Geriatric Nursing Commons^™

Enhancing Sepsis Prevention In Long-Term Care Facilities: Development Of An Infection Prevention Sepsis Toolkit, Emmalyn A. Tuhin

Student Scholarly Projects

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs).

Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment.

Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older …

Best Practice Toolkit For Nursing Staff Caring For Ventilated Patients, Erin Belisle

Student Scholarly Projects

Practice Problem: Best practice tool kits are used to guide better outcomes for ventilated patients and staff members. Many reasons can contribute to requiring a patient to be on mechanical ventilation, but the most common reasons are a trauma event and infection.

PICOT: The PICOT question that guided this project was: In critical care staff such as nurses, respiratory therapists (RT), and critical care providers caring for mechanically ventilated patients (P), what is the effect of implementing a best practice coordination toolkit (I) compared to standard care procedures (C) on the adherence to best practices by critical care providers (O)? …

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

Rounding With A Purpose: Reducing Falls In Geriatrics Residing In A Community Living Center, Ashley Wesson

Student Scholarly Projects

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts.

PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)?

Evidence: In fifteen high-quality …

Implementation Of Purposeful Hourly Rounding To Decrease Fall Rates, Dannette Kizy

Student Scholarly Projects

Practice Problem: Patient falls can lead to an increased length of stay and potentially reduce the quality of life. In addition to serious injury, the patient and the hospital have a significant financial burden. PICOT: On a medical-surgical unit, does incorporating purposeful hourly rounding in the patient care routine compared to no purposeful rounding decrease patient fall rates over eight weeks?

Evidence: Of the 35 articles related to fall prevention and PHR, a final selection of eight articles met the criteria and were of high quality and evidence levels.

Intervention: PHR was implemented to decrease falls over …

Evidence-Based Selection Of A Fall Risk Assessment Tool: A Program Evaluation Review, Lindsey Adams

Student Scholarly Projects

Fall prevention strategies are a consistent topic of discussion for healthcare regarding patient safety, as patient falls are costly to the patient and the organization. This project uses the CDC Framework for Program Evaluation to assess the fall prevention policy of a local hospital system, with particular emphasis on the fall risk assessment tool, Hester Davis. This project also explores the risks and benefits of adopting an alternative fall risk assessment tool, predictive analytics. Predictive analytics uses electronic health record (EHR) data analysis to provide a highly individualized patient fall risk score based on a large variety of patient and …

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

Addressing Anxiety In Hospitalized Adults Using A Music Intervention, Raina M. Rochon

Student Scholarly Projects

Practice Problem: The practice problem is anxiety related to hospitalization among adults in an acute care setting. Increased anxiety can lead to other issues while hospitalized including disruptive behaviors.

PICOT: The PICOT question that guided this project was: In hospitalized medical-surgical adults (P), how does the implementation of a music intervention as an adjunct to standard distraction techniques (I) compared to standard care (C) affect symptoms of anxiety as observed by the rate of behavior de-escalation team calls (O) within eight weeks (T)?

Evidence: There were five systematic reviews, four systematic reviews with meta-analysis with high level of …

Evidence-Based Best Practice Toolkit For Competency-Based Orientation In Integrating An Adult Pneumococcal Protocol To Improve Vaccine Rate: A Program Evaluation Review, Magda Angel Cifuentes

Student Scholarly Projects

Practice Problem: Low pneumococcal vaccine uptake among high-risk adults is partly due to underutilized or lack of nurse-driven vaccine protocols, limited understanding of vaccine intervals and indications by nurses, and lack of proper training. Currently, physician-driven orders are the only avenue for high-risk adults to obtain this vaccine in ambulatory sites.

PICOT: In adults 65 years or older within an ambulatory setting, does the use of an adult pneumococcal vaccine protocol, compared to a physician order (no vaccine protocol) impact the rate of vaccination over 2 months?

Evidence: Utilization of two or more interventions provided higher immunization rates. …

Action Planning With Self-Monitoring Blood Pressure Improves Blood Pressure Control In Geriatric Patients, Thuy Ai Oh

Student Scholarly Projects

Practice Problem: Uncontrolled hypertension is a global healthcare problem. Hypertension is controlled in fewer than 1 in 5 people and has been attributed to premature deaths (WHO, 2021).

PICOT: The PICOT question that guided this project was “In patients 65 years of age and older with uncontrolled blood pressure, how does a nurse-led blood pressure control program compared to standard of care improve blood pressure control at an outpatient clinic over 8 weeks?”

Evidence: Five studies provided evidence that a nurse-led blood pressure decreased blood pressure results. The evidence supported the practice change of implementing a nurse-led …

Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

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 …

Implementing Geriatric Frailty Screening In Acute Care, Christine Longley

Student Scholarly Projects

Practice Problem: Frailty is a syndrome of age-related physiologic decline characterized by an increased burden of symptoms and higher susceptibility to adverse health, including higher functional decline rates, pressure ulcers, falls, and delirium. In the general medicine unit of this project, geriatric patients were not screened for frailty.

PICOT: The PICOT question that guided this project was: In hospitalized patients 65-years-of-age and older (P), how does implementing a geriatric frailty screening tool (I), compared to standard assessments (C), influence frailty identification and personalized plans of care (O) over eight weeks (T)?

Evidence: Literature supports screening for frailty in the hospitalized …

Reduction Of Inpatient Fall Rate In An Adult Acute Care Setting, Manjusha Maprel

Student Scholarly Projects

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries.

PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 …

Improving Caregivers’ Perceived Involvement In Care Through Facilitating Communication With Hospital Providers, Heather Manolas

Student Scholarly Projects

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and …

The Use Of Tailored Interventions To Prevent Falls: A Quality Improvement Project In The Telemetry Unit, Roda Galang

Student Scholarly Projects

Background: Every year in the United States, hundreds of thousands of patients fall in hospitals with 30 to 50 percent resulting in injury. In Texas, the fall rate in adult patients is 33.9 percent, and in one teaching hospital in South Texas, patient fall rates have been above the national benchmark for two years (2017-2019), despite increased use of sitters for patient safety and multiple fall prevention strategies. The annual direct care cost of all fall events in the United States for individuals more than 65 years old is about $34 billion.

Practice problem: The objectives of the fall initiative …

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

Student Scholarly Projects

Practice Problem:There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

PICOT: This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Evidence: Thirteen pertinent studies recommended the use of …

A Policy Change To Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project, Nia Hidalgo

Student Scholarly Projects

Practice Problem: At a small community facility in Los Angeles County, there was a reporting rate of hospital-acquired Clostridium difficile cases that was higher than both state and national benchmarks.

PICOT: The PICOT question that guided this project was: In acute care patients aged 18-90, does not retesting for CDI for at least seven days compared to retesting in less than seven days reduce the incidence of false positive CDI tests during the first seven days of the hospital stay?

Evidence: The evidence demonstrates that if patients are tested initially for Clostridium difficile and then retested seven days after, the …