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Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl 2021 The University of San Francisco

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral ...


Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan 2021 University of San Francisco

Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan

Master's Projects and Capstones

Section I: Abstract

Problem: January and February 2021 data showed a rise in readmissions for the NSTEMI population. This is significant as 2020 had a readmission rate of 5.6% and 7.3% in 2019. This sudden increase in readmissions within the first two months of the year is a cause for concern and immediate action is needed.

Context: 2020 had a reduction in cardiac catheterizations due to the multiple canceled cases during the COVID 19 pandemic. As the cases were being rescheduled along with new cases in 2021, the institution experienced an uptake in readmissions.

Interventions: The staff of ...


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 ...


Patient Placement Matters: A Systematic Review Of The Impact Of Multiple Patient Placement, Jacqueline Strinden 2021 The University of San Francisco

Patient Placement Matters: A Systematic Review Of The Impact Of Multiple Patient Placement, Jacqueline Strinden

DNP Qualifying Manuscripts

Abstract

Background

Inattention to the frequency of patient movement has been correlated with system-induced harm events, diminished favorable health outcomes, and reduction in patient and staff satisfaction. The incidence of adverse events increases significantly when multiple unnecessary lateral relocations result from secondary efforts to relieve hospital capacity constraints and improve efficiency.

Methods

A systematic review of literature was conducted to evaluate the impact of adverse events, patient and staff perceptions, and resource utilization on frequent patient placement events.

Results

Results of the analysis demonstrate that increased adverse events, negative patient and staff perceptions, increased workload, and resource utilization is significantly ...


Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond 2021 The University of Southern Mississippi

Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond

Doctoral Projects

The purpose of this DNP project was to create a tool to teach and evaluate student registered nurse anesthetists (SRNAs) at TheUniversity of Southern Mississippi (USM) on supraclavicular and femoral nerve blocks to promote safety in the clinical setting. An objective structured clinical evaluation (OSCE) for ultrasound-guided supraclavicular and femoral nerve blocks was created as the basis for this project. Best-practice techniques as identified by the AANA’s 14thstandard of nurse anesthesia practice were researched and used in the development of the OSCE to promote a culture of safety for SRNAs and patients (AANA, 2019).

A culture of ...


Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo 2021 Dominican University of California

Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo

Nursing | Senior Theses

As nurses, working towards the best health outcomes for our patients is critical to our care. A large aspect of this care includes being knowledgeable of risk factors and precautions to take to avoid conditions and illnesses. Colorectal cancer remains to be a highly preventable disease, yet it is one of the top five leading causes of cancer deaths in the nation. Preventing colorectal cancer requires the efficient use of screening and education, while also addressing barriers of inconvenience and affordability. This senior thesis delves deeper into colorectal cancer prevention by asking the research question: For young and middle-aged adults ...


Improving Data Collection And Documentation In A Post-Discharge Follow-Up Phone Call Program, Lindsay Horihan, Tasha Flicek 2021 Winona State University

Improving Data Collection And Documentation In A Post-Discharge Follow-Up Phone Call Program, Lindsay Horihan, Tasha Flicek

Nursing DNP Projects

Purpose and Rationale: The purpose of this project is to improve a post-discharge follow-up phone call program by creating evidence-based methods of collecting, documenting, and analyzing data that will provide insight of the program’s impact on patient and process outcomes. There was sufficient evidence to support the use of follow-up phone calls as an effective method to limit hospital readmissions within thirty days of being discharged. The literature also revealed patient and process outcomes to be measured as a final step in the program and to provide data for ongoing process improvement. Practice Change and Implementation Strategies: The current ...


Evidence Based Im Injection Practice, Sarah Simpson, Amanda Bailey 2021 Murray State University

Evidence Based Im Injection Practice, Sarah Simpson, Amanda Bailey

Scholars Week

Abstract

This evidence-based study of literature investigated best IM injection practice. The review was based on evidence from 3 main sources, all found on the CINAHL database. The three studies were reviewed and assessed, and best practice was found to be recommended. The first article found that several healthcare workers use different methods and techniques when administering IM injections, this leads to incorrect administration or injections not evidence based. The second article found that in order administer IM injections effectively, 5mm penetration into the muscle is needed. Therefore, skin bunching is not recommended for the reasoning that it creates a ...


The Impact Of Faith Community Nursing Programs For Chronic Disease Screening And Management In Vulnerable Populations: A Comprehensive Review Of The Literature, Gabri Warren 2021 Bellarmine University

The Impact Of Faith Community Nursing Programs For Chronic Disease Screening And Management In Vulnerable Populations: A Comprehensive Review Of The Literature, Gabri Warren

International Journal of Faith Community Nursing

Faith Community Nursing (FCN) programs in the United States (U.S.) emerged in the 1980's; however, the intertwining of health promotion in religious institutions has been present for millennia. Today, challenges facing healthcare are prompting health care providers to find creative and cost-effective methods of providing care. Determining whether FCN positively impacts the health of individuals with limited access to healthcare services would encourage healthcare providers to collaborate with the specialty, reinforcing the benefit of their service. An integrative literature review was conducted to identify studies measuring the impact of FCN on the health outcomes of individuals with hypertension ...


Spiritually Influenced Health: Results Of A Health Promotion Initiative In Houses Of Worship, Crystal C. Shannon 2021 Indiana University Northwest

Spiritually Influenced Health: Results Of A Health Promotion Initiative In Houses Of Worship, Crystal C. Shannon

International Journal of Faith Community Nursing

Promoting health within communities is a primary responsibility for nurses and other healthcare professionals. This involves the active incorporation of spiritual and faith-based approaches to health. Challenges remain in the delivery of effective health delivery that incorporates faith for at-risk communities. This is a retrospective descriptive study designed to explore the effects of faith-based health promotion sessions on existing health habits within local faith organizations from 2015-2018. The protocol utilized nursing students as project developers in collaboration with faith leaders and subject matter experts in the delivery of health education on nutrition, cardiac health, and physical activity. Findings suggest positive ...


Faith Community Nurses: Caring For Individuals, Congregations, And Communities During The Covid-19 Pandemic, Mary Lynne Knighten DNP, RN, NEA-BC, LORIE HACKER, Phyllis Ann Solari-Twadell, Lanet Owen BSN, RN-BC, Bob Kentner DNP, RN, CHPQ, CEN, TCRN, Linda F. Garner 2021 Azusa Pacific University

Faith Community Nurses: Caring For Individuals, Congregations, And Communities During The Covid-19 Pandemic, Mary Lynne Knighten Dnp, Rn, Nea-Bc, Lorie Hacker, Phyllis Ann Solari-Twadell, Lanet Owen Bsn, Rn-Bc, Bob Kentner Dnp, Rn, Chpq, Cen, Tcrn, Linda F. Garner

International Journal of Faith Community Nursing

As the COVID-19 pandemic continues for nearly two years, communities of faith are struggling to meet the spiritual needs of individuals, congregants, and communities during a particularly trying time in history. They have experienced closures, phased re-openings, and reinstated restrictions as the pandemic sees the fourth surge and a deadly more transmissible form of COVID in the Delta Variant. Faith Community Nurses, who are specially educated to provide intentional care of the spirit, play a pivotal role in providing care, support, and education to maintain and improve whole person health when people are isolated, physically distant, and at times critically ...


Acuity Based Staffing, Halie Lewis, Perri Hogan 2021 Murray State University

Acuity Based Staffing, Halie Lewis, Perri Hogan

Scholars Week

For decades nurses have been fighting for safe nurse to patient ratios. Thousands of studies have been done proving that an increased patient load leads to burnout, job dissatisfaction, occupational injuries, adverse events, and patient mortality. In an effort to keep nurses at the bedside, California passed The Patient Safety and Quality Improvement Act of 2005. This act was the first of its kind as it established legislatively mandated nursing ratios and required staff to take several breaks throughout the day. However, mandated ratios come with a cost that most institutions cannot afford and therefore is not appropriate as a ...


Self-Study: A Method For Continuous Professional Learning And A Methodology For Knowledge Transfer, Judy C. Woods 2021 None

Self-Study: A Method For Continuous Professional Learning And A Methodology For Knowledge Transfer, Judy C. Woods

Quality Advancement in Nursing Education - Avancées en formation infirmière

Purpose: Clinical nursing instructors must participate in continuous professional learning to maintain competency in nursing practice and in clinical instruction to prepare nursing students adequately for professional practice. The purpose of this research was to examine self-study as a method of continuous professional learning in nursing education.

Procedures: A clinical instructor undertook to improve her clinical instruction with regard to five formative assessment strategies illustrated to promote student learning in regular classrooms. She translated and then implemented these strategies in nursing education. This self-study of instructional practice employed a reflective journal and systematic documentation of iterative processes of planning, action ...


Food Addiction And Obesity, Lisa Ling 2021 Abilene Christian University

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes ...


Patient Experience As A Metric For Performance In Outpatient Bone Marrow Transplant Patient Populations, Olivia S. Marlinski 2021 The University of San Francisco

Patient Experience As A Metric For Performance In Outpatient Bone Marrow Transplant Patient Populations, Olivia S. Marlinski

Master's Projects and Capstones

Problem: Patient satisfaction and perception of care provided have been linked to the overall quality of healthcare delivery. The Acute Infection Management clinical support department lacks a standardized method to collect information from patients regarding their satisfaction with care provided therefore impeding the units’ ability to capture performance results related to satisfaction, and improve care delivery processes accordingly.

Context: The Acute Infection Management unit is an outpatient clinical support department located within a large university-affiliated hospital that has been recently designated as the unit to operate the facility’s new outpatient bone marrow transplant program.

Intervention: The proposed project seeks ...


Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio 2021 The University of San Francisco

Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio

Master's Projects and Capstones

Abstract

Problem: The facility has less than 70% adherence to handwashing hygiene every week. Moreover, staff does not comply with the required PPE, affecting their infection-control performance and compliance to circumvent COVID-19. Furthermore, the microsystem lacks information flow and communication systems focusing on hand hygiene, and PPE usage significantly affects the healthcare staff's ability to perform such vital practices.

Context: Herman Health Care Center provides multiple services to its residents depending on medical needs after patient hospitalizations, such as short-term rehabilitation and long-term skilled nursing services. The COVID-19 pandemic had a remarkably negative impact on the skilled nursing facility ...


The Impact Of Nurse-Led Initiative Interventions On Cauti, Dalveer Kaur 2021 University of San Francisco

The Impact Of Nurse-Led Initiative Interventions On Cauti, Dalveer Kaur

Master's Projects and Capstones

Problem: National Healthcare Safety Network (NHSN) has reported U.S. hospitals having 0.2 to 4.8 per 1000 catheter-days for adult inpatient units. The insertion of a catheter and delay in removal have a significant impact on morbidity, mortality, length of stay, and reimbursement.

Context: Post-Acute Care Unit (PACU) is a microsystem that provides rehabilitation services for a patient with various post-surgical procedures. The staff of this unit was well aware of policies of catheterizations that led to prolonged use of urinary catheters and an increased rate of CAUTIs in the last quarter of this year. This project aims ...


Improving Patient Knowledge On Medication Communication, Deborah Cha 2021 Kaiser Permanente

Improving Patient Knowledge On Medication Communication, Deborah Cha

Master's Projects and Capstones

Abstract

Problem: Effective medication communication, including potential side effects, is a key determinant of safe patient care and better health outcomes. 3SA scores a 1-2 out of 5-stars for medication communication with the HCAHPS survey from October 2020-March 2021.

Context: As one of the medical-surgical units at this California hospital, it serves the purpose of providing medical and/or surgical management to acutely ill patients. The unit is a 24-bed, 1:5 nursing ratio with medical-telemetry and Covid-19 overflow.

Intervention: The interventions include a structured, evidence-based multi-component program in improving patient knowledge about new medications they receive, the possible side ...


Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao 2021 University of San Francisco

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is ...


"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa SANCHEZ-NAVARRO 2021 Duquesne University

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b ...


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