Medicine and Health Sciences Commons^™

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Exploring The Patients’ And Family Members’ Perspectives On Home-Based Palliative Care, Nadia Sultan Ali

Theses & Dissertations

Background: Home health care is considered as a partial substitute for institutional long-term care, because patients and families with known poor prognoses prefer to stay home with their loved ones and people mostly cannot bear the cost of care at the hospital. Therefore, the importance of home-based palliative care is raised via a shared and coordinated model for saving lives through care.
Purpose: To explore patients' and family members' perspectives and experiences of receiving home-based palliative care services.
Method: This was a qualitative exploratory study conducted in Karachi, targeting patients and family members receiving home-based palliative care services. The data …

Pre-Operative Anxiety Of Patients In District Hospitals In Ashanti Region, Ghana, Sawan Dankyi Sa, Million Bimerew Mi, Jennifer-Anne Chipps Ja

Journal of Perioperative Nursing

Objectives: To investigate pre-operative anxiety of patients at district hospitals in Ashanti Region, Ghana.

Method: A descriptive survey was conducted with patients who were being prepared to undergo various surgical operations at ten hospitals. The questionnaire included the Hamilton Anxiety Rating Scale (HAM-A) and questions about factors that may contribute to patients’ anxiety prior to surgery.

Results: Most of the 210 respondents reported anxiety with 189 (90%) reporting some anxiety before the surgical operation (20.57/30, +/-10.07), range 0–26). Respondents reported moderate anxious mood (2.14, +/-1.45), tension prior to surgery (2.00, +/-1.35) and insomnia on the day before the procedure (2.00, …

An Evidence-Based Teaching Plan For Preventing Wrong-Site Block Placement During Regional Anesthesia, Mark A. Michetti, Kristen E. Newbrough

DNP Scholarly Projects

Wrong-site regional anesthetic block placement is a threat to patient safety and quality perioperative care. The adverse outcomes for patients, providers, and institutions demonstrate safety risks that are linked to inconsistent use of comprehensive guidelines in clinical practice. The purpose of this Doctor of Nursing Practice Project is to create a comprehensive evidence-based Teaching Plan for preventing wrong-site block (WSB) placement during regional anesthetic induction and for use in institutions by anesthesia providers to prevent wrong-site anesthetic block placement. The teaching plan focuses on four main constructs to prevent WSBs, which include the incidence of WSBs, the consequences of WSBs, …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

Patient Positioning To Prevent Pressure Injuries, Maria D. Trevis

Theses and Graduate Projects

Skincare is an important intervention to prevent pressure injuries (PIs) during hospitalization. Prolonged pressure on a body part can result in restricted blood flow and oxygen, inadequate nutrition, and varying degrees of tissue damage, ultimately leading to a PI. Patients who have undergone surgery or have limited mobility are particularly vulnerable to developing PIs. The Centers for Medicare and Medicaid Services made a ruling in 2008 that hospitals would not be reimbursed for any hospital-acquired PIs as they are costly and preventable. Unfortunately, there is a knowledge gap in PI prevention due to a shortage of nursing staff, and changes …

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 …

Evaluation Of Internalized Stigma And Quality Of Life Of Patients With Psoriasis, Bedriye Cansu Demirkiran, Emine Kiyak

Makara Journal of Health Research

Background: Internalized stigma is defined as individuals’ acceptance of negative stereotypes created by society and then their alienation from society. Psoriasis is a dermatological disease that affects the quality of life. The study evaluated the internalized stigma and quality of life of patients diagnosed with psoriasis.

Methods: This cross sectional study enrolled 222 patients. Data were collected using the internalized stigma scale and the dermatology life quality index questionnaires. Data were analyzed using the Cronbach’s alpha.

Results: The internalized stigma score of the patients was 78.41 ± 23.14, and the quality of life score was 12.30 ± …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

Patient Experience Of Inpatient Care And Services Received At A Teaching Hospital In Malaysia: A Cross-Sectional Study, Wan Nor Fatihah Wan Nawawi, Vimala Ramoo, Mei Chan Chong, Nor Zehan Ahmad

Makara Journal of Health Research

Background: Patients’ experience reflects the quality of healthcare services from the end user’s perspective and therefore is an essential indicator of healthcare quality. This study aimed to measure patient experience of inpatient care and services received at a teaching hospital.

Methods: A total of 321 patients were enrolled in this quantitative, cross-sectional study during their discharge. Data were collected from May to September 2018 through a validated self-administered questionnaire adapted from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Analysis of patient experience and overall hospital quality rating was conducted using SPSS version 25.

Results: …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Nursing Students Attitudes Towards Patients' With Disabilities, Sonny Miles

Honors Theses

Attitudes have been found to impact the quality of healthcare provided to patients. Nursing students are individuals that will eventually care for and impact the livelihood of all individuals including those with disabilities. Measurements of attitudes among nursing students serves to evaluate the efficacy of nursing curriculums regarding disability and determines if revision is needed to better promote healthcare administration for the patient with a disability. This study utilized the Scale of Attitudes Toward Disabled Persons (SADP) to measure attitudes among nursing students enrolled in a baccalaureate nursing program at a Southeastern University. The mean score from participants was 108.49 …

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 …

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 …

Reducing Hospital Noise Levels Through Nursing Staff Education, Althea Sanders

Walden Dissertations and Doctoral Studies

AbstractNoise levels can negatively affect a patient’s hospital experience. Increased noise levels in the hospital can trigger sleep disturbance and affect the length of recovery for patients; the increased noise levels can also cause increased anxiety and exhaustion for nursing staff members. Due to a gap in nursing practice related to nurses’ knowledge to safely reduce noise levels, this project addressed if nursing staff education on noise reduction could increase the knowledge among nursing staff members to use specific strategies to reduce noise levels in an intensive care unit (ICU) setting. The purpose of this project was to educate eight …

Patient Coordinated Care Response Team, Joshua Fox

Master's Projects and Capstones

Section I: Abstract

Problem: Communication between medical professionals and patients is a critical element to patient satisfaction and safety. The 2020 patient overall satisfaction scores for the local Roseville hospital were 73%. These data demonstrated an opportunity to enhance processes and the culture at the local Roseville hospital to meet the communication needs of its patient population.

Context: A patient coordinated care response team was developed to improve communication for newly diagnosed cancer patients or other life-altering diagnosis patients.

Interventions: A survey was completed to establish the current state of patient satisfaction with communication practices with healthcare providers in the …

Hourly Rounding To Reduce Patient Falls - A Quality Improvement Project, Shelley L. Lloyd

MSN Capstone Projects

Patient falls are devastating. They can result in injury and even death. They also result in extra costs for the patient as well as they facility. Hourly rounding is a simple process that can help reduce the number of patient falls within an acute care facility. Purposeful hourly rounding will help meet the needs of the patient as well as allow the staff member to asses the environment for safety issues. Rounding should happen every hour during the day and every two hours at night. During these rounds, staff will ask the patient about pain, bathroom needs, comfort, peacefulness of …

Does Ipe Improve Patient Safety?, Katie Henson

Student Research Poster Presentations 2021

No abstract provided.

Inspiring Nurse Leader Connectedness To Improve Patient Experience, Shauna Maxson

Doctor of Nursing Practice Projects

Objectives:

1. Interventions targeted at improved communication, retention, empowerment, and encouragement will be utilized to enhance the practice environment of incumbent and future nurses in the emergency department. Nurse connectedness will be improved 25% over baseline following implementation of interventions to positively augment practice environment.

2. Patient experience scores in the emergency department will be sustained at benchmark, or greater, following efforts to improve nurse connectedness.

Design: Prospective, single-center, non-randomized, pre- vs. post-

Data Sources: Scholarly, peer-reviewed journal articles and texts, results from pre- and post-intervention completion of Utrecht Work Engagement Scale, Press Ganey patient experience scores

Review Methods: Review …

Improving Patient And Provider Engagement By Utilizing Ask Me 3®, Joseph G. Smith, Msn, Arnp, Fnp Bc

Doctor of Nursing Practice Projects

Background: Patient and provider engagement in healthcare has an impact on health outcomes.

Purpose: To study the implementation of the Ask Me 3 (AM3) tool, a tool that encourages patients to ask three questions about their health to their care provider. The aim of the project is to explore the level of patient and provider engagement by patients` reports of their perception of engagement with their provider and in understanding their diagnosis.

Methods: The setting was a small urban family practice in the Pacific Northwest. Every patient that checked in for their appointment, excluding pediatric and younger than 18 years …

Clinical Practice Patient Education Guideline For Elective Induction Of Labor, Allison Keleske

Walden Dissertations and Doctoral Studies

In 2018, the state of Florida had a cesarean section birth rate of 38.3% which was the 3rd highest in the nation with the national average being 31.9%. Elective induction of labor (EIOL) involves the initiation of labor for convenience and not because of medical necessity. EIOL carries risks for the mother and fetus, including an unplanned cesarean section. The problem identified in this project was the lack of informed decision-making by pregnant women related to risks, benefits, and management of EIOL. Using the Informed Decision-Making through Engagement Model, the purpose of the project was to develop an evidence-based clinical …

Caring Science Education: The Essence Of Professional Practice For The Registered Nurse, Linda C. Ackerman

Doctor of Nursing Practice (DNP) Projects

Problem: Hospitals have moved from caring, healing environments to business or economic models of caring institutions that focus on census instead of on patients and on technology instead of on touch or human connection (Watson, 2006).

Context: As nurse leaders, we have an obligation to create an environment of authentic, professional, human caring practices within our organizations. Caring science empowers nurses to balance the art and science of clinical judgment by engaging and collaborating with the patient and their family, focusing on the needs of the whole person, honoring the unique perception of health and healing, and engaging them to …

The Social Process Of Dying In The Hospital: A Grounded Theory Study, Alyson Prokop

Doctoral Dissertations

The majority of deaths in the United States occur in the hospital (Xu, Kochanek, Murphy, & Tejada-Vera, 2010). Because there is little understanding of the meaning behind this delicate social process for the patient, the purpose of this study was to develop a theory that describes the social processes one undergoes during the in-hospital end-of-life phase. Grounded theory methodology was chosen to understand this phenomenon and then explain it theoretically (Charmaz, 1990). The data used to develop the theoretical model was previously collected by StoryCorps and therefore components of secondary analysis were taken into consideration. Stories that are housed at …

Strengthening Safety Culture By Leveraging The Daily Management System, Suneela Nayak, Mark Parker, Erin Graydon Baker, Amy Sparks, Ruth Hanselman, Stephen Tyzik, Sydney Green

Operations Transformation

STRENGTHENING SAFETY CULTURE BY LEVERAGING THE DAILY MANAGEMENT SYSTEM

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis …

A Coaching And Team Performance Evaluation Model To Build Capacity For High-Impact Lean Improvement, Ruth Hanselman, Mark Parker, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis identified 5 areas for improvement and several countermeasures were …

A Survey Of Healthcare Workers On Safe Patient Handling And Mobility Resource Availability, Utilization, And Adherence, Kimberly Waltrip

Dissertations

The purpose of this study was to examine the current status of safe patient handling and mobility—specifically resource availability, utilization, and adherence to established safe patient handling and mobility standards—and measure any relationships among these factors. This study builds on the reliability and validity of the adapted American Nurses Association’s (2016) Safe Patient Handling and Mobility Self-Assessment Resource. Responses came from a one-shot survey of healthcare workers in direct patient care across several private and Veterans Health Administration healthcare organizations in the Midwestern United States. The risk of injury is higher in patient handling than in many other professions; …

Increasing Advanced Care Planning In An Ambulatory Care Setting, Jennifer Aronson, Elizabeth Eisenhardt, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

Maine is experiencing an increasing percentage of its population being over 65 years old. Advanced Care Planning (ACP) is an important part of this aging population medical care so those ends of life preferences are known well in advance. An adult internal medicine clinic in a large academic tertiary medical center decided to create a performance improvement project that addressed ACP with embedded workflows.

The goal of this project was to have a minimum of 40% of patients 65 or older have an Advanced Care Directive or Serious Illness Conversation documented in EPIC.

Baseline metrics demonstrated that ACP discussion rates …

Use Of A Communication Tool To Improve The Perception Of Continuity Of Care, Annette Lotz

Electronic Theses and Dissertations

Inadequate or incorrect communication during transfer from skilled nursing facilities leads to misunderstandings about patient care needs, jeopardizes patients’ trust in the health care system, and leads to poor clinical outcomes. Due to gaps in communication from one health care setting to another, it was essential to determine if a patient-centered discharge tool would improve patients’ perception of continuity of care. The purpose of the study was to implement a patient-centered tool that would help improve the information needed at the time of discharge from a skilled nursing facility. Roy’s Adaptation Model supports the relevance of effective communication in the …