Medicine and Health Sciences Commons^™

Reexamining Overuse Of Frequent Observation For New Admissions On Psychiatric Units To Increase Nurse/Patient Engagement, Samuel Novela

Master's Theses

People in California who suffer from mental health conditions are often admitted involuntarily to hospitals on 72 hour psychiatric evaluation holds if they are deemed imminently dangerous to themselves, or others, or are gravely disabled. Observational patient safety checks are performed and based on patient acuity and hospital standards. Variations exist among different clinical settings with regard to best practices and the patient subpopulations that may warrant less frequent safety checks. Nurses experience different levels of satisfaction with regard to frequency of safety checks because there is no national consensus on which subsets of patients may require them. A senior …

Prevention Of Functional Decline In Hospitalized Geriatric Patients: An Evidence-Based Mobility Pilot Project On An Acute Care Elderly (Ace) Unit, Hannah Grushkowsky

Doctor of Nursing Practice Final Manuscripts

Problem: Functional decline is the leading complication of hospitalization in the elderly. Loss of functional independence during hospitalization results from the inability to maintain function during hospitalization compounded by acute illness. Potential negative outcomes from decreased function include increased length of stay (LOS), morbidity, and added discharges to a skilled nursing facilities (SNF).

Introduction: A mobility-based protocol created by an interdisciplinary team was implemented for three months on an 8 to 12-bed specialized Acute Care Elderly (ACE) medical-surgical floor. The purpose of the project was to evaluate if an evidence-based practice (EBP) mobility protocol can decrease discharges to SNFs, falls, …

Using Critical And Transformative Theory To Describe Basic Palliative Care In The Acute Care Setting, Tammy Neiman

Theses and Dissertations

The population of chronically ill, older adults is expected to grow in the coming years as the baby boomer generation ages. The Institute of Medicine recommends that all healthcare providers have a basic competency in palliative care, also referred to as basic palliative care. The definitions and descriptions to date are vague and do not provide an in-depth description of how basic palliative care differs from the care provided by specialists. The purpose of this study was to describe nurses’ understanding and perceptions of basic palliative care in the acute care setting. Focus group and individual interviews were utilized for …

An Education Intervention To Increase Rounding And Toileting And Reduce Falls In A Hospital Acute Care Of The Elderly (Ace) Unit, Amelia Grayson

Doctoral Projects

Introduction: Falls are the most common accident reported in acute care hospitals and patients who are 65 and older are the most vulnerable. Falls can lead to physical and emotional injury, reduced mobility and functioning, increased length of hospital stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) has eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. Research on fall prevention in adult acute care found multifactorial interventions that address multiple risk factors for falls are the most successful at prevention. This …

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

The Effect Of Training And Recognition On Nursing Assistant Retention In Acute Care Settings, Rachael Austin Swann

Nursing Theses and Capstone Projects

Nursing assistants are being hired in acute care settings to alleviate staffing issues associated with the nursing shortage. This has been a great economical solution to ensure adequate staff because of the large number of trained individuals in this vocation. Turnover and retention with nursing assistants in all settings including acute care is an expensive and reoccurring problem. Although several strategies have been implemented to prevent this, few provide a sustainable positive outcome. This situation requires an approach to look at the causes of turnover and provide interventions to reverse the negative impact. The intent of this research looked at …

Evidence-Based Interventions: Improving Influenza Vaccination Rate Among Health Care Workers (Hcws) Targeting Direct Care-Givers, Jennelyn Fraser-Johnson

Doctor of Nursing Practice (DNP) Projects

Background: Influenza is a contagious disease affecting over three million people every year. It is associated with yearly seasonal outbreaks which increases the risk of mortality among immune-compromised, hospitalized clients, clients in long-term care facilities and also enhances the risk of infection in healthcare workers (HCWs). Nosocomial infections and employees’ absenteeism are often associated with the flu. A high influenza vaccination rate in health care professionals reduces the risk of influenza infection as well as being a cost- effective strategy to reduce lost work hours. A Joint Commission criterion for accreditation for healthcare facilities is to achieve a 90% …

A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan

Walden Dissertations and Doctoral Studies

Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …