Medicine and Health Sciences Commons^™

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Jillian J. Abinader

Master's Projects and Capstones

Problem: A sepsis protocol and bundle has been implemented in an urban Emergency Department to help screen patients and treat sepsis efficiently and effectively. The benchmarks from the bundle are not being met consistently every month and are below the targeted 90%.

Context: A microsystem assessment and a gap survey sent out to nurses, helped determine that there is room to improve nurses’ knowledge and confidence about sepsis and the sepsis bundle workflow. Sepsis is one of the most expensive and burdensome conditions in U.S. hospitals. Literature supports staff education to improve sepsis bundle compliance.

Intervention: A video was created …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …

Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan

Master's Projects and Capstones

Section I: Abstract

Problem: January and February 2021 data showed a rise in readmissions for the NSTEMI population. This is significant as 2020 had a readmission rate of 5.6% and 7.3% in 2019. This sudden increase in readmissions within the first two months of the year is a cause for concern and immediate action is needed.

Context: 2020 had a reduction in cardiac catheterizations due to the multiple canceled cases during the COVID 19 pandemic. As the cases were being rescheduled along with new cases in 2021, the institution experienced an uptake in readmissions.

Interventions: The staff of department 220 …

Adopting Complex Case Management Competencies, Phyllis Stark

Doctor of Nursing Practice (DNP) Projects

Improving disposition management of complex hospitalized patients is crucial to the success of acute care facilities. Most hospital patients discharge in less than 5 days, but there is a cohort of complex patients whose length of stay far-exceeds the norm (Centers for Medicare and Medicaid Service Website, n.d.). Today’s case managers are focused on patients who are discharging today or tomorrow in order to keep hospital census cycling through. This phenomenon known as “throughput” drives daily operations and is a measure of success. When case managers are faced with complex patients whose length of stay measured in weeks, months, or …

Pregnancy Loss In The Emergency Department, Gudrun Reiterhiltebrand

Master's Projects and Capstones

Abstract

The aim of this project is to improve the care for patients experiencing pregnancy loss in the emergency department (ED). Objectives are to enhance understanding of staff about the patients’ experience and their knowledge on how to best care for emotional needs, thus improving quality of patient care, work satisfaction, knowledge, confidence and comfort levels, while decreasing experienced stress. The project was implemented in a midsized community hospital with 117 beds, which discharged 74 patients with “interrupted pregnancies” over the previous year from the ED. The project was directed toward nurses, doctors, care partners, chaplains, and social workers. The …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

Utilizing Tiger Competencies To Improve Informatics Practice, Kwun Ying M. Fung

Doctor of Nursing Practice (DNP) Projects

Nursing Informatics (NI) is quickly becoming an essential part of nursing. From the classroom, to the bedside, and to the boardroom, nurses across the nursing continuum are expected to use NI in their practice with the hopes of delivering better quality care to their patients. However, the training and education of NI provided to all levels of nurses is unable to keep up with the pace of technology. This project seeks to improve the NI competency of the nursing workforce at a pediatric hospital through an educational course using NI competencies identified by the Technology Informatics Guiding Educational Reform (TIGER) …