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Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton

Doctor of Nursing Practice (DNP) Projects

The demand for surgical services continues to increase, creating a strain in our healthcare system and causing increasing backlog hours for the operating room. Allowing nurse practitioners (NP) to function in an expanded role in the perioperative environment requires additional training beyond the generic NP program. With this additional training, the NP can function as a first assistant, providing delegated medical functions in the perioperative environment. An in-house NP registered nurse first assistant orientation program was developed based on the adult learning theory as a conceptual framework combined with the AORN perioperative standards as a foundation. The cost of using …

Fall Prevention, Linda Fang

Master's Projects and Capstones

Fall Prevention Abstract

Background: According to the CDC, the medical cost for falls was approximately $30 billion in 2012. When a patient falls, and gets serious injury, these costs could sum up to $14,056 per patient. As a result, hospital stays per patient are observed to increase by approximately 6.3 days longer than those patients who haven’t encountered falls.

This study focused on identifying high fall risk patients, and developing a plan of care to reduce the occurrence of falls in a hospital setting. Nurses using safe fall interventions techniques have been proven to inspire fall preventions.

An assessment of …

Surgical Site Infection Reduction Through Nasal Decolonization Prior To Surgery, Melissa S. Schmidt

Master's Projects and Capstones

Surgical site infections (SSIs) are the most common and expensive healthcare-acquired infection. The objective of this nurse-driven process improvement project was to implement a cost-effective and practical decolonization protocol to improve outcomes for high-risk veteran populations undergoing surgery at a large veteran’s hospital in the Pacific Northwest. Prior to the implementation, a decolonization protocol was used for cardiac and orthopedic preoperative patients. The process involved screening for methicillin-resistant Staphylococcus aureus (MRSA) colonization via nasal swab preoperatively and treating positive patients with mupirocin ointment to nares BID and chlorhexidine showers for five days prior to surgery. Adherence to the protocol was …

Reducing Turnover Time To Improve Efficiency In The Operating Room, Myrna Jafari

Master's Projects and Capstones

Abstract

The purpose of this project is to improve efficiency by reducing turnover time in the operating room (OR) that can consequently enhance patients’ and physicians’ satisfaction, promote teamwork, and decrease the cost of operating room delays. The increasing trend of turnover time (TOT) requires attention for microsystem improvement in the OR of Santa Rosa Memorial Hospital. The intervention to improve efficiency is to educate the OR team members on roles and responsibilities to establish a standard workflow which can promote accountability and teamwork during the turnover process. Havelock’s theory of change is used as a framework for the action …

Implementation Of An Evidenced-Based Practice Curriculum To Improve Nursing Practice For Epidural Administration And Monitoring, Chatty O'Keeffe

Master's Projects and Capstones

Abstract

Epidural analgesia (EA) is one inpatient pain management option prescribed by Acute Pain Services (APS) at VA Puget Sound Health Care Services (VAPSHCS). Historically, EA nursing care at VAPSHCS has been managed by surgical units. However, in the last two years, facility restructuring and budget constraints have led to reorganization and consolidation of units. The reduction in units providing nursing EA care has resulted in an overflow of EA patients to the medical intensive care unit (MICU). A previous gap analysis of the compliance in nursing performance of EA nursing care on the surgical acute care unit demonstrated poor …

Reducing Operating Room Turnover Times, Marivic Z. Paraz-Lee

Master's Projects and Capstones

Background

The operating room (OR) in an ambulatory surgery center (ASC) is what generates income for an organization, but it can also be costly if it’s improperly managed. The purpose of this project is to decrease OR turnover time (TOT) in order to increase OR efficiency, patient and staff satisfaction, as well as be cost effective. As defined by Gottschalk et al. (2016), OR turnover time is “the duration of time from a patient exiting the OR to the time the succeeding patient enters the OR” (p. 489).

Methods

The method utilized for this project is gathering weekly average TOT …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …