Medicine and Health Sciences Commons^™

Implementation Of An Education Program To Decrease Inpatient Falls, Elizabeth M. Carpenter, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors …

"Girls Don't Strike Without Provocation.": African American Women, The General Strike, And The Good Samaritan Hospital School Of Nursing, Charlotte, North Carolina, 1956-1959., Francena F.L. Turner

Sociology Department Faculty Working Papers

No abstract provided.

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Effect Of A Community Hospital’S Sustainable And Enhanced Fall Prevention Quality Improvement Program On Inpatient Falls And Falls With Injury: A Before And After Study, Anne Catino

DNP Scholarly Projects

The frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 …

Reducing Urinary Catheter Usage In The Intensive Care Unit Setting And Education Related To Preventing Cautis: A Qi Project, Kristina Diurno

DNP Projects

Significance and Background: Catheter-associated urinary tract infections (CAUTIs) are common but preventable hospital-associated infections. The inappropriate and prolonged use of indwelling urinary catheters can pose a significant risk for patients and healthcare organizations. The Centers for Disease Control and Prevention identified that the most important factor related to an increased risk of CAUTI is the length of time an indwelling catheter remains in place. This DNP (Doctor of Nursing Practice) project assessed the barriers to removing indwelling catheters in the intensive care unit (ICU) while providing encouragement of prompt removal.

Purpose: Three aims were developed for this quality improvement project: …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Hospital Nursing Factors Associated With Decreased Odds Of Mortality In Older Adult Medicare Surgical Patients With Depression, Aparna Kumar, Douglas Sloane, Linda Aiken, Matthew Mchugh

College of Nursing Faculty Papers & Presentations

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship.

Methods: This was a retrospective cohort study employing a national nurse survey, hospital data, and Medicare claims data from 2006-2007. The sample included: 296,561 older adult patients, aged 65-90, who had general, orthopedic, or vascular surgery in acute care general hospitals …

Knowledge And Practices Regarding Standard Precautions For Infection Control Among Nurses Working At A Public, Tertiary Care Hospital Islamabad, Pakistan, Samina Yasmeen, Tazeen Saeed Ali, Wardah Khalid, Zohra Kurji, Shair Muhammad Hazara, Shahzad Bashir

School of Nursing & Midwifery

Introduction: To protect patients and healthcare providers from healthcare-associated infections (HAIs), standard precautions have been promoted universally. Nurses are the forefront force in patient care; therefore, evidence-based and up to date knowledge and practices can play a vital role in helping nurses apply standard precautions (SPs).
Methods: The analytical cross-sectional study design was used. Through purposive sampling, the data were collected from 320 nurses, via, a self-administered questionnaire, from April to May 2017, from a public tertiary level hospital in Islamabad. The validity and reliability of each section was established. Mean and standard deviation were computed for continuous variables’ whereas; …

Sleep Disruptions Within The Hospital, Faith Walls

Senior Honors Theses

The circadian rhythm is a complex and interwoven system within each human being that creates an internal clock each day. However, patients in all hospital settings continue to have their sleep disrupted by many factors. Seep being disrupted in the hospital patients can develop serious complications. To this day, the issues causing have not been adequately assessed and therapeutically intervened with consistency within nursing practice. Using the Whittemore and Knalf Framework, this integrative review will examine the literature on aspects of inpatient care that contribute to circadian disruptions within hospitals. By doing so, the research can be built upon with …

Exploring Orthopaedic Patients’ Experiences Of Hospital Discharge: Implications For Nursing Care, Rosemary Saunders, David Dineen, Karen Gullick, Karla Seaman, Renee Graham, Sandra Finlay

Research outputs 2022 to 2026

Background

Nurses play a key role in providing discharge education. With the increased demand for orthopaedic surgery and subsequent fast‐track surgical programmes resulting in reduction in hospital length of stay, obtaining patient feedback about discharge is important to inform nursing practice of discharge.

Aim

To explore patients’ experiences of discharge from hospital following orthopaedic surgery.

Methods

A descriptive qualitative study was undertaken with a sample of 34 patients discharged following orthopaedic surgery at a private acute Australian hospital. Individual semistructured telephone interviews were conducted and analysed using inductive thematic analysis.

Findings

From the analysis, patient experiences have been described in …

Evidence-Based Change Benchmark: Implementing Intervention Strategies Aimed At Reducing Patient Falls, Victoria Nix

MSN Capstone Projects

This paper provides an overview of an evidence-based change project that arose from the following PICOT: In patients at risk for falls [P], how does implementing fall risk prevention [I] compared to no fall risk prevention [C] affect fall rates [O] within 3 months of implementation [T]? A comprehensive review of primary sources dealing in clinical studies was found to support the case that fall prevention measures, specifically patient-specific bedside tools, have shown to be instrumental in reducing patient falls. The development and implementation of a robust Fall Prevention Program designed around the latest research was the goal; however, the …

Code Gray Response Team, Charlie A. Brizzee

IPS/BAS 495 Undergraduate Capstone Projects

This video presentation addresses the declining feeling of safety by frontline clinical staff due to the recent escalation of combative patients and workplace violence in the healthcare setting, identified through Emotional intelligence and the approach created to address it. This project was crafted as an innovative and creative approach to addressing the issue in the clinical setting without adding additional staff or additional expense to the organization. Additionally, the approach had to be innovative and creative as the author does not own the current process, and knowing to receive stakeholder acceptance, the ownership had to remain with the current stakeholder. …

Fall Prevention: Remote Video Monitoring, Shawna Moser

MSN Capstone Projects

Patient safety is a top priority for all healthcare organizations, but as a healthcare facility, is everything, within the means of the facility, being done to ensure patient safety? Challenges exist for all healthcare organizations when faced with patient safety, but there it is a necessity for these healthcare organizations to overcome these challenges and protect their patient population. A common challenge within the acute care setting is the prevention of falls. “Falls during hospitalization harbor both clinical and financial outcomes” (Gringauz et al., 2017, p. 1). Research on fall interventions has shown that a multifocal approach is most effective …

Developing Organizational Support And Leadership Structures For Advanced Practice Nurses In The Hospital Setting, Andrea L. Childress

Doctor of Nursing Practice Projects

Background: Hospitals are increasing utilization of advanced practice nurses (APNs). APNs do not fit within the traditional nursing or medicine department structures. They are often hired by organizations without full evaluation and assessment of management issues and structures to support them.

Problem: APNs are employed to work throughout an acute care hospital. They report to medical leadership but have no voting rights or representation on medical committees. They lack connection to nursing staff and existing structures which impairs their ability to exhibit leadership and advance nursing practice.

Purpose: This project seeks to answer: What organizational support and leadership structures are …

Clinical Staff Perceptions On The Quality Of End-Of-Life Care In An Australian Acute Private Hospital: A Cross-Sectional Survey, Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

Research outputs 2014 to 2021

Objective: To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods: A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results: Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt …

What Do We Learn When The Unknown Suddenly Appears?, Kari Singletary, Linda Paradiso

Publications and Research

No abstract provided.

Improving Survival Rates In Patients Suffering Cardiac Arrest With Specialized Resuscitation Teams: An Integrative Review, John Campbell Holcomb

Doctoral Dissertations and Projects

Over 300,000 hospitalized patients suffer a cardiac arrest requiring a Code Blue activation each year in the United States. These patients have an extremely high mortality rate. These rates are not uniform across all hospitals and facilities that employ specialize Code Blue resuscitation teams have a higher percentage of patients that survive resuscitation events. This Integrative Review shows that these teams are essential to patient survival but are prone to barriers that must be overcome to provide effective teamwork. Quality improvement projects centered around Code Blue teams can be created at the local level and have been found to be …

Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber

MSN Capstone Projects

With rising healthcare costs and increasing demands placed on healthcare workers, it is no wonder that decreasing hospital length of stay for patients is high priority for hospitals today. Hospital acquired infections are one of the culprits keeping so many patients hospitalized. Specifically, in intensive care units (ICU) and intermediate care (IMC) units that care for mechanically ventilated patients, ventilator associated pneumonia secondary to intubation is a complication and cost that is being sought to be avoided. Hospitals have been pro-active to prevent ventilator associated pneumonia from occurring by placing oral care bundles or protocols in place to care for …

A Well-Being Vision: Transcending Care., Judith A Boerger, Pamela Bland, Carolyn Meyer, Kristen Ruble, Sue Ehinger Pnd

Nursing Publications

Well-being is a competitive strategy to attract the best and brightest talents and keep them from burning out or leaving.

Improving Patient Experience And Education By Leveraging Technology, Cathy Palleschi, Wendy Osgood, Mark Parker, Cecilia Inman, Alicia Russell, Eileen Shanahan, Erin Pappal

Operations Transformation

It is estimated that 65% of the population are visual learners. With that in mind, a team of cardiac nurses in a large academic tertiary hospital developed a quality improvement project to hopefully improve patient engagement as well the patients’ perception that the nurses explained things in a manner that they could understand.

Baseline patient survey scores for the question, “Nurses Explained Things In A Way That I Understand”, were under the 75^thpercentile for a period of 9 months. A root cause analysis was conducted and it demonstrated numerous reasons for this score.

Several countermeasures were instituted to …

Barriers To Hospital Food Waste: A Pilot Exploratory Study, Jennifer Goulding

Honors College

Food waste is an ever-growing problem in this country and hospitals are large producers of food waste. Food is something that is beneficial to everyone on the planet, but when wasted, it creates added methane gas production which contributes to the greenhouse gas effect. There is a paucity in the literature concerning industry specific food waste disposal processes. To add knowledge about food waste in Maine, a 24-question survey was used to ask healthcare organizations nutritional and environmental personnel about, food disposal, reuse, and environmental sustainability efforts. The data was analyzed using descriptive statistics. The response rate was low, however …

The Effect Of Volunteers’ Care And Support On The Health Outcomes Of Older Adults In Acute Care: A Systematic Scoping Review, Rosemary Saunders, Karla Seaman, Renée Graham, Angela Christiansen

Research outputs 2014 to 2021

Aim: To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services.

Background: Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care‐related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care‐related harm, volunteer programmes to support patient care have been established in many hospitals worldwide.

Design: A systematic scoping review.

Methods: The …

Sustaining Daily Management With Gemba Walks: A Scheduling Model, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

SUSTAINING DAILY MANAGEMENT WITH GEMBA WALKS: A SCHEDULING MODEL

At an academic tertiary care medical center, there are 110 Operational Excellence teams across 4 campuses. Every weekday, 10 GEMBA walks occur with the 11^th on Wednesdays. The expanding program has made daily leadership visits to all KPIs challenging. As a result, consideration of reduced gemba walks to departments who have met specific maturity/performance criteria.

The scope of the eight-week pilot consisted of 13 pre-identified teams that have weekly workflows. The teams must have met a baseline level of performance. Performance was scored for 9 variables measuring engagement, PDSA, use …

Improving Communication Between Child Life Services And Nursing On An Inpatient Pediatric Unit, Sherryann St. Pierre, Elizabeth Shaughnessy, Bethany Kay, Barbara Bush Children's Hospital, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

IMPROVING COMMUNICATION BETWEEN CHILD LIFE SERVICES AND NURSING ON AN INPATIENT HOSPITAL UNIT

Effective communication between patient caregivers has been shown to reduce stress and trauma related to hospitalization and subsequent improved outcomes. An HCAHP score for a 30 bed acute inpatient pediatric unit illustrated the confusion faced by children as a result of nursing and care life specialists not working together as a team.

A root cause analysis identified a number of issues as to why patients were not benefitting fully from child life services. Several counter measures were instituted with the goals of improving the HCAHP score and …

Increasing Bedside Medication Safety In An Intensive Care Setting, Natasha Stankiewicz, Jonathan Archibald, Scu 2, Mark Parker, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

A PERFORMANCE IMPROVEMENT PROJECT FOR INCREASED BEDSIDE MEDICATION SAFETY

The convenience of having certain medications directly available at bedside has long been a priority for a medical intensive care nursing team in an academic tertiary medical center.

However, it was apparent to new staff and leadership that there was a lack of awareness and interest in securing medications within the department. This posed a risk to patients, families, visitors and colleagues.

Baseline metrics on patient safety were collected and a root cause analysis was conducted. Countermeasures included increased education of medication safety as well as a instituting a KPI which …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Maine Medical Center

PATIENT FALL PREVENTION STRATEGIES IN AN ACUTE HOSPITAL

Every year in the United States, hundreds of thousands of patients fall resulting in injury. Injured patients often require prolonged hospital stays and a resultant increase in medical costs.

The purpose of this study was to identify the current state of fall prevention strategies on a hospital inpatient acute care cardiac unit. Through a root cause analysis, some deficiencies were identified and a process improvement plan was implemented.

Several positive outcomes were attained as a result of the countermeasures initiated. Patient falls per month and total waste in dollars saw a decline …

Nonprofit Pay In A Competitive Market: Wage Penalty Or Premium?, Christian King, Gregory B. Lewis

Department of Nutrition and Health Sciences: Faculty Publications

Two competing theories argue that the nonprofit sector pays differently: Nonprofit employees may accept lower pay to be able to do meaningful work for a good cause, or they may earn higher pay due to nonprofit organizations’ tax exemptions and weaker incentives to hold down wages. To test these opposing expectations, we use the 2005-2013 American Community Surveys to examine pay differences among registered nurses working for nonprofit, for-profit, and public hospitals. We also test hypotheses that public and nonprofit hospitals have smaller pay disparities by gender, race, and relationship status. We find that pay is highest in nonprofit hospitals, …