Medicine and Health Sciences Commons^™

Intervention To Increase Home Preparation For Colonoscopies, Joshua Victor Stone

Master's Projects and Capstones

Abstract

Problem: Inpatient colonoscopies are costly to healthcare systems and inconvenient for eligible patients. The cost for a two-night inpatient bed is currently $4800.00 currently. The department manager led a five-month quality improvement project that was initiated in one 180-bed community medical center in Northern California to increase outpatient options, reduce the census and decrease the admission rate.

Context: Overburdened medical facilities often miss the opportunity to utilize ambulatory procedures due to competing operational priorities. In this setting, the Care Without Delay (CWD) department microsystem addresses barriers that impact operational throughput, efficiency, and unnecessary admissions.

Intervention: A …

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused …

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically …

Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens

Master's Projects and Capstones

Abstract

A High Reliability Organization (HRO), such as this Northern California Medical Center, holds itself to high standards of performance in the areas of recognition, ranking, and accreditation. The commonality between these high-scored and valuable acknowledgements is the pillars of Quality Outcomes. As benchmarking and reporting allow this facility to measure outcomes against self and other plans, it greatly strengthens the internal focus for continual improvement and goal setting in direct patient care and outcomes. A deeper layer of the Quality Department includes the bundle “ERAS – Enhanced Recovery After Surgery”, which is compiled of principles aiming to minimize opioid …

Reiki For Recovery: Incorporating Japanese Health Practices To Increase Contemporary Resiliency In American Health, Leif Peterson

Master's Projects and Capstones

The Japanese health practice of Reiki attempts to maximize the latent ability of the human system to heal itself. The Reiki system, established over a century ago, combines multiple Asian health traditions, experimenting with practices that maximize the natural processes of the body to perform its own repairs. Reiki encourages healthy behaviors that balance the mind and body, return the human system to a lowered stress level, and allow for an optimal recovery state for the patient. This paper illustrates how this Japanese health-affirming method can be integrated and utilized within existing health and medical practices. An area that is …

Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith

Master's Projects and Capstones

Abstract

Introduction Cancer survivors can face post-cancer treatment effects that need addressing throughout their care trajectory. Education provided to stakeholders and patients will be beneficial in preventing fragmented care, increasing patient satisfaction, and expanding ongoing supportive clinical survivorship care. Methods An adapted Dr. Joanne Lester survivorship needs survey was given to n=7 post-cancer treatment patients within a northern California cancer patient advisory committee. The survey results were analyzed to identify common underserved chronic long-term survivorship needs. Based on the data, an evidence-based educational component was included within a booklet to enhance future survivorship care. Additional surveys were sent to stakeholders …

Assessment Of Falls On A Medical-Telemetry Unit, Andie Reed

Master's Projects and Capstones

The purpose of this quality improvement project aimed at reducing falls on a medical-telemetry unit in a large metropolitan Magnet hospital. It was important for the MSN/CNL students to focus on falls because it is not just a concern for this institution, it is a national dilemma that needs to be addressed. Due to the complexities and intricate details of the IRB process, the MSN/CNL students were unable to collect data or further advance their project into the microsystem. Instead, information was attained from the University of San Francisco database to allow the MSN/CNL students to continue with the steps …

Meeting Joint Commission Compliance By Improving The Chart Audit Process, Nicole Hiroi

Master's Projects and Capstones

A hospice and home health care agency with an estimated 300 current patients looking to gain Joint Commission accreditation tasked its quality improvement department with identifying and improving deficiencies in the nursing documentation of patients’ charts. In order to do so, a redesign of their current chart auditing system needed to occur to take the process from pen and paper to an electronic database where the data gathered from the audit could be disseminated. The quality improvement team focused on ensuring that the new electronic process was user-friendly, encompassed all the quality areas needed, and allowed charts to be reviewed …

Response To Quality Of Life Surveying: An Analysis Of Patients With Wiskott-Aldrich Syndrome, Tara Bani-Hashemi

Master's Projects and Capstones

Patient-reported outcomes and surveying has increased in clinical settings in order to assess outcomes and patient health status. However, there is a lack of these assessments from a pediatric standpoint, an inpatient standpoint, and family perspective. In addition to health status and overall clinic experience, expanding the self-reported evaluation to include quality of life on physical and psychosocial levels will provide a more comprehensive evaluation of the patients’ health services. The PedsQL ™ scale scores four domains: physical, emotional, social, and school/work functioning. It includes a parent-proxy report as well as self-report for patients ages 5 to 18 years. Infant …

Discharge Prospectus, Cynthia Y. Vasquez

Master's Projects and Capstones

Background and Purpose:

The goals of the project are to improve the efficiency of the discharge process, to increase bed availability, to decrease readmission rates, and to increase patient satisfaction through implementation of multidisciplinary huddles.

Methods:

The intervention of the huddle took place on a medical-surgical unit at UC Davis Medical Center in the local Sacramento area serving various Medical Services.

This was a prospective pre- and post-quality intervention by utilizing HCAPHS survey, electronic medical record, RN surveys, and discharge data collection.

Results:

Discharges were increased from 15% to 23%. Currently, data is up-to-date for nine months but the project …

Quality Management: A Global Case Study In Organ Transplantation, Cassie L. Rodriguez

Master's Projects and Capstones

Every year the US and European countries face an epidemic of organ failure from a multitude of reasons: cancer, genetic predisposition, exposure to harmful chemicals in home or surrounding areas or through drinking, drugs and smoking. Another problem faced, is the ratio of organ donors to organ recipients. Over 121,000 patients are on the waiting for an organ transplant, and a fraction of those waiting will die because of time. The Hanover Medical school and department of quality management, have created an integrated approach to organ transplant avenues. Quality management is a systematic guide for organ transplantation that allows all …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Safe Patient Handling & No Lift Policy: Reducing The Incidence Of Work-Related Injuries Among Nursing Staff, Marissa N. Scanlon

Master's Projects and Capstones

Background: Patient handling is a major risk factor for work-related injuries among nurses. Inadequate and inappropriate safe patient handling practices contribute to increased work-related injuries, lost/restricted work days, and hospital costs.

Purpose: The focus of this study was to increase the use of mechanical lift equipment and Lift Team to reduce the incidence of work-related injuries among nursing staff involved in patient handling activities on the Medical-Cardiac IICU.

Methodology: The theoretical framework employed for this project was Lippitt’s change theory. Pre-and post-survey self-report evaluations were conducted prior to and following the implementation of the Bedside Mobility Assessment Tool (BMAT) and …