Improving A Clinic's Process To Increase Preventative Health Screenings, Melissa A. Weathington

Master's Projects and Capstones

Performing health screenings on patients is a potential way to prevent or even identify health issues that may have not otherwise been apparent. In recognition of the importance of this matter, this CNL aims to improve and increase the percentage rate of depression and cervical cancer screenings by addressing barriers that have hindered staff from performing these health screenings. This CNL project took place at a health clinic located in the marginalized community of San Francisco. The health clinic’s primary focus is to foster care to the underserved population—homeless, uninsured, LGBTQ, people of color—and provide them with qualitative patient care. …

Post-Traumatic Stress Disorder (Ptsd) In The Veteran Population: An Education Simulation For Nursing Students, Deven Jennings, Stacie Hunsaker

Journal of Undergraduate Research

The veteran population receives health care in various locations outside of Veteran Affairs facilities. Current research supports that 18-30% of veterans suffer from PTSD. Census records show that in 2013, 19.3 million veterans living in the US, this means that nearly 3.5-5.8 million American veterans suffer from PTSD currently (Census.gov, 2014). The need for nurses to become more familiar with PTSD and specific nursing care related to PTSD is necessary to care for the diverse population we find in many health care settings. The purpose of this project was to create a simulated educational experience for nursing students in order …

Implementation Of Patient Mobility Assessment Tool: A Clinical Nurse Leader Initiative Towards Improved Patient And Nurse Health Outcomes, Janet Lopez

Master's Projects and Capstones

Abstract

Early ambulation during hospitalization has been recognized as a fundamental and logical intervention to reduce patients functional decline and muscle weakness. Recently, our healthcare system is encouraging nurses to become more actively involved in assessing patient’s mobility status and managing their mobilization. However, since the high nursing workload affects the time that a nurse can assign per task, more often than not they have little time to accurately assess patient’s mobility status; Presenting a safety concern for nurses and patients. In an effort to ease this challenge, the Patient Mobility Assessment Tool (PMAT) is introduced as an efficient nurse-driven …

Healing Touch: Enhancing Quality Of Life, Julia Mccann-Khludenev

Evidence-Based Practice Project Reports

Healing touch (HT) is a non-invasive energy therapy used in the management of symptoms of various health conditions. HT utilization has demonstrated enhanced comfort and relief of symptoms such as chronic pain, post-traumatic-stress, depression, and anxiety. The purpose of this evidence-based practice (EBP) project was to promote awareness and appointment compliance rate of HT amongst veterans, and also to determine effectiveness of HT intervention on symptom relief and well-being. The PICO question was: “For Veterans, what is the effect of HT education material and mail notification on appointment compliance rate, and HT delivery on symptom relief and well-being as compared …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

Communicatively Constructing The Bright And Dark Sides Of Hope: Family Caregivers' Experiences During End Of Life Cancer Care, Jody Koenig Kellas, Katherine M. Castle, Alexis Johnson, Marlene Z. Cohen

Journal Articles: College of Nursing

(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; …

Implementation Of Sbar Reporting In The Ed, William Russel Carpenter

Master's Projects and Capstones

Implementation of SBAR reporting in the ED

Abstract

In our emergency department, reports given to the accepting floor nurse, transfer of care between emergency department nurses and nurses reporting to physicians are given in many different formats with no continuity. It has been reported that 1,744 deaths and $1.7 billion in hospital costs related to miscommunications (CRICO Strategies, 2015). With the implementation of the SBAR reporting tool, we can begin to see a decrease in miscommunications, and improve patient and staff satisfaction. The SBAR framework not only enhances the clarity and efficiency of communication between team members but also assures …

Safe Sleep In The Nicu Environment For Sids Prevention, Renee J. Aumua

Master's Projects and Capstones

Abstract

Sudden Infant Death Syndrome(SIDS) remains a leading cause of death for infants less than one year of age. Historically, Neonatal Intensive Care units have been exempt from following SIDS safe sleep guidelines recommended by the American Academy of Pediatrics(AAP) for SIDS prevention due to patient medical status and environment. However, in 2011 these guidelines were updated by the AAP to include NICU specific recommendations. This is a very important change due to this patient population being at a higher risk for SIDS than the term, well newborn. The Safe Sleep project was conducted in a 35 bed, tertiary care …

Implementing An Evidence-Based Education Program For Labor And Delivery Nurses In A Community Hospital Setting, Sara E. Humphrey

Graduate Theses, Dissertations, and Capstones

Many factors contribute to the success of an organization. The nursing workforce is the guiding strength behind the delivery of safe patient care resulting in quality outcomes. Preparing the nursing staff to deliver safe care begins with the introduction of evidence based practice as a viable partner to clinical expertise and knowledge. Implementing an evidence based education program is a critical step in the process of integrating evidence into clinical practice. This paper focuses on the implementation of an evidence based education program or Labor and Delivery nurses in a community hospital setting. Evidence based education can promote competency development, …

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

Improved Postpartum Care After A Participatory Facilitation Intervention In Dar Es Salaam, Tanzania: A Mixed Method Evaluation, Eunice Pallangyo, Columba Mbekenga, Pia Olsson, Christine Rubertsson, Carina Källestål

School of Nursing & Midwifery, East Africa

Background: In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings.

Objective: To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in Dar es Salaam, Tanzania.

Methods: A before-and-after evaluation of an intervention and comparison group was conducted using mixed methods (focus group discussions, questionnaires, observations, interviews, and field-notes) at health institutions. Maternal and child health aiders, enrolled nurse midwives, registered nurse midwives, and medical and clinical officers participated. A collegial facilitation intervention was …

Improving Health Outcomes And Lifestyle Choices In An Underserved Community Through The Implementation Of A Wellness Program, Ekaterini Boutos

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a wellness program with the purpose of bridging the gap in lifestyle and disease knowledge in a socioeconomically vulnerable mentally ill population. The participants were members of an adult day mental health facility which aided the local underserved population. The wellness program emphasized improving knowledge of chronic health conditions, healthy lifestyle habits and the practice of mindfulness meditation.

Significance: The significance of this project is the advancement of health status via health education from a wellness perspective. Vulnerable populations who are at higher risk of chronic physical and mental illness can …

Implementation Of The Reengineered Discharge Process And Transitional Care Management At A Rural Critical Access Hospital, Chad L. Wilfong

Doctoral Projects

Healthcare in the United States is changing from a fee-for-service to a value based healthcare delivery system. One area of national focus is reducing 30-day hospital readmissions by providing high-quality transitions-of-care. Patients leaving the hospital without proper assessment of home care needs, patient education, and coordination of care run into barriers managing health conditions, which contributes to hospital readmissions. Poor transitions-of-care contribute to deterioration of health leading to acute care utilization and hospital readmissions, which is costly for healthcare organizations, insurance payers, and individuals. In 2017, the value based healthcare structure will be decreasing reimbursement to hospitals that have 30-day …

Retrospective Comparative Costs And Benefits Of Registered Nurses (Rns) In A Perioperative 101 Program Residency (P101); An Immersive Perioperative Specialty Residency (Psr); And Registered Nurses Hired Into General Perioperative Services From 2009-2016, Johanna K. Stiesmeyer

Doctor of Nursing Practice Scholarly Projects

This study addresses the cost to benefit ratio of a healthcare organization’s investment in specialty perioperative residency programs for newly licensed registered nurses and experienced registered nurse orienting into perioperative services. The outcomes for transition to practice residency programs is widely reported however a standardized approach to measuring and reporting cost to benefit ratios and return on investment to these programs as well as specialty residencies remains an opportunity. This study contributes to national standardization and approach by defining the costs of a perioperative residency program and determining the cost to benefit ratio using a return on investment calculator. The …

Enhancing Clinical Manager Self-Efficacy Through A Change Management Academy, Chet Hurley Doering Iii

Doctor of Nursing Practice Scholarly Projects

Healthcare systems are facing increased pressure to develop their clinical managers’ abilities and competencies leading change. Clinical managers that are equipped with these capabilities can influence greater quality and safety outcomes for patients. Literature and industry findings both strongly suggest that leaders who possess increased self-efficacy are more effective leading change. This is demonstrated at the unit and system level through improved project management, successfully executing strategic initiatives, retaining staff, and being more fiscally responsible. There are significant clinical and business advantages for healthcare systems that foster change management skills for their clinical managers When organizations do not provide support, …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Implementation Of An Evidence-Based Process For The Management Of Concussions In Adolescent Patients For A Primary Care Office, Ashley D. Karczewski

Doctoral Projects

The number of recreation and sports-related concussions (SRC) are estimated at 3.8 million every year in the United States. Recently, widespread media attention has been paid to concussion, and with this there has been a rise in adolescents with SRC seeking health care. Primary care providers are often the first to evaluate and provide treatment for adolescents with concussion. Despite the abundance of literature on concussions, there has been little empirical data to support management practices for this patient population. The purpose of the project was to provide an evidence-based process along with a clinical decision support tool to the …

Civility Matters: Overcoming Workplace Incivility Using An Interactive Education Intervention, Joy L. Stoddard

Doctor of Nursing Practice Scholarly Projects

Workplace Incivility, a global issue, particularly affects healthcare settings due to stressful work environments and a largely female workforce. Victims of WPI have up to 33% increased turnover, with many leaving their professions entirely. The cost of turnover, particularly within the first year, may be as high as 125% of the nurse's salary Researchers identified the need to implement measures to prevent and manage WPI. The Joint Commission (TJC) calls for requiring hospitals to implement code-of-conduct policies defining acceptable and unacceptable behaviors. Code-of-conduct policies assist leaders in addressing offenders of WPI. Targets of WPI typically lack the skill set and …

Assessment Of Nurse Engagement, Manuelita I. Chapman

Doctor of Nursing Practice Scholarly Projects

Organizations with high employee engagement reap the benefits of higher employee retention and improved customer satisfaction. Studies find that engaged workers are in the minority. Among healthcare workers, nurses are found to be the least engaged. The association of the registered nurse (RN) at the bedside with improved patient outcomes has been documented by many. Today, the goal of providing safe, high quality and efficient patient care and an exceptional patient experience are benchmark measures for patient care delivery. Since nurses are essential to optimal patient outcomes, it is important to understand what motivates them. Career advancement programs (CAPs) are …

Establishing A Nurse Practitioner Residency Program In A Rural Federally Qualified Health Center: A Feasibility Analysis And Pilot Study, Seson Kahn Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Jodie Sandhu Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Projects

Abstract

Rural communities are disproportionately underserved and have been identified as a priority population to improve health outcomes and access to care (Agency for Healthcare Research and Quality [AHRQ], 2015). National organizations have recognized a deficit in primary care providers, recommended nurse practitioners (NPs) as a solution, and supported NP residency programs as a means to prepare and recruit qualified practitioners into communities (Institute of Medicine [IOM], 2010; The Patient Protection and Affordable Care Act [PPACA], 2010). However, there are only three primary care NP residency programs in rural California (National Nurse Practitioner Residency and Fellowship Training Consortium [NNPRFTC], 2015). …

The Trilogy Of Health Care: Spirituality And Caring, Bro. Ignatius Perkins, O.P.

Faculty Conference Presentations

Presented at the 2017 Spirituality Forum, Caring for the Human Spirit in the Changing Health Care World, Hospital for Special Surgery, New York, NY, May 8, 2017.

New Mexico Trauma System Funding Strategy, Razvan N. Preda

Doctor of Nursing Practice Scholarly Projects

Trauma is the leading cause of death among individuals 1 to 44 years of age. Nationally, one individual dies of traumatic injuries every three minutes. In the United States, the financial impact of trauma is estimated to be approximately $671 billion annually, spent on direct trauma care and associated costs, such as loss in productive days and rehabilitation. The New Mexico trauma system registered dramatic development over the past 10 years. In 2007, the state had only three designated trauma centers, and today there are 12. However, over the same period, trauma system funding registered an equally dramatic decrease of …

Return On Investment Comparison Of Three Payment Models For Chronic Care Management Under Medicare In A Northwestern Physician Hospital Organization, Megan J. Madole

Doctoral Projects

Chronic disease is the most prevalent and costly health condition. The coordination of care provided to those with multiple chronic conditions (MCCs) is suboptimal and fragmented. This population is among the highest utilizers of healthcare, and accounts for the majority of Medicare expenditures annually. Chronic care management (CCM) programs represent evidence-based initiatives shown to improve outcomes, reduce hospital and emergency department utilization, and reduce healthcare costs. Centers for Medicare and Medicaid Services (CMS) have provided various payment models for reimbursement of CCM services. Primary care practices have stated that inadequate reimbursement and confusing payment models are barriers to CCM implementation. …

Preparing For The Merit-Based Incentive Payment Structure: A Value-Based Business Plan, Ali R. Saheb

Doctoral Projects

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based …

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

A Crosswalk Protocol For Implementation Of The Patient-Centered Medical Home And Meaningful Use At A Midwest Nurse Managed Center, Kaitlyn Rath

Doctoral Projects

Healthcare expenditures in the United States far exceed the spending that occurs in other high-income countries (Squires & Anderson, 2015). However, the healthcare outcomes are poorer in the U.S. on multiple key health care measures including life expectancy and the prevalence of chronic illnesses and comorbid conditions (Squires & Anderson, 2015). New care models not only focus on improvement of key health outcomes, but also on healthcare providers to reduce fragmented care with care coordination. This DNP scholarly project addresses the need for financial stability within a Midwest nurse managed center. This center would benefit from utilization of a new …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …