Nursing Commons^™

Identification Of Potentially Inappropriate Medication Utilizing The Beers Criteria Among Elderly Patients, Christine B. Mitchell

Doctor of Nursing Practice

Background: The normal process of aging causes numerous physiological changes that affect pharmacodynamics and pharmacokinetics. Therefore, the geriatric population is more vulnerable to the effects of potentially inappropriate medication. The American Geriatric Society’s Beers Criteria identifies potentially inappropriate medication to be avoided for this population and can be implemented in efforts to avoid risks associated for this population.

Aim and Methods: The purpose of this project was to implement the Beers Criteria to identify potentially inappropriate medications among patients 65 years and older. The objectives were to increase the percentage of charts reviewed for inappropriate medications and to increase the …

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Dissertations, Masters Theses, Capstones, and Culminating Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained …

Advanced Disease Management In Home Healthcare: Palliative Integration, Missy Stober

Graduate Theses, Dissertations, and Capstones

Advanced Disease Management in Home Healthcare: Palliative Care Integration

Abstract

With home health caring for patients with serious illnesses and advancing disease states, palliative care in a community setting like the home, can provide many benefits. This population currently has a gap in the healthcare continuum at the point of advancing disease state to end of life care. Recently, new payment models based around clinical outcomes, including hospitalization scores and quality indicators, has caused home health to explore different ways to deliver quality and effective care, especially for those with the highest risk of hospitalization. A literature review was conducted …

Implementation Of The Banner Mobility Assessment Tool For Bariatric Patients, Nicole Benkert

Scholars Week

Abstract

The prevalence of morbidly obese patient within the United States is on a rapid incline. Evidence correlates an increase in patient falls, comorbidities, and hospital admission among this specific patient group. As a result, there is an increase in workload and injuries to staff as they tend to these patients. Healthcare facilities need to continuously update current patient handling programs and create specific policies for safely handling obese patients. Research suggests that Safe Patient Handling and Mobility Programs, as well as the Banner Mobility Assessment Tool (BMAT), have substantially decreased nurse injuries through a wide range of nursing specialties. …

Mobility And Aging: The Benefits Of Incorporating Yoga Amongst Seniors, Chelsey Davenport, Scott Gorman, Laura Covert

Paper Presentations

Aging happens to everyone on different levels. As we get older our bodies naturally have the tendency to lose flexibility and our joints become less mobile and rigid. One must continue to move in ways that allows the body to stay active in a healthy and obtainable way. This paper will discuss the importance of physical fitness for senior citizens while incorporating yoga into daily life. I will focus my research on the mental and physical effects of how yoga can help older adults with symptoms of arthritis, disease and illness, while using breathing exercises for overall better relaxation and …

Direct Care Nursing Aide Turnover In Long-Term Care Facility, Qilian Luo

Muskie School Capstones and Dissertations

This capstone project, Direct Care Nursing Aide Retention in a Long-Term Care Facility, will uses both qualitative and quantitative analyses to identify the possible contributors to high nursing aide turnover rates in Maine. The quantitative analyses of this project are based on the staffing payroll data of one Maine assisted living facility. The final product of this capstone project will be shared with the study facility, in the hope that they may find uses for its content.

Identification Of Risk Factors Associated With Falls In The Long Term Care Setting, Jacqueline L. Patel, Dnp, Ms, Anp-Bc

Doctor of Nursing Practice Projects

Background: Falls threaten the safety of older adults in long term care (LTC).

Objectives: To assess environmental, clinical and pharmacological causes of falls as well as compare Fall Risk Assessment Score, Brief Interview of Mental Status (BIMS) score, Activities of Daily Living (ADL) scores, age and gender of residents with one fall, recurrent falls, and no falls.

Methods: Using a descriptive-comparative design, we included a convenience sample of 290 adults ≥50 years old at our LTC facility. Fall and recurrent fall groups were matched to those with no falls. We assessed environmental, clinical and pharmacological variables, Fall Risk Assessment Scores, …

Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong

Doctoral Projects

The purpose of the project was to examine if the identification of readiness for an advance care planning (ACP) discussion of elderly participants would enhance the outcomes of participants' satisfaction, improve the likelihood of having an ACP discussion and increase the completion rates of an advance directive (AD) document after an office visit.

Forty-four elderly participants, who met the selection criteria, were recruited from a primary clinic in Northern California from October 1, 2017 to December 31, 2017 (Female, n =28). All participants were randomly assigned to either an intervention group (n= 22) or a control group ( …

Health Benefits Of Pet Ownership For Older Adults, Molly Cook, Sydney Busch

Grace Peterson Nursing Research Colloquium

Background: Over the last few decades, life expectancy has increased causing a significant rise and rising number of senior citizens. This has resulted in greater demand and spending in healthcare for this growing population, due to, the increase risk for health problems that are associated with older age.

Objectives: The purpose of this literature review is to examine the health benefits of pet ownership for older adults. This study will provide information on what health benefits come with pet ownership, and how this can affect the elderly population.

Method: A computerized integrative review was conducted using various combinations of the …

Adult Day Service Providers: Untapped Potential For Care Coordination, Nicole Ruggiano, Ellen L. Brown, Karen L. Fortuna

Nursing & Health Sciences Research Journal

Adult Day Services (ADS) have become increasingly available for community-dwelling older adults who are often experiencing multiple chronic conditions and/or dementia. ADS providers spend a significant amount of time with their clients and offer the opportunity for a wealth of clinical information that can be used by primary care providers and specialists for decision-making about patient care. There are also opportunities for hospitals to coordinate care transitions with ADS providers by involving them with discharge planning with appropriate patients who require post-hospital care. However, ADS providers are often viewed as social service providers, and there is little known about the …

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Aerobic Physical Exercise Increases The Health-Related Quality Of Life In Older Adults, Patricia L. Parker

Doctor of Nursing Practice Projects

Abstract

Problem Description: Globally, the older adult population is expected to substantially increase in number throughout the next few decades. The aging process causes the body and mind to undergo many detrimental changes. Typically, older adults succumb to a more sedentary lifestyle due to factors such as decreased musculature and skeletal changes, chronic pain, socioeconomic and psychological stressors, and memory changes. Inevitably, health-related quality of life and overall independence dwindles in this population negating their perception of happiness and life satisfaction. There is significant research on preventing and/or managing cognitive disabilities in the older adult; however, Western medicine approaches, such …

Outcomes Of Family Presence During Resuscitation (Fpdr) In The Acute Care Setting: A Review Of The Literature, Audra M. Corn

Honors Undergraduate Theses

Family Presence During Resuscitation (FPDR) remains controversial and is not consistently implemented during resuscitation events or invasive procedures. Evidence has demonstrated positive outcomes produced by implementation of FPDR; such as, decreased rates of post-traumatic stress symptoms, decreased symptoms of anxiety, and depressive symptoms were not significantly different. Unfortunately, use of FPDR in the acute care setting is not widely accepted or readily implemented. The primary purpose of this integrative literature review is to evaluate the use of FPDR in the acute care setting. The secondary purpose is to evaluate the health care professional's level of perceived value associated with the …

Transitional Care Medical House Call: A Pilot Project, Ron B. Ordona

Doctor of Nursing Practice Projects

Problem Description: Vulnerable, homebound older adults are highly susceptible to unplanned 30-day hospital readmissions, which is costly for the healthcare system. As a result, health care expenditures for this population continue to rise. Studies have shown that transition of care programs, when complemented with home-based primary care delivery, may improve health care outcomes for this population.

Purpose: The purpose of this quality improvement pilot project was to implement medical house calls as a component of transitional care management (TCM) and measure patient outcomes such as unplanned 30-day readmission rates and correlate predictors of readmission. As a secondary outcome, the project …

Job Satisfaction Of Nursing Home Administrators, Cathy Abell

Nursing Faculty Publications

Background: The older adult population, age 65 and older, in the United States has increased 30% since 2005 and is projected to continue to grow. Nursing homes have become the living arrangement for some older adults. Nursing home administrators (NHAs) can play a vital role in the long-term care industry. Job satisfaction is important as it can enhance retention of NHAs.Methods: A purposive sample of NHAs was utilized for this descriptive correlational research study to examine job satisfaction. A researcher developed demographic questionnaire and the Nursing Home Administrator Job Satisfaction Questionnaire (NHA-JSQ), which has six specific domains, were utilized to …

Comparing Perceptions Of Hospice Care In Northeast Mississippi, Christina Metz

Merge

In an effort to identify a population possibly responsible for the underutilization of hospice care and services in northeast Mississippi, the student researcher compared the average perceptions among healthcare professionals and the general public. Having anticipated there was a significant difference between the averages of the two populations, the student researcher tested a null hypothesis that there was no statistically significant difference between the average perceptions of hospice care among healthcare professionals and the general public in northeast Mississippi. The two 37-member sample populations were formed using convenience sampling and were asked to complete a survey of knowledge and opinion-based …

Effects Of Music Therapy On Individuals With Dementia: An Intergrative Literature Review, Liani Sanchez

Honors Undergraduate Theses

The purpose of this integrative review was to examine the effects of music therapy, a complementary intervention, on individuals with dementia. Peer-reviewed journals were retrieved from MEDLINE, CINAHL, CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Music Index to evaluate their relevance to music therapy use in people diagnosed with dementia. English and Spanish-language research articles published from 2000-2017 were included for the review (n=15). The literature indicates the use of music therapy as an adjuvant therapy for the treatment of dementia in older adults may be beneficial in decreasing symptoms of aggression, anxiety, agitation and depression. …

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

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 …

Social Support, Relationship Quality, And Self-Care Behaviors In Patients With Heart Failure, Majdi Mohammad Rababa

Theses and Dissertations--Nursing

The purpose of this dissertation was to examine the associations among social support, gender, relationship quality, and self-care behaviors in patients with heart failure (HF). Specific aims were to: 1) compare the psychometric properties of the 12-item and the 9-item European Heart Failure Self-Care Behavior Scale (EHFScBS) when used to measure self-care behaviors in patients with HF in the United States; 2) determine whether gender moderated the association between perceived social support and daily sodium intake in patients with HF; and 3) determine whether a patient’s gender and relationship with the primary family caregiver (spousal or non-spousal) moderated the association …

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 …

Education On Fall Prevention To Improve Self-Efficacy Of Nursing Staff In Long Term Care: A Pilot Study, Mark D. Leverenz, Jennifer Lape

Internet Journal of Allied Health Sciences and Practice

Purpose: Fall prevention is an ongoing concern in long-term care. Self-efficacy of nursing staff affects their performance levels related to fall prevention. Research concerning falls in the elderly is plentiful but there are no published studies addressing self-efficacy of nursing staff for implementation of fall prevention strategies in long-term care. The authors hypothesize that fall prevention education by an occupational therapist would be effective to improve the self-efficacy of nursing staff for implementation of fall prevention strategies and self-efficacy to prevent resident falls.

Method: A pre-test post-test pilot study implementing a five-week, multifaceted, fall prevention education course was conducted by …

The Effect Of An American Heart Association Telephone Follow-Up Intervention On Knowledge And Self-Efficacy In Rural Heart Failure Patients, Haley Fuller

DNP Projects

Background: An increased national and local prevalence of heart failure fostered a review of the evidence to identify best practice interventions focusing on improving self-care and knowledge. Heart failure remains a leading cause of 30-day readmission in the United States and in Madisonville, Kentucky, the site of study. A review of the literature emphasized improving transitions from hospital to home with a multi-dimensional approach. Self-care and knowledge were identified as major determinants to adequately prepare a patient to manage this chronic disease. A pre- and post quasi experimental study was performed at a rural hospital in Kentucky. Objective: The goal …

An Assessment Of Potentially Inappropriate Medications Among The Elderly And The Effect Of An Educational Intervention On Provider Knowledge Of These Medications, Amanda Brown

DNP Projects

Objectives: The aims of this study were to assess potentially inappropriate medications (PIMs) or Beers medications among outpatient older adults within one Midwestern healthcare system, to determine rates of patient education on Beers medications, and to pilot an educational intervention for providers.

Methods: This study involved two parts. For part 1 of the study, a randomized retrospective chart review of 493 older adult patients seen in 2017 from four practices was conducted to assess Beers medication prescriptions and rates of patient education. Following the chart review, for part 2 of the study, an educational intervention was delivered to two providers …

Barriers To Promoting Mobility In Hospitalized Older Adults, Gordana Dermody, Christine R. Kovach

Research outputs 2014 to 2021

Hospitalized older adults who do not receive sufficient mobility are more likely to sustain negative health outcomes, including higher rates of mortality and institutionalization. Accordingly, the purpose of the current secondary data analysis was to examine the nurse-promoted mobility of hospitalized older adults and the association between nurses’ barriers and nurse-promoted mobility. In addition, the relationship among patient severity of illness, proxy levels for function, and nurse-promoted mobility was examined. The final study sample included 61 nurses working in medical units caring for a total of 77 older adults. Findings suggest nurse knowledge gaps and attitude barriers could potentially influence …

A Systematic Review Of Non-Pharmacological Interventions To Improve Nighttime Sleep Among Residents Of Long-Term Care Settings, Elizabeth Capezuti, Rana Sagha Zadeh, Kevin Pain, Aleksa Basara, Nancy Ziyan Jiang, Ana C. Krieger

Publications and Research

Background: Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents.

Methods: The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome. We categorized each intervention …

Exploring The Lived Experiences Of Female Retirement Living Seniors And Their Social Relationships, Kathy Procyk

Theses and Dissertations (Comprehensive)

Objective

This research examines the lived experiences of seniors living within a retirement home (RH) and their social relationships with friends, family, and RH peers. The phenomena is explored through two perspectives (the senior and their support person) in order to better understand how retirement home living affects individuals’ social patterns and social well-being.

Methods

The theoretical orientation used to guide this study was phenomenology. After completing a background questionnaire, one-on-one semi-structured interviews were conducted with 11 women living in a retirement home and 7 primary support persons. Interviews were transcribed verbatim for further data analysis. Field notes, member checks, …

The Applicability Of The Decisional Conflict Scale In Nursing Home Placement Decision Among Chinese Family Caregivers: A Mixed Methods Approach, Yu-Ping Chang, Loralee Sessanna, Joanne Kraenzle Schneider

Asian/Pacific Island Nursing Journal

This study aimed to 1) examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2) describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data.

We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. …

The Effectiveness Of Nurse-Driven Early Mobility Protocol, Viktoriya Fridman

Seton Hall University DNP Final Projects

Purpose: The purpose of this quality initiative is to introduce the nurse driven evidence-based practice change related to patient mobility in the hospital setting with the aim to improve nurse knowledge, attitude, and behavior on a medical-surgical unit.

Significance of Project: The proposed DNP quality project is devised from the American Academy of Nursing (AAN) Choosing Wisely campaign unique to the elements of “don’t let older adults lay in bed or only get up to a chair during their hospital stay” to achieve a practice change. A significant aspect of patient care in a hospital setting is patient …