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Articles 1 - 30 of 169
Full-Text Articles in Medicine and Health Sciences
Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith
Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith
Master's Projects and Capstones
Abstract
Introduction Cancer survivors can face post-cancer treatment effects that need addressing throughout their care trajectory. Education provided to stakeholders and patients will be beneficial in preventing fragmented care, increasing patient satisfaction, and expanding ongoing supportive clinical survivorship care. Methods An adapted Dr. Joanne Lester survivorship needs survey was given to n=7 post-cancer treatment patients within a northern California cancer patient advisory committee. The survey results were analyzed to identify common underserved chronic long-term survivorship needs. Based on the data, an evidence-based educational component was included within a booklet to enhance future survivorship care. Additional surveys were sent to stakeholders …
An Informatics Solution For Operating Room Efficiency, Richard A. Barrow
An Informatics Solution For Operating Room Efficiency, Richard A. Barrow
Doctor of Nursing Practice (DNP) Projects
Problem: For most hospitals, a major cost is the operating room. Inefficiency increases costs and risks for adverse events. An efficient operating room can also be a major revenue generator.
Context: This evidence-based performance improvement project was conducted in a small rural Veteran’s Hospital, which belongs to an integrated health network in Central California. The facility has four operating rooms and is expanding services provided to their patients.
Intervention: The intervention was the use of analytics and evaluations to improve the operating room efficiency by five percent. The use of 3 separate queries which were combined to generate reports and …
A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra
A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra
Master's Theses
Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …
Coping With Labor Education For Nurses, Donna Vo
Coping With Labor Education For Nurses, Donna Vo
Master's Projects and Capstones
The “Coping With Labor Education for Nurses” education plan is substantiated by data from the California Maternal Quality Care Collaborative (CMQCC) vaginal birth initiative toolkit and other research. Evidence-based data from multiple sources indicates that improving how labor support is offered at the bedside for the laboring patient can potentially decrease cesarean rates, reduce expenses, and increase savings. The objectives of this plan are to improve patient advocacy and the level of labor support interventions labor and delivery nurses will provide for patients to improve patient satisfaction score above 80%, decrease or maintain cesarean rates below 24.9%, and improve patient …
Improving Nurse Proficiency: Breastfeeding And The Opioid-Dependent Mother And Infant Diagnosed With Neonatal Abstinence Syndrome (Nas), Lauren Mountanos
Improving Nurse Proficiency: Breastfeeding And The Opioid-Dependent Mother And Infant Diagnosed With Neonatal Abstinence Syndrome (Nas), Lauren Mountanos
Master's Projects and Capstones
Management of the opioid-dependent mother-infant dyad is complex. Evidence suggests breastfeeding may decrease the severity of NAS symptoms, delay its onset, and decrease the need for pharmacologic treatment (Macmullen et al., 2014). Therefore, education of nursing staff on the benefits of breastfeeding for opioid-dependent dyads will enable them to safely recommend breastfeeding for long-term health (Pritham, 2013). The Clinical Nurse Leader (CNL) project, “Improving Nurse Proficiency: Breastfeeding and the Opioid-Dependent Mother and Infant Diagnosed with Neonatal Abstinence Syndrome (NAS)” aims to globally increase the number of infants diagnosed with NAS discharged on breast milk by 10% by June 30, 2018. …
Saving The Brain Matter(S): Improving Stroke Outcomes Utilizing A Direct To Ct Workflow, Robert Schambach
Saving The Brain Matter(S): Improving Stroke Outcomes Utilizing A Direct To Ct Workflow, Robert Schambach
Master's Projects and Capstones
Saving the Brain Matter(s): Improving Stroke Outcomes Utilizing a Direct to CT Workflow was a project implemented to improve outcomes for acute ischemic stroke patients arriving at a rural emergency department. The project focused on a revision of the emergency department workflow for acute ischemic stroke patients with an aim of lowering the door to needle time to under sixty minutes. An interdisciplinary team used lean methodology and the PDCA cycle to examine and revise the workflow. The workflow was revised to eliminate testing no longer required under the national clinical practice guidelines for the treatment of ischemic stroke. Within …
To Asq Or Not To Asq: A Suicide Risk Screening Improvement Project, Gina Mumper
To Asq Or Not To Asq: A Suicide Risk Screening Improvement Project, Gina Mumper
Master's Projects and Capstones
Abstract
Suicide is the second leading cause of death in children between the ages of 10-19 years. Most people who die by suicide have visited a healthcare provider within the prior year. Inpatient healthcare providers, particularly clinical nurse leaders (CNLs), are in a strategic position to assess adolescents for suicide risk regardless of their admitting diagnosis. “To ASQ or Not to ASQ” is an evidence-based project aimed at improving compliance with the Ask Suicide Screening Questions (ASQ) in an eight-bed medical-surgical adult and pediatric overflow intensive care unit (MSICU) in a large tertiary 629-bed academic medical center. Methods included convenience …
Ready, Set, Action: Potential Breakthrough Therapy For Treatment-Resistant Depression, Alvin Garlejo
Ready, Set, Action: Potential Breakthrough Therapy For Treatment-Resistant Depression, Alvin Garlejo
Master's Projects and Capstones
Major depressive disorder is a psychiatric illness that is associated with a variety of debilitating symptoms such as persistent sadness, lack of interest and motivation, lassitude, pessimistic thoughts, and in severe cases, suicidal ideation and behavior. Current psychological and pharmacological treatments have been demonstrated efficacious; however, an ever-growing number of individuals frequently report minimal to no improvement with these treatments; and in some cases, a worsening of symptoms. This inadequacy to treatment is commonly known as treatment-resistant depression. At Kadima Neuropsychiatry Institute, Dr. Feifel treats individuals with treatment-resistant depression with advanced treatments such as TMS and ketamine. During my fieldwork …
Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton
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 …
An Evidence-Based Implementation Project On High Utilizers In The Emergency Department, Bernadette Martin Ruggles
An Evidence-Based Implementation Project On High Utilizers In The Emergency Department, Bernadette Martin Ruggles
Doctor of Nursing Practice (DNP) Projects
Abstract
Challenges have been presented to the Emergency Department (ED) over the last several years as the dramatic rise in health insurance enrollment continues. Although, with the Republican bill, the American Health Care Act, changes to Medicaid may alter the health program leaving many uncertainties (Kaplan & Pear, 2017). Evidence reflects EDs are inundated with even more patients taking advantage of the availability of a one-stop shop for their care and treatment. Costs of ED services and resource allocation are rising as a result of these unnecessary visits contributing to a total healthcare expenditure of approximately 17.6% of the US …
Gerontological Community-Academic Partnership For An Msn Internship, Francine Serafin-Dickson
Gerontological Community-Academic Partnership For An Msn Internship, Francine Serafin-Dickson
Doctor of Nursing Practice (DNP) Projects
The growing population of older adults beckons nursing education to evolve and prepare the future nursing workforce with skills and knowledge to coordinate care for the community-dwelling older adult (gerontological) population. The purpose of this project is to develop, implement, and evaluate academic partnerships with agencies serving community-dwelling older adults for the Master of Science in Nursing (MSN) Clinical Nurse Leader (CNL) students. The formation of Community-Academic Partnerships (CAP) offers the opportunity for an experiential learning internship in combination with a gerontological curriculum. The curriculum is integrated into the CNL role courses and internship, focusing on person-centered interactions with older …
Float Rns: Unit Specific Tools To Promote A More Positive Float Experience, Tarra Abdullah-Grayson
Float Rns: Unit Specific Tools To Promote A More Positive Float Experience, Tarra Abdullah-Grayson
Doctor of Nursing Practice (DNP) Projects
Despite efforts to transition large portions of primary health care services to more community-based outpatient settings, federal projections say the rising complexity of acute care will increase demand for RNs in hospital settings by 36% in 2020 (American Association of Colleges of Nursing [AACN], 2017). Other projections indicate that by 2025, the U.S. registered nursing shortage will expand to more than 260,000 (Buerhaus, Auerbach, & Staiger, 2009). In an effort to address the ongoing challenges of nursing staff shortages, many hospitals have established a core of internal float pool RNs as a practical and cost effective solution to address the …
Increasing Faculty Knowledge And Empathy Related To Nursing Students With Learning Disabilities, Jodi Kushner
Increasing Faculty Knowledge And Empathy Related To Nursing Students With Learning Disabilities, Jodi Kushner
Doctor of Nursing Practice (DNP) Projects
The purpose of this paper is to provide a project overview for the implementation of a disability training module and simulation experience offered to university school of nursing faculty to increase faculty knowledge and empathy related to nursing students with learning disabilities. The number of students with learning disabilities in the postsecondary education setting has tripled in the past decade (Orr & Hammig, 2009). This growing student population makes faculty preparation essential in order to effectively meet the needs of these students. The literature indicated that best practices include disability training, faculty support, student support, inclusive strategies such as Universal …
The Development Of A Cardiovascular Competency Checklist For Chinese Nurses, Amy B. Xiong
The Development Of A Cardiovascular Competency Checklist For Chinese Nurses, Amy B. Xiong
Doctor of Nursing Practice (DNP) Projects
Cardiovascular disease is a global issue affecting millions of lives around the world. Today, countries like the U.S. and China have joined forces to take on the global issue. In the U.S., the American Heart Association is the largest organization dedicated to reducing the mortality rate of cardiovascular disease by requiring healthcare services to uphold standard cardiovascular guidelines. Astonishingly, within the last 10 years, the U.S. has reduced their cardiovascular mortality rate by 30%.
This quality improvement project sought to determine the gap between the United States and China’s standard nursing education and practices and to help Chinese nurses achieve …
Improving Early Sepsis Identification On Inpatient Units, Yee Yang
Improving Early Sepsis Identification On Inpatient Units, Yee Yang
Master's Projects and Capstones
Sepsis is a serious complication caused by an overwhelming immune response to infection that affect millions of people worldwide each year. Sepsis is a time sensitive illness that requires early identification and quick interventions to improve patient outcomes. This quality improvement project includes a team of clinical nurse leader (CNL) students and gathering information on the nursing compliance of the sepsis protocol at a large metropolitan hospital. The observations on different inpatient units and chart review conducted at the large metropolitan hospital led to increased awareness of gaps that prolong the identification of sepsis among patients; also to the creation …
Teaching A Primary Prevention Falls Program: Using The Stop Elderly Accidents, Deaths, And Injuries (Steadi) Toolkit, Janice Mark
Teaching A Primary Prevention Falls Program: Using The Stop Elderly Accidents, Deaths, And Injuries (Steadi) Toolkit, Janice Mark
Doctor of Nursing Practice (DNP) Projects
Problem: Falls in the community dwelling older adult (CDOA) are a growing health concern, placing large financial and social burdens. Primary care providers (PCPs) are not engaging in falls assessment and prevention activities due to the lack of knowledge and time. Context: Falls are the leading cause of fatal and nonfatal injuries, and is projected to worsen with the increase in the aging population. STEADI is a fall assessment and prevention toolkit created by the CDC to tackle this problem designed to address the knowledge and practice gaps of PCPs. Interventions: A DNP project was crafted and implemented to train …
Leadership Development, Succession Planning And Simulation: A Succession Plan For Organizational Success, Beth Eichenberger
Leadership Development, Succession Planning And Simulation: A Succession Plan For Organizational Success, Beth Eichenberger
Doctor of Nursing Practice (DNP) Projects
Future executive nurse leaders must be identified and prepared for the challenges of 21st century health care. The literature suggests a lack of existing standardized succession plans for these leaders. Senior leaders are often faced with the complex issue of how to develop and validate the competencies required for these leadership roles (Dyess, Sherman, Pratt, & Chiang- Hanisko, 2016). Therefore, in the absence of a succession plan, creating a leadership development program, which provides a pipeline of new executive leaders, would alleviate this gap. The motivating force is an effort to promote current talent and provide a higher level of …
Fall Prevention In The Ed, Ninojoseph Lacap
Fall Prevention In The Ed, Ninojoseph Lacap
Master's Projects and Capstones
This project focuses on the prevention of patient falls in the emergency department (ED). Kaiser Santa Clara Hospital is an academic medical facility in the heart of Silicon Valley. The facility has a 46 bed ED with an average daily census of 220, specializing in stroke, pediatrics, heart, and left-ventricular assist device (LVAD) patients. For the calendar year of 2016 there were thirty-reported patient falls in the ED. The global aim is to reduce the patient fall rate by 35% for the 2017 calendar year. The project’s objective is to continue the road to patient safety and to have less …
Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass
Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass
Master's Projects and Capstones
Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used …
Developing Ostomy Educational Tools To Decrease Hospital Length Of Stay, Morgan Whitmore
Developing Ostomy Educational Tools To Decrease Hospital Length Of Stay, Morgan Whitmore
Master's Projects and Capstones
A quality improvement project “Developing Ostomy Educational Tools To Decrease Hospital Length Of Stay” is aimed at reducing length of stay (LOS) for patients undergoing elective ostomy surgery from the current twelve days (Kirkland-Kyhn, 2017), to less than five days. Methods included use of a Pre-Ostomy Survey, which was distributed and completed by the nursing staff. Pre-survey analysis identified the need for three ostomy educational tools which were developed using a set of evidenced based patient care “milestones” and included: a Colostomy and Ileostomy Nursing Resource Binder, Patient Milestone Checklist, and the R.N. Postoperative Process For Ostomy Patients. The evidenced …
Lessons Learned From Cuba: Using Healthcare Systems And Stillbirth Rate Example, Ravi Patel
Lessons Learned From Cuba: Using Healthcare Systems And Stillbirth Rate Example, Ravi Patel
Master's Projects and Capstones
Cuba and the U.S. have different health care systems but similar health outcomes. In 2015 U.S. and Cuba had the same stillbirth rate. Cuba is a prevention-based system that is free for all, while the U.S. is a treatment-based system that uses a fee for service system. Cuba has ratified international laws that hold it accountable for improving health outcomes especially for women and children. The U.S. can learn from Cuba when it comes to improving health outcomes. The U.S. can improve their health outcomes by including more preventative based interventions and ratifying international law that will hold the U.S. …
No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass
No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass
Master's Projects and Capstones
Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …
Improving Early Sepsis Identification On Inpatient Units, Leslie Virtudazo
Improving Early Sepsis Identification On Inpatient Units, Leslie Virtudazo
Master's Projects and Capstones
Sepsis is a life-threatening condition that arises from a complication of severe infection characterized by a systemic inflammatory response (SIRS). As a time critical illness requiring early identification and treatment, delayed recognition of sepsis can lead to organ failure and death. Effective sepsis protocols need to be established and implemented to reduce the number of patients declining to sepsis in the hospital setting. For this project, nursing practice and knowledge of SIRS and sepsis protocol were assessed to obtain a baseline measure of the nurses’ knowledge.
A root cause analysis was used to identify existing barriers to performing timely sepsis …
Simulation Based Post-Partum Hemorrhage Training In Nigeria: A Pilot Project, Nneka Chukwu
Simulation Based Post-Partum Hemorrhage Training In Nigeria: A Pilot Project, Nneka Chukwu
Doctor of Nursing Practice (DNP) Projects
Postpartum hemorrhage (PPH) is one of the leading causes of mortality and morbidity among childbearing women globally (Ononge, Mirembe, Wandabwa, & Campbell, 2016). Although this outcome is preventable, it remains a significant cause of death among women, especially in underdeveloped countries. This paper examines an educational project that was aimed to increase the knowledge of student midwives and registered midwives in a rural academic setting in Nigeria.
Methods: A one-day educational pilot training which consisted of a didactic component and a case-based simulation training focused on identifying risk factors, assessment techniques, and management protocols for the PPH patient. There were …
Lost In Translation, Daniel Pena
Lost In Translation, Daniel Pena
Master's Projects and Capstones
At the conclusion of a patient’s hospitalization the Registered Nurse (RN) will review all discharge instructions in the patients room in their preferred language. Plan time for the discharge and facilitate a calm quiet environment, such as the patient’s room with the door closed, if possible. Get the discharge instructions printed out in their preferred language and a set for yourself in English would be best so you are able to review the instructions line by line with them. When the patients medical team, such as but not limited to, medical doctors, pharmacists, physical therapists, and social work have completed …
A Multi-Prong Fall Awareness Program To Reduce The Occurrence Of Falls In A Skilled Nursing Unit, Cheri Labrador
A Multi-Prong Fall Awareness Program To Reduce The Occurrence Of Falls In A Skilled Nursing Unit, Cheri Labrador
Master's Projects and Capstones
Abstract
A multi-prong falls awareness program to reduce the occurrence of falls in a skilled nursing unit
Keywords: Fall awareness program, skilled nursing unit, fall rate
The project goal was to reduce the patient fall rate by 20% by implementing a fall awareness program for clinical staff. The program had two prongs and began with a pre-survey to determine current fall prevention knowledge. The staff was encouraged to participate in the training by providing risk factors that contribute to falls and simple strategies to prevent falls based on their knowledge of the patients (Boushon et al, 2012). A post-survey was …
Fall Prevention, Linda Fang
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 …
Improving Nurses' Proficiency And Confidence In The Use Of Aromatherapy For Patients In The Hospice Setting, Erika Bigwood-Keaton
Improving Nurses' Proficiency And Confidence In The Use Of Aromatherapy For Patients In The Hospice Setting, Erika Bigwood-Keaton
Master's Projects and Capstones
The Institute of Medicine noted patient centered care as one of the six priority areas of improvement for the U.S. healthcare system. Recognizing that patients in hospice require specialized care to address the physical, emotional and spiritual needs that are associated with a terminal illness, the focus of this project is to improve the hospice nurses’ knowledge of and confidence in the use of aromatherapy for symptom management. There is recognition within the field of healthcare that patients are interested in having options for treatment. With little to no side effects, aromatherapy has been shown to be an effective alternative …
Oh Baby! Evaluating The Impact Of Blossom's Natural Childbirth Prep Course On Women's Childbirth Experience, Florence Oxenham
Oh Baby! Evaluating The Impact Of Blossom's Natural Childbirth Prep Course On Women's Childbirth Experience, Florence Oxenham
Master's Projects and Capstones
The United States has some of the highest rates of maternal morbidity and mortality among developed countries. Comprehensive childbirth education is an important component of improving maternal health outcomes. This project was a pilot evaluation of a childbirth education course offered by Blossom Birth Services, a community-based non-profit organization providing resources for new and expectant families in the San Francisco Bay Area. A 41-item survey questionnaire was developed and administered to explore the impact of Blossom’s Natural Childbirth Prep course on women’s knowledge, feelings, and sense of self-efficacy regarding childbirth. Likert scales were used and thematic analysis of qualitative data …
"All Set Togo Home":Improving Discharge Planning For Patient's Safe And Timely Discharge, Jasmin Milana
"All Set Togo Home":Improving Discharge Planning For Patient's Safe And Timely Discharge, Jasmin Milana
Master's Projects and Capstones
Abstract
The project focuses on the improvement of the discharge planning for patient’s safe and timely discharge in the medical oncology and telemetry unit at the county hospital. The facility has 54-bed capacity with an average daily census of 35 to 40 specializing in cancer, end-stage diseases, cardiac issues, HIV/AIDS, sepsis, palliative and comfort care, diabetes, respiratory diseases, psychiatric and placement patients. The unit has no discharge coordinator. Nurses are responsible for the quality and safe discharge of patients. These nurses experience frustrations due to fragmented system of the discharge process, nurses’ heavy workload, and prioritizing patients with higher acuity. …