Geriatric Nursing Commons^™

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Gender Differences In Administration Of Tpa In Treatment Of Ischemic Stroke, Christina Annerino

CURE Proceedings

As medicine and pharmacology advance through the years, new life-saving treatments are studied or discovered every day, and a medical emergency is no longer a death sentence. Even with conditions as serious as ischemic stroke, there is hope for survival and rehabilitation with the ‘clot-busting’ drug, tissue plasminogen activator, colloquially known as ‘tPA’. tPA is a thrombolytic agent, a substance that acts on fibrin in clots to dissolve them so they can no longer cause ischemia in blood vessels that results in a stroke. (Vega, 2022). tPA is an extremely effective treatment for ischemic stroke, demonstrated in 2013 by a …

An Evidence--Based Intervention: Use Of Visual Aids For Patient Education During Bedside Team Rounding, Kristin Clifford, Shay Gruber

Nursing DNP Projects

Abstract Purpose: To increase patient health literacy and satisfaction in hospitalized adult medical-surgical patients through an evidence-based provider intervention (advanced practice providers, APPs, or physicians, MDs) adding visual aids to current verbal patient education methods during daily bedside team rounding (BTR).

Strength of Evidence: A literature review resulted in 15 studies meeting inclusion criteria including two meta-analyses, three randomized control trials, two quasi-experimental studies, five systematic reviews, two descriptive studies, and one clinical practice guideline. Evidence revealed the addition of visual information to verbal and written education methods significantly improves patient knowledge, understanding, and recall of health information and increases …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

Correlation Between Myostatin And Lean Muscle Mass In Older Adults, Mishann Luedders

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Correlation Between Myostatin and Lean Muscle Mass in Older Adults.

Luedders, M., Gray, M., Patton, S., Washington, T., Binns, A. Exercise Science Research Center, University of Arkansas, Fayetteville, AR.

Background: Our older adult population is growing exponentially and with it, the number of falls and debilitating injuries that afflict their population grows as well. A fall brings with it many possible injuries, healthcare costs, fear and increased mortality. There seems to be a lack of preventative measures in our healthcare system to help protect our elders. One possible measure is a simple blood test that looks at the level of …

Early Identification Of Frailty Predictors In A Vowed Religious Community Of Catholic Men: A Strategy For Successful Aging In Place, Julia Senn-Reeves

Graduate Theses, Dissertations, and Capstones

Background: The population in the United States is aging and experiencing age- and disease-related changes, leading to increased frailty, as well as increased disability, morbidity, and mortality. Timely recognition of these vulnerabilities, and intervention implementation, are crucial to prevent adverse outcomes and to support successful aging in place. Purpose: The purpose of this project is to develop and implement a multifaceted assessment process to identify early predictors of frailty among members of a vowed religious community of Catholic men to ultimately support successful aging in place. Participants: A single vowed religious community of Catholic men in the United States, living …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Final Manuscripts

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy behavior …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

Advanced Practice Nurses Knowledge And Use Of Fall Prevention Guidelines, Katherine Hays

Doctor of Nursing Practice Scholarly Projects

Falls are a significant public health issue resulting in a significant economic and social burden on society. Specific strategies are available that can reduce the risk of falling for older adults age 65 and older; however, providers have failed to integrate these guidelines into clinical practice (Rubenstein, Solomon & Roth, 2004; Chou, Tinetti, King, Irwin, & Fortinsky, 2006; Jones, Ghosh, Horn, Smith, & Vogt, 2011). The CDC has published the STEADI toolkit, a healthcare resource for integrating fall prevention guidelines into clinical practice; but little information is available on the knowledge and use of the STEADI toolkit by Advance Practice …