Other Nursing Commons^™

Resuscitation Quality Improvement Mortality Rates, Jordan Priest

Dissertations

This paper explores and answers the question: What is the impact of Resuscitation Quality Improvement on survival at discharge rates after suffering an IHCA when compared to every two-year BLS/ACLS training? Articles are explored that identify positive patients’ outcomes when resuscitation training is repetitively learned. The design consists of a BLS/ACLS and RQI evaluation of quarterly survival to discharge rates prior to the initiation of the new RQI program and after the initiation of the new RQI program. The setting of the study is the east region of a midwestern faith-based health care system, that includes four hospitals in one …

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

The Effects Of Chemotherapeutic Agents On Cognitive Function: A Literature Review, Corinne Menz

The Eleanor Mann School of Nursing Undergraduate Honors Theses

With increasing cancer diagnoses and an increase of chemotherapy treatment, many patients complain of cognitive decline during the duration of treatment as well as once treatment has been completed. The purpose of this review is to compile relevant research regarding chemotherapy-related cognitive impairment and its implications for the care of cancer patients. Peer-reviewed articles and studies focusing on the impact of chemotherapy on cognitive function were evaluated, resulting in a total of 12 studies utilized in this review. Overall, it has been found that a large percentage of patients undergoing chemotherapy treatment report a subjective decline in cognitive functioning, but …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Compliance With A Nurse-Driven Hypoglycemia Protocol: Time From Hypoglycemia Event To Euglycemia, Robin A. Chappell

Student Scholarly Projects

Practice Problem: Hypoglycemia is a known complication of diabetes mellitus and is considered one of the top three adverse drug events by the U.S. Department of Health and Human Services (2019) because it is common, clinically significant, measurable, and preventable.

PICOT: The PICOT question that guided this project was: In non-critical hospitalized adult patients on medical-surgical units with documented HGEs, how does active surveillance for strict adherence to a nurse-driven hypoglycemia protocol, compared to no surveillance, affect the time from hypoglycemia to euglycemia?

Evidence: Treatment of hypoglycemia is commonly inconsistent and prolonged; however, active surveillance and monitoring of a …

Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

The Effects Of Moderate-Severe Plaque Psoriasis On Patient Well-Being And Prevention Of Flares, Glenn Devera

Nursing | Senior Theses

Psoriasis is a chronic skin condition that is indicated by red, patchy and scaly skin that can be painful when irritated. Patients with psoriasis have an increased risk for a number of chronic diseases. Despite the expansion of treatments for moderate-to-severe psoriasis over the last decade, patients may still find that treatment strategies are not as successful, leaving them dissatisfied with their treatments. A relationship built upon trust between the nurse and the patient diagnosed with psoriasis may serve to help ensure optimal care. A comprehensive literature review was performed and found that best practices for patient management need to …

Early Diagnosis Of Alzheimer’S Disease In The Primary Care Setting, Raymond R. Romano

Theses and Dissertations (ETD)

The burden of Alzheimer’s disease (AD) affects not just the individual but also families, providers, and society. Early recognition and diagnosis of AD may reduce cost by reducing interaction with the health care system, earlier initiation of treatment, and prolonging time to long- term care. Primary care providers, the first contact for diagnosis of patients with AD, are not fulfilling the potential of early diagnosis for a variety of reasons. Biomarkers of AD emerge on average 15 to 20 years before clinical diagnosis, yet currently established biomarkers are not easily available in the primary care setting. A growing body of …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Parental Nutrition Health Literacy, Sheila F. Towson

Regis University Student Publications (comprehensive collection)

Executive Summary

Parental Nutrition Health Literacy and Children’s Health

Problem: The problem identified in the following study is that overweight and obesity is associated with comorbidities that contribute to chronic diseases such as depression, decreased academic performance, type 2 diabetes, cardiac disease and others (Allesio, 2018; Barlow & Expert Committee, 2007). Demographics reveal obesity prevalence among children and adolescents to be 18.9% in the lowest income group, 19.9% in the middle-income group, and 10.9% in the highest income group (CDC, 2018). School and home environments are especially influential in affecting school-age children’s health behaviors (Luesse, Paul, Koch, Contendo, & Marsick, …

Std Education Among African American Women: An Educational Improvement Initiative, Marqueta V. Abraham

Electronic Theses and Dissertations

Research reveals there is a knowledge gap facing African American women regarding sexual health education, specifically sexually transmitted diseases. The Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) was used to assess participants’ knowledge and attitudes regarding sexually transmitted diseases. The STD-KQ self-assessment was administered to African American women and utilized to develop a 45-minute education seminar to bridge the knowledge gap. After an education seminar was held, a posttest was administered to test the women’s knowledge and to determine their level of awareness. Using a paired-samples t test, the researcher found an overall increase in awareness of the types of sexually …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

A Malignant Hyperthermia Competency Training For Nurse Anesthesia Trainees: Development, Implementation, And Evaluation, Andrew Christ

Grace Peterson Nursing Research Colloquium

A Malignant Hyperthermia Competency Training for Nurse Anesthesia Trainees: Development, Implementation, and Evaluation

Andrew Christ, RN, BSN, DNP Candidate

Faculty: Karen Kapanke, CRNA, DNP

Background: Video simulation is an alternative method of teaching that can play an important role in nurse anesthesia education. Using video simulation for uncommon crisis could prove beneficial.

Objectives: The purpose of this study is to analyze the effects of an educational video simulation regarding malignant hyperthermia (MH) recognition and management on knowledge of nurse anesthesia trainees (NATs).

Methods: A single group pretest-posttest design was used to compare knowledge on recognition and management of malignant hyperthermia. …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

A Functional Algorithm For Weight Loss And Obesity Practice: Guide For Clinical Decision-Making For Treating Women, Jennifer A. Tice Williams

Dissertations

ABSTRACT

Background

Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.

Objectives

To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.

Methods

After an extensive literature review to identify best-practice guidelines for weight loss a …

The Effect Of Alcohol Prep Pads And Blood Drop Number On Capillary Blood Glucose Values, Joanna E. Foos

Honors Theses and Capstones

Capillary blood glucose monitoring is a common nursing procedure. However, no consensus exists regarding which drop of blood to test (drop 1 vs. drop 2) and whether using alcohol pads to prepare the fingertip affects blood glucose values. The purpose of this study was to evaluate the impact of these factors and contribute to the development of evidence-based nursing protocols for capillary blood glucose monitoring. A quantitative, quasi-experimental study was conducted in a laboratory at the University of New Hampshire. 96 volunteers were randomly assigned to one of three groups. Each group underwent a pair of capillary blood glucose tests …

Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi

Williams Honors College, Honors Research Projects

Abstract

Background

The risk of infection by antibiotic resistant organisms is a common problem in hospital settings. Methicillin-resistant Staphylococcus Aureus (MRSA) is the most common type of resistant bacteria that can have serious consequences or even lead to death. Nurses' knowledge of how to prevent and treat this problem is essential for patient safety. The purpose of this study is to determine the differences in level of knowledge of MRSA in sophomore and senior level baccalaureate nursing students.

Methods

This descriptive, comparative study will examine differences in knowledge of MRSA between sophomore and senior baccalaureate nursing students and determine if …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien

Doctor of Nursing Practice Final Manuscripts

Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.

Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …

Transition After Breast Cancer Treatment: Implementing Survivorship Care Plans, Susan Hope Klein

Doctor of Nursing Practice Final Manuscripts

The success of cancer treatments have resulted in a rapid growth of survivors, providing the impetus for the oncology community to examine models of care supporting smooth transition from active treatment to survivorship care. While initially a recommendation of the Institute of Medicine, treatment summaries and survivorship care plans are now an accreditation requirement for many organizations. This article describes the implementation of an evidence based practice project designed to meet these standards while improving the knowledge and satisfaction of a population of breast cancer patients at a community-based oncology practice.

Bacteria On Shared Mobile Phones Can Lead To Infections, Roberta Basol, Jean Beckel, Judy Gilsdorf-Gracie, Amy Hilleren-Listerud, Terri Mccaffrey, Sherri Reischl, Pamela Rickbeil, Mary Schimnich, Kirsten Skillings, Mary A. Struffert

Articles

It's now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs) if they aren't properly disinfected. The Guidelines for Disinfection and Sterilization in Healthcare Facilities describe "non-critical environmental surfaces" as items that are frequently touched by the hand and may pose a risk of secondary infection transmission.

Endoscopic Pancreatic Pseudo-Cyst Drainage, Judith Dorsam Rn

Patient Care Services / Nursing

No abstract provided.

Project Title Improving Pci Door-To-Balloon Times Through Team Collaboration, Diane Rydzy Rn, Kenneth Forte Dnp, Rockman Ferrigno, Stuart Zarich

Posters

Objective: To utilize a team approach in identifying areas of improvement to reduce median door-to-balloon times (D2B) for heart attack patients