Medicine and Health Sciences Commons^™

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, An Evidence-Based Intervention, Kara M. Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Increasing Prevention And Recognition Of Delirium In A Non-Icu Acute Care Population, Anne Gembrowski

Doctoral Projects

Delirium is associated with increased mortality, nosocomial complications, increased length of hospital stay, and greater chance of readmission, increased hospital costs, and a need for skilled nursing aid after discharge from the hospital. In a hospital, delirium can affect up to 50 percent of older patient 65. The solution is to prevent delirium from occurring and to regularly screen for its presence. The purpose of this paper is to explore the best prevention strategies and screening tool for delirium and to successfully implement a delirium bundle on a medical surgical unit. The question this paper attempts to answer is if …

Prevention Of Central Line-Associated Bloodstream Infection (Clabsi) In Adult Oncology Patients, Christina Winkelman

Doctoral Projects

Central Line-Associated Bloodstream Infection (CLABSI) is a preventable issue in healthcare. CLABSI contributes to negative patient outcomes and increased healthcare cost. Research demonstrates that many interventions are effective in reducing the rate of CLABSI. The implementation of CLABSI bundles can significantly reduce the occurrence of CLABSI. This quality improvement project implemented a CLABSI bundle that specifically targeted identified areas of weakness in CLABSI prevention at an organization with a focus on adult oncology care. The three part CLABSI prevention bundle focused on: (a) registered nurses (RN) changing and documenting endcaps in the electronic health record after blood administration, (b) RNs …

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

Patient Falls: Reducing Patient Falls With Injury, Frederick Comer

Master's Projects

The occurrence of patient falls is a very important health concern facing the healthcare industry. Many patients not only experience falls, but have falls with an injury. This is a patient safety concern that can have serious effects on patient outcomes, is a leading cause of patient injuries in hospitals, and are costly adverse events (Trepanier & Hilsenbeck, 2014). It is important that healthcare professionals determine ways to prevent what has been deemed a preventable event (Bemis-Dougherty & Delaune, 2008). In 2005 The Joint Commission (TJC) included patient falls with injury as part of their National Patient Safety Goals (Bemis-Dougherty …

A Cyberbullying Needs Assessment In A Middle School Population: Identifying A Direction For Nurses, Ashley M. Eggleston

Doctoral Dissertations

Cyberbullying is a fairly new phenomenon that most adolescents will experience or be exposed to during their lifetime. It produces devastating outcomes on those who are victims and perpetrators of cyberbullying. There is a limited amount of research regarding the prevention of cyberbullying. The evidence that is available is mostly exploratory in nature. Currently, the literature recommends conducting a needs assessment to validate the problem, raise awareness, and identify potential solutions that are specific to a population and/or setting. Therefore, the purpose of this scholarly project was to administer a cyberbullying needs assessment at a local west Michigan middle school. …

Protecting The Skin Of Older Adults Through Surveillance And Pressure Ulcer Prevention Beginning In Emergency Services, Jennifer L. Zoeteman

Doctoral Dissertations

ED (emergency department) personnel are admitting to inpatient services increasing numbers of elderly clients who are at risk for skin breakdown. The ED environment is designed for short term care in response to emergent situations. Pressure related injuries originating in the ED lead to both physical suffering and financial burdens. Pressure relief strategies have been actively employed on an inpatient basis without translation to the ED environment. Evidence for best practice in PUP (pressure ulcer prevention) in the ED is not widely embraced. Prevention of PUs is primarily within the scope of nursing practice and amenable to improvements in the …

An Evidence-Based Approach For The Implementation Of An Osteoporosis Educational And Exercise Intervention Among Perimenopausal Women, Joanne Maura Cecile Finazzi

Doctoral Dissertations

According to the osteoporosis criteria developed by the World Health Organization, 10 million individuals residing in the United States are estimated to have osteoporosis, and 8 million of these individuals are women (National Osteoporosis Foundation [NOF], 2009). Educational and exercise interventions (Bohaty, Rocole, Wehling, & Waltman, 2008) have been developed in an effort to prevent osteoporosis. However, medical record reviews reveal that only 18% of patients receive counseling regarding osteoporosis educational interventions and exercise preventive measures during health care visits (Lee, Zuckerman, & Weiss, 2002).

The purpose of the pilot study was to examine the effectiveness of a 4-week, 4- …

Central Line-Associated Bloodstream Infection Prevention In The Long-Term Acute Care Setting, Mary Lisbeth Dougherty Msn Rn Aocna

Doctoral Dissertations

Sustained reduction of central line-associated bloodstream infections remains elusive in many institutions, including the long-term acute care hospital (LTACH), despite a focus on improving patient outcomes. A clinical practice survey was distributed electronically to nurses working in the LTACH setting. The survey provided for an anonymous assessment of knowledge related to policy/procedure, fidelity to practice as well as site-specific barriers to adherence to clinical practice guidelines. Results revealed opportunities for education related to clinical practice guidelines and basic central line-associated bloodstream infection strategies as well as perceived barriers to adherence to policy/procedure. Strategies aimed at mitigating gaps and barriers are …