirium development while evaluating the effectiveness of a sleep promotion protocol to decrease the incident of delirium in those ICU patients 65 years or older.

Method A literature review of peer-reviewed studies from PubMed and additional search engines was completed. Articles reviewed were published within the last five …

Evidence-Based Best Practice Toolkit For Competency-Based Orientation In Integrating An Adult Pneumococcal Protocol To Improve Vaccine Rate: A Program Evaluation Review, Magda Angel Cifuentes

Student Scholarly Projects

Practice Problem: Low pneumococcal vaccine uptake among high-risk adults is partly due to underutilized or lack of nurse-driven vaccine protocols, limited understanding of vaccine intervals and indications by nurses, and lack of proper training. Currently, physician-driven orders are the only avenue for high-risk adults to obtain this vaccine in ambulatory sites.

PICOT: In adults 65 years or older within an ambulatory setting, does the use of an adult pneumococcal vaccine protocol, compared to a physician order (no vaccine protocol) impact the rate of vaccination over 2 months?

Evidence: Utilization of two or more interventions provided higher immunization rates. …

Action Planning With Self-Monitoring Blood Pressure Improves Blood Pressure Control In Geriatric Patients, Thuy Ai Oh

Student Scholarly Projects

Practice Problem: Uncontrolled hypertension is a global healthcare problem. Hypertension is controlled in fewer than 1 in 5 people and has been attributed to premature deaths (WHO, 2021).

PICOT: The PICOT question that guided this project was “In patients 65 years of age and older with uncontrolled blood pressure, how does a nurse-led blood pressure control program compared to standard of care improve blood pressure control at an outpatient clinic over 8 weeks?”

Evidence: Five studies provided evidence that a nurse-led blood pressure decreased blood pressure results. The evidence supported the practice change of implementing a nurse-led …

How To Control Healthcare Associated Infection, Yeojin Son, Jungyoon Hur

Scholars Week

Healthcare-Associated Infections (HAI) are infections patients acquire while receiving care in hospital. The main reasons of occurring the infections are insufficient knowledge about infection control and decreased compliance with rules by hospital protocol. The purpose of this evidence-based presentation is to exemplify how to control HAI via motivating healthcare workers to comply with infection control policy.

Effective Communication In Dementia Patients, Morgan Loveless, Callie Hardesty

Scholars Week

Effective Communication with Dementia Patients - Abstract

Throughout every nurse’s career, one will have the experience of working with those with dementia. Patients who suffer with dementia require different approaches to communication and may have difficult interactions with healthcare workers. A barrier many nurses continue to endure is poor communication and relationships with dementia patients. Many nurses work at a very quick and stressful pace, putting a strain on many nurses’ relationships with dementia patients. Ineffective communication may lower the quality of care dementia patients receive as nurses may lack the extra time needed to effectively communicate. This can lead …

Qualitative Data Analysis For Health Research: A Step-By-Step Example Of Phenomenological Interpretation, Sue Monaro, Janice Gullick, Sandra West

The Qualitative Report

Phenomenological studies have been critiqued when analytic activities and intersection with the underpinning philosophy lack clarity. This methodological discussion paper describes data analysis in hermeneutic interpretive phenomenology. Data management strategies (transcript preparation, coding, philosophy application, tabling/concept maps, and Microsoft Word) and data analysis processes (reduction, display, and conclusion drawing/verification) are illustrated. Deconstruction, reconstruction, and reorganisation of themes/subthemes using hierarchical heading styles to populate the navigation pane and philosophical tenets acted as analytic hooks. This paper has outlined data analysis in hermeneutic interpretive phenomenology, including the use of MS Word and its functionality, which was supported by other data display strategies …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Pre-Implementation Of Cocare Help, Thomas D. Finn, Autumn Baldwin, Elizabeth Hill

Doctoral Dissertations

Background: Delirium is a change in consciousness characterized by rapid onset and fluctuating attention, causing impairment in the ability to process and recall information, occurring in 30% of hospitalized older adults. Delirium can increase falls, length-of-stay, mortality, and cost. The CoCare Hospital Elder Life Program® (HELP) is an evidence-based bundle of interventions targeting cognitive impairment, sleep deprivation, immobility, visual/hearing impairment, and dehydration, embedding geriatric principles in care to prevent delirium.

Objectives: To further analyze the pre-implementation of the HELP in order to optimize success of program administration.

Methods: Mixed methods were used to collect retrospective/prospective data (interviews (N=25], surveys [N=25], …

Developing A Standardized Process For An Effective, Evidence-Based Fall Management Program To Reduce Falls In A Nursing Home Setting, Katrina K. Little

Doctor of Nursing Practice Projects

Background: Falls among the elderly population, aged 65 years and older, are a significantly growing public health problem. For elderly people residing in residential care facilities and facility administrators, falls are of great concern due to the post-fall associated consequences. Preventing resident falls in long-term care is a priority to reduce injuries and associated costs.

Project Design: This evidence-based quality improvement (EBQI) pilot project focused on fall prevention and was conducted on 1 unit (3 long-term care hallways) at a facility that provides both long-term care (LTC) and short-term rehabilitation services in Utah County, Utah. Interventions chosen for the Falls …

Alzheimer's And Patient Caregiver Burnout: A Review Of The Literature, Madeline Hekeler

James Madison Undergraduate Research Journal (JMURJ)

The term “silent epidemic” is fitting for Alzheimer’s disease (AD), as its negative impact is widely felt but rarely discussed. Burnout among AD caregivers has become an epidemic of its own as caregivers experience an increase in health risks, stress, and financial burden. This literature review focuses on caregiver burnout and how imperative it is that caregivers are better supported in their role. Researchers have developed instruments to assess and intervene in caregiver burnout that have shown effectiveness among caregivers and their families.Nevertheless, further longitudinal research is warranted regarding more effective interventions, including stress management and social support mechanisms.

Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

Delirium Screening To Prevent Falls In The Long-Term Care Setting, Jonathan David White, Bsn, Rn, Samereh Abdoli, Phd, Rn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background

Nearly 30 million people fall in the United States (U.S.) every year with 20% resulting in serious injury. These incidents disproportionately occur in the elderly population. Of the 1.6 million people living in long-term care (LTC) settings in the U.S., between 50-75% experience a fall annually with many experiencing multiple falls. This population is 2 times as likely to experience such an event – and due to increased age, they are least likely to recover. Delirium, a main contributing factor to fall, has been found to go undetected in as many as 66% of individuals in the clinical …