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Evaluating Patient Outcomes When Adding Licensed Practical Nurses To The Staffing Mix, Isabel C.M. Shephard, DNP, MSN, RN 2018 George Washington University

Evaluating Patient Outcomes When Adding Licensed Practical Nurses To The Staffing Mix, Isabel C.M. Shephard, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: An incorporation of licensed practical nurses (LPNs) in the RN staffing mix was made in a small community hospital. Research shows that RNs at the bedside equates to less adverse patient outcomes such as falls, pressure ulcers and an increase on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Objectives: To evaluate the effects of incorporating LPNs in the staffing mix on the number of patient falls, pressure ulcers and HCAHPS survey results.

Methods: A Pre and Post study design was used to compare baseline data obtained four months prior to implementing and four months during ...


Referral Patterns From Long-Term Care Services To Palliative Care: Perceptions Of Directors Of Nursing, Karen S. Sharrah, DNP, MSN, APRN, FNP-C 2018 George Washington University

Referral Patterns From Long-Term Care Services To Palliative Care: Perceptions Of Directors Of Nursing, Karen S. Sharrah, Dnp, Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Palliative care referrals are important in long-term care facilities because they are the first step in generating the services that the patient may need. This study looked at the phenomena of how Directors of Nursing in long-term care facilities that had access to palliative care services determined if a referral was needed.

Objectives: The purpose of this study was to gain a deeper understanding of the decision- making process used by Directors of Nursing for referrals. The study’s aims were to determine what factors prompt a referral in long-term care settings. The primary research question was: How do ...


Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, DNP, MSN, RN-BC 2018 George Washington University

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports ...


Measuring Nursing Students’ Perceptions Of Teamwork In A Multiple Patient Simulation, Christine Seaton, DNP, MSN 2018 George Washington University

Measuring Nursing Students’ Perceptions Of Teamwork In A Multiple Patient Simulation, Christine Seaton, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Simulation based education offers safe, reflective learning opportunities. However, data had not been obtained of nursing students’ perceptions of teamwork performed during Virtual Hospital (VH), a multiple patient simulation.

Objectives: This evaluation gap was addressed using the Agency for Healthcare Research and Quality’s (AHRQ) TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ). The validated survey measures self-reported perceptions of teamwork in communication, mutual support, and situational awareness on a Likert scale from 1 to 5 (AHRQ, 2014).

Methods: A pre-and post, one group design was used to measure perceptions of teamwork. Twenty participants were recruited from students, enrolled in a second-degree ...


Nurse Practitioner Clinical Education: Evaluation Of A Clinical Residency Model, Lisa Wilson Hood 2018 California State University, Northern California Consortium Doctor of Nursing Practice

Nurse Practitioner Clinical Education: Evaluation Of A Clinical Residency Model, Lisa Wilson Hood

Doctoral Projects

A new clinical residency education model was developed and implemented in response to a family nurse practitioner program’s difficulty in securing and maintaining qualified preceptors and clinical sites for students in the program, and a community hospital’s shortage of nurse practitioners for their rural healthcare clinics. This Doctor of Nursing Practice project conducted an evaluation on this new model. The evaluation results showed that the clinical residency model met standards of nurse practitioner education, incorporated nursing leader recommendations for new clinical models, and proved to be an effective model for clinical education.


Efficacy Of Post-Discharge Interventions On Preventing Hospital Readmissions In Stroke Patients, Monica R. Vickery 2018 University of New Mexico

Efficacy Of Post-Discharge Interventions On Preventing Hospital Readmissions In Stroke Patients, Monica R. Vickery

Doctor of Nursing Practice Capstones

More than 795,000 people in the United States have a stroke every year. Some 610,000 of them are first or new strokes, and 185,000 of these are recurrent strokes (Centers for Disease Control and Prevention, 2016). Studies show that anywhere from 17.4% to 66% of patients discharged from a healthcare facility following an acute stroke are readmitted within 30 days (Zhong et al., 2016; Lahiri et al., 2015; Strowd et al., 2015; Bjerkreim, Thomassen, Waje-Andreassen, Selvik, & Naess, 2016; Burke, Skolarus, Adelman, Reeves, & Brown, 2014; Kilkenny, Longworth, Pollack, Levi, & Cadilhac, 2013; Lichtman, Leifheit-Limson, Jones, Wang, & Goldstein, 2012; Li, Yang, & Chung, 2011). Hospital readmissions are costly both to the healthcare system and to patients. In 2016, the average hospital cost for each admission that resulted in a live patient discharge was $17,500, and that figure has been projected to increase in 2017 and 2018 (U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality, 2016, p. 16). All the conclusions in the reviewed literature recommend the use of multiple or bundled interventions versus the use of just one intervention (Poston, Dumas, & Edlund, 2014; Verhaegh et al., 2014; Wong, Chow ...


Informatics: Rn To Bsn Students’ Perceived Competence, Cathy Abell, Tonya Bragg-Underwood, Lori Alexander 2018 Western Kentucky University

Informatics: Rn To Bsn Students’ Perceived Competence, Cathy Abell, Tonya Bragg-Underwood, Lori Alexander

Nursing Faculty Publications

Background: Nurses utilize informatics to aide in providing safe, quality care to patients across the lifespan in a variety of settings; therefore, it is important that nurses have knowledge of nursing informatics. Nurses entering RN to BSN completion programs bring a range of clinical experience which often includes application of informatics. This poses a challenge for nursing faculty in designing programs to meet the needs of this specific population regarding informatics.Method: In this descriptive correlational research study, data were collected from a convenience sample of RN to BSN students using a demographic questionnaire and the Nursing Informatics Competency Assessment ...


When Faculty Downsizing And Student Success Collide, Yasenka Peterson, Jessica Nelson, Marcee Everly, Kathyrn Berlin, Peggy Weber 2018 Indiana State University

When Faculty Downsizing And Student Success Collide, Yasenka Peterson, Jessica Nelson, Marcee Everly, Kathyrn Berlin, Peggy Weber

Academic Chairpersons Conference Proceedings

This session will discuss increasing challenges chairpersons and associate deans’ experience when faced with decreasing or limited faculty resources and how this ultimately impacts student success. Opportunities and best practices related to working together as a cohesive leadership team, increasing on time graduation rates and course scheduling will also discussed.


Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton 2018 Liberty University

Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton

Graduate Student Projects and Scholarship

The addition of Nurse Practitioners (NPs) on the trauma service at night was examined to see if it has positively impacted healthcare utilization and satisfaction in trauma patients. This four-month evidence-based, quasi-experimental project took place on the Trauma Medical Surgical Unit (TMSU) at a level II trauma center in California. Retrospective analysis of medical records and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) satisfaction surveys were performed for those trauma patients located on the TMSU 60-days prior to NPs starting at night and 60-days after. The measured outcomes were LOS, readmissions within 30-days of discharge, LOS after readmission ...


Using Safety Checklists Outside Of The Operating Room, Annabelle Gerhardt 2018 University of New Mexico

Using Safety Checklists Outside Of The Operating Room, Annabelle Gerhardt

Doctor of Nursing Practice Capstones

Abstract

The use of a Time Out checklist for patient safety in non-operating room procedural areas is equally important for positive patient outcomes as in the operating room (OR). In this busy southwestern United States hospital, the procedural teams in the non-operating room areas were reported to not be fully engaged during the performance of the Time Out pre-procedural pause prior to gastroenterological (GI) procedures. This study was conducted to improve compliance with the scripted Time Out checklist and promote full engagement of the GI procedural team during the Time Out thus reducing risks of wrong site surgery. Literature has ...


What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler 2018 Baptist Hospital of Miami, Miami Cancer Institute, Baptist Health South Florida

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.


Use Of The Coleman Transition Model To Reduce Copd Readmissions, Sara Briggs 2018 Eastern Kentucky University

Use Of The Coleman Transition Model To Reduce Copd Readmissions, Sara Briggs

Doctor of Nursing Practice Capstone Projects

This paper explores the use of the Coleman Transition Model as an evidenced based intervention to reduce 30-day readmissions of Chronic Obstructive Pulmonary Disease (COPD) patients on a pulmonary unit. Nearly 20% of Medicare beneficiaries are re-hospitalized within 30 days after discharge, resulting in an annual cost of approximately $17 billion. Hospitals can engage in activities to lower their rate of readmissions. The evidenced based intervention includes robust case management using The Coleman Transition Model in hospitalized COPD patients to reduce readmissions. COPD is a prevalent, complex, and costly condition to manage. COPD is now the third leading cause of ...


Academic Incivility In Modern Generation Of Nursing Students, Laila Akber Cassum 2018 Aga Khan University

Academic Incivility In Modern Generation Of Nursing Students, Laila Akber Cassum

School of Nursing & Midwifery

Incivility in nursing academia and workplace is one of the emerging and complex issues in recent years, and can have substantial consequences on the organizational benchmark as well as on the teaching and learning milieu of the institution. Growth of academic incivility among the modern and diversified generation of students can have a profound destructive impact on their academic life and professional career. Impolite and discourteous attitude and behavior in a classroom atmosphere can originate from the learners as well the teachers, which can significantly impact the critical thinking and learning outcomes of the learner. This matter needs to be ...


How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston 2018 Old Dominion University

How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston

Nursing Faculty Publications

PROBLEM:

Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult.

APPROACH:

A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space.

OUTCOMES:

To date, 594 students have participated demonstrating capacity to: 1 ...


Best Practices For Sepsis Patients: A Quality Improvement Project, Kevin Mark Smith Jr 2018 wvu

Best Practices For Sepsis Patients: A Quality Improvement Project, Kevin Mark Smith Jr

Graduate Theses, Dissertations, and Problem Reports

Sepsis is a complication caused by the overwhelming and life-threatening response of the body to an infection. Sepsis can lead to tissue damage, organ failure, and death (Center for Disease Control and Prevention, 2016). Sepsis is the leading cause of death in U.S. hospitals. Mortality from sepsis increases 8% for every hour that treatment is delayed. Each year, 258,000 people die from sepsis in the U.S. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment (Sepsis Alliance, 2016). This project seeks to improve the ability of the transfer unit to screen ...


Can The Implementation Of Interprofessional Rounds Improve Hospital Throughput Efficiency?, Rebecca Howdyshell 2018 James Madison University

Can The Implementation Of Interprofessional Rounds Improve Hospital Throughput Efficiency?, Rebecca Howdyshell

Doctor of Nursing Practice (DNP) Final Clinical Projects

Abstract

Efficient throughput processes are a vital part of providing cost effective, safe, quality patient care. Research has shown interprofessional rounds can have success at improving throughput processes. A rural, not-for-profit, 255 bed hospital in a Mid-Atlantic State was experiencing issues with throughput/patient flow. The aims of this quality improvement project were 1). to implement Interprofessional Rounds on the Progressive Care Unit (PCU); 2). To design and build a working Interprofessional Rounds template into meditech to guide Interprofessional Rounds and streamline discharge documentation; 3). to increase the amount of discharge orders entered between 0700 and 1300 by ten percent ...


The Efficacy Of The Teach-Back Method Of Education On Readmission Rates In Heart Failure Patients Within 30 Days Of Discharge, Catherine Lynch 2018 James Madison University

The Efficacy Of The Teach-Back Method Of Education On Readmission Rates In Heart Failure Patients Within 30 Days Of Discharge, Catherine Lynch

Senior Honors Projects, 2010-current

Background: The teach-back method is a method of education that is being used with heart failure patients in order to improve their quality of education and lower readmission rates. This literature review is aimed at synthesizing studies conducted to determine the efficacy of the teach-back method with this specific patient population.

Methods: Electronic searches of CINAHL and PubMed were performed through James Madison University libraries. Articles selected for inclusion were evaluated for study design, relevance, and sample size.

Results: Three studies met eligibility criteria, these studies showed statistically significant evidence that the teach-back method did reduce readmission rates in heart ...


Reducing Urinary Catheter Use: A Protocol For A Mixed Methods Evaluation Of An Electronic Reminder System In Hospitalised Patients In Australia, Oyebola Fasugba, Allen C. Cheng, Philip L. Russo, Maria Northcote, Hannah Rosebrock, Brett G. Mitchell 2018 Australian Catholic University

Reducing Urinary Catheter Use: A Protocol For A Mixed Methods Evaluation Of An Electronic Reminder System In Hospitalised Patients In Australia, Oyebola Fasugba, Allen C. Cheng, Philip L. Russo, Maria Northcote, Hannah Rosebrock, Brett G. Mitchell

Faculty of Health Sciences Publications

Introduction: Despite advances in infection prevention and control, catheter-associated urinary tract infections (CAUTIs) are common and remain problematic. Prolonged urinary catheterisation is the main risk factor for development of CAUTIs; hence, interventions that target early catheter removal warrant investigation. The study’s objectives are to examine the efficacy of an electronic reminder system, the CATH TAG, in reducing urinary catheter use (device utilisation ratio) and to determine the effect of the CATH TAG on nurses’ ability to deliver patient care. Methods and analysis: This study uses a mixed methods approach in which both quantitative and qualitative data will be collected ...


Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen 2018 University of New Hampshire, Durham

Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen

DNP Scholarly Projects

Background

Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital.

Purpose

The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse ...


A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock 2018 University of New Hampshire, Durham

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an ...


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