Quality Improvement Commons^™

Ped-Pdcds German, Marianne E. Weiss, Gaby Stoffel

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Pdcds - Adult Portugese (Brazil), Marianne E. Weiss, Clediane Trindade

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Ob-Pdcds Polish, Marianne E. Weiss, Malgorzata Nagorska

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Improving Postpartum Depression Screening Practices In The Postpartum Setting, Courtney Lynn Cole

Dissertations

Abstract

Problem: Postpartum Depression (PPD) is frequently undetected in women due to barriers that limit effective recognition and diagnosis. Depression screenings and treatment referrals improve outcomes in the immediate postpartum period. Follow-up methods for positive depression screens are often missed by postpartum care teams.

Methods: A descriptive, observational design was used for this quality improvement project. A formalized depression screening protocol was created to help guide nursing staff on a Postpartum Unit when detecting a positive depression screen. Convenience sampling was utilized and the sample included patients aged 18-45. Data collected throughout this quality improvement project included Edinburgh Postnatal Depression …

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …

Virtual Visits In Routine Prenatal Care, Katrina K. Wu

MUSC Theses and Dissertations

Problem

One million pregnant persons in the United States do not receive early prenatal care or the recommended number of prenatal visits each year, and this gap in care access disproportionately affects people of color, those with lower incomes, and those living in rural communities. Telemedicine was widely utilized in prenatal care during the COVID-19 pandemic, and optimizing prenatal telemedicine has the potential to improve prenatal care access beyond the pandemic.

Purpose

This dissertation focused on examining the integration of virtual visits in routine prenatal care during the COVID-19 pandemic. The purpose of this dissertation was to:

Aim 1. Explore …

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

The Effects Of Prenatal Patient Education Regarding Epidural Anesthesia, Auburn Merritt

Symposium of Student Scholars

This project is important because there is a lack of education for prenatal women regarding epidural anesthesia which causes misunderstanding, confusion, a deficit of knowledge, and a lack of support. The purpose of this project is to analyze and suggest the importance of proper education regarding epidural anesthesia. Proper prenatal education causes resolution of misconceptions as well as causes patients to be more satisfied with their pain management during labor. Evidence that I found suggested that after proper education more pregnant women planned to receive epidural anesthesia (Cutajar, 2018). Women preferred detailed education to increase knowledge of the risks and …

Team Engagement & Obstetrics Transformation Committee, Colette Dumais, Faye Weir, Lynn Willey, Kristen Heanssler, Brittany Babb, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Obstetrics Transformation Committee,Maine Medical Center

Operations Transformation

Gallup defines employee engagement as the involvement and enthusiasm of employees in their work and workplace. Employee engagement helps to measure and manage employees' perspectives on the crucial elements of workplace culture. Based on over 50 years of employee engagement research, engagement employees produce better outcomes (better patient care) than other employees. Based on the unit survey, team members, with the support of local leaders, formed the Transformation Committee. This Committee was developed as a shared governance, team led model to address process improvement needs and create a culture of active engagement in problem solving.

Implementation Of Infant Driven Feeding™ In A Level Ii Nicu, Kelly Gardner

Graduate Theses, Dissertations, and Capstones

In the United States, currently, 1 in 10 babies are born premature. Due to the immaturity of their neurological, gastrointestinal, and cardio-respiratory functions, preterm infants can experience the inability to coordinate sucking, swallowing, and breathing that is essential to oral feed. Cue-based oral feeding methods are designed to give the caregiver the ability to recognize signs of readiness and respond appropriately to the infant cues to adjust the manner in which feeding intervention is performed to match the infant’s current state of physiologic tolerance. The Infant Driven Feeding™ program incorporates scales to assess readiness and quality of the oral feeding, …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Improving The Delivery Of Discharge Instructions On The Postpartum Unit By Increasing The Nurses' Knowledge, Judy Anne Settles

Master's Projects and Capstones

Abstract

The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the …

Neonatal Developmental Care Makes Sense: Implementation Of An Evidence-Based Guideline For Developmentally Appropriate Multi-Modal Positive Sensory Exposures., Nicole Moseley Jaeger

Doctor of Nursing Practice Papers

Background: There is increasing awareness of the contribution of the neonatal intensive care (NICU) environment and the importance of developmental care (DC) interventions to long-term outcomes in high-risk infants. Care at the project site reflected that given at many hospitals, where positive sensory experiences and negative sensory mitigation are done but inconsistently. There was not a guideline in place for DC interventions.

Setting: The project site housed a newly renovated single-family room (SFR) NICU with 12 licensed Level II beds and ability to flex to 19 beds. Neonates at gestational ages ≥28 weeks, requiring critical care for a …

Podium Presentation: Racial Inequities And Breastfeeding In A Nicu: A Quality Improvement Project, Emilia C. Garcia

2022 Providence Nurse Research Conference

No abstract provided.

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 …

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused …

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

A Better Way To Non-Invasively Measure Bilirubin Levels To Protect Infant Health, Kristen Mackeil

Symposium of Student Scholars

Background: Jaundice screening using transcutaneous bilirubin(TcB) monitors often produce inaccurately low results for lighter skin tone newborns and inaccurately high results for darker skin tone newborns. While high jaundice levels for lighter skin tone newborns risk going undetected, darker skin tone newborns receive unnecessary follow up heel sticks for serum bilirubin determination. This is a problem because dangerous jaundice levels may be under or over reported. Additionally, unnecessary heel sticks for darker skin tone newborns increase the risk of complications from puncture and increase newborn discomfort. Performing the heel stick and processing the blood sample also cost nurses and …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads to …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Intrapartum Guidelines For Nurse Midwives, Tanya Owens

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Intrapartum Guidelines for Nurse-Midwives

Abstract

Intrapartum clinical practice guidelines for certified nurse-midwives (CNMs) can improve quality of care and patient outcomes. Such improvements, however, often relate to the level of rigor in guideline development to assure quality and utilize the most recent and best evidence. This quality improvement project, introduced in three phases, aims to align existing clinical practice guidelines with national clinical practice guidelines and standards of care for certified nurse-midwives providing care in an intrapartum hospital setting. Phase One of this project will review existing clinical practice guidelines for midwifery care, accomplished by appraising 28 intrapartum guidelines. Phase …

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.

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 …

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. …

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

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No abstract provided.

Development Of A Maternal Child Health Department-Wide Neonatal Resuscitation Cart Educational Project, Anna M. Munoz, Beverly Holland

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No abstract provided.

How Much Blood Is That? The Use Of Scorecard Feedback To Improve Measurement Of Blood Loss At Delivery, Marilyn Cejka Steinberg

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No abstract provided.