Medicine and Health Sciences Commons^™

Process Improvement To Reduce The Incidence Of Delirium In An Overflow Unit, Raquel G. Chong

Master's Projects and Capstones

Abstract

Problem: This quality improvement project aims to reduce the incidence of hospital-acquired delirium in an overflow unit, which serves a diverse patient population from medical-surgical and telemetry microsystems. The unit averages 96 delirium episodes annually, costing approximately $3,456,000. The goal is to reduce delirium incidence by 25%, decreasing monthly cases from 8 to 6 by October 31, 2024, and annual cases to 72 by April 2026.

Context: Delirium is a prevalent and severe neuropsychiatric syndrome that significantly affects older hospitalized patients, characterized by acute disturbances in attention, awareness, and cognition.

Interventions: The project introduced a bundle of four interventions …

A Clinical Nurse Leader Nurse Navigator Program For Heart Failure Patients, Shanna Lantel Negron

Doctoral Dissertations and Projects

The purpose of this integrative review is to examine the literature regarding nurse-led educational interventions, transitional care (TC) strategies for heart failure (HF) patients, nurse navigation, HF self-care, and the clinical nurse leader (CNL) role to support integrating a CNL into the care delivery model serving as a nurse navigator (NN) for adult HF patients being discharged home from the hospital. The basis for this review is to identify an innovative way to improve patient reported and clinical outcomes for the HF population which increases each year. The economic and symptom burden associated with this disease is high further enhanced …

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …

Care Coordination And Empowerment In People With Type 2 Diabetes, Erik M. Wilson

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

1. Background: In 2018, approximately one in seven Americans had been diagnosed with Type 2 Diabetes, a number that is projected to increase to one in three by 2050. Approximately 40% of individuals with Type 2 diabetes develop long-term complications, accounting for one-in-four healthcare dollars spent in the United States. Current initiatives supported through Accountable Care Organizations place an emphasis on improving the quality of care delivered in chronic medical problems such as diabetes to optimize patient outcomes, moving away from the traditional fee-for-service. One cornerstone of improving quality of care is care coordination and education.

1. Methods: Utilizing the Plan-Do-Study-Act methodology …

An Innovative Contest: A Team Approach To Improving Patient Satisfaction Scores For Medication Side Effects, Jennifer Natsch-Jensen

Master's Projects and Capstones

Problem The Home Healthcare Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey question 14 regarding providers discussing possible side effects is below the organizational goal of 74.1 linear mean in this home health microsystem.

Context According to the Agency for Healthcare Research and Quality (AHRQ), nearly 20% of patients discharged home from the hospital had an adverse event within the first few weeks of discharge and most are related to medications (AHRQ, 2019).

Interventions An innovative contest was introduced to promote engagement and to use teach-back best practices, including planned discussions with the patient and caregivers regarding name of …

Registered Nurses’ Self-Assessment Of Their Clinical Leadership Knowledge And Competence, Valerie Wright, Diane Whitehead, Corinne Romano

Journal of Excellence in Nursing and Healthcare Practice

Clinical nurses play an important role in the healthcare team. The practice question for this Doctor of Nursing Practice project explored the perceptions of RNs about their clinical leadership knowledge and competencies at a 160-bed rehabilitation hospital in a metropolitan city in the southeast United States. Thirty RNs completed the following three surveys: an 8-question clinical leadership knowledge assessment, a 17-question leadership competency assessment, and a 6-question emotional intelligence self-assessment. Fifty percent or more of clinical nurses believed that they were knowledgeable in identified components of clinical leadership. The leadership competency skills assessment revealed a wide range: from 3–6% of …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls are …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Abstract

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls …

Improving Quiet-At-Night On A Telemetry Unit: Introducing A Holistic Sleep Menu Intervention, Christian Karl Antonio

Master's Projects and Capstones

Improving Quiet-at-Night on a Telemetry Unit:

Introducing a Holistic Sleep Menu Intervention

Abstract

Problem

A hospital in San Francisco, California has performed poorly on patient care service as evidenced by low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. The survey’s lowest score was from the “Quiet at Night” measure.

Context

A Sleep Menu initiative was implemented in the hospital’s telemetry unit. Microsystem assessment and Strengths-Weakness-Opportunities-Threats (SWOT) analysis identified practices that might impede intervention success. Findings showed that benefits and opportunities outweighed costs; cost-benefit analysis estimated an annual net benefit of $6,354. Other benefits included improved patient well-being, …

Improving Early Sepsis Identification On Inpatient Units, Corrina Lau

Master's Projects and Capstones

Background: On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a core measure addressing the care of septic patients. Now that care for sepsis patients is a core measure, it is important that all healthcare providers are knowledgeable in how to treat and identify sepsis.

Purpose: The Purpose is to be a “values-driven integrated healthcare delivery system in collaboration with those who share our values.” Patients observed were ages 18-years-old and older from five inpatient units. The professionals in this hospital consisted of a multidisciplinary approach that included, but not limited to, a team …

Reducing Turnover Time To Improve Efficiency In The Operating Room, Myrna Jafari

Master's Projects and Capstones

Abstract

The purpose of this project is to improve efficiency by reducing turnover time in the operating room (OR) that can consequently enhance patients’ and physicians’ satisfaction, promote teamwork, and decrease the cost of operating room delays. The increasing trend of turnover time (TOT) requires attention for microsystem improvement in the OR of Santa Rosa Memorial Hospital. The intervention to improve efficiency is to educate the OR team members on roles and responsibilities to establish a standard workflow which can promote accountability and teamwork during the turnover process. Havelock’s theory of change is used as a framework for the action …

Innovation Through An Academic Practice Partnership: A New Clinical Nurse Leader (Cnl) Implementation Model, Nancy P. Taquino

Doctor of Nursing Practice (DNP) Projects

Problem

The IOM reports (1999, 2001) were catalysts for development of a new nursing role - the Clinical Nurse Leader (CNL). Academic practice partnership models are needed to integrate the CNL role in health care systems.

Context

A large integrated health care system in Northern California and a university Clinical Nurse Leader (CNL) program initiated a formal academic practice partnership, establishing a hospital based MSN CNL program.

Intervention

A CNL implementation model was developed that includes (a) academic practice partnership advisory charter; (b) academic practice partnership roles (MSN CNL program director, MSN CNL faculty liaison, and hospital-based CNL …

Evidence Based Protocol: Discharge Delays In The Acute Care Setting, Kylie C. Schaberg

Master's Projects

According to Batalden, Nelson, Godfrey and Lazar (2011, p, 25), the clinical microsystem is a “place where patients, families and health caregivers meet” and encompasses all interactions from the moment a patient enters the system up to and including when the patient leaves the system. In order to understand the complex and dynamic changes that occur at the microsystem level, a thorough assessment must be completed. The purpose of this chapter is to gain a greater understanding of the mechanism of the microsystem and the effects that this microsystem has on the process for discharging patients from the hospital setting …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

Clinical Nurse Leaders In The Community: Building An Academic Faculty Practice Partnership, Chenit Ong-Flaherty

Nursing and Health Professions Faculty Research and Publications

The Affordable Care Act (ACA) emphasis on preventive care and primary health has given community organizations and outpatient care environments renewed attention. Nursing has been offered the opportunity to lead healthcare into a new era. One of the two new nursing programs to be given life in this movement is the Clinical Nurse Leader (CNL). The CNL is a graduate level educated nurse who specializes in healthcare systems leadership, a facilitator of care in the complex healthcare environments of today. They are equipped to see the wider and broader perspective of things, assess needs, research the best interventions for problems …