Nursing Commons^™

Optimizing The Assisted Living Experience: Integration Of Value-Based Care To Foster Augmented Resident-Centered Quality, Jennette Pietrzak

DNP Scholarly Projects

Background: Fee-for-Service models are quantity-focused reactive approaches and have historically been at the forefront of healthcare. Value-based models focus on proactive, resident-centered care that is aimed at quality care over quantity. Implementation of ValueBased Care models can positively impact healthcare and fiscal outcomes

Purpose: The quality improvement project aimed to develop, integrate, and implement a valuebased model in Memory Care as an alternative to traditional Fee-for-Service models. The project aimed to improve key performance indicators by reducing hospitalizations, emergency room visits, and falls following the implementation of Value-Based Care (VBC) models.

Method: Data metrics for hospitalizations, emergency room visits, and …

Educational Plan For Certified Nursing Assistants In Long-Term Care Facilities On Assessing Pain Of Residents With Dementia, Rachel Lynn Spoon

DNP Scholarly Projects

Certified nursing assistants employed in long-term care agencies may have little education on the assessment of pain experienced by residents with dementia. The purpose of the Doctor of Nursing Practice Project was to develop an evidenced-based teaching plan for certified nursing assistants caring for residents with dementia in long-term care settings. The plan includes content on dementia, dementia symptoms, pain indicators, and pain assessment in residents with dementia, non-medicinal management strategies, and communication strategies for referring assessment findings to licensed practical and registered nurses. Supplemental PowerPoint™ slides were developed that match the teaching plan. The draft teaching plan was judged …

Implementation Of Telehealth Clinical Nurse Leader Interventions To Reduce Rehospitalizations In Rural Home Health Patients, Briana White

DNP Scholarly Projects

Reimbursement for home-based care is moving towards a value-based purchasing (VBP) model. This change brings a renewed sense of urgency to focus efforts in care delivery to sustain positive outcomes such as reducing rehospitalizations. The Clinical Nurse Leader role has been instrumental in hospital settings in improving patient outcomes, and evidence points toward the potential success of implementation of this role in the rural microsystem setting. This quality improvement project implemented a remote telehealth intervention led by Clinical Nurse Leaders, to decrease rehospitalizations of Medicare patients assessed as at-risk for 30-day rehospitalization. The DMAIC QI model was used to ensure …

Increasing Rates Of Urine Albumin Creatinine Ratio Ordering By Providers In Diabetics In Adult Primary Care: A Quality Improvement Initiative, James Ehrlich

DNP Scholarly Projects

Background: The rising incidence of diabetes within the United States and worldwide has led to increased diabetes related morbidity and mortality. As the leading cause of end stage renal disease (ESRD), more attention needs to be placed on increasing rates of diabetic nephropathy screening. The vast majority of diabetics are treated in primary care, positioning primary care as a center focus for diabetes related screening and treatment.

Local problem: Low rates of diabetic nephropathy screening were noted at an academic medical center affiliated primary care clinic. A quality improvement initiative was elicited to increase the number of urine microalbumin creatine …

A Quality Improvement Project To Improve Communication And Reduce Hospital Readmissions, Mackenzie Thomas

DNP Scholarly Projects

Background: More than 25 million people are readmitted to the hospital within 30 days of nursing home admission. With most nursing home patients receiving Medicare, Medicaid, or other publicly funded services, readmissions significantly burden the healthcare system. Poor communication within nursing homes may contribute to poor health outcomes and unplanned hospital readmissions. Purpose: To reduce readmission rates at two skilled nursing facilities by improving staff communication through consistent use of the INTERACT STOP AND WATCH (SW) tool. Design: The quality improvement project reviewed all admissions, transfers, and readmissions occurring before and during the project to determine the impact of the …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

Implementation Of Safe Patient Toileting To Decrease Patient Falls On Medical-Surgical Unit, Kimberly A. Goldsborough

DNP Scholarly Projects

BACKGROUND: Patient falls are a serious safety concern in the hospital setting throughout the country. Falls are one of the most challenging patient safety events to prevent, as there are many contributing factors with toileting activities producing the highest incidence. Fall prevention bundles are used to minimize and reduce these such events although multifaceted. The project was conducted with an academic medical center on an acute inpatient medical-surgical unit primarily housing burn wound patients. Nursing leaders and front-line nursing staff participated.

METHODS: Literature review to determine the gap in knowledge of interventions to prevent acute inpatient falls was completed. Concepts …

An Inpatient Rehabilitation Interprofessional Care Pathway For Traumatic Hip Fracture: A Pilot Quality Improvement Project, Sarah Plante

DNP Scholarly Projects

Background: Each year over 300,000 older adults are hospitalized for hip fracture. The impact of the cost of hip fracture on the US health care system is estimated to be as high as $9 billion, with the typical cost of a hip fracture episode around $30,000. Formalized pathways have been developed and successfully utilized for many patient presentations, including hip fracture, in the acute setting. Although this research is important to the comprehensive care of the elderly hip fracture patient, very little research exists that outlines evidence-based best-practice for patients in the post-acute recovery period.

Purpose: The primary aim of …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …