Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction And Reducing Turnover Rates Of Advanced Practice Providers, Christian Brooks

Doctor of Nursing Practice Scholarly Project

Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction and Reducing Turnover Rates of Advanced Practice Providers

Background: The CVS practice in a Midwestern state had a shift in morale and job satisfaction in their advanced practice providers (APPs). This shift lead to the high turnover rate of 35% in 2018. In an effort to bring a halt to the high turnover rate, and to continue the excellent patient care for which the hospital is known, hospital administration became involved and set up a committee to guide the development of a new CVS APP practice model. The goal was to develop …

Gw Nursing, Spring 2020, George Washington University, School Of Nursing

GW Nursing Magazine

No abstract provided.

Cultivating Appropriate Prescribing In A Primary Care House Calls Practice: A Quality Improvement Project, Sarah J. Marzolf

Doctor of Nursing Practice Projects

Problem Description: Polypharmacy in the frail elderly can lead to suboptimal management of medical issues. Primary Care Providers (PCPs) often lack knowledge of best practices regarding deprescribing and lack a systematic process for assessing mediation appropriateness. A quality improvement project was developed and executed at Housecall Providers, a home-based primary care practice in Portland, Oregon to facilitate the incorporation of deprescribing into daily practice.

Interventions: Following a literature review, a curriculum was developed and utilized during an educational intervention for PCPs regarding deprescribing best practices. A system for introducing new PCPs to evidence-based deprescribing for the frail elderly. This information …

Implementation Of Doll Therapy For Agitated Residents With Dementia, Jechell Lary-Waller

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

The aim of this evidence-based practice (EBP) intervention project was to decrease agitated behaviors in residents with dementia as well as educate the staff on the proper implementation of doll therapy. The facility used was a local skilled nursing and rehabilitation center that offers short-term and long-term care processes to residents with dementia. A sample of residents with dementia (N = 8) and staff caring for the residents (N = 14) participated in the project. Residents and staff were evaluated before the EBP project and four weeks after the education program on introduction to EBP. Despite the …

Educational Session To Improve The Knowledge And Confidence Of State Agency Surveyors In Deficiency Citation Of Immediate Jeopardy Findings In Nursing Homes, Aileen Renolayan, Msn, Ma, Rn, Phn

Doctor of Nursing Practice Projects

Background: The oversight of nursing homes is a shared federal-state responsibility. Under the agreement with Centers for Medicare and Medicaid Services (CMS, 2018), state survey agencies assess nursing homes using standard surveys. Several studies indicate that the type of deficiencies issued to nursing facilities varies significantly by state, suggesting inconsistency in the survey process for issuing deficiencies. For example, variation in Immediate Jeopardy (IJ) citations among state agency surveyors has been the subject of reports from the Government Accountability Office (GAO, 2019) and the Office of the Inspector General (OIG, 2014).

Objective: To determine if a 1-hour educational session about …

Not A Magic Pill: An Educational Model On Antibiotic Prescribing, Christina Rose Leonard

Nursing Capstones

Background: Inappropriate antibiotic prescribing is common in outpatient settings across the United States. The Centers for Disease Control and Prevention has found in studies that nearly 1 in 3 antibiotics prescribed at outpatient facilities is unnecessary. The misuse and overuse of antibiotics is accelerating the process of antibiotic resistance, as well as causing an increase in adverse events, including death. The literature indicates that knowledge plays a major factor in overprescribing, as well as provider attitude and patient expectations.

Objective: Present clinical practice guidelines to providers within a rural family practice clinic setting aimed at improving antibiotic prescribing. Gather information …

Using Five Wishes To Improve Advance Care Planning In A Maryland Primary Care Practice, Amanda Bridges, Msn, Acnp-Bc

Doctor of Nursing Practice Projects

Background: Advance Care Planning (ACP) at this primary care practice was minimal and lacked a consistent process to document existing advance directives (AD) or educate patients about ADs.

Objectives: The purpose of this QI project was to improve ACP engagement, documentation of existing ADs and educate patients about Five Wishes.

Methodology: Adults, at each office encounter, were asked three kiosk questions: Do you have an AD, know what ADs are and want to discuss ACP? The responses were uploaded to the EHR to become an evidence backed, visual reminder. Affirmation of existing ADs were descriptively documented. ACP engagement was analyzed …

Using Multi-Faceted Validated Tools To Evaluate The Functional Outcomes And Quality Of Life In Patients Undergoing Elective Spine Surgery And Associated Referral Patterns For Post-Hospital Rehabilitation: A Quality Improvement Project, Mercy Oigbokie, Msn, Agnp-C, Aprn

Doctor of Nursing Practice Projects

Background/Significance: A lack of validated multi-facet assessment tools to assess postoperative patients’ functional ability and quality of life may result in untimely or no referrals to rehabilitation.

Objective: The objective of the DNP project was to introduce the use of validated multi-facet questionnaires in assessing patient-reported outcomes and to assess effect on the time in generating prescriptive rehabilitation therapies and the type of therapies following elective spine surgery evaluated in the outpatient neurosurgery clinics.

Methods: This was a quality improvement (QI) project comprising of 100 patients (50 pre and 50 post the intervention). After the introduction of baseline data, the …

Mitigating Delirium For The Elderly Post-Operatively Without Medication, Ann Lo Basso

Doctor of Nursing Practice Projects

Background: Often occurring after surgery, or hospitalization, the development of delirium in older adults, initiates a cascade of events culminating in loss of independence, increased morbidity and mortality, and high health care costs (Oh, et al., 2017).

Objective: The purpose of this quality improvement (QI) project was to adapt and implement best practices using HELP for managing older patients with postoperative delirium through the existing 1:1 observation structure and implementing cognitive care strategies. The 1:1 sitter roles and responsibilities were redesigned to include non-pharmacological, multicomponent interventions.

Methods: The QI project used a pre-test post-test intervention design comparing groups before and …

Utilization Of Patient Toolkit And Discharge Algorithm For Providers To Reduce Readmission Due To Repeat Ground Level Fall, Sara Karl

Doctoral Projects

Introduction. Falls are the leading cause of injury and injury death in adults over the age of 65. A retrospective examination at Level 1 trauma center in the Midwest found that 19.4% (118/605) of older adults admitted with a ground level fall were readmitted with a subsequent fall and injury. The aim of this quality improvement initiative is to determine if the implementation of an evidenced based patient toolkit and a discharge algorithm for providers will reduce outpatient falls. The objective was to reduce hospital readmission due to repeat fall.

Methods: The design of this project was mixed methods, observational, …

Effect Of Provider Education On Urinary Incontinence Knowledge And Assessment, Kendra L. Roloff

Nursing Capstones

Nearly 50% of women in the United States will experience urinary incontinence at some point during their lives. Urinary incontinence impacts multiple aspects of a woman’s life, yet remains underdiagnosed by primary care providers. The purpose of this project is to implement education and reminders for primary care providers, in order to improve urinary incontinence knowledge and assessment of women 18 years of age or older. The project was carried out in a primary care clinic with primary care providers serving as the participants.

A quasi-experimental one-group pretest-posttest design was utilized. Data from a five question pre- and posttest were …

Improving Palliative Care Utilization Process: An Effort To Enhance Providers` Contribution, Orina Machoka

Nursing Capstones

Worldwide, an estimated 20 million people require palliative care. The Worldwide Palliative Care Alliance has identified the need for palliative care has never been higher and is increasing at a rapid rate due to the world`s aging population, increase in cancer, and noncommunicable disease. Despite the increased need, the palliative care establishment has not been efficient in identifying patients who need palliative care. The use of a standardized screening process to assist in the timely identification of patients with palliative care needs is lacking, or in some cases, non-existent. At a Midwestern pain clinic lack of screening is causing a …

Designated Turn Teams For Q2 Turns In The Icu, Abigail Bauer Rn, Emily Clowes Rn

Patient Care Services / Nursing

No abstract provided.

Effectiveness Of Otago Exercise On Health Status And Risk Of Fall Among Elderly With Chronic Illness, Stefanus Mendes Kiik, Antonius Rino Vachapo, Maria Fitrya Elfrida, Muhammad Saleh Nuwa, Siti Sakinah

Jurnal Keperawatan Indonesia

Falls are a serious consequence of declining physical function. Otago exercise is a strength and balance training program designed to prevent falls and enhance health status among the elderly. This study aimed to investigate the effect of a 12-week Otago exercise intended to reduce the risk of falls and health status among the elderly with chronic illness in the social elderly institution. This quasi-experimental study employed a pre-and post-test design using a control group. The study involved an intervention group (21 respondents) and a control group (21 respondents). The sample used in this study were elderly living in a social …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Anne Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

• Nursing Faculty Publish Article

Ethical Considerations When Conducting Research With Older Adults, Karen Arrant

Journal of Interprofessional Practice and Collaboration

The ethical issue exists between the researcher’s passion for the study focus and the human rights of the participant. This manuscript provides a case study, an actual illustration, but names were changed to protect anonymity. Objectives include examining the researcher’s perspective and personal beliefs, identifying the process to recruit participants, the ethical manner to disseminate information, and identifying ethical principles during the study process.It is mandatory that minute attention is given to the details of caring for the safety and welfare of study participants.

Students’ Knowledge Of Alzheimer’S Disease, D'Anna Helms

Nursing Theses and Capstone Projects

Preparing nursing students to care for the ever-growing aging population with memory impairment is vital. This research study aimed to determine the prevalence of knowledge of Alzheimer’s disease (AD) among Baccalaureate nursing students. A descriptive correlational design was used to determine the prevalence of AD knowledge among juniors in an Adult I course and seniors in a Mental Health nursing course. A cross-sectional design was used to collect data using the Alzheimer’s Disease Knowledge Scale (ADKS). A convenience sample of 63 student cohorts completed the survey. Results indicated that students were aware that AD is a form of dementia; however, …

Shared Governance Council: Improving Staff And Patient Satisfaction, Haley O'Brien Hall

Master of Science in Nursing Theses and Projects

Due to the decreased staff and patient satisfaction on one post-operative unit, the author has developed a project plan to establish a unit specific Self Governance (SG) committee to improve staff and patient satisfaction. One SG committee and two councils will be formed giving all staff the opportunity to be a voice for change on their unit. The committee is focused on building and maintaining each council. One council will focus on staff satisfaction and one council will focus on patient satisfaction. The progress and outcomes of each committee and council will be evaluated in three ways: staff surveys, patient …

Preparing The Nurse Aide I Student For The Workplace: Combating Burnout And Compassion Fatigue, Patrice Staley

Master of Science in Nursing Theses and Projects

Abstract not available

Caring Minds, Uthealth Cizik School Of Nursing

Caring Minds

No abstract provided.

Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo

Walden Dissertations and Doctoral Studies

Falls are common in the older population and can result in disability, increased dependence, or mortality. Falls have received increased attention in the literature as the most common cause of injuries among older individuals. The incidence of falls in the older population has a positive correlation with adverse health issues necessitating major lifestyle adjustments. The problem is magnified for older patients in long-term care settings where they are 3 times more susceptible to falls. The purpose of this project study was to conduct a systematic review of the literature to understand the impact and incidence of fall rates among older …

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

Decreasing Thirty-Day Readmissions For Heart Failure Patients, Willybroad Che

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies …

Geographic Access To Community Mental Healthcare And Adherence To Treatment Among Patients With Schizophrenia Spectrum Disorders, Marie Smith-East

Electronic Theses and Dissertations, 2020-2023

Disparities in access to mental health care for individuals with schizophrenia spectrum disorders continue to exist in the United States despite the creation of mental health policies seeking to improve access to care. As an integral element of healthcare system delivery, access is influenced by spatial (location) and non-spatial (sociodemographic) factors. Highlighting both spatial and non-spatial dimensions of access to mental healthcare, this study employed an innovative approach encompassing the geography of access and the integration of location analyses to bridge the gap between psychosocial dynamics and mental health services for improving cost-effective continuity of care. The aims were as …

Socio-Spatial And Quality Of Life Themes In Aged Care Architecture: A Qualitative Methods Protocol, Sarah Mcgann, Caroline Bulsara, Holly Farley

Arts Papers and Journal Articles

Aim: To evaluate the connection between residential aged care architecture, the residents’ ability to find home and Quality of Life themes.

Design: This study uses convergent qualitative mixed methods approach across the three phases of the research project to explore the lived experience of residential aged care residents, their family members, and direct care staff.

Methods: The chosen qualitative methodology is based on a constructionist paradigm and uses a combination of observations, photo production and prompted discussions, and architectural visual data collection methods. Funding was approved in March 2018.

Discussion: This research will provide a novel approach to understanding ways …

Patient Satisfaction With Nurse Versus Non-Nurse Post-Discharge Outreach, Iyore Adonri

West Chester University Doctoral Projects

In today’s current healthcare environment, there has been an extensive focus on patient satisfaction, and healthcare leaders struggle with the options of utilizing a registered nurse or a non-nurse when making outreach follow-up calls to recently discharged patients. Healthcare leaders find that designing, implementing and managing an efficient telephone outreach program can be challenging, however, this has become a necessary aspect of the patient continuum of care plan. Studies demonstrate that patient follow-up post-discharge increases patient satisfaction and their compliance with post-discharge instructions, thereby reducing readmission rates and emergency room visits (Meek, Williams, & Unterschuetz (2018). This quality improvement project …

Education Toolkit On Restraint Reduction In The Intensive Care Unit, Sharon Watkins

Walden Dissertations and Doctoral Studies

The use of physical restraints in hospitals has been in practice for the better part of a century despite the many adverse effects it can have on patients. Socially, restraint use can strip the patient of their dignity in addition to their freedom. This evidence-based project was to build a toolkit to educate intensive care unit (ICU) nurses regarding the negative effects physical restraint use can have on their patients and to present alternatives to their use. Tools developed from prior research were included in the toolkit, and the Neuman systems model was applied to the overall education project. The …

Pain Assessment Strategies For People With Cognitive Impairment In Nursing Home Settings, Meskelo Tsegaye Bobo

Walden Dissertations and Doctoral Studies

Assessment of pain in patients with a diagnosis of dementia or cognitive impairment continues to be underdiagnosed as there are no objective ways of assessing their pain. Available evidence also indicates that these patients are not receiving satisfactory pain management. Due to a lack of self-reporting of pain, accurate assessments of pain are challenging. This systemic review aimed to find a pain assessment strategy effective in identifying pain in patients with a diagnosis of dementia. Kolcaba's theory of comfort was used as the theoretical framework for the study. The databases of Medline, Cochrane Database of Systematic Reviews, Embase, and Cumulative …