Digital Commons Network^™

Improving Patient Medication Reconciliation Participation And Compliance Through Education, Maria Elena Herrera

Master's Projects and Capstones

Abstract

The healthcare world is complex. At the center of this world are patients and their safety. Medication knowledge and medication reconciliation compliance are factors that influence patient’s safety and their overall health outcomes. This project explores the theme of patient safety by examining the relationship between patient education and health outcomes. The microsystem, located in the heart of San Francisco, is an outpatient clinic specializing in patients with renal impairment that each diverse and unique. A pre-implementation survey found that only 38% of patients were bringing their medications to appointments. A goal of improving compliance to 50% by December …

Improving Patient Satisfaction, Wait Times, And Access To Care In A College Health Setting; Expanding The Rn Role As Prescribing Agent With Standardized Procedures, Kimberly D. Perris

Master's Projects and Capstones

The CNL theme for this project is Nursing Leadership, Advocate for the Profession and is inspired by the Institute of Medicine’s call for all nurses to work to the maximum scope of their practice. The specific aim was to demonstrate RN confidence working independently, and proficiency using one RN protocol to provide hormonal contraception with an overall aim of improving patient satisfaction and access to care. This project took place in a rural university student health center where family planning and contraception services are the number one service provided.

The RN visit project has been multidisciplinary and collaborative in creating …

Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley

Master's Projects and Capstones

Patient satisfaction scores regarding how effectively staff educates patients about possible side effects of new medications are not consistently above the national average at a large metropolitan hospital in California (MHC). The results of these patient satisfaction scores shed light on the need for evidence-based strategies to improve a patient’s perception of the medication education provided to them. The basis of the incentive to improve care is ultimately increased safety and better patient outcomes. From the Root Cause Analysis, it became apparent that a few common barriers need to be addressed, but the one most frequently reported by everyone that …

Beyond Access To Education: Using Collaborative Learning To Promote Agency In Unauthorized Latinos Entering Community College, Amanda C. Price

Master's Projects and Capstones

The US is widely recognized as a nation of immigrants; however, when an estimated 70,000 unaccompanied child migrants arrived from Central America in 2014, unauthorized immigration became a full-blown humanitarian crisis. Unauthorized immigrants, 71% of whom come from Mexico and Central America, make up an increasingly significant portion of the population. This is particularly true in California, where 28% of unauthorized immigrants reside. However, despite the overwhelming consensus that command of English is paramount to a successful life in the US, an alarming 51% of unauthorized immigrants speak English “not well” or “not at all”.

Unauthorized immigrants face unique challenges …

The Battle Against Childhood Obesity, Allison Fox

Capstones

When 16-year-old Eric Foy came home from high school one weeknight in the fall of 2005, his life changed forever. His mother, Claudia, was resting on the tan couch in the living room, but she was slumped over to the left, towards the end table that held a dozen framed photos of his extended family. “Get me juice,” Claudia whispered to her son. Immediately, Eric knew what was happening –his mother’s blood sugar level was crashing. As he ran to the kitchen to pour a glass of orange juice, he started to panic.

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …

Implementation Of A Warming Protocol To Prevent Inadvertent Perioperative Hypothermia In The Ambulatory Surgical Setting, Joan Abigail Slagle

Master's Projects and Capstones

The implementation of a standardized warming protocol aims to improve patient outcomes by preventing inadvertent perioperative hypothermia (IPH) and its complications in the ambulatory surgical setting. All patients, regardless of age or gender, are at risk for experiencing a 1-2° C drop in body core temperature within thirty minutes of anesthesia induction. The global aim of this project is to prevent IPH and its complications in the ambulatory surgical setting by implementing a warming protocol at a freestanding ambulatory surgery center. While an audit of the microsystem revealed a normothermia rate of 28%, a standardized warming protocol is expected to …

Alarm Management: Electrocardiographic Lead Management, Dale Elaine Dominguez Ms.

Master's Projects and Capstones

Abstract

Alarm Management: Electrocardiographic Lead Management

Quality improvement and safety that incorporates the Clinical Nurse Leader (CNL) competency of putting in place quality improvements plans that are bases on evidence, analysis, and risk anticipation is the thesis for this project. The associated problem is the myriads of electrocardiographic (ECG) alarms that alert staff to patient issues each day. Of those alerts, 88% to 90% are false or do not require immediate attention (Sendelbach & Jepsen, 2013). The high numbers of false alerts cause staff to become desensitized to the sound. This desensitization may cause staff not to respond to a …

Decrease Arrival To Ct Time To Improve Stroke Outcomes, Curt Peterson

Master's Projects and Capstones

Abstract Final

The specific goal of the project is to decrease the arrival to t-PA treatment times to <45 minutes in > 50% of the cases. The decreased treatment time will prove to shorten the average length of stay on average by two days (Audebert & Sobesky, 2014). The goal will be accomplished by decreasing the arrival to computerized tomography (CT) scan completion time by at least 20%. The specific population of patients will be all stroke alert arrivals to the process’s microsystem via EMS, an Advanced Primary Stroke Center in Sacramento California. Root Cause Analysis, Strength, Weakness, Opportunity, Threat (SWOT), and Plan, Do, …

Empowering Patients With Central Venous Catheters: Utilizing Evidence-Based Video-Assisted Education To Reduce Central Line-Associated Bloodstream Infections, Pritam C. Steiner

Master's Projects and Capstones

An evidence-based Central Venous Catheter (CVC) dressing change video was created to enhance patient independence, and to increase resource efficiency among nursing staff in an inpatient pediatric setting in which Central Line-Associated Bloodstream Infection (CLABSI) rates were rising. Pediatric oncology patients confer the highest risk of developing CLABSIs due to long-term CVC access, neutropenic effects of treatment regimens, and constant fluctuations between inpatient, outpatient clinic, and homecare settings. Use of video-assisted education is anticipated to standardize and improve patient care, decrease healthcare costs, and increase nurse productivity, and is widely supported by research. Qualitative data collection was conducted by surveying …

Epacs: Epigenetic Regulators That Affect Cell Survival In Cancer., Catherine Murari

Theses & Dissertations

Cyclic adenosine monophosphate (cAMP) is a second messenger responsive to many external stimuli, playing an important role in cellular gene expression, metabolism, migration, differentiation, hypertrophy, apoptosis and secretion. All of these cellular functions are important in many diseases including cancer. Most of its effects were initially attributed to the classical protein kinase A (PKA) protein, but cellular functions such as proliferation and migration were found to be PKA independent and dependent on the newly discovered exchange proteins directly activated by cAMP (EPACs). EPACs are single polypeptides that primarily function as guanine exchange factors (GEFs) for Rap proteins that allow the …

Control Of The Basal Recycling And Surface Expression Of Epidermal Growth Factor Receptor By The Endocytic Recycling Regulator Ehd1 Utilizing A Pathway Shared By Rusc2, Eric Tom

Theses & Dissertations

The epidermal growth factor receptor (EGFR) is a prototype receptor tyrosine kinase (RTK) and oncogene aberrantly expressed or mutated in solid tumors. Its surface expression is dynamically regulated. Display of an activation-competent pool is essential for response to ligands. Internalization and degradation of EGFR following stimulation has received the most attention, fewer studies have characterized the recycling arm of EGFR transit, basal traffic and surface display are poorly understood. Thus, we evaluated the endocytic recycling of EGFR for its therapeutic potential in EGFR driven cancers. The C-Terminal Eps15 homology (EH) domain-containing proteins have emerged as regulators of surface receptor recycling …

Preoperative Education: A Patient-Centered Care Approach, Gia L. Wendt

Master's Projects and Capstones

Abstract

This project addresses the need for delivering high quality preoperative education to the Arabic speaking patient population served by Sharp Healthcare’s orthopedic service line. A goal set during the institution’s 2015 The Joint Commission Disease-Specific Care survey is to discharge major joint patients to home in two days or less. Data abstracted from Sharp Healthcare’s orthopedic registry revealed that only 30% of Arabic speaking patients are meeting this goal. The current process for educating Arabic speaking patients preoperatively during a one to one educational session with a third party interpreter takes three hours, costs $402.00 per patient, and education …

Decreasing Risk Of Delirium With Early Progressive Mobility, Donna J. Larson Mrs.

Master's Projects and Capstones

Abstract

The goal to consistently mobilize the mechanically ventilated patient to decrease the risk or progression of delirium is the primary focus of my project. This project took place in two, 12-bed critical care units. One is a cardiovascular, medical, surgical intensive care unit and the other is a neurotrauma critical care unit. The methods for implementation included writing the management of pain, agitation, and delirium policy based upon the recommended bundle from the Society of Critical Care Medicine referred to as the ABCDE bundle. As part of this bundle, the progressive mobility policy was revised so that a physician …

Social Emotional Learning And Mindfulness: Learning To Be Human, Jena-Lee Rogers

Master's Projects and Capstones

I am a teacher. I always have been and always will be. As a little girl, I developed a passionate need to see fairness and justice in my world, which of course outside of my family of origin revolved around my life at school. If one of my friends could not understand something, even if I was not totally sure about it myself, I would endeavor to help them learn it in a way that made sense to them. A small act of friendship helped me learn and develop my own a belief in the oneness that connects all of …

Building Awareness Of The Mental Health Issues Of Asian American College Women, Julie S. Baek

Master's Projects and Capstones

The purpose of this project is to build awareness of the mental health issues of Asian American college women. The National Alliance on Mental Illness (2009) reports among all women between the ages of 15 to 24, Asian Americans have the second highest suicide rates across all racial or ethnic groups whereas only 27 percent of them seek a professional help. Very little is known about what makes this population of students take their own lives at higher rates than their ethnic counterparts because of a model minority myth and lack of studies and attention. The project aims to develop …

Reducing Preventable Emergency Department Visits By Improving Patient Care Access To Primary Care, Lizeth Rodriguez

Master's Projects and Capstones

Abstract

Inadequate access to primary care creates a concern to receive comprehensive medical care. Improving access to a consistent source of care can help to obtain high quality of care, continuity of care, and reduce preventable emergency department (ED) visits. The aim of this project is to reduce preventable ED visits by improving patient care access to primary care. Comparing preventable ED visit rates between patients with access to primary care against those without access to primary care services, essentially focusing on those without access to primary care, which live in a medically undeserved community. The data collected was analyzed …

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …

Reducing Clostridium Difficile, Norabel V. Zafra

Master's Projects and Capstones

This CNL project aims to reduce the number of laboratory identified Clostridium Difficile Infections (CDI) events by 20% by December 2015. This CNL projects focuses on reducing CDI in an 8 unit bed specifically designated for medically ill geriatric patients above 70 years old residing in the West Texas region. A majority of the geriatric patients living with multiple co-morbidities require maximum assistance with activities of daily living and medication management. The geriatric patients will be discharge to a skilled nurse facility, long-term acute care, rehabilitation, independent living, or home with home health. A variety of methods such as reinforcing …

Reduced A1c Levels Through Diabetes Self-Management Strategies In The Teen Population: A Systematic Review, Nicole O'Neil

Master's Projects and Capstones

This project utilized current evidence-based practices to improve the diabetes education in the endocrine clinic for the adolescent population ages 15-18. Based on a clinic audit, an average hA1C level of 8.1% was revealed. The goal was to decrease these levels from 8.1% to 7.9% within 90 days through the implementation of the revised diabetes brochure. Evidence suggests the following: DSME improves clinical outcomes and quality of life; an A1C level >7% is associated with increased risks of complications ; teaching aimed at lowering glycemic levels have decreased numerous complications; there is a need to ensure age appropriate, family-centered care, …

Reinforcing Teach-Back Method Regarding Pain Management For Non-Verbal Patients And Their Families, Renee Krystle Doll Lazaro

Master's Projects and Capstones

Pain has been known to have physiologic, psychologic and emotional consequences. Education in pain management has been part for standard care for nurses. The purpose of this study was to reinforce teach-back techniques with nurses when delivering pain management education with non-verbal patients in order to improve patient outcomes in the adult ICU. By using the teach-back method, the nurse will be able to hone a more collaborative approach in dealing with pain, encourage autonomy and include the patient/family in making informed decisions regarding treatment for pain. Reinforcement regarding teach-back was focused on teaching points, and rewording teach-back cues to …

Prospectus Elements: Increasing Pediatric Immunization Rates, Catherine Le

Master's Projects and Capstones

There has been a recent outbreak of Measles and the majority who contracted the disease were unvaccinated (CDC, 2015). An increase in pertussis cases from 2013 to 2014 have occurred as well from 28,639 cases to 32,971 in 2014 (CDC, 2015). This is endangering the community, and putting infants and the younger generation at risk. Increasing immunization rates for patients to be fully immunized has become crucial. Being fully immunized not only reduces their chances of getting these diseases, but also helps the rest of the population who are too young to get these vaccines (Daly, Matthew F. & Glanz, …

Reducing Clabsi In The Nicu With Iv Tubing Competency, Tessa A. Toscano Ms

Master's Projects and Capstones

Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to …

Utilizing Ecological Connectivity In California Desert Wilderness Preservation, Lauren Kahal

Master's Projects and Capstones

The Wilderness Act of 1964 gave the federal land management agencies—the National Park Service, United States Forest Service, U.S Fish and Wildlife Service, and Bureau of Land Management—the authority to identify, propose, and manage lands as wilderness. Wilderness, once approved by Congress for inclusion in the National Wilderness Preservation System, is offered the highest form of land preservation in the nation. However, the wilderness identification process used by the implementing agencies is based on a half-century old statute with an aging definition of wilderness. While designated wilderness can protect the plant and wildlife communities within its borders from direct anthropogenic …

Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias

Master's Projects and Capstones

Purpose: The aim of the study was to identify barriers encountered by registered nurses (RNs) and nursing assistants (NAs) that prevent purposeful (hourly) rounding.

Background: The literature has shown that purposeful rounding improves patient outcomes and safety. However, few studies show the barriers encountered by nursing staff that hinder the purposeful rounding process.

Methods: A pre-post test design was implemented on a 25-bed oncology, urology medical surgical unit with a staff of 38 RNs, 9 NAs, and 4 Unit Secretaries (US). A pre-implementation needs assessment survey was completed by 55% (21/38) of RNs, 33% (3/9) of NAs, and 100% (4/4) …

Proactive Environmental Strategies: Managing A Corporate Culture Shift Toward Sustainability, Mark E. Calub

Master's Projects and Capstones

The roles and responsibilities of Environmental, Health and Safety (EHS) professionals have expanded over the last several decades. Initially focused solely on reducing a firm's ecological impact, many EHS professionals are now tasked with managing a firm's cultural shift towards sustainability. EHS professionals need to develop proactive environmental strategies that further interconnect the environmental, social, and economic performance goals of the firm. Using a concept analysis and integrative literature review approach, the research examines the evolving role of corporate environmental management and evaluates strategic management tools for environmental compliance, environmental performance, and corporate sustainability. The research reveals that the role …

Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter

Doctor of Nursing Practice (DNP) Projects

Abstract

A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …

Uap 7200: Cash Management, University Of New Mexico

Section 7000: Fiscal Management

Process Owners: University Controller (Main Campus) and HSC Senior Executive Officer for Finance and Administration

Uap 7710: Property Management And Control, University Of New Mexico

Section 7000: Fiscal Management

Process Owners: University Controller (Main Campus) and HSC Senior Executive Officer for Finance and Administration

The Constitution And Societal Norms: A Modern Case For Female Breast Equality, Brenna Helppie-Schmieder

DePaul Journal of Women, Gender and the Law

“The Constitution and Societal Norms: A Modern Case for Female Breast Equality” argues that laws prohibiting the public display of the female breast, but not the male breast, are unconstitutional under the Fourteenth Amendment’s Equal Protection Clause. That these laws discriminate against women is obvious, yet courts have historically refused to recognize an Equal Protection Clause violation. However, the primary reasons courts rely upon are ripe for review. Most significantly, courts typically justify female breast censorship laws based on the government interest in protecting public sensibilities, without recognizing that public sensibilities change. Indeed, perceptions of the public female breast have …