Digital Commons Network^™

Mobile Video Monitoring To Reduce Falls And Sitter Usage, Jennifer L. Forman

Doctor of Nursing Practice Projects

In the United States between 700,000 to 1,000,000 people fall in hospitals each year. Reducing patient falls in the inpatient setting remains a challenge for many acute care hospitals. Inpatient falls can lead to serious injuries such as fractures and internal bleeding. Fall-related complications can lead to increased hospital stay, prolonged rehabilitation, and increased healthcare costs. Inpatient falls are considered preventable. One intervention commonly used to prevent falls and keep patients safe is the use of an in-person sitter or a patient safety companion (PSC). However, sitters are very costly and considered a variable staffing resource. The need for a …

A Psychoeducational Support Group For Family Caregivers Of Elders With Major Neurocognitive Disorder/ Dementia, Brooke D. Katz

Doctor of Nursing Practice Projects

Background: Dementia is a major public health problem impacting an estimated 65.7 million people worldwide by 2030. It primarily occurs in the elderly population (over age 65) and also affects family caregivers, who often experience significant stress and burden. A psychoeducational support group may be an easy and cost-effective solution to caregiver stress and financial burden.

Objective: To determine whether or not there is an effect on self-reported stress and burden on family caregivers of elders with dementia (EWD) of a voluntary psychoeducational support group in the setting of Assisted Living, Memory Support, and Skilled Nursing led by a psychiatric …

Improving Infection Management Of The Institutionalized Elderly, Jovel Angela Viloria Broqueza

Doctor of Nursing Practice Projects

Abstract

As the elderly population rapidly grows in the United States, the burden of managing infection in long-term care facilities (LTCF) escalates. The use of evidence-based infection identification algorithms for early recognition and treatment of pneumonia, urinary tract infections (UTI) and skin and soft tissue infections (SSTI) was evaluated at a Midwest suburban 110-bed long-term care facility. Focus group sessions were conducted at the facility with four nurse practitioners, the medical director, eight nurses and certified nursing assistants (CNAs) prior to an educational in-service which was provided to all staff at the facility. As criteria of infection were reported, nurses …

Promoting Antibiotic Stewardship For Uti Management In Long Term Care Residents Through Standardized Clinical Practice Guidelines., Juliana M. Enoakpa

Doctor of Nursing Practice Projects

Urinary tract infections (UTIs) are the most diagnosed infections requiring antibiotics in long-term care (LTC) facilities. The rising prevalence of antimicrobial resistance (AMR) threatens treatment of infections that were once responsive to antibiotic therapy. The inappropriate use of antibiotics in this Midwestern LTC facility provided the impetus for implementing a standardized clinical practice guideline (CPG) for diagnosing UTIs among the LTC residents. A data collection tool was developed for the audit that identified the specific assessment criteria for UTI management and eligibility criteria for antibiotics. Physicians and NPs at the LTC facility were administered a questionnaire prior to implementation of …

Postoperative Delirium Education, Aaron Wede

Doctor of Nursing Practice Projects

Surgical patients, aged 65 and older, comprise the largest surgical population. Increased age correlates with an increased incidence of postoperative delirium. Postoperative delirium (POD) can drastically increase healthcare costs, length of hospital stay, and overall morbidity and mortality. A clinical reference tool was created to have available for perioperative staff members at a 200-bed community hospital in the Midwest. The tool describes risk factors, prevention methods, and treatment options for POD. The initial implementation of the project was achieved with a PowerPoint presentation which was created to summarize the information found in the literature review and to instruct perioperative staff …

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports generalizability. …

Educating Oncology Nurse Practitioners To Provide Basic Palliative Care, Lynn Adams, Dnp, Ms, Anp-Bc, Aocn

Doctor of Nursing Practice Projects

Background: Approximately 1.66 million Americans are diagnosed with cancer each year and another 589,430 die from the disease. As treatment options have expanded, many cancer patients are living longer with worsening symptoms and disabilities and an increased illness burden. These patients are ideal candidates for palliative care. Palliative care involves care delivered by a team of clinicians with specialty training and a focus on improving the quality of life for patients with serious illnesses. A number of major organizations have made formal recommendations regarding the integration of palliative care into comprehensive cancer care including the American Society of Clinical Oncology …

Aerobic Physical Exercise Increases The Health-Related Quality Of Life In Older Adults, Patricia L. Parker

Doctor of Nursing Practice Projects

Abstract

Problem Description: Globally, the older adult population is expected to substantially increase in number throughout the next few decades. The aging process causes the body and mind to undergo many detrimental changes. Typically, older adults succumb to a more sedentary lifestyle due to factors such as decreased musculature and skeletal changes, chronic pain, socioeconomic and psychological stressors, and memory changes. Inevitably, health-related quality of life and overall independence dwindles in this population negating their perception of happiness and life satisfaction. There is significant research on preventing and/or managing cognitive disabilities in the older adult; however, Western medicine approaches, such …

Implementing An Evidence Based Fall Prevention Program In A Long-Term Care Facility, Annie Schweikert

Doctor of Nursing Practice Projects

Falls among the elderly are a significant problem with severe consequences. Residents of long-term facilities account for twenty percent of fatal falls. It is imperative that evidence-based practices be implemented at this level of care to address this problem. A multifaceted evidence-based fall prevention program was implemented at a 70 bed, skilled nursing, long-term care facility located in Florida, whose fall rate of 7.14 is above than the national average (2.74-5.48). The fall prevention program included staff education, implementation of a checklist for universal fall precautions, post fall huddles, and the appointment of a falls champion. One-month post intervention results …

The Effect Of Fall Prevention Education That Includes A Fall Safety Agreement On Fall Incident Rates, Rebecca Dotson

Doctor of Nursing Practice Projects

Patients experiencing falls while in the acute care setting is a challenge that plagues healthcare. In 2014, 29 million hospitalized patients fell causing 7 million injuries. Eighty-five percent or greater of unfavorable hospital occurrences are linked to falls. Falls occur regularly and can have detrimental effects both physically and psychologically. Literature reviews revealed encouraging results in relation to a reduction in falls with fall prevention education and the use of a fall safety agreement. The purpose of this project was to explore the effect of fall prevention education including a fall safety agreement on falls and falls with injury during …

Transitional Care Medical House Call: A Pilot Project, Ron B. Ordona

Doctor of Nursing Practice Projects

Problem Description: Vulnerable, homebound older adults are highly susceptible to unplanned 30-day hospital readmissions, which is costly for the healthcare system. As a result, health care expenditures for this population continue to rise. Studies have shown that transition of care programs, when complemented with home-based primary care delivery, may improve health care outcomes for this population.

Purpose: The purpose of this quality improvement pilot project was to implement medical house calls as a component of transitional care management (TCM) and measure patient outcomes such as unplanned 30-day readmission rates and correlate predictors of readmission. As a secondary outcome, the project …

Geriatric Competency Training For Staff Providing Chronic Care Management Services, Brigette C. Holleran

Doctor of Nursing Practice Projects

Americans 65 and older are the growing at an unprecedented rate. Older adults with complex needs are outpacing the number of healthcare providers equipped to care for them. In preparation for implementation of Chronic Care Management (CCM) service, it will be important to engage staff and motivate participation through planned education and training. The purpose of this project was to implement a staff training that included increasing basic knowledge of the CCM program and participant knowledge of age-based competency principles. A pretest posttest design evaluated participants (N=31) who attended the Older Adult Sensitivity Training (OAST) program. Knowledge was measured using …

Investigating The Incidence Of Postoperative Mild Cognitive Impairment In Cognitively Intact Patients Aged 65-80 Years Undergoing General Anesthesia For Surgery, Bryon Ward

Doctor of Nursing Practice Projects

The purpose of this prospective, descriptive pilot study is to establish a baseline measure for mild cognitive impairment (MCI) in patients aged 65-80 years following elective surgery with general anesthesia (GA). Older adults scheduled for elective surgery routinely undergo GA with a combination of volatile and intravenous anesthetic agents. Current literature shows that patients aged 65-80 who receive GA agents are at increased risk for MCI postoperatively. Data also suggests that further studies are necessary in order to more completely evaluate alternative anesthesia techniques and agents that may prove to reduce the risk and incidence of MCI associated with anesthesia …

Faith Community Nurse Care Transitions Intervention Feasibility Project, Jennifer Palagi

Doctor of Nursing Practice Projects

Background: A major national-to-local healthcare quality and safety goal is to reduce hospital readmissions, which are considered preventable patient harm. While the literature shows the impact of using care transitions programs to reduce readmissions, few studies have utilized faith community nurses (FCNs) within care transition programs. An FCN-integrated care transitions program potentially could help fill the gap in community clinical support for chronic illness care. Saint Alphonsus Regional Medical Center (SARMC), a Catholic hospital in Boise, Idaho, sponsors an FCN network within many Southwest Idaho faith communities. This presented a local opportunity to create and test the feasibility of an …

Establishing A Nurse Mentor Program To Improve Nurse Satisfaction And Intent To Stay, Sara Jane Jones

Doctor of Nursing Practice Projects

Retention of new graduate registered nurses (RNs) is a problem within the healthcare system negatively impacting patient safety and health care outcomes. The problem of retention of qualified RNs is compounded by the potential shortage of RNs, the aging RN workforce and the aging US population. During a period of transition, a novice RN requires the guidance of others to learn to apply theoretical knowledge to real life clinical experiences. In the linear progression of Benner’s levels of clinical competency, the beginning two levels of nurses need a resource person to guide their progression in clinical practice. A mentoring relationship …

Process Evaluation On Crisis Services In Northern Idaho, Claudia G. Miewald

Doctor of Nursing Practice Projects

Background: Idaho ranks last of all states for per capita spending on mental health treatment (Kaiser Family Foundation, 2014). In Idaho, individuals in crisis who suffer from mental illness or Substance Use Disorder (SUD) have few options for care. They often utilize the most expensive treatment through the emergency department, inpatient services, or by going to jail. Idaho has the 7^th highest suicide rate in the nation (Suicide Prevention Action Network of Idaho, 2015), while Region 1 of Idaho has the second highest suicide rate in the state from 2010-2014 (Suicide Prevention Action Network of Idaho, 2015).

Methods: This …

Improving A Fall Prevention And Management Program In An Acute Care Setting, Ashlee D. Gallion

Doctor of Nursing Practice Projects

In-patient falls are common but preventable adverse events. A patient fall has become a targeted event that hospitals across the country are trying to prevent by implementing new evidence-based strategies and techniques. The purpose of this capstone project was to implement a valid and reliable fall risk assessment tool and a post-fall huddle process. Following a 30-day pilot of the new fall prevention protocol on a medical-surgical unit at the Cabell Huntington Hospital, the documentation of fall risk and post-fall huddles was examined. Fall rates during the pilot were compared to pre-implementation rates. During this project, the new fall risk …