Medicine and Health Sciences Commons^™

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Chronic Lower Back Pain Among Women In India: Evidence-Based Approach To Risk Factors And Interventions, Aelita Matosova

Master's Projects and Capstones

Chronic lower back pain (CLBP) is a prevalent issue worldwide, affecting about 1.71 billion people, with a significant proportion being women. CLBP is a major health concern in India, particularly among women, which were 80% reported experiencing this condition. Several factors, such as personal beliefs, sociocultural norms, restricted healthcare access, repetitive movements, and psychological aspects, contribute to this high prevalence leading to severe health and economic implications, including reduced work productivity and income. Although there have been several reports on prevalence and risk factors of CLBP, to our knowledge, there has not been enough work focusing on evidence-based interventions to …

Increasing Vaccination Rates In The Latin X Communities Through A Public Health Initiative For Increasing Education And Vaccination, Gabriela Carrico

Doctor of Nursing Practice (DNP) Projects

Background: The COVID-19 disease has been found to cause an estimated 570,003 deaths in the United States (Centers for Disease Control and Prevention [CDC], 2021). Statistics showed that the elderly, immunocompromised, and vulnerable populations are the most at risk for this disease. Vaccination is an important aspect of disease prevention in healthcare issues around the world. Vaccination against the COVID-19 prevents this communicable disease from the spread and serious adverse health outcomes.

Problem: The Latin X communities in the Tenderloin District in San Francisco city are confronted with multiple factors that affect their willingness to receive the COVID-19 vaccine. Factors …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration: An Integrative Review, Purnima Krishna

DNP Qualifying Manuscripts

Purpose/Objectives: This review evaluates the published studies on how post-acute care collaboration ensures a continuum of care and reduces heart failure (HF) readmissions.

Primary Practice Setting: An integrated literature review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. PubMed and Cumulative Index to Nursing and Allied Health were searched for the keywords heart failure AND (post-acute care OR transitional care OR skilled nursing facility OR rehabilitation facility OR home health agency) AND (readmission) AND (care coordination OR collaboration OR interprofessional OR partnerships). Seventy-nine studies were returned, and a reverse reference search yielded four …

An Online Self-Directed Learning Module For Regional Stroke Survey Success, Winchell Rodriguez Kuttner

Doctor of Nursing Practice (DNP) Projects

The lack of a standardized education for stroke coordinators focusing on The Joint Commission (TJC) standards and requirements in preparation for the stroke program disease-specific care (DSC) certification survey every two years has led to undue added stress prior to survey. The development of tools and resources has been identified to address the current educational gap in stroke coordinator orientation. This project addressed the gap by creating an online, self-directed learning module to assist the stroke coordinators in knowledge acquisition of the stroke standards and requirements.

A stroke coordinator plays a critical role in stroke care delivery. An educational module …

Improving Patient Safety By Reducing Falls, Laura Jefferson

Master's Projects and Capstones

In the microsystem setting of this project, there have been two patient falls, within the last year. These falls did not result in injury, hence, did not create additional cost for the hospital, nor the patient. Evaluation of the patient’s charts concluded that the fall risk assessments for the patients in question were not entirely indicative of their risk for falls. Additionally, the fall risk care plans were not patient specific in that they did not fully address the designated fall risks of the patient. An abundance of evidence exists supporting the need to reduce falls, and that fall reduction …

Improving Management Of Obstetrical Emergencies: Using Simulation-Based Training, Amira Amatullah

Doctor of Nursing Practice (DNP) Projects

The aim of this Executive Leadership Doctorate in Nursing Practice project was to assess the effectiveness of simulation-based training as a strategy to ensure patient safety and quality care by improving the knowledge and confidence of obstetric nursing staff. Collateral goals included the development of a simulation-based interactive training program to improve staff response to obstetric emergencies and the establishment of an Interprofessional Simulation Training Center.

The use of simulation-based training is widely accepted ans used in healthcare education. Several benefits of simulation-based training include a learner-centered approach, safe acquisition of technical skills training and development of effective communication skills. …

Preventing Hospital Acquired Pneumonia: A Quality Improvement Project, Calyn Pascual

Master's Projects and Capstones

Abstract

Problem: From October 2016 to September 2017, the 5^th floor medical surgical telemetry unit has had 9 incidences of hospital-acquired pneumonia (HAP). Among the facility, this is the floor with the highest HAP incidences.

Context: HAP is associated with $40,000 to $65,000 to each patient care cost; an additional 7-9 days of stay in the hospital, increases the chances of discharging a patient to a skilled nursing facility instead of home, and has an attributable mortality rate (Quinn, et al., 2014).

Interventions: Daily oral brushing self-audits are given to patient care technicians (PCT) for both day and evening …

Stress Urinary Incontinence In Collegiate Female Athletes: Prevalence And Impact, Marie Bouchard

Master's Projects and Capstones

Abstract

Introduction, definition: Urinary incontinence is the involuntary leaking of urine (a few drops to a few milliliters). It can happen while exercising with no urge to urinate (stress urinary incontinence), with a sudden urge to urinate (overactive bladder or urgency urinary incontinence), or a combination of the two (mixed urinary incontinence). This issue is very common among female athletes. However, because of the reluctance to discuss this problem, it remains underdiagnosed and undertreated.

Methods:An anonymous and confidential survey was distributed to the 90 University of San Francisco female student athletes from seven different varsity sports in December 2017. …

Baseline Prevalence Study Of Hendrich Ii Fall-Risk Assessment Tool At A Local Community Hospital, Emanuelle Vasconcelos Barbosa Borba Pontual

Master's Projects and Capstones

Each year, 700,000 to 1,000,000 people in the United States fall in hospitals; 30%–35% of those sustain injuries, and 20% of falls will cause serious traumatic injuries. Yet, research shows that close to one-third of these falls could be prevented. This paper presents the analyses of two fall-risk tools, Hendrich II fall risk model (HFRM II) and PMAT, in a local community hospital. Extensive review of literature and statistical analysis of 106 patients’ assessments practices were used to determine the current assessment skills for falls and PMAT. The aim was to understand if RNs are using the tools appropriately and …

Interdisciplinary Team Approach In Fall Prevention: Physician Perspective Focus, Anna Gryn

Master's Projects and Capstones

An in-hospital fall is a devastating event for patients and care providers resulting in injuries, physiological and psychological patient declines, and sometimes deaths. Furthermore, fall related costs greatly increase hospitals’ expenses and cause massive distress to caregivers and health providers. Many patient-specific, organizational, and seemingly erratic factors contribute to the occurrence of in-hospital falls. Despite this, hospitals must undertake consistent evidence-based measures to prevent fall occurrences as much as possible.

The traditional nursing approach to falls prevention is not sufficient to control fall rates because the issue is too complex and must be approached from multiple perspectives rather than just …

Creating A Culture Of Mobility: A Quality Improvement Project, Vincent K. Samuel

Master's Projects and Capstones

Abstract title: Creating A Culture of Patient Mobility in An Acute Care Setting.

Unit: Medical Surgical unit.

Author: Vincent Samuel RN, BSN

Institution: University of San Francisco; Kaiser Permanente Nurse Scholar Academy; Kaiser Permanente Hospital, San Francisco (CNL practicum site).

Background Information

The medical/surgical unit had the average ambulation score of 54% in the year 2015, much below the benchmark of 65% set for the year. The direct impact of low ambulation score was the increase in patient’s length of stay. The micro-system analysis revealed various factors that contributes to this problem such as, inadequate staffing, unit culture, unavailability of …

Falls Program On An Acute Psychiatric Unit, Joseph Hunter Rose

Master's Projects and Capstones

In the metropolitan hospital’s acute psychiatric unit there has been an increase in falls incidence as well as need for evaluation of the effectiveness of Schmid Fall Risk Assessment tool in its ability to properly identify those at risk. In the last fiscal year there were 45 falls among 28 patients on the acute psychiatric unit.Falls are harmful to the patients and can cause prolonged hospital stays with non-reimbursable costs to the hospital. Falls amongst psychiatric patients is an even greater challenge to address due to the nature of the mental health disease process. This project addresses general costs of …

Implementing A Rib Fracture Management Pathway And Pic Scoring Tool To Reduce Icu Readmissions, Susan Mastroianni

Master's Projects and Capstones

The purpose of the project was to improve the management of patients with rib and or sternal fractures in a 413 bed Level I Trauma Center. The pathway included best practice guidelines paired with clinical expertise to reduce Intensive Care Unit (ICU) readmissions, costs, complications and length of stay (LOS). Analysis of the data revealed 55% of ICU readmissions were due to respiratory causes. The timeline guided the creation, deployment, and evaluation of the project over a two phase, one and one half year period. Methods included analysis of the data, meetings with lead team members to define the scope …

Bioharness Multivariable Monitoring Device. Part I: Validity, James A. Johnstone, Paul A. Ford, Gerwyn Hughes, Tim Watson, Andrew T. Garrett

Kinesiology (Formerly Exercise and Sport Science)

The BioharnessTM monitoring system may provide physiological information on human performance but there is limited information on its validity. The objective of this study was to assess the validity of all 5 BioharnessTM variables using a laboratory based treadmill protocol. 22 healthy males participated. Heart rate (HR), Breathing Frequency (BF) and Accelerometry (ACC) precision were assessed during a discontinuous incremental (0- 12 km·h-1) treadmill protocol. Infra-red skin temperature (ST) was assessed during a 45 min-1 sub-maximal cycle ergometer test, completed twice, with environmental temperature controlled at 20 ±0.1 °C and 30 ± 0.1 °C. Posture (P) was assessed using a …

Field Based Reliability And Validity Of The Bioharness Multivariable Monitoring Device, James A. Johnstone, Paul A. Ford, Gerwyn Hughes, Tim Watson, Andrew C.S. Mitchell, Andrew T. Garrett

Kinesiology (Formerly Exercise and Sport Science)

The BioharnessTM device is designed for monitoring physiological variables in free-living situations but has only been proven to be reliable and valid in a laboratory environment. Therefore, this study aimed to determine the reliability and validity of the BioharnessTM using a field based protocol. Twenty healthy males participated. Heart rate (HR), breathing frequency (BF) and accelerometry (ACC) were assessed by simultaneous measurement of two BioharnessTM devices and a test-retest of a discontinuous incremental walk-jog-run protocol (4 – 11 km·h-1) completed in a sports hall. Adopted precision of measurement devices were; HR: Polar T31 (Polar Electro), BF: Spirometer (Cortex Metalyser), ACC: …