Other Nursing Commons^™

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 …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

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 …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

Evaluation Of Emergency Department Use By Adult Patients With Established Primary Care Provider, Sherry Tolentino

DNP Projects

BACKGROUND: Overutilization of the Emergency Department (ED) contributes to the unnecessary use of healthcare resources. One common cause is related to barriers to Primary Care access. Patients use the ED for conditions that can be managed in primary care due to the perception of urgency and convenience.

PURPOSE: The purpose of this project was to evaluate factors contributing to the use of the ED for adult patients with primary care providers (PCP). METHODS: A retrospective chart review was completed on 280 randomly selected patients over the age of 18 who presented to the ED between January and June 2018. Only …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

College of Graduate Studies: Theses & Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …

Hazardous Drug Administration In The Home Setting: Reducing Exposure Risks, Cynthia D. Huff Msn, Rn, Ocn, Crni, Cnl

Master's Projects and Capstones

Hazardous drug (HD) administration used to be contained in controlled-healthcare settings, however, the introduction of HDs for home administration has become a growing area of concern for home health agencies. The objectives of the Clinical Nurse Leader (CNL) project aims to improve homecare nurses' knowledge of HDs and improve competency with personal protective equipment (PPE). The microsystem provides short-term homecare services for acute and chronically-ill patients. One team leader, two home infusion coordinators, and twelve registered infusion nurses participated in learning about exposure risks and PPE use with HD administration. Kotter's 8-step change theory was used to develop behavior change …

Turning A Blind Eye: How Lack Of Communication With Er Nurses Nearly Cost A Patient Permanent Vision Loss, Kenneth Royal, April Kedrowicz

Patient Experience Journal

This narrative presents a case in which a patient was treated for conjunctivitis, but a breakdown in several layers of communication (between the hospital and the patient, and between hospital personnel) resulted in multiple medical errors that nearly costs the patient permanent vision loss. This real-life case underscores how simple communication errors may lead to life-altering consequences. Recommendations for improving communication to ensure similar errors do not happen to others are provided.

Patient Experiences Of Cancer Care: Scoping Review, Future Directions, And Introduction Of A New Data Resource: Surveillance Epidemiology And End Results-Consumer Assessment Of Healthcare Providers And Systems (Seer-Cahps), Michelle A. Mollica, Lisa M. Lines, Michael T. Halpern, Edgardo Ramirez, Nicola Schussler, Matthew Urato, Ashley Wilder Smith, Erin E. Kent

Patient Experience Journal

The shift towards providing high value cancer care has placed increasing importance on patient experiences. This scoping review summarizes patient experience literature, highlights research gaps, and provides future research directions. We then introduce a new resource that links the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program with the Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and longitudinal medical claims data. We conducted a scoping review to identify relevant research within the Medicare CAHPS domain that examine factors associated with patient-reported experiences with their cancer care. Gaps indicate a need …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Bundle Vs. Non-Bundle: Looking At Differences In Care And Outcomes At A Skilled Nursing Facility, Georgia Tsmasiros

Capstone Projects 2015-Present

The Centers for Medicare and Medicaid Services (CMS) introduced the Bundled Payments for Care Improvement Initiative (BPCI) in 2013 in an effort for consumers to have higher quality and more coordinated care. This research compared the care and outcomes of four individuals with bundled payment insurance plans and four non-bundle insured individuals with the same diagnosis, accessing rehabilitation services at a skilled nursing facility. The results show no observable differences between the outcomes of individuals with a bundled insurance plan and individuals without a bundled insurance plan. The financial implications are negative for healthcare agencies participating in BPCI who must …

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

The Challenges And Blessings Of Missionary Nursing In Africa, Jordan E. Woosley

Senior Honors Theses

Nursing is a popular career choice in the twenty-first century, and there are many opportunities within the profession to serve. An American nurse has the ability to utilize nursing skills in Africa and share knowledge with the locals. The American nurse may face challenges when adapting to the African culture and healthcare but also may be blessed by the work and ministering to the people. The American nurse faces specific challenges such as educational differences, lack of facilities and equipment, unique diseases, and poor sanitation. In spite of these challenges, the American missionary nurse is able to grow through this …

Retaining Intensive Care Nurses In Las Vegas: The Importance Of Nurse Manager Leadership, Megan Vendetti

UNLV Theses, Dissertations, Professional Papers, and Capstones

In today's healthcare climate, retaining staff nurses is desirable and may be a more permanent solution to improve the nursing shortage. Employing a leadership style that is conducive to staff nurse job satisfaction may be needed to achieve that goal. The purpose of this study was to determine the relationship of the unit manager leadership style with job satisfaction and intent to stay in the intensive care setting. Staff nurses in two Las Vegas hospitals, one private and one public, were surveyed. A questionnaire was developed and voluntarily completed by 125 registered nurses employed in adult and pediatric intensive care …