Medicine and Health Sciences Commons^™

Filling The Gap: Educating Caregivers And Patients Post Stroke In An Acute Care Setting, Gabrielle A. Blecke

Occupational Therapy Capstone Presentations

Background: According to the U.S. Department of Health and Human Services (2022), every 40 seconds someone in the United States experiences a cerebrovascular accident (CVA), also known as stroke. A recent study suggests that 63% of these individuals will need informal caregiving from family, friends, or loved-ones throughout their rehabilitation process in order to safely transition home. Research suggests that patients and caregivers post stroke are not receiving enough education to prevent concerns such as caregiver burden, decreased caregiver wellness, and decreased patient outcomes, all which are within the scope of occupational therapy. Methods: Experiences at MyMichigan Midland Hospital drove …

Addressing Equitable Access In A Safety-Net Hospital System: An Implementation Framework, Hillary Alycon

Dissertations: Doctor of Public Health

Acute care organizations face a significant challenge in effectively implementing health equity programs, particularly in rural areas where guidance is often lacking. Despite abundant literature focusing on health outcomes, there remains a noticeable dearth of published data on implementing health equity initiatives. In response to this gap, I present a comprehensive analysis that utilizes readily available, open-sourced data to address this critical issue.

A thorough assessment of the demographic characteristics of acute care facilities within the catchment regions was conducted based on data from reputable sources such as the US Census Bureau, the American Community Survey, and the County Health …

Anterior Cervical Discectomy And Fusion After Presentation To The Acute Care Setting: A Comparison Of Post-Operative Outcomes, Alex Miller, James Whaley, Daniel Park

Conference Presentation Abstracts

Introduction: For patients presenting with cervical radiculopathy or cervical myelopathy, surgical treatment is typically pursued after discussion in the outpatient setting. Yet, there exists a group of patients presenting to the acute care setting with intractable pain or progressive neurologic deficits who are indicated for operative treatment outside of outpatient evaluation. Given the differences in initial management and pre-operative optimization, it is unclear if surgical and post-operative outcomes differ between these populations. Materials and Methods: This was a retrospective cohort study from an academic medical center. Surgical case logs from the institution’s electronic medical record were used to identify patients …

Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust

Electronic Theses and Dissertations

This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …

The Use Of Alcohol Impregnated Port Catheters For Decreasing Central Line Infections In Acute Care, Shana M. Coons

Student Scholarly Projects

Practice Problem: Lack of proper sterile protocol for central lines was noted as a problem in the acute care units, causing CLASBI rates to be higher than the national average at the hospital in question.

PICOT: In hospitalized acute care adult patients 18 years of age and older with central lines, how does the use of alcohol impregnated port protectors (AIPPs) compared to current central line sanitation practices affect central-line associated infections (CLASBI) within 10 weeks?

Evidence: The literature evidence suggests that Alcohol Impregnated Port Protectors (AIPPs) decrease CLASBI rates and provide better outcomes for acute care patients with central …

Reflections From The Other Side Of Acute Care, Debbie Amini

The Open Journal of Occupational Therapy

An occupational therapist of 40 years experiences a traumatic event during her time in an acute care hospital. She journeys through a host of life-altering experiences, including cognitive decline, delusion, paranoia, and an inability to engage in her desired occupations. While on this journey and during reflections following her return home, she is able to see more clearly how an occupational therapist may have assisted with several of the major concerns she was experiencing, thus improving her well-being and quality of life. She is an Assistant Editor for the Open Journal of Occupational Therapy (OJOT) and this is her story.

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Jessica Lee

Master's Projects and Capstones

Sepsis is a deadly condition if not treated promptly and urgently. To help lower the mortality rate from Sepsis, education on Sepsis is essential for nurses at all levels and experience. Opportunity at a healthcare organization in Northern California arose when it was found through a survey that about 6 percent of Medical-Surgical nurses have "expert knowledge" of the sepsis bundle elements. Only about 35 percent of these nurses who reported having "expert knowledge" are confident in treating sepsis patients. A team of clinical nurse leader students implemented a quality improvement project. The project was designed to expand nurses' knowledge …

Reducing Readmission Rates Among Patients Who Have A Dual Diagnosis Of Both Mental And Physical Illnesses, Hannah M. Shahan

Electronic Theses and Dissertations

Readmission rates are a primary indicator used by acute care hospitals to determine the effectiveness of healthcare treatments and interventions. High readmission rates indicate the existence of a gap in the continuum of care. Acute care hospitals focus on the treatment of the immediately urgent physical health condition. Once the immediate presenting illness is treated or stabilized, the patient is discharged. This focus largely leaves mental illness undiagnosed and untreated. However, chronic, untreated mental illnesses are often comorbid with physical illnesses. In studies comparing patients with comorbid physical and mental illness to patients with only a physical illness, comorbidity was …

Mental Health Education For Acute Cardiac Patients, Allison Blackburn

Post-Professional Occupational Therapy Doctorate - Innovations in OT Symposium: Transforming Possibilities into Practice

No abstract provided.

The Impact Of Pandemics On Healthcare Providers' Workloads: A Scoping Review, Gemma Doleman, Annemarie De Leo, Dianne Bloxsome

Research outputs 2022 to 2026

Aims: To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. Design: Scoping review. Data Sources: A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers’ workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria. Review Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist. Results: Healthcare workers experience an increase in workload pressures …

The Effects Of Cognitive-Linguistic Interventions To Treat Aphasia In The First 90 Days Post-Stroke: A Systematic Review, Emily Eley, Maayken Van Den Berg, Miranda L. Rose, John E. Pierce, Abby Foster, Edwina Lamborn, Sarah D’Souza, Erin Godecke, Lucette Lanyon, Ciara Shiggins, Ian Kneebone, Caroline Baker

Research outputs 2022 to 2026

Background: Cognitive-linguistic interventions for aphasia are behavioural-based approaches to therapy that aim to treat language impairment skills post-acquired brain injury. The purpose of cognitive-linguistic intervention is to restore and rehabilitate language impairment skills through targeting phonologic, semantic and syntactic systems, which may support goals to improve everyday communication. Aims: The aim of this systematic review was to investigate the effects of cognitive-linguistic interventions on language processing for aphasia in the first 90 days post-stroke. Secondary aims include the investigation of the effects of these interventions on functional communication and quality of life. Methods: A systematic search was conducted across six …

The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve acute care nurses’ knowledge of evidence-based palliative care interventions utilizing the framework from the End-of-Life Nursing Education Consortium (ELNEC) training modules. Increasing the knowledge, comfort, and competence of acute care nurses has the potential to improve end-of-life care delivery in the acute care setting. A lack of access to specialized inpatient palliative care service teams was identified in a rural county in the Southeastern United States. This county is served by a small, criticalaccess hospital. The frontline nursing staff of this facility regularly provides end-of-life …

Iadls In Acute Care, Taylor Brownlie

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Clinical Practice Skills In Executive Function Within Acute Care, Jasmine Lake

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Education For Patients And Caregivers To Reduce 30-Day Readmissions Into Acute Care, Tyler W. Taylor

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of this capstone project was to reduce 30-day readmissions of patients into the acute care setting by developing, enhancing, and implementing education materials for patients and their caregivers during occupational therapy treatment sessions. Patients who experience unplanned readmissions into acute care within 30 days are subjected to disruption in occupations, functional decline, occupational deprivation, and role strain and stress on caregivers and families. All patients with occupational therapy orders from a physician that matched certain criteria received this treatment. However, only readmission rates for patients with chronic obstructive pulmonary disease (COPD), heart failure (HF), pneumonia, and cerebrovascular accident …

Effects Of Inadequate Nurse Staffing And Need For Standard Nurse-To-Patient Ratios To Increase Patient Safety In Acute Care Settings, Macey Schwenker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This study includes articles including research regarding the effects of the current nursing staff shortage and overtime on patient care and outcomes. A systematic review of research was conducted guided by PRISMA guidelines and consists of articles collected from PubMed. Studies were taken place in the United States, England, Taiwan, Singapore, United Kingdom, Brazil, South Korea, Sweden, India, and Australia involving hundreds of thousands of participants. Methods include mean ratio, regression models, surveys, and questionnaires. Nurse staffing shortages, overtime, and inadequate staffing increased the risk of patient mortality and decreased overall patient safety and quality of care in acute care …

Discharge Care Bundle To Reduce Copd 30-Day Readmission Rates In A Hospital Acute Care Unit, Dao Vang

Student Scholarly Projects

Practice Problem: Chronic obstructive pulmonary disease (COPD) readmissions severely impact patients’ health, mortality, and quality of life and increase unnecessary healthcare use and spending. Utilization of a protocol and discharge care bundle to reduce the readmission rate for COPD patients is critical to combat the problem.

PICOT: The PICOT question that guided this project was in adult patients 65 years or older admitted to a hospital acute care unit for acute exacerbation of COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) reduce the 30-day hospital COPD readmission rate …

Improving Heart Failure Patient Referrals To The Center For Advanced Heart Failure & Pulmonary Vascular Disease At Hartford Hospital: A Quality Improvement Project, Dawn M. Surprenant

DNP Projects

Significance and Background: According to the Health Resources & Services Administration (2021), health literacy is the degree to which individuals have the capacity to process and understand basic health information to make appropriate health decisions. Low health literacy is prevalent in populations such as older adults, minorities, and in individuals with lower socioeconomic status and living in medical underserved areas. Recommendations are to access health literacy in cardiac patients, especially in the acute care setting to improve health outcomes upon discharge.

Purpose: To determine whether a health literacy assessment in hospitalized congested heart failure patients, before discharge, will affect referral …

Music Intervention And Its Effect On State Anxiety: An Integrative Literature Review, Courtney Olek

Nursing Masters Papers

Approximately 5 million patients are admitted to Intensive Care Units (ICU) in the United States for acute or life-threatening medical problems or injuries annually. The ICU patient experience has been described in the literature as dehumanizing, stressful, and anxiety provoking. Given the adverse physiological and psychological effects of sustained state anxiety, it is important anxiety is effectively managed in the ICU environment. Standard care for management of anxiety often relies heavily upon sedative medications and are correlated with poor outcomes when used in high doses and over a long duration. The SCCM recommends nonpharmacologic adjunctive measures to decrease the occurrence …

Smoking Cessation: A Nurse-Led Approach To Address Gaps In Patient Care, Katie L. Durham

Master of Science in Nursing Theses and Projects

Currently, the rate of smoking in the US is 13.7%. While this value represents the lowest rate of smoking in documented US history, cigarette smoking remains the leading cause of preventable death, disease, and morbidity. Healthy People 2030 has set a goal to reduce the rate of smoking to 5%. Though many patients report wanting to quit smoking, nearly half report they did not receive advice from a healthcare professional to do so. Many recommended smoking cessation tools and resources remain underutilized by both clinicians and patients. To help mitigate this issue, this project sought to develop a nurse-led smoking …

Reducing The Use Of Physical Restraints Of The Elderly In The Acute Care Setting, Rachael Malone

Master of Science in Nursing Theses and Projects

The aim of this MSN project is to identify and improve the gaps in education regarding physical restraint use in the acute care setting on the elderly patient population. When admitted into hospitals, elderly patients are at much greater risk for being placed in physical restraints due to little education regarding alternative measures to physical restraints and inappropriate assessments. The purpose of this project is to implement education about the detrimental factors and consequences patients may suffer once placed in physical restraints and improve the use of alternative measures to physical restraints. This project will be evaluated by acute care …

Program Evaluation Of The Rapid Response System Prior To And During A Covid Surge, Sarah Born

Doctor of Nursing Practice (DNP) Manuscripts

Between the years 2004-2008, the Institute for Healthcare Improvement (IHI) and The Joint Commission made a recommendation for healthcare facilities nationwide to implement rapid response systems (RRS). Rapid response systems consist of four limbs: recognition and alert (afferent); response and providing timely patient management (efferent); delivering support and oversight (administrative), and monitoring the RRS patient outcome data (quality improvement). The intent of implementing RRS was to increase patient safety and outcomes within the acute care setting. The following question (PICO) formed the basis of the project: “How does the current rapid response system workflow compare to the rapid response system …

The Art Of Nurse Mentoring: A Framework Of Support, Diane S. Kramer, Victoria Y. Mccue, Eve Butler, Andrea S. Prentiss, Maria M. Ojeda, Kayce K. Tugg, Vivian Fuentes, Sally Bonet

Nursing & Health Sciences Research Journal

Introduction: Nursing mentoring relationships are vital to the advancement of personal and professional growth in nursing. Mentoring has been identified as an effective method to decrease turnover resulting in retention of experienced nurses. Despite the benefits of a mentoring relationship, barriers exist in creating and cultivating a formal mentoring program in the hospital setting.

Methods: A qualitative descriptive study approach that explored nurses’ perceptions of a mentoring culture within a hospital environment. Open-ended, conversational-style interviewing techniques with a semi-structured interview guide were utilized to gain a full description of nurses’ perceptions of a mentoring culture within a hospital environment.

Results: …

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

Delirium In The Acute Care Setting: Occupational Therapy’S Role In Delirium Management And Prevention, Regina Antoni, Grace Gaus, Kathleen Greaney, Marisa Ortiz-Brazak

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives

• Explain delirium and its prevalence in the hospital setting
• Identify the role of occupational therapy in treatment of acute care patients with delirium
• Apply evidence-based interventions that address and prevent delirium in the acute care setting

PICO Question
What is the role of occupational therapy in delirium management for patients in the acute care setting?

Reducing Delirium In Patients With Covid-19, Allison E. Brewer Mot/S, Amy Carver Mot/S, Allison Nance Mph, Mot/S, Mallori Rodrigue Mot/S, Olivia Smith Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding interventions that would be effective in reducing delirium in patients with COVID-19 in the acute care setting. The final portfolio contains a total of five research articles. Study designs include three randomized controlled trials, one non randomized controlled trial, and one quasi-experimental quantitative design. All studies relate directly to interventions within the OT scope of practice and were implemented in the acute care setting. Due to limited research on the novel coronavirus, these findings apply to critically ill patients but are not specific to patients …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Self-Efficacy: Nurses’ Perceptions Of Caring For Patients Living With Diabetes, Victoria Yaros Mccue

Student Theses, Dissertations and Capstones

Diabetes is an epidemic that affects over 415 million people worldwide. In the United States, the number of people diagnosed with diabetes is projected to triple to over 60 million by 2060. With this surge, the number of hospitalizations across the country has significantly increased. Direct care nurses play a vital role in the management of patients living with diabetes. The purpose of this research study was to explore and describe medical-surgical nurses’ perceptions of self-efficacy related to caring for patients living with diabetes. This study's guiding research question was: What are nurses’ perceptions on the influences that impact self-efficacy …

Collaborating With A Transitional Care Unit To Provide Student Hands-On Time: A Win-Win For Hospital And Academic Institution, Emily Grattan, Amanda K. Giles

Journal of Occupational Therapy Education

Occupational therapy students crave hands-on learning experiences that take place in authentic environments. This study describes an innovative experiential learning activity involving collaboration between an academic institution and an inpatient transitional care unit (TCU). Three cohorts of second year occupational therapy students (N=138) participated in the TCU learning activity, which involved reviewing the electronic medical record, planning and delivering a treatment, documenting the therapy session, and intentionally reflecting on the experience. Based on an optional, anonymous survey, one hundred percent of students reported that “this learning experience was valuable” and “provided opportunity to practice clinical reasoning.” Ninety-nine percent of students …