Digital Commons Network^™

Improving Patient Satisfaction In The Medical-Surgical Setting, Victoria A. Ogundeko

Student Scholarly Projects

Problem: Patients’ experiences at hospitals are multidimensional, and their satisfaction with the service is linked to the quality of patient care provided. In evaluating the quality of care of a hospital, the nursing handoff of patients, and the engagement efforts of healthcare staff is an important element of patient satisfaction.

PICOT: In adult medical-surgical patients, does the implementation of nursing bedside handoff reports, compared to the current method of nursing practice desk handoff reports, improve patient satisfaction scores by 10% within two months?

Evidence: After reviewing 103 articles, 12 were relevant to this project, and included observation …

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

Student Scholarly Projects

Practice Problem:There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

PICOT: This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Evidence: Thirteen pertinent studies recommended the use of …

Essential Oil Therapy For Alleviation Of Discomfort In Surgical Patients, Nenhuan Huang

Student Scholarly Projects

Practice Problem: Post-surgical pain (PSP) has not been sufficiently managed despite routine opioid use. The adverse effects of opioids led to the search for non-pharmaceutical intervention.

PICOT: The PICOT question that guided this project was, "In an acute hospital surgical setting, does essential oil therapy complement pain and discomfort relief comparing to conventional pain management alone after 6 weeks?”

Evidence: Seven clinical studies, five systematic or integrative reviews, and four conference proceedings were reviewed. The evidence supported lavender essential oil for the alleviation of PSP and discomfort.

Intervention: Patients breathe through a personal lavender essential oil inhaler hourly or …

Impact Of 5-Minute Preceptor Training On The Senior Nursing Student Perception Of Clinical Preceptor Feedback Effectiveness, Darla Daylene Smith

Articles, Abstracts, and Reports

Feedback is a tool that is often not utilized effectively. Clinical preceptors, when utilized, are the primary oversight for nursing students and should be able to provide feedback that is constructive and timely. Clinical preceptor feedback directly impacts the nurse generalists’ transition to practice which can increase competency levels by providing timely and quality feedback (Phillips, Mathew, Aktan, & Catano, 2017; Duteau, 2012). The purpose of this study was to determine if training clinical preceptors in the 5-Minute Preceptor method providing feedback to senior nursing students had an impact on the clinical teaching effectiveness. The research design was a comparative, …

Con Confianza: Using Community-Based Participatory Research Principles To Inform Community-Academic Partnership Practices And Build Trust In Hispanic Communities, Sharon Tafolla

Master's Projects and Capstones

Hispanic communities are at disproportionate risk for chronic diseases and researchers have cited the need for further community and culturally informed studies to improve research outcomes to either make treatments and interventions more generalizable or modify them to the needs of Hispanic communities. However, many of the same linguistic and cultural barriers to health care access and utilization also impact the ability for Hispanic groups to participate in research studies. Community Academic Partnerships (CAPs) are positioned to conduct culturally and linguistically competent research in Hispanic communities. For research in Hispanic communities to be effective, CAPs must prioritize practices that build …

Positive Patient Experience In Eye Care During Covid-19: A Case From Eye Hospital Sistina Oftalmologija, Vesna Cado

Patient Experience Journal

COVID-19 was a wake-up call, changing the world we know and our experiences in every possible way. Healthcare systems, as the most exposed and stressed in this situation, were called to urgently respond to the new reality. Physical distancing and stay-at-home directives have flattened the curve and decreased the risk of viral transmission but also decreased the clinical volume in eye care medical practice. Hospitals must work hard to find a balance in responding to the pandemic while providing quality care and positive patient experiences. Previous research on crises has been mostly focused on implementing crisis management strategies to handle …

Understanding The Importance Of Formative Assessment Programs In Undergraduate Medical Education, Matthew Gentile

All Theses And Dissertations

The purpose of this quantitative research study was to investigate the impact and relationship formative assessment in undergraduate medical education has on summative assessment performance. Previous research has investigated the important role formative assessment has on the broad education process (Menéndez, Napa, Moreira, & Zambrano, 2019). This research study examined that role in undergraduate medical education. This research study utilized a preexisting de-identified data set consisting of 332 third-year medical student assessment records from five different cohorts. The initial analyses investigated the differences in summative assessment performance for students who completed a formative assessment program during their third year of …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

How Can Care Settings For People With Intellectual Disabilities Embed Health Promotion?, Kristel Vlot-Van Anrooij, Monique C. J. Kiks-Leensen, Anneke Van Der Cruijsen, Henk Jansen, Koos Van Der Velden, Geraline Leusink, Thessa I. M. Hilgenkamp, Jenneken Naaldenberg

Physical Therapy Faculty Research

Background:People with intellectual disabilities (ID) depend on their environment to live healthily. Asset‐based health promotion enhances a settings’ health‐promoting capacity starting with identifying protective or promotive factors that sustain health. Method: This inclusive mixed‐methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities. Results: Fifty‐one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways “people” can support, (ii) assets in/around …

It Governance For Balancing Evolveability And Standardization In Health Information System Implementation In Ethiopian Context, Birkinesh Lagebo, Birkinesh Lagebo, Mark Gaynor Prof., Temtim Assefa Dr

African Conference on Information Systems and Technology

Failing to balance standardization and evolveability in IS design and implementation process results sustainability failure which is common in developing country. IS research provides various IS design solution including layered modular architecture to address both evolveability and standardization simultaneously. However, this design solution requires appropriate IT governance mechanisms which lacks both theoretical and empirical explanation in IS research. The core of this research is understanding IT governance mechanism design that can balance standardization and evolveability in the course of IS design and implementation. The research uses the case of District Health Information System-2 (DHIS-2), layered modular architecture, design and implementation …

Development Of A Certificate In Healthcare Improvement For Inter-Professional Teams, Kathleen M. Fairfield, Hannah R. Martin, Peter W. Bates, Erin M. Graydon-Baker, Mark G. Parker, Jordan S. Peck, Debra A. Rothenberg, Ghassan A. Saleh, Isaac Z. Stickney, John Tooker, Robert L. Trowbridge, John E. Wennberg

Journal of Maine Medical Center

Introduction

To address gaps in care team improvement-science education and connect geographically dispersed learners, we created a healthcare improvement certificate program, now completing the third program year, for inter-professional (IP) healthcare teams, including third year medical students.

Methods

This hybrid learning program consists of five modules: Learning Healthcare Systems, Improvement Science, Patient Safety and Diagnostic Error, Population Health and Health Equity and Leading Change. The curricular materials are comprised of focused readings, concise videos, faculty-moderated discussion boards, weekly synchronous calls of participants with faculty, and a longitudinal improvement project. The faculty are content experts, and worked with a curricular designer …

Are Advanced Practice Registered Nurses In Mississippi Participating In Practices That Advocate The Nursing Profession, Sarah Adams, Melanie Bush, Lacy Estes, Lisa King, Paige Long

MSN Research Projects

Previous research studies have focused on patient outcomes related to healthcare interventions, but there is little research available regarding nurses’ involvement in activities that would advance the profession. Advanced Practice Registered Nurses’ (APRN) contributions to the healthcare system lead to direct improvement of patient outcomes through research, mentoring new professionals, and participating in professional organizations. The theoretical motivation behind the study is Ray’s Theory of Bureaucratic Caring that proposed healthcare personnel consider incorporation of the business aspects of healthcare to propel nursing into the future. Ray dared nurses to become leaders in the field, understand the corporate aspects of health …

Physician Burnout: Slowing The Burn Through Positive Deviance Strategies, Swapna Reddy

Dissertations and Theses (Open Access)

Introduction: Affecting 42% of physicians in the United States, “physician burnout” is considered a public health crisis with adverse impacts for personal providers, patients and organizations. Though much research has been devoted to the existence and causes of burnout, to date few studies have been conducted to identify factors associated with physician fulfillment. Aims: This dissertation research was intended to increase and improve knowledge of factors effective in contributing to physician professional fulfillment utilizing a Positive Deviance based approach. To that end, two studies were conducted: the first, a narrative review of the literature to identify specific correlates of physician …

Protecting The Integument: Changing Nursing Practice To Prevent Pressure Injuries, Latonya Lawery

Doctor of Nursing Practice Projects

The purpose of this project is to assess and improve nurses’ knowledge of pressure injuries and pressure injury preventions using evidence-based guidelines and a southeastern United States hospital’s skin integrity policy. My population of focus is direct care professional nurses caring for adults and geriatric patients in the acute care setting.

Design and Methods: The DNP student’s project is a quality improvement project using a Quasi-experimental design, which includes using a pre-test (Appendix A) and post-test (Appendex B). FADE (Appendix C) is the quality improvement method chosen for this project. FADE (Appendix C) is an acronym representing focus, analyze, develop, …

Does Marriage, Employment And Having Children Matter? A Secondary Analysis On Physical Activity Levels, Leisure Time Physical Activity, And Social Roles Among Women In The United States, Tramaine Paul Mcmullen

Theses and Dissertations

Background: Social roles, such as being married, employed, or having children, have been shown to have independent negative relationships with moderate to vigorous physical activity (MVPA) levels among women. Increasing the number of women with children that meets physical activity guidelines is critical to reduce chronic disease and early mortality in this population. However, few studies have examined the relationship between holding multiple social roles, MVPA, and leisure-time physical activity (LTPA) among women with children. The study had two aims: 1) to determine the relationship between objectively measured MVPA by social roles and 2) to examine the frequency of specific …

Low Health Literacy Impact On Heart Failure Patients' Readmissions: An Integrative Review, Melissa S. Goodwin

Doctoral Dissertations and Projects

Heart failure is a common chronic disease that affects numerous people throughout the world. Low health literacy plays a critical role in heart failure mismanagement. The purpose of this systematic review was to summarize what is known about the impact of health literacy of heart failure patients’ readmissions. MEDLINE, CINAHL, PSYCHINFO, and PUBMED databases were searched for the years 2010-2020 and for English language articles. The findings indicated that low health literacy has a significant impact on heart failure patients’ unplanned readmissions. Interventions for low health literacy also affect outcomes for heart failure patients; for example, reduce unplanned hospital readmissions. …

An Innovative Approach For Type 2 Diabetes Education, Rachel Domagala

Nursing DNP Projects

Objective: To improve self-efficacy in patients with type 2 diabetes and a Hemoglobin A1c (HbA1c) of 8% (64 mmol/mol) or greater using an innovative education multidisciplinary approach in a group setting.

Research Design and Methods: Out of 248 patients that were contacted with type 2 diabetes, who had a HbA1c of 8% or greater, five patients from a large clinic in the Midwest agreed to participate in group education. The primary outcome of interest was lowering HbA1c levels to increase the number of patients with type 2 diabetes who meet the community standard of care.

Results: Patients …

The Role Of Social Work In Health Care For Veterans In The United States Of America (Praca Socjalna W Lecznictwie Weteranów Służby Wojskowej W Usa), Jaroslaw Richard Romaniuk

Faculty Scholarship

Clinical social work in the American system of health care and its specific features in the Veterans Affairs (VA) of veterans are described in this paper. VA hospitals are the largest employers of social work worldwide. Because health care for veterans is paid for from government funds, VA hospitals are subject to regulations developed on the basis of research into the system’s effectiveness and efficiency. Clinical social workers cooperate with physicians and nurses to comprise an integral part of the health care team. Social workers fulfill the usual tasks related to social well‑being but also act as health educators and …

Resistance To Change: A Concept Analysis, Briony Marie Dubose Rn, Mhi, Ann M. Mayo Rn, Dnsc, Faan

School of Nursing and Health Science: Faculty Scholarship

The purpose of this concept analysis is to explore the concept of resistance and provide an operational definition for nurse leaders. While resistance has been deemed a major barrier to the implementation of successful practice change in popular literature, specific evidence as to how it is a barrier within health care organizations is lacking. The Walker and Avant model of concept analysis was used to analyze the concept of resistance. Literature searches utilized the Cumulative Index for Nursing and Allied Health Literature (CINAHL), PsychARTICLES, and Google scholar. Resistance is defined as an individual's behavior in response to perceived or actual …

Revisiting Cauti Prevention: A Multifaceted Approach Using Lean Six Sigma, Lisa Ann Behrend

Student Scholarly Projects

This project identified gaps in policy and processes to improve patient outcomes related to workflow in the catheter-associated urinary tract infection policy and process at a 400-bed hospital in southern California. Even with an evidence-based infection prevention bundle in place, the current process was not working, as demonstrated by high catheter-associated infection rates for the last two years.

This project answers the question: Does the use of a comprehensive evaluation of the current policy and process using the Lean Six Sigma quality improvement model influence a reduction in infection rates in patients who have an internal urinary catheter over 15 …

Fit For Population Health Service: Assessing The Change In Public Health Competencies Of Interprofessional Undergraduate Health Sciences Students, Cassity Gutierrez, Sara Johnston

International Journal of Health Sciences Education

Background. A 2012 IOM report is just one of an increasing number of recommendations to incorporate a population health approach into training of all health professionals. In light of the emphasis on and necessity for all future health professionals to possess core public health competences, a medium sized public University incorporated Introduction to Public Health as a required course in their undergraduate, interprofessional Health Sciences curriculum.

Purpose. The purpose of this study was to assess the change in core public health competencies of undergraduate Health Sciences students who completed an Introduction to Public Health course.

Methods. The Tier 1 …

Factors Predicting Sustainability: A Correlational Study Of One Multi-Site Program, Meredith L. King Jensen

Dissertations, Theses, and Capstone Projects

Healthcare organizations invest significant economic, physical, and human resources to implement changes and expect sustained benefits for their investments in the long term. Yet, few studies have examined long-term sustainability and factors contributingto sustainability. The primary aim of the study was to gain a better understanding of sustainability and five factors (champions, leadership support, policy, resources, and training and education) that might predict long-term sustainability within the context of one Safe Patient Handling and Mobility (SPHM) program implemented in a large, nationwide system more than 7 years ago. The secondary aim was to examine the number of nursing staff injuries, …

A Dnp-Led Educational In-Service To Increase Depression Screening In Primary Care, Shaylyn White

Doctor of Nursing Practice Final Manuscripts

Background: Depressive disorders are a major contributor to disability in the United States and worldwide. They are associated with multiple comorbid conditions including cardiovascular disease, obesity, stroke, and premature mortality. In the US, only 4.2% of primary care patients are being screened for depression and approximately 50% of cases of major depression are being missed.

Purpose: Implementation of a nurse practitioner-led educational intervention, discussing when, why, and how to screen utilizing the PHQ-2 and PHQ-9 screening tools, with the medical assistant staff in order to increase compliance with annual screening.

EBP Model/Frameworks: The Iowa model was used to guide implementation …

Dnp Final Report: Pressure Injury Prevention Patient Initiative (Pippi), Melissa A. De Los Santos

DNP Final Reports

Background: Pressure injuries have been known to affect approximately 2.5 million patients each year, with roughly 60,000 patients dying as a direct result of a pressure injury. Associate healthcare costs are between $9.1-$11.6 billion per year in the United States. The cost of individual patient care was estimated between $20,900 and $151,700 per pressure injury. During the last three years, pressure injury prevalence has risen within the local long-term care organization. Pressure injury prevention interventions have been developed to improve healthcare outcomes, cut costs, and increase revenue for long-term care organizations.

Purpose: Deliver evidence-based educational intervention that incorporates strategies for …

Reducing The Second Victim Phenomenon: Promoting Healing With Caritas Coaching, Shanda N. Whittle

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The second victim phenomenon is one in which healthcare providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol to cope with serious mistakes in the absence of a healthier means for healing (Wu, 2000). This phenomenon can be caused by adverse events or other personal/professional crises and can lead to healthcare professional absenteeism, leaving the job or leaving the profession altogether (Burlison et al., 2018; Hirschinger et al., 2015).

Context: The second victim phenomenon was identified as a problem within this DNP student’s organization and support was obtained for conducting the project. A …

Dnp Final Report: Sedation Protocol Compliance For Improved Outcomes In Intensive Care, Sonya M. Grigsby

DNP Final Reports

Background: Current evidence-based practice guidelines show that lighter sedation reduces mechanical ventilator days (MVD) and intensive care (ICU) length of stay (LOS). Guidelines (2018) for the management of pain, agitation, delirium, immobility, and sleep were released to direct appropriate high-quality care to achieve positive outcomes. However, studies demonstrated there were barriers to compliance of these guidelines.

Objective: To improve compliance with an existing evidence-based sedation protocol in an intensive care, and, thereby, improve patient outcomes (MVD and ICU LOS).

Methods: The three-month quality improvement (QI) project evaluated processes leading to compliance with the guideline. First, nurses were surveyed to determine …

Accelerating Primary Care Transformation At Jefferson (Jeffapct): Reflections From A Five- Year Hrsa Grant, Christine A. Arenson, Md, Amy Cunningham, Phd, Mph, Samantha Kelly, Ma, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

JeffAPCT Overview

Five year HRSA-funded grant (7/1/15-6/30/20)

Leadership team from Family Medicine, Internal Medicine, Physician Assistant Program

• Objective 1: To improve/ expand primary care and population health curriculum across the continuum of primary care providers and trainees (students, residents, and practitioners)
• Objective 2: To create an enhanced, sustainable model of primary care physician faculty development for PCMH Transformation
• Objective 3: To create a new, sustainable model of faculty development for community-based primary care preceptors (MD/DO, PA, NP, others)

Organizational Risk In Multi-Sector Health Partnerships: A Case Study Of Oregon's Accountable Health Communities, Shauna Jean Nicole Petchel

Dissertations and Theses

The literature on collective action has documented that the perception of organizational risk -- both the uncertainty of potential outcomes and the meaning attached to them -- is an important factor in whether and how organizations engage in cross-sector collaborations. Yet there are few examples to date that document how health and social service leaders perceive organizational risks in cross-sector health partnerships focused on social determinants of health, or how their perceptions influence organizational commitment and willingness to engage in these partnerships over time.

This research aimed to fill this gap through a mixed methods case study of health and …

The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts

Evidence-Based Practice Project Reports

Substance use disorders are a worldwide problem, according to the Center for Disease Control (CDC) there were 70,237 drug overdose deaths that occurred in the United States in 2017, of which 47,600 were opioid related. Illinois had a 14.3% increase of opioid deaths from 2016-2017 (CDC, 2017). Numerous interventions exist to address this health concern, yet evidence shows that Motivational Interviewing (MI) was the most efficient and effective way to promote behavioral change. The purpose of this EBP project was to provide evidence that MI increased referrals and promoted compliance with appointments to treatment programs. The sample for this project …

Stress And Burnout In Nurse Leaders, Laura E. Johnson, Kiersten J. Nichols, Jayme A. Sakhitab

Nursing Masters Papers

Problem: Nurse leaders commonly experience stress and self-reported burnout. The associated negative consequences are compelling, yet few studies to date consider the nurse leader population. Stress is “a multidimensional phenomenon determined by a person’s perceptions and may be assessed as harm, loss, threat, or challenge” (Udod, Cummings, Care, & Jenkins, 2017a, p. 160). Burnout is a lack of professional fulfillment caused by emotional, physical, and psychological stress (Nurse Burnout, 2019). Drivers are associated and contributing factors which lead to stress and self-reported burnout.

Purpose: The purposes of this correlational study are to (a) identify drivers from the literature and …