Digital Commons Network^™

Behavioral Code Team, Daniel Mcgrath

Student Scholarly Projects

Practice Problem: The organization lacked an evidence-based intervention for behavioral emergencies within the inpatient acute care setting, leading to increased mechanical restraints. A security-driven paradigm was the organization's primary tool for addressing behavioral crises and lacked a more patient-centered treatment and support paradigm.

PICOT: The PICOT question that guided this project was In the Veteran patient population admitted to acute inpatient services (P), how does having a behavioral code team respond to behavioral emergencies (I) compared to the current practice (C) affect the prevalence of mechanical restraint usage (O) within an eight week period (T).

Evidence: Seven …

A Multi-Stage Process To Develop Quality Indicators For Community-Based Palliative Care Using Interrai Data, Dawn M. Guthrie, Nicole Williams, Cheryl Beach, Emma Buzath, Joachim Cohen, Anna Declercq, Kathryn Fisher, Brant E. Fries, Donna Goodridge, Kirsten Hermans, John P. Hirdes, Hsien Seow, Maria Silveira, Aynharan Sinnarajah, Susan Stevens, Peter Tanuseputro, Deanne Taylor, Christina Vadeboncoeur, Tracy Lyn Wityk Martin

Health Sciences Faculty Publications

Background: Individuals receiving palliative care (PC) are generally thought to prefer to receive care and die in their homes, yet little research has assessed the quality of home- and community-based PC. This project developed a set of valid and reliable quality indicators (QIs) that can be generated using data that are already gathered with interRAI assessments-an internationally validated set of tools commonly used in North America for home care clients. The QIs can serve as decision-support measures to assist providers and decision makers in delivering optimal care to individuals and their families.

Methods: The development efforts took part in multiple …

An Evidence-Based Practice Handbook For The Reduction Of Perioperative Pressure Injuries: An Implementation Guide, Krystal Dopson

Student Scholarly Projects

The Association of Perioperative Nurses (AORN) Prevention of Perioperative Pressure Injury Tool Kit is a comprehensive set of evidence-based practices that can reduce the development of pressure injuries (PI) (AORN, 2022). A bundled set of prevention strategies is positively associated with reducing the development of injury or ulceration and improved patient outcomes. To effectively implement this Prevention of Perioperative Pressure Injury Tool Kit, there are evidenced strategic practices to support change readiness, including engaging stakeholders around the reasons for the change, gaining leadership support, assembling an interprofessional implementation team, providing compelling information that highlights the need for the change, and …

Implementing A New Emergency Department: A Qualitative Study Of Health Professionals' Change Responses And Perceptions, Nina Thórný Stefánsdóttir, Per Nilsen, Mette Bendtz Lindstroem, Ove Andersen, Byron J Powell, Tine Tjørnhøj-Thomsen, Jeanette Wassar Kirk

2020-Current year OA Pubs

BACKGROUND: The aim of the study is two-fold. It explores how managers and key employees at the Emergency Department (ED) and specialist departments in a university hospital in the Capital Region of Denmark respond to the planned change to a new ED, and how they perceive the change involved in the implementation of the new ED. The study investigates what happens when health professionals are confronted with implementation of policy that changes their organization and everyday work lives. Few studies provide in-depth investigations of health professionals' reactions to the implementation of new EDs, and particularly how they influence the implementation …

Discharge Care Bundle To Reduce Copd 30-Day Readmission Rates In A Hospital Acute Care Unit, Dao Vang

Student Scholarly Projects

Practice Problem: Chronic obstructive pulmonary disease (COPD) readmissions severely impact patients’ health, mortality, and quality of life and increase unnecessary healthcare use and spending. Utilization of a protocol and discharge care bundle to reduce the readmission rate for COPD patients is critical to combat the problem.

PICOT: The PICOT question that guided this project was in adult patients 65 years or older admitted to a hospital acute care unit for acute exacerbation of COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) reduce the 30-day hospital COPD readmission rate …

Improving Access And Delivery Of Mental Health Care To Veterans Through A Care Coordination Pilot At A Texas Department Of Veterans Affairs Hospital, Jacqueline Buval

Doctor of Nursing Practice Projects

Background: Mental health (MH) disorders are among the leading cause of disabilities in adults, with an even greater prevalence among Veterans who served in combat. Forty percent of troops returning from combat zones report suffering from post-traumatic stress disorder (PTSD) or depression and 33% report trouble accessing MH care. Access to care is directly influenced by care coordination procedures in health care systems. If care coordination is poor or lacking, patients remain in settings that are inappropriate for their level of care. Implementing a care coordination program can improve care transitions, provide the necessary support for patients to successfully …

Utilizing Motivational Interviewing Intervention To Improve Compliance With Self-Care Among Hispanic Adults With Obesity, Type 2 Diabetes Mellitus, And Hypertension, Mariagorety O. Nwiloh

Cohort X

Obesity, hypertension, and type 2 diabetes mellitus (type 2 DM) have continued to plague the healthcare system and the economy of the United States of America. They are most common among African Americans and Hispanic Americans. The objective of this quality improvement project was to improve compliance to self-care regarding self-monitoring of blood glucose, blood pressure, and exercise to achieve target fasting blood glucose (FBG) ≤ 120 mg/dL, blood pressure (BP) ≤ 130/80mm Hg and a weight loss of ≥5 pounds among adult Hispanics aged 18- 65 years old. A weekly motivational interviewing (MI) session was conducted for 6 weeks …

Reducing Central Line-Associated Bloodstream Infections At A Rural Midwestern Hospital Through An Evidence-Based Nurse-Led Practice Change Intervention, Crystal B. Lavalley

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) are responsible for increased patient morbidity, mortality, and healthcare costs, despite being a preventable harm (Barnes et al., 2015; Furuya et al., 2016). Evidence-based (EB) research suggests that the use of central line bundles is the most effective way to reduce CLABSIs in hospitals (Barnes et al., 2015; Furuya et al., 2016). Researchers have also found a statistically significant correlation between nurse compliance with bundle components and CLABSI rates (Aloush & Alsaraireh, 2018; Furuya et al., 2016). The purpose of this study was to determine if a nurse-led collaborative that focused on CLABSI reduction using …

Implementation Of A Zone Of Silence During Administration Of Breastmilk To Decrease Nurses’ Distractions In A Neonatal Intensive Care Unit: Quality Improvement Project, Lauren Crociata

DNP Projects

Introduction: In the NICU, breastmilk is handled and administered as safely and carefully as a medication. Administration errors occur when incorrect breastmilk is administered to the wrong patient. This can lead to the transmission of infectious disease and create the loss of trust between families and the healthcare team during a neonate’s NICU stay. Nurses are often faced with interruptions and distractions during administration, and evidence shows that interventions to reduce nurses’ distractions lead to reduction of administration errors in inpatient settings. This quality improvement project took place in a level III NICU. It implemented an evidence-based zone of silence …

Evaluating Telehealth As A Means Of Communicating With Living Donors And Its Effect On Quality Of Care, Ashley Anne Hamby Rn Msn

Doctor of Nursing Practice Projects

Background: Despite the advantages of living donor kidney transplantation (LDKT), there are barriers that potential donors face that make living donation less appealing. Research supports the use of telehealth as an effective method of enhancing access to care and building efficiencies.

Aims/Objectives: To evaluate access to care, effectiveness, financial impact, and experience after implementing telehealth as a means of communicating with living donors.

Methods: Utilizing a pretest-posttest design, an analysis was performed among medically cleared donors evaluated in-person between January 1, 2019 to December 31, 2019 (Control Group; N=64) and donors evaluated via telehealth (Zoom®) between January 1, 2021 to …

Evaluation, Validation & Implementation Of A Computerized Diagnostic Decision Support System In Primary Practice, Joe Bridges

Translational Projects (Open Access)

Background: Medical diagnosis may be the most complex task attempted by humans. Studies estimate that 95% of diagnoses in outpatient care are accurate, implying that the annual rate of inaccurate diagnoses is 12 million in the US alone, with the potential for patient harm in about half. A well-researched differential might reduce inaccurate diagnoses by offering alternatives matching the patient’s symptoms. This study searched the literature for articles evaluating the diagnostic performance of commercially available computerized diagnostic decision support systems. This search led to selecting Isabel Pro, developed by Isabel Healthcare, Ltd. of Haslemere, UK.

Evaluation and Validation: …

Standardizing Naturalistic Teaching Opportunities For Problem-Based Learning In Diabetes Education: A Quality Improvement Project, Austin Mccaslin

DNP Projects

Significance and Background:

Poor diabetes management is linked to serious long and short-term health complications. Despite this, medication adherence is a significant problem in adolescents with type 1 diabetes. Management is further complicated by low socioeconomic status, even when mitigated by free healthcare, highlighting health literacy as a culprit of disparities. Evidence shows that a common barrier for adolescents is proficiency in dose determination. Carbohydrate counting is an integral skill, necessary for attaining glycemic control. At a homecare agency serving adolescents with poorly controlled diabetes by providing oversight of medication administration and education, it was noted that patients continued to …

A Telehealth Blood Pressure Education Program On Hypertension Knowledge, Selfcare, And Behavior, Cheynnie N. Burnett Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypertension poses a significant risk for morbidity and mortality. Regular blood pressure monitoring, medication compliance, and/or lifestyle modifications have shown to improve control. Digital communication in healthcare, such as telemedicine provides patients and primary care offices an opportunity to improve access to care and education.

Objectives: This Quality Improvement (QI) Project aimed to answer the question: In adult patients with a diagnosis of hypertension, what is the effectiveness of implementing an evidence- based telehealth blood pressure management program in a primary health care setting, when compared to baseline, on blood pressure knowledge, management, and self-care over a nine- week …

Organizational Change And Applicability Of Six Sigma Management Modelin The Turkish National Soccer Team, Halil Orbay Cobanoglu, Mustafa Serdar Terekli, Necmi Gursaka, Necip Serdar Sever

Baltic Journal of Health and Physical Activity

Background: ‪In recent years, the Six Sigma Methodology has been primarily applied to the enhancement of performance. The purpose of this study was to implement Six Sigma Management Models in the Turkish National Soccer Team. Material and methods: ‪24 matches of the Turkish National Soccer Team constituted the sample of research. The DMAIC method was used in this study. For statistical analysis of research data, IBM SPSS 18.0 for Windows and Minitab 17 statistical software program were used. As statistical techniques, brainstorm, fishbone, chi-square correlation analysis, Spearman correlation test, process capability analysis and control charts were used, which were the …

Development Of An Evidence-Based Compendium Of Institutional Graduate Medical Education Leadership Competencies (Gmelcs), Margaret Hadinger, Edd Ms, Brigham C. Willis, Jacqueline E. Levesque, Kathryn M. Andolsek, Sharon Hall, Karen Broquet

Department of Education

No abstract provided.

Reducing Catheter-Associated Urinary Tract Infections: Beyond The Bundle, Deana Cirillo

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) are preventable but are still the most common healthcare-associated infection (HAI) worldwide, encumbering the health of patients and escalating financial burden on society (CDC, 2021; Shadle, 2021).

PICOT: In adult patients with spinal cord injury, does direct observation of urinary catheter insertion, compared to the standard of care, reduce the rate of catheter-associated urinary tract infections, within ten weeks of implementation?

Evidence: Multiple factors contribute to Healthcare-Associated Infections (HAIs), but hand hygiene is the most important prevention measure to decrease contact transmission (Gould et al., 2017). The Centers for Disease Control (CDC) clinical …

Gender Inequalities In Polish And International Sports Organisations, Zbigniew Dziubinski, Natalia Organista

Baltic Journal of Health and Physical Activity

Background: The aim of this article is to check whether gender inequalities occur in Polish sports organisations and what the scale of those inequalities is in comparison to international organisations. Other aims relate to verification whether there exists a policy to align these inequalities: provisions prohibiting discrimination due to gender, rules and regulations providing women with a specified number of seats in the crucial positions of the organisation and activity of women’s sports committees. Material/Methods: The study used methods characteristic of sociology, especially methods of examining official documents: on the one hand, information generated by other empirical data from official …

Still Unnoticed. Women In Polish Sports Associations. Content Analysis Of Polish, International, And British Formal Rules Of Sports Organizations, Natalia Organista

Baltic Journal of Health and Physical Activity

From a critical paradigm point of view sport has been a sexist institution. Despite the women empowerment in sport they are still trivialized and marginalized. Research also shows that sport organizations may be exceptionally opposed to women, valuing hegemonic masculinity. Therefore, the aim of this article is to check whether gender inequalities occur in Polish sports organizations and what the scale of those inequalities is in comparison to international and British organizations. Content analysis was used to examine official documents of organizations. The sample consists of seventeen Polish, international and British sports organizations. The content analysis indicates that international and …

Nurse-Driven Protocols For Abdominal Pain In The Emergency Department, Chris Schmidt

Student Scholarly Projects

Practice Problem: Emergency department (ED) crowding hinders the opportunity to deliver safe, quality care to abdominal pain patients and detrimentally affects clinical outcomes. Leadership of a rural community ED recognized a comparable issue by introducing a nurse-driven protocol (NDP) to reduce patient length of stay (LOS) and the rate of patients who leave the department prior to physician evaluation.

PICOT: The PICOT question that guided this project was: For adult patients in an emergency department, how does a nurse-driven protocol for abdominal pain compared to no protocol use affect the LOS and left without being seen (LWBS) rate over 10 …

Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

Evaluation Of The Clarity, Usefulness And Willingness To Adopt A Joint Military Nursing Professional Practice Model By Military Nurse Leaders, Lozay Foots Iii

Graduate Theses, Dissertations, and Capstones

Abstract

The goal of this project was to evaluate the clarity, usefulness and willingness to adopt a Joint Military Nursing Professional Practice Model by military nurse leaders into the military health system. This paper specifically examined leader feedback and perceptions prior to implementation of the Joint Professional Practice Model (JPPM) into designated pilot sites within the Military Health System (MHS) Nursing environment. This project includes Chief Nursing Officer (CNO) discussions reflecting the clarity of definition of model components, usefulness of the model and its components, and willingness to adopt the JPPM. This information will be used to modify the new …

“This Isn’T Just Busy, This Is Scary”: Stress, Social Support, And Coping Experiences Of Frontline Nurses During The Covid-19 Pandemic, Erin S. Craw, Tess M. Buckley, Michelle Miller-Day

Communication Faculty Articles and Research

Despite having previous experience and extensive trauma training, the COVID-19 pandemic presented unprecedented challenges for nurses working in hospital settings. During the pandemic, nurses struggle to care for patients and protect themselves from infection, while navigating ongoing organizational changes. Guided by prior literature on social support and coping, this study explores nurses’ experiences of coping with stress while treating COVID-19 patients during the pandemic. In-depth semi-structured interviews were conducted with 14 active staff nurses working in hospitals and one licensed practical nurse (LPN) at a rehabilitation center who treated COVID-19 patients during the pandemic. An inductive thematic analysis was employed …

The Influence Of The Organization Structure Changes On Management And Sports Results In The Lech Poznan Sports Club Between 2011 And 2014, Lukasz Karski

Baltic Journal of Health and Physical Activity

Background: The increase in the competitiveness on the sports market forces elaboration of the proper organization structure in sports clubs. In 2011 Lech Poznan Club found itself in a situation which was inadequate to its ambition. The aim of this work is to present the influence of the implemented organization structure changes on the process of club management. Material and methods: The subject of the research was the Lech Poznan club and its organization structure between 2011 and 2014. The applied research methods were the interview and the survey questionnaire. Results: The introduction and the strategy realization, as well as …

Performing Innovative Business Activity In Sport In The Polish Regulatory System, Szymon Gajda

Baltic Journal of Health and Physical Activity

Innovation is widely recognized as necessary feature of progress in various areas of economy. It has also been supported by the EU and its Member States, including Poland. However, in the sport industry it has been visibly less exploited so far to achieve a market value. Literature quoted, hard and soft law documents legal analysis was performed. Although there are many existing examples of innovation provided by sport entrepreneurs, the regulatory system, by unclear regulations related to the most profitable kinds of innovation in sport, does not provide them equal stimulus as in other trade sectors. This study shows lack …

Nurse Practitioner Role Perception, Job Satisfaction, And Anticipated Turnover In The Middle Atlantic States, Jenna R. Sabatino

Seton Hall University Dissertations and Theses (ETDs)

Background: The need for nurse practitioners (NPs) in the US has become very evident in recent years. However, the established significance of NPs in the healthcare system does not ensure that NPs are satisfied with their role. To date, no studies have examined NP job satisfaction in the Middle Atlantic States (MAS), which includes New York, New Jersey, and Pennsylvania. Only one study, thus far, has looked at NP role perception from the NPs own perspective, and was completed in the Midwest region of the US. Similarly, no studies have examined NP anticipated turnover the Mid-Atlantic region of the US. …

The Transformational Leader In Nursing Practice – An Approach To Retain Nursing Staff, Anita C. Reinhardt, Teresa G. Leon, Linda Ochart Summers

Administrative Issues Journal

Transformational leaders have been shown to influence positive work environments and support the retention of nursing staff. While exemplars have been found in upper-level management, the implementation of these characteristics in unit-based leaders is less explained. The elements of the transformational leader on followers and the organization—individual consideration, individual stimulation, inspirational motivation, and idealized influence—can engage nursing staff to remain in an organization which will promote positive patient outcomes. This article will review the elements of the transformational leader and share two exemplars of the transformational metanarrative as demonstrated in nursing care units. Both exemplars demonstrate how the transformational leader …

The Impact Of Disruptive Physician Behavior On Support Staff And Patients: A Quantitative Secondary Analysis, Michael C. Marino

Electronic Theses and Dissertations

In this quantitative secondary analysis, the purpose was to examine the nature of disruptive physician behavior (DPB) from the support staff and patient perspectives. Healthcare staffing shortages existed prior to the global pandemic and have increased, creating importance for employee retention and recruitment. I wanted to understand the impact of physician behavior on staff turnover rates in a private oncology practice, its effect on patient satisfaction rates, and to compare these rates of physicians that display DPB with physicians that do not display this behavior in a private hematology oncology community outpatient setting in the Southwest United States. To answer …

Commentary On “Burnout And The Sexual Assault Nurse Examiner: Who Is Experiencing Burnout And Why?”, Jacqueline Callari Robinson, Jeneile Luebke, Sarah J. Hoffman, Kaylen M. Moore, Peninnah M. Kako, Lucy Mkandawire-Valhmu

College of Nursing Faculty Research and Publications

In the paper Burnout and the Sexual Assault Nurse Examiner: Who is Experiencing Burnout and Why? in this edition of the Journal of Emergency Nursing (JEN), Zelman et al examine the frequency of burnout and its accompanying features among sexual assault nurse examiners (SANEs) in North Carolina using the Maslach Burnout Inventory scale. The authors’ cross-sectional study provides the field of forensic nursing with essential knowledge and contextual understanding of burnout among SANEs working within forensic programs and those working in emergency departments of varying sizes, including some located in rural areas. The knowledge garnered from this study is also …

Applying Evidence-Based Intervention (Ebi) Mapping To Identify The Components And Logic Of Colorectal Cancer Screening Interventions, Jacob Szeszulski, Derek W Craig, Timothy J Walker, Maya Foster, Patricia Dolan Mullen, Maria E Fernandez

Faculty, Staff and Student Publications

Implementation of evidence-based interventions (EBIs) can help to increase colorectal cancer screening (CRCS). Potential users of CRCS EBIs are often unclear about the specific features, logic, and core elements of existing EBIs, making it challenging to use or adapt them. We used EBI Mapping, a systematic process developed from Intervention Mapping that identifies an EBI's components and logic, to characterize existing CRCS EBIs from the National Cancer Institute's Evidence-Based Cancer Control Programs website. The resulting information can facilitate intervention adoption, adaptation, and/or implementation. Two trained coders independently coded intervention materials to describe intervention components and logic (n = 20). We …

An Occupation-Based Clinic Makeover: Perceptions And Experiences Of Occupational Therapists, Wendy B. Stav, Alison Herman

The Open Journal of Occupational Therapy

Background: Researchers sought to discover the experiences of occupational therapists transitioning from existing clinical practice to exclusively occupation-based approaches.

Method: This phenomenological study captured the experiences of clinicians as exercise-based equipment was temporarily removed from the rehabilitation gym and replaced with occupation-based kits. The therapists used the new occupation-based materials with all clients for 4 months and participated in interviews and a focus group.

Results: The study yielded a greater understanding therapists’ process and experiences through the themes: (a) challenges to occupation-based practice and (b) occupation-based metamorphosis.

Conclusions: The personal and contextual obstacles associated with implementing …