Open Access. Powered by Scholars. Published by Universities.®
- Institution
-
- The University of San Francisco (5)
- Gardner-Webb University (2)
- Northern Michigan University (2)
- University of San Diego (2)
- Augsburg University (1)
-
- Jacksonville State University (1)
- Northern Illinois University (1)
- Southern Illinois University Edwardsville (1)
- University of Arkansas, Fayetteville (1)
- University of Louisville (1)
- University of New Hampshire (1)
- University of South Carolina (1)
- University of St Augustine for Health Sciences (1)
- Winona State University (1)
- Publication
-
- Master's Projects and Capstones (4)
- Doctor of Nursing Practice Projects (3)
- DNP Scholarly Projects (2)
- Doctor of Nursing Practice Final Manuscripts (2)
- Doctor of Nursing Practice (DNP) Projects (1)
-
- Doctor of Nursing Practice Papers (1)
- Doctor of Nursing Practice Scholarly Projects (1)
- Honors Capstones (1)
- Master of Science in Nursing Theses and Projects (1)
- Master's Theses and Capstones (1)
- Nursing DNP Projects (1)
- Student Scholarly Projects (1)
- The Eleanor Mann School of Nursing Undergraduate Honors Theses (1)
- Theses and Graduate Projects (1)
Articles 1 - 21 of 21
Full-Text Articles in Medicine and Health Sciences
Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho
Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho
Master's Projects and Capstones
The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …
Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter
Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter
Master's Projects and Capstones
Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).
Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).
Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …
Contributing Factors And Solutions For Inappropriate Use Of The Emergency Department, Lesia M. Kozych
Contributing Factors And Solutions For Inappropriate Use Of The Emergency Department, Lesia M. Kozych
Honors Capstones
Emergency departments are overwhelmed with the sheer quantity of patients, many of which are there for the non-emergent reasons. The purpose of this project is to identify factors that contribute to emergency department (ED) misuse, initiatives or programs that have been successful in decreasing ED misuse, and ED personnel’s opinions on contributing factors and potential solutions. A literature review followed by semi-structured interviews of ED personnel produced the necessary information. Common themes were drawn from participant responses in the interview portion. A major barrier to appropriate use of the emergency department is access to primary care. Others include: lack of …
A Bedside Handoff Tool To Enhance Fall Safety Measures In The Emergency Department, Isha Adora Godbold
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, …
Advancing Treatment For Opioid Use Disorder In A Rural Emergency Department, Jill M. Wabbel
Advancing Treatment For Opioid Use Disorder In A Rural Emergency Department, Jill M. Wabbel
Doctor of Nursing Practice (DNP) Projects
Background: The opioid epidemic escalated in the United States due to the availability of prescription opioids, heroin, and synthetic opioids like fentanyl. Unfortunately, access to treatment is not always accessible, especially in rural communities with limited resources.
Local Problem: Tehama County is a rural county in northern California with limited access to treatment for opioid use disorder. The local Emergency Department (ED) and primary care-based Medication-Assisted Treatment (MAT) clinic collaborated to increase access. However, services remain under-actualized due to limited understanding of MAT best practices, stigma related to substance use within the ED culture, and poor articulation between the ED …
Improving Confidence And Job Satisfaction In Emergency Nurses Through Teamstepps., Anna Moore
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 …
Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton
Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton
Doctor of Nursing Practice Projects
Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).
Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.
Methods: …
Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding
Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding
Doctor of Nursing Practice Projects
Nationwide, the volume of emergency department (ED) visits has steadily increased over the last several decades. This steady increase in volume frequently causes ED crowding and considerable delays in patient evaluation and treatment. Recently, teletriage has been used in emergency departments to evaluate less emergent patient needs while freeing up in-house providers to care for more critical patients. The goal of this DNP project was to develop a protocol for the utilization of teletriage in an Emergency Department in a level 1 trauma center in central Illinois using nurse practitioners to assess patients in the waiting room and order appropriate …
Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, Kelly Chambers, Megan Gilmartin, Martha Narasimhan-Narayanan
Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, Kelly Chambers, Megan Gilmartin, Martha Narasimhan-Narayanan
Doctor of Nursing Practice Final Manuscripts
In 2019, it was estimated there were 18 million avoidable emergency department (ED) visits, totaling $32 billion in unnecessary healthcare spending. Super-utilizers (SU), individuals that seek care in the ED 3 or more times per year, account for a disproportionately large segment of healthcare consumption and costs. These patients inefficiently access the healthcare system and often fail to get the follow-up care that could prevent them from repeat ED visits.
This evidence-based project aimed to reduce unnecessary ED visits by at least 25% annually and have no use of the ED during the intervention period, by implementing social and medical …
Improving Completion Rate Of Identifying Seniors At Risk (Isar) Screening Tool In Emergency Department (Ed) Setting, Ashley Clark
Improving Completion Rate Of Identifying Seniors At Risk (Isar) Screening Tool In Emergency Department (Ed) Setting, Ashley Clark
Doctor of Nursing Practice Final Manuscripts
Background: Patients age 65 and older are identified as being an at-risk population for readmissions to the hospital within 30 days. Evidence based practice has shown that completing the Identifying Seniors At Risk (ISAR) screening tool can help to identify the needs of these patients so they can age in place at home with the proper resources. The screening tool consists of 6 questions. A score of 3 or more on the ISAR is deemed high-risk and a consult with case management should be considered. The average completion rate in an emergency department was identified as being 33%. The goal …
Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Yvonne Oliva
Master's Projects and Capstones
Problem: This quality improvement project aims at Hospital X meeting the new Joint Commission (JC) provisional deadline through the implementation of simulation training and video development as a way of educating emergency department (ED) staff in recognizing and treating preeclampsia (PreE) and postpartum hemorrhage (PPH).
Context: This quality improvement project utilizes evidence-based practice, California Maternal Quality Care Collaborative (CMQCC) toolkits, and JC standards to educate ED staff on worsening cases of maternal morbidity and mortality nationwide. Research shows that early recognition and prevention of maternal hemorrhage and preeclamptic emergencies has the highest probability of decreasing maternal complications in the ED. …
Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky
Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky
Master's Projects and Capstones
In order to address shortcomings of the health care system within the United States surrounding the early recognition and response to preeclampsia (PreE) and postpartum hemorrhage (PPH) emergencies The Joint Commission (TJC) revised the accreditation requirements regarding implementing yearly maternal hypertension and hemorrhage simulation scenarios in emergency departments. A Quality improvement team of Clinical Nurse Leader (CNL) students at University of San Francisco, working alongside the emergency department and labor and delivery department nurse educators assisted a dual hospital system in the Bay Area of California to develop and implement training materials and simulations for the hospital system’s Emergency Department …
Perceived Sources Of Stress Related To Burnout Amongst Emergency Department Staff Due To The Covid-19 Pandemic: A Literature Review, Sydney Craig
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Emergency departments (ED) are usually considered high stress environments. The effects of the COVID-19 pandemic and the accompanying challenges such as frequent exposure to the novel virus, lack of personal protective equipment (PPE), being over worked and underpaid, and the uncertainty surrounding the overall trajectory of the COVID-19 pandemic have resulted in an increased level of burnout for ED staff, especially nurses. This study involves a meta-analysis of current literature surrounding ED burnout including incidence rate and causes during the COVID-19 pandemic. Because studies indicate upwards of three fourths of ED staff reporting increased stress and burnout, finding ways to …
Improving Advanced Practice Nursing Care To Children With Autism In The Emergency Department, Suzanne J. Bartell
Improving Advanced Practice Nursing Care To Children With Autism In The Emergency Department, Suzanne J. Bartell
Theses and Graduate Projects
Autism Spectrum Disorder (ASD) prevalence rates are increasing within the pediatric population. Often, these children present to emergency departments (EDs) for care that could typically be managed in a primary care setting. Furthermore, pediatric patients with ASD utilize EDs at a rate higher than children without (Baio et al., 2018). Parents, patients, and providers within the pediatric ED setting report a lack of understanding and tools needed to provide quality and meaningful care to this population. The utilization of nurse practitioners in the ED setting is increasing due to affordability and quality of care delivery. The intersection of these two …
Nurse-Driven Protocols For Abdominal Pain In The Emergency Department, Chris Schmidt
Nurse-Driven Protocols For Abdominal Pain In The Emergency Department, Chris Schmidt
Student Scholarly Projects
Practice Problem: Emergency department (ED) crowding hinders the opportunity to deliver safe, quality care to abdominal pain patients and detrimentally affects clinical outcomes. Leadership of a rural community ED recognized a comparable issue by introducing a nurse-driven protocol (NDP) to reduce patient length of stay (LOS) and the rate of patients who leave the department prior to physician evaluation.
PICOT: The PICOT question that guided this project was: For adult patients in an emergency department, how does a nurse-driven protocol for abdominal pain compared to no protocol use affect the LOS and left without being seen (LWBS) rate over 10 …
Trauma-Informed Care In The Emergency Department, Kayla Kvell, Kristin Oscarson
Trauma-Informed Care In The Emergency Department, Kayla Kvell, Kristin Oscarson
Nursing DNP Projects
Introduction: This project aims to analyze the effectiveness of trauma-informed care (TIC) education on attitudes of registered nurses (RNs) and psychiatric associates (PAs) towards TIC. The purpose of this project was to educate ED (emergency department) RNs and PAs on the effects of trauma and increase attitudes towards implementing a TIC approach to care for mental health (MH) patients in the ED.
Method: This project followed a pre–post-survey design with quantitative data. Participants included RNs and PAs newly hired to the ED, and/or if they had no previous TIC education. Data were collected utilizing a 10-question Likert scale survey.
Results: …
The Impact Of Early Goal Directed Sepsis Bundle Sets In The Emergency Department And The Impact Of Sep-1 Compliance Rates, Christie L. Ferrari
The Impact Of Early Goal Directed Sepsis Bundle Sets In The Emergency Department And The Impact Of Sep-1 Compliance Rates, Christie L. Ferrari
DNP Scholarly Projects
Sepsis is a medical emergency that is prevalent throughout hospitals everywhere. Due to the growing crisis, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Surviving Sepsis Campaign (SSC) adopted core measures for sepsis (SEP-1) which aim at improving overall compliance of evidence-based treatment standards for sepsis. The purpose of this Doctor of Nursing Practice (DNP) project was to determine if incorporating early goal directed sepsis bundles in a rural Midwestern ED was effective in increasing compliance with SEP-1 rates. The secondary purpose evaluated how nursing knowledge, awareness, and compliance with sepsis bundles affects SEP-1 compliance rates. …
Utilization Of The Calm Apparatus To Adult Men And Women With Atrial Fibrillation To Decrease Emergency Department Visits For Atrial Fibrillation, Ami Klein
DNP Scholarly Projects
The purpose of this project is two-fold. The first is to determine if the CALM APP use by adult men and women with atrial fibrillation (AF) will decrease anxiety. The second is to determine if decreased anxiety utilizing the CALM APP will deter admissions to the emergency department (ED) for AF in the first month post-catheter ablation of AF. The Zung SAS was used to determine the pre- and post-anxiety scores. The Seven Days of Calm (free app) was used to teach deep breathing and meditation. This study showed a moderate decrease in ED visits with use of the Calm …
Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin
Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin
Master of Science in Nursing Theses and Projects
Implementation of a quick, reliable pediatric child abuse assessment tool for use in the emergency department is of great importance. A thorough assessment of all pediatric patients presenting to the emergency department (ED), regardless of complaint, should become second nature in order to recognize the signs of child abuse. Because a tool of this nature is lacking in many ED's, the Escape Instrument is needed. This instrument is a successful, efficient screening tool that can be applied to all pediatric patients during triage in the emergency department. This tool will allow the emergency department staff to quickly identify children under …
Reduction Of Order-To-Scan Times To Increase Patient Throughput And Improve Patient Outcomes: A Quality Improvement Project, Jason Harrington
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 1st, 2022
Methods: Plan was …
Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington
Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington
Doctor of Nursing Practice Projects
A rural facility in the foothills of North Carolina found a need for process improvement regarding the emergency department and completion of the NIHSS. The DNP student and the Stroke Coordinator along with the Quality Improvement Coordinator agreed with the need for education of staff concerning accurate assessment and documentation of the NIHSS. The DNP project implemented additional training for the emergency department nurses and paramedics in the form of face-to-face classes with a PowerPoint. A pre-and post-survey was conducted to gauge the comfort level of staff with the NIHSS and stroke processes of the rural emergency department. The Stroke …