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Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr 2016 University of San Francisco

Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr

Master's Projects

Patient safety is one of the major concern of any healthcare provider during their patient’s hospital stay. This project addressed the steady trend of fall incidences compared to last fiscal years’ data of an average of 4 falls per month. This trend created urgency to envisioned a plan for solutions to prevent this circumstance from happening. This Clinical Nurse Leader led a project in creating a process in identifying all patients that are high risk to fall (HRTF) prior to their admittance or transfer to Medical Surgical/Intermediate Care Unit and throughout their hospital stay until they are discharged ...


Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee 2016 The University of San Francisco

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL ...


Nurse Shift Handoff Report At The Patient's Bedside: Improving Nurse-To-Nurse Communication, Francis R. Estrella 2016 University of San Francisco

Nurse Shift Handoff Report At The Patient's Bedside: Improving Nurse-To-Nurse Communication, Francis R. Estrella

Master's Projects

The purpose of the CNL project is to develop a standardized approach to communication during nurse shift handoffs through utilization of bedside shift reporting (BSR). Shift handoffs are integral to nursing practice; therefore, this process must be accurate, effective, and consistent in order to ensure the delivery of safe and quality care. The project focuses on the CNL curriculum element of Quality Improvement and Safety, under the role of an Outcomes Manager. Prior to BSR implementation, shift handoffs in the sub-acute unit were being conducted at the nurse’s station or by the medication carts. Nurse shift handoffs were often ...


Minimizing The Inappropriate Use Of Physical Restraint, Shiela Marie C. Telmo 2016 University of San Francisco

Minimizing The Inappropriate Use Of Physical Restraint, Shiela Marie C. Telmo

Master's Projects

The aim of this project is to be able to improve patient safety by minimizing the inappropriate use of physical restraints from 45% to about 20% in the acute respiratory unit which caters to patients with acute respiratory issues, such as exacerbation of chronic obstructive pulmonary disease (COPD), patients with new or old tracheostomy, needing bipap, rigorous nebulizer treatment, and other respiratory-related devices, not to mention the multiple comorbidities that oftentimes very difficult to stabilize which makes the hospital stay longer than usual. The Clinical Nurse Leader (CNL) as an educator and an outcome manager is an agent to empower ...


Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale 2016 University of San Francisco

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys ...


Standardization Of Body Imaging Huddle In Raidology, Margaret M. Browne McManus 2016 University of San Francisco

Standardization Of Body Imaging Huddle In Raidology, Margaret M. Browne Mcmanus

Master's Projects

Mag Browne McManus

Clinical Nurse Leader Abstract

University of San Francisco

Abstract

Communication amongst healthcare providers is critical to reducing errors, and in procedural areas, the huddle can be used to standardized communication amongst the team before the beginning of interventional procedures (Goldenhar, Brady, Sutcliffe, Muething, & Anderson, 2013). Prior to the implementation of the revised huddle, a staff survey indicated none of the staff were satisfied with the current process. The objectives of the standardization of the body imaging huddle in the department of radiology were to increase staff satisfaction by 15% and reduce the time from patient arrival to ...


Debriefing In The Emergency Department, Alyssa Johnson 2016 University of San Francisco

Debriefing In The Emergency Department, Alyssa Johnson

Master's Projects

Emergency Department (ED) staff are repeatedly exposed to high stress situations and as a result suffer from compassion fatigue, secondary traumatic stress, symptoms of post-traumatic stress disorder, burnout and high turnover rates. Staff turnover is costly to the health system in the form of training new staff and potential poor patient outcomes due to under staffing or inexperience of staff. Based on a survey about debriefing, Level 1 Adult and Pediatric Emergency Department staff reported 81% felt there was inadequate support for critically stressful events that occur. Debriefing was identified by 75% of the staff as an option for support ...


Common Statistical Tests And Interpretation In Nursing Research, Maria E. Main, Veletta L. Ogaz 2016 Western Kentucky University

Common Statistical Tests And Interpretation In Nursing Research, Maria E. Main, Veletta L. Ogaz

International Journal of Faith Community Nursing

Faith community nurses need a basic understanding of common statistical tests and their interpretation to aid in the appraisal of research for evidence-based practice. The purpose of this article is to review statistical concepts, define common statistical tests, and interpret the results of statistical tests. Common statistical tests that measure differences in groups are independent samples t-test, paired sample t-tests, and analysis of variance. Common statistical tests that measure relationships are Pearson product moment correlation and chi-square. Knowledge of statistical concepts and common statistical tests assist in the appraisal of nursing research for evidence-based practice.


Critiquing Quantitative Research Reports: Key Points For The Beginner, Cathy H. Abell, Dawn M. Garrett Wright 2016 Western Kentucky University

Critiquing Quantitative Research Reports: Key Points For The Beginner, Cathy H. Abell, Dawn M. Garrett Wright

International Journal of Faith Community Nursing

Nursing research has a long history, beginning with the first nursing researcher--Florence Nightingale. As research continues to evolve, the dissemination of findings is important. Nurses must have have an understanding of how to critically read and appraise research articles in order to assess the value of the findings.


Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps 2016 The University of Southern Mississippi

Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps

Doctoral Nursing Capstone Projects

The birth of a child is one of the most memorable moments in a woman’s life, and many women undergo an elective cesarean section, requiring spinal anesthesia. At this time, the patient and the unborn child’s well-being become the anesthetist’s main focus. The ultimate goal of anesthesia providers is to provide the safest care to the patient. Spinal anesthesia has many benefits, but has a common side effect of hypotension, which can also result in nausea. Hypotension, dangerous to mother and child, is often treated with vasopressors, but can also cause nausea, which is treated by the ...


Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgicalpatients 65 Years Of Age Or Older, Simon Jack Gibson 2016 The University of Southern Mississippi

Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgicalpatients 65 Years Of Age Or Older, Simon Jack Gibson

Doctoral Nursing Capstone Projects

Postoperative delirium (POD) is the most common postoperative complication in the elderly, accounting for approximately $164 billion in costs per year in the United States (Inouye, Westendorp, & Saczynski, 2014, p. 911). This complication occurs in as many as 50% of elderly patients, but can be prevented as much as 40% of the time (Inouye et al., 2014). The use of processed encephalographic monitoring, such as Bispectral Index (BIS) monitoring, to guide anesthetic dosage is the single intraoperative intervention with enough evidence to support it as a recommendation for use to reduce POD (American Geriatrics Society, 2015). There were two parts ...


Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler 2016 University of Southern Mississippi

Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler

Doctoral Nursing Capstone Projects

One prominent side effect in the use of a neuraxial anesthesia is pruritus, with an incidence in the obstetric patient of 60-100% (Kumar & Singh, 2013). Another side effect of an epidural placement is nausea and vomiting. Nausea and vomiting occurs frequently during the progress of labor and is difficult to determine an incidence that is related to epidural opioid administration (Chestnut, Wong, Tsen, Ngan Kee, Beilin, & Mhyre, 2014). A review of literature was performed and established evidence that ondansetron is effective in reducing incidence of pruritus in intrathecal administered opioids for cesarean sections in the obstetric patient. No literature was ...


Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman 2016 East Tennessee State Universtiy

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related ...


Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel 2016 University of Southern Mississippi

Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel

Doctoral Nursing Capstone Projects

Problem: Pain has been historically mismanaged potentially leading to a host of negative physiological consequences. Today’s dynamic health care reform offers an opportunity to increase satisfaction with care. Utilizing the PICO question, in adults undergoing laparoscopic cholecystectomy over a 12 month period, does medication with fentanyl during emergence versus not medicating during emergence reduce the need for pain medications and discharge times? Evidence/Background: Two national studies surveyed patient perception of pain management following surgery. The first, conducted by Apfelbaum et.al (2003) showed that 80% of patients experienced acute pain after surgery with 86% rating that pain as ...


Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell 2016 University of Southern Mississippi

Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell

Dissertations

The purpose of conducting this research was to determine the perception of group empowerment capacity (EC) and group empowerment capability (E) among faculty and administrators in associate degree nursing programs (ADN) in the United States (U.S.), whether there was a significant difference in the scores of EC and E between the two groups and if there was a significant relationship between the mediating variables and EC. The study was conducted online with administrators and faculty of ADN programs throughout the United States (U.S.). Information letters with questionnaire links were sent to all members of the Organization of Associate ...


Faculty-To-Faculty Incivility As Perceived By Nursing Faculty, Melinda Lofton Sills 2016 The University of Southern Mississippi

Faculty-To-Faculty Incivility As Perceived By Nursing Faculty, Melinda Lofton Sills

Dissertations

The purpose of this research was to determine the perceived presence of workplace incivility among nursing faculty in associate, baccalaureate, and graduate nursing programs and whether there was a significant difference between workplace incivility behaviors, occurrence of incivility, extent of incivility, and engagement of incivility among the three groups. A convenience sample of faculty from nursing programs accredited by Accreditation Commission for Education in Nursing and Commission of Collegiate Nursing Education in Alabama, Arkansas, Florida, Louisiana, and Tennessee completed the Incivility in Nursing Education-Revised (INE-R) survey. The final sample included 169 nursing faculty.

Based on the results of the study ...


Bariatric Surgery Weight-Loss Maintenance Among Hispanics: A Multiple Case Study, Minerva Aguilera 2016 University of Texas at Tyler

Bariatric Surgery Weight-Loss Maintenance Among Hispanics: A Multiple Case Study, Minerva Aguilera

Nursing Theses and Dissertations

Obesity significantly contributes to human illness and to subsequent rising healthcare expenditures. Bariatric surgery has been identified as the only effective option to achieve the weight loss necessary for those who are morbidly obese. Previous research indicated that maintaining significant weight loss has been a problem for individuals who undergo bariatric surgery. The number of bariatric surgeries is increasing and factors that contribute to or interfere following bariatric-surgery weight-loss maintenance need to be determined. Research on weight-loss maintenance following bariatric surgery is very limited, particularly among the Hispanic population. This case-study research used an explanatory, multiple-case-study design to gain greater ...


Personal Protective Equipment Use For Patients With Clostridium Difficile, Mallory L. Compton 2016 Murray State University School of Nursing

Personal Protective Equipment Use For Patients With Clostridium Difficile, Mallory L. Compton

Scholars Week

In researching the literature on correct PPE by healthcare staff when a patient has C. diff. I have found that the policy on PPE for patients with C. diff at Baptist Health Paducah is compliant. The theoretical framework used for this research is that of Imogene King. Their policy is evidence based and is also cost effective when it comes to preventing the spread of infection from patient to patient. There is no need for change to this policy at this time because it is supported by evidence in the literature.


The Perception For Good Death Of Community Dwelling Japanese And Thailand Respondents, Michiyo Ando, Supawadee Somchit, Mitsunori Miyashita, Laiad Jamjan 2016 St.Mary's College

The Perception For Good Death Of Community Dwelling Japanese And Thailand Respondents, Michiyo Ando, Supawadee Somchit, Mitsunori Miyashita, Laiad Jamjan

Asian/Pacific Island Nursing Journal

Having a “good death” is a very important goal of palliative care, and it is useful for nurses to understand cultural differences in the perception of a good death to propose nursing care. The purpose of this study was to compare the perception of a “good death” among community-dwelling Japanese and Thai people. Three hundred sixty-nine respondents completed the Good Death Questionnaire. The research design was a cross-sectional study. The scores of the Japanese respondents on “good relationships with medical staff,” “being respected as an individual,” and “fighting against cancer” were higher among Thai respondents. On the other hand, “environmental ...


Tasmanian Acute Public Hospitals Healthcare Associated Infection Surveillance Report 21 - Quarter 1 2014, Anne Wells, Fiona Wilson, Alistair McGregor, Brett Mitchell 2016 Department of Health and Human Services TAS

Tasmanian Acute Public Hospitals Healthcare Associated Infection Surveillance Report 21 - Quarter 1 2014, Anne Wells, Fiona Wilson, Alistair Mcgregor, Brett Mitchell

Brett Mitchell

This surveillance report describes data relating to a number of key Healthcare Associated Infection (HAI) indicators. The Tasmanian Infection Prevention and Control Unit (TIPCU) publish this report quarterly. The TIPCU website (www.dhhs.tas.gov.au/tipcu) contains details of the surveillance program, including the rationale for the indicators surveyed and the methodologies used in data collection, validation and analysis. In addition, an explanatory document has been developed to accompany this surveillance report. Any form of comparison between hospitals should be done with extreme caution and direct comparisons are not recommended. Information about how Tasmanian rates compare with those of ...


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