Medicine and Health Sciences Commons^™

Improving Nursing Shift Handoff Reports: A Quality Improvement Project, Nathan Mm Secrest

Master's Projects and Capstones

Nursing shift-to-shift handoff report can greatly impact a patient’s quality of care. According to the Joint Commission, “an estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off” (Inadequate handoff communication, 2017). In total, this quality improvement (QI) project worked with three hospital inpatient units on three different floors in an urban California (CA) city. Each unit and even shifts within each unit varied, leading to the conclusion that interventions should be trialed by units with the most buy-in, then adjusted to the unique needs of each unit. For our main intervention we …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

From The First Encounter: A Communication Program For High Volume, High Acuity Patient Care Locations, Shazam Bacchus

Student Scholarly Projects

Effective communication is a true value to healthcare organizations. Far too many communication sessions are detrimental to patient health outcomes. National data and hospital records are proven information to suggest communication is a major barrier to overall patient satisfaction. Organizations struggle to increase market share and patient satisfaction with a likelihood to recommend because of poor communication by physician and nurses. The use of a strategic communication tool like AIDET plus the Promise can influence the improvement of an organization’s quality of care.

This paper examines the use of AIDET plus the Promise as a strategic communication tool. High volume, …

Communication Techniques For Nursing Students, Erin Raby

Honors Theses

This thesis will discuss the effects nursing preceptors have on nursing students' clinical experience. This thesis will explore multiple factors that negatively impact nursing student’s communication with their preceptors. It has been found that clinical experiences are extremely important for the future of nursing students. However, there is often a communication barrier between nursing students and their preceptors. This barrier can lead to negative outcomes for new nurses entering the field. Strained communication can also create dangerous situations for patients. Students who fear harsh comments or vertical violence may be reluctant to disclose the limitations of their knowledge. We completed …

A Bedside Handoff Tool To Enhance Fall Safety Measures In The Emergency Department, Isha Adora Godbold

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Emergency Department (ED) is a fast-paced environment where the risk of communication failure enhances due to the variation in patient acuity, variety of shift options, and constant interruptions (White- Trevino & Dearmon, 2018). Ineffective communication can lead to increased adverse events, medical errors, and poorer patient health outcomes (Campbell & Dontje, 2019). Additionally, medical errors, such as falls, are more likely to occur during handoff when nurses change shifts (Campbell & Dontje, 2019). The most reoccurring medical error in the ED is patient falls.

Purpose: This quality improvement project aims to introduce a structured handoff rounding

tool, …

Improved Data Communication With Frontline Staff, David Sprecher

Master's Projects and Capstones

Problem: Frequently, communication from the Quality Department (QD) needs to be filtered through several organizational layers without first-hand knowledge of what message was given to frontline staff. Current mechanisms of communication between the QD and front-line microsystem teams have barriers preventing them from being consistent and reliable.

Context: Research has found that collaborating with and supporting frontline staff was key to establishing a culture that supports change and a focus on safety. Establishing open communication and effective teamwork with individuals on the frontline leads to shared values within a team and better collaboration which drives performance improvement.

Interventions: For trended …

Genomics-Informed Nursing Care: A Survey Of Nicu Nurses' Experience And Perspectives Related To Genomic Sequencing, Rachel I. Anderson

Theses and Dissertations

Background: Genomic sequencing is used in the Neonatal Intensive Care Unit (NICU) to diagnose babies with genetic disorders. Purpose: To explore the experiences and knowledge of nurses working in NICUs related to genomic sequencing. Methods: This was a mixed-methods, cross-sectional descriptive survey of NICU nurses attending a national conference. Quantitative data were analyzed using descriptive statistics. Qualitative data were coded into categories and themes. Results: Of 188 NICU nurses, nearly half reported experience with genomic sequencing. Among nurses with experience, 62.7% rated the amount of discussion they had with families about genomic sequencing as "0". Additionally, 72.7% of participants reported …

Implementation Of Scripted Debriefings Following Neonatal Delivery Room Resuscitations., Kimberly M. Knott

Doctor of Nursing Practice Papers

Abstract

Background: The functioning of neonatal delivery teams can be affected by technical and non-technical skills of individual team members. The team in this project was challenged by varying knowledge and skill levels and did not have a standardized process for debriefing resuscitation events. The literature shows that debriefings can aid in improving knowledge, skills, teamwork, and communication of resuscitation teams.

Purpose: The purpose of this quality improvement project was to implement a scripted, post-resuscitation debriefing with the neonatal delivery team to improve non-technical skills of the resuscitation team and identify challenges to providing optimal care.

Method: Scripted, …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Implementing A Standardized Nursing Communication Tool To Improve Inpatient Nursing Communication, Ashley D. Nator

Dissertations

Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Chairperson

Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022

Abstract

Problem: Patient handovers occur among nurses more than 4,000 times …

Utilization Of Staff Education To Improve The Management Of Aggression And Violence In The Rural Inpatient Psychiatric Setting, Clara Ugwuibe-Ogunseye

Doctor of Nursing Practice Projects

Background: Workplace violence (WPV) is a global concern and an occupational hazard faced by healthcare professionals worldwide. Aggression and violence can result in serious injury to the patient, healthcare professional, other patients, or visitors and cause stress to healthcare workers, and increase work absences (Picot, 2021).

Purpose: This DNP process improvement project aim was to utilize an educational training program on violence risk assessment, therapeutic communication, and verbal de-escalation techniques, to improve the confidence of mental health nursing staff in using early intervention to manage aggressive, violent patients. This education and early intervention reduced rates of aggression and violence escalation, …

Improving Confidence And Job Satisfaction In Emergency Nurses Through Teamstepps., Anna Moore

Doctor of Nursing Practice Papers

Problem Statement: New-graduate nurses (NGNs) are experiencing job dissatisfaction related to low communication confidence leading to high turnover rates and avoidance behaviors.

Purpose: To improve communication confidence and job satisfaction in NGNs through a nurse-led education session on emergency department (ED) communication techniques.

Methods: One online class lasting ~60 minutes was provided to educate NGNs on standardized emergency communication techniques. A pre-test post-test design was used with evaluations occurring before the education, immediately after, and 30 days later.

Results: Descriptive statistics were used to analyze the sample makeup. The Wilcoxon signed-rank test was used to calculate significant changes in communication …

Improving Healthcare Team Communication With Limited English Proficiency Families In The Nicu, Ivonne Mandell

Doctor of Nursing Practice Projects

Language barriers are common in healthcare settings, creating disparities in care between individuals with limited English proficiency and those with English proficiency. In the NICU setting, professional medical interpreters have been shown to improve parent/staff communication and increase parent satisfaction by allowing parents to ask questions and form trusting relationships with staff. Solid parent-provider communication can result in better health outcomes by increasing parental empowerment and participation in their child’s care. Despite the acknowledged advantages of using professional interpreters in healthcare settings, they are frequently under-utilized, even when readily available. The purpose of this project was to improve communication with …

Civility And Communication Interventions To Improve Patient Outcomes, Lane Denney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Communication in health care is vital for the successful care of patients and their outcomes while they are hospitalized. Healthcare workers are responsible for communicating patient information whether it is between change of shifts or reporting to a patient’s provider. It is important that this information is communicated effectively. This review evaluates how nurses communicate in shift- report and how this affects patient outcomes and civility between nursing units and teams. Overall, bedside shift reports promoted the best patient outcomes and increased teamwork on hospital units.

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox

Nursing Theses and Dissertations

Objective: The purpose of this body of work was to explore relationships among emotional intelligence (EI) and interprofessional (IP) competency domains to enhance IP team dynamics and communication.

Background: Decentralization of healthcare delivery may hinder effective handoffs creating opportunity for miscommunication of vital information and subsequent medical errors. Fostering effective communication is paramount for IP teams; however, differing communication styles can promote misunderstanding and conflict. Behavioral aspects of team dynamics and communication that comprise EI may be a solution but are rarely addressed in educational and safety programs.

Methods: Included in this portfolio are three manuscripts that help elucidate …

Reduction Of Order-To-Scan Times To Increase Patient Throughput And Improve Patient Outcomes: A Quality Improvement Project, Jason Harrington

Master's Theses and Capstones

Background: Throughput is a key metric for both the emergency department and the hospital system. Diagnostic tests, such as CT scans, can lead to a large delay in patient throughput which can negatively impact patient satisfaction and patient outcomes. Finding ways to reduce delays in CT scan acquisition can positively impact patient satisfaction and patient outcomes.

Aim: The specific aim of this quality improvement project was to decrease the amount of time it takes to complete abdominal CT scans with IV contrast once ordered from 61 minutes to below 35 minutes by July 1^st, 2022

Methods: Plan was …

Optimizing Secure Patient Messaging Workflow In A Vermont Primary Care Clinic, Kimberly S. Oleary

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Optimizing Secure Patient Messaging Workflow in a Vermont Primary Care Clinic

Kim O’Leary, DNPc, RN

DNP Advisor: Margaret Aitken, DNP, AGNP, ANP-BC

Site Mentor: James Williamson, MHA, Site Supervisor, Adult Primary Care

Background: Secure patient messaging is a popular tool designed for non-urgent questions, yet patients sometimes use it to relay urgent concerns. As office workflows tend to prioritize responses to other methods of communication, this presents a potentially unsafe situation in which clinical staff may not respond to these urgent messages in a timely manner.

Purpose: To develop a methodology to improve the timeliness, effectiveness, and safety of secure …

Situation-Background-Assessment-Recommendation During Hand-Off In A Mental Health Nursing Unit, Renel Ramos

Walden Dissertations and Doctoral Studies

AbstractCommunication failures, especially inadequate hand-off communication, in U.S. hospitals has accounted for 30% of malpractice claims, resulting in 1,744 deaths over 5 years. This prompted the Joint Commission to recommend utilizing standardized communication tools to reduce the number of medical errors related to miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) Communication Tool has been used to improve the effectiveness of communication among health care providers. The partner organization noted failures to communicate patient-care-related information between psychiatric mental health nurses (PMHN) during hand-off, given the absence of standardized communication. This project aimed to develop a program to educate PMHNs on the SBAR Communication Tool. …

Identification, Treatment, And Management Of Patients With Suicidal Ideation On The Medical-Surgical Unit For Nurses, Renea Crawford

Walden Dissertations and Doctoral Studies

Suicide and suicidal ideations are among the leading causes of death in the United States. The Joint Commission identifies inpatient suicide as a sentinel event that should never happen. Nurses working on the medical/surgical (M/S) unit in a hospital located in the midwestern region of the United States voiced their concern that they were not prepared to recognize the signs that may indicate an escalating emotional situation in patients with suicidal ideation; in addition, there were no guidelines in the hospital to use as a resource. The purpose of this project was to determine whether an evidence-based (EB) clinical practice …

Huddle Implementation In The Perioperative Setting, Tina Thomas

DNP Projects

Background: Communication is essential for safe and effective patient care. In the perioperative setting, information sharing is critical to care coordination. Lack of communication between caregivers can lead to medical errors. Evidence shows that huddles lead to increased communication, satisfaction, and engagement between team members resulting in better patient outcomes. Huddles are short, less than 10-minute gatherings that focus on the daily schedule, identify potential obstacles, explain unique needs, and discuss preceding day issues.

Objectives: This project aimed to evaluate the effectiveness of huddles on employee satisfaction, engagement, and communication of healthcare workers while also determining if huddles were …

An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi

Walden Dissertations and Doctoral Studies

AbstractDementia is a progressive chronic disease that requires skilled nursing care. Staff at a skilled nursing facility were not using best practices to prevent and manage the psychological and behavioral symptoms of dementia. The purpose of this DNP project was to implement a dementia care education to address this gap in knowledge. The question for the evidence-based educational project was whether the program increased knowledge, promoted positive attitudes, and increased confidence in dementia care staff. A 5-hour workshop was presented in person, twice in two weeks. The person-centered care model served as a framework for the project. Nursing staff (N …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …