Medicine and Health Sciences Commons^™

Program Evaluation Of A Bundled Educational Intervention To Enhance Implementation Of Professional Exchange Report, Luanne M. Shaw

Doctoral Projects

Communication handover is a source of potential error and risk to patient safety. Electronic-based tools may reduce errors and mitigate risks to patient safety. Electronic tools have been successfully implemented using multiple methods of education and training. Electronic tools vary in functionality and integration with the electronic health record (EHR). A large West Michigan Regional Health System (RHS) implemented a new EHR containing an embedded tool for communication handover called Professional Exchange Report (PER). There was inconsistency in the practice of bedside report by nurses. The RHS planned to use a bundled approach of educational interventions to implement the new …

Implementation Of A Patient-Centered Communication Model In The Emergency Department, Carrie Mull

Doctoral Projects

The objective of this scholarly project is to determine the impact of patient-centered communication education in an emergency department (ED) on the perception of workplace safety. The ED is a vulnerable setting and susceptible to workplace violence (WPV) due in part to increasing numbers of patients presenting to EDs with primary psychiatric complaints. High-quality patient-staff interactions correlate positively with better treatment outcomes. Patient-centered communication skills can be taught, and patients have similar expectations of what patient-centered communication means no matter their diagnoses. The purpose of this quality improvement project was to conduct patient-centered communication education with nurses, nursing assistants, and …

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 …

Rural Appalachian Person And Family Decision Making At End Of Life, Mary Lou Clark Fornehed

Doctoral Dissertations

The dynamics of delivering care to persons at end of life (EOL) have dramatically changed in the last twenty years. Improved management of chronic illness and provision of aggressive life sustaining measures for an illness once deemed fatal are more common, significantly increasing longevity. While it is estimated that more than 40 million persons with life-limiting illness worldwide are candidates for some form of palliative or end-of-life care (EOLC), less than 14% of them will receive it.

When coping with life-limiting illness, people and their families are asked to make many complex and difficult decisions about EOL, palliative, or hospice …

What Should Be Included In A Measure Of Communicative Participation? Perspectives Of Speech-Language Pathologists, Natalie Kelly Graceffa

Theses and Dissertations

ABSTRACT

WHAT SHOULD BE INCLUDED IN A MEASURE OF COMMUNICATIVE PARTICIPATION? PERSPECTIVES OF SPEECH-LANGUAGE PATHOLOGISTS

by Natalie Graceffa

The University of Wisconsin-Milwaukee, 2017 Under the Supervision of Professor Dr. Shelley Lund

As the field has developed, speech-language pathologists (SLP) need to validate their therapies and prove, beyond clinical judgment, that their therapy is necessary and ethical. SLPs and other healthcare professionals must prove they are achieving positive outcomes with their treatment, and that the outcomes they set are appropriate for their patients and clients. To bring this validity to the treatment of health, the International Classification for Functioning, Disability, and …

Evaluating Effective Communication Methods: Improving Internal Communication, Amber L. Suthers

Electronic Theses and Dissertations

Relaying information from a Chief Communications Officer (CIO), or centralized communications departments to hospital employees is not always efficient or effective. Employees may not be informed of important changes to department protocols or hospital policies. The purpose of the study was to determine the most efficient and effective forms of internal communications in the hospital setting.

A total of 83 surveys were mailed to communication officers working in Tennessee hospitals in and east of Nashville. Sixteen communication officers responded. This low response rate may be attributed to poor designation of communication responsibilities and an abdication of responsibilities to an off …

How To Effectively Improve Nurse-Physician Communication, Savannah R. Lacoste

Honors Theses

A study of the issue of Nurse-Physician communication, its causes, effects, importance, and possible improvements through research. The results suggest both physicians and nurses agree that nurse-physician communication is an important problem, and can be effectively improved in many ways including: a required nurse-physician communication class for pre-medical and pre-nursing students at an undergraduate level, improved and structured communication tools, and inter-professional education (IPE) between nurses and physicians. The research provides the outlooks of twenty-five nurses and twenty-five physicians independently, as well as demonstrating the nurse-physician disconnect through data comparison and analysis.

Interactive Physical And Cognitive Exercise System (Ipaces™): The Neuropsychological Effects For Youth On The Autism Spectrum, Michaela Haller

Honors Theses

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects 1 in 68 children in the United States (Center for Disease Control, 2016). The disorder is characterized by deficits in social interaction, verbal communication, restricted interests, and repetitive behaviors (DSM- V, 2013). While the apparent cause of ASD is biological, the diagnosis remains based on social deficits (Hapé & Frith, 1996). Exercise has been found to improve executive function for children with an Autism Spectrum Disorder, but motivation is an issue and exergames hold promise. This pilot study evaluated an interactive Physical and Cognitive Exercise System (iPACES™), wherein children pedal …

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 …

Maladaptive Behavior And Communication Disorders Following Tbi: Survivor, Caregiver And Speech-Language Pathologists' Perspectives, Marena S. Jones

Senior Honors Projects, 2010-2019

Following traumatic brain injury (TBI), individuals often face neurobehavioral challenges (e.g., aggression) that hinder treatment. Research on the relationship between communication disorders and maladaptive behaviors is limited. Participants from a convenience sample of two survivors of TBI, a caregiver, and a speech-language pathologist were interviewed about their experiences and perspectives. The interviews reflected focused questions that were congruent across participants. Interviews were recorded, transcribed, and coded. Each coder coded the transcriptions individually, they were then compared using consensus coding for reliability, and finally analyzed for emergent themes. The two most referenced themes were “Communication challenges” and “Changes through rehab”. “Communication …

What We Can't Understand: The Non-Verbal Communication Among Autistic Children, Samantha Simmons

Senior Theses

This project is about children on the Autism Spectrum Disorder and the tools they use to communicate with others. I touch on the ways parents can help their children at home and how they can assist their child to talk even if they are told they will never do so. Discussed in the paper are the various methods of communication including PECS, the QWERTY keyboard, and mobile applications. These can be used on an iPad, iPhone, smartphone etc. The nutritional benefit of some foods for children with autism is also a contributing factor of how they act. Eating foods such …

The Role Of The Speech-Language Pathologist When Working With Clients Who Are Transgender: A Guide Of Gender Identity And Cultural Competency, Brett Welch

Theses and Dissertations

It is within the scope of practice of a speech-language pathologist to work with a client who is transgender for voice. However, regardless of the setting, a speech-language pathologist is likely to encounter a person who is transgender on their caseload. The American Speech-Language-Hearing Association mandates that all of its members be culturally competent when working with clients from different cultural backgrounds, including those from the lesbian, gay, bisexual, transgender, and queer community.

This thesis pulls from sociological, linguistic, and queer theory literature to provide an in-depth understanding of identity, gender, and transgender identity formation. With this nuanced understanding of …

Aided Communication For Adults With Developmental Disabilities, Lindsay Bolding

Honors Projects

This honors project is a series of templates that will serve as a guide for residential facilities for individuals with autism and other developmental disabilities. What is the most effective way to facilitate communication in residential facilities for adults with developmental disabilities? While working at this type of facility during my time at Bowling Green State University, I have witnessed a need for implementation of new communication routes in the homes. While skill building such as communication is stressed in the homes, plans for staff to fulfill these skills can be lacking. The templates I have created can be used …

Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley

DNP Scholarly Projects

Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013) …

Pediatric Oncology Nurses' Experiences With Prognosis-Related Communication, Amy Rose Newman

Dissertations (1934 -)

Health care providers (HCPs) in pediatric oncology are faced with the challenge of communicating the devastating news of a cancer diagnosis and prognosis. This type of communication can be referred to as prognosis-related communication (PRC). While the initial conversation with the patient and family regarding prognosis is generally considered the responsibility of the physician, patients and family members will subsequently turn to nurses for clarification of the information presented. If nurses are excluded from initial conversations, they may feel as though they are “working in the dark,” trying to answer questions while not contradicting what the physician said. This strained …

Perceived Stress, Self-Compassion, And Emotional Variance In Parents Of Children With Communication Disorders: A Family Approach To Service Delivery In Speech-Language Pathology, Olivia Marie Arnos

Theses and Dissertations

The amount of children born with developmental disorders in the United States is on the rise, increasing from 12.8% in 1998 to 15.04% in 2008 (Huang, Chang, Chi & Lai, 2013). Children with developmental disabilities often have chronic conditions that require additional support across their lifetime, ranging in deficits of attention, physical abilities, visual impairments, hearing impairments, learning disabilities, and communication disorders. Research has shown as dependency of a child on caretakers increases, there is an increase in parental stress and a decrease in perceived well-being. Hall and Graff (2011) found parents of children with developmental disorders are less likely …

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …

Patient Safety In The Ambulatory Oncology Environment: A Teamstepps® Journey, Tammi Phelps Hick

Nursing Theses and Capstone Projects

Problem: Children have reported that pain and anxiety were the most difficult part of hospitalization, and under treatment of pain and anxiety can have short and long term effects on health outcomes. Most healthcare professionals recognize a link between emotional health and physical health, but this may be especially true for pediatric patients who may not be able to marshal adequate coping skills due to their developmental age. Providing age appropriate alternatives, such as distraction therapy, may result in less invasive treatments for pediatric patients. Distraction therapy is an effective non-pharmacological intervention that is often under-utilized in the acute care …

Do Bilingual Speakers Shift Fundamental Frequency Based On Language Acquisition Or Language Dominance?, Nydia Abigail Mendez

ETD Archive

As Spanish-English bilingual speakers continue becoming a growing part of the population in the United States it is essential to investigate their acoustic measures. The purpose of this study was to investigate a possible shift in fundamental frequency (F0) measures in bilingual speakers, and it sought to determine whether that shift was based on language acquisition or language dominance. Eleven Spanish-English bilinguals were asked to complete the following tasks 1) answer the Language Experience and Proficiency Questionnaire (LEAP-Q) 2) complete 3 Spanish and 3 English category fluency trials by naming words belonging to a category (e.g. animals), each one minute …

Nurse-Physician Collaboration And Satisfaction, Fatima Brewton

Nursing Theses and Capstone Projects

The purpose of the study was to examine the effects of interdisciplinary rounds (IDR) on a neurology medical-surgical inpatient unit. Existing research shows that IDR improves nurse-physician relationships and satisfaction and improves patient outcomes. Using the Collaboration and Satisfaction about Care Decisions (CSACD) tool developed by Baggs, nurse-physician collaboration and satisfaction was measured pre and post implementation of interdisciplinary rounds. Twenty-one nurses and five physicians participated in the study which included education sessions, a two week trial of IDR, and a pre and post survey. Nurses and physicians in this sample perceived a significant increase in collaboration (X = 5.6563, …

Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson

Walden Dissertations and Doctoral Studies

Work environment influences the effectiveness of care for patients in any healthcare setting. It is even more important in settings such as the neonatal ICU (NICU) where this project took place. When the environment is not healthy, communication may suffer and result in poor patient outcomes and, family, patient, and staff dissatisfaction. The purpose of this quality improvement project was to understand how the implementation of the TeamSTEPPS program, for nurses in the NICU, could impact the safety culture as measured by the AACN Healthy Work Environment (HWE) tool. Lewin's professional practice change theory and the AHRQ change model were …

Family Rounds In The Medical Intensive Care Unit: An Intervention To Enhance Communication, Travis R. Klein

DNP Projects

Background: In the Intensive Care Unit (ICU) family member satisfaction is an important element of quality patient care. Families of ICU patients value communication with care providers and involvement in their relative’s care.

Objectives:

1. To determine if scheduled family rounds each day can improve the satisfaction and feelings of support with decision-making for family members of ICU patients?

2. Evaluate any associations between patient characteristics (hospital length of stay, ICU length of stay, and ventilator days) and family satisfaction?

Methods: This pilot project was conducted in a 12-bed medical ICU led by advanced practice nurses (APRN-MICU). Using the family …

Nurse Perceived Barriers To Effective Nurse-Client Communication, Sara J. Brandenburg

Honors Undergraduate Theses

Successful client care depends on effective nurse-client communication. It is essential in meeting clients' needs, providing quality care, and maximizing positive client outcomes. The intent of this thesis was to explore nurse perceived barriers to effective nurse-client communication. A literature review was conducted and nine articles were identified as addressing nurse perceived barriers to communication. Four major barriers were identified: nurse comfort and knowledge, environment, time, and culture and language. Research on interventions to address nurses' perceptions of barriers to effective nurse-client communication may provide a better understanding of communication barriers and address issues created by ineffective communication with clients.

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd

Walden Dissertations and Doctoral Studies

Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …

Improving Leadership Communication In Nurse-Physician Dyad Teams, Lisa James

Theses and Dissertations

Background: Changes in the delivery of healthcare services in the United States have been driven by cost containment over the last 20 years. To have a thriving organization within the current healthcare environment, nurses and physicians need to closely collaborate. As healthcare organizations prepare for the value-based era, new leadership models need to be implemented. This project addressed collaboration between nurse and physician leaders with a focused communication strategy to improve team performance, engagement, and quality outcomes in the acute care setting.

Method: A quality improvement project was designed to improve communication between front line team members and …

The Impact Of Telemedicine On Teamwork And Communication, Workload, And Clinical Performance: A Randomized Controlled Trial, Lucas Christopher Butler

Yale Medicine Thesis Digital Library

Telemedicine can be used to provide specialty care to critically ill patients in rural and community hospital settings. However, the effects of this technology on quality of care are unclear. The objectives of this study were to evaluate the impact of a telepresent team leader on teamwork and communication, workload, and quality of care during a simulated pediatric resuscitation, and to explore provider perspectives on the use of telemedicine during resuscitations.

Twenty standardized teams (lead MD + bedside MD + two confederate clinical team members) were randomized to have a telepresent or an in-person leader. Telepresent leaders were connected via …

Dimensions Of Nurse-Physician Communication, Rachel Malek Hamdan

Walden Dissertations and Doctoral Studies

Hospital leaders set quality and safety as high priorities in their strategic goals. Improving the quality and safety of patient care requires improving internal processes that have direct implications for patient care. Hospital leaders need to improve health care providers' communication as part of improving quality and safety. The problem addressed in this study was the lack of strategies health care administrators use to guide nurse-physician communication patterns in a university medical center in the Middle East. The purpose of this qualitative case study was to explore communication strategies that health care administrators use to guide nurse-physician communication. Relational coordination …

A Toolkit To Support Nurse-Patient Communication Through Nurse-Expressed Empathy, Jessica Delano Holden

Walden Dissertations and Doctoral Studies

Empathy is the ability of a person to understand what another is experiencing from the receiver's perspective and the ability to communicate that understanding to the receiver. In nursing, empathy is believed to be a necessary component to the nurse-patient relationship. Evidence shows a decline in empathy specifically noted over time in nursing students who are preparing to graduate and enter the workforce. The practice focused question for this project asked whether an experiential learning toolkit for development of nursing empathy can improve sophomore nursing student empathy as measured via the Jefferson Scale of Empathy. This project was guided by …

Performance Outcomes Of Nurses Based Upon Nursing Students'classroom Expereinces, Beatrice Obiageli Eweni

Walden Dissertations and Doctoral Studies

Schools of nursing educators are faced with redesigning nursing education to meet the complexity of implementing communication and patient- centered care to improve patient safety. This qualitative case study addressed the problem that teaching communication and patient- centered care were not threaded throughout curriculum, which left many new graduates nurses unprepared. The purpose of this study was to understand classroom experiences of new graduate nurses to meet performance outcomes. The research questions focused on understanding the classroom experiences of new graduates' of a nursing program by assessing the two concepts and how to address preparatory practices. The target populations were …

Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm

Walden Dissertations and Doctoral Studies

Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool …