Medicine and Health Sciences Commons^™

Improving Patient Satisfaction Through Reducing Nurse Overtime And Redesigning Nurse Staffing And Scheduling, Abby Romme

Master's Projects and Capstones

Increasing cardiac device patient demands within a large Midwest healthcare institution resulted in significant increases in staff shift requirements and corresponding patient complaints. The quality improvement project aimed to decrease patient complaints by executing a standard baseline daily full time equivalent (FTE) staffing strategy for future schedules, increasing nursing FTE, and maintaining institutional staffing standards. Standard calculated daily nursing requirements targeted 17.0 FTE. Implementation occurred over a three month period including schedule reprocessing, a pending incremental nursing FTE request, and a restructuring of unit based scheduling and paid time off guidelines. The completed schedule accurately captured staffing requirements for 100% …

A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish

Collected Faculty Scholarship

Objective: This study examined the effect of a 10-week intensive medical-surgical course on ability to perform 16 common, acute care skills among Philippine educated nursing students seeking licensure in California. The aims of the study were to (1) determine competency in performing skills at the start of the medical-surgical course and (2) evaluate the effectiveness of the medical-surgical course in improving skill competency.

Methods: Twenty-three Philippine educated nursing students participated in a 4-hour skills competency test procedure that involved 4 patient care stations and 16 common acute care skills. During the last week of the 10-week medical-surgical course that included …

Hypertension Management Through Patient Education, Shaleena Kumar

Master's Projects and Capstones

Hypertension serves as a common diagnosis among Americans, and its management to prevent further cardiovascular complications remains as an organizational goal. To prevent complications, the goal of a Primary Care Provider’s patient panel maintaining a blood pressure less than 140/90 has been established on the organization’s national office. In the Primary Care Clinic, an interdisciplinary team consisting of a Registered Nurse, Clinical Psychologist, and Cardiologist implemented a group education class aimed at a Hypertensive Veteran cohort. The purpose of this project is to improve self-management behaviors in the Veteran population, and to help increase the hypertension performance metric by 2% …

Addressing The Problem Of Alarm Fatigue: Enhancing Patient Safety Through Cardiac Alarm Customization, Kimberly A. Kinghorn

Master's Projects and Capstones

The global aim of this project was to improve patient safety on the Surgical Unit at an acute care facility in Southern California through enhanced cardiac alarm customization. Alarms are intended to enhance patient safety. However, unnecessary and non-actionable alarms contribute to alarm desensitization and fatigue, lessening response time to critical alerts. Alarm fatigue has become a growing patient safety concern and is included as one of the Joint Commission’s 2015 National Patient Safety Goals. Assessment data on the Surgical Unit revealed lack of alarm customization and inappropriate default settings. The framework for the project focuses on the CNL curriculum …

Monitoring Non Compliant Diabetic A1c Levels, Laura J. Tracy

Master's Projects and Capstones

The AIM of this CNL project is to identify and connect with, those diabetic patients within the out-patient clinic that are not in compliance with their A1C laboratory values. Contacting these patients to schedule follow up and re-engagement in their health care plan, may improve their overall health care outcomes and decrease their risk of more frequent or prolonged hospitalization and increased use of medications. There are over 25.6 million adult diabetic people living in the United States as of 2010. The total cost of direct and indirect medical care is 174 billion dollars as of 2007. With over 3.9 …

Implementation Of A Debrief “Takeaway” Board, Carly A. Skeath

Master's Projects and Capstones

Abstract

My original focus of my project was to implement Team STEPPS, to help improve the communication and teamwork within our entire perinatal service department. However, as I started I ran into barriers with time and with other projects put out by our management that needed to take president. It is then that I decided to narrow my focus on one aspect of Team STEPPS which we are already implementing, and that is debriefs. As a member of the Perinatal Patient Safety Program (PPSP), I was able to learn about all the takeaway’s we received from debriefs that had occurred, …

Quantify Blood Loss To Prevent Escalation Of Blood Loss, Manprit Virk

Master's Projects and Capstones

Abstract

The CNL project’s aim is to implement quantifying blood loss (QBL) after each delivery to prevent the escalation of postpartum hemorrhage (PPH), and decrease maternal mortality and morbidity related to PPH in Maternal Child Health (MCH). This project is initiated in a Northern California acute-care facility’s MCH department, which consists of: childbearing women pregnant at gestation age of more than thirty-four weeks, and women post delivery. According to CMQCC (2014), 1-3% of pregnancies are affected by postpartum hemorrhage, and the acute-care facility has a current postpartum hemorrhage rate of 2.7%. There is lack of standardized method of measuring blood …

Reducing Wait Time Of Chemotherapy And Biotherapy Administration To Inpatients By Increasing The Numbers Of Chemotherapy Providers, Jessica Y. Liang

Master's Projects and Capstones

The purpose of my CNL project is to decrease the chemotherapy administration wait-time for adult oncology patients by increasing the numbers of certified providers. Unfortunately as an oncology unit, about 44% of the providers are not active chemotherapy providers. As a CNL, we must constantly evaluate our microsystems to improve our clinical practice and standards for the benefits of our patients, organization, and our clinical growth. Four barriers for not taking the online course were identified through surveys (course difficulty, low census of oncology patients, lack of knowledge or uncomfortable giving chemotherapy, and the cost of the course if failed). …

Improving Nurse-Patient Communication About New Medicines, Srimala Thinsan

Master's Projects and Capstones

Improving Nurse-patient Communication about New Medicines

Abstract

The project aimed at improving nursing communication with patients and families about medication in order to increase patient satisfaction in terms of safety, quality of care, and patient-centeredness in an acute care setting. The selected patient cohort was at a 42-bed medical-surgical unit in a trauma center in Oakland, California. The gap of nurse-patent communication about medicines was identified based on the HCAHPs scores that had been found to be lower than average (44.1% in March 2015; 40.9% in April 2015). The visibility board was provided to show the staff the HCAHPS scores, …

Improving Patient Safety By Calculating The Qt Correction In Critical Care Patients, Diane F. Newcombe

Master's Projects and Capstones

Prolonged QTc is recognized as a precursor to Torsades de Points and other lethal ventricular arrhythmias. 52% or patients in critical care units have prolonged QTc and 69% or critical care patients have risks of developing QTc. Many commonly administered medications in the critical care unit are known to prolong QTc yet a microsystem assessment and a gap analysis revealed only 3% of the patients in the surgical ICU had the QTc calculation performed and assessed by the critical care nurse.

The global aim is to improve patient safety by incorporating calculating of the QT correction (QTc) into the regularly …

Home Health: The Process Of Assigning An Appropriately Trained Skilled Nurse To Provide Safe Patient Care, Susanne Polos, Msn, Rn, Cnl

Master's Projects and Capstones

The objective of this CNL project was to improve the process of placing an appropriately trained nurse in the client's home to provide safe, quality care. This project is relevant to nursing because of nursing accountability, patient safety, and lack of education of home health nurses. The population included home health patients in the Bay Area of San Francisco of all ages. The project had its base at a home health agency office in Emeryville, California with no actual hands-on patient contact. A CNL was added to the team to ensure appropriate training of the skilled nurse has been completed …

Closing The Loop: The Effects Of Scheduling Patients' Follow-Up Prior To Emergency Department Discharge, Jens Hansen

Doctor of Nursing Practice (DNP) Program

Background: A large percentage of serious medical errors involve miscommunication during the hand-off of patients between medical providers. In addition, care providers do not effectively or completely communicate important information among themselves, to the patient, or to those taking care of the patient at home in a timely fashion. The communication method whether verbal, recorded, or written has proven to be ineffective. As healthcare disparities increase with healthcare complexity, it is important to extrapolate the best evidence based practice and bring these practices to the front line.

Literature Search: A comprehensive literature search using the Cumulative Index to Nursing and …

Association Between Socioeconomic Status And Bmi Among People With Schizophrenia And Bipolar Disorder, Nicholas Guenzel

Theses & Dissertations

Background: Many health disparities among individuals with schizophrenia and bipolar disorder are due to obesity-associated diseases. Several causes of obesity have been discovered, but few risk factors are known. In the general public, low socioeconomic status (SES) is associated with obesity.

Objective: Examine the relationship between SES and body mass index (BMI) among people with schizophrenia and bipolar disorder.

Design: A secondary analysis of the Collaborative Psychiatric Epidemiology Surveys dataset. The psychiatric group (N=480) included individuals with symptoms of schizophrenia or bipolar disorder. Those reporting no symptoms were controls (N=5,161). Childhood SES variables included mother and father education and profession, …

Psychiatric Comorbidities And Bmi: An Exploratory Analysis, Nicholas Guenzel

Theses & Dissertations

Background: Individuals with most forms of mental illness have higher rates of obesity than members of the general public putting them at an increased risk for many physical health problems that reduce both quality of life and life expectancy. The presence of multiple comorbid psychiatric disorders has been associated with poorer clinical outcomes in other mental health measures such as disability and sobriety and is proposed as a risk factor for elevated BMI (body mass index) in this study.

Objective: Determine if multiple psychiatric comorbidities are associated with elevated BMI and, if so, which combinations are linked with the greatest …

Determinants Of Patient Activation In Hospitalized Multimorbid Patients, Myra S. Schmaderer

Theses & Dissertations

Post-hospitalization care transition is a vulnerable time for multimorbid patients. Self-management challenges happen due to acute symptoms and complex new treatment plans. Literature suggests higher activated patients have better outcomes; however, there is little research that identifies determinants that predict patient activation in the multimorbid hospitalized patient. Understanding predictive factors will facilitate planning interventions that promote self-management of multimorbid conditions. The purpose of this dissertation was to identify determinants that predict patient activation in patients with multimorbidity at discharge from the hospital.

A descriptive, predictive research study was conducted with 200 hospitalized multimorbid patients discharged to home. Their mean age …

Association Between Adverse Events In Childhood And Bmi Among People With Schizophrenia And Bipolar Disorder, Nicholas Guenzel

Theses & Dissertations

Background: People with schizophrenia and bipolar disorder die significantly earlier than members of the general public (16-18 years and 12-13 years, respectively). Diseases associated with obesity such as diabetes, heart disease, and stroke account for much of this discrepancy. People with mental illness often have difficulty losing weight despite intensive interventions. As a result, nurses caring for patients with mental illness need to monitor their weight diligently and implement individualized interventions to promote achieving or maintaining a healthy weight. Because intensive interventions come with some risk and expense, programs must target individuals with the most potential to develop obesity. In …

Physical Activity Behaviors Of Prehypertensive And Stage I Hypertensive African American Women, Hope Jackson

Theses & Dissertations

The purpose of this study was to describe the physical activity (PA) behaviors and PA biomarkers of prehypertensive and stage I hypertensive African American women (AAW) and to examine the relationships between PA and personal factors and selected behavior-specific influences (perceived barriers to and interpersonal support for PA). Pender’s Health Promotion Model was the conceptual framework for the study.

A cross sectional design and convenience sample were used. Personal factors examined were: systolic and diastolic blood pressure [BP], body mass index [BMI], and waist circumference. Other variables measured were: International Physical Activity Questionnaire, 400 meter walk test, Borg perceived exertion …

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

• School of Nursing Ranks 8th for the Most Affordable Competitive College

The Effect Of Workload, Job Satisfaction, And Role Conflict On The Timing Of Leaving Of Nursing Faculty From Their Current Faculty Position, Sherri Henry Suozzo

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Due to the significant nursing faculty shortage and the probable impact on healthcare, it is imperative to expand the available literature on the nursing faculty shortage. The descriptive data in this study highlight the critical nature of the aging and retiring nursing faculty body. The statistics available in this study regarding this are quite alarming. The Northeast may be looking at a mass exodus of nursing faculty in the next 5 years with up to 70 percent of the faculty leaving their current position. Another alarming factor is the significant level of inexperience the remaining faculty may have and …

Use Of A Blog In An Undergraduate Nursing Leadership Course, Shelly Jensen Reed, Debra Edmunds

Faculty Publications

In this study, the use of a blog in a senior leadership clinical nursing course was analyzed qualitatively through two means; focus group interviews of those using the blog, and analysis of blog content. Initial feelings expressed by students were annoyance and intimidation concerning the blogging assignment. These feelings quickly dissipated, with students verbalizing many positive aspects related to the blog, including having a place to reflect, feeling connected as a group, valuing feedback provided by their peers, and learning from theirs and others' experiences. The mechanics of having to synthesize their thoughts in written form, in a shared venue …

Vitamin D Deficiency And Infertility: A Systematic Review, Susanne Stoddard Sollis

Student Works

Vitamin D regulates calcium and phosphorus homeostasis in the body. In recent years, studies have been conducted examining the role vitamin D plays in reproduction. Vitamin D deficiency is associated with infertility, decreased pregnancy rates, and hormonal changes. Asians appear to have a reverse correlation with pregnancy rates and vitamin D levels. There are some conflicting studies regarding vitamin D levels in relationship to infertility. This paper reviews the most recent literature focusing on the relationship between vitamin D status and infertility. This review evidences vitamin D levels >30 ng/mL result in improved fertility outcomes.

Improving Hand Off Communication To Enhance Patient Outcomes And Staff Satisfaction, Karin Weinstock

Master's Projects and Capstones

Abstract

The specific aim statement is: Improving hand off communication to enhance patient outcomes and staff satisfaction 50% by August 6. Staff had 100% participation. Reduction in unnecessary appointments occurred and a structured standardized hand off form with situation, background, assessment, and recommendation (SBAR) was implemented at the start date. The clinic has 2 exam rooms, 1 lab, a reception area, and two small offices. The majority of the clients are Hispanic females ages 15-25. The non-profit clinic provides free medical services to the community. Evaluation methods yielded quantitative and qualitative results through chart audits and direct observations.

In-services, one-to-one …

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

• Georgia Southern University Receives $1.6 Million Grant for Advanced Nursing Education

Global Collaboration Between Tanzania And Japan To Advance Midwifery Profession: A Case Report Of A Partnership Model, Yoko Shimpuku, Shigeko Horiuchi, Sebalda C. Leshabari, Dickson Mkoka, Yasuko Nagamatsu, Miwako Matsutani, Hiromi Eto, Michiko Oguro, Yukari Yaju, Mariko Iida, Columba Mbekenga, Lilian Mselle, Agnes Mtawa

School of Nursing & Midwifery, East Africa

The global health agenda to reduce maternal mortality is delayed in Sub-Saharan Africa. The shortage of skilled birth attendants in Tanzania hinders the improvement of midwifery care to prevent maternal mortality and morbidity. It is urgently neccesary to develop midwifery leaders capable of working as educators, researchers, administrators, and advanced practitioners, contributing to the improvement of midwifery care and maternal child health in their own country. This report describes the process of establishing the first midwifery master’s program in Tanzania through the efforts of two academic institutions, one in Tanzania and one in Japan. The collaboration developed a sustainable partnership …

Improving Nutrition Habits In Overweight Obese Adults With Physical Disabilities, Michelle Ullery

Nursing Capstones

No abstract provided.

Written Debriefing: Evaluating The Impact Of The Addition Of A Written Component When Debriefing Simulations, Shelly Jensen Reed

Faculty Publications

Debriefing, the reflective period following a simulation, is said to be where the bulk of simulation learning takes place. Many expert opinions regarding debriefing exist, but evidence-based best practices have yet to be identified. Written debriefing is one of these practices; experts state learning can be extended through the addition of a written component to the debriefing process, but no evidence exists to support this. This study compares three debriefing types: discussion alone, and discussion followed by journaling or blogging. Undergraduate nursing students participating in a simulation were randomized as a simulation group to one of these three debriefing types. …

Screening The Commercial Motor Vehicle Driver For Sleep Apnea, Dianna Ohlman

Dissertations

Abstract The transportation industry has the third highest occupational risk for death and disability (BLS, 2010) with 7% of Commercial Motor Vehicle Drivers (CMVD) falling asleep while driving (NHTSA, 2006). One contributing factor may be undiagnosed Obstructive Sleep Apnea (OSA) (Tregear et al, 2009). In 2006, a Joint Task Force (JTF) published screening recommendations for OSA, which led to a change in the Department of Transportation screening practices within a local Occupational Medicine clinic. The purpose of this study was to: (a) determine what percentage of drivers having had a positive clinical screening examination (met two of three objective measures) …

Effects Of An Instructional Intervention On Student Nurses' Awareness Of Hearing Impaired Patients' Communication Needs, Charles G. Marx, Kimberly Ward, Edward L. Goshorn, Virginia L. Sumrall

Journal of Health Ethics

A recent survey (Kemker, et al, 2013) of practicing nurses’ awareness of hearing impaired patients’ communication needs revealed a potential need to supplement the curriculum. The instructional areas that required supplemental information were related to assisting patients with their amplification devices and in verifying that a verbal message has been accurately received. These areas may not be sufficiently covered in a typical School of Nursing curriculum. To meet the curriculum needs and to address any potential ethical concerns regarding provision of care to this patient population, instructional materials were developed by the authors that directly addressed the identified areas. These …

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

Prescriber Education Of Current Clinical Practice Guidelines For Urinary Tract Infections, Carol Medura

Doctor of Nursing Practice (DNP) Program

Urinary tract infections are one of the most common illnesses and inappropriate treatment of a urinary tract infection can have severe implications for the patient, including development of antibiotic resistance, increases in illness and health care costs. Discrepancies exist between provider practice behaviors and use of current clinical practice guidelines. This capstone project was to present clinical practice guidelines to emergency department providers to educate and improve the use of first-line antibiotics for the treatment of uncomplicated urinary tract infections. The review of the literature supported the use of education to increase adherence to guidelines. The providers at the emergency …