Medical Specialties Commons^™

Hello Darkness My Old Friend: An Experience Of A Transformative Session With Zero Balancing, James Mccormick

Journal of Transformative Touch

An Experience of a Transformative Session with Zero Balancing showing the effects of client experiencing an expanded state of consciousness furring a Zero Balancing session.

Smoking Cessation Interventions In South Asian Countries: Protocol For Scoping Review, Sajid Iqbal, Rubina Barolia, Laila Ladak, Pammla Petrucka

School of Nursing & Midwifery

Introduction: Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the …

Health In Environment: Reduce Surgical Site Infections By Applying Florence Nightingale's Environmental Theory, Anna Rana

School of Nursing & Midwifery

Surgical site infection is one of the most common causes of readmission in hospitals and it also leads to an overall increased burden. This can be decreased by applying basic concepts of Nightingale (1860) "Environmental Theory" while giving care to the patients. Keeping in view Nightingale's environmental theory, this paper aims to discuss the case of a patient suffering from a surgical site infection. It will help readers to understand the environmental factors which affect the patients' health and provide a way to promote healing and fast recovery by modifying their environment.

Implementation And Sustainment Strategies For Open Visitation In The Intensive Care Unit: A Multicentre Qualitative Study, Kerry A. Milner, Suzanne Marmo, Susan A. Goncalves

Nursing Faculty Publications

Objective

Open visitation in adult intensive care units has been associated with improved family and patient outcomes. However, worldwide adoption of this practice has been slow and reasons for this are unclear. This study documents barriers and strategies for implementing and sustaining open visitation in adult intensive care units in the United States experienced by nursing leadership.

Research design

Qualitative approach using grounded theory.

Participants

Nurse leaders in adult intensive care units with open visitation.

Setting

Magnet® or Pathway to Excellence® designated hospitals in the United States.

Methods

Semi structured interviews were conducted with 19 nurse leaders from 15 geographically …

Visit-To-Visit Blood Pressure Variability And Sleep Architecture, Xiaoyue Liu, Jeongok Logan, Younghoon Kwon, Jennifer M. Lobo, Hyojung Kang, Min-Woong Sohn

Health Management and Policy Faculty Publications

Visit‐to‐visit blood pressure (BP) variability (BPV) is an independent risk factor of cardiovascular disease (CVD). Sleep architecture characterizes the distribution of different stages of sleep and may be important in CVD development. We examined the association between visit‐to‐visit BPV and sleep architecture using in‐lab polysomnographic data from 3,565 patients referred to an academic sleep center. BPV was calculated using the intra‐individual coefficient of variation of BP measures collected 12 months before the sleep study. We conducted multiple linear regression analyses to assess the association of systolic and diastolic BPV with sleep architecture—rapid eye movement (REM) and non‐rapid eye movement (NREM) …

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.

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.

Risk Factors Of Breast Cancer Among Patients In A Tertiary Care Hospitals In Afghanistan: A Case Control Study, Zekrullah Baset, Jamshid Abdul Ghafar, Yasmin Parpio, Ahmed Maseh Haidary

School of Nursing & Midwifery

Background: Breast cancer is the second most common causes of women's death, worldwide. Data on risk factors associated with female breast cancer in the Afghan population is very limited. The aim of our study was to identifying risk factor associated with female breast cancer in Afghanistan.
Methods: A retrospective case-control study was conducted with inclusion of 201 cases and 201 controls. Patient information was collected by interviewing the patient through a structured questionnaire. Histopathological information was collected from the hospital integrated laboratory management system. The data was analyzed by using logistic regression with univariate and multivariable analyses to determine the …

Improving Hepatitis B Vaccination Rates In Nephrology Patients With Chronic Kidney Disease: A Qi Initiative, Jill Swanson

Nursing Posters

• Hepatitis B vaccination is an important health maintenance preventative measure for patients with chronic kidney disease (CKD)
• Prior to initiating dialysis, hepatitis B vaccination administration is proven to be more effective than waiting until patients begin dialysis treatments.
• Efficacy and immune response of the hepatitis B vaccine is greater when kidney function is greater
• To better improve hepatitis B vaccine administration among the CKD stage 4 population, education measures and Epic modifiers will be implemented to achieve change
• Nursing knowledge and hepatitis B vaccine administration will improve after implementation of these measures

Performance Improvement Leadership Rounding Implementation, Dena Walz

Nursing Posters

To improve patient experience scores and address patient concerns in real time.

A proactive behavior that facilitates leaders building relationships with patients and families, managing expectations, and achieving and validating consistency of key behaviors.

A member of leadership will conduct a purposeful conversation with a chosen patient three days a week regarding the care provided during their procedural appointment.

Contemporary Treatment Options For Pulmonary Embolism, Tanya Glenz, Teresa Jahn

Nursing Posters

Purpose:

Provide RNs education on the classifications of PEs and new catheter directed treatment options.

Significance:

• PE remains a common and lethal entity
• PE is the 3rd leading cause of cardiovascular death in hospitalized patients (60,000-1000,000 per year)
• 150,000-250,000 PE related hospitalizations per year
• RNs must be knowledgeable of the classifications of PEs and catheter directed therapies to promote positive patient outcomes
• Prior to catheter directed therapies, submassive PEs had a mortality rate up to 20% at 3 months and were traditionally treated with IV heparin, or oral anticoagulant therapy

Suspension Of Independent Double-Check For Subq Insulin Administration, Mallory Mondloch, Jennifer Watson

Nursing Posters

Study:

After a 1-month pilot of suspending the dual sign-off/independent double-check process, 160/163 random subQ insulin administrations from various units were administered correctly. This yielded a 98% success rate. No patient harm occured.

Plan:

Per Institute of Safe Medication Practices, dual sign-offs/independent double-checks are more effective for select high risk meds and not all. Since implementation of the insulin calculator, medication errors related to subQ insulin administration have reduced compared to previously when solely two licensed staff members performed a manual, independent double-check. After implementation of the validated eMAR tool - the insulin calculator - it was still required for …

A Practice Innovation To Improve Staff Vaccination Knowledge And Skills, Ijeoma Ugochukwu

Nursing Posters

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and …

Atrial Fibrillation In Covid-19: A Descriptive Study Of Incidence, Mortality And Related Factors, Diana L. Taylor

DNP Research Projects

Abstract

This scholarly project determined the relationship of atrial fibrillation (AF) occurrences in COVID-19, as it is the most frequent arrhythmia in the U.S. and is driven by inflammatory pathology. In COVID-19 positive patients with AF occurrences understanding the relationship between these conditions could help identify patients with poor prognosis, higher morality, and other factors earlier in the hospital course.

This single-center scholarly project was a retrospective descriptive chart review to determine the relationship between AF and COVID-19 over a 6-month timeline in Chattanooga, TN. Of the 565 hospitalized COVID-19 positive patients included, 82 (14.5%) had AF occurrences. A higher …

Postpartum Hemorrhage Management: Improving Quality And Patient Safety Through Multidisciplinary Simulation Training, Beverly Mayfield

DNP Research Projects

Abstract

Purpose: To evaluate the effectiveness of a multidisciplinary moderate fidelity simulated postpartum hemorrhage (PPH) educational intervention on accurate and timely adherence to a standard PPH protocol during simulated PPH events.

Methods: The study design was a quasi-experimental one group pretest- posttest time series utilizing a convenience sample of multidisciplinary nurses, nursing assistants, laboratory, and physician staff working at one rural hospital with an annual birthrate less than 100. The intervention was an educational in situ PPH moderate fidelity scenario with pre-brief and debrief. Change in performance was evaluated using unannounced PPH simulation drills at three one-month intervals following the …

Pediatric Caregiver Health Literacy: Comparing Perceptions Of Pediatricians And Nurse Practitioners, Kirbey Flora

Mahurin Honors College Capstone Experience/Thesis Projects

Throughout life, most people will interact with the healthcare system to manage information in order to make healthcare decisions. Health literacy is the ability to comprehend health information needed to make healthcare decisions. Pediatric patients often do not have a voice in their healthcare decisions; therefore, their health outcomes may be affected by the health literacy of their caregivers. In addition, the child’s health may be impacted by the ability of the healthcare team to provide appropriate health education. The purpose of this honors thesis was to determine pediatric healthcare providers’ perception of health literacy in their practices. Qualitative data …

Aromatherapy As A Non-Pharmacological Complementary And Integrative Sleep Intervention For Veterans, Amy D. Stewart

Doctor of Nursing Practice Projects

Twenty-seven percent to 54% of military personnel and veterans experience insomnia, with apnea and insomnia being the most common disorders in this same population. Due to high incidences of sleep disorders in the veteran population, this project sought to identify and validate a non-pharmacological intervention, aromatherapy, as a viable option for veterans with sleep problems. Aromatherapy, essential oils, have proven to be a natural, safe, low-cost, and non-pharmacological option for improving patient health outcomes and patient satisfaction.

Statins And Women, Debra Schulte

Rural Health Professions Projects

Low-density lipoprotein (LDL) elevation is a primary risk factor for atherosclerotic cardiovascular problems such as heart disease and stroke. Heart disease is the leading cause of death in the United States and stroke is the fifth leading. Earlier LDL reduction improves morbidity and mortality. Literature indicates fewer women start statin medications compared to men.

Improving Delirium Assessment In Critical Care, Michelle Reed

Doctor of Nursing Practice Projects

The objective of this project was to identify barriers that impact nurses completing delirium assessments and to improve compliance rates with delirium assessments. The design was an observational, single group pretest-post-test. The preliminary results demonstrated an educational intervention, using the Knowledge-to-Action theory, improved nurses’ compliance with delirium assessments.

Perceptions Of Self-Efficacy And Experiences Of Mindfulness On Pain And Anxiety In Patients Undergoing A Colorectal Surgery: A Prospective Mixed Methods Study, Rebecca Brown, Julie Fitzgibbons, Rachel Farrington

Costas T. Lambrew Research Retreat 2021

Introduction

• Pain and anxiety have a physiological response on the body.

• Increased heart rate, respiratory rate and blood pressure can lead to complications, and thus longer hospitalization along with decreased patient satisfaction.

Counting Stillbirths And Covid 19-There Has Never Been A More Urgent Time, Caroline S E. Homer, Susannah Hopkins Leisher, Neelam Aggarwa, Joseph Akuze, Delly Babona, Hannah Blencowe, John Bolgna, Richard Chawana, Aliki Christou, Rafat Jan

School of Nursing & Midwifery

No abstract provided.

Partnership Between Islam And Palliative Care At Swedish Health Services (First Hill And Cherry Hill), Hodo Mohamud

Articles, Abstracts, and Reports

INTRODUCTION  The spiritual practice of Islam is considered one of the three major monotheistic religions. There is minimal research about Palliative care and Muslim patients in both Muslim majority and Muslim minority countries. Engaging in internal assessment of palliative care provision to Muslim patients is important for quality care. This project aimed to examine gaps in Palliative needs assessment of Muslims in one institution.

OBJECTIVES Assess Swedish palliative care team’s barriers to spiritual care (SC) and baseline knowledge of Islamic influences on healthcare. Interview Muslim patients and insights from a Muslim Imam trained in chaplaincy about PC experience. Develop …

Effect Of Emergency Severity Index (Esi) Annual Competency Assessment On Mistriage Rates, Stefanie Hoffman

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: In order to accurately assign an Emergency Severity Index (ESI) acuity level to patients who present to the emergency department (ED) triage area, it is essential triage nurses remain competent in the ESI triage tool. In addition, effective use of the ESI triage tool is critical in preventing patients from being mistriaged.
Objective: The purpose of this quality improvement project was to determine the effect of an ESI annual competency assessment in an ED for triage trained registered nurses (RNs).
Methods: Triage trained RNs completed an ESI competency assessment composed of 25 patient scenarios in competency assessment A, and …

Improving Emergency Department Quality Of Care, Carmen Smith

Doctor of Nursing Practice Projects

Emergency department (ED) crowding can cause an extended length of stay (LOS) and high rates of patients who leave without being seen (LWBS). This quality improvement ED project sought to reduce LOS and LWBS by implementing a triage (PIT) team. The design included an outcomes evaluation with available data and a staff pre and posttest. Length of stay and LWBS rates were compared before and after implementation. Results indicated a reduction in the average LOS and LWBS rates for the 30 days of project implementation compared to the 30 days before the project initiation. The overall goal of the PIT …

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.

Colorectal Cancer: Screening And Prevention Education, Johnna Boggs

Rural Health Professions Projects

Colorectal cancer is the 2^nd leading cause of cancer related deaths in the United States (USPSTF, 2016). In 2017 there were over 141, 000 cases diagnosed with over 51,000 deaths reported (Center for Disease Control, 2020). This raises great concern for primary care clinicians. One guideline recommended by USPSTF, is that patients undergo screening who are at low to moderate risk for colorectal cancer. This can be done by various studies. Cologuard, which is a fecal occult screening that detects certain DNA markers or blood is currently recognized by the USPSTF for colorectal cancer. The purpose of this quality …

Evaluation Of A Rural Clinic's Compliance With Bone Density Screening In Women Aged 65 And Greater, Chelsea B. Brincks

Rural Health Professions Projects

Osteoporosis affects over 12 million Americans, leading to fractures, chronic pain, reduced independence, and decreased quality of life (United States Preventative Services Task Force [USPSTF], 2018). Up to 30% of individuals who suffer an osteoporotic hip fracture will not survive 12 months post-fracture, and 71% of all osteoporotic fractures occur in women (USPSTF, 2018). Due to increased risk with age, the USPSFT recommends all women have initial bone densitometry at age 65 or greater (2018). Medicare reimburses DEXA screening, the gold standard bone densitometry, every 24 months in individuals at risk (Centers for Medicare & Medicaid Services [CMMS], 2018). The …

Evaluating The Clinical Utility Of A Novel Electroencephalography System For Assessing Perioperative Neurocognition In Older Surgical Patients, Lloyd H. Barnwell Iii

Theses and Dissertations

Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems …

Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More

DNP Projects

Abstract

Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.

Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria …

Evaluating The Use Of Telehealth To Manage Hypertension In Primary Care, Alexandra M. Wiesner

DNP Projects

Background: Hypertension remains one of the most common chronic conditions in the United States leading to several health complications and immense financial burdens, yet it remains grossly undertreated despite the availability of evidence-based treatment options. The 2017 guidelines from the American College of Cardiology and American Heart Association recommended the use of home blood pressure monitoring with a telehealth component as an adjunct to regular hypertension treatment; however, implementing this into practice can be difficult depending on the setting, available resources, and the knowledge and skills of the providers. Aims: The purpose of this investigation is to evaluate patient adherence …