Digital Commons Network^™

Meeting The Educational Needs Of The Busy Bedside Nurse: Curbside Education An Innovative Program, Ashley O'Connell, Kayla Waldoch, Amy Junes

Nursing Posters

• Seek out educational needs of staff based on current changes, trends and new hires
• Provide on the spot reinforcement of skills, policies, education and policy changes for all staff
• Implement skill stations, including "off shifts", to increase staff cohesiveness and preparedness in emergent and nonemergent scenarios

Implementation Of An Anxiety Screening And Treatment Protocol In Primary Care, Danielle E. Garcia

Student Theses, Dissertations and Capstones

Background: Anxiety is a prevalent problem frequently presenting in the primary care setting in the United States. The lack of routine anxiety screening and evidence-based treatment protocols in the adult primary care setting causes physical, social, and economic consequences.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) evidence-based practice (EBP) quality improvement project was to implement an EBP anxiety screening and treatment protocol for adults in a primary care clinic to increase early identification and improve management of generalized anxiety disorder (GAD).

Theoretical Framework: W. Edwards Deming’s Plan-Do-Study-Act (PDSA) cycle framework was utilized for this project. The PDSA …

The Lived Experience Of Novice Senior Nurse Leaders During Organizational Role Transitions, Sharon Kauffman

Student Theses, Dissertations and Capstones

The qualitative interpretive phenomenological study investigates the lived experiences of novice senior nurse leaders, who have transitioned to new organizational roles within a single healthcare organization in the Southeast United States. Senior nurse leaders have complex responsibilities but may not have training adequate to lead masterfully at new organizational levels. This phenomenon is poorly understood. Senior nurse leaders who do not develop the appropriate interpersonal skills and systems thinking may experience a sense of role insufficiency. Yet, strong leadership among senior nurses is vital to the successful performance of healthcare organizations, given the current landscape of change and the rapidity …

Future Trends Of Nursing Homes, Thomas Wade Martin, Kristopher Clark

Theses, Dissertations and Capstones

Introduction: Nursing homes are a major part of the long term care sector and have provided services to elders and the disabled population for years. Regulation change and new demands from the market have forced nursing homes to adapt. The purpose of this literature review was to analyze current regulation in place in the nursing home sector and determine how nursing homes will adapt and continue to provide quality care to patients in the future.

Methodology: The methodology of this research was a literature review. Overall, there were 4 databases used to gather research and 35 sources were used …

An Organizational Readiness Assessment And Patient Survey For Adoption Of An Opioid De-Escalation Protocol In Curative Oncology Patients, Adria Myers

Doctor of Nursing Practice Projects

Since 2012, statistics illustrate an explosion in the number of Americans admittedly misusing prescription opioids which increase the risk of long-term adverse effects. By 2016, individuals admitting to taking opioids for non medical reasons exceeded eleven million and 1.9 million of these individuals met the mental health guidelines for opioid abuse. Oncology patients represent a target population with an unmet met need for opioid reduction. Goals for de-escalation or tapering opioids for non-cancer pain have gained increasing attention across healthcare. Evidence-based opioid de-escalation guidelines specific for curative oncology patients are lacking in the literature. The aim of this DNP project …

Are Quality Improvement Projects Improving Health Outcomes?, Erin Taborelli

Student Research Poster Presentations 2020

Quality improvement projects such as pressure injury prevention does improve health outcomes for patients.

Quality And Clinical Care Development In Spine Surgery-Connecting The Dots: An Expanded Clinical Narrative., Sarah Hopkins, Polly Brune, Jens R Chapman, Marc Horton, Rod J Oskouian, Akshal Patel, Marc D Moisi

Articles, Abstracts, and Reports

Our health care system is an evidenced-based quality-centric environment. Pursuit of quality is a process that encompasses knowledge development and care advancements through collaboration and expertise. Depicted here is the foundational knowledge, process, and contributions that hallmark successful clinical quality programs. Beginning with methodology, followed by process and form, we create the foundational knowledge and exemplars demonstrating framework and continuum of process in pursuit and attainment of successful clinical quality and care development for patients. Although our protocol has been devised for complex spine care, this could be implemented across all health care specialties to provide individualized and high-quality care …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Self Reported Cardiovascular Disease Risk Factors Among Deaf Users: A Communication Barrier, Dr. Jolene Ayres Ogunjirin

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the number one cause of mortality worldwide, and may disproportionately affect the Deaf and Hard of Hearing (DHOH) subpopulation in the United States. It has been suggested that communication barriers among the DHOH subpopulation contribute to the high prevalence of CVD risk factors. To assess this claim, this quantitative study utilized a cross-sectional data set of 400 DHOH and 400 non- DHOH participants taken from the National Health and Nutrition Examination Survey (NHANES) database. The differences of being told by a health professional of having specific CVD risk factors were assessed between the two groups and …

Appreciative Inquiry Of An Exemplary Trauma Informed Wellness Center Created For The Community And Families Affected By A School Shooting, Halle Solomon

Department of Family Therapy Dissertations and Applied Clinical Projects

Gun violence has flooded our society with human-caused disasters, making mass shootings an unfortunate new normal. In the wake of large- scale shootings, the United States Government and other agencies provide financial support and resources to the affected community in hopes of bringing solidarity to the fractured system. This financial reinforcement and other funding sources have been utilized to build resiliency centers within a certain distance of the unnerving events. Resiliency facilities play a pivotal role in helping communities recover from human-caused disasters such as mass shootings. These resources are becoming customary across the country, with resiliency centers in Newton, …

Relationship Of Demographic Characteristics Of Occupational And Physical Therapists Towards Their Knowledge And Attitude On Person-Centered Care In Skilled Nursing Facilities, Sadashiv R. Aggarwal

Theses and Dissertations

The study aimed to assess the relationship of specific demographic characteristics of occupational (OTs) and physical therapists (PTs) with their knowledge and attitudes towards principles of Person-Centered Care (PCC) in skilled nursing facilities (SNFs). The study further examined if knowledge and/or attitudinal differences exist between OTs and PTs towards PCC. The proposed descriptive study used the Person-Centered Care theory, which is a holistic (bio-psychosocial-spiritual) health care delivery approach. PCC delivers services that are respectful and individualized, allowing negotiation of care, and offering choice through a therapeutic relationship where persons receiving care are empowered to be involved in health decisions at …

Impact Of Performance-Based Budgeting On Quality Outcomes In U.S. Military Healthcare Facilities, Kimberly L. Decker Virginia Commonwealth University

Theses and Dissertations

Performance-based budgeting (PBB) is a variation of pay for performance that is applicable to government programs. It works by increasing or decreasing funding based on pre-established performance thresholds, which incentivizes organizations to improve performance. In late 2006, the U.S. Army implemented a PBB program in all of its healthcare facilities due to rising concerns over costs and quality in its facilities. The U.S. Army’s PBB program tied hospital-level funding decisions to performance on key cost and quality-related metrics. This study examined the impact of this program and a subsequent PBB program on quality improvement in U.S. Army healthcare facilities. Drawing …

Integrating Technology In Improving Communication To Reduce Discharge Cycle Time, Julieta Fajardo

Walden Dissertations and Doctoral Studies

One of the most important milestones during a patient’s transition to care is discharge from hospital. Consequently, delays in the discharge process can lead to patient dissatisfaction and affect outcomes in intensive care and emergency rooms. The purpose of the project was to evaluate the tools built into the electronic system to improve communication and reduce the discharge cycle time. The focus of the project is to enter the expected date of discharge (EDD) and identify discharge barriers within 24-48 hours of admission to reduce this time. Evidence was from the project site’s discharge initiative dashboard. Analysis of the problem …

A Systematic Review Of The Literature On Bedside Shift Reports, Dana Wickersheim

Walden Dissertations and Doctoral Studies

AbstractIn 2017, The Joint Commission issued a sentinel event alert regarding inadequate nurse hand-off communication. Inadequate hand-off communication can lead to medication errors, delay in treatment, falls, and wrong-site surgery. To help ensure safe handoff of care between nurses by involving the patient and family, bedside shift report was created. Bedside shift report was developed to help improve patient safety and quality, patient experience of care, nursing staff satisfaction and time management, and accountability between nurses. Despite the implementation of bedside shift report in nursing practice, it continues to be inconsistently applied, which poses risks to patients and can lead …

Assessing Accuracy Of Attending Provider On The Pennsylvania Birth Certificate, Emily C. Mcgahey

Doctor of Midwifery Advances in Midwifery Projects

Introduction: Birth certificate data is a cornerstone of public health reporting, yet numerous studies document that much of the data collected is unreliable. Limited evidence suggests that the attendant at birth item may not be accurately captured on the current birth certificate, therefore not representative of the care provided by midwives in the United States. The primary purpose of this study was to determine whether midwives are accurately represented as attendant at birth on the Pennsylvania birth certificate. A secondary purpose was to assess midwives’ motivation to improve data collections if significant discrepancies were found.

Methods: A cross-sectional survey was …

Hpv Immunization Intervention Application In Rural Arkansas, Randi M. Wright

Doctor of Nursing Practice Projects

HPV (Human Papillomavirus) is the most common sexually transmitted infection (STI) contracted with over 33,000 cases of cancer attributable to the virus in the United States. The socioeconomical impact of HPV can be combatted with the HPV vaccine which is almost 100 percent successful in preventing infection. A strong provider recommendation is the most effective way to increase HPV vaccination. A private clinic in Arkansas with a total of 13 employees were provided HPV vaccination education. A survey was provided to evaluate knowledge on the topic prior to the presentation. An intervention bundle including 9 changes to vaccination procedures was …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Forecasting Issues In Ncaa Division I Fbs Athletics, James T. Morton, Donna L. Pastore

Kinesiology and Health Science Faculty Publications

The National Collegiate Athletic Association (NCAA) and its member institutions have been faced with significant changes in the recent past. This study was used to predict issues, caused by some of these changes, which will impact leaders of NCAA Division I Football Bowl Subdivision (FBS) athletic departments over the next five to seven years. The Delphi technique was employed to obtain expert opinions for the forecast. The expert panel consisted of sport management faculty who were surveyed over three rounds to determine what issues were likely to occur and whether or not those issues would have a significant impact. The …

Nutritional Strategies For Nurses In A Fast Paced Occupation, Zachary Christman

Department of Agronomy and Horticulture: Dissertations, Theses, and Student Research

The foundation of the medical system are the nurses and certified medical assistants. Their personal health condition affects how well diseases and other medical conditions are handled. This article will begin with an overview of the eating behavior of nurses. Three different interventions which have been shown effective in a fast paced workplace are presented in order to improve the health of nurses and certified medical assistants. The first intervention is organizational changes that would increase the amount of time nursing staff have to eat. The second is the use of a messenger bag delivery system to provide needed food, …

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

Increasing Compliance Of Chlorhexidine Wipes To Prevent Hospital-Acquired Infections, Kelly Jean Dunn

Walden Dissertations and Doctoral Studies

AbstractHealthcare-acquired infections (HAIs) are complications of healthcare linked to increased mortality, morbidity, and length of stay. Assiduous surveillance and constant reeducation can decrease HAI incidence and reduce the healthcare burden caused by these events. Evidence has demonstrated that using 2% chlorhexidine wipes instead of bathing with soap and water greatly reduces the bacteria on the skin and prevents infections such as catheter-associated urinary tract infections and central line-associated bloodstream infections. The practice-focused question for this quality assurance doctoral project was to evaluate if an educational intervention improved compliance of chlorhexidine wipe use among ICU nurses with the hope of improving …

Strategies For Implementing The International Organization For Standardization 15189 For Medical Laboratories, Wilson Mtotela

Walden Dissertations and Doctoral Studies

Inadequate quality management systems (QMS) in medical laboratories result in errors, which cost the United States healthcare industry approximately $29 billion per year. Healthcare managers who fail to implement the International Organization for Standardization (ISO) 15189 QMS are at high risk of managing costs. Grounded in Lewin’s 3-step organizational change model and the force field analysis, the purpose of this qualitative multiple case study was to explore strategies healthcare managers use to design, develop, and implement an ISO 15189 QMS using a mentorship approach. The participants comprised 5 healthcare managers from the United Republic of Tanzania, East Africa, who implemented …

The Effect Of Dyad Rounding On Collaboration And Patient Experience, Amy Christensen, Korby Miller, Jason Neff, Rusty A. Moore, Sharee Hirschi, Katreena Collette Merrill

Faculty Publications

Communication among the healthcare team is essential to providing high-quality patient care. In the hospital, nurses care for multiple patients during their shift. Physicians or advanced practice clinicians (APCs) visit hospitalized patients daily to update orders, complete assessments, and contribute to care plans. One method to ensure that healthcare providers communicate effectively is interdisciplinary, or dyad, rounding in the hospital. This consists of purposeful rounding on each patient by the nurse and the physician or APC together to review the patient's status and update the care plan. When healthcare providers and nurses round together, it improves communication, patients are more …

The Relationships Among External Environments, Organizational Structures, And Performance In Pursuit Of The Clinical And Academic Missions At Academic Health Centers, Eric J. Strucko

Theses and Dissertations

Clinical and academic missions place Academic Health Centers (AHCs) at the center of the American health care system, and the future viability of these institutions requires successful performance in competitive environments. AHCs are organizations involving hospitals, physician group practices, and medical schools, and treat patients with complex conditions, conduct bio-medical and health science research, and educate future physicians and health professionals. AHCs account for 20% or $540 billion of national health care expenditures, conduct over 80% of all heart, liver, and lung transplants, utilize over $27 billion in annual sponsored research funding, and graduate approximately 17,300 medical doctors annually. Financial …

Clarifying Workforce Flexibility From A Division Of Labor Perspective: A Mixed Methods Study Of An Emergency Department Team, Sarah Wise, Christine Duffield, Margaret Fry, Michael Roche

Research outputs 2014 to 2021

Background: The need for greater flexibility is often used to justify reforms that redistribute tasks through the workforce. However, "flexibility" is never defined or empirically examined. This study explores the nature of flexibility in a team of emergency doctors, nurse practitioners (NPs), and registered nurses (RNs), with the aim of clarifying the concept of workforce flexibility. Taking a holistic perspective on the team's division of labor, it measures task distribution to establish the extent of multiskilling and role overlap, and explores the behaviors and organizational conditions that drive flexibly.

Methods: The explanatory sequential mixed methods study was set in the …

We Have The Program, What Now? Development Of An Implementation Plan To Bridge The Research-Practice Gap Prevalent In Exercise Oncology, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel A. Spry, Dennis R. Taaffe, Nicolas H. Hart, Michael Davis, Aileen Eiszele, Daniel A. Galvão

Research outputs 2014 to 2021

© 2020 The Author(s). Background: Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate research into practice; however, implementation barriers have limited their success in part because successful translation of exercise oncology research into practice requires context-specific implementation plans. The aim of this study was to employ the implementation mapping protocol to develop an implementation plan to support programming of a co-located exercise clinic and cancer treatment center. Methods: The Implementation Mapping protocol, which consists of five specific iterative tasks, was used. A stakeholder advisory group advised throughout the process. Results: …

Association Of A Multisite Interprofessional Education Initiative With Quality Of Primary Care, Samuel T. Edwards, Elizabeth Hooker, Rebecca Brienza, Bridget O’Brien, Hyunjee Kim, Stuart Gilman, Nancy Harada, Lillian Gelberg, Sarah Shull, Meike Niederhausen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance Studies have shown that interprofessional education (IPE) improves learner proficiencies, but few have measured the association of IPE with patient outcomes, such as clinical quality.

Objective To estimate the association of a multisite IPE initiative with quality of care.

Design, Setting, and Participants This study used difference-in-differences analysis of US Department of Veterans Affairs (VA) electronic health record data from July 1, 2008, to June 30, 2015. Patients cared for by resident clinicians in 5 VA academic primary care clinics that participated in the Centers of Excellence in Primary Care Education (CoEPCE), an initiative designed to promote IPE among …

Evaluation Of The Impact Of An Educational Intervention Aimed At Improving Tuberculosis Infection Control Knowledge Among Health Care Workers In A Military Treatment Facility: A Quality Improvement Project, Allen C. Potter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Florida (FL) is one of the top five states in the nation for Tuberculosis (TB) infections. A majority of new infections can be found in the minority populations which represents 78% of all TB infections in the state. A combination of TB rates in FL, Orlando located 60 miles away and a transient population who frequently deploys worldwide to austere locations may result in an increased risk of acquiring TB. Literature suggests Health Care Providers (HCPs) obtain training regarding TB Infection Control (TB-IC). The Patrick AFB Military Treatment Facility (MTF) lacked a TB Infection Control (TB-IC) plan. Objective: The …

Improving The Implementation And Sustainment Of Evidence-Based Practices In Community Mental Health Organizations: A Study Protocol For A Matched-Pair Cluster Randomized Pilot Study Of The Collaborative Organizational Approach To Selecting And Tailoring Implementation Strategies (Coast-Is), Byron J Powell, Amber D Haley, Sheila V Patel, Lisa Amaya-Jackson, Beverly Glienke, Mellicent Blythe, Rebecca Lengnick-Hall, Stacey Mccrary, Rinad S Beidas, Cara C Lewis, Gregory A Aarons, Kenneth B Wells, Lisa Saldana, Mary M Mckay, Morris Weinberger

2020-Current year OA Pubs

BACKGROUND: Implementing and sustaining evidence-based programs with fidelity may require multiple implementation strategies tailored to address multi-level, context-specific barriers and facilitators. Ideally, selecting and tailoring implementation strategies should be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. There is a need for more rigorous methods for assessing and prioritizing implementation determinants (barriers and facilitators) and linking implementation strategies to determinants. The Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS) is an intervention designed to increase the effectiveness of evidence-based practice implementation and sustainment. COAST-IS …

Work-Life Balance Of Rotational Workers In The Nigerian Energy Sector, Israel Olalekan Jolaolu

Walden Dissertations and Doctoral Studies

Rotational workers in the Nigerian oil and gas industry otherwise referred to as the energy sector, are confronted with challenges and stresses of work-life balance (WLB). Using boundary theory, 15 oil and gas workers with more than 5 years of rotational work experience were recruited to examine the strategies they employed to deal with the stresses and work-life balance required for the social well-being of the workers, which translates to improved job performance in the oil and gas sector in Nigeria. The research question was designed to explore the lived experiences of rotational workers with more than 5 years in …