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Articles 1 - 30 of 34
Full-Text Articles in Medicine and Health Sciences
Improving Nursing Shift Handoff Reports: A Quality Improvement Project, Nathan Mm Secrest
Improving Nursing Shift Handoff Reports: A Quality Improvement Project, Nathan Mm Secrest
Master's Projects and Capstones
Nursing shift-to-shift handoff report can greatly impact a patient’s quality of care. According to the Joint Commission, “an estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off” (Inadequate handoff communication, 2017). In total, this quality improvement (QI) project worked with three hospital inpatient units on three different floors in an urban California (CA) city. Each unit and even shifts within each unit varied, leading to the conclusion that interventions should be trialed by units with the most buy-in, then adjusted to the unique needs of each unit. For our main intervention we …
Improved Data Communication With Frontline Staff, David Sprecher
Improved Data Communication With Frontline Staff, David Sprecher
Master's Projects and Capstones
Problem: Frequently, communication from the Quality Department (QD) needs to be filtered through several organizational layers without first-hand knowledge of what message was given to frontline staff. Current mechanisms of communication between the QD and front-line microsystem teams have barriers preventing them from being consistent and reliable.
Context: Research has found that collaborating with and supporting frontline staff was key to establishing a culture that supports change and a focus on safety. Establishing open communication and effective teamwork with individuals on the frontline leads to shared values within a team and better collaboration which drives performance improvement.
Interventions: For trended …
Aidet And Commit To Sit Implementation In The Outpatient Surgical Setting, Olivia V. Meehan
Aidet And Commit To Sit Implementation In The Outpatient Surgical Setting, Olivia V. Meehan
Master's Projects and Capstones
Problem: This quality improvement project implements AIDET and commit to sit to improve communication and increase the patient satisfaction of an outpatient surgery microsystem. The microsystem’s patient satisfaction is assessed, and it is currently scoring below the reach goal of 85th percentile. The detractors from their overall score mainly stem from the patient not feeling listened to, informed, or updated on the timeline. AIDET and commit to sit are ideal tools for addressing those deficits.
Context: The microsystem being addressed is an outpatient surgery unit that specialized in general surgery for the pediatric population. The pediatric population that the …
Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis
Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis
Doctor of Nursing Practice (DNP) Projects
Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.
Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …
Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash
Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash
Master's Projects and Capstones
Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.
Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.
Intervention: This project implemented an Add-On Communication Tool for …
Standardizing And Documenting Decision-To-Incision Intervals For Unscheduled Cesarean-Section Deliveries, Molly Bloom
Standardizing And Documenting Decision-To-Incision Intervals For Unscheduled Cesarean-Section Deliveries, Molly Bloom
Master's Projects and Capstones
The term decision-to-incision interval (DII) refers to the interval between when a laboring patient and their healthcare provider agree to an unscheduled surgical cesarean section (C/S) delivery and when the first incision is made in the operating room. The ideal length for this interval varies with the urgency of each case, and there is no international consensus regarding the timing. In an urban labor and delivery unit in a private hospital, examination of this interval revealed inconsistent documentation of the decision, as well as unclear guidelines on the DII for two of the three unscheduled C/S urgency levels. This quality …
Improving Clinical Communication And Collaboration Through Technology, Michelle Machon
Improving Clinical Communication And Collaboration Through Technology, Michelle Machon
Doctor of Nursing Practice (DNP) Projects
Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.
Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …
Standardizing The Bedside Shift Report: Improving Nurse-To-Nurse Communication, Deepi Sahota
Standardizing The Bedside Shift Report: Improving Nurse-To-Nurse Communication, Deepi Sahota
Master's Projects and Capstones
PROBLEM: The Community Living Center (CLC) reveals an immense concern on shift-to-shift handoff report. Shift-to-shift report is done in the report room, often times unclear information is given and critical information is not appropriately conveyed.
CONTEXT: The project was implemented on a 50-bed unit at the Veterans Affairs. The improvement project was focused on collaborative partnerships, standardized bedside shift report, and utilization of the SBAR tool. in the prevention of communication errors.
INTERVENTIONS: The SBAR tool was utilized to provide a framework for effective communication between nurses. The CNL facilitated an hour in-service on bedside shift report to nurses …
Chief Nurse Executive Work Engagement: System Leadership Through A Natural Disaster, Strike, And Pandemic, Ryan Fuller
Chief Nurse Executive Work Engagement: System Leadership Through A Natural Disaster, Strike, And Pandemic, Ryan Fuller
Doctor of Nursing Practice (DNP) Projects
Problem. In a 21-hospital region of a 39-hospital integrated health system, CNE turnover peaked at 63% (12 CNEs) in 2015. Interviews were conducted in 2019 with 12 CNEs across the region to understand potential issues related to CNE job satisfaction. Responses revealed concerns regarding empowerment, alignment, work-life balance, information transparency/sharing, and recognition. While identifying a solution to address CNE concerns, the organization experienced successive crisis events during a 12-month period that included a record-setting wildfire, multiple labor union strikes, and a novel pandemic. The regional leadership team (RLT) required new approaches to facilitate effective communication during a crisis between the …
Standardizing The Bedside Shift Report: Improving Communications And Promoting Patient Safety, Chona C. Alforque
Standardizing The Bedside Shift Report: Improving Communications And Promoting Patient Safety, Chona C. Alforque
Master's Projects and Capstones
PROBLEM: Nursing shift reports are integral to nursing as they allow for the transfer of critical information and responsibility of patient care from one nurse to another. Ineffective communication during shift-to-shift reports can contribute to gaps in patient care and breaches in patient safety, including medication errors, falls, and sentinel events. The greatest risk of communication breakdown is during transitions in care.
CONTEXT: St. Louise Regional Hospital, a small community hospital, consisting of an eight-bed medical-surgical intensive care unit lacked structure in how handoff should occur and had variances in shift handoffs. Observation of the shift handoff at the nurses’ …
Improving Nurse-Physician Collaboration: Building An Infrastructure Of Support, Marshall Blue
Improving Nurse-Physician Collaboration: Building An Infrastructure Of Support, Marshall Blue
Doctor of Nursing Practice (DNP) Projects
Abstract
Healthcare organizations have come to realize the 21st century brings many challenges. First and foremost is the challenge of improving patient satisfaction with their health care and their associated experience accessing this complex system. Other challenges are incorporating the patient perceptions of delivering high quality, safe, equitable care to the surrounding community while demonstrating cohesive teamwork. Healthcare professionals and organizations must find an effective and efficient pathway to provide excellent care to the patient within an extremely competitive market. Current research demonstrates a patient perceives they are receiving exceptional care when interdisciplinary conversations are noticed between the nurse and …
A Literature Review On Improving Nurse-Patient Communication Manuscript, Irene Gabbedon
A Literature Review On Improving Nurse-Patient Communication Manuscript, Irene Gabbedon
DNP Qualifying Manuscripts
Effective communication happens when the sender of the message sends it, and it is conveyed and understood by the receiver (Gilbert & Hayes, 2009). Medical errors are the third leading cause of death in the United States alone (McMains, 2016). The Joint Commission (TJC) (2019) implemented National Patient Safety Goals (NPSG) in 2002, and improving communication among caregivers has been a goal that has been frequently revised. Due to ineffective communication, life-threatening errors are created among healthcare workers. Nurses play an important role in the communication channel and barriers can be created when there is a lack of health literacy. …
"Improving Nursing Communication Outcomes Through The Tell-Us Card", Jillian Cule, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Maricarmen Reyes
"Improving Nursing Communication Outcomes Through The Tell-Us Card", Jillian Cule, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Maricarmen Reyes
Master's Projects and Capstones
Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …
Improving Nursing Communication Outcomes Through The Tell-Us Card, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes, Jeffrey Salao
Improving Nursing Communication Outcomes Through The Tell-Us Card, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes, Jeffrey Salao
Master's Projects and Capstones
Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …
Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield
Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield
Doctor of Nursing Practice (DNP) Projects
Abstract
Problem: The importance of communication between nurses, patients, and their family members with respect to treating each other as partners in safety cannot be overstated. It is imperative that families and patients feel empowered to speak up and report clinical errors at any time and be able to communicate effectively to prevent harm and encourage communication.
Context: This is especially important in the acute care setting, where patients may be in contact with multiple people and processes daily. Attention to this safety partnership can be established through improvements in patient satisfaction scores, which are usually collected from patients and …
Improving Nursing Communication Outcomes Through The Tell-Us Card, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes
Improving Nursing Communication Outcomes Through The Tell-Us Card, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes
Master's Projects and Capstones
Abstract
Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined …
Improving Nursing Communication Outcomes Through The Tell-Us Card, Brittney Pilker, Jillian Cule, Laura Le, Nina Park, Jeffrey Salao, Maricarmen Reyes
Improving Nursing Communication Outcomes Through The Tell-Us Card, Brittney Pilker, Jillian Cule, Laura Le, Nina Park, Jeffrey Salao, Maricarmen Reyes
Master's Projects and Capstones
Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …
Improving Communication: Huddling For Change, Harnoor Chahal
Improving Communication: Huddling For Change, Harnoor Chahal
Master's Theses
The purpose of this communication improvement project is to incorporate huddles between interdisciplinary departments within a microsystem in order to improve customer satisfaction by decreasing the number of grievances. Based on the increasing number of grievances due to delayed hospital discharge, which results from a lack of communication between team members, there is an increased need for communication between the microsystem. By implementing weekly huddles between the Inpatient and Outpatient nurses, not only will there be increased care-coordination, but there will also be a decreased delay in discharge from the hospital caused by missed or no communication. Evidence-based practice indicates …
Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan
Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan
Doctor of Nursing Practice (DNP) Projects
Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …
Introduction Of Communication Strategies To Decrease Patient Falls In An Acute Rehabilitation Setting, Alicia Joachim
Introduction Of Communication Strategies To Decrease Patient Falls In An Acute Rehabilitation Setting, Alicia Joachim
Master's Projects and Capstones
Background: Due to the lack of appropriate fall prevention measures in an acute rehabilitation unit, there has been a notable increase of patient fall occurrences within a 6 month period. The purpose of this practice improvement project was to reduce patient falls within a 36-bed unit, using visual aids and effective communication among nursing staff. The multi-disciplinary members involved licensed nurses, nursing assistants, nursing supervisors, director of nursing, and executive administrator. Methods: The method used to implement this project included a literature search, informational interviews and staff surveys, and prioritization of interventions by the team. Project implementation was guided by …
Improving Communication In A Virtual Team: A Quality Improvement Project, Deepali Addagarla
Improving Communication In A Virtual Team: A Quality Improvement Project, Deepali Addagarla
Master's Projects and Capstones
Problem: Data analysis based on two surveys revealed team communication, interdependence, technology interfaces, and integration as the quality gaps in the Virtual Surveillance Team. When compared with traditional in-person teams, a virtual working team faces different types of communication challenges.
Context: The virtual surveillance team in the regional quality department at Oakland monitors both Advance Alert Monitor (AAM), a statistical model developed by the Kaiser Permanente (KP) Division of Research (DOR) that is used to predict an individual’s likelihood of deterioration, and eHospital care gaps for Kaiser Foundation Hospitals in Northern California (KFH, NCAL). The latest evaluation from DOR of …
The Interactive Patient Careboard: A Technological Innovation To Improve Patient Safety, Perla Q. Baldugo
The Interactive Patient Careboard: A Technological Innovation To Improve Patient Safety, Perla Q. Baldugo
Master's Projects and Capstones
Problem: An innovative method to communicate with the patient and between interdisciplinary team members is the use of the interactive patient careboard (IPC) which has declined since its implementation. Concurrently, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for the med surg unit need improvement. The low HCAHPS scores in communication suggested to nursing leadership that revitalizing use of the IPC could lead to improvements in the scores. The ideal shift handoff includes IPC as a focal point of communication. The RN is expected to display the careboard during handoff and identify for the patient the healthcare …
Improving The Use Of The Integrative Healing Approach, Kristina Horak
Improving The Use Of The Integrative Healing Approach, Kristina Horak
Master's Projects and Capstones
The Integrative Healing Approach (IHA) is an initiative that promotes holistic healing and includes the use of essential oils, deep breathing techniques, and therapeutic touch. Its purpose is to relieve pain, anxiety, insomnia, and depression among patients, and stress among staff. The IHA pilot initiative was implemented on the Acute Rehabilitation Unit (ARU) and faced barriers to implementation after the first round of staff education. By rounding with staff and conducting surveys, it was identified that the staff are not using IHA interventions as often due to time constraints. Additionally, there is an identifiable rift between Registered Nurses (RNs) and …
Creating A Healthy Work Environment Using Communication And Recognition, Rachel A. Coicou
Creating A Healthy Work Environment Using Communication And Recognition, Rachel A. Coicou
Doctor of Nursing Practice (DNP) Projects
Working in a healthy environment is of interest to nurses at every level of employment. Whether a frontline nurse or a nurse executive, it just feels better to wake up each morning and go to work in a place that respects clear communication and recognizes the great work that is being done. Working in such an environment is engaging and encourages employees to thrive (Shirey, 2006). Teamwork, camaraderie, and work satisfaction will increase in a healthy environment (Hall, Doran, & Pink, 2008). Thus, nurse leaders’ imperative is to meet the obligation of creating a healthy work environment (HWE) for the …
Multifarious Interventions To Reduce Falls On The Medical-Surgical Units, Wenjie Ying
Multifarious Interventions To Reduce Falls On The Medical-Surgical Units, Wenjie Ying
Master's Projects and Capstones
The CNL project was conducted on the 56-bed adult medical-surgical units in a trauma center. There were total eight fall incidences from January to February. The SWOT analysis, stakeholder analysis, pre-educational survey, cost-effective analysis and root-cause analysis suggested in-depth training on multifaceted fall prevention. The objectives include reducing falls by 50%, increasing staff’s adherence to fall prevention protocols, boosting staff’s confidence in patient mobility, improving staff responsiveness and communication with meds in HCAHPS, and enhancing knowledge of medications’ side effects by May 14, 2018. The literature reviews indicated that the multicomponent preventative measures to prevent falls along with leadership supports …
Improving Communication Competency In Perioperative Nurse Managers, Philomena Whelan
Improving Communication Competency In Perioperative Nurse Managers, Philomena Whelan
Doctor of Nursing Practice (DNP) Projects
Abstract
Aim: This paper outlines the project planning, implementation and evaluation of a project aimed at improving the communication competency of perioperative nurse managers. Leadership development consisted of providing education and simulation practice to managers of the operating room (OR), pre and post anesthesia recovery (PACU) area and sterile processing (SPD). The goal was to improve the OR turnover time, cost per OR hour, patient access and the perception of the participants in their ability and willingness to speak up.
Background: The literature shows that training is needed to improve the ability of teams to understand the factors influencing the …
Improving The Quality Of Bedside Shift Report Behavior: Implementing A Standardized Bedside Report Tool On The Medical-Surgical Floor At Woodland Healthcare, Amanda Waggoner
Master's Projects and Capstones
Abstract
Nursing handoff communication at change-of-shift is a frequent, yet highly essential nursing responsibility that lays the foundation for providing care that is safe and consistent (Grimshaw, Hatch, Willard, & Abraham, 2016). A microsystem assessment conducted on the medical-surgical unit at Woodland Healthcare (WHC) utilizing the 5P’s (Purpose, Patients, Professionals, Processes, Patterns) revealed that only 6% of twelve hour night shift nurses were performing a quality BSR and 40% of twelve hour day shift nurses reported feeling satisfied with shift report. Additionally, three reportable events occurred as a result communication related errors which led to increased spending on behalf of …
Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno
Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno
Master's Projects and Capstones
The focus of this CNL project is quality improvement using high quality hourly rounds to achieve improved patient satisfaction and communication with nurses. It was determined by reviewing survey results that patient satisfaction and nurse communication is below National levels. Data shows that rounds are not being done well on a medical unit before the improvement project. It is proven that patients receive and perceive higher quality care and communication with increased nurse presence at the bedside. The population of the medical unit has high numbers of confused/dementia, and dual-diagnosis patients. It was determined that the unit would benefit from …
Use Of The Patient Whiteboard To Improve Communication Of Pain Medication Schedule, Carmela Gonzalez-Shalaby Msn, Rn
Use Of The Patient Whiteboard To Improve Communication Of Pain Medication Schedule, Carmela Gonzalez-Shalaby Msn, Rn
Master's Projects and Capstones
Abstract
Despite advances in treatment, pain remains a significant problem in healthcare today. Sub-optimal pain management results in poor patient outcomes and patient satisfaction, culminating in decreased quality of life and financial loss for the health care facility. An important component of pain management is transparent and timely health care team/ patient communication. This project aims to improve patient satisfaction in pain management by incorporating pain medication last given and next available times on patient whiteboards. The targeted floor was a busy post-op medical floor in a medium sized community hospital. Staff were educated with short educational sessions, educational pamphlets, …
The Use Of Personalized Whiteboards In The Inpatient Acute Care Setting And Their Effect On Patient And Nurses Perception Of Communication, Cheryl Karn
Master's Projects and Capstones
A microsystem assessment of two inpatient medical-surgical wards in a medical facility determined a majority of nurses reported dissatisfaction with the amount and type of communication with the interdisciplinary team. This, along with a review of Press-Ganey scores from the inpatient wards, revealed patients reported decreased satisfaction when asked if “nurses kept me informed”, compared to previous quarterly reports as well as other VA facilities. Multiple studies have shown the benefit of personalized whiteboards (PWs) at the patient bedside in improving not only communication but also safety and patient outcomes. A PW was developed by the Clinical Nurse Leader …