Digital Commons Network^™

The Development And Implementation Of A Forecasting Model For Inpatient Nurse Scheduling, Danielle Bowie

Yale School of Nursing Digital Theses

Objective: This study was designed to develop a model for predicting nurse scheduling needs in a hospital unit based on historical patient census and nurse staffing requirements.

Background: Many hospitals use outdated non-data driven methods for nurse scheduling.

Methods: Historical nurse scheduling and staffing datasets for 2015, 2016, and 2017 from a 33-bed surgical unit in an inner-city urban hospital in Portland, Oregon, were used to build a predictive model for nurse scheduling needs.

Results: The patient census for 2017 was three patients higher than the two previous years and showed a variation in the day of the week, with …

Utilizing Relational Coordination Theory To Evaluate And Improve Interdisciplinary Communication During Emergency Cesarean Sections: A Quality Improvement Project, Angelarosa Didonato

Yale School of Nursing Digital Theses

Abstract

Interdisciplinary communication is a complex, dynamic process that can be difficult to achieve during an emergency cesarean section. Poor communication can have negative effects on patients and providers. The Relational Coordination Model focuses on improving team function by embracing the interdependence of team members and building a shared vision. The Relational Coordination Survey 2.0 was used to assess gaps in communication and collaboration. An education program was implemented to address team specific weaknesses. Reassessment of the teams showed improved an RC Team Score within most groups. The Relational Coordination Model provides a viable theoretical framework with which to institute …

Reducing The Emergency Room Revolving Door Syndrome For The Poor, Uninsured And Chronically Ill Patient: Pilot Recommendations From A Process Improvement Evaluation, Stephanie Fassu Noulaheu

Yale School of Nursing Digital Theses

CONTEXT: My Health LA (MHLA) is a Los Angeles County program that allows residents who are poor, without medical insurance (due to unaffordability and/or illegal immigration status), and without a primary care provider (un-empaneled) to enroll with an affiliated primary care clinic and receive free healthcare – related services.1 Despite the launch of this initiative in October 2014, 35 percent of MHLA enrollees did not follow-up with a primary care clinic and 15 percent of their emergency department (ED) visits were considered avoidable in fiscal year 2015-2016. OJECTIVE: In light of these findings, the MHLA enrollment pathway was evaluated at …

Staff Perceptions Of Risk Factors For Violence And Aggression In Ambulatory Care, Ashley Rose Folgo

Yale School of Nursing Digital Theses

Management of violent acts by patients and visitors in the ambulatory care environment is an important issue that research has not addressed. This report utilizes research conducted in inpatient healthcare settings regarding violence, patient and visitor risk factors for violence, staff characteristics that increase the likelihood of victimization, and the impact violent acts have on staff morale as well as impacts on patients’ perceived quality of care. Identification of interventions to de-escalate aggressive patients and visitors from research conducted within the inpatient environment is synthesized for evaluation of its application to ambulatory care. Feedback regarding these risk factors from clinic …

Development And Validation Of A Medical Home Model For Persons With Spinal Cord Injuries In An Acute Rehabilitation Outpatient Specialty Center, Aries Limbaga

Yale School of Nursing Digital Theses

Abstract

Background:

Primary care is difficult for patients with spinal cord injuries to find. As such, these patients typically turn to rehabilitation centers and clinics that do not provide primary care services.

Purpose:

The purpose of this project was to develop a model of care that integrates primary care into specialty care clinics for patients with spinal cord injuries.

Design:

A review of the literature on the healthcare needs of patients with spinal cord injuries was completed. The Donabedian framework was used to guide the development of the Spinal Cord Injury Medical Home Model (Donabedian, 1966).

Methods: An expert panel …

Integrating Health Literacy And Ethnogeriatric Training For Anesthesia Providers To Improve Perioperative Care Of The Geriatric Patient, Autumn Spence

Yale School of Nursing Digital Theses

The healthcare system requires consumers to be active participants in their care by making decisions in conjunction with their provider; managing complex medication regimens and scheduling appropriate medical visits in a timely fashion. Health literacy for racial and ethnic minority elders, is an often ignored national problem that must be addressed through research-driven initiatives that are tied to metrics that measure improvement across providers, health plans, and healthcare organizations. To address this problem, the authors implemented an adaptation of two evidenced-based educational interventions into a practice improvement project. The intervention format included a self-guided training on health literacy and ethnogeriatrics …

Examining The Association Between Cigarette Smoking And Hypertension In Rural China, Yi Guo

Public Health Theses

Cigarette smoking and hypertension are well known risk factors for cardiovascular disease, but the association between cigarette smoking and blood pressure/hypertension remains controversial. Although several existing studies have examined this association, their results are inconsistent. Therefore, this study is intended to examine the association between smoking and blood pressure/hypertension. This cross-sectional study was conducted in rural China. The study subjects were 575 volunteers with a mean age of 48.3 ± 5.6 years. They were divided into smokers and non-smokers. The effects of smoking on blood pressure and the prevalence of hypertension were examined. The results show that current smoking is …

Improving Quality Through Nursing Participation At Bedside Rounds In A Pediatric Acute Care Unit, Rafael Acal Jimenez

Yale School of Nursing Digital Theses

Implementation of bedside rounds enhances communication and collaboration between physicians and nurses, resulting in improved clinical outcomes. Yet, the literature demonstrates that it remains difficult for nurses to attend rounds if they don't know when they are happening. This project aimed to: increase nurses' presence, participation and contribution at bedside rounds in a pediatric acute care unit, enhance clinical teamwork and collaboration, and improve quality outcomes. Nurses carried a pager so that physicians could alert them of rounds. Perception of teamwork and collaboration was assessed via surveys pre- and post- intervention as well as the National Database of Nursing Quality …

Trauma Informed Brief Mindfulness Training: A New Adaptation For Homeless Women With Ptsd, Brighid Gannon

Yale School of Nursing Digital Theses

Women and children are the fastest growing segment of the homeless population and the United States has more homeless women than any other Industrialized nation (Committee on Health Care for Underserved Women, 2013). Many homeless women experience lifelong trauma and are increasingly at risk for Post Traumatic Stress Disorder (PTSD) (Goodman et al, 1995). Although Cognitive Behavioral Therapy (CBT) is a gold standard treatment for PTSD, homeless women face a variety of barriers when trying to access this type of care including cost, stigma, and geographic inaccessibility (Dutton et al, 2013). Mindfulness may be a good treatment alternative because once …

Transforming A Culture Of Quality Through Nurse Engagement: A Leadership Framework, Rudy Jackson

Yale School of Nursing Digital Theses

Bedside nurses can be key in improving care. Engaging the workforce to develop processes and work through implementations can be challenging. This article focuses on a framework to help leaders engage bedside nursing staff in developing quality initiatives within their work environment. The framework, implemented in a large academic hospital in New York State, was used to reduce hospital falls. Falls reduced by 30% during the year-long implementation, despite an increase in patient volume.

Developing And Validating Learning Domains, Competencies, And Evaluation Items For Global Health Clinical Immersion Practicums For Graduate-Level Nursing Programs, Tracy Kelly

Yale School of Nursing Digital Theses

Aim: To identify and validate learning domains, competencies, and evaluation tool for experiential nursing global health programs at the graduate level.

Background: Standard competencies have not been synthesized and delineated nor have evaluation tools been developed for global health programs at the graduate level.

Design: An integrative review of the literature to identify evidence-based learning domains, competencies, and evaluation items and expert consensus panels to validate the results.

Method: Used the Whittemore and Knafl (2005) integrative literature review methodology to identify learning domains, competencies, and evaluation items. The NLM and CINAHL databases were searched for articles relevant to graduate-level global …

Developing A Next Generation Strategic Structure For Sustainable Safety Culture: Utilizing "Leading A Culture Of Safety: A Blueprint For Success", Kami Rapp

Yale School of Nursing Digital Theses

During the first generation of patient safety, healthcare leaders began to learn about, assess, and try to improve their organization’s safety culture. However, they never developed or agreed upon an evidenced-based tool containing proven strategies to improve safety culture (NPSF, 2015). Though they were successful in making incremental steps toward improvement, safety is not currently an organizational value completely embedded within the healthcare industry (ACHE & NPSF LLI, 2017). As such, the National Patient Safety Foundation’s Lucian Leape Institute, a part of the Institute for Healthcare Improvement, partnered with the American College of Healthcare Executives to write “Leading a Culture …

Adolescent Prep Administration: An Education Curriculum For Providers, Caroline Carnevale

Yale School of Nursing Digital Theses

Background: On May 15, 2018, the Federal Drug Administration (FDA) approved once daily tenofovir/emtricitabine (TDF/FTC) for use as preexposure prophylaxis (PrEP) for adolescents (weighing greater than 35kgs) engaging in high-risk sexual behavior (Gilead, 2018). This decision was largely based on the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 113 which demonstrated that PrEP was well tolerated among the adolescents, age 15-17, enrolled in the study (Hosek, 2017). The use of TDF/FTC for PrEP in adults (18 and older) was approved by the FDA in 2012 after its safety and efficacy had been demonstrated in multiple international clinical trials (FDA, …

Annual Report 2017, Central Bank Of Ireland

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No abstract provided.

Financial Stability Company Annual Report 2017, Finansiel Stabilitet (Fsc)

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Fannie Mae Form 10-K 2017, Federal National Mortgage Association (Fannie Mae)

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Financial Statements And Report Of The Board Of Directors 31.12.2017, Arsenal Ltd Finnish Asset Management Company

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Banco Central De La Republica Argentina - 2017 Financial Statements, Argentina: Banco Central De La Repãºblica

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Can The Provision Of Long-Term Liquidity Help To Avoid A Credit Crunch? Evidence From The Eurosystem's Ltro, Philippe Andrade, Christophe Cahn, Henri Fraisse, Jean-Stèphane Mèsonnier

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Southern Program Countries – Cyprus, Portugal, Spain, Carlos Botelho Moniz, Pedro De Gouveia E Melo, Luis Do Nascimento Ferreira

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Chapter 5: The States' Toolkit For Rescuing Banks In Difficulty, François-Charles Laprévote, Florine Coupa©

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Chapter 12: State Aid To Banks In Belgium, Jean-Sébastien Duprey

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Chapter 15: Iceland, Dora Sif Tynes

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Monetary Policy In Korea (Fourth Edition), Bank Of Korea

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State Aid And The Financial Sector: The Evolution Of The Legal Framework Of State Aid Law, Violeta Iftinchi

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Bankia, Bmn Merger Cleared; Banco Bpm Completes Deal; Italy Heads For Elections, Jasim Zahid

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«Открытие» Снова Здорово, Anna Eremina

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Otkritie Fc Bank's Board Elects Vtb 24 Execs As New Members, Prime News

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MOSCOW, Dec 22 (PRIME) -- The supervisory board of Otkritie Financial Corporation (FC) Bank has elected several executives of VTB 24, the retail arm of Russia’s second largest bank VTB, as new members of the board, the bank said in a statement Friday. VTB 24’s executive Alexander Sokolov has become a member of the supervisory board on Thursday, while VTB 24’s Retail Business Department Director Veniamin Polyantsev and Director of Customer Service for Small Business Nadiya Cherkasova will enter the board from January 1, 2018 and Director of Banking and Information Technology Department Sergei Rusanov will enter the board from …

Letter From Fhfa To The Treasury Regarding The Fannie Mae Agreement, United States: Department Of The Treasury, Steven T. Mnuchin, Federal National Mortgage Association (Fannie Mae), United States: Federal Housing Finance Agency (Fhfa), Melvin L. Watt

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No abstract provided.

Statement From Fhfa Director Melvin L. Watt On Capital Reserve For Fannie Mae And Freddie Mac, United States: Federal Housing Finance Agency (Fhfa)

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Mentions the agreement to reinstate a $3 billion capital reserve amount under the Senior Preferred Stock Purchase Agreements for each Enterprise.