Other Nursing Commons^™

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is to …

Effectiveness Of The Purewick External Urinary Collection Device In A Long-Term Acute Care Hospital: A Program Evaluation, Charlotte Sheppard

Doctor of Nursing Practice (DNP) Manuscripts

In December 2017 a 77 bed Long Term Acute Care Hospital (LTACH) added PureWick External Urinary Collection Devices (ECD) to their Hospital Acquired Infection (HAI) Bundle. The PureWick ECD is utilized in the female patient population when urinary management is necessary and can be achieved without an indwelling urinary catheter.The PureWick ECD is a flexible wick like external catheter that allows for collection of urine through the hospital wall suction system. A program evaluation was performed relative to a program beginning in January, 2018 through September 2020 to determine if the implementation of the PureWick ECD reduced the catheter associated …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok

Student Scholarly Projects

CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that …

Implementation Of The National Early Warning Score Tool In The Acute Care Setting, Amanda Reyes

Student Scholarly Projects

Practice Problem: The organization arbitrarily called a rapid response or code blue call based on abnormal vital signs or intuition and needed a new process to identify early recognition of patient deterioration.

PICOT: For adult inpatients in an acute care setting in a large healthcare system (P), will implementation of the National Early Warning Score (NEWS) across the organization (I) compared to data from the last fiscal year where NEWS was not used (C) decrease code blue calls (O) within 8-weeks (T)?

Evidence: Eleven high quality studies met the inclusion criteria and found that the NEWS is a validated …

Pre-Admission Patient Education For A Prostatectomy Enhanced Recovery After Surgery Pathway, Vanessa C. Cotton

Doctor of Nursing Practice

Background. In the United States, prostate cancer is the most common cancer diagnosed in men and a common treatment choice is a radical prostatectomy. The Enhanced Recovery After Surgery® Society developed evidence-based guidelines to optimize treatment and improve outcomes in prostatectomy patients, yet not all hospitals are utilizing these guidelines or employing all of the elements, including pre-admission education. Purpose and Objectives. The purpose of this quality improvement project was to develop, implement, and evaluate a pre-admission patient education component for a prostate surgery pathway based on the Enhanced Recovery After Surgery guidelines. Objectives included assessing the nurse’s intention to …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Discovering Hidden Signs And Symptoms Of Heart Failure In The Electronic Health Record Using The Omaha System, Anita Reger

Dissertations

Purpose/Background/Significance: For the past 30 years, heart failure has been in the top 3 readmission diagnoses with patients discharged to community care. This is costly to the healthcare system and negatively impacts the patient’s quality of life. The purpose of this study is to evaluate a community care database to determine if previously under-considered latent variables exist that could provide early detection of heart failure signs and symptoms. Theoretical/Conceptual Framework: The theoretical and conceptual frameworks surrounding this work are the Omaha System and Donabedian’s structure, process, and outcomes theory for healthcare quality improvement supported by Neuman’s Systems Model. The Omaha …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Improving Outcomes For Sexual Assault Patients In Alignment With Hiv Npep Clinical Guidelines, Maria Dahlke, Rachel Kanz

Nursing DNP Projects

Purpose and Rationale

The purpose of this project is to improve the follow-up care given to adult patients, 18 years and older, who require human immunodeficiency virus (HIV) non-occupational post-exposure prophylaxis (nPEP) treatment after a sexual assault. The goal is to determine if organizational alignment with HIV nPEP clinical guidelines through staff education improves medication adherence for adult sexual assault patients. Currently, sexual assault survivors have the lowest medication adherence rate to HIV nPEP among those at risk for HIV.

Synthesis of Evidence

The evidence supports the standardization of care for sexual assault patients' individual needs. Educating health care professionals …

Using Infographics To Improve Completion Rates Of The Sepsis Protocol Bundle, Stephen Newbern

Doctor of Nursing Practice Projects

Hospitals have sepsis protocols that must be implemented when a patient shows positive signs and symptoms of a septic infection. Nurses learn about sepsis in nursing school and rarely further their education beyond this basic understanding of the disease. So, when nurses fail to comply with organizational instructions outlined within a defined sepsis protocol bundle, this often leads to a progression of severe sepsis in a patient and, most likely, increased cost for the healthcare facility. Multiple sepsis protocol bundle failures negatively impact organizational ratings established by The Joint Commission for patient care and are highly associated with increased sepsis …

Reflecting On The Now: Race, Gender, Socio-Economic Status And Covid-19, Ariana Montemayor, Sydney M. Scanlon

VA Engage Journal

Early in 2020, we began a project for our Women and Technology class at Old Dominion University to highlight women working in health sciences. However, our original project idea drastically changed with the onset of the COVID-19 pandemic. COVID-19 focused our attention on issues regarding societal inequalities and health disparities. Therefore, we decided to create a new project that emphasized the societal inequalities and the disproportionate impact COVID had on People of Color, women and low-income individuals. In this paper, we critically reflect on the journey of our project from conception to completion, as well as how we, and the …

Commencement Program 2021 (School Of Nursing), Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

2 | 2021 Events of Commencement

4 | University Administration

5 | Significance of Academic Regalia

6 | University History Highlights

8 | Criteria for Institutional Awards

10 | Loma Linda University Health and Loma Linda University Honorees

23 | The Program, The School Honorees, and The Speaker

25 | Candidates for Degrees

40 | Nurse's Pledge

Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya

Doctor of Nursing Practice Final Manuscripts

According to research literature, 15% of Medicare beneficiaries spend more than 7 days in the intensive care unit before they die. These Medicare beneficiaries receive aggressive, life-prolonging medical treatments that might not be in agreement with their wishes. Approximately 13% of SNF residents have improperly completed POLST forms that can result in intensive treatments that patients did not want. One barrier to the lack of POLST completion in SNFs is staff difficulty with understanding and explaining the form, a result of inadequate education.

In August 2020, the San Diego Coalition for Compassionate Care formed an education program to provide virtual …

Food Insecure Copd Patients And Healthcare Utilization: A Retrospective Study, Kristine Mendoza

Dissertations

Abstract

Purposes/Aims: Despite advances in the recognition and treatment of high-cost users of health care, the incidence of healthcare utilization remains high. Rates of hospital admissions and emergency room visits among chronic disease like COPD have become a targeted group for health management. COPD patients have multiple and complex health and social needs, but the impact of their unmet food needs is not well understood and warrants further investigation. The purpose of this study is to explore the relationships between COPD food insecure patients and healthcare utilization in San Diego County.

Background/Rationale: Government programs targeting patients with high healthcare costs …

Improving Vaccination Uptake In The Latinx Community Through Standardized Outreach, Stephanie Ramirez

Master's Projects and Capstones

In the United States, Latinx communities have experienced a disproportionately high burden of COVID-19 infections and hospitalizations throughout the pandemic. The focus of this quality improvement project is to standardize the patient outreach process and education to increase COVID-19 vaccine uptake. The ambulatory community clinic in the city of Oakland, California serves a majority of underserved Latinx patients that have demonstrated distrust of the healthcare system and their disbelief in the positive outcomes of the COVID-19 vaccine. The high burden of COVID-19 infections among the Latinx community has led to misinformation and fear. In order to overcome this issue, Clinical …

Improving Patient Experience And Staff Workflow During Ed To Inpatient Interfacility Transfers, Jonathan Nakagawa

Master's Projects and Capstones

ED overcrowding has been an issue for Facility X pre-COVID19 and has been exacerbated following the first shelter in place mandate around March 2020. Facility X had proposed to increase the amount of interfacility transfers (IFT) to mitigate overcrowding and, hopefully, improve patient outcomes. 2020 Census data had shown that patient satisfaction scores and Nurse Daily Engagement scores were down; leading Facility X to believe that there can be improvements made to the IFT workflow and communication. Patient interviews also revealed that not all patients were satisfied with how they were treated during the IFT process. This quality improvement project …

Preventing Central Line Associated Bloodstream Infections In An Adult Intensive Care Unit, Monica Shaw

Master's Projects and Capstones

Central line associated blood stream infections (CLABSI) are considered preventable healthcare acquired infections, and are associated with significantly increased morbidity, mortality, and length of hospital stay. The CLABSI rate in an inpatient unit is a meaningful metric in relation to the safety and quality of care in that microsystem. This quality improvement project examines the efficacy of a CLABSI prevention bundle in reducing CLABSI events and improving adherence to central line care policy within a medical surgical adult intensive care unit. The target areas the bundle aimed to improve were unit processes, awareness of CLABSI and central line policies, and …

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

Evaluation Of A Renewal Room For Nurses, Danica Lee, Courtney Batra, Megan Knutson

Doctor of Nursing Practice Projects: College of Nursing

Wellness is an emerging and prominent issue in recent years, and specifically has a heavy influence on healthcare institutions and their employees. Having an outlet for self-care is important in developing resilience to life’s challenges. A Renewal Room is one approach to encouraging resilience and mental health restoration. The purpose of this study is to evaluate the usability of a wellness room for nurses. Data were collected in the form of an electronic survey that examined the utility (does it do what users need) and usability of the Renewal Room by determining who uses the room, when it is used, …

Attitudes Towards Treating Injured Patients In Urgent Care, Erin Beverly

Doctor of Nursing Practice Scholarly Projects

There has been published literature on the topic of clinician bias and the effects of bias on patient care, however, a review of the literature did not yield any research on the topic of clinician bias towards treating patients injured in motor vehicle accidents (MVA’s). There has been concern about clinicians not preferring to see patients injured in MVA’s however this is only anecdotal. If this topic is to be addressed through quality improvement efforts, there should first be scholarly evidence to support these efforts. This study employed a prospective survey of a convenience sample of clinicians who practice in …

Dnp Final Report: Teamstepps For Nursing Students, Jennifer Matranga

DNP Final Reports

The purpose of this paper is to discuss the DNP project, which focused on improving communication skills for associate degree nursing students. The background and significance of this problem was identified, a systematic review of the literature was completed, and TeamSTEPPS, based on the body of evidence, was implemented in a clinical immersion setting. The project objectives were to implement communication techniques, using TeamSTEPPS, as recommended from the body of evidence. The anticipated outcomes were that nursing students would have increased confidence in asking questions in the clinical setting, reduced fear of communicating, and improved patient safety. A review of …

Leadership Strategies To Support Resilience, Katee Paine

Nursing Masters Papers

Healthcare institutions have garnered national attention due to high levels of healthcare worker burnout, stress, and turnover rates. As the largest population of healthcare workers, nurses are often confronted with stressors that can lead to burnout in their practice and work environment. The global COVID-19 pandemic has highlighted and magnified these stressors over the past year, such as emotional strain of caring for dying patients, long shifts, rotating schedules, increased workload demands, and high-stress work environments. Resilience, characterized by an ability to bounce back from adverse situations, has been found to play an important role in navigating and adapting to …

Eastern European Orthodox Christian Immigrant Women: A Pilot Study And Needs Assessment, Kimberly A. Babich-Speck

Doctor of Nursing Practice Scholarly Projects

The healthcare perceptions of the Eastern European Orthodox Christian immigrant women (EEOCIW) to the United States (U.S.) are under-represented in the literature. Although they appear similar to Americans, their cultural and religious traditions are outside the mainstream American culture. This pilot study and health needs assessment examines the women’s healthcare perceptions of 14 EEOCIW and identifies similarities and differences with 25 U.S. born Orthodox Christian women (USOCW). Between September and November 2020, interviews were conducted with Orthodox Christian immigrant women from Eastern Europe and Orthodox Christian women born in the U.S. Questions covered the perceptions of women’s healthcare, factors influencing …

Professional Quality Of Life Indicators And Turnover Intention In Forensic Nurses, Leigh Anne Meyer

Doctor of Nursing Practice Scholarly Projects

Background/Significance: Significant barriers to forensic nurse workforce development exist, affecting patient access to care. Retention of forensic nurses is a persistent problem. Turn-over of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS).

Methods: A convenience sample of forensic nurse program coordinators was used to identify the effect of an educational session on professional quality of life and strategies for reducing stressors within the role on ProQOL-5 and TIS-6 scores using a pre- post-test quasi-experimental survey design. Correlation between professional quality of life indicators …

Baccalaureate Nursing Students’ Personal Health-Promoting Attitudes And Behaviors, Margo Leavitt

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Are future nurses equipped to manage the nursing environment and set an example for their patients through personal health promotion practices? Nursing education can cause significant stress that negatively impacts nursing students’ health behaviors. In addition, the college years are an important period for the development of health habits with long-ranging effects on individuals’ health outcomes. The purpose of this study is to evaluate whether Eleanor Mann School of Nursing Baccalaureate students demonstrate changes in their self health-promoting attitudes and behaviors related to the unique demands of nursing education. A cross-sectional survey format was used to evaluate health behaviors, measured …

Post-Operative Nursing Care Of The Renal Transplant Patient, Emily Smith

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Kidneys are the most commonly transplanted organ in the United States. All patients who receive a renal transplant must be on lifelong immunosuppressants to prevent rejection of the donor organ. The majority of patients do not take their immunosuppressant medications as instructed, making noncompliance a huge issue for medical professionals. The purpose of this literature review is to explore what evidence-based techniques nurses should employ to increase the long-term compliance of immunosuppressants in renal transplant patients. A literature review was performed of fifteen studies to identify interventions that nurses can employ to increase immunosuppressant compliance. CINAL and Medline were …

Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …

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 …

The Changing Face In The Workplace: The Arrival Of The Millennial Generation, Sarah Clonch

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The entrance of the Millennial generation into the nursing workforce signifies a bright future for the nursing profession and the nursing workforce. This study began with a current review of available research that identified the Millennial generation and their views toward job satisfaction and work engagement, as compared with Baby Boomer and Generation X nurses.

PubMed, CINAHL Complete, and Google Scholar databases were employed to find 15 peer-reviewed articles for evaluation. The research findings suggest that Millennial nurses have lower rates of job satisfaction and work engagement, compared to nurses of older generations. Overall, the extracted data results were significant …