Medicine and Health Sciences Commons^™

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Promoting Patient Mobility To Decrease Hospital Length Of Stay, Saira Kinuthia

Student Scholarly Projects

Practice Problem: Promoting patient mobility may reduce hospital-acquired complications and length of stay (LOS). Evidence-based studies have established that there is a correlation between immobility and an increased length of stay in the hospital. How can nurse-driven mobility interventions effectively increase patient mobility and reduce the risk of complications and length of hospital stay?

PICOT: The PICOT question that guided this project was: For veteran patients in the Progressive Care unit (PCU) of a medical center (P), will using the Johns Hopkins Highest Level of Mobility tool (JH-HLM) (I) compared to not using a mobility tool (C) decrease hospital length …

Practicum Structures And Nursing Student Retention/Achievement Rates In A United Kingdom University: A Quantitative Analysis, Phil M. Coleman

Quality Advancement in Nursing Education - Avancées en formation infirmière

This study sought to examine whether the consistent application of a specific placement design to student practice learning experiences within two pre-registration nursing degree programmes offered by a university in the United Kingdom (UK) affected retention and achievement levels. The quantitative analysis involved a sample of 460 employer-sponsored undergraduates, all of whom worked as non-registrant carers, within two cohorts of a part-time adult (physical) or mental health nursing degree programme, both of four years duration, offered by a large academic institution with a presence in all four UK nations. Cross-tabulation and multinomial logistic regression analyses found no statistically significant relationship …

Mystay – Development Of Nurse-Facilitated Condition-Specific Multimedia Resources To Facilitate Patient Participation In Postoperative Care, Jo Mcdonall, Anastasia F. Hutchinson, Natalie Heynesbergh, Bernice Redley, Richard De Steiger, Damien Khaw, Mari Botti

Patient Experience Journal

Improved postoperative outcomes and the global drive toward the provision of patient-centred care underpins efforts to enhance the nature and capacity of patient participation in acute postoperative hospital care. In this paper, we describe the design, framework and processes used to develop a modular, procedure-specific, digital health intervention platform aimed at improving the patient experience and patient participation in care following surgery. The intervention, a multimedia application MyStay, uses bedside delivery of audio-visual and text-based information to engage postoperative patients to better participate in their care. MyStay modules are developed using an iterative, multi-method approach intended to balance procedure-specific best …

Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare

Dissertations

Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …

Neuropathic Pain Management Of Adult Males A Quality Improvement Project In A Correctional Facility, George Egesi

Cohort IX

Disease or a lesion of the somatosensory system can cause neuropathic pain, a common condition seen in most primary care settings, including my adult correctional setting. I became aware of this fact after completing a 10-day Reflective Practice Log (RPL). After a literature review, the recommended intervention, Duloxetine 30 mg daily for seven days with follow-up in seven days. In my practice, I prescribed Cymbalta 30 mg daily for 30 days. I used self-reporting as the neuropathic signs and symptoms along with pain severity. The literature recommended the use of a numeric rating scale of 0-10 for pain assessment and …

Elearning Module For Nursing Students To Improve Delirium Identification, Prevention, And Management, Shannon Baker

Doctor of Nursing Practice (DNP) Projects

Background and Review of Literature: Delirium is a serious, acute alteration in cognition and consciousness, which is common amongst older hospitalized patients and has an overwhelmingly negative impact on patient outcomes. Under-recognition by healthcare providers poses a barrier and contributes to poor patient outcomes, including increased morbidity and mortality.

Purpose: To reduce the incidence of delirium amongst acutely ill patients via internet-based education for student nurses on delirium prevention, assessment, and management.

Methods: An eLearning intervention consisting of a virtual lecture with an unfolding case study for undergraduate nursing students. This project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) …

Is High-Intensity Focused Electromagnetic Field Stimulation More Effective Than Pelvic Floor Muscle Training In Treating Stress Urinary Incontinence In Women?, Monica Friedman

Nursing | Senior Theses

INTRODUCTION: Stress urinary incontinence, an involuntary loss of urine during physical exertion or effort, affects a disproportionately large number of women worldwide. Although pelvic floor muscle training is the first-line treatment for urinary incontinence, long term adherence is low, and therefore, is usually not an effective treatment. Medications may be costly and aren’t always effective; surgery is invasive and often not appropriate. This condition warrants further studies to find more effective solutions.

OBJECTIVE: To evaluate whether or not focused electromagnetic field therapy is more effective than pelvic floor muscle training in treating stress urinary continence in women.

PROPOSAL FOR FURTHER …

Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake

Dissertations

Abstract

Purpose: This quality improvement (QI) project aimed to determine if a standardized nurse teaching approach improved patient understanding of diagnosis and treatment as it relates to women diagnosed with a pelvic floor disorder (PFD) after receiving a standardized nurse education (SNE) session in an urban tertiary care Urogynecology practice.

Methods: Females aged 18 and older with a newly diagnosed PFD and prescribed PFPT for the first time who agreed to receive the SNE and complete the CAHPS® survey were included in the project. Patient perception of PFPT was assessed via phone interview utilizing the Consumer Assessment of Healthcare …

Approachability Of The Nursing Clinical Instructor: Psychometric Assessment Of A Scale Development, Angela Collier

International Journal of Health Sciences Education

Approachability of nursing clinical instructors is largely unknown and misunderstood, yet critical for millennial students which currently comprise 82% of nursing students (National League for Nursing, 2014). Nursing education consists of both a didactic and a clinical component. Clinical education is dynamic and allows the student an experiential learning opportunity. Therefore, clinical nursing educators are vitally important. Approachability has been identified in many studies as a leading characteristic of an effective instructor. Although the importance of approachability of the instructor is established, currently no scale exists to measure this concept. The purpose of this study was to examine the validity …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Caring For Young Adults With Cancer: A Systematic Review, Sarah M. Pelletier

All Graduate Theses, Dissertations, and Other Capstone Projects

Young adulthood is unique period of life in which critical developmental milestones are achieved amid dynamic physical, emotional, and social changes. During this period of life, young adults are charged with establishing personal and social independence. When challenged with a cancer diagnosis, the already turbulent late teens, twenties, and thirties are dramatically and permanently altered. Hence, the needs of young adults vary from that of their pediatric and older adult counterparts. The aim of this systematic review of the literature was to identify what age-specific needs must be addressed by healthcare professionals to enhance quality of care and outcomes for …

Examining Eshift Through The Caregiver Policy Lens: A Content Analysis, Ashlee A. Worrall

Electronic Thesis and Dissertation Repository

Purpose: This research study intended to understand how a new model of palliative home care in Ontario, Canada called eShift aligned with the needs of caregivers who cared for a family member at the end-of-life.

Methods: A qualitative secondary analysis using a deductive content analysis of 14 caregiver interviews, three decision-maker interviews, and six home care agency documents collected in a three-year study and were analyzed using The Caregiver Policy Lens framework.

Findings: The eShift model of care met caregivers’ needs through timely access to respite, education, collaborating with the health care team, and physical and psychological support. Caregivers were …

Preventing Hospital Acquired Pneumonia: A Quality Improvement Project, Calyn Pascual

Master's Projects and Capstones

Abstract

Problem: From October 2016 to September 2017, the 5^th floor medical surgical telemetry unit has had 9 incidences of hospital-acquired pneumonia (HAP). Among the facility, this is the floor with the highest HAP incidences.

Context: HAP is associated with $40,000 to $65,000 to each patient care cost; an additional 7-9 days of stay in the hospital, increases the chances of discharging a patient to a skilled nursing facility instead of home, and has an attributable mortality rate (Quinn, et al., 2014).

Interventions: Daily oral brushing self-audits are given to patient care technicians (PCT) for both day and evening …

Implementation Of A Scripted Education On Comfort Goals To Improve Patient Perception Of Pain Control, Vicki F. Mclean

Doctoral Dissertations and Scholarly Projects

Pain management is the culmination of physician, nurse, and patient expectations. Successful pain management is impacted by the patient’s perception and expectation of the provided interventions, as well as the perception of the care provider of the patient’s pain. Pain assessment tools have been utilized for decades and still pain control is rated as inadequate. Providing scripted education to the patient on the purpose and utilization of these tools impacts the patient’s perception of pain management. This project implemented the evidence-based practice intervention of education to improve the relationship of comfort goals to pain management. Nurses’ knowledge of pain management …

Inter-Professional Education: A Literature Analysis And Description Of Pacer Study At Western Michigan University, Kari Scholten

Honors Theses

Inter-professional education is a topic that is widely gaining popularity throughout the healthcare field. Because inter-professional practice in the hospital and beyond has proven its value time and time again, universities must take it upon themselves to train their healthcare students to work efficiently and communicate effectively with other disciplines in the healthcare field. Through a thorough literature review, it was demonstrated that inter-professional education studies and simulations that were performed in a range of settings have had positive effects on a variety of factors, including communication, quality of care given, and perceptions of professional roles. A study performed at …

Interdisciplinary Team Approach In Fall Prevention: Physician Perspective Focus, Anna Gryn

Master's Projects and Capstones

An in-hospital fall is a devastating event for patients and care providers resulting in injuries, physiological and psychological patient declines, and sometimes deaths. Furthermore, fall related costs greatly increase hospitals’ expenses and cause massive distress to caregivers and health providers. Many patient-specific, organizational, and seemingly erratic factors contribute to the occurrence of in-hospital falls. Despite this, hospitals must undertake consistent evidence-based measures to prevent fall occurrences as much as possible.

The traditional nursing approach to falls prevention is not sufficient to control fall rates because the issue is too complex and must be approached from multiple perspectives rather than just …

Baseline Prevalence Study Of Hendrich Ii Fall-Risk Assessment Tool At A Local Community Hospital, Emanuelle Vasconcelos Barbosa Borba Pontual

Master's Projects and Capstones

Each year, 700,000 to 1,000,000 people in the United States fall in hospitals; 30%–35% of those sustain injuries, and 20% of falls will cause serious traumatic injuries. Yet, research shows that close to one-third of these falls could be prevented. This paper presents the analyses of two fall-risk tools, Hendrich II fall risk model (HFRM II) and PMAT, in a local community hospital. Extensive review of literature and statistical analysis of 106 patients’ assessments practices were used to determine the current assessment skills for falls and PMAT. The aim was to understand if RNs are using the tools appropriately and …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Interprofessional Simulation: Students' Perceptions, Elizabeth Katherine Welch

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

An alarming number of errors occur in the healthcare system. The Institute of Medicine (IOM) responded to the error rate by encouraging changes in professional education and recommending interdisciplinary team training. A variety of professions, including aviation and the military, have utilized simulation in their education and training for mastering skills and also to assist with respect and appreciation of other professional roles on the healthcare team. The purpose of this study was to examine undergraduate nursing students, graduate social work students, and APRN students’ perceptions of one another as healthcare professionals using interdisciplinary simulation. The research study was a …

Efficacy Of Continuous Passive Motion After Total Knee Arthroplasty In Veteran Patients, Jaimee Riza B. Hare

Doctoral Projects

Since the early 1980s, continuous passive motion has been used as adjunct therapy in patients’ rehabilitation following total knee arthroplasty. Although existing literature challenged the benefits of continuous passive motion claiming it had no added short-term or long-term benefits after knee arthroplasty (Boese et al., 2014; Chen et al., 2012; Herbold et al., 2014; Leach et al., 2006; Maniar et al., 2012), the existing literature is difficult to generalize and apply to the veteran population at San Francisco Veterans Affairs Medical Center. This study was undertaken to determine the efficacy of continuous passive motion in helping veteran patients at San …

Generation Y Health Professional Students’ Preferred Teaching And Learning Approaches: A Systematic Review, Caroline Mary Hills, Tracy Levett-Jones, Samuel Lapkin, Helen Warren-Forward

The Open Journal of Occupational Therapy

Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published …

Nursing Management And Mirror Therapy For Phantom Limb Pain, Bridget Henry

Honors Undergraduate Theses

Phantom limb pain may occur after the accidental removal or surgical amputation of a limb. Phantom limb pain is the experience of pain in the limb that is no longer present. The clinical management of phantom limb pain is essential in the overall reduction of patient rehabilitation and poor patient outcomes. A patient’s degree of phantom limb pain is influenced by their personal response to loss and pain and can have devastating effects to a person’s social performance, occupational role, family role, relationships, and involvement in activities or hobbies. Like most chronic pain, phantom limb pain decreases the quality of …

The Relationship Between Osteoarthritis, Hip Arthroplasty, And Post-Operative Ambulation Distances, Melissa E. Ings

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Osteoarthritis, total hip replacements, and post-operative ambulation distances are three interrelated concepts that lead patients from diagnosis, to intervention, and to the first indications of recovery post-operatively. The purpose of the project was to quantify the ambulation distances of patients with one of three surgical approaches for total hip replacements (THR). The timeframe for measurement was from the day of surgery (day 0) through the second post-operative day (POD 2) comparing different surgical approaches with length of ambulation distances. Pre-operative elective joint replacement educational classes, may play a role in post-operative recovery, which provided the rationale for including them in …

The Prevalence Of Smoking In Nursing Students, Jennifer Trotter

Undergraduate Honors Theses

Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

Hospital-Based Nurse Practitioner Practice: An Exploration Of Interprofessional Teams., Christina J. Hurlock-Chorostecki

Electronic Thesis and Dissertation Repository

Nurse practitioner (NP) roles within hospital teams are evolving worldwide. However, understanding of their practice within the context of interprofessional (IP) teamwork remains limited. This two-phase study undertaken within Ontario, Canada provides a new multi-perspective understanding of the value of NP practice within IP hospital teams. Constructivist grounded theory, a modification of the classic methodology, guided an interpretive approach based in exploration of process and meaning construction, privilege and power exposure, and juxtaposition with extant theory. A conceptual rendering of NP practice was determined through supplemental analysis of 30 team member focus groups. This new perspective emerged as three practice …

The Decision Making Process Involved When Changing Career: A Qualitative Study Of Registered Nurses Who Have Left The Profession, Katherine S. Gallager

Theses : Honours

Career choice is an important decision an individual has to make during their lifetime. Personal, environmental and organisational factors all assist this decision process as individuals strive for a work-life balance within careers that meet their needs and realise their potential. This research study investigated which factors contributed to the decision process of Registered Nurses (RNs) who have left the profession for a career change. There is currently a global shortage of RNs, which is of major concern to healthcare policy makers in most countries, including Australia. This qualitative study examined the narrative interviews often females over the age of25 …

A Phenomenological Study Of Partners Of People With Parkinson's Disease Who Demonstrate Communication Changes, Elsie Janet Doherty

Theses: Doctorates and Masters

Parkinson's disease is a common progressive neurological illness for which there is no known cure. While the cardinal signs are tremor, bradykinesia or slowness of movement, muscle rigidity and postural instability (Jahanshahi & Marsden, 1998, p.3) the patient may face an extended number of years experiencing all, or any combination of, the many other manifestations of the disease process. These manifestations include changes to various aspects of communication including loss of voice volume, diminished body language and loss of facial expression. All of these affect both verbal and non verbal communication. Given the progressive nature of Parkinson's disease the patient …

Influence Of Public Image Of Nurses On Nursing Practice, Miyuki Takase

Theses: Doctorates and Masters

Many researchers believe that nurses live in a dual structure, encompassing both the social and nursing worlds. They contend that these two worlds have contrasting views toward nurses. This is, while nurses are guided to establish professional status, society still expects them to remain in a dependent role. This conflict is assumed to have a negative impact on nurses’ psychological and functional states (Kalisch & Kalisch, 1983 & 1987). However, this assumption has not yet been explored sufficiently. The aim of this descriptive correlational study was therefore to investigate the relationships among the public image of nurses, nurses’ self concept, …