Digital Commons Network^™

Facilitating Palliative Care In The Intensive Care Unit, Crystal Sanchez

Master's Projects and Capstones

Abstract

Problem: Critically ill patients in the intensive care unit (ICU) frequently experience unmet palliative care needs due to inconsistent identification processes and delayed goals‑of‑care (GOC) discussions. Prior to this project, palliative care consultation practices were highly variable and lacked standardized criteria, resulting in missed opportunities for early communication and symptom management. This gap underscored the need for a structured, nurse‑driven approach to improve timely palliative care integration.

Context: This quality improvement project was conducted in a 20‑bed adult ICU within a large community‑based hospital system where palliative care integration was inconsistent and not systematically monitored.

Interventions: A nurse‑driven palliative …

The Effect Of A Patient-Centered Fall Prevention Tool On Reducing Falls, Maria Gracia Skallet

Master's Projects and Capstones

Problem: Maintaining patient safety is of utmost importance in healthcare. Healthcare organizations develop policies and protocols to minimize preventable harm and deliver care safely. However, hospital falls continue to occur, and preventing falls remains challenging. Falls and fall-related injuries can significantly impact the patient’s quality of life, cause prolonged hospital stays, and higher hospital expenses. Implementing an effective fall prevention program is imperative.

Context: There has been an increased incidence of falls within two medical-surgical units (5C and 5D) at Hospital J in Northern California despite using fall prevention measures such as hourly rounding, wearing yellow skid socks and yellow …

Implementation Of Feeding Education To Increase Hospice Volunteer Knowledge, Hannah Franzwa

Master's Projects and Capstones

Problem: Hospice volunteers have no formal training on end-of-life nutrition and how to feed patients. Insufficient knowledge of feeding patients presents safety issues, leading to decreased patient satisfaction and diminished volunteer role fulfillment.

Context: The setting was an independent non-profit hospice organization that serves around 1,000 patients within the San Francisco Peninsula and South Bay communities. The project was a collaboration between hospice leadership and the quality and education department.

Intervention: Volunteer education was implemented to increase volunteer knowledge about end-of-life nutrition and feeding patients. The educational session included a PowerPoint lecture, a small group discussion portion, and hands-on skills …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities.

Context: Frailty, …

Hazardous Drug Administration In The Home Setting: Reducing Exposure Risks, Cynthia D. Huff Msn, Rn, Ocn, Crni, Cnl

Master's Projects and Capstones

Hazardous drug (HD) administration used to be contained in controlled-healthcare settings, however, the introduction of HDs for home administration has become a growing area of concern for home health agencies. The objectives of the Clinical Nurse Leader (CNL) project aims to improve homecare nurses' knowledge of HDs and improve competency with personal protective equipment (PPE). The microsystem provides short-term homecare services for acute and chronically-ill patients. One team leader, two home infusion coordinators, and twelve registered infusion nurses participated in learning about exposure risks and PPE use with HD administration. Kotter's 8-step change theory was used to develop behavior change …

Improving Nurses' Proficiency And Confidence In The Use Of Aromatherapy For Patients In The Hospice Setting, Erika Bigwood-Keaton

Master's Projects and Capstones

The Institute of Medicine noted patient centered care as one of the six priority areas of improvement for the U.S. healthcare system. Recognizing that patients in hospice require specialized care to address the physical, emotional and spiritual needs that are associated with a terminal illness, the focus of this project is to improve the hospice nurses’ knowledge of and confidence in the use of aromatherapy for symptom management. There is recognition within the field of healthcare that patients are interested in having options for treatment. With little to no side effects, aromatherapy has been shown to be an effective alternative …