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Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities.

Context: Frailty, …

Health-Services Utilisation Amongst Older Persons During The Last Year Of Life: A Population-Based Study, Danielle Ní Chróinín, David E. Goldsbury, Alexander Beveridge, Patricia M. Davidson, Afaf Girgis, Nicholas Ingham, Jane L. Phillips, Anne M. Wilkinson, Jane M. Ingham, Dianne L. O'Connell

Research outputs 2014 to 2021

BACKGROUND: Accurate population-based data regarding hospital-based care utilisation by older persons during their last year of life are important in health services planning. We investigated patterns of acute hospital-based service use at the end of life, amongst older decedents in New South Wales (NSW), Australia.

METHODS: Data from all persons aged ≥70 years who died in the state of NSW Australia in 2007 were included. Several measures of hospital-based service utilisation during the last year of life were assessed from retrospectively linked data comprising data for all registered deaths, cause of death, hospital care during the last year of life …

Individualized Glycemic Targets For The Elderly Residing In Long Term Care Facilities, Abegail Hubberd

Doctor of Nursing Practice

Of people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to …

Impact Of Nursing Interventions On Positive Confusion Assessment Method (Cam) Scores, Katie Halsell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Delirium occurs in patients of all ages, especially in the older adult population. Symptoms vary from patient to patient, and delirium is often misdiagnosed. Patients with delirium have a higher cost of care and a longer length of stay in the hospital. Delirium is a stressful event for both the nurse and the patient, resulting in poor patient outcomes. The Confusion Assessment Method (CAM) tool is used to diagnose delirium in confused patients; a positive CAM score indicates delirium. Nursing interventions are used to treat delirium. Interventions used range from non-pharmacologic measures to use of pharmacological measures and restraints. This …

The Effect Of Art Therapy On Hospice And Palliative Caregivers, Carol E. Gress

Nursing Theses and Capstone Projects

A quazi-experimental, one-group, pretest/posttest study was conducted with a group of 25 hospice workers employed by a medium sized county hospice organization in the southeastern United States that was experiencing rapid personnel turn-over. Participants in the study included a doctor, a physician’s assistant, a nurse practitioner, a massage therapist, a grief counselor, a licensed practical nurse, a certified nursing assistant, two clergy, three administrative staff, three social workers, seven volunteers, eight registered nurses and one other. The purpose was to investigate whether attending four 1-hour art therapy sessions could help reduce stress and thereby Burnout. Stamm’s (2010) Professional Quality of …

Two Cultures Of Caring: A Comparative Study, Lisa Armstrong, Chistina Polito

Honors Theses and Capstones

There is much that the UK and the US could and should learn from each other to understand the quality of end-of-life care, through comparison of practice, analysis of care patterns and via original research (Higginson, 2005, p.170). Although comparisons between end-of-life care in the United Kingdom and United States have demonstrated similarities and disparities in many contexts, there is little evidence of research that directly compares nursing perspectives between the two Atlantic partners. This research explores nurse’s perceptions and experiences of caring for people within a hospice context and identifies themes of commonalities and disparities in theory and practice, …

Attitudes Of Nurses To Palliative Care In Nursing Homes In The Perth Metropolitan Region, Lynne Cohen

Theses: Doctorates and Masters

Zanna and Rempel (1988) have proposed that attitudes are a summary evaluation of an attitude object based on three classes of information, namely: cognitive information, affective information and behavioural information. This model has mainly been tested in the social groups and social policies area investigating two classes of information: cognitive and affective, and therefore there is a need for research to test the validity of this model in other areas. The present study applies the model to the area of palliative care in nursing homes. 76 directors of nursing, 76 clinical nurse specialists, and 76 nursing assistants working in nursing …