Digital Commons Network^™

Guide Lines Vol. Ii, Issue 2 - April 2020, College Of Health And Human Services

GUIDE Lines

Periodic Newsletter of the Governors State University - University of Illinois, Chicago - Disparities Education Cancer research training and education project (The GUIDE Project).

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 …

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 …

Alcohol Screening, Brief Intervention, And Referral To Treatment Protocol In The Emergency Department, Malvis Ndips Achonduh Tamon, Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The impact that results from inappropriate alcohol consumption poses challenges to public health. The rate of alcohol-related visits to the Emergency Department (ED) has increased, which has resulted in an increased annual cost of alcohol-related visits. ED serves as a common portal of entry into the healthcare system for many patients and offers a unique opportunity to impact drinking behaviors.

Objectives: To increase the number of alcohol screenings and brief interventions when indicated to adult patients who visit the ED and increase ED nurses' knowledge regarding alcohol misuse and indications for brief interventions.

Methods: An educational module was delivered …

Creating Opportunities For Personal Empowerment: A Project Evaluation, Ann L. Cudney

Doctoral Projects

Introduction: 66% of individuals in the United States who experienced a major depressive episode in the last year saw a general practitioner or family doctor and not a psychiatrist or psychotherapist (Center for Behavioral Health Statistics and Quality, 2018). Many primary care providers treat with medication, however, a combination of medication and psychotherapy is associated with better results (Anxiety and Depression Association of America, n.d.). A Midwestern faith-based healthcare organization implemented a pilot cognitive behavioral therapy program at a family medicine residency clinic to improve mental health care.

Objectives: The purpose of this project was to evaluate if the implementation …

Increasing Annual Retinal Exams Among Patients With Type 2 Diabetes, Afokoghene H. Odhu

Doctoral Projects

The Center for Disease Control and Prevention (CDC, 2017) reports that approximately 30 million people in the United States (US) have diabetes. Approximately 8 million have diabetes retinopathy (DR) (CDC, 2018). DR is the leading cause of vision impairment in type 2 diabetes patients. Left untreated, DR can result in loss of vision and blindness (Hernández, Simó-Servat, Bogdanov, & Simó, 2017). The US spends approximately $500 million dollars annually in the treatment of diabetes-related blindness (CDC, n.d.). Early detection and management of DR through tight glycemic control, aggressive blood pressure and lipid management is essential to preventing complications of the …

A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel

Doctoral Projects

Background and Objectives: Home palliative care services are challenging to bill due to the complexity of services and competing time demands. Objectives and protocol were developed to guide coding and billing to increase Relative Value Unit generation and improve financial sustainability.

Design: A quality improvement project.

Setting: A home-based palliative care program in one health system in the Midwest.

Participants: Participants included 7 nurse practitioners.

Intervention: Coding protocol were developed, providers were educated, electronic health record audits were conducted to collect data on improvement, and feedback provided to prompt improvement.

Measurement and Analysis: Documentation of advanced care planning and billing, …

Improvement In Heart Failure Management Through Implementation Of An Interdisciplinary Algorithm To Reduce 30 Day Hospital Re-Admission, Lindsey Whiting

Nursing Capstones

Heart failure (HF) is a progressive disease in which the heart is unable to pump enough blood to support the body’s vital functions. Recent projections estimate that by the year 2030 the number of HF patients will increase by 46%, resulting in an increased financial strain on the health care system. In response to increasing health care costs the Hospital Re-Admission Reduction Program (HRRP) was implemented. The goal of the HRRP is to improve the quality of patient care by linking defined parameters of quality of patient care to the payment/reimbursement of health care providers and hospitals. A rural northern …

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 …

The Prevalence And Predictive Factors Of Breast Cancer Screening Among Older Ghanaian Women, Akosua F. Agyemang, Agnes Naki Tei-Muno, Veronica Millicent Dzomeku, Emmanuel Kweku Nakua, Precious Adade Duodu, Henry Ofori Duah, Anna Boakyewaa Bentil, Pascal Agbadi

College of Nursing Faculty Research and Publications

Background

Breast cancer cases are on the rise in Ghana, with older adult women being more at risk of the disease. However, there is a paucity of current studies on factors that predict breast cancer screening among older adult women using nationally representative data. The present study, therefore, addressed this gap by estimating the prevalence of and identifying the factors that predict breast cancer screening among older adult women in Ghana.

Methods

We used the cross-sectional survey dataset of the 2014/2015 (wave II) Study on global AGEing and adult health (SAGE). A complex survey design methodology was employed to estimate …

Physician Behaviors, Nursing, And Other Obstacles In End-Of-Life Care: Additional Critical Care Nurse Perceptions, Elizabeth Elouise Willmore

Theses and Dissertations

Background: Critical Care Nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Barriers to EOL care in ICUs exist and have been previously published, but qualitative reports from CCNs themselves remain scarce. Qualitative data exploring barriers faced during ICU EOL care may increase awareness of obstacles and help remove them. Objective: Excluding family experiences, what are the major themes recounted by CCNs when asked to share common obstacles experienced in providing ICU EOL care? Methods: Members of the American Association of Critical-Care Nurses were randomly surveyed and responses to a single qualitative question were used. …

A Smartphone App For Self-Management Of Heart Failure In Older African Americans: Feasibility And Usability Study, Sue P. Heiney, Sara B. Donevant, Swann Arp Adams, Pearman D. Parker, Hongtu Chen, Sue Levkoff

Faculty Publications

Background: Mobile health (mHealth) apps are dramatically changing how patients and providers manage and monitor chronic health conditions, especially in the area of self-monitoring. African Americans have higher mortality rates from heart failure than other racial groups in the United States. Therefore, self-management of heart failure may improve health outcomes for African American patients.

Objective: The aim of the present study was to determine the feasibility of using an mHealth app, and explore the outcomes of quality of life, including self-care maintenance, management, and confidence, among African American patients managing their condition after discharge with a diagnosis of heart failure. …

Guide Lines Vol. Ii, Issue 1 - March 2020, College Of Health And Human Services

GUIDE Lines

Periodic Newsletter of the Governors State University - University of Illinois, Chicago - Disparities Education Cancer research training and education project (The GUIDE Project).

Nursing Annual Report 2019, Children's Mercy Hospital

Nursing Annual Reports

Annual report for nursing services at Children's Mercy Kansas City.

Nursing Annual Report: 2020, Centracare Health

Nursing Annual Report

Message from the CNO

St. Cloud Hospital Statistics

Message from Craig Broman, St. Cloud Hospital President/CEO

Nursing Strategic Plan FY 2020

Message from Tom Schrup, MD/CPO

Education & Certification

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Examining Factors Associated With Failure To Fail In The Clinical Setting, Dee A. Adkins

Student Theses, Dissertations and Capstones

Clinical nursing faculties struggle to assign failing grades to underperforming students in the clinical setting; this is known as failure to fail. Qualitative literature has revealed common factors for failure to fail; however, quantitative studies are required to determine the extent to which those factors affect the faculty’s decision-making process. The purpose of the study is to explore the relationship between face-implicating factors and the faculty’s likelihood of failing students in the clinical setting who do not meet the passing criteria. What is the relationship between face-implicating factors and the nursing faculty’s likelihood of passing students in the clinical setting …

Supports For Migrant Farmworkers: Tensions In (In)Access And (In)Action, Susana Caxaj, Amy Cohen, Sarah Marsden

Health and Rehabilitation Sciences Publications

Purpose: This study examined the role of support actors in promoting or hindering access to migrant agricultural workers' (MAWs) needs, and, to determine the factors that influence adequate support for this population.
Methodology: Employing a Situational Analysis methodology, we carried out focus groups and interviews with 35 support actors complimented by a community scan (n=28) with public-facing support persons and a community consultation with migrant agricultural workers (MAWs).
Findings: Two major themes were revealed: (In)access and (In)action, and; Blurred Lines in Service Provision. The first illustrated how support actors could both reinforce or challenge barriers for this population through tensions …

Exploring The Effects Service Dogs Have On Veterans With Ptsd, Shelby E. Reeves

Honors Undergraduate Theses

Post-Traumatic Stress Disorder (PTSD) is a mental illness resulting from exposure to a traumatic event. Symptoms of PTSD vary, but those affected commonly experience nightmares, flashbacks, hypervigilance, and trouble sleeping; they may also avoid people or situations that trigger traumatic memories. It is estimated that PTSD affects about 10-30% of all United States veterans. Additionally, traditional treatment methods have an average dropout rate of 25% among military personnel. Inadequate PTSD symptom management may lead to depression, anxiety, suicidality, isolation, unstable relationships, and substance misuse. The purpose of this review is to examine the current research concerning the use of service …

Creating A Community-Based Protocol To Prevent Unintended Pregnancy In Homeless Women In Monongalia County, West Virginia, Jessica Eva Wukasch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At any given time, 10% of homeless women are pregnant, about twice the rate of all U.S. women of reproductive age (5%) (Healthcare for the Homeless, 2001). According to Healthcare for the Homeless Council ([HHC], 2012), approximately “73% of pregnancies among homeless women were unintended at the time of conception.” In addition, “about 12% of homeless children are placed in foster care compared to 1% of other children” (HHC, 2012). There is an evident need to address unintended pregnancy among homeless women.

Objective: The overall objective was to create an accessible and useful community-based protocol to reduce the rate …

Increasing Culturally Competent Care Of Lgbtq Patients By Providing Staff Education, Victoria Jacoby

Walden Dissertations and Doctoral Studies

The majority of health care professionals do not feel confident or competent to adequately care for a lesbian, gay, bisexual, transgender, and queer (LGBTQ) patient. Research has identified a link between poor preparedness of the provider/staff and poor patient outcomes. The purpose of this study was to evaluate the effectiveness of an in-person staff education module about providing culturally competent care to LGBTQ patients. The study focused on providers’ attitudes, preparedness, and confidence in caring for a LGBTQ patient. The Iowa and Kirkpatrick models were utilized to ground and evaluate the study. This study was a one-group pre- and posttest …

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 …

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

Process Improvement To Reduce Route Of Medication Administration Errors In Patients With Enteral Feeding Tubes, Elizabeth Scott

Doctoral Projects

Advances in health information management in the form electronic health records, computerized provider order entry systems, and clinical decision support systems and tools have enhanced the productivity, effectiveness, and efficiency of healthcare. However, the cost of these positive effects does come at the expense of other factors. Along with the introduction of Clinical Provider Order Entry (CPOE) systems, organizations have experienced new possibilities for medication errors and risks to patient safety. Factors associated with these errors should be evaluated in detail in order to mitigate the causes of these types of errors and to plan strategies for prevention. Continued research …

Substance Use Disorder Policy For Certified Registered Nurse Anesthetists: A Policy Analysis, Justin D. Mcadoo

Doctor of Nursing Practice Projects

Substance use disorders (SUDs) negatively impact society and communities while causing substantial harm to families and friends. The leading occupational hazard for Certified Registered Nurse Anesthetists (CRNAs) is SUDs. It is estimated that 15% of actively practicing CRNAs in the United States will have a SUD during their career. In order to address SUDs related to CRNAs in the workplace, anesthesia groups and healthcare facilities must develop, implement, and evaluate policies and procedures based on the translation of evidence-based research into the practice of anesthesia. This Doctor of Nursing Practice (DNP) project analyzed LifeLinc Anesthesia’s SUD policy for CRNAs, compared …

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 …

Nursing Student Stress, Ruthanne Emily Hawks, Hannah Rae Wilson, Carly Marie Gillota, Taylor Anne Hall, Edward William Mccain

Williams Honors College, Honors Research Projects

Nursing students deal with a variety of stressors, including difficult curriculum and new endeavors such as clinical and lab experiences. The purpose of this study was to identify the relationship between stress levels and coping mechanisms and readiness to change unhealthy coping mechanisms in baccalaureate nursing students. The Transtheoretical Model of Change guides this non-experimental, correlational study and measured readiness for change. The Student Nurse Stress Index was used to measure stress. The abbreviated COPE Inventory was used to measure coping. Online recruitment, consent forms, and surveys were distributed to nursing students via the Student Success Center in the College …

Effects Of Interventions On Violence Against Nurses, Shelby Secreto, Morgan Suponcic, Taylor Gatts, Erin Ross

Williams Honors College, Honors Research Projects

Violence against nurses is a problem in the healthcare system that is becoming more prevalent. The purpose of this systematic review is to critically appraise the evidence about the effectiveness of interventions to outcomes indicating that nurses are better prepared to handle violent situations and possibly prevent them all together in acute care settings. The following PICOT question, a question that addresses patient problem, intervention, comparison, outcome, and time, will be answered: What effect does preventative and educational interventions have on violence against nurses in the hospital setting and influence nurses’ perceptions regarding their ability to handle episodes of violence? …

Patients With A Left Ventricular Device And Factors Affecting Readmission, Diana Pitcher

Electronic Theses and Dissertations, 2020-2023

Patients with a left ventricular assist device have a high rate of hospital readmissions after their index (placement of left ventricular device) discharge. With these devices becoming more common providers of care must understand why this population is being readmitted in order to promote well-being and keep patients out of the hospital. The purpose of this study was to identify and describe characteristics of the hospital readmission. This research study was a retrospective analysis of aggregate data from 2013-2019 with a sample size n = 32. The summary of data was described with descriptive statistics. The data was grouped and …