Nursing Commons^™

Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth

Doctoral Dissertations and Projects

The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …

Intensive Care To Intermediate Care Bridge Program, Natasha Bartlett, Sally Langerak, Lindsey Lucas, Jonathan Archibald, Tayla Robbins, Miranda Thompson, Patrice Tetu, Calla Hastings, Megan Garland, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operational Transformation

To deliver the highest quality of care across the continuum, a large academic tertiary medical center envisioned a project that would provide an internal source of cross trained nurses for their medical intensive care unit (SCU2) and their medical intermediate care unit (R4/IMC/AVU). The hope for this program was to improve communication and collaboration between nurses and enhance the care that they provide to patients and their families.

A highly qualified team of nurses was established to create a performance improvement project. The overall goal of this endeavor was to build a more collaborative relationship between the units and ultimately …

Clarifying Model For Continuity Of Care: A Concept Analysis, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Aim

The aim is to clarify the use of the term continuity in the specific context of acute care hospitalization and discharge.

Background

The meaning of “continuity” is often co‐mingled with other concepts, specifically coordination and communication. To increase usefulness for contemporary concerns with the hospitalization‐postdischarge continuum, continuity of care is examined from the specific context of acute hospitalization and discharge.

Design

Concept analysis.

Data Sources

Medline via Ovid, Cochrane Library, Cinahl, and Google Scholar. Search years encompassed 2001–2016.

Review Methods

Rodgers evolutionary concept analysis method.

Results

A total of 50 papers were included in this concept analysis. Synthesis of …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Improving Communication Between Child Life Services And Nursing On An Inpatient Pediatric Unit, Sherryann St. Pierre, Elizabeth Shaughnessy, Bethany Kay, Barbara Bush Children's Hospital, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operational Transformation

IMPROVING COMMUNICATION BETWEEN CHILD LIFE SERVICES AND NURSING ON AN INPATIENT HOSPITAL UNIT

Effective communication between patient caregivers has been shown to reduce stress and trauma related to hospitalization and subsequent improved outcomes. An HCAHP score for a 30 bed acute inpatient pediatric unit illustrated the confusion faced by children as a result of nursing and care life specialists not working together as a team.

A root cause analysis identified a number of issues as to why patients were not benefitting fully from child life services. Several counter measures were instituted with the goals of improving the HCAHP score and …

Strategies To Improve Timeliness For Cleaning Inpatient Rooms Following Patient Discharge, Lora Dixon, Mark Parker, Ruth Hanselman, Suneela Nayak, Amy Sparks

Operational Transformation

STRATEGIES TO IMPROVE THE TIME FRAME FOR CLEANING INPATIENT ROOMS BY ENVIRONMENTAL SERVICES

In an inpatient rehab hospital, it was noted that Environmental Services (EVS) was delayed in cleaning rooms between patient discharges and admissions. This resulted in the frequent use of a “stat clean” order that allows only 50% of the normal cleaning time , forcing patients to wait and impacting patient flow.

A root cause analysis demonstrated lack of communication between the rehab hospital and the contracted cleaning services. A number of counter measures were initiated with the goal that cleaning would be started within 20 minutes of …

Patient Acceptance Of Remote Scribing Powered By Google Glass In Outpatient Dermatology: Cross-Sectional Study, Sandra Odenheimer, Deepika Goyal, Veena Jones, Ruth Rosenblum, Lam Ho, Albert Chan

Faculty Publications

Background: The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient’s relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, …

Educating Health Care Professionals To Improve Communication In Advance Care Planning, Laura E. Clubb

Doctor of Nursing Practice (DNP) Projects

DNP Project Goal:The goal and expected outcome of this DNP project was to increase providers’ self-reported preparedness and comfort levels by 50% when discussing advance care planning (ACP) and end of life wishes with patients.

Background: The Institute of Medicine designed ACP as a national health priority. However, health care professionals often do not facilitate discussions of ACP with patients, even in patients with chronic or life-limiting illnesses. This occurs due to professionals’ lack of knowledge about ACP, lack of comfort when discussing the issue, and a misperception that the patient may be too young or not sick enough …

Reducing Delays In Sexually Transmitted Infections(Sti) Treatment: A Quality Improvement Project To Improve Timely Communication Among Providers And Patients, Kattie Khadar

Doctor of Nursing Practice (DNP) Projects

Abstract

Purpose: To use a nurse-communication intervention for timely provider notification of abnormal chlamydia, gonorrhea and syphilis infections, to reduce delays in treatment at a large Northeastern United States hospital. Methods: The hospital’s communicable disease report was reviewed daily, and treatment of all patients who were seen in the Infectious Disease clinic and diagnosed with chlamydia, gonorrhea and syphilis infections was monitored. Emails were sent to inform treating providers whenever a patient was not treated within 72 hours after diagnosis. Data from patients in the three months preceding was compared with data during the three months of nurse-communication intervention …

Reducing Rehospitalizations From One Skilled Nursing Facility: A Quality Improvement Project, Victoria Ann Phillips

Doctoral Dissertations and Scholarly Projects

The purpose of this quality improvement project initiated by a core project team in a large medical center was to investigate possible causes for increased hospital readmissions from one specific skilled nursing facility. The conceptual framework utilized was the Define, Measure, Analyze, Improve, Control (DMAIC) model from the Lean Six Sigma methodology. Data collection from chart audits, a staff survey, a system probe, and a process mapping project assisted to narrow the focus of the plan to improve communication among facilities by standardizing documentation and coordination of care as patients transitioned from the skilled nursing facility to the medical center’s …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Communication Of Medication Side Effects In An Acute Care Hospital, Deb Bachand, Rachel Caiola, R6 Neurology Med-Surg Unit, Haley Pelletier, Brendan Lilley, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Maine Medical Center

COMMUNICATION OF MEDICATION SIDE EFFECTS IN AN ACUTE CARE HOSPITAL

Effective patient education of prescribed medication side effects improves patient safety and reduces overall risk. On an acute care hospital unit, nursing staff felt previous attempts at this education had been ineffective as demonstrated by their HCAHPs scores for communication about medications.

A root cause analysis demonstrated some flaws and several countermeasures were instituted. The goal of this KPI project was to attain a higher than national average for the specific HCAHPs score.

Post KPI inception, the unit’s HCAHPs data showed steady improvement. Within one month, the goal of an …

Transprofessional Education – An Asynchronous Approach, Courtney Reinisch

School of Nursing Faculty Scholarship and Creative Works

Creating an opportunity inter-professional educational for nursing students involves challenges in logistics and resources.

Lymphoma Therapy And Adverse Events: Nursing Strategies For Thinking Critically And Acting Decisively, Amy Goodrich, Nina Wagner-Johnston, Dana Delibovi

Faculty Scholarship

BACKGROUND: Multiple treatment options, combined with disease heterogeneity, have created nursing challenges in the management of adverse events (AEs) during antilymphoma therapy. Testing has revealed that less than half of participating nurses correctly graded peripheral neuropathy and neutropenia related to antilymphoma regimens.

OBJECTIVES: This article identifies nursing challenges in the management of AEs associated with therapy for lymphomas and describes how strategies in critical thinking can help meet those challenges.

METHODS: A comprehensive literature search in oncology nursing, nursing education, and critical thinking was conducted; participant responses to pre- and post-tests at nursing education programs were evaluated; and a roundtable …

Assent Described: Exploring Perspectives From The Inside, Rebecca D. Poston

Nursing Faculty Publications

Purpose- The purpose of this study was to describe the informed consent and assent experience for oncology research from the perspective of the participants: adolescents, their parents, and their physician providers.

Design & Methods- This descriptive mixed-methods study included the pilot use of the Quality of Informed Consent Questionnaire (QuIC) with an adolescent population and semi-structured interviews with adolescents, their parents, and their physician providers within 48-72 hours of the informed consent and assent discussion for a pediatric oncology clinical trial and again 6-9 weeks later. Results: Adolescents and their parents scored considerably lower on part A of the QuIC …

Fostering Interdisciplinary Communication Between Pharmacy And Nursing Students, Aleda M.H. Chen, Mary E. Kiersma, Carrie N. Keib, Stephanie M. Cailor

Pharmacy Practice Faculty Publications

Objective. To evaluate pharmacy and nursing student self-perceptions of interdisciplinary communication skills, faculty member perceptions of interdisciplinary communication skills, and changes in those skills after increasing the interdisciplinary education content.

Design. Two cohorts of pharmacy and nursing (bachelors of science in nursing, BSN) students in respective, semester-long research courses engaged in active learning on interdisciplinary communication, with the second cohort receiving additional content on the topic. At semester completion, students presented a research project at an interdisciplinary poster session.

Assessment. Self-, peer-, and faculty evaluations (4 items; 5-point Likert-type) assessing self-confidence and actual interdisciplinary communication skills were completed during the …

Vcu Health: Adult & Pediatric Inpatient Pain Communication Guide (Algorithm), Veronica Nolden, Jessica Keiser

VCU Health Nursing

Abstract Related to Algorithm:

Description/Background

Improving pain management is a priority for all healthcare providers, yet the process for how pain is assessed, reported and resolved often lacks a defined process. This lack of structure can lead to delays in pain control for patients and frustrations within healthcare teams. In an effort to facilitate patient-centered care, an interdisciplinary workgroup was constructed to address this process.

Action

In order to eliminate delays and define a process for pain management, an interdisciplinary workgroup utilized performance improvement processes to develop a communication algorithm. The group membership included nurses, physicians, advanced practice providers, nursing …

Developing The Synergy Between University And Industry-Based Nursing Courses : Lessons In Engagement, Joyce M. Hendricks Phd, Vicki C. Cope Ms

Research outputs 2014 to 2021

On the surface the process of engagement seems functional, however, if the engagement process does not take into account people dynamics and the effects of the wider social, organisational and cultural context, multiple tensions may occur. This paper shares the story of the tensions related to culture, relationships, communication and the impact of change in bringing a University-Community project to its completion. The scholarship of engagement revealed the nature of this complex process and uncovered the need for a richer understanding of the people involved and their mindset. The challenges and opportunities encountered in the engagement process will be identified …

Teaching Communication And Therapeutic Relationship Skills To Baccalaureate Nursing Students: A Peer Mentorship Simulation Approach, Leslie Miles, Linda Mabey, Sarah Leggett, Katie Stansfield

Faculty Publications

The literature on techniques for improving student competency in therapeutic communication and interpersonal skills is limited. A simulation approach to enhance the learning of communication skills was developed to address these issues. Second-semester and senior nursing students participated in videorecorded standardized patient simulations, with senior students portraying the patient. Following simulated interactions, senior students provided feedback to junior students on their use of communication skills and other therapeutic factors. To integrate the learning experience, junior students completed a written assignment, in which they identified effective and noneffective communication; personal strengths and weaknesses; and use of genuineness, empathy, and positive regard. …

Children With Developmental Disabilities At A Pediatric Hospital: Staff Education To Prevent And Manage Challenging Behaviors, Norah L. Johnson, Joel Lashley, Alice V. Stoneck, Annette Bonjour

College of Nursing Faculty Research and Publications

Children with developmental disabilities may get frustrated in unpredictable hospital environments. Frustration may escalate to challenging behaviors, which are a safety concern and may contribute to staff and patient injuries, use of restraints, and procedure delay or cancelations. The purpose of this article was to describe a pilot staff education program on preventing and managing challenging behaviors of children with developmental disabilities at a pediatric hospital. The 2-hour-long education (1 hour on-line and 1 hour instructor led) content focused on family-centered care and communication skills, including verbal judo™ modified for use in the health care setting. Participants in the instructor-led …

Communication And Teamwork Focused Simulation-Based Education For Nursing Students, Jared M. Kutzin

Doctor of Nursing Practice (DNP) Projects

Simulation has become a common teaching method for healthcare providers, including nursing students. Until recently, the focus of simulation for nursing students has been on clinical skills. This study used a compilation survey to determine if knowledge and attitude scores improved in the bachelor degree nursing student after exposure to a simulation-based teamwork and communication training. Participants were 51 students from the senior leadership course of a bachelor’s degree in nursing program at a university in New Jersey. Control participants received normal clinical rotations with faculty led discussions, and intervention participants received a 4-hour simulation, focused on teamwork and communication. …

Parent Involvement In End-Of-Life Care And Decision Making In The Newborn Intensive Care Unit: An Integrative Review, Lacey M. Eden, Lynn Clark Callister

Faculty Publications

Survival rates for very preterm and critically ill infants are increasing, raising complex ethical issues for health-care providers and parents who face the challenge of making end-of-life decisions for newborns. The purpose of this integrative literature review was to evaluate parental involvement in end-of-life care and decision making for their infant in the newborn intensive care unit. Findings revealed that establishing good relationships and clear communication between health-care providers and parents builds trust and eases stress placed on parents making decisions about the care of their infant. Palliative care programs provide support for parents and facilitate their decision making. Parents …

Shift Report And Sbar: Strategies For Clinical Postconference., Fatima Ascano-Martin

Nursing | Faculty Scholarship

Conducting an effective postconference continues to be challenging because of low levels of student participation. Many students are exhausted at the end of the clinical day, which lessens their participation in postconference. In my experience, students often omit important information, such as patients’ age, sex, race, and other medical problems, during initial reports. Some have trouble providing patients’ information in an organized manner as well. The SBAR (situation-background-assessment-recommendation) communication tool can be used as a strategy to conduct clinical postconference.

Improving Communication Among Healthcare Providers: Preparing Student Nurses For Practice, Lorretta Krautscheid

Faculty Publications - College of Nursing

Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission’s 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student’s ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the …

Beyond 'Hot Lips' And 'Big Nurse': Creative Writing And Nursing, Sandra Young

English Faculty Publications

This essay describes a special topics creative writing course designed for nursing students, and argues that creative writing strategies work to improve nurses' compositional skills. Also discussed are other potential benefits from creatively writing patients' lives, notably, the blending of arts and sciences, and the ways in which medical schools are encouraging their students to study the humanities, especially literature and creative writing. The essay includes student creative writing samples.

The essay also discusses the depiction of nurses in popular culture. M*A*S*H*, Richard Hooker’s black comedy about the antics of doctors and nurses during the Korean War, gave us “Hot …