Health and Medical Administration Commons^™

Patient Satisfaction With Noise, Robert W. Kentner Ii

Student Scholarly Projects

Practice Problem: Noise on hospital units can interfere with patient rest, timely recovery, and statisfacton with care. Improvements in the reduction of hospital noise levels lead to improved patient satisfaction and improved rest. Patients were surveyed on their satisfaction with noise during the day and at night.

PICOT: In Acute Care Patients (P), does the implementation of a noise reduction program (I) compared to no noise reduction program (C), affect patient satisfaction with noise (O) over a six-week period (T)?

Evidence: Studies show that many hospitals have noise levels that exceed the World Health Organization’s recommended standards for noise …

Evidence-Based Practice: Delaying Infant Bathing, Gabrielle Wadle, Grace Frankland

Scholars Week

A hospital's policy regarding infant bathing is currently not congruent with best nursing practice. The hospital’s current policy is to bathe an infant once they are stable and their rectal temperature is at or above 98.6 °F. Although the infant may become stable within the first 24-hours of birth, the World Health Organization recommends that, “Bathing should be delayed until 24 hours after birth.” (2013, p. 4). Research has been completed to support delaying infant bathing until 24 hours post-delivery, suggesting potential modifications to current policy.

Pediatric Wound Care: Establishing A Consensus Group To Develop Clinical Practice Guidelines, Ryan Krasnosky, Geran Barton, Linda Highfield, Sheila Martinez, Stephen Linder, Edward Buchanan, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. Wound care practices for neonatal and pediatric patients have created a lack of standardized evidence-based guidelines for treatments in clinical practices. Unfortunately, published clinical guidelines for the evaluation and management of wounds in pediatric populations is limited. Consensus groups are used to develop clinical guidelines which define key aspects of the quality of health care, particularly appropriate indications for interventions. The aim of this initiative was to conduct the first two steps of the guideline development process, and to report on the findings from the expert consensus group for pediatric wound care.

Methods. The goal was to recruit a …

A Systematic Review Of Acuity-Based Staffing In Acute Healthcare Environments, Demitria Idella Stafford

Electronic Theses and Dissertations

Nursing leadership is responsible for considering the equity of patient care assignments when providing nursing care. Nursing leadership is responsible for assuring the delivery of patient care assignments with the intent to offer nurses an unbiased, evenly distributed patient load. Effective distribution of patient care assignments ensures patients receive the safest, most efficient, and highest quality of care. The purpose of this project was to provide nursing leadership with an executive summary of a systematic review of evidence-based research on the structure and process of making patient care assignments, and it provided evidence on how those patient care assignments affect …

Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Improve The Risk Of Central Line-Associated Bloodstream Infections With Central Line Dressing Changes Through A Team Approach, Jessica Comstock

Student Scholarly Projects

Practice Problem: Central Line Associated Bloodstream Infections (CLABSI) are a preventable hospital acquired infection which contributes to patient morbidity, mortality and rising healthcare costs.

PICOT: The PICOT question that guided this project was: In adult inpatients with central venous catheters, does the use of a two-person dressing change team, compared to a single person procedure, decrease the rate of central line associated bloodstream infections over the course of 8 weeks?

Evidence: The prevention of CLABSI is most effective when multifaceted line maintenance bundles are implemented and adherence to these bundles nears 100% (Schreiber et al. 2018).

Intervention: A two-person, …

A Watched Pot Never Boils: Attentive Care Needs No Timer, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the premise that length of patient consultation time is less important than what patients perceive happened during that time. Regardless of the time allotted to a clinical visit, health care providers should make efforts to address the emotional and psychosocial needs of their patients. As always, taking a little time to express empathy can make a big difference in patient satisfaction.

In Gratitude Of 2020 Jpcrr Peer Reviewers

Journal of Patient-Centered Research and Reviews

Peer review is an essential component to publishing high-quality scientific literature. Journal of Patient-Centered Research and Reviews relies on volunteer reviewers to grade and improve submissions to the journal. Our editorial team gratefully acknowledges the experts credited in this supplement for their generous contributions in 2020.

Staff Perceptions Of The Health Call Center Workplace Environment, Eric Lee Escobedo-Wu

Regis University Student Publications (comprehensive collection)

The complexities of the Health Call Center (HCC) amidst of a pandemic has caused an uptick in nurses and staff experiencing physical, emotional, and mental fatigue. An increase in sick calls during peak call days and times, breakroom discussion related to workload and competing patient and clinical priorities, and the consistent need to care for patients and caregivers, while maintaining familial and fiscal responsibilities and priorities contribute to the exhaustion of the nurses. The purpose of this Quality Improvement (QI) project was to use a structured survey tool and open-ended questions to identify HCC nurses’ perceptions of stressors and burnout …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Large Scale Organizational Intervention To Improve Emergency Department Throughput In A Community Hospital, Karen Elliott

DNP Scholarly Projects

Abstract

BACKGROUND: Emergency Department boarding is a well-documented systemic problem across the country. ED-2b, the time from decision to admit a patient to Emergency Department departure, is specified by the Joint Commission as a quality measure for Emergency Department boarding. ED-2b metrics have been a longstanding challenge at this community hospital outside the nation’s capital. The aim of this study was to reduce median ED-2b times by 10% compared to fiscal year 2020 (FY20). To accomplish the reduction in time, a multidisciplinary throughput committee was developed with subsequent action plans designed to improve Emergency Department throughput.

METHODS: The Plan Do …

Developing An End-Of-Life Discussion Protocols, James Hawley

Rural Health Professions Projects

End of life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a provider-patient communication protocol that would shift advanced directive conversations proactively back into the local rural primary care setting.

Strategies To Reduce Costs Caused By Medication Errors In Us Hospitals, Janice Leah Chobanuk

Walden Dissertations and Doctoral Studies

Medication errors result in patient harm, including deaths, costing American hospitals over $20 billion annually. The financial impact and reduced public confidence in safe patient care create a business problem for hospital leaders trying to contain costs, maintain a competitive edge, and sustain patient satisfaction. Grounded in the sociotechnical conceptual framework, the purpose of this generic qualitative study was to identify strategies hospital leaders use to reduce costs caused by medication errors in hospitals. Data collection involved semistructured interviews with 10 hospital leaders from various high-reliability hospitals across the United States and a review of documents related to medication management …

Changing The Culture Of Nurse Practitioners: Incorporating Medical Billing And Coding To Prevent Fraud, Waste And Abuse, Tralissa Morrow

DNP Research Projects

Medical coding and billing errors are avoidable problems that have afflicted practitioners for decades. Correct coding and billing are required for reimbursement of healthcare services. Fraud, waste and abuse increase healthcare costs, reduce the quality of care provided and directly impact costs to patients. This pilot study was intended to evaluate the impact of an educational webinar on medical billing and coding, fraud, waste and abuse on nurse practitioner (NP) knowledge using a pretest posttest design. Mean scores increased from 58.4% to 76.4%. Test reliability was low at 0.477 (pretest) and 0.142 (posttest) with two questions that were unable to …

Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi

Walden Dissertations and Doctoral Studies

AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …

The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore

Walden Dissertations and Doctoral Studies

AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …

Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe

Walden Dissertations and Doctoral Studies

Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu

Walden Dissertations and Doctoral Studies

AbstractThis study explored the lack of formalized managerial education and training for nurses new to leadership. This quantitative study specifically explored the knowledge gap of beginner nurse managers based on a lack of formalized education, a universal approach is supported by the research. Currently, there is no standard or formal nurse manager education program through the Department of Nursing or the Department of Learning and Development. The focus of the evidence-based project was to evaluate pre- and post-data assessing the impact of instituting a formal education program for beginner level nurse managers in collaboration with the human resources department of …

Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy

Walden Dissertations and Doctoral Studies

AbstractLow quality of care is a problem for many United States (U.S.) emergency departments (E.D.). The use of electronic medical records (EMR) with quick embedded tools, treatment plans, and protocols decrease E.D. overcrowding, reduce boarding time, to approximate the 4- hour recommendation by the Joint Commission on Accreditation of Healthcare Organizations, and improve quality of care. The project question asked whether a systematic review of EMRs with quick embedded tools, treatment plans, and protocols decreased overcrowding and boarding time, and improved E.D. quality care. This systematic review used the Johns Hopkins Model to answer the project question by guiding selection, …

Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris

Walden Dissertations and Doctoral Studies

Individuals serving in the nurse manager role are critical stakeholders supporting frontline nurses delivering quality care within acute care settings. Despite evidence supporting nurse managers’ contributions to improved quality outcomes for patients by proxy, there is scant evidence supporting direct relationships between the role and outcomes. This study intended to provide quantitative evidence of relationships between nurse managers’ engagement, nurse managers’ tenure, and patient outcomes. The leadership complexity theory classified the nurse manager as a meso-level leader, requiring support from the macro- and microlevels of the organization. Acting as a liaison, meso-level leaders’ function in the space between executive leadership …

Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo

Walden Dissertations and Doctoral Studies

Distracted nurses who use their personal smartphone at work has resulted in the diversion of attention from patient care. The specific problem is the personal smartphone use by nurses in the hospital settings has resulted in distracted patient care, leading to wrongful release of patient’s information, medical errors, injury or preventable patient death. The purpose of this qualitative study was to describe the perceptions of nurses regarding distracted patient care in their clinical workplace due to personal smartphone use by nurses. The study was grounded in the distraction-conflict theory conceptual framework. The key research question examined the perceptions of nurses …

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Interprofessional Reflective Journals: Content Themes And Self-Regulated Learning, Joan M. Tunningley

Journal of Occupational Therapy Education

Self-reflection has been linked with clinical reasoning, academic, and clinical outcomes. The purpose of this study was to examine self-reflective journal entries from thirty students for interprofessional core competencies and for self-regulated learning components. The text data was analyzed using an in-depth three cycle coding process, thoroughly described in the methods. The findings were structured into two themes confirming interprofessional content learning: collaboration, team, and communication; and respect and roles. One additional theme emerged, transformation and relatedness, which indicated self-regulated learning components as well as supporting transformative learning. This qualitative case-study contributed to the research of occupational therapy students’ self-reflection …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

Creation Of A Covid-19 Community Testing Team For Home Health And Hospice, Lilah Raja

Master's Projects and Capstones

The novel SARS-CoV-2 strain (COVID-19) was identified in Wuhan, China in December 2019 (Eddy et. al, 2020). The resulting US outbreak has affected the Kaiser Permanente (KP) Oakland health care system. With the threat of COVID-19 highest among immunosuppressed and elderly clients, KP Oakland home health and hospice (HH/HO) department is rapidly mobilizing to provide community and in-home testing for eligible clients. A project was created to build a COVID-19 testing team workflow to provide diagnostic and preventative testing. This project focuses on team-based interventions that will change the pre-existing practice of requiring HH/HO clients to travel to remote testing …