Nursing Commons^™

Avoiding 30-Day Readmissions Of Acute Mi Patients Utilizing Cardiac Rehabilitation, Patricia T. Forsberg

Doctor of Nursing Practice (DNP) Projects

A significant number of Acute Myocardial Infarction (AMI) patients were readmitted to an urban San Francisco Medical Center within 5-7 days post discharge this year. Two of the main identified causes were symptom management issues and medication instructions, both of which are part of the discharge instructions. It’s not surprising that 80% of all discharge teaching is forgotten by patients by the time they hit the parking lot. With the recommended timeframe for post discharge follow up appointments at 48 to 72 hours post discharge and as those appointments are not typically available within the recommended timeframe, patients are more …

Minimizing Avoidable Interruptions During Medication Administration, Jaleel Anne Arnado

Master's Projects and Capstones

The objective of this CNL Internship Project is to improve patient outcomes and nurse satisfaction by minimizing the avoidable interruptions that occur during medication administration. The microsystem is a pediatric and adult medical-surgical overflow unit at a large, urban teaching hospital in Northern California. A series of surveys for nurses and patients and observations of medication administrations were conducted to assess barriers during mediation administration. It was determined phone calls interrupt a nurse the most during medication administration. Interruptions leave the medication administration process vulnerable to errors because it disrupts the nurse’s workflow and thought process. Because most pediatric medication …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Family Nurse Practitioner Mentoring Relationships' Impact On Organizational Commitment, Patricia Bartley-Daniele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family nurse practitioners (FNPs) are vital primary care providers who are responding to increased primary health care needs in the United States. Organizational commitment is reflective of workplace relationships that foster professional development, innovation, and outcome achievement. An organizationally committed FNP workforce is essential to achieving primary health care goals.

Mentorship has been proposed as a strategy to foster FNP organizational commitment. Mentoring has been characterized as a teaching-learning relationship. The mentor can serve as a guide to foster graduate FNP practitioner transition into primary care practice. Types of mentoring relationships occur in formal workplace settings or develop as informal …

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

Improving The Patient Experience Through Nurse Leader Rounds, Judy C. Morton, Jodi Brekhus, Megan Reynolds, Anna Kay Dykes

Patient Experience Journal

While providing exceptional care experiences to patients is a priority for many organizations, creating and sustaining measureable success in this area remains a challenge for many. This article examines the impact of implementing nurse leader rounds on patient perception of care in the hospitals and emergency departments of a large healthcare system. Nurse leader rounds were implemented as a system-wide improvement practice at Providence Health & Services in 2012. Analysis of Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results indicates that implementation of nurse leader rounds is associated with statistically significant improvement in patient …

Comparing Generational Differences In Job Satisfaction And Retention (Anticipated Turnover) Among Nurses Working In Magnet Versus Non-Magnet Designated Hospitals, Laura E. Cima

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Experts in the nursing profession predict a catastrophic nursing shortage by 2025. Nursing shortages have devastating effects on hospitals from a quality of care, patient and family satisfaction and financial perspectives. Given these issues, the most logical approach to this shortage is retention of nurses rather than recruitment. The Magnet designation is one mechanism to retain nursing staff.

Another phenomenon exists within the work environment that makes this shortage different from others. Currently, there are four generations of nurses working in the healthcare environment. Each of these generational cohorts has different values and …

Re-Engineered Discharge Planning In A Rural Mississippi Hospital To Reduce 30 Day Readmission Rates Among Heart Failure Patients, Roxie Mae Hogan

Doctoral Projects

The hospital discharge is a complex process that involves interdisciplinary efforts to avoid readmissions and decrease health care costs. The purpose of this capstone project was to take a leadership role in translating evidence into practice by successfully preparing NWMRMC discharge planning stakeholders to adapt Project RED for use with HF patients admitted to NWMRMC.

A comprehensive systematic improvement plan, Project RED is designed to improve the work flow process through the use of timelines and strategies. Project RED supports discharge planning, helps to prevent readmission, and facilitates knowledge transfer that promotes sustainable changes. Re-Engineered Discharge Planning (RED), 6 step …

The Effect Of A Professional Practice Model On Clinical Nurses' Perceptions Of Their Practice Environment And Job Satisfaction On Medical And Medical-Surgical Units, Susan Zimmermann

Dissertations, Theses and Capstone Projects

Purpose: The purpose of this study is to examine the effect of a PPM on clinical nurses’ perceptions of their practice environment and job satisfaction. Secondly, this study examined clinical nurses’ perceptions of the PPM through survey questions focusing on elements of the PPM.

Design: A descriptive, pretest-posttest design using secondary data to analyze nurses’ perception of their practice environment and job satisfaction before and after implementation of the healthcare organizations PPM. Also, a prospective design using a survey method was used to measure nurses’ perceptions of the PPM.

Methods: Data were collected from a convenience sample …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

Psycap And The Impact On The Development Of Intercultural Sensitivity Of Healthcare Educators: A Mixed Methods Study, Helen A. S. Fagan

Department of Agricultural Leadership, Education, and Communication: Dissertations, Theses, and Student Research

This purpose of this explanatory sequential mixed methods study was to examine the intercultural sensitivity development process of faculty and staff at a health sciences college in the Midwest. In the quantitative phase, this study investigated changes in intercultural sensitivity over a three year period, along with the relationship between developmental level of intercultural sensitivity (as measured by Intercultural Development Inventory [IDI] [Hammer, Bennett, & Wiseman, 2003]) of participants and Psychological Capital (PsyCap, a multidimensional construct consisting of hope, efficacy, resiliency, and optimism [Luthans, Youssef, & Avolio, 2007]). In the qualitative phase (Case Study) data collection and analysis further explored …

Optimizing Care -- Inspiring Leadership To Improve Quality And Efficiency While Controlling Costs, Anne Panik Ms, Rn, Nea-Bc, Kim Jordan Mha, Bsn, Rn, Ne-Bc

Patient Care Services / Nursing

No abstract provided.

Nursing's Ethical Responsibilities In Value-Based Purchasing, Wendy B. Bailes, Marcia M. Rachel, Sheila Keller

Journal of Health Ethics

Healthcare changes have resulted in the development of reimbursement initiatives such as value-based purchasing. These initiatives are designed to improve quality of care, decrease healthcare costs and improve the perception of care. Many of the compliance mandates are related to care provided by the professional nurse. Ethical considerations of these mandates will be explored utilizing the American Nurses Association Code of Ethics.

Healthy Work Environment Orientation Training And Psychiatric Nurse Retention, Lawanda Rollins

Walden Dissertations and Doctoral Studies

According to recent research, more than 75% of newly employed nurses leave employment within 6 months. Changes in organizational training programs are needed in order to improve psychiatric nurse retention, nationally and globally. A healthy work environment (HWE) has been described as an environment that includes mentoring for good communication skills; it is also one that explores collaborative strategies for safe practice; professional advancement; and empowerment through research, education, and skill development. Examination of the impact of this HWE psychiatric nurse orientation training program on nurse retention was done using Rogers' theory of diffusion. Study variables included the length of …

Enhancing Nurses' Perceptions Of Patient Safety Culture Through The Just Culture Model, Aida Solomon

Walden Dissertations and Doctoral Studies

An organizational culture of safety affects employees' attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The purpose of this project was to determine the influence of introducing the just culture model through staff engagement in an interactive workshop. A convenience sample of acute care staff were recruited for this 1-sample pretest and posttest project design. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture instrument was used to measure safety culture perceptions on 7 dimensions pre and post intervention. For the theoretical framework, Ajzen's theory of …

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

Perceptions Of A Dedicated Education Unit In The Mississippi Delta, Jacquelyn Felecia Brownlow

Doctoral Projects

The highest health care disparities in the country plague the Mississippi Delta. A weakened economy, minimal access to healthcare and an outdated traditional clinical learning environment place enormous strains on nursing education in this area to provide more nurses. The office of Nursing Workforce reported a 14% to 16% nursing turnover in the Delta compared to the national average of 13.5%. As a result, the health care organization has encountered high nurse turnover, increased staffing shortages, and a decrease in nursing quality indicators. As an effort to improve clinical education and bridge gaps between education and practice, several schools in …

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

Transforming Patient Care Through Telehealth (Presentation), Joseph Tracy Ms, Ba, Terry A. Capuano Mba, Msn, Rn, Fache, Ne-Bc, Anne Panik Ms, Rn, Nea-Bc, Sharon Kromer Ccrc, Ctc, Lori Yesenofski Msn, Rn, Ccrn, Ctc

Patient Care Services / Nursing

No abstract provided.

The Influence Of Organizational Culture On Affinity For Knowledge Management Practices Of Registered Nurses, Gregory Allen

Faculty Publications - George Fox Digital

This study addressed the problems of hospitals’ duplicated effort and ad hoc knowledge management (KM) practices. The purpose of this quantitative study was to examine the focus and type of organizational culture in order to describe and predict the relationship between organizational culture and the affinity for KM of nurses working in health care organizations in Portland, Oregon. Guided by the competing values framework and social capital theory, this research study was undertaken to illuminate the possible relationship between the affinity for and probable use of KM and organizational culture in Oregon hospitals. Data were collected from 93 registered nurses …

Evaluation Of An Educational Intervention On Perceptions Of A Patient Safety Culture Among Staff In Acute Care Nursing Units, Cynthia Ann Parkman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety has always been a central focus of nursing practice. Current research makes it increasingly clear that what occurs in the surrounding health care environment impacts patient safety. The protracted nursing shortage and nurse turnover may adversely affect patient outcomes and are exacerbated by an environment of disruptive behavior, conflict, and poor communication in the nursing workplace. The Joint Commission has identified these behaviors as key elements that jeopardize the "culture of safety" necessary to assure safe, quality patient outcomes. A culture of safety includes the attributes of teamwork, communication openness, collaboration, and a manager's positive focus on prevention …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …

Barriers To Health Care For People With Disabilities And Practice Administrators’ Knowledge Of The Ada: Nevada Compared With The Nation, Jennifer Pharr, Michelle Chino

Interdisciplinary Research Scholarship Day

The purpose of this study was to determine if the number of barriers reported in the clinics could be predicted by characteristics of the administrators or
characteristics of the practice.To increase accessibility to health care, interventions should focus on practices located in buildings built before 1993, practices with administrators who are younger and have limited experience as administrators, administrators with low levels of ADA knowledge and practices with smaller number of patients.

Effects Of An Interprofessional Simulation Activity To Improve Students' Perceptions Of Other Healthcare Professions, Chase Raymond Poulsen

STEMPS Theses & Dissertations

Healthcare professionals have historically been educated and trained by members of their own profession within a curriculum that reinforces their individual discipline-specific strengths. This differentiation has contributed to students having little interaction with other professionals until after they have entered the workforce and consequently little formal education in collaboration or integration. The purpose of this mixed-method study was to evaluate the impact of an interprofessional (IP) collaborative activity on student's perceptions of the others discipline for the improvement in care of medical patients.

The sample population consisted of students from two programs, nursing (n=40) and respiratory therapy (n=33). Students were …

The Challenges And Blessings Of Missionary Nursing In Africa, Jordan E. Woosley

Senior Honors Theses

Nursing is a popular career choice in the twenty-first century, and there are many opportunities within the profession to serve. An American nurse has the ability to utilize nursing skills in Africa and share knowledge with the locals. The American nurse may face challenges when adapting to the African culture and healthcare but also may be blessed by the work and ministering to the people. The American nurse faces specific challenges such as educational differences, lack of facilities and equipment, unique diseases, and poor sanitation. In spite of these challenges, the American missionary nurse is able to grow through this …

Value Based Purchasing: Positioning A Healthcare Organization For The Future, James Dale Heard

Doctoral Projects

In 2005, the Deficit Reduction Act introduced Value Based Purchasing (VBP) into the healthcare system as a means of hospital reimbursement for acute care hospitals receiving reimbursements from the Centers of Medicare and Medicaid (CMS). The purpose of this Capstone Project was to increase the knowledge of healthcare executives concerning Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and VBP and the effect it will place on the organization though the utilization of a consultant program. The role of the consultant in this project is to provide expert advice to healthcare executives about the impacts of HCAHPS and provide …

Advancing Leadership In Public Healthcare: Beyond Crowded Hospitals And Labour Shortfalls, Singapore Management University

Perspectives@SMU

Features a panel discussion on the Singapore ageing population and the expanding demand for healthcare by four public healthcare leaders, at the SMU-Singhealth Graduate Diploma in Healthcare Management and Leadership graduation ceremony.