Medicine and Health Sciences Commons^™

Improving Patient Safety Through Accurate Medication Reconciliation, Dominique Watt

Master's Projects and Capstones

Medication errors due to incorrect medication reconciliation are a very present and serious problem in our microsystem. As an preop/postop outpatient unit, we see an average of 50 patients daily and perform medication reconciliations regularly. The problem is our nurses perform this task inconsistently and often incomplete, leading us to potential medication errors. During my CNL project, I worked with a committee of staff champions and developed a standard work guide for nurses to use in order to effective reconcile patient medications. We used fishbone diagrams, audit tools, surveys and led regular discussions in our huddles in order to develop …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Fall 2015, Volume 6, Issue 2

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download entire issue- Jefferson Interprofessional Education and Care Newsletter, Fall 2015, Volume 6, Issue 2

An Online Approach To Interprofessional Education, E. Adel Herge, Otd, Otr/L, Faota, Amber E. King, Pharmd, Bcps

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Despite increasing interest in providing interprofessional education (IPE) opportunities for health profession students, the logistics of scheduling and integrating diverse curriculums remain challenging. Several models to address these potential barriers have been proposed and utilized (Blue et al, 2010). Faculty from three colleges within Thomas Jefferson University developed an asynchronous online interprofessional course as one solution to overcome logistical barriers to IPE.

Interprofessional Grand Rounds is offered to third year pharmacy students and second year occupational therapy (OT) students in the fall semester. The course utilizes a variety of learning activities to evaluate the influence of current public health and …

Examining Health Mentors’ Perceptions Of Student Teamwork, Deirdre Yarosh, Bs, Ma, Pharmd Student, Elena M. Umland, Pharmd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Statement of Issue:

With the increasing emphasis on interprofessional teamwork in healthcare, the need to train future health care professionals to work together as a functional team to provide patient-centered care is clear. Limited information exists regarding education of health care students and teamwork training.1,2 This research evaluates student team performance.

Background:

Thomas Jefferson University (TJU) offers a unique, two-year program emphasizing delivery of patient-centered care and providing valuable skill development by pairing interprofessional student teams with a Health Mentor (HM). The HM is an adult community volunteer with one or more chronic health condition(s). Student teams include representatives from …

In Addition To Checking Out A Book, You Can Check Out Your Health Too: A New Partnership Between Jefferson College Of Nursing And The Philadelphia Free Public Library, Kathryn Shaffer, Edd, Rn, Msn, Cne

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

At Jefferson Health is all we do, but at Jefferson College of Nursing (JCN), Health is H.E.R.E (humanistic, evidenced-based, reflective, excellence in clinical leaders). With a redesign of the undergraduate nursing curriculum, Jefferson College of Nursing (JCN) has transformed the way nurses of the 22nd century will practice, with a focus on caring for patients in all areas of the care continuum. The newly designed curriculum centers around four themes that are threaded throughout, Innovation, Practice Excellence, Interprofessional Collaboration, and Population Health. JCN believes that patients are partners in their health and that care is a collaborative effort.

To model …

From The Editors, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Christine Arenson, Md, Lauren Collins, Md, Shoshana Sicks, Edm

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

This fall has seen a flurry of activity at the Jefferson Center for InterProfessional Education (JCIPE). In September, Lauren Collins, MD, Associate Director of JCIPE, was selected as one of five recipients of the prestigious Macy Faculty Scholars (MFS) program, a two-year career development award supported by the Josiah Macy Jr. Foundation. She now joins a national network of other MFS recipients in helping to re-envision training of health professions students and delivery of collaborative care. Elizabeth Speakman, EdD, RN, ANEF, FNAP, JCIPE Co-Director, completed her three-year Robert Wood Johnson Executive Nurse Fellowship and was recently selected to attend the …

Fnp Led Mobile Health Services For The Homeless Population, Tenzin D. Lama

Doctor of Nursing Practice (DNP) Projects

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing …

Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez

Doctor of Nursing Practice (DNP) Projects

Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …

Family Studies Graduates With National Honors, College Of Education And Human Development

Family and Consumer Sciences News

Jerry Phelps, a family studies student who graduated in fall 2015, is one of 29 students from across the country graduating with National Council on Family Relations (NCFR) honors.

Exploring The Factors Of Persistence For African American Senior Nursing Students, Yolanda Nelson

Theses and Dissertations

African American nursing students experience commonalities within their college experience. Often these students may be faced with challenges, barriers, and/or struggles that may place a hindrance on their success in meeting their educational goals. This qualitative study used a phenomenological approach to explore African American female nursing students perceptions of faculty-student relationships and its implications for persistence. Four African American female nursing students and two nursing faculty agreed to participate in this study. This research study offers an examination of past and present research regarding the history of African American nursing students, health disparity, social justice and diversity within the …

Process Mining Of Medication Revisions In Electronic Health Records, Deevakar Rogith

Dissertations and Theses (Open Access)

Objective: The objective of this work is to develop process mining techniques for analysing Electronic Health Record (EHR) events in order to uncover factors contributing to the event, and understanding deviations in the process. We have outlined a method for combining data mining with expert review to model the EHR process and develop automated algorithms that can be used to detect potential deviations for a defined process.

Introduction: To analyse EHR events meaningfully, process mining can be applied to distil structured process description from a set of real executions. Process mining can be applied for 1) Discovery, 2) Conformance, and …

Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter

Doctor of Nursing Practice (DNP) Projects

Abstract

A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …

Designing A Care Delivery System Through Interprofessional Coordinated Care In A Medical Neighborhood Setting, Diane P. Kelly

Doctor of Nursing Practice (DNP) Projects

Abstract

The Patient Protection and Affordable Care Act (2010) has two significant aims: to improve the quality of healthcare and in doing so, to lower the cost of healthcare. The Centers for Disease Control and Prevention (CDC) reports that chronic health conditions, such as diabetes, hypertension, cardiovascular disease, and mental health, which in 2005 affected nearly one of every two Americans, continues to increase (CDC, 2010). Chronic health conditions and lack of access to care are both national and local concerns. These challenges will require the exploration of new models for the delivery of care, as needs shift over time …

Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata

Doctor of Nursing Practice (DNP) Projects

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …

Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby

Doctor of Nursing Practice (DNP) Projects

Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn

Doctor of Nursing Practice (DNP) Projects

Health care is a complex business currently undergoing extensive reform. These changes require new methods of care deliver and ways in which health care organizations are operating. At the forefront of this change effort is the 2010 Patient Protection and Affordable Care Act, which is transforming health care from a volume-based, fee-for-service process to the delivery of services that have value, improve quality outcomes, increase satisfaction, elicit greater efficiency, demonstrate improved safety outcomes, show cost-effectiveness, promote better access to services, and result in high reliability between providers and organizations. The goal of providing a more positive health care experience is …

A Population Health Approach For Community Health Improvement, Sandra Gregg

Doctor of Nursing Practice (DNP) Projects

Providence Health & Services (Providence), a not-for-profit Catholic health care system serving five western states, established an organizational vision of Creating healthier communities, together (Providence Health & Services, 2014). This vision served as the catalyst for the alignment of divisional initiatives to positively impact community health status. To effectively achieve its vision, the organization committed to the incorporation of population health principles in the development of an infrastructure to expand the reach and impact of community investments, along with the establishment of effective processes for inter-divisional collaboration and compliance with community benefit mandates. Thus, in 2015, Providence established a community …

Caution: Line-Of-Sight In Icu Designs, Diane C. Bartos

Doctor of Nursing Practice (DNP) Projects

It has been estimated that by the end of 2015, the U.S. will spend approximately $200 billion in new healthcare facilities construction. Infection prevention, patient and family satisfaction, and technologies influence contemporary designs of critical care units. All of these impacts have created larger patient care units, with a majority of single patient rooms. These larger spaces have created challenges for the clinicians to maintain the line-of-sight. The line-of-sight is one tool clinicians often use to maintain patient safety.

Since the seminal publication by the Institute of Medicine in 1999, patient safety concerns have escalated after revealing numerous deaths in …

The Role Of A Psychiatric Mental Health Nurse Practitioner As Part Of A Mobile Health Unit For The Homeless Population, Joan Alviar Fraino

Doctor of Nursing Practice (DNP) Projects

An estimated 2.3 to 3.5 million people are homeless in the U.S., often living with chronic medical and mental illnesses. The underserved population, such as the homeless, continues to experience gaps in services, resulting in poor healthcare outcomes and readmission to the hospital setting. They often present in crisis through the emergency room, contributing to an already overburdened healthcare system. Increased spending and overutilization of healthcare services continues to rise in the United States (U.S.). Due in part to advancements in technology and expanded health insurance coverage, American healthcare continues be one of the most expensive commodities in the U.S. …

The Creation And Implementation Of Guidelines For The Appropriate Termination Of Patient-Provider Relationships, Rowena D. Nolasco

Doctor of Nursing Practice (DNP) Projects

Primary care providers have terminated patient-provider relationships when they deem them no longer therapeutic. Healthcare providers are increasingly considering this an acceptable practice. However, the criteria for this decision remain unclear. As providers discharge challenging or difficult patients from their practices, questions to support this decision arise. Discharged patients face displacement and healthcare is disrupted. This project will (a) describe problematic patient-provider relationships and its effects, (b) identify possible alternatives to the firing of patients, (c) list appropriate reasons for termination, and (d) present recommended procedures to avoid allegations of medical abandonment. The project's product is an Appropriate Discharge or …

Impetus To Transform: Essential Nursing Leadership Development Through Simulation, Mary J. Mette

Doctor of Nursing Practice (DNP) Projects

Abstract

A nurse manager’s ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting, as well as the culture present in the organization as a whole. The aim of this Doctor of Nursing evidence-based change in practice project was to create an educational modality that supported training nurse leaders through innovation and creative problem solving in today’s acute healthcare setting.

A survey was administered to 48 frontline managers in a Northern California healthcare system to access the gaps and voids in their ability to integrate …

Fall Reduction With Nursing Interventions, Sin Ting Chan

Master's Projects and Capstones

The aim of the project is to reduce the patient’s fall rate in the medical surgical unit at an acute care hospital through improving the fall precaution process. The unit consists of 37 bed with a population of stroke, medical, and surgical patients. The focus of the nursing staff education using handouts, brochures, and poster will be based on the results from pre and post intervention audits. The goal of this fall reduction project is to have the nursing staff learn, review, and apply fall prevention interventions for fall risk patients in order to help reduce fall rate by 50 …

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …

Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco

Master's Projects and Capstones

Abstract

The overall goal of this project was to increase HPV 2nd and 3rd dose compliance rates by a combined 10% among the female adolescent population (ages 11-26). This was to be achieved by implementing EBP follow-up calls to not only schedule appointments but also to serve as a reminder for patients to come into previously scheduled appointments. This project was chosen as prior clinic and organization-wide meetings had delineated compliance rates at just 7%. There were various methods employed to implement this project including an initial microsystem assessment, which entailed a Root Cause Analysis, Process Mapping, SWOT analysis, Cost-Analysis, …

The Use Of Speech-In-Noise Testing As A Measure Of Hearing Aid Benefit, Morgan Ann Thrasher

Student Theses and Dissertations

This study investigated the feasibility of quantifying hearing aid benefit by means of speech-in-noise testing, specifically a modified version of the QuickSIN. Participants were recruited from the files of a licensed audiologist and all had sensorineural hearing loss, requiring hearing aids. Nineteen experienced hearing aid users were selected to participate in the study. Each individual listened, in aided and unaided conditions, to sentences embedded with increasing levels of background noise. Signal-to-noise ratio loss scores were calculated and averaged across conditions. Additionally, the relationship between participants’ audibility indexes and aided and unaided signal-to-noise ratio loss scores were analyzed. Results from this …

College Students' Knowledge About Stuttering: A Preliminary Investigation, Nichole Marie Terry

Student Theses and Dissertations

There is ample research on the public’s perception of individuals who stutter, but little research was found about the public’s knowledge about the definition and etiology of stuttering. The present study attempted to address whether college students in a specific area of study possessed either quantitative or qualitative differences in their knowledge about the definition and etiology of stuttering. Subjects included 80 males and 100 females across 9 different academic colleges to assess their knowledge of stuttering. Five open response questions were presented to each participant. Responses were orthographically transcribed and coded based on the current notions on the etiology …

Squamous Cell Carcinoma Response To Cisplatin Exposure, Khanh V. Luong

Theses & Dissertations

Purpose: This thesis attempted to quantitatively analyze the individual cell fate choice in resistant head and neck UM-SCC38 cells exposed to cisplatin using the most current techniques available.

Methods: UM-SCC-38 cells were grown in Dulbecco’s modified Eagle’s medium (DMEM) supplemented with 10% fetal bovine serum (FBS). They were treated with cisplatin and ATM/ATR inhibitors of known dosages. Using live cell imaging, one hundred cells were tracked in each experiment and their behaviors were analyzed and entered into Microsoft Excel Spreadsheet to generate cell profile graphs. HaCaT cells, non-tumorigenic keratinocyte cell line, were also analyzed using live cell imaging and their …

The Effect Of Body Mass Index On Graft Function And Kidney Transplant Outcomes, Morgan Galle

Theses & Dissertations

Background: When determining eligibility for kidney transplantation, body mass index (BMI) is often a debatable criterion for transplant due to the clinical indication, an elevated BMI has adverse effects on kidney transplant outcomes. There is a current gap in research on the effect BMI has on kidney transplant outcomes.

Purpose: The purpose of this study was to determine the role BMI plays in post-kidney transplant clinical outcomes including delayed graft function, new onset diabetes after transplant, wound complications, hospital length of stay, albumin, and readmissions to the hospital from initial hospitalization and at six months following kidney transplantation. The primary …

Biodegradable Hybrid Nanogels For Combination Chemotherapy, Swapnil Desale

Theses & Dissertations

Combination chemotherapy is commonly used to treat cancer, because such a therapy regimens usually involve sequential administration of multiple drugs and allow targeting different cell signaling pathway. The co-delivery of drug combination at a controlled ratio via the same vehicle is offering the advantages such as spatial-temporal synchronization of drug exposure, synergistic therapeutic effects and suppression of drug resistance. Undoubtedly, there are several molecular and pharmacological factors that determine the effectiveness of drug combinations. A rationally designed drug combination is required since certain drug ratios and the definitive exposure to the targets of interest can only be synergistic while others …