Nursing Administration Commons^™

Implementing The Heart Score Guideline To Decrease Length Of Stay In Low-Risk Chest Pain Patients In A Rural Hospital, Tonja D. Walker

The Corinthian

Abstract

This quality improvement (QI) project evaluated the length of stay (LOS) of low-risk chest pain (CP) patients in a rural hospital. A convenience sample of emergency department (ED) physicians and non-physician providers ages 18-75 employed at Navicent Health Baldwin were eligible for recruitment. Pre- and post-surveys were used to evaluate to evaluate ED providers’ knowledge of low-risk chest pain metrics for statistical significance and a comparison of LOS for low-risk chest pain patients was compared for clinical and statistical significance seen at the facility. The mean scores of eight items on the postintervention to preintervention knowledge survey were identical. …

Bedside Shift Report: A Way To Improve Patient And Family Satisfaction With Nursing Care, Audriana Pevec

Student Scholarly Projects

Poor communication during the handoff process contributes to approximately 30% of malpractice claims costing up to $1.3 billion annually (Fenner, 2017), which demonstrates the importance of evaluating the quality of information exchange between nurses, patients, and families when associating quality of care to patient satisfaction (Kullberg et al.,2017).

The following question guided this Evidence-Based Project (EBP) project. In adult, progressive care unit patients (P), does the implementation of a nursing bedside handoff (I) compared to current handoff practices (C) improve patient/family satisfaction with nursing care (O) over eight weeks (T)?

The literature revealed evidence from 10 studies answering …

Family Presence During Resuscitation, Brittany Whistle

Scholars Week

Background:

Families want more involvement in their loved one’s care than they did just twenty years ago. Especially, in the matter of resuscitation efforts, this involvement remains controversial.

Evidence and Findings:

Based on research, theories, and multiple educated opinions, family presence during resuscitation (FPDR) needs to be implemented in hospitals. Theories by Kolcaba and Helvie demonstrate a need for comfort and positive energy around patients to enhance the healing process. Evidence has shown multiple benefits of FPDR. The patient receives a holistic approach of care, the family gains closure and feeling of participation of care, and provides a plan for …

Peripheral Iv Bundle, Alicia Hanna

Graduate Theses, Dissertations, and Capstones

Abstract

It is estimated that over 90% of hospitalized patients require IV access during their hospitalization. Peripheral IVs (PIVs), while less risky than central lines, are not without risk to the patients. Intravenous (IV) infiltration in pediatric patients is a very common complication associated with IV access, accounting for about 67% of IV catheter removals; a less common complication, but much more serious complication of a PIV can be a blood stream infection (BSI) which can account for up to 35% of BSIs seen in patients. BSIs are associated with increased length of stay, increased morbidity and can result in …

State Actions And Shortages Of Personal Protective Equipment And Staff In U.S. Nursing Homes, Diane M. Gibson, Jessica Greene

Publications and Research

BACKGROUND: It is crucial that nursing homes have adequate personal protective equipment (PPE) and staff to protect residents and staff from COVID-19. Some states have taken actions to mitigate shortages of PPE and staffing in nursing homes, including creating dedicated long-term care (LTC) teams and supporting staffing capacity.

OBJECTIVE: To examine whether state actions and nursing home characteristics are associated with shortages of PPE and staffing.

DESIGN AND SETTING: Facility-level data, released July 31, 2020, from the Nursing Home COVID-19 Public File, were combined with data from other sources. Our sample was the 13,445 facilities with information about PPE and …

Simulation: An Effective Tool For Mentoring The Novice Nursing Faculty, Charlene B. Smith, Jeanne Hamner, Carol Hession, Cari Granier, Travis "Pete" Lewis, Ashley Thibodeaux

Journal of Interprofessional Practice and Collaboration

Abstract

The American Association of Colleges of Nursing (AACN) (2019) reported in 2018-2019, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs due to insufficient numbers of faculty and clinical sites. Two-thirds of the nursing schools related a shortage of nursing faculty and/or clinical preceptors as a reason for not admitting qualified applicants (AACN, 2019).

There is a triad of challenges facing nursing today. The evolving triad is a nursing shortage, a lack of clinical facilities and nursing faculty. Nursing education must increase enrollment to fulfill the upcoming nursing shortage. Nursing schools are …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Improving Patient Satisfaction In The Medical-Surgical Setting, Victoria A. Ogundeko

Student Scholarly Projects

Problem: Patients’ experiences at hospitals are multidimensional, and their satisfaction with the service is linked to the quality of patient care provided. In evaluating the quality of care of a hospital, the nursing handoff of patients, and the engagement efforts of healthcare staff is an important element of patient satisfaction.

PICOT: In adult medical-surgical patients, does the implementation of nursing bedside handoff reports, compared to the current method of nursing practice desk handoff reports, improve patient satisfaction scores by 10% within two months?

Evidence: After reviewing 103 articles, 12 were relevant to this project, and included observation …

Pressure Injury Documentation And Reporting: A Quality Gap, Mary Ann Laslo

Master's Projects and Capstones

Abstract

Problem: Inaccurate and incomplete pressure injury (PrI) assessment and documentation leads to inaccurate reporting of PrI quality reporting measures to the Centers for Medicare and Medicaid Services. Inaccurate, incomplete documentation of pressure injuries and wounds adversely affects the quality of care, financial reimbursement, and hospital reputation as well as increasing the risk of litigation to medical providers. Barriers to accurate and complete documentation by the nurses were inaccuracy in identification of PrIs Stage 1 or greater and knowing what and where to document the information in the electronic medical record.

Context: This quality improvement project attempted to improve nurse …

Nurse Leader Rounding: A Stellar Strategy To Improve The Patient Experience Of Care In The Emergency Department, Polina Shishkina

Master's Projects and Capstones

Abstract

Many clinical outcomes that occur in the emergency room determine the patient’s continued care and experience in the hospital and beyond as well as influence the organizational reputation in the community. Mack and Fill emphasize that “an ED visit is a significant encounter between a patient and a hospital and one that affects ‘repurchase’ decisions for future health care” (as cited in Welch, 2010, p. 65). Thus, patient experience in the emergency department necessitates continued quality improvement efforts. The emergency room, or “the front door to the hospital”, provides equitable and affordable care to patients who need urgent medical …

Nursing Leadership During Covid-19: Enhancing Patient, Family And Workforce Experience, Anne Aquilia, Karen Grimley, Barbara Jacobs, Maryellen Kosturko, Jerry Mansfield, Charlotte Mathers, Peggie Parniawski, Laura Wood, Victoria Niederhauser

Patient Experience Journal

The global COVID-19 pandemic has challenged nurse leaders in ways that one could not imagine six months ago. Along with ongoing priorities of providing high quality, cost-effective and safe care, nurse leaders are also committed to creating environments that support excellence in patient and family experience. This article will provide exemplars of how nurse leaders used decisive decision-making, adapted to novel situations and issues, ensured reliable and safe delivery of care and engaged patients, families and their workforce to create excellent experiences of care during the pandemic. Throughout this crisis, nurse leaders have learned how to grapple with quick and …

Qualifications Of Executive Nurses For Service On Hospital Boards, Michelle Lee Foxx

Electronic Theses and Dissertations

Abstract Healthcare governing boards have responsibility for the legal and financial stability of the organization. They are assuming more responsibility for quality care and outcomes. Nurse leaders have valuable insights into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. Yet, only 5% of the 3.2 million nurses in the U.S. health workforce hold a seat on hospital governing boards in the United States. The purpose of this study was to explore how nurses with executive experience perceive their own leadership qualities in the context of established requirements for executive hospital boards. Fifty …

Preceptor Education And Structured Onboarding Process, Charles Morato

Master's Projects and Capstones

Problem: Staff nurse retention is an ongoing problem for this intensive care unit (ICU). Through exit interviews from staff who left, inadequate onboarding and education made them feel unprepared for their job and not part of the team. The preceptors on the unit have never been trained on the roles and responsibilities of being a preceptor. The current onboarding process consists of pairing new hires with a preceptor who either happens to be willing to do it that day or someone who has been there the longest. There is no consistency or personalizing the orientation information to the new hire. …

Pediatric Bullying Education In Arkansas Baccalaureate Nursing Programs, Jasmine Jackson

McNair Scholars Research

Over the years, there has been an ever-increasing spotlight on the issue of bullying among adolescents. Nurses are another adult-figure, in addition to parents and teachers, that can help identify and address bullying if educated properly. The purpose of this study was to examine pediatric bullying education in Arkansas baccalaureate nursing programs. Through the use of a mixed-method approach, the newly created survey was to be completed by one faculty member from each of the 12 BSN programs in Arkansas (12 participants; 6 respondents). The paper describes the quantitative and qualitative data analysis from this non-experimental descriptive pilot study. Results …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

The Relationship Of Span Of Control To Nurse Manager Satisfaction, Jeffrey Batcher

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to examine the relationship between span of control (SOC) and nurse manager job satisfaction for nurse managers working in a hospital system. The study may help administrators identify how wide and narrow SOC correlates to the overall job satisfaction of nurse managers.

Design: A non-experimental descriptive correlational study design was used.

Methods: Data were collected from a convenience sample of nurse managers working within an eleven-hospital healthcare system. Survey Monkey was used for data collection and included a demographic questionnaire, The Ottawa Hospital Model of Nursing Clinical Practice (TOH MoNCP) Clinical Management Span …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

The Watson Room: Mitigating Compassion Fatigue In Oncology Nurses, Patricia A. Viscardi

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The aim of this project was to plan, develop, and implement “The Watson Room” or “Quiet Room” in an inpatient oncology nursing population and evaluate changes in Professional Quality of Life (ProQOL).

Background: Oncology Nurses are at high risk for compassion fatigue (CF), burn-out (BO), and secondary traumatic stress (STS) related to the effects of living the traumas of oncology patients and their families through their cancer journey and the innate stress in a complex and intense workplace. High levels of compassion fatigue, burn-out, and secondary traumatic stress that are poorly managed reduces the nurse’s ability to self-regulate their …

Stress And Burnout In Nurse Leaders, Laura E. Johnson, Kiersten J. Nichols, Jayme A. Sakhitab

Nursing Masters Papers

Problem: Nurse leaders commonly experience stress and self-reported burnout. The associated negative consequences are compelling, yet few studies to date consider the nurse leader population. Stress is “a multidimensional phenomenon determined by a person’s perceptions and may be assessed as harm, loss, threat, or challenge” (Udod, Cummings, Care, & Jenkins, 2017a, p. 160). Burnout is a lack of professional fulfillment caused by emotional, physical, and psychological stress (Nurse Burnout, 2019). Drivers are associated and contributing factors which lead to stress and self-reported burnout.

Purpose: The purposes of this correlational study are to (a) identify drivers from the literature and …

Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber

MSN Capstone Projects

With rising healthcare costs and increasing demands placed on healthcare workers, it is no wonder that decreasing hospital length of stay for patients is high priority for hospitals today. Hospital acquired infections are one of the culprits keeping so many patients hospitalized. Specifically, in intensive care units (ICU) and intermediate care (IMC) units that care for mechanically ventilated patients, ventilator associated pneumonia secondary to intubation is a complication and cost that is being sought to be avoided. Hospitals have been pro-active to prevent ventilator associated pneumonia from occurring by placing oral care bundles or protocols in place to care for …

Evidence-Based Policy And Procedure Review System, Meredith A. Stokes

Doctoral Projects

Policies and procedures guide practice and the care of patients in every field of healthcare. Incorporating best practice evidence into clinical practice is a critical step towards providing safer patient care and improved patient outcomes. The challenge has been finding a way to incorporate best practice evidence into policies and procedures. Accordingly, an evidence-based project to answer the following clinical practice question was proposed: What is an evidence-based strategy for reviewing, updating, and disseminating policies and procedures for office staff at a cancer treatment organization? Through the use of Donabedian’s Model for Quality Improvement, student created tools, and an evidence-based …

Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba

Nursing | Senior Theses

When caring for people with severe dementia, the concept of the person being central is increasingly advocated in clinical practice. Person-centered care acknowledges autonomy in all facets of care. Recent studies examine behavioral changes in individuals with dementia and how health care teams address these alterations. Health care providers are vital for effective holistic management. Therefore, this review focuses on the current knowledge regarding care goals, practices, and perceptions of the client battling with cognitive decline. A literature review ascertains that clients with dementia respond to interventions and have decreased negative health outcomes, when providers ensure values and needs are …

A Multifactorial Intervention To Reduce Weight Bias In Healthcare Providers, Rose M. Flinchum

Evidence-Based Practice Project Reports

No abstract provided.

Reducing Catheter Associated Urinary Tract Infection (Cauti) Rates Benchmark Study, Tendai B. Shambare

MSN Capstone Projects

Abstract

Urinary Tract Infections (UTIs) make up to about 40 % of all healthcare associated infections, and about 13,000 patients die yearly from Catheter Associated Urinary Tract Infections (CAUTI) complications. Urinary catheters at times maybe unjustified or inappropriate, which can potentially create increased hospital costs, patient discomfort and pain, length of hospital stay. And even death. The longer the catheter is left in place also increases the patient’s risk of developing a CAUTI. CAUTI bundle packages have been found to be effective in reducing CAUTI rates when used consistently. The bundle is a combination of evidence-based practice policies, nurse and …

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

Dnp Project: Improving No-Show Rates In Primary Care, Mai-Linh T. Nguyen, Sarah M. Kuzara

Doctor of Nursing Practice Projects

Abstract

This paper explores the factors that contribute to no-show rates in the primary care setting and effective interventions to improve no-show rates. The average no-show rate in the primary care setting is 23%, (Dantas, Fleck, Olivaria, & Humacher 2018). In 2018, the no-show rate at the WeCare Clinic was 50-60%. A literature review was conducted to gather information regarding why patients choose to no-show their appointments, the common causes of high no-show rates, and effective interventions found to decrease no-show rates. We investigated the primary causes of a high no-show rate at the WeCare Clinic by interviewing staff and …

Preventing Readmissions Through Community Health Nursing, Stephanie Dawson

MSN Capstone Projects

Incorporating community health nurses to follow patients with a moderate to high risk of readmission post-discharge could improve the risk of readmission for these patients. When a patient is discharged from the hospital, they can become overwhelmed and not be adequately prepared to go home despite the discharge education given (Kenney-Lueptow, 2020). Telephone follow up is a low-cost way to decrease readmissions and provide continued education to the patients (Heitkam, 2019). Utilizing the bedside nurses that have been caring for the patients in the hospital can create a greater sense of community for the hospital and its population. By connecting …

Reducing Readmissions In The Heart Failure Population, Yvette Castellanos

MSN Capstone Projects

This paper will explore the importance of preventing acute hospital readmissions in the heart failure adult population. Prevention of re-hospitalization is aimed at improving patient care and outcomes as well as reducing the financial stress caused by readmissions. Recurrent hospitalizations are expensive and unnecessarily overutilize resources (Donzé, Lipsitz, Bates, & Schnipper, 2013). Research shows that improving transitions of care during hospitalization and developing specific heart failure interventions healthcare providers can assist in reducing readmissions. For this project the Plan Do Check Act (PDCA) tool combined with the lean methodology. The PDCA cycle consist of planning, to identify the problems, do …

Bedside Shift Report Improves Patient Safety, Scott Meyers

MSN Capstone Projects

In the inpatient setting, Parkland Health & Hospital System has continued to have patient falls with injury above its target goal. This occurred every month throughout 2019. Additionally, multiple egregious IV medication administration errors occurred over the last year related to nurses bypassing established safety practices.

An evaluation of evidence-based literature reveals that the practice of bedside shift report (BSR) leads to a reduction in both patient falls and medication administration errors. Indeed, BSR is evidence-based practice (EBP) that promotes an overall environment of safety, quality care, and improved communication between nurses and patients. Additionally, there is virtually no risk …