Implementation Strategies To Reduce Hospital Readmission Rates In Adults With Sepsis: A Quality Improvement Project, Erin Kucharek

Doctoral Projects

Background: Sepsis is a concern in healthcare, as patients are 2 to 3 times more likely to be readmitted to the hospital than those with other illnesses. Readmitted patient with sepsis costs the healthcare system $3.5 billion dollars per year. Effective care coordination is a tool that decreases readmission rates in other illnesses and is likely applicable to those with sepsis. The purpose of this quality improvement project was to determine if primary care provider follow-up appointments, increased home care utilization, and patient education would reduce sepsis readmissions.

Methods: The Transitional Care Model guided project design and The Kotter Model …

Utilization Of Patient Toolkit And Discharge Algorithm For Providers To Reduce Readmission Due To Repeat Ground Level Fall, Sara Karl

Doctoral Projects

Introduction. Falls are the leading cause of injury and injury death in adults over the age of 65. A retrospective examination at Level 1 trauma center in the Midwest found that 19.4% (118/605) of older adults admitted with a ground level fall were readmitted with a subsequent fall and injury. The aim of this quality improvement initiative is to determine if the implementation of an evidenced based patient toolkit and a discharge algorithm for providers will reduce outpatient falls. The objective was to reduce hospital readmission due to repeat fall.

Methods: The design of this project was mixed methods, observational, …

Increasing Annual Retinal Exams Among Patients With Type 2 Diabetes, Afokoghene H. Odhu

Doctoral Projects

The Center for Disease Control and Prevention (CDC, 2017) reports that approximately 30 million people in the United States (US) have diabetes. Approximately 8 million have diabetes retinopathy (DR) (CDC, 2018). DR is the leading cause of vision impairment in type 2 diabetes patients. Left untreated, DR can result in loss of vision and blindness (Hernández, Simó-Servat, Bogdanov, & Simó, 2017). The US spends approximately $500 million dollars annually in the treatment of diabetes-related blindness (CDC, n.d.). Early detection and management of DR through tight glycemic control, aggressive blood pressure and lipid management is essential to preventing complications of the …

Pulmonary Rehabilitation Initial Education, Allison Vititoe

Scholars Week

Abstract

Pulmonary rehabilitation has been proven successful among those with chronic pulmonary diseases. However, there is a low rate of involvement and a lower rate of completion for these patients.

One of the major underlying factors contributing to this problem is patients’ lack of motivation. If the patients can be given information on the benefits of this program that align with what they hold as important there will be increased level of motivation and subsequently completion of pulmonary rehabilitation.

How Do Nurse-To-Patient Ratios In The Emergency Department Impact Patient Experience?, Jessica L. Marcoux

Electronic Theses and Dissertations

There is a lack of consensus about the staffing matrix across nursing and especially in emergency

nursing, where variations in arrival patterns, acuity, social determinants of health, and length of stay all impact the workload of emergency nurses. The objective of this paper was to determine if government-mandated staffing ratios had a greater impact on patient experience at hospitals in California than staffing based on hours per patient visit at hospitals in Massachusetts. Seven hospitals from the state of California with government-mandated nurse-to-patient ratios were compared to 7 hospitals from Massachusetts that did not have mandated staffing ratios to determine …

Disruptive Innovation: Impact For Practice, Policy, And Academia, Heather V. Nelson-Brantley, K. David Bailey, Joyce Batcheller, Laura Caramanica, Bret Lyman, Francine Snow

Faculty Publications

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US States, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

Nursing Annual Report: 2020, Centracare Health

Nursing Annual Report

Message from the CNO

St. Cloud Hospital Statistics

Message from Craig Broman, St. Cloud Hospital President/CEO

Nursing Strategic Plan FY 2020

Message from Tom Schrup, MD/CPO

Education & Certification

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Front-Line Nurse Manager Succession Planning: Building And Promoting Strong Nurse Leaders Through Implementation Of A Nurse Manager Development Program, Melany Boyd

Master of Science in Nursing Theses and Projects

Succession planning plays a pivotal role in the infrastructure of any company. Succession planning is designed to identify individuals with potential and prepare them as successors when the current leader vacates their position. With the ageing nurse population, increased role demand, and lack of interest from incoming nurses there is an increase in nurse leader (particularly nurse managers) vacancies. Through the implementation of a Nurse Manager Development Program, executives have the opportunity to strengthen the nurse manager pipeline and promote succession planning through early identification of potential leaders and placing those individuals through a 3-month program that focuses on the …

Gratitude Journaling As Intervention To Combat Nurse Burnout In Cardiac Surgery Intensive Care Nurses, Melinda Simpson

Master of Science in Nursing Theses and Projects

As a practicing registered nurse in the intensive care setting, this researcher witnessed an episode of burnout characterized by a public meltdown, crying, and yelling. This sparked an interest in an intervention to combat nurse burnout. Literature was found on gratitude which has been found to increase resiliency. An increase in resiliency, in various populations, has been found to decrease perceived stress and feelings of burnout. This researcher investigated the use of gratitude journaling for 21 days as means to decrease perceived stress and feelings of burnout while increasing gratitude and resiliency. The PSS, GQ, BRS, & BBI tools were …

Preparing Ambulatory Care Leaders For Service: Onboarding To Mentorship, Kara Simpson

Doctor of Nursing Practice Projects

At a large academic medical center in the Southeastern United States, a gap was identified in the process for onboarding and mentorship new leaders in the ambulatory care setting. Based on the evidence in the literature, a standardized onboarding and mentorship program can improve job satisfaction and retention of leaders. A program was developed to bridge this gap and provide educational support for new leaders. Participants completed surveys at the onset and conclusion of the program with a validated survey tool. While the quantitative results were not statistically significant, the feedback from the participants indicated the time spent in the …

Crowded Er Waiting Rooms – Are Freestanding Ers The Way To Go?, Jesse Keats

Student Research Poster Presentations 2020

This poster discusses the differences in freestanding and hospital emergency departments. My position on this topic focuses on the idea that free standing ERs do not reduce overcrowding in an emergency room.

Are Healthcare Workers In The Hospital Ready For Disasters In The Community?, Nicholas Hromek

Student Research Poster Presentations 2020

This poster presents the idea that healthcare workers in hospitals are not equipped for disasters in the community. During such a vulnerable and relevant time such as the COVID-19 pandemic, this poster focuses on the pitfalls of the healthcare and hospital system.

Uninsured/Underinsured: Who's Problem Is It?, Manpreet Kaur

Student Research Poster Presentations 2020

The problem of uninsured and underinsured in terms of health care was implored in the population of the United States of America. Other developed nations have implemented universal health care whereas the United States have fallen behind. It is an ongoing problem in the nation, and it is not only the problem of the people who face being uninsured and underinsured. It is everyone’s problem because it affects the economy as a whole and every person is affected by the way the country decides to treat health care. Nurses, as health care professionals, have the opportunity to help patients access …

Safety Promotion Via A Just Culture, Eric Gurzynski

Student Research Poster Presentations 2020

No abstract provided.

The Effect Of Acuity-Based Nurse Staffing On Nursing Medication Errors, Egidius Maria Eugene Waterval

Electronic Theses and Dissertations, 2020-2023

Nurses spend on average one third of their time on direct patient care, and most on indirect care in hospital settings. However, nursing workload is challenging to measure in a systemized, accurate, and timely way. Patient classification systems are designed to capture information about nursing workload based on the illness severity of the patient (acuity) to determine staffing resources and balance nursing workload. These systems are instruments that group nursing care activities in different categories to determine patient acuity. Electronic health records provide opportunities to use available data sets to accurately, and in real-time, document many direct and indirect patient …

Patient Satisfaction With Nurse Versus Non-Nurse Post-Discharge Outreach, Iyore Adonri

West Chester University Doctoral Projects

In today’s current healthcare environment, there has been an extensive focus on patient satisfaction, and healthcare leaders struggle with the options of utilizing a registered nurse or a non-nurse when making outreach follow-up calls to recently discharged patients. Healthcare leaders find that designing, implementing and managing an efficient telephone outreach program can be challenging, however, this has become a necessary aspect of the patient continuum of care plan. Studies demonstrate that patient follow-up post-discharge increases patient satisfaction and their compliance with post-discharge instructions, thereby reducing readmission rates and emergency room visits (Meek, Williams, & Unterschuetz (2018). This quality improvement project …

Creating Restful Environments: Applying Evidenced-Based Interventions To Increase The Patients Perceptions Of Room Quietness At Night, Timothy Marks

West Chester University Doctoral Projects

Florence Nightingale first described the detrimental effects of noise on patients as an element nurses could control. Hospitalized patients who sleep in the hospital are at risk for poor periods of rest from unwanted noise in the care environment. This Doctor of Nursing Practice Project will assess interventions aimed at increasing the patient’s perception of quietness around the care environment at night for a pilot population. Swanson’s Theory of Caring will be utilized as a framework for the project. Outcomes of nursing interventions were reviewed for the improved patient perception of the care environment at night and resultant health outcomes. …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

Promoting A Culture Of Civility Among Oncology Nurses In The Ambulatory Care Setting To Improve Patient Safety And Nurse Retention, Sheila Evans

DNP Scholarly Projects

INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations.

AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association …

Using The Bedside Care Conference To Improve The Patient Experience, Eileen Keefe

DNP Scholarly Projects

Abstract

Improving the patient experience of hospital care is a priority for nursing leaders. The terms patient satisfaction and patient experience have been used interchangeably to define the patient’s unique perspective on care quality and the impact of patient engagement on health outcomes. Patients and families experience suffering when their expectations are not congruent with their care in the hospital setting, and there are significant cost and financial implications for organizations that do not reach performance thresholds. Communication with nurses is highly correlated to overall patientsatisfaction in the Center for Medicare and Medicaid (CMS) Hospital Consumer Assessment of Providers and …

The Effects Of Mindfulness Practices On Nurse Leader Resiliency, Kimberly Blanton

DNP Projects

Background: The purpose of this study was to evaluate if brief Mindfulness Based Stress Reduction (MBSR) sessions can improve nurse leader resilience and overall mindfulness.

Conceptual Framework: Two different conceptual frameworks, Jean Watson’s theory of caring and Albert Bandura’s theory of self-efficacy, were used to guide this project. Watson’s theory of caring is defined as healing of the mind, body, and spirit. This theory supports caring for oneself while caring for others. Bandura’s theory focuses on the belief that individuals can influence their own lives.

Methodology: This study employed a descriptive, pretest-posttest single site comparative design. Sixty-six nursing leaders from …

Measuring Nurse Competence In The Emergency Department, Matthew Lojo

University of the Pacific Theses and Dissertations

Background: “Nurses provide essential care to the millions of people who are hospitalized each year as a result of illness or injury” (Smith, 2012, p. 172). The Institute of Medicine reported approximately 44,000-98,000 patients die annually resulting from a medical error, and health care errors ranked among the top 10 for the leading causes of death in the United States (Smith, 2012).

Problem: Nurse competence impacts safe and quality nursing, and several research studies investigated the measurement of nurse competence among nurses in various nursing settings (Flinkman et al., 2016). However, a review of the research revealed limited studies in …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Abstract

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls are …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

Expanding Magnetic Resonance Imaging Access For Patients With Cardiovascular Implantable Electronic Devices, Rosalie Geronimo

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem. Patients with non-conditional cardiovascular implantable electronic devices (CIEDs), which lack magnetic resonance imaging (MRI) components, are unable to undergo MRI.

Context. The Heart Rhythm Society guidelines for patient device management and Centers for Medicare and Medicaid Services requirements for persons with specific expertise in implanted permanent devices to manage CIEDs during MRI spurred policy, procedure and staffing changes.

Interventions. The evidence-based change-of-practice project comprised of workflow development, policy and procedure changes, implementation of required staffing support to manage the CIED during an MRI.

Measures: The outcome measure was to improve access to MRI for patients with CIEDs, measured …

Burnout, Depression And Suicide Prevention For Nursing Staff In High-Intensity Settings, April Ritchie

Doctor of Nursing Practice (DNP) Projects

Nurses working in high-intensity settings experience burnout at higher rates than in other nursing areas. Burnout in healthcare is a problem estimated as high as 70% by the Agency for Healthcare Research and Quality. Burnout can lead to depressive symptoms, which can lead to suicidal ideation in affected healthcare providers, which makes early identification and treatment of utmost importance to the mental and physical wellbeing of these nurses.

The purpose of this project is to examine burnout in nursing staff working in high-intensity areas of the hospital in order to help identify burnout and/or depressive symptoms before they lead to …

Coaching Nurse Leaders In Conflict Management And Team Building To Improve Retention, Jeanette Black

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Retention of assistant nurse managers (ANMs) was identified as a concern from interviews with executive leadership and ANMs employed at a large hospital within a Northern California integrated health system. The nurse leader orientation training was reviewed, with gaps identified in conflict management and team building.

Context: The attrition rate of U.S. nurse managers in 2010 was 8.3%, higher than executive nurse leaders, with replacement costs equal to 75% - 125% of a nurse manager’s salary (Loveridge, 2017). Employee turnover and dissatisfaction due to conflict can have detrimental effects on retention, productivity, morale, and quality of patient care. …

Nurse Manager Succession Planning: Building A Leadership Pipeline For The Future, Katie Stephens

Doctor of Nursing Practice (DNP) Projects

Problem. This academic medical center was increasing bed-capacity and needed to hire 12 additional nurse managers (NM) to meet these new requirements. Promoting assistant nurse managers (ANM) to the NM role saves time and money, supports leadership and cultural continuity, and demonstrates a strong organizational commitment to internal human capital.

Context. Formal nurse manager succession planning (NMSP) programs have been shown to increase nurse manager competency and retention rates, while also helping to identify and develop new generations of nurse leaders. To mitigate the recent loss of ANMs and strengthen the remaining leadership bench strength, the organization is developing, implementing, …