Geriatric Nursing Commons^™

Don’T Fall For It: Just-In-Time Staff Education To Reduce Patient Falls On An Adult Telemetry Unit, Forrest Wilcox, Kyle Knight, Jennifer Paiz, Zaira Garcia-Vega

Master's Projects and Capstones

Objective: Patient falls remain a leading cause of preventable harm among hospitalized adults and carry significant clinical and financial consequences. On an adult medical-surgical telemetry unit at this study site, a one-year review of 45 fall events found that most falls occurred among patients classified as high risk on the Morse Fall Scale, frequently without continuous observation or consistent purposeful rounding. Aim: The aim of this project is to reduce falls on the telemetry unit to the national benchmark of 3.2 falls per 1,000 patient days within a 6-month period. Methods: A just-in-time (JIT) education intervention was delivered to registered …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Don't Let Them Fall, Let Ai Call, Ella Mills, Sara Barker, Andreea Ifrim, Yvette Uwase

SPARK Symposium Presentations

This project proposes a nurse-led pilot of AI-supported predictive mobility monitoring on a cardiac medical-surgical unit, to improve early identification of high-risk mobility behaviors and enhance patient safety. Current fall-prevention strategies, such as bed alarms and virtual sitters, often alert staff after unsafe movement has begun, creating a reactive cycle that contributes to alarm fatigue and delayed intervention (Abbe & O’Keeffe, 2020). This initiative uses monitors with contactless infrared sensors to identify movement before patients exit the bed, an alert system that goes straight to the nurse and PCT phones, and a central console for floor management and care coordination. …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Implementation Of Medication Administration Education To Increase Medication Technician Knowledge And Confidence, Nicole C. Yan

Master's Projects and Capstones

Problem: Medication technicians have minimal formal training and education in medication administration. Insufficient knowledge and a lack of confidence present safety concerns, such as medication errors, which decrease the quality of patient care.

Context: The setting is an assisted living facility in the San Francisco Peninsula that provides around-the-clock patient care, promoting independence in a safe and home-like environment for 53 patients.

Interventions: The proposed intervention involves implementing a quality improvement (QI) project to educate medication technicians on medication administration safety. The educational sessions, completed in two in-person sessions, include a PowerPoint lecture, interactive case studies, and group discussion.

Measures: …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Awareness Of The Physiological Changes Occurring In Older Adults Can Reduce Dehydration And Electrolyte Imbalances, Lisa Isley

Nursing | Senior Theses

Background: Individuals over 65 years are at an increased risk of dehydration. The physiological changes that occur with age and medication consumption can cause fluid and electrolyte imbalances that can physically and mentally impair individuals over 65 years old. Objective: By providing education to individuals 65 years and older regarding the significance of drinking water and consuming electrolytes daily, older adults can reduce their dehydration symptoms and improve their quality of life. Method: The proposed research is a quasi experimental study geared towards individuals 65 years and older. The quasi-experimental study will include two pre-surveys and then two post-surveys. The …

Awareness Of The Physiological Changes Occurring In Older Adults Can Reduce Dehydration And Electrolyte Imbalances, Lisa Isley

Nursing | Student Research Posters

Background: Individuals over 65 years are at an increased risk of dehydration. The physiological changes that occur with age and medication consumption can cause fluid and electrolyte imbalances that can physically and mentally impair individuals over 65 years old. Objective: By providing education to individuals 65 years and older regarding the significance of drinking water and consuming electrolytes daily, older adults can reduce their dehydration symptoms and improve their quality of life. Method: The proposed research is a quasi-experimental study geared towards individuals 65 years and older. The quasi-experimental study will include two pre-surveys and then two post-surveys. The survey …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Preventive Strategies For Elder Abuse Within Hospice Care By Healthcare Professionals, Joshua Eason

Nursing | Student Research Posters

Background: Healthcare professionals providing hospice care need to have particular specialized abilities, empathy, and trust. Unfortunately, some of these medical professionals are unable to provide their patients the care they need, so they will instead abuse and ignore them. Elder abuse must be identified and addressed in hospice care settings if older patients are to have their rights and dignity upheld and a standardized, compassionate end-of-life care program is to be provided for each patient.

Purpose: The purpose of this study is to examine the effectiveness and preventative strategies for elder abuse, implemented by healthcare providers within the hospice care …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

The Effects Of Hospital Policy And Procedure On Cauti Occurrence, Kevin Kaga, Michaela Morrison, Daniel John

Symposium of Student Scholars

Abstract

Background: Clients that require indwelling catheterization often get bacterial infection causing catheter-associated urinary tract infections. These infections lead to longer hospital admissions and poorer outcomes for clients.

Objectives: To assess the effectiveness of the use of suggested hygiene methods from hospital policy/guidelines in preventing catheter-associated urinary tract infections.

Methods: Using the Kennesaw State Library search system, 10 articles were found to support that the use of consistent evidence based practices can prevent urinary tract infection occurrence.

Results: Our articles identified appropriate and inappropriate indications for catheterization and effective hygiene techniques used by nurses in the prevention of CAUTIs. These …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

Lgbt Community And Mental Health, Danielle Schleeter

Epsilon Sigma at-Large Research Conference

Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities.

Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health.

Literature Review: This literature review utilized search engines …

Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Dnp Final Report: Reducing The Rate Of Falls With A Stuctured Fall Program, Elanda L. Douglas

DNP Final Reports

Background: Fall rates continue to be a significant problem in health care facilities despite all the research and tool kits created to prevent falls. Hospitals that have successfully reduced fall rates find it challenging to sustain a reduction in the fall rates. During hospitalizations, 3%-20% of patients fall, with 30%-50% resulting in injury (Joint Commission, [JC], 2015).

Internal Evidence: Despite Medical City Alliance (MCA) having an evidence-based fall program, the fall rate has not decreased. Falls are one of the quality measures identified at the division level that needs improvement.

PICOT: In adult patients in a progressive care unit (P), …

A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard

Dissertations

There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock

MSN Capstone Projects

Diabetes is a disease that affects millions of people from children to older adults. There is no cure, although it can be managed to prevent complications. Education of student nurses is where they are born and raised to become nurses who save and change lives. Teaching student nurses in depth about diabetes as a disease and the treatments that best fit their specific needs is where educating patients begins. Learning about a secondary option for blood glucose checks can make all the difference for several patients. Multiple finger sticks daily has been the leading way to check blood sugar for …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Reduing Hospital Readmissions: Ideal Discharge Planning For Heart Failure Management, Chun Mei Chen, Chun Mei Chen

Master's Projects and Capstones

Abstract

The objectives during this project were to achieve by the end of 2018 an overall reduction of 25% in HF readmissions within 30 days. By identifying root causes of readmissions and using needs assessment within the microsystem, literature highlights the elements defining interventions that can be used to improve transitions of care and reduce avoidable HF hospital readmissions. A plan was developed for integrating an evidence-based practice, IDEAL Discharge Planning, along with engaging patients and families at bedside from the first day of admission until discharge to more effectively assist staff in providing patient-centered education and self-care skills. The …

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Dissertations, Masters Theses, Capstones, and Culminating Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Evaluating The Effectiveness Of Abilities Care Approach™ Training, Michelle E. D'Amato, Sophie E. Miller, April Perez, Carmen Joaquin, Louiza Alexandria Villarina

Student Research Posters

Approximately 50% of US nursing home residents have a diagnosis of dementia. Abilities Care Approach® was created by occupational therapists (OTs) to promote quality dementia care for residents in skilled nursing facilities (SNFs). Certified nursing assistants (CNAs) are often the primary caregiver for residents with dementia. To ensure carryover of ACA principles, ACE dementia training was targeted towards CNAs. The purpose of this study was to evaluate Abilities Care Experts®(ACE) training program which provides CNAs with an occupation-based dementia care approach by focusing on the importance of occupational engagement and knowledge of dementia stages. Results indicated that ACE trained CNAs …

Physician Orders For Life-Sustaining Treatment (Polst) Utilization In A Skilled Nursing Facility: An Educational Quality Initiative, Ryan Hazley Bsn, Rn, Dnp Student, Karl Steinberg Md, Cmd, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …