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The Ketogenic Diet: Its Effectiveness As An Adjuvant Therapy For Cancer, Rheaonn Marin 2022 Dominican University of California

The Ketogenic Diet: Its Effectiveness As An Adjuvant Therapy For Cancer, Rheaonn Marin

Nursing | Senior Theses

This paper explores a total of six research studies and will contain a literature review and proposal for further study regarding the effectiveness of the ketogenic diet as an adjuvant cancer therapy. Each study addresses a variety of different factors involved in KD implementation, ranging from effects on body composition and lipid profiles, to self-proclaimed quality of life, to tumor expression and progression under a KD regime. Ultimately, each were divided into three separate categories depending on the aspects of research that were covered. Two studies, by Hagihara et.al and Jansen and Walach respectively, discuss the potential benefits of ...


Factors Affecting Nurses’ Intention To Leave Their Primary Nursing Position, Scott P. Kaye 2022 The Graduate Center, City University of New York

Factors Affecting Nurses’ Intention To Leave Their Primary Nursing Position, Scott P. Kaye

Dissertations, Theses, and Capstone Projects

The United States is facing an imminent nurse staffing crisis. An aging workforce, an increasing elder population, and new staffing legislation have added to existing difficulties in retaining nurses. Retaining nurses is a priority in emergency departments, one of the few specialty departments that exceed the national average turnover rate, with an average of 95% of the nursing staff leaving their positions every five years. This dissertation used dual-factor theory, dimensions of nursing surveillance, and intersectionality as theoretical frameworks; employed secondary analysis of the National Sample Survey of Registered Nurses (2018) dataset; and utilized hierarchical regression Modeling to examine the ...


Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller PA-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino 2021 Texas Children's Hospital

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed ...


Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis 2021 University of San Francisco

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient ...


Optimizing Interprofessional Rounds To Reduce Extended Length Of Stay In Complex Patients, Christina May P. Santiago 2021 The University of San Francisco

Optimizing Interprofessional Rounds To Reduce Extended Length Of Stay In Complex Patients, Christina May P. Santiago

Master's Projects and Capstones

Problem: Organizations have taken measures to reduce the length of stay by addressing logistical issues such as care coordination across the continuum. This becomes especially important for patients being discharged to skilled nursing facilities (SNF), where placement can be impeded due to complex care needs. In March 2021, the facility accounted for 20% of all extended length of stay (ELOS) patients across the organization. The average ELOS was 36 days, with 42% of these patients being discharged to a SNF.

Context: The Extended Length of Stay (ELOS) team functions at a mesosystem level within twenty-one medical centers across Northern California ...


Patient Coordinated Care Response Team, Joshua Fox 2021 The University of San Francisco

Patient Coordinated Care Response Team, Joshua Fox

Master's Projects and Capstones

Section I: Abstract

Problem: Communication between medical professionals and patients is a critical element to patient satisfaction and safety. The 2020 patient overall satisfaction scores for the local Roseville hospital were 73%. These data demonstrated an opportunity to enhance processes and the culture at the local Roseville hospital to meet the communication needs of its patient population.

Context: A patient coordinated care response team was developed to improve communication for newly diagnosed cancer patients or other life-altering diagnosis patients.

Interventions: A survey was completed to establish the current state of patient satisfaction with communication practices with healthcare providers in the ...


Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya 2021 The University of San Francisco

Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya

Master's Projects and Capstones

Abstract

Problem: Falls are considered never events, yet continuously occur in the inpatient setting. Falls,

especially falls with injuries, impact the patients, the staff, and the hospital. Falls cause extended lengths of stay, affect the morale of the patients and the staff, and are non-reimbursable events.

Context: There have been an increased rate of falls within a medical/surgical/telemetry unit

microsystem at a Northern California hospital despite standardized screening and prevention tools. The unit can house up to 52 patients and is the designated Covid unit of the hospital at the time of this project.

Interventions: The interventions include ...


Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe 2021 University of San Francisco

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new ...


Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris 2021 The University of San Francisco

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the DNP ...


Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens 2021 University of San Francisco

Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens

Master's Projects and Capstones

Abstract

A High Reliability Organization (HRO), such as this Northern California Medical Center, holds itself to high standards of performance in the areas of recognition, ranking, and accreditation. The commonality between these high-scored and valuable acknowledgements is the pillars of Quality Outcomes. As benchmarking and reporting allow this facility to measure outcomes against self and other plans, it greatly strengthens the internal focus for continual improvement and goal setting in direct patient care and outcomes. A deeper layer of the Quality Department includes the bundle “ERAS – Enhanced Recovery After Surgery”, which is compiled of principles aiming to minimize opioid use ...


Nurse Manager Communication Associated With Staff Nurse Satisfaction Or Retention, Svetlana Periut 2021 Kennesaw State University

Nurse Manager Communication Associated With Staff Nurse Satisfaction Or Retention, Svetlana Periut

MSN in Leadership in Nursing Final Projects

Background: Nursing communication is a significant part of a nurse's job, especially when communicating with their patients, patient's families, and the healthcare team. Communication is the center of attention of many studies, and the way nurse leaders relate massages can influence an organization’s outcomes, including nurse satisfaction and retention. This integrative review aims to analyze communication styles, behaviors, and instruments used by hospital unit nurse managers to increase staff nurse satisfaction and retention.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis were used in the literature search and review. The Johns Hopkins Evidence-Based Practice Model ...


Development And Implementation Of An Evidence-Based Practice Mentor Fellowship, Stacy L. Alves 2021 The University of San Francisco

Development And Implementation Of An Evidence-Based Practice Mentor Fellowship, Stacy L. Alves

Doctor of Nursing Practice (DNP) Projects

Background: The Institute of Medicine (2008) set a goal that 90% of healthcare decisions would be based on the best evidence possible by 2020, yet many challenges remain. Common barriers include clinicians’ beliefs about the value of evidence-based practices, their competency to implement it, and systems issues such as time, resources, and organizational value and preparedness (Melnyk et al., 2017).

Local Problem: A hospital within an integrated health care system sought to increase the use of EBP for clinical decision making. A gap analysis revealed a lack of sufficient EBP mentors to lead efforts to promote system-wide EBP implementation.

Context ...


Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner 2021 Kennesaw State University

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

MSN in Leadership in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses ...


Manager Onboarding To Improve Retention, Knowledge, And Confidence To Lead, Christine Asiimwe 2021 The University of San Francisco

Manager Onboarding To Improve Retention, Knowledge, And Confidence To Lead, Christine Asiimwe

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of this paper is to review the literature on manager onboarding best practices and their impact on turnover intention, knowledge, and confidence to lead teams in primary healthcare settings.

Background: Primary care onboarding is often insufficient due to competing operational priorities, time constraints, lack of mentorship, and cost. With primary care increasingly the setting for affordable, coordinated, end-to-end patient care, primary care managers must be well-prepared to lead the care team.

Methods: A review of the literature identified best onboarding practices associated with job satisfaction and turnover, reduced time to proficiency, increased knowledge, and confidence to lead ...


Bullying In The C-Suite: A Nurse Leader Perspective, Kimberly Ann Colonnelli 2021 University of San Francisco

Bullying In The C-Suite: A Nurse Leader Perspective, Kimberly Ann Colonnelli

Doctor of Nursing Practice (DNP) Projects

An estimated 35% of American workers have experienced bullying, and in 80% of those situations, the perpetrator was a supervisor or boss. 1 However, the reality is that bullying can come from anyone in the workplace, including subordinates. Victims are generally well liked and good performers, making them feel like threats to a bully’s power base. Bullying, unlike harassment, is not a legally defined behavior, so no laws currently exist to punish it. Victims are, therefore, at the mercy of their bosses, supervisors, co-workers, and human resource departments for protection or relief. Bullying is not a singular event, but ...


The Relationship Between Collective Nursing Knowledge And Nurse Turnover: An Application Of Nursing Intellectual Capital Theory, Pamela Russman-Chambers 2021 Kennesaw State University

The Relationship Between Collective Nursing Knowledge And Nurse Turnover: An Application Of Nursing Intellectual Capital Theory, Pamela Russman-Chambers

Doctorate of Nursing Science Dissertations

The value of a healthcare organization is vested in the expertise, intellect, and wisdom of employees. Nursing knowledge resides both within the individual nurse and the collective knowledge embedded in organizational structures and practice environments. Healthcare organizations rely on their ability to utilize this knowledge to deliver high-quality care to patients. Hospitals wanting to gain a competitive advantage and achieve financial stability must be adept at acquiring, cultivating, and using the nursing knowledge stocks of the organization. When this knowledge can be utilized to mitigate healthcare issues and improve patients' health, this collective knowledge or intellectual capital is often the ...


A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judith E. Bowling, Ana L. Santos 2021 Homestead Hospital

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judith E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary ...


Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale 2021 University of Texas at Tyler

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the ...


Stroke Education Program To Reduce Readmission, Karnesha Dominguez 2021 University of Texas at Tyler

Stroke Education Program To Reduce Readmission, Karnesha Dominguez

MSN Capstone Projects

Stroke is a major cause of long-term disability and mortality in the United States, exemplifying a complex chronic disease with high co-morbidity, associated healthcare costs, and readmission rates. Unfortunately, patients diagnosed with strokes often present to acute care settings with stroke events after they have had been previously diagnosed. Readmission rates among stroke patients are as high as 13% with most readmissions being unplanned and many avoidable (Brom et al., 2021). An estimated 6.6 million Americans aged 20 years and older have had a stroke, and each year approximately 795,000 people experience a new or recurrent stroke (Duncan ...


Bedside Handoff In The Emergency Department, Sheila Pochron 2021 University of Texas at Tyler

Bedside Handoff In The Emergency Department, Sheila Pochron

MSN Capstone Projects

Background

A standardized approach to bedside handoff improves nurse and patient satisfaction as well as quality outcomes.

Objectives

To compare the preference for bedside handoff in the emergency department post implementation by analyzing nursing surveys and Press Ganey data.

Design

A mixed method pilot study.

Settings

A not-for-profit community-based safety net hospital which is Magnet designated. ED is a level 3 trauma center with 60,000 visits annually.

Participants

ED nurses (n=52) and adult patients (n=86)

Methods

A pre and post implementation survey that utilized the 5-point Likert scale was given to nursing staff in the emergency department ...


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