Medicine and Health Sciences Commons^™

Pet Loss And Grieving Strategies: A Systematic Review Of Literature, Ruth E. Cervantes

Master's Projects

The impact that companion animals have on human lives has been explored in many aspects including therapy and emotional support. In some cases, these types of pets have been deemed necessary for pet owners with medical problems. However, pets are not only a medical necessity for some humans, but they are also companions, and most are included as family members. The loss of a pet often brings on intense grief that is not often acknowledged in the workforce. Bereavement leave for immediate family members is a benefit offered to employees, and as we will read in this literature review pet …

A Systematic Review: Relationship Between Medication Adherence And Hypertension, Monica Chan

Master's Projects

Chronic diseases are defined as conditions that are present for over one year and limit activities of daily living or require ongoing medical attention. Heart disease is the number one leading chronic disease in the United States, making up one third of all deaths. In turn it costs the health system $216 billion per year (Center for Disease Control and Prevention, 2023). Uncontrolled blood pressure is a key risk factor for heart disease and stroke. 1 in 2 adults will need to take prescription medication to control blood pressure and lower the risk of having a cardiovascular event. This systematic …

Resilience Training For Healthcare Professionals: A Literature Review, Michelle Dictor

Master's Projects

Purpose: An exploration of various resilience training programs to determine if there is a significant impact on the psychological resilience of health care professionals.
Method: An electronic systematic review using San Jose State University’s OneSearch database search engine was completed. The review contains published research articles between 2011-2022. Nine published articles were reviewed and used for this systematic review.
Results: There is limited data related to resilience training and resources in accredited nursing programs. Resilience training programs are both a feasible and acceptable way of building psychological resilience among interdisciplinary health care professionals.
Conclusion: Mindfulness-based resilience training programs can be …

Standardizing Patient Transfer Process Among Nurses From Labor & Delivery To Mother-Baby Unit: A Quality Improvement Project, Kiratraj Kaur Grewal

Master's Projects

Purpose: To implement and evaluate the efficacy of a standardized patient transfer process among registered nurses (RN) from Labor & Delivery (L&D) to Mother-Baby Unit (MBU) using PDSA cycle to improve RN satisfaction and reduce patient transfer time
Conceptual Framework: PDSA Cycle
Setting: Labor & Delivery and Mother-Baby Unit of a tertiary care hospital
Methods: The project consisted of collecting both objective (estimated patient transfer time from L&D to MBU) and subjective data (anonymous nursing pre- and post-intervention surveys). Standardization of transfer process included implementing a transfer checklist, patient transfer tool, updating the workflow, and a sample patient transfer video. …

Reducing Catheter-Associated Urinary Tract Infection Rates By Educating Staff On Bundle Interventions, Tirath Kaur

Master's Projects

PURPOSE: Catheter associated urinary tract infection is an undesired burden to the patients and healthcare system. This systematic review explores the published literature and determines the impact of educating nursing staff on the indication of urinary catheter, insertion of foley catheters, maintenance of urinary catheters, and periodical communication between nurses and physicians for changing foley catheters can reduce the CAUTI rates in adult patients in the acute care hospital setting. METHOD: A systemic review was conducted using CINHAL, Science Direct, PubMed, and MEDLINE within the time period of ten years from 2012 to 2022. Eight published articles are reviewed and …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …

The Effect Of Providing End Of Life Care On The Mental Health Of Critical Care Nurses, Christy Nelson

Master's Projects

Critical care nurses are providing care to acutely ill patients now more than ever and may experience moral or emotional distress due to providing end of life care to their patients. The purpose of this literature review is to determine the mental health effects of a critical care nurse providing palliative end of life care. A literature search using PubMed and CINHAL was conducted and fourteen published articles between 2012-2023 were included in this review. Several interventions were identified which may be useful in decreasing burnout and moral distress in critical care nurses. Overall, nurses experienced the most negative mental …

Cabg Vs. Pci: Greater Outcomes For Severe Coronary Artery Disease, Haejin Cho

Master's Projects

Coronary artery disease is the leading cause of mortality in the United States. The lifetime probability of developing coronary artery disease after 40 is 40% in men and 32% in women. Cardiac revascularization for patients with complex coronary artery disease is performed commonly. Two common procedures for cardiac revascularization are coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this systemic review is to compare long-term outcomes of CABG and PCI in patients with severe artery disease. This review concluded that PCI was associated with higher rate of repeat revascularization compared to CABG, but the incidence …

Efficacy Of Gabapentin Versus Benzodiazepines In The Management Of Alcohol Withdrawal Syndrome, Douglas R. Fredona

Master's Projects

Alcohol abuse, complicated by a dependency relationship, is the third leading modifiable cause of death in the United States. In patients with chronic alcohol use disorder who experience a sudden cessation or significant decrease in alcohol consumption, half will experience symptoms of alcohol withdrawal syndrome. Benzodiazepines are the typical first line treatment for alcohol withdrawal. However, benzodiazepines carry with them significant risks and side effects. As a result, ongoing research has taken place to find either an alternative treatment or a method of reducing total benzodiazepine dosage during treatment. Gabapentin is a medication that is primarily used for seizure control …

Effectiveness Of Standardized Vs. Individualized Cancer Treatment Education, Jija Issac

Master's Projects

As the number of cancer diagnoses continues to increase and is expected to keep rising, it becomes imperative to explore avenues to optimize patient education. Research has consistently demonstrated that effective education plays a crucial role in improving patient outcomes. Through my previous experiences in various outpatient oncology infusion centers, I have observed significant variations in the methods employed for delivering patient education across different facilities. In this literature review, I explored the effects of standardized chemotherapy education and individualized chemotherapy education on patients in outpatient oncology clinics. The predominant themes across these studies encompass patient awareness of anticipated symptoms, …

Cultural Perspectives In Pain And Palliative Care, Loan Lagué

Master's Projects

Culturally and linguistically diverse (CALD) patients are constantly challenged by the different levels on which lack of cultural competency or bias occurs in healthcare. This literature review focuses on the healthcare providers’ experiences when providing pain and palliative care to CALD populations and explores the challenges that may result in health inequalities. A review of current literature was conducted using PubMed, CINHAL, Sage Journals, Ovid, and Science Direct electronic databases. Sixteen published articles between 2015-2023 were reviewed. Findings from this review identified factors that induce poor quality palliative, pain, and end-of-life (EOL) care among culturally diverse groups. Improving quality of …

Efficacy Of Utilizing A Discharge Checklist At A Northern California Hospital, Becky Le

Master's Projects

Standardization of patient discharges by utilizing a discharge checklist would address discharge barriers, improve discharge times, enhance communication among the multidisciplinary team, and improve efficiency of care. A 5-week pilot, which was a quality improvement study, explored whether the utilization of a discharge checklist would improve discharge times and communication among the multidisciplinary team. This study was conducted in a northern California county hospital, on 2 medical- surgical units, with a participating physician team, case managers, and approximately 150 medical- surgical registered nurses. The study yielded results of improved discharge times by 1 hour, and improved efficiency of care by …

The Impact Of Utilizing The Eat, Sleep, Console Model On Pharmacologic Interventions And Length Of Stay, Kareena Parks

Master's Projects

Purpose: This systematic review seeks to explore whether utilizing Eat, Sleep, Console (ESC) over the Finnegan Neonatal Abstinence Scale (FNASS) in the neonatal abstinence syndrome (NAS) population decreases length of stay or pharmacological interventions.
Method: Systematic literature review utilizing CINAHL, PubMed and Google Scholar databases.
Results: Utilizing Eat Sleep Console, over FNASS decreased length of stay and pharmacologic intervention.
Conclusions: There is compelling research suggesting a change in NAS treatment from FNASS to ESC with a decrease in length of stay and pharmacologic intervention. However, there is an opportunity for further studies providing higher levels of evidence as the current …

The Effects Of Nursing Bedside Shift Report On Patient Safety And Satisfaction: A Systematic Review Of The Literature, Alyssa Wong

Master's Projects

Introduction: Nursing bedside shift report is a recommended strategy to promote the effective exchange of accurate patient information during the handoff process with the goal of decreasing communication errors and adverse patient events. However, adopting this handoff method into nursing practice has been challenging in the clinical setting. This systematic review aims to understand the rationale behind nursing bedside handoff by identifying the advantages and barriers to implementation and exploring how this affects patient safety and experience.
Methods: A systematic review was conducted by searching through electronic databases and Google Scholar to identify English-language peer-reviewed journal articles published between 2012 …

A Standardized Unit Based Process For Obtaining Heart Failure Patient Weights, Lesli E. Teed

Master's Projects

Introduction: A CNL student-led process improvement process improvement project was proposed to help improve the accuracy of Heart Failure patient weights on a geriatric specialty unit. Cardiology voiced a preference for patients to be weighed using electronic standing scales rather than in-bed scales to improve accuracy. A literature review revealed that in-bed scale weights were less accurate due to inconsistencies in zeroing the bed prior to obtaining the weight, not removing excess patient care equipment and bed linens, and not ensuring that the patient was wearing a minimal amount of clothing.

Methods: Electronic standing scales were purchased, current practice state …

Implementing Purposeful Rounding As A Quality Improvement Project To Improve Patient Satisfaction In The Emergency Department, Kersten O'Brien

Master's Projects

Purpose: The purpose of this paper is to describe a quality improvement project to develop and implement a purposeful rounding protocol to improve patient satisfaction and call light rates which affect both patient and nursing staff satisfaction in the emergency department (ED). Importantly, patient satisfaction scores in the ED tend to be low but high scores are related to improved competitive advantage, reimbursement rate, patient outcomes, and nursing staff interruptions.

Methods: A literature review was conducted to determine best practices. Using the lean process and the Plan-Do-Study-Act (PDSA) model, this information was used to identify opportunities for improvement and to …

Developing An Evidence-Based Discharge Process For Patients On A Cardiac/Renal Acuity-Adaptable Inpatient Unit, Tami Gallagher

Master's Projects

Introduction: Readmissions continue to negatively impact patient outcomes and create a significant financial burden. Regardless of efforts to reduce readmission rates, the cost of readmission continues to increase.

Clinical Problem: All-cause, 30-day readmission rates on a cardiac/renal acuity-adaptable inpatient nursing unit ranged from 11% to 33% from July to December 2018 for patients diagnosed with COPD, AMI, HF, and sepsis. The readmission rate for the organization was 16.2% in September 2018 with a target goal of 14.8%.

Project Aim: To use quality improvement tools and an interdisciplinary team to implement the teach-back method during discharge education and a discharge preparedness …

A Quality Improvement Project To Enact Evidence-Based Guidelines To Improve Documentation Of Hemoglobin A1c For Inpatient Diabetes Populations, Karyn C. Kinney

Master's Projects

The purpose of this paper is to describe a quality improvement project aimed to improve the documentation of hemoglobin A1c in the discharge instructions for patients with a diagnosis of diabetes prior to a transition from the acute care setting. Clinical practice guidelines from the American Diabetes Association and patient education recommendations from The Joint Commission are the impetus for this process improvement. The Plan-Do-Study-Act (PDSA) model was utilized to identify, design, and implement the process change in collaboration with an interprofessional team. The documentation rate of hemoglobin A1c was measured on two medical-surgical inpatient hospital units both pre- and …

Improving A Discharge Process To Decrease Readmission Rates, Erni Ensing

Master's Projects

No abstract provided.

Implementing Evidence-Based Fall Reduction Interventions In An Urban Emergency Department, Nichole L. Schmidt

Master's Projects

The patient population that is falls in the emergency department (ED) tends to differ from population that falls on inpatient units. However, there is no validated fall risk assessment for the ED setting. In an ED in a western Michigan hospital a fall reference card was designed and trialed by a small group of ED nurses on twenty-five ED patients. The fall reference card was created as a quick-reference guide for the assessment of fall risk, and the implementation of evidence-based fall risk interventions. The card utilized interventions supported by literature as the most common reasons for ED falls. The …

Hospital Acquired Pressure Injury Gap Analysis, Mary Lou Hall

Master's Projects

Hospital acquired pressure injuries (HAPIs) were identified as an area for a quality improvement (QI) project in a progressive care unit (PCU) in a Midwestern Hospital. In order to reduce HAPIs and provide the best possible preventative care, a gap analysis between the current care practices on the progressive care unit and the best evidence-based practice recommendations for HAPI prevention in the areas of risk/skin assessment, surface support, nutrition and hydration, repositioning/movement, moisture management, and prophylactic dressings was conducted. The Model for Improvement (MFI) was the QI framework that guided this pressure injury gap analysis.

The goals of this gap …

Increasing Use Of A Tobacco Cessation Quitline In A Rural Prenatal Population, Rachel T. Schleenbaker

Master's Projects

This paper addresses prenatal smoking rates within in a rural northern Michigan district health department (HD) through a Master of Science in Nursing (MSN) quality improvement project. The paper provides a detailed microsystem assessment of the Maternal Infant Health Program (MIHP) at the district HD describing the clinical problem and identifying a practice gap in care of prenatal smokers. The literature review describes the three most effective prenatal smoking cessation interventions: counseling, incentives, and feedback. The literature review also addresses the effectiveness of and barriers to smoking quitlines. The clinical protocol followed the Model for Improvement framework with the completion …

Applying Process Standardization And Health Literacy Precautions To Increase Older Adult Patient Satisfaction With Medication Teaching, Casie N. Sultana

Master's Projects

The purpose of this paper is to describe a quality improvement (QI) project with the goal of creating an evidence-based, standardized process for nurses to teach older adult patients about newly prescribed medications.

Evidence Based Protocol: Improving Nutrition Monitoring In Hospitalized Adults, Philip W. Jackson

Master's Projects

Malnutrition affects a large number of adult inpatients. For these patients, the implications of the high rate of malnutrition include impaired wound healing, higher rates of infection, and an increased risk of death. These complications contribute to increased healthcare costs and longer lengths of stay. The level of monitoring and documentation of patients’ meal consumption was acknowledged to be below expectations in an acuity-adaptable neurosciences unit situated in a downtown hospital located in the Midwestern United States. The define-measure-analyze-improve-control (DMAIC) quality improvement framework guided the quality improvement team to develop a standard process for meal related activities. The rate of …

Early Progressive Mobility In The Intensive Care Unit Adult Patient Population, Kimberly Henry

Master's Projects

No abstract provided.

Evidence-Based Protocol: Decreasing Falls And Falls With Injury In A Nsdu, Jennifer J. Komm

Master's Projects

Patient falls in acute care tend to be the most common adverse events reported. The Centers for Medicare and Medicaid Services report that fall-related injuries are classified as hospital-acquired conditions and no longer reimburses for the diagnosis and treatment of injuries incurred from falls during hospitalization. Falls are decreasing at too slow a rate even with a variety of fall prevention guidelines being available. Falls are a complex problem within hospitals and the prevention of falls is challenging. Literature supports the individualization of fall prevention interventions based on the risk factors exhibited by a patient. Tailoring interventions to specific fall …

Cesarean Section Surgical Site Infection Prevention Evidence-Based Practices And Implementation Plan, Amanda K. Smith

Master's Projects

The Cesarean section (C-section) surgical site infection prevention implementation plan has been designed as a quality improvement project. The project included a microsystem assessment, identifying the problem, literature review, application of a nursing theory and conceptual model, and development of an implementation plan. The microsystem assessment involved a Labor and Delivery Unit who had initiated a new surgical site infection (SSI) prevention bundle developed by an interprofessional team utilizing evidence-based practices and other hospitals protocols. The problem defined was the elevated rates of SSIs due to gaps in the SSI bundle risking the sustainability of the bundle. A literature review …

Early Ambulation For Colorectal Enhanced Recovery Patients In A Surgical Specialties Unit, Jessica P. Pelletier

Master's Projects

Early ambulation is a key concept in surgical recovery and overall improvement of medical conditions. The initiation of Enhanced Recovery programs (ERP) for surgical procedures have used evidence-based research to bundle best practices for a quicker and more effective recovery.

The author evaluated the consistency of early ambulation on a surgical specialties unit using the ERP method. Through process improvement methods, data and practice were evaluated to show inconsistencies in documentation, data report abstraction, and understanding of complete collaborative bundle components.

Impacting Adherence To Infant Safe Sleep Practice, Danielle M. Hartig

Master's Projects

This paper provides a complete microsystem assessment of a pediatric unit. The assessment includes identification of a process problem with infant safe sleep practice in the hospital setting. The paper explores six different published articles regarding clinical practice guidelines, best practices, and evidence-based interventions. The literature review indicates agreement amongst various authors following infant safe sleep guidelines in the hospital setting. The literature review also indicates that caregiver role modeling while in the hospital setting is the most influential component that affects parents’ practices upon return to the home setting. The clinical project will include baseline needs assessments of both …

Improving The Supply Process In An Interventional Procedures Unit, Megan M. Rose

Master's Projects

In the combined cardiac catheterization and interventional radiology unit of an urban Midwestern hospital, having supplies when and where they are needed is necessary for efficiently and safely completing a wide variety of procedures. Due to the complexity of the supply chain process in this setting, baseline data collection revealed many missing supplies, overnight shipments, and expired items. In this project, the MSN student sought to determine whether a Clinical Nurse Leader driven Lean Six Sigma based approach to supply chain interventions in the interventional procedures setting would improve outcomes and lead to financial savings by decreasing waste and variation. …