Digital Commons Network^™

Implementation Of The National Early Warning Score Tool In The Acute Care Setting, Amanda Reyes

Student Scholarly Projects

Practice Problem: The organization arbitrarily called a rapid response or code blue call based on abnormal vital signs or intuition and needed a new process to identify early recognition of patient deterioration.

PICOT: For adult inpatients in an acute care setting in a large healthcare system (P), will implementation of the National Early Warning Score (NEWS) across the organization (I) compared to data from the last fiscal year where NEWS was not used (C) decrease code blue calls (O) within 8-weeks (T)?

Evidence: Eleven high quality studies met the inclusion criteria and found that the NEWS is a validated …

The Impact Of Public Reporting Schemes And Market Competition On Hospital Efficiency, Ahreum Han, Keon Hyung Lee

Health Care Administration Faculty Research

In the wake of growing attempts to assess the validity of public reporting, much research has examined the effectiveness of public reporting regarding cost or quality of care. However, relatively little is known about whether transparency through public reporting significantly influences hospital efficiency despite its emerging expectations for providing value-based care. This study aims to identify the dynamics that transparency brought to the healthcare market regarding hospital technical efficiency, taking the role of competition into account. We compare the two public reporting schemes, All-Payer Claims Database (APCD) and Hospital Compare. Employing Data Envelopment Analysis (DEA) and a cross-sectional time-series Tobit …

Evaluating Quality Of Life And Participant Satisfaction In A Cancer Support Community Yoga Program., Lauren Topp

Doctor of Nursing Practice Papers

Purpose: The purpose of this EBP project was to evaluate program processes and outcomes of an established cancer support community yoga program for persons impacted by cancer and explore the impact of the program on quality of life (QoL) in persons with cancer.

Design: This project was a quality improvement project with a pre-test/post-test design. QoL was explored through the EROTC QLQ C30 questionnaire. Descriptive and explorative methods were conducted through a survey of participants’ satisfaction with the yoga program. Feedback for future improvements around QoL services were provided.

Methods: Members of Gilda’s Club (440 persons) received an …

Leadership Role In Improving Patient Care At Mount Carmel East, Mrudula Maddipatla

Masters Theses/Capstone Projects

My journey to pursue career in healthcare leadership helped me realize how crucial it is to understand the role of a leader in delivering a better care for the patients. To gain that experience, I reached out to the president of Mount Carmel East (MCE) hospital for a practicum opportunity under her staff. I worked with the executive team and other senior leadership team at MCE during my practicum. I participated in Senior Leadership Team strategic meetings, Gemba walks and various colleague engagement activities.

During my time at MCE, I had many valuable learning opportunities from understanding policies and procedures, …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience: Master of Public Health

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …

Systematic Review Of Alternative Interventions For Construction Workers To Manage Work-Related Musculoskeletal Pain And Discomfort, Isaac Abraham Rodriguez

Open Access Theses & Dissertations

Background: The prevalence of Work-Related Musculoskeletal Pain and Discomfort (WRMSPD) among construction workers in 2017 was almost 20,000 injuries. Close to 60% were overexertion, others included lifting and lowering. The most common form of WRMSPD could originate from the upper back to lower back and neck pain. It was reported that the highest prevalence of WRMSPD were in the upper extremities (nearing 60%) because of the physically demanding factor of the job (heavy lifting and repetitive movement). Over 250,000 cases were reported to be WRMSPD in the private sector of the U.S. Purpose: The purpose of this systematic review was …

Reduction Of Inpatient Fall Rate In An Adult Acute Care Setting, Manjusha Maprel

Student Scholarly Projects

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries.

PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 …

Introduction Of A Nursing Evidenced-Based Practice Model To Improve Heart Failure At A Rural Community Hospital, Brandi Fields

Graduate Theses, Dissertations, and Capstones

Abstract

BACKGROUND: This project took place at a community-based rural hospital in eastern Kentucky. During completion of a needs assessment, adoption of an evidence-based nursing practice model and improvement of clinical outcomes of the community’s heart failure patient population were revealed as opportunities.

PURPOSE: The purpose of this project was to introduce the organization’s key stakeholders to the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP), encourage implementation of an evidence-based practice (EBP) committee, and to use heart failure as an exemplar to facilitate discussions and stakeholder education.

METHODS: The goal of this project was to develop a supportive EBP culture …

Gaining Glycemic Control In Patients With Uncontrolled Type 2 Diabetes In Rural Health, Demetric Childs-Hicks

Student Scholarly Projects

Practice Problem: Diabetes is a significant global healthcare problem. The number of individuals diagnosed with Type 2 Diabetes (T2D) is alarmingly high and the numbers are steadily increasing. Because of various barriers, individuals living in rural communities are at greater risk of having uncontrolled T2D.

PICOT: The PICOT question that guided this project was “Will patients with uncontrolled T2D in rural health have better control of their glucose levels when using telephone or web-based monitoring by healthcare providers than patients with uncontrolled T2D in rural health who do not use technology to achieve glycemic control as evidenced by lower pre-prandial …

Use Of A Mindfulness-Based Resiliency Intervention To Reduce Nurse Intention To Quit The Organization, Sherie Ambrose

Student Scholarly Projects

Practice Problem: Nurse turnover is a rapidly growing problem that affects the healthcare industry worldwide. Nursing shortages created by increased turnover have a negative effect on patients and staff and create a financial strain on healthcare organizations.

PICOT: For registered nurses within a select pilot group, does implementation of a mindfulness-based resiliency (MBR) intervention, compared to no intervention, reduce nurse intent to quit over an eight-week period?

Evidence: The positive impact of resiliency on turnover was best described in eight articles and two doctoral papers. Studies using MBR interventions have been shown to improve the coping skills of …

The Impact Of An Evidence-Based Multi-Component Intervention On Colorectal Cancer Screening In Primary Care At A Healthcare System, Ahnnya Slaughter

Student Scholarly Projects

Practice Problem: Colorectal cancer is the second leading cause of cancer death in the United States; many of the deaths are preventable with early detection. Adherence rates for colorectal cancer screening with fecal immunochemical test kits (FIT) was below the national benchmark at this facility.

PICOT: The PICOT question that guided this project was: Among veterans 50 – 75 years old requiring average risk colorectal cancer screening (CRCS) seen in primary care at a veterans affairs healthcare system facility (P), how does the use of a multi-component intervention (I), compared to the usual care (C), affect the number of …

Reducing The Incidence Of Compassion Fatigue In Obstetrical Nurses, Naveen Samuel

Student Scholarly Projects

Practice Problem: Compassion fatigue is a growing problem that can affect 21% to 39% of nurses who work in hospital settings (Berger et al., 2015). Compassion fatigue has been further exacerbated due to the COVID-19 pandemic. Compassion fatigue negatively impacts the nurses in profound physical and emotional ways.

PICOT: The PICOT question that guided this project was: For obstetrical nurses working in a nonprofit organization, what is the effect of a compassion fatigue program, compared with no program, on nurses in reducing compassion fatigue after two months?

Evidence: Current evidence shows that mindfulness decreases compassion fatigue and increases compassion …

Wound Care Management And Documentation Non-Compliance In Prevention And Care Of Wounds, Tobechukwu Unaegbu

Student Scholarly Projects

The incidence of non-compliance and adherence to best practices wound care competence continues to be an issue among the clinical staff of the Veterans Affairs Medical Center (VA). At the VA, there is a practice problem of non-compliance and adherence to best practices wound care competency as evidenced in the electronic medical record (EMR) documentation among the clinical staff. A PICOT question was developed to explore if the establishment of a staff best practices wound care policy focusing on EMR documentation will improve proper wound care management among the clinical staff. The clinical site is a hospital consisting of 40 …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Evaluation Of Nurse Staffing, Engagement And Satisfaction In A South Carolina Rehabilitation Facility: Impact On Patient Outcomes, Eileen Klang

Doctor of Nursing Practice (DNP) Manuscripts

An acute care rehabilitation facility in Horry County, South Carolina was the setting for this program evaluation of nurse staffing, engagement and satisfaction and if those factors had any effect on patient outcomes in the facility. Nursing department staffing, engagement and patient outcome data was evaluated for trends and themes. Through stakeholder meetings, data was collected, a qualitative and quantitative satisfaction survey was administered to nursing staff. Evaluation of the data occurred and revealed multiple factors that led to nursing department turnover between 2018 and 2020. During the increase in turnover, it was noted that patient falls, and catheter associated …

Organizational Mission Impact On Achieving Competitive Advantage In Jordanian Pharmaceutical Sector, Yaser Adwan, Ruba Al-Hamshari

Jerash for Research and Studies Journal مجلة جرش للبحوث والدراسات

The current study examined the impact of organizational mission's components, quality, research and development (R & D), customer satisfaction, and technology, on achieving a competitive advantage as measured by sales volume, market share, and net financial profit. Five public Jordanian pharmaceutical companies in Amman city were randomly selected from a population of eighteen pharmaceutical industrial companies. Out of two-hundred and fifty surveyed, one hundred and sixty-eight respondents were received with a rate of 67% responses. Different statistical procedures were conducted including analysis of variance and stepwise regression, among others. The results suggested that there was a statistically positive significant impact …

Re-Educating Healthcare Workers In Long-Term Care Facilities To Improve Hand Hygiene Compliance, Jennifer A. Ukeje

Doctor of Nursing Practice Projects

Hand hygiene is one of the most significant measures for protecting nursing home residents from healthcare-associated infections (HAIs). An estimated 1.6 million to 3.8 million infections occur each year; of these infections, 32% of all healthcare-associated infections (HAIs) are urinary tract infections (UTI), 15% are pneumonia (lung infection), and 14% are bloodstream infections. The high incidence of HAIs in nursing homes is due to multiple factors such as understaffing, inadequately trained staff, staff to resident ratio, lack of antibiotics stewardship, and the increasing clinical complexity of the average nursing home. In addition, most long- term care (LTC) residents are older …

Fall Prevention: The First Line Of Defense. Integration Of Innovated Strategies To Decrease Falls For The Hospitalized Patient, Milledge Smalls

Doctor of Nursing Practice Projects

Background: Falling is defined as an accidental encounter with the ground or other surfaces. Individuals with dementia are at a greater risk for falls due to conditions such as neurological impairments in perception or cognition. Presently, 50 million people live with dementia worldwide, which is projected to increase to 152 million by 2050 because of a rise in life expectancy and an aging population. The incidence of falls has rapidly become a major public health problem around the world. Approximately 30% of people older than 65 years of age fall each year, and patients with dementia cost the nation $236 …

The Nature And Role Of Perceived Threats In User Resistance To Healthcare Information Technology: A Psychological Reactance Theory Perspective, Madison N. Ngafeeson, Joseph A. Manga

Information Systems Faculty Publications

The efforts of the United States government in the past 15 years have included harnessing the power of health information technology (HIT) to improve legibility, lessen medical errors, keep costs low, and elevate the quality of healthcare. However, user resistance is still a barrier to overcome in order to achieve desired outcomes. Understanding the nature of resistance is key to successfully increasing the adoption of HIT systems. Previous research has showed that perceived threats are a significant antecedent of user resistance; however, its nature and role have remained vastly unexplored. This study uses the psychological reactance theory to explain both …

Site Supervisors' Perspectives On Supervision Of Counselor Trainees In Integrated Behavioral Health (Ibh) Settings: A Q Methodology Approach, Yeşim Giresunlu

Counseling & Human Services Theses & Dissertations

Integrated Behavioral Health (IBH) is an integrated care approach where primary care and mental health providers work together to address the medical and behavioral health needs of the patients, or clients (Unützer et al., 2012). An increasing number of clinical mental health counselors are providing services in IBH settings and experiencing challenges with navigating unique aspects of their work in these complex systems. Clinical supervision in these settings appears as a critical resource for mental health counselor trainees (supervisees). However, we have very limited knowledge on clinical supervision provided to supervisees at IBH settings. An exploration of site supervisors’ supervision …

National Health Insurance Program In Nepal: Early Experiences And Its Effect On Health Service Utilization, Rajani Bharati

Dissertations and Theses

Introduction: Nepal initiated the Health Insurance program in 2016 to achieve Universal Health Coverage by 2030. However, the enrollment rate is low, and people are already starting to drop out. Therefore, this study aimed to explore the demand and supply side (service providers) experiences with Nepal's National Health Insurance Program and its effect on insurance enrollment and health service utilization.

Methods: We employed a mixed-method design. Ethnographic methods were used to explore the rich holistic insights into people's views and actions. We conducted 14 focus group discussions and 20 key informant interviews, mainly in Kailali and Baglung districts. …

Leader Development Of The Health Information Management (Him) Professional, Theresa Jones

Dissertations

This study contributes to the body of knowledge in leader development by examining how higher education programs in a female dominated profession assist learners in developing person-related characteristics that support leader development. A ten-part online survey was sent to directors of health information management (HIM) programs accredited by the Commission on Accreditation for Health Informatics and Information Management (CAHIIM). Results suggest an opportunity for improvement in the curriculum for development of person-related characteristics critical for leadership positions. In the interest of the progression of women these results should be taken into consideration.

From Managing Nurses To Serving Nurses: The Case For Transfusing Nursing Management With Servant Leadership During The Global Covid-19 Pandemic, William P. Jimenez, Seterra D. Burleson, Matthew J. Haugh

Psychology Faculty Publications

No abstract provided.

Standardized Outreach: Increasing Vaccine Uptake In The Latinx Community Through A Standardized Phone Call Process, Vanesa Vazquez

Master's Projects and Capstones

Vaccine hesitancy during the COVID-19 pandemic has been an issue in several minority communities since the initial discussions of the emergency use of the experimental Moderna and Pfizer vaccines (Increased risk, 2020). The aim of this project is to standardize the patient outreach process to increase COVID-19 vaccine uptake, particularly in the Latinx community. Patients at a community clinic in Oakland, California have made apparent their distrust of the healthcare system and their disbelief in the positive outcomes of the COVID-19 vaccine. Most of these patients are Latinx-identifying and are considered more at risk for development of COVID-19 in …

Code Blue: Do You Know What To Do? Increasing Nurse Confidence And Readiness Through In-Situ Mock Code Simulation, Katelyn Nusser

Master's Projects and Capstones

An underprepared nurse is the most dangerous threat to patient survival in the intense and frightening environment of a code blue situation. With basic life support certification required on merely a biannual basis, it cannot be expected that nurses maintain the skills and knowledge without routine application. This quality improvement project proposed the following PICOT question: for medical-surgical nurses, how does in-situ mock code blue training between BLS recertification periods affect nurse readiness and confidence in a code blue situation? Mock code simulations were conducted over a three-week period with an emphasis on hands-on practice as well as teamwork and …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Museums & Community Resilience: Improving Post-Crisis Outreach In Latinx Communities By Combining Library And Museum Practices, Sua Lorena Mendez

Seton Hall University Dissertations and Theses (ETDs)

Museums are held in the public trust and are accountable to their communities, including minority groups such as the Latinx population. Despite this, museums struggle to engage with Latinx communities, who are particularly affected during and after a crisis or emergency. Currently, museums do not have professional guidelines on supporting community resilience, or a community’s ability to respond to and recover from a crisis. In contrast, libraries, which function as similar community organizations, have field-wide community resilience plans and professional librarians have actively researched how libraries can assist their communities after a significant crisis. Using a multi-case library and museum …

Evidence-Based Recommendations For Assistive Technologies For Safety In Dementia Care, Lee A. Diener

Masters Projects

A Quality Improvement (QI) project in a Midwestern Continuing Care Residential Community (CCRC) was designed to examine the evidence-base of four assistive technology platforms marketed as safety platforms as means to improve outcomes for older adults residing in memory care environments. Using the Evidence-Based Design Model Socio-Technical Systems Theory, survey data and observational data collected from the organization were considered with respect to the evidence-base supporting each technology. Ten organizational priorities derived from collected data were used to develop an Evidence-Based Assistive Technology Fitness score for each of the AT platforms reviewed. This methodology provides a means to evaluate planning …

Implementing An Evidence-Based Multifactorial, Multidisciplinary Fall Prevention Program In A Nursing And Rehabilitation Center To Reduce Fall Rates Among Patients, Tincy Poovathur

Doctor of Nursing Practice Projects

Falls are the leading cause of morbidity and mortality in the elderly in the United States. Patients in long-term care facilities are at increased risk for falls, accounting for 20 percent of fatal falls that require hospitalization. The economic and social burden of falls and fall-related injuries is significant. Fall-related injuries and their resulting expenditures are expected to increase substantially with the increasing aging population making this a problem of high priority. The literature recommends and supports incorporating evidence-based fall prevention initiatives into long-term care facility safety programs to address this problem. Based on the literature review and the facility's …

Subepidermal Moisture Measures And Their Relationship To Early Identification Of Pressure Injuries In Both Dark And Light Skin Tones In The Acute Care Setting, Cecilia Zamarripa

Electronic Theses and Dissertations

Background: Pressure injuries are an important quality measure. Most are avoidable and can be prevented by implementing nursing care strategies early. Pressure injury prevention is significant to nursing practice. There is a gap in the ability to detect early skin damage through standard visual skin assessment in dark skin toned individuals. Subepidermal moisture (SEM) values have been shown to detect early tissue damage in people with dark skin, prior to it being detected through standard visual skin assessment.

Objectives: This study sought to explore the relationship between visual skin assessment and SEM as indicators of pressure injury and …