Medicine and Health Sciences Commons^™

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock

Doctor of Nursing Practice (DNP) Projects

The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical …

Innovative Approach To New Nurse Residency, Meaningful Use And Health Care Reform, Pamela V. Stanley

Doctor of Nursing Practice (DNP) Projects

The project’s aim was to examine the financial impact of replacing registered nurse (RN) travelers, RN registry and RN overtime with new graduate RNs. Newly graduated RNs are often viewed by hospital administrators as a more costly staffing resource. This project contributes knowledge regarding the potential cost savings with the utilization of a centralized float pool incorporating new graduates. In addition, it contributes a novel idea for reducing organizational costs of implementing an electronic medical record with the utilization of new graduates as super users.

A new graduate program, which incorporated the use of a formal preceptor and mentoring program, …

The Design, Implementation And Evaluation Of A Technology Solution To Improve Discharge Planning Communication In A Complex Patient Population, Susan M. Manfredi

Doctor of Nursing Practice (DNP) Projects

Unnecessary delays in discharge planning can extend the length of stay (LOS) and add non-reimbursable days for socially and medically complex patients thereby increasing the financial burden to healthcare organizations. The literature supports enhanced discharge communication strategies and the use of checklists to facilitate safe and timely discharges. Following root cause analyses of significant discharge delays, one hospital identified gaps in communication as key precursors associated with discharge planning breakdown when discharging patients to skilled nursing facilities. Review of these events demonstrated the need for concurrent communication strategies between multidisciplinary care team members in planning for complex discharges.

Following a …

Transforming The Journey For Newly Licensed Registered Nurses: A Community Based Transition-To-Practice Program In Ambulatory Care Settings, Cathryn A. Halford Dnp

Doctor of Nursing Practice (DNP) Projects

Abstract

In response to the job shortage for newly licensed registered nurses (RNs), transition to practice and residency programs have been established in many areas of the country including the San Francisco Bay Area. The programs were designed as demonstration projects to assist new graduates by increasing their competence, confidence, and skills, and their employability. Evidence from new graduate programs suggests that the programs provide an important bridge that is necessary for the critical transition from classroom to clinical practice and from newly licensed RN to qualified nursing professional. The University of San Francisco (USF)

Transition-To-Practice (nurse residency) program in …

Adherence To Guidelines For The Screening And Treatment Of Vitamin D Deficiency In Elderly Patients, Alyssa Simmons, Mary Williams

MSN Research Projects

The purpose of this study was to evaluate healthcare providers compliance with the guidelines established by The Endocrine Society regarding Vitamin D.

Factors Mediating Disruptive Behaviors In A Veterans Affairs Medical Center, Marylois Lacey

Dissertations

. Disruptive behaviors are often related to care giving situations in which the patient wants something that is not possible, refuses to participate in what is required, demands instant gratification, or demands immediate emotional support. In response to the patients’ demands and actions, health care providers use limit setting, activity demand, and denial of request. This study sought to answer the following questions: (a) Are code greens associated with symptoms of a medical and/or psychiatric diagnosis, denial of request, limit setting, and activity demand? (b) Are activity demand, denial of request, and limit setting more likely to be associated with …

The Creation And Implementation Of Interprofessional Simulation Leadership Scenarios, Angeline C. Delucas

Doctor of Nursing Practice (DNP) Projects

Healthcare is in a historical state of change creating an era that requires superior leadership skills. Leaders face burgeoning challenges in a competitive environment ensconced in reform. Today’s dynamic healthcare environment demands that nurse and interprofessional leaders be astute in a variety of areas including: fiscal responsibility and accountability, organizational politics, interpersonal skills, human resources, communication, conflict resolution, and emotional intelligence. Some areas such as fiscal management are considered hard skills, or skills which can be taught, while others such as conflict resolution are referred to as soft skills, or skills that are learned through experience. Though soft …

Healthcare Provider's Adherence To The Centers For Disease Control And Prevention's Guidelines Regarding The Human Papillomavirus Vaccine In Males, Lacey Gullick, Kevin Miller

MSN Research Projects

The purpose of this study was to determine the number (percentage) of boys, ages 9-21, who were educated on or who received the HPV vaccine at their local community clinic.

Tetanus, Diphtheria, And Pertussis Screening And Pertussis Prevention Throughout The Age Span, Lacey Gullick, Kevin Miller

MSN Research Projects

The purpose of this study was to determine the number (percentage) of boys, ages 9-21, who were educated on or who received the HPV vaccine at their local community clinic.

Adherence To Guidelines For The Screening And Treatment Of Vitamin D Deficiency In Elderly Patients, Kelly Massey, Rebekah Overstreet, Franklin Golden

MSN Research Projects

The purpose of this study was to determine if health care providers are educating adult asthma patients according to the NHLBI guidelines.

Managing Congestive Heart Failure : A Study Comparing The Management Provided By A Cardiologist, Family Physician And Nurse Practitioner, Jill Lyle, Misti Garnett, Lisa Hayes

MSN Research Projects

The purpose of this project was to compare the care provided to congestive heart failure patients by three different provider types. The providers chosen were a cardiologist, a family physician and a nurse practitioner. The researchers used guidelines set forth by the American Heart Association and the American College of Cardiology.

Are Health Care Providers Following Evidence-Based Practice Guidelines For The Screening, Diagnosis And Treatment Of Childhood Obesity?, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

Healthcare Provider Adherence To Asthma Education Guidelines, Jill Lyle, Misti Garnett, Lisa Hayes

MSN Research Projects

The purpose of this project was to compare the care provided to congestive heart failure patients by three different provider types. The providers chosen were a cardiologist, a family physician and a nurse practitioner. The researchers used guidelines set forth by the American Heart Association and the American College of Cardiology.

Primary Care Management Of Type 2 Diabetic Patients With Dyslipidemia According To Ncep Atp Iii Guidelines, Alyssa Simmons, Mary Williams

MSN Research Projects

The purpose of this study was to evaluate healthcare providers compliance with the guidelines established by The Endocrine Society regarding Vitamin D.

Tetanus, Diphtheria, And Pertussis Screening And Pertussis Prevention Throughout The Age Span, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

Healthcare Provider Adherence To Asthma Education Guidelines, Kelly Massey, Rebekah Overstreet, Franklin Golden

MSN Research Projects

The purpose of this study was to determine if health care providers are educating adult asthma patients according to the NHLBI guidelines.

Influencing Change In Healthcare Providers: Communication Strategies For A New Era In Healthcare, Ceonne Raasikh

Doctor of Nursing Practice (DNP) Projects

Effective provider communication is the key to patient engagement. However, many providers are not able to effectively communicate with patients, in part due to low health literacy. Evidence in the literature supports the use of specific strategies aimed at improving communication with patients. The purpose of this quality initiative was to influence providers to adopt new communication strategies with their patients. Pharmacists, nurses and physicians were invited to participate in a free, full-day, educational event. During the event providers were alerted to the issue of health literacy and provided communication strategies to improve patient comprehension and engagement. Following the presentation, …

Exploring Factors That Influence The Choice To Retire From Driving In Older Adults, Debra J. Jenkins

Theses and Dissertations

No

Initial Impact Of Tailored Web-Based Messages About Cigarette Smoke And Breast Cancer Risk On Boys' And Girls' Risk Perceptions And Information Seeking: Randomized Controlled Trial, Chris G. Richardson, Laura L. Struik, Kenneth C. Johnson, Pamela A. Ratner, Carolyn Gotay, Jasmina Memetovic, Chizimuzo T.C. Okoli, Joan L. Bottorff

Nursing Faculty Publications

BACKGROUND: Recent evidence indicates a causal link between both active smoking and secondhand smoke (SHS) exposure and breast cancer (BC).

OBJECTIVE: The objective of the present study was to evaluate the initial reactions of girls and boys to tailored Web-based messages that describe the relationship between SHS and BC, using a parallel, single-blinded cluster randomized controlled trial.

METHODS: This trial was nested within a cycle of an ongoing longitudinal study of 1498 students from 74 secondary schools. Self-reported assessments were used to evaluate the impact of study messages on participants' risk perception and interest in obtaining additional information after participants …

Improving The Implementation Of The Acute Care Nurse Practitioner (Acnp) Role: Development Of Acnp Role Implementation Guidelines, Megan Elizabeth Liego

Doctor of Nursing Practice (DNP) Projects

With the implementation of the Patient Protection and Affordable Care Act (PPACA) and the Value Based Purchasing (VBP) initiative, hospitals and the health System have rolled out a strategic goals of focusing on meeting the VBP objectives and standardizing care within their hospitals. To help meet these goals and improve patient care, many hospitals have looked toward the implementation of the acute care nurse practitioner (ACNP) role in the hospital setting. There is a lack of guidelines, though, on how to implement the ACNP role. This has led to several barriers, which have created variation in practice and outcomes across …

Primary Care Management Of Type 2 Diabetic Patients With Dyslipidemia According To Ncep Atp Iii Guidelines, Kate Totty, Nancy Grissom, Shannon Weathers

MSN Research Projects

The purpose of this study was to identify patient care practices of primary care providers in the monitoring and management of dyslipidemia in patients with type 2 diabetes according to the third report of the National Cholesterol Education program Adult Treatment Panel. The study presented here was a retrospective chart review of 300 charts completed in three primary care clinics in a southeastern state.

Grant Application: Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods, Richard J. Fehring

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

No abstract provided.

Comparison Of Abstinence And Coital Frequency Between Two Natural Methods Of Family Planning, Richard J. Fehring, Thomas Bouchard, Mary Schneider

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Problem Statement: The length of periodic abstinence, due to overestimation of the fertile phase of the menstrual cycle is often a reason for dissatisfaction, discontinuation, and user error with natural family planning (NFP) methods. The objective of this research was to compare the length of required abstinence (i.e., estimated fertility) and coital frequency between two NFP methods.

Study Design: Analysis of existing data from a 12 month prospective comparison study in which participants were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group, both of which included a fertility algorithm as …

Authoring Simulations For High Stakes Student Evaluation, Janet Willhaus, Gail Burleson, Janice Palaganas, Pamela Jeffries

Nursing Faculty Publications and Presentations

Although simulation methods have primarily been used for teaching in nursing education, there is a growing interest in the use of simulation for student and program evaluation. Developing simulation scenarios for high stakes evaluation differs from traditional teaching/learning scenario authorship in a number of ways. This manuscript describes the process used to write, pilot test, and revise scenarios used in the National League for Nursing High Stakes Testing feasibility study. Observations and reported differences in scenario development and facilitation may provide insight to others regarding the best use of summative simulation scenarios.

Secondary Analysis Of Adolescent And Young Adult Sexual Health In Kalamazoo And Jackson Counties, Kayla Bolter

Honors Theses

Based off of the Healthy People 2020 goals regarding sexual health behaviors and reduction in the proportion of gonorrhea infections among males and females ages 15-44, the purpose of this thesis to provide the necessary evidence that a sexual health education intervention needs to be implemented into the campus of Western Michigan University in order to reduce the rates of gonorrhea among college students aged 20-24 in Kalamazoo County. This is a secondary analysis that compared the reported gonorrhea rates in Kalamazoo County, Michigan to the reported rates of gonorrhea in Jackson County, Michigan. Several components were compared within each …

Secondary Analysis Of Adolescent And Young Adult Sexual Health In Kalamazoo And Jackson Counties, Jenna Moreau

Honors Theses

This secondary analysis is a comparison of two Counties, Kalamazoo and Jackson, to see if the presence of a university has impact on reported Chlamydia cases. Nationally, 20-24 year olds account for the highest number of reported Chlamydia infections. This age group also accounts for the large majority of college students that attend Western Michigan University found in Kalamazoo County. It is believed that by collecting this data, there will be an obvious need for implementation of an education intervention for students at Western Michigan University regarding sexual health.

It was proposed that there would be a higher prevalence of …

Quality Of Life Among Southwest American Indians And Alaska Natives Living With The Hepatitis C Virus, Rydell Todicheeney-Mannes Phd, Rn, Acns-Bc

Dissertations

Background: Hepatitis C Virus is considered to be a global public health threat because seventy-five percent of infected persons have no symptoms and are unaware of their infection. It is significant to note that AI/ANs commonly contend with issues that prevent them from receiving or seeking medical care. Objectives: The purpose of this study was to: (a) Characterize the level of depression, alcohol consumption, stigma, and quality of life; (b) Examine the relationship among the variables of age, gender, residing on an AI/AN reservation, current partner status, depression, alcohol consumption, and stigma with quality of life in a sample of …

Work Stress Reactivity And Health Outcomes: A Study Of Nurses, Laurie Marie Jacobs

Dissertations and Theses

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health.

Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on …