Nursing Commons^™

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

Transient Ischemic Attack And Admission To A Dedicated Unit, Bandi Davini

Student Scholarly Projects

Transient ischemic attacks account for admissions of approximately 70% of patients who present to the emergency department with transient vascular symptoms, with an average length of stay of one to seven days, costing, on average, $22,087 (Qureshi et al., 2013). A hospital organization's bed efficiency directly affects quality metrics. Reducing the length of stay in TIA patients by having them admitted to a dedicated unit with whom the staff has experience managing stroke patients and the understanding of specific criteria needing to be met before discharge can directly impact quality metrics and provide cost-effective delivery of care. The PICOT question …

Preventing And Reducing Nurse Burnout In An Outpatient Military Facility, Lisa Haik

Student Scholarly Projects

Practice Problem: Nurse burnout adversely affects nurses, patients, and healthcare organizations. Implementing changes to address key contributors to burnout can effectively reduce and prevent burnout.

PICOT: The PICOT question that guided this project was: In outpatient clinic nurses (P), how does implementing a bundled strategy (I) compared to not providing interventions (C) affect nurse burnout (O) within eight weeks (T)?

Evidence: Evidence from an extensive literature review showed that there is no single cause for burnout and therefore no single intervention to reduce or prevent it. The primary themes in the literature to address burnout include practicing mindfulness, …

Reducing Central Venous Infections, Desiree Banton

Student Scholarly Projects

Practice Problem: Patients in the hospital are 36.6% more likely to die after a diagnosis of a Central Line-Associated Bloodstream Infection (CLABSI) (Chovanec et al., 2021). The purpose of this evidence-based practice implementation is to reduce CLABSI rates in the Neurological ICU (Neuro ICU) at a private medical center through use of a CLABSI prevention bundle checklist each shift.

PICOT: In the adult neuro-ICU (P), how does implementing a CLABSI prevention bundle checklist each shift (I), compared to current practice (C), affect CLABSI rates (O) within eight weeks (T)?

Evidence: Evidence-based research supports that if clinical staff completed each part …

From The First Encounter: A Communication Program For High Volume, High Acuity Patient Care Locations, Shazam Bacchus

Student Scholarly Projects

Effective communication is a true value to healthcare organizations. Far too many communication sessions are detrimental to patient health outcomes. National data and hospital records are proven information to suggest communication is a major barrier to overall patient satisfaction. Organizations struggle to increase market share and patient satisfaction with a likelihood to recommend because of poor communication by physician and nurses. The use of a strategic communication tool like AIDET plus the Promise can influence the improvement of an organization’s quality of care.

This paper examines the use of AIDET plus the Promise as a strategic communication tool. High volume, …

Establishment Of Unit Based Council Using A Shared Governance Toolkit, Viji George

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational structure that provides healthcare professionals control over their professional practice. Lack of a unit-based council (UBC) was noted as a problem disrupting the shared decision-making and problem-solving approach.

PICOT: In an adult acute care unit lacking a UBC structure (P), what is the effect of the implementation of a SG toolkit (I) compared to no SG toolkit (C) on the establishment of a SG UBC within a period of 10-weeks (T)?

Evidence: The literature evidence suggest that SG enables nurses to engage as a partner with nursing leaders within …

Influence Of Cultural Competency Program On Bias In A Community Volunteer Program, Melodie L. Anderson

Student Scholarly Projects

Practice Problem: Individuals may express hesitancy in volunteering in community health programs that directly interface with persons experiencing poverty due to poverty biases. Failure to understand the issues and needs of those experiencing poverty may factor into disparities and inequities along the social determinants of health, leading to poorer population health, well-being, and quality of life.

PICOT: The PICOT question that guided this project was in volunteers (mentors) of community health programs (P) how does a cultural competency program (I) compare to the standardized training program(C) influence bias (0) over 8 weeks (T)?

Evidence: An evidence review indicated …

Increasing Appointment Adherence In Patients With Diabetes Mellitus Via Appointment Reminders And Patient Education, Leslie Guy

Student Scholarly Projects

Practice Problem: Appointment no-shows and nonadherence have been an organization-wide concern within the project setting, resulting in increased healthcare costs and workload while disrupting the continuity of patient care.

PICOT: The PICOT question that guided this project was: In adult diabetic patients ages 19-99 (P), how do appointment reminders by nursing staff and patient education related to appointment adherence (I) compared to the current practice of appointment reminders by administrative assistants and no patient education related to appointment adherence (C) affect appointment adherence rates (O) within ten weeks (T)?

Evidence: Current evidence demonstrates that patient appointment reminders improve appointment …

The Utilization Of Stress Management In Critical Care Nurses To Decrease Nursing Burnout, Danny Atkins

Student Scholarly Projects

Practice Problem: Since COVID-19, nurses have felt the pressure from the pandemic on their shoulders. The practice problem has helped nurses manage stressors to decrease the symptoms of burnout.

PICOT: In critical care nurses (P), how does the implementation of HeartMath techniques for stress management (I) compared to standard practice (C) affect rates of absenteeism, request for assignment transfer, and resignations (O) over 8-weeks (T)?

Evidence: The evidence that guided this project change is based on the Johns Hopkins nursing evidenced-based-practice model.

Intervention: The intervention assisted critical care nurses in dealing with stress and fatigue by …

Implementation Of Daily Nhppd Calculator In The Acute Care Setting, Spencer Y. Cho

Student Scholarly Projects

Practice Problem: In the United States, it is estimated that hospitalized patients experience an adverse event that require a rapid response and/or code blue event in 3% to 18% of hospitalizations.

PICOT: In the adult medical-surgical inpatient (P), does the implementation of a daily NHPPD calculator (DNC) (I) compared to an annual staffing methodology for calculating NHPPD (C) reduce rapid response calls, code blue episodes, and unplanned admission to critical care (O) over 8 weeks (T).

Evidence: Seven studies provided evidence that implementation of staffing methodology, nursing surveillance, and nurse staffing that supports meeting targeted nursing hours per patient …

An Evidence-Based Practice Handbook For The Reduction Of Perioperative Pressure Injuries: An Implementation Guide, Krystal Dopson

Student Scholarly Projects

The Association of Perioperative Nurses (AORN) Prevention of Perioperative Pressure Injury Tool Kit is a comprehensive set of evidence-based practices that can reduce the development of pressure injuries (PI) (AORN, 2022). A bundled set of prevention strategies is positively associated with reducing the development of injury or ulceration and improved patient outcomes. To effectively implement this Prevention of Perioperative Pressure Injury Tool Kit, there are evidenced strategic practices to support change readiness, including engaging stakeholders around the reasons for the change, gaining leadership support, assembling an interprofessional implementation team, providing compelling information that highlights the need for the change, and …

A Contemporary Shared Governance Structure And Its Role In Managing Nurse Turnover, Kagale Kiwanuka

Student Scholarly Projects

Practice Problem: Nurse turnover can adversely impact any health system's financial performance and the clinical practice environment, and it is detrimental to patient safety and quality of care.

PICOT: The PICOT question that guided this project was for nurses on a Labor and Delivery and Antepartum unit at a 382-bed community hospital in Austell, GA(P), does the utility of a contemporary shared governance structure in everyday practice (I) compared to the current shared governance structure (C) decrease nurse turnover rates (O) within four weeks (T)?

Evidence: Shared governance permits the reduction of turnover and the intent to …

Oral Care Bundle Impact On Staff Assisted Oral Care, Sabrina Oliver

Student Scholarly Projects

Practice Problem: Non-ventilator hospital acquired pneumonia (NV-HAP) is more common than ventilator acquired pneumonia. Oral care is the only modifiable risk factor for all patient populations.

PICOT: The PICOT question that guided this project was: In non-ventilated patients in a tertiary care setting (P), how does implementing an oral care bundle (I) compared to the current practice of individual tasks without a bundle (C) affect adherence to facility oral care standard of patients receiving oral care at least once a day (O) over six weeks (T)?

Evidence: Lack of an oral bundle that has been proven to decrease …