Health and Medical Administration Commons^™

Three Good Things To Extinguish Caregiver Burnout, Justin Haley

Master's Projects and Capstones

Caregiver burnout is a widespread issue in healthcare and institutions should be increasingly concerned about burnout because of the significant impact on quality of patient care, employee health, and financial stability. Many interventions and studies regarding burnout are focused on improving systems issues or removing negative stressors on caregivers. Although such interventions may be necessary to attempt, comprehensive systems-wide changes can be cumbersome and expensive, while removing negative stressors may be an unrealistic goal in a fast-paced, demanding healthcare environment. The Three Good Things method is an evidence-based, effective, simple, low-cost intervention to improve feelings of caregiver burnout in which …

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

Heart Failure Transitions Of Care Benchmark Project, Tamera M. Brandon

MSN Capstone Projects

Heart failure (HF) is a major cause of death associated with extensive morbidity and impaired quality of life. The incidence and prevalence of HF has also increased dramatically in the past three decades (Whitaker-Brown et al., 2017). HF now affects approximately 5.7 million people in the United States and is the cause of more than 55,000 deaths annually (Whitaker-Brown et al., 2017). Consequently, readmission rates of HF patients are an area of great concern. The purpose of this benchmark project is to decrease HF readmission rates in adults who had a recent HF related hospitalization by providing comprehensive transitional care …

Impact Of Hourly Rounding On Fall Rates: A Benchmark Paper, Monica D. Smith

MSN Capstone Projects

Falls and fall-related injuries create a significant financial burden on patients and healthcare organizations, particularly in adult inpatient hospital units such as rehabilitation and medical-surgical units. Costs associated with additional hospital days, diagnostic testing, and potentially fall-related surgeries can average about $14,000 per fall (The Joint Commission, 2015). Moreover, falls can be devastating in older adults, impacting their overall quality of life. According to Abou et al., 20% of yearly individual costs associated with falls are among patients with Parkinson's disease (2020). This is a proposal to implement a pre-and post-implementation change project. This paper addresses the use of evidence-based …

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

Reducing Patient Falls By Realigning Nursing Hours Per Patient Days, Hermes Vargas

Student Scholarly Projects

Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019).

The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

Patient-Centered Implementation Of Statin Therapy In Patients With Type 2 Diabetes, Giovanna P. Favarato

Doctor of Nursing Practice

Heart disease is the leading cause of morbidity and mortality in Americans with type 2 diabetes mellitus. The American Diabetes Association recommends statins and lifestyle modifications for all patients with type 2 diabetes mellitus for the prevention of atherosclerotic cardiovascular events. A patient-centered approach to primary prevention is encouraged, yet there are no specific instructions regarding implementation. The Statin Choice Decision Aid is a tool designed to facilitate shared decision-making between the patient and the provider in the clinical setting. The 2018 American College of Cardiology/American Heart Association guidelines for the primary prevention of atherosclerotic cardiovascular disease for patients with …

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

Reducing Patient Falls Through Purposeful Hourly Rounding, Amanda Savage

Student Scholarly Projects

Practice Problem: Falls significantly affect patients, resulting in temporary or permanent harm, even death. In a large acute care facility, patient falls increased from 444 in 2016 to 556 falls in 2019.

PICOT: In an adult inpatient hospital setting, does purposeful hourly rounding (PHR), compared to no rounding, reduce patient falls over a period of 30 days during the same time period from the previous year?

Evidence: Of the 360 articles reviewed, 12 articles, varying from evidence levels two (1), level three (4), and level five (7), supported PHR as effective in reducing harm from falls in adult …

Preventing Falls In Long-Term Care Using Patient-Centered Fall Interventions, Angela Blakley

Student Scholarly Projects

Practice Problem: The practice problem identified within the Community Living Center included continuous falls, despite using current fall prevention strategies and provider-driven interventions. Baseline data reflected a fall rate of 4.2 in the long-term care areas despite improving the fall prevention program.

PICOT: The PICOT question that guided this project was: In older adult residents (P), what is the effect of a standing operating procedure (SOP) using patient-centered interventions (I) compared to physician-driven fall interventions (C) on decreasing falls and falls with injuries (O) within one month (T)?

Evidence: In twelve high-quality articles that fit the eligibility criteria and …

Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp

Dissertations

Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).

Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.

Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = …

Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake

Dissertations

Abstract

Purpose: This quality improvement (QI) project aimed to determine if a standardized nurse teaching approach improved patient understanding of diagnosis and treatment as it relates to women diagnosed with a pelvic floor disorder (PFD) after receiving a standardized nurse education (SNE) session in an urban tertiary care Urogynecology practice.

Methods: Females aged 18 and older with a newly diagnosed PFD and prescribed PFPT for the first time who agreed to receive the SNE and complete the CAHPS® survey were included in the project. Patient perception of PFPT was assessed via phone interview utilizing the Consumer Assessment of Healthcare …

Patient Participation Strategies: The Nursing Bedside Handover, Irene Decelie

Patient Experience Journal

Patient participation is an important goal in today’s health care and considered necessary to achieve safe and quality patient care. The purpose of this paper is to discuss the historical and theoretical background surrounding the concept of patient participation in health care and specifically to examine patient participation strategies which have been reported to be of influence when employed during the nurse to nurse and patient to nurse activities encompassed in the bedside handover. The bedside handover is the nursing activity of transferring primary nursing responsibility of care from one nurse to another. Encouraging patients to participate during this process …

Couplet Care, Melanie Husk

Scholars Week

Abstract

In many recent studies, maternity units in hospitals have been making the transition from traditional separate care for the mother and baby to couplet care for the mother and baby. (Brenneman, 2014; Abney-Roberts, 2012; Backus, 2017) Couplet care is family-centered care in which the mother and the baby stay together from childbirth until discharge. (Emory-Decatur, 2019) Studies have shown that this form of care has many benefits for both the mother and the baby. Parents become more educated on how to care for their newborn and infants gain the foundation for how they will develop socially, emotionally, and behaviorally. …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

Predictors Of Birth Center Sustainability In The United States, Melanie Cabezas Phipps

Nursing ETDs

Pregnant women from all racial and socioeconomic communities deserve safe, personalized, and affordable ways to give birth. To meet all three needs, focus is increasing on birth centers, a midwifery model that provides family-centered care before, during, and after normal pregnancy, labor, and birth. However, many U.S. birth centers face significant obstacles to financial sustainability, particularly in rural areas. A better understanding of the factors that contribute to a birth center’s operational success is needed for practitioners and groups interested in establishing or maintaining a birth center, as well as to inform policymakers seeking to improve health care equity, outcomes, …

What Are The Nurse’S Perception Of The Effectiveness Of The Electronic Go-Jo Monitoring System On Hand Hygiene Compliance And Hospital Acquired Infection’S?, Patricia James

Seton Hall University DNP Final Projects

Background: The importance of hand hygiene compliance in preventing hospital acquired infections is well known. Yet national averages for compliance rates with hand hygiene among healthcare workers remains unsatisfactory. Noncompliance with hand hygiene practices can contribute to increased patient mortality, prolonged length of hospitalization, increase healthcare costs and decreased reimbursement for hospitals from the Centers for Medicare and Medicaid. Project Aim: The purpose of this quality improvement project was to explore the nurses’ perceptions of the effectiveness of the electronic Go-Jo monitoring system on hand hygiene compliance and hospital acquired infections. Methods: This was a performance …

Building Pipelines: Partnering For Successful Rn Residency, Leann Ogilvie, Laurie Ryan-Mcdonald

Books, Presentations, Posters, Etc.

No abstract provided.

Achieving Quality Care In A Timely Manner: The Utilization Of Observation Unit At Covenant Medical Center, Daisy Bolla, Daisy Dagohoy, Camie Rowland

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No abstract provided.

Building A Culture Committed To Fall Prevention, Mary Uppinghouse, Queena Kim, Marissa Evans

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No abstract provided.

Effects Of Sedation Vacations And Sedation Level Quality Improvement Project, Gisele Bazan, Bo Ewing, Cynthia Grissman, April Marpa, August Montgomery, Tana Overman

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No abstract provided.

Intersection Between Accreditation And Ebp, Lauren Smith

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No abstract provided.

Language Diversity In The Healthcare Workplace And Its Impact In The Delivery Of Patient Care And Teamwork, Daisy Bolla, Catherine Albano

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Bridging The Gap: An Innovative Web-Based Approach For Evaluating Ebp Readiness In Direct Care Nurses, Stacey Spalding, Nikki L. Galaviz, Jamie Roney, Joann Long, Karen Baggerly

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No abstract provided.

Improving The Nicu Experience Through Experience -Based Co-Design, Julie Metcalf, Sarah Pearce

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Process Improvement For Simethicone Use During Endoscopic Procedures, Airene D. Albutra, Mary Estelle De Vera, Sarah J. Wyrick

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No abstract provided.

Electronic Solution For Low Census Requests, Tina Bardavid, Robert Wong

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Improving Ed Sepsis Bundle Compliance, Jen Selby

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No abstract provided.