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Articles 1 - 30 of 550
Full-Text Articles in Entire DC Network
Transitional Care To Reduce 30-Day Heart Failure Readmissions Among The Long-Term Care Elderly Population, Shantha Franks
Transitional Care To Reduce 30-Day Heart Failure Readmissions Among The Long-Term Care Elderly Population, Shantha Franks
Seton Hall University DNP Final Projects
Throughout the nation, there is an increased focus on reducing preventable hospital readmissions. This initiative started with the Patient Protection and Affordable Care Act (PPACA) (CMS, 2014), which sets forth certain provisions for Medicare spending. Hospitals with higher than usual readmission rates, especially in terms of preventable readmissions, are receiving reductions in Medicare reimbursements (Stone & Hoffman, 2010, CMS, 2014). Congestive Heart Failure (CHF) or Heart Failure (HF) is recognized as a primary cause of 30-day hospital readmissions. Causes of HF readmission include inadequate patient education and planning for discharge, inappropriate medication reconciliation, and poor or inadequate follow-up in the …
Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas
Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas
Seton Hall University DNP Final Projects
Purpose: The purpose of this project was to implement a Wellness program to address the health disparities in a vulnerable population. The population targeted was a local population that was served at a mental health facility for socioeconomically disadvantaged. The program focused on improving knowledge of cardiovascular health, empowerment and communication skills. Significance: The significance of the project is the improvement in ones wellness by provision of education, empowerment and communication skills. The attaining of these skills can translate into other areas of wellness and improved health outcomes. Populations at risk due to socioeconomic and racial differences can …
Initiating A Bystander Awareness Program At A State University, Kristine B. Sparks
Initiating A Bystander Awareness Program At A State University, Kristine B. Sparks
Seton Hall University DNP Final Projects
Crime in schools, colleges and universities is a troublesome social problem. It affects not only those involved in the criminal incident, but it also inhibits societal growth and stability. To address this issue, the Campus Sexual Violence Elimination Act (SaVE Act) of 2013 requires that colleges participating in federal student aid programs must provide “primary prevention and awareness programs” for new students and employees, as well as ongoing crime prevention and awareness campaigns. Implementation was mandated to be started by October 1, 2014. Most prevention programs teach students how to avoid situations, abusive behaviors and potential attacks. This project initiates …
Improving Patient Care Outcomes To Reduce Recurrent Admissions Of Patients With Chronic Obstructive Pulmonary Disease, Lisa Maria Friedrich
Improving Patient Care Outcomes To Reduce Recurrent Admissions Of Patients With Chronic Obstructive Pulmonary Disease, Lisa Maria Friedrich
Seton Hall University DNP Final Projects
Purpose:Transitional care is time-limited, with the goal of ensuring safety and health continuity for at-risk patients with chronic obstructive pulmonary disease (COPD) as they move from one setting to the next. An acute care episode of COPD ranges from relatively healthy adults to adults with multiple chronic conditions or those in the end-of-life phase. The primary quality concern of an urgent need to improve health care is in response to the gaps of sufficient experience to manage patients with COPD, leading to hospital readmissions. Implementation of standards of care for the improvement of health-related quality of life (HRQL) of COPD …
Early Prevention Of Pressure Ulcers In The Emergency Department, Marie Fagan
Early Prevention Of Pressure Ulcers In The Emergency Department, Marie Fagan
Seton Hall University DNP Final Projects
Purpose: Pressure ulcers characterize a major health problem in clinical practice, which in turn, can have an impact on quality of life and health care costs (Dugaret, Videau, Faure, Gabinski, Bourdel-Marchasson & Salles, 2012). Pressure ulcers can develop during treatment regardless of the setting. They develop in long term facilities, family homes and hospitals. The purpose of this DNP project was to ensure patient health and safety by educating the primary emergency room nurses to at-risk individuals presenting to the Emergency Department and to initiate early intervention strategies. Significance of the Project: Until recently, there has been very little literature …
Improving Patient Safety Through Accurate Medication Reconciliation, Dominique Watt
Improving Patient Safety Through Accurate Medication Reconciliation, Dominique Watt
Master's Projects and Capstones
Medication errors due to incorrect medication reconciliation are a very present and serious problem in our microsystem. As an preop/postop outpatient unit, we see an average of 50 patients daily and perform medication reconciliations regularly. The problem is our nurses perform this task inconsistently and often incomplete, leading us to potential medication errors. During my CNL project, I worked with a committee of staff champions and developed a standard work guide for nurses to use in order to effective reconcile patient medications. We used fishbone diagrams, audit tools, surveys and led regular discussions in our huddles in order to develop …
Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter
Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter
Doctor of Nursing Practice (DNP) Projects
Abstract
A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …
Impetus To Transform: Essential Nursing Leadership Development Through Simulation, Mary J. Mette
Impetus To Transform: Essential Nursing Leadership Development Through Simulation, Mary J. Mette
Doctor of Nursing Practice (DNP) Projects
Abstract
A nurse manager’s ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting, as well as the culture present in the organization as a whole. The aim of this Doctor of Nursing evidence-based change in practice project was to create an educational modality that supported training nurse leaders through innovation and creative problem solving in today’s acute healthcare setting.
A survey was administered to 48 frontline managers in a Northern California healthcare system to access the gaps and voids in their ability to integrate …
Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata
Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata
Doctor of Nursing Practice (DNP) Projects
The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …
Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris
Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris
Doctor of Nursing Practice (DNP) Projects
Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …
Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez
Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez
Doctor of Nursing Practice (DNP) Projects
Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …
Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn
Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn
Doctor of Nursing Practice (DNP) Projects
Health care is a complex business currently undergoing extensive reform. These changes require new methods of care deliver and ways in which health care organizations are operating. At the forefront of this change effort is the 2010 Patient Protection and Affordable Care Act, which is transforming health care from a volume-based, fee-for-service process to the delivery of services that have value, improve quality outcomes, increase satisfaction, elicit greater efficiency, demonstrate improved safety outcomes, show cost-effectiveness, promote better access to services, and result in high reliability between providers and organizations. The goal of providing a more positive health care experience is …
Alarm Management: Electrocardiographic Lead Management, Dale Elaine Dominguez Ms.
Alarm Management: Electrocardiographic Lead Management, Dale Elaine Dominguez Ms.
Master's Projects and Capstones
Abstract
Alarm Management: Electrocardiographic Lead Management
Quality improvement and safety that incorporates the Clinical Nurse Leader (CNL) competency of putting in place quality improvements plans that are bases on evidence, analysis, and risk anticipation is the thesis for this project. The associated problem is the myriads of electrocardiographic (ECG) alarms that alert staff to patient issues each day. Of those alerts, 88% to 90% are false or do not require immediate attention (Sendelbach & Jepsen, 2013). The high numbers of false alerts cause staff to become desensitized to the sound. This desensitization may cause staff not to respond to a …
Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias
Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias
Master's Projects and Capstones
Purpose: The aim of the study was to identify barriers encountered by registered nurses (RNs) and nursing assistants (NAs) that prevent purposeful (hourly) rounding.
Background: The literature has shown that purposeful rounding improves patient outcomes and safety. However, few studies show the barriers encountered by nursing staff that hinder the purposeful rounding process.
Methods: A pre-post test design was implemented on a 25-bed oncology, urology medical surgical unit with a staff of 38 RNs, 9 NAs, and 4 Unit Secretaries (US). A pre-implementation needs assessment survey was completed by 55% (21/38) of RNs, 33% (3/9) of NAs, and 100% (4/4) …
Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard
Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard
Doctor of Nursing Practice (DNP) Projects
The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …
Caution: Line-Of-Sight In Icu Designs, Diane C. Bartos
Caution: Line-Of-Sight In Icu Designs, Diane C. Bartos
Doctor of Nursing Practice (DNP) Projects
It has been estimated that by the end of 2015, the U.S. will spend approximately $200 billion in new healthcare facilities construction. Infection prevention, patient and family satisfaction, and technologies influence contemporary designs of critical care units. All of these impacts have created larger patient care units, with a majority of single patient rooms. These larger spaces have created challenges for the clinicians to maintain the line-of-sight. The line-of-sight is one tool clinicians often use to maintain patient safety.
Since the seminal publication by the Institute of Medicine in 1999, patient safety concerns have escalated after revealing numerous deaths in …
Exploring The Factors Of Persistence For African American Senior Nursing Students, Yolanda Nelson
Exploring The Factors Of Persistence For African American Senior Nursing Students, Yolanda Nelson
Theses and Dissertations
African American nursing students experience commonalities within their college experience. Often these students may be faced with challenges, barriers, and/or struggles that may place a hindrance on their success in meeting their educational goals. This qualitative study used a phenomenological approach to explore African American female nursing students perceptions of faculty-student relationships and its implications for persistence. Four African American female nursing students and two nursing faculty agreed to participate in this study. This research study offers an examination of past and present research regarding the history of African American nursing students, health disparity, social justice and diversity within the …
Improving Patient Medication Reconciliation Participation And Compliance Through Education, Maria Elena Herrera
Improving Patient Medication Reconciliation Participation And Compliance Through Education, Maria Elena Herrera
Master's Projects and Capstones
Abstract
The healthcare world is complex. At the center of this world are patients and their safety. Medication knowledge and medication reconciliation compliance are factors that influence patient’s safety and their overall health outcomes. This project explores the theme of patient safety by examining the relationship between patient education and health outcomes. The microsystem, located in the heart of San Francisco, is an outpatient clinic specializing in patients with renal impairment that each diverse and unique. A pre-implementation survey found that only 38% of patients were bringing their medications to appointments. A goal of improving compliance to 50% by December …
Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby
Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby
Doctor of Nursing Practice (DNP) Projects
Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …
Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens
Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens
Master's Projects and Capstones
The congestive heart failure patient faces many challenges after discharge from the hospital. Learning how to manage diet, medications, and other lifestyle changes needed for symptom management can lead to multiple readmissions and rapid progression of condition. Many patients feel overwhelmed at time of discharge from the hospital, and many miss key components in discharge instructions and education. The main objective of the organizations Heart Failure program is to educate patients who have been admitted into the hospital with systolic or diastolic heart failure. Within our team we set out to educate our patients and their families on reducing incidents …
Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn
Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn
Master's Projects and Capstones
A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.
An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …
Implementation Of A Warming Protocol To Prevent Inadvertent Perioperative Hypothermia In The Ambulatory Surgical Setting, Joan Abigail Slagle
Implementation Of A Warming Protocol To Prevent Inadvertent Perioperative Hypothermia In The Ambulatory Surgical Setting, Joan Abigail Slagle
Master's Projects and Capstones
The implementation of a standardized warming protocol aims to improve patient outcomes by preventing inadvertent perioperative hypothermia (IPH) and its complications in the ambulatory surgical setting. All patients, regardless of age or gender, are at risk for experiencing a 1-2° C drop in body core temperature within thirty minutes of anesthesia induction. The global aim of this project is to prevent IPH and its complications in the ambulatory surgical setting by implementing a warming protocol at a freestanding ambulatory surgery center. While an audit of the microsystem revealed a normothermia rate of 28%, a standardized warming protocol is expected to …
Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia
Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia
Master's Projects and Capstones
Abstract
Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …
Decrease Arrival To Ct Time To Improve Stroke Outcomes, Curt Peterson
Decrease Arrival To Ct Time To Improve Stroke Outcomes, Curt Peterson
Master's Projects and Capstones
Abstract Final
The specific goal of the project is to decrease the arrival to t-PA treatment times to <45 minutes in > 50% of the cases. The decreased treatment time will prove to shorten the average length of stay on average by two days (Audebert & Sobesky, 2014). The goal will be accomplished by decreasing the arrival to computerized tomography (CT) scan completion time by at least 20%. The specific population of patients will be all stroke alert arrivals to the process’s microsystem via EMS, an Advanced Primary Stroke Center in Sacramento California. Root Cause Analysis, Strength, Weakness, Opportunity, Threat (SWOT), and Plan, Do, …45>
Fall Reduction With Nursing Interventions, Sin Ting Chan
Fall Reduction With Nursing Interventions, Sin Ting Chan
Master's Projects and Capstones
The aim of the project is to reduce the patient’s fall rate in the medical surgical unit at an acute care hospital through improving the fall precaution process. The unit consists of 37 bed with a population of stroke, medical, and surgical patients. The focus of the nursing staff education using handouts, brochures, and poster will be based on the results from pre and post intervention audits. The goal of this fall reduction project is to have the nursing staff learn, review, and apply fall prevention interventions for fall risk patients in order to help reduce fall rate by 50 …
Preoperative Education: A Patient-Centered Care Approach, Gia L. Wendt
Preoperative Education: A Patient-Centered Care Approach, Gia L. Wendt
Master's Projects and Capstones
Abstract
This project addresses the need for delivering high quality preoperative education to the Arabic speaking patient population served by Sharp Healthcare’s orthopedic service line. A goal set during the institution’s 2015 The Joint Commission Disease-Specific Care survey is to discharge major joint patients to home in two days or less. Data abstracted from Sharp Healthcare’s orthopedic registry revealed that only 30% of Arabic speaking patients are meeting this goal. The current process for educating Arabic speaking patients preoperatively during a one to one educational session with a third party interpreter takes three hours, costs $402.00 per patient, and education …
Decreasing Risk Of Delirium With Early Progressive Mobility, Donna J. Larson Mrs.
Decreasing Risk Of Delirium With Early Progressive Mobility, Donna J. Larson Mrs.
Master's Projects and Capstones
Abstract
The goal to consistently mobilize the mechanically ventilated patient to decrease the risk or progression of delirium is the primary focus of my project. This project took place in two, 12-bed critical care units. One is a cardiovascular, medical, surgical intensive care unit and the other is a neurotrauma critical care unit. The methods for implementation included writing the management of pain, agitation, and delirium policy based upon the recommended bundle from the Society of Critical Care Medicine referred to as the ABCDE bundle. As part of this bundle, the progressive mobility policy was revised so that a physician …
Improving Patient Satisfaction, Wait Times, And Access To Care In A College Health Setting; Expanding The Rn Role As Prescribing Agent With Standardized Procedures, Kimberly D. Perris
Improving Patient Satisfaction, Wait Times, And Access To Care In A College Health Setting; Expanding The Rn Role As Prescribing Agent With Standardized Procedures, Kimberly D. Perris
Master's Projects and Capstones
The CNL theme for this project is Nursing Leadership, Advocate for the Profession and is inspired by the Institute of Medicine’s call for all nurses to work to the maximum scope of their practice. The specific aim was to demonstrate RN confidence working independently, and proficiency using one RN protocol to provide hormonal contraception with an overall aim of improving patient satisfaction and access to care. This project took place in a rural university student health center where family planning and contraception services are the number one service provided.
The RN visit project has been multidisciplinary and collaborative in creating …
Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco
Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco
Master's Projects and Capstones
Abstract
The overall goal of this project was to increase HPV 2nd and 3rd dose compliance rates by a combined 10% among the female adolescent population (ages 11-26). This was to be achieved by implementing EBP follow-up calls to not only schedule appointments but also to serve as a reminder for patients to come into previously scheduled appointments. This project was chosen as prior clinic and organization-wide meetings had delineated compliance rates at just 7%. There were various methods employed to implement this project including an initial microsystem assessment, which entailed a Root Cause Analysis, Process Mapping, SWOT analysis, Cost-Analysis, …
Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn
Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn
Master's Projects and Capstones
The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …