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Achieving Advance Care Planning In Diverse Populations Via Teleconferencing With Skilled Nursing Facility Residents, Tania Huezo 2021 University of San Diego

Achieving Advance Care Planning In Diverse Populations Via Teleconferencing With Skilled Nursing Facility Residents, Tania Huezo

Doctor of Nursing Practice Final Manuscripts

Background: Advance care planning (ACP) has always been a priority in healthcare, and even more crucial during the COVID-19 pandemic. It has been extremely challenging for ACP to occur in the skilled nursing facility (SNF) population once social distancing restrictions were put in place to protect residents and staff.

Purpose: The purpose of this evidence-based project was to assess the effectiveness of ACP via teleconferencing with skilled nursing facility (SNF) residents in the hope of increasing completion of high-quality Physician’s Orders for Life-Sustaining Treatment (POLST) forms.

Methods: The San Diego Coalition for Compassionate Care developed an ACP community outreach ...


Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller PhD 2021 University of San Diego

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote ...


Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht 2021 University of San Diego

Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht

Doctor of Nursing Practice Final Manuscripts

Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.


Communication In Interventional Radiology: Addressing The Challenges Of Complexity And The Impact Of Secure Text-Message Communications, Aakriti Mishra, Daniel Harwood, William Schaeffer, Anna Fabre, Emily Ochmanek, Paul Vantine, Sean Biggs, Ryan LeBaron 2021 University of New Mexico

Communication In Interventional Radiology: Addressing The Challenges Of Complexity And The Impact Of Secure Text-Message Communications, Aakriti Mishra, Daniel Harwood, William Schaeffer, Anna Fabre, Emily Ochmanek, Paul Vantine, Sean Biggs, Ryan Lebaron

Quality Improvement/Patient Safety Symposium

Background: The utilization of smartphone-based technology to improve multidisciplinary communication and patient care provides an exciting opportunity for quality improvement research. In our institution, consult requests have traditionally been responded to verbally, in person or over the phone. Unfortunately, this is prone to communication errors and duplication of work. Approximately three years ago, our division developed a uniform consultation note that could easily be placed in the patient record. Additionally, we analyze the impact of a HIPAA compliant messaging system (“Tiger Connect™”) on communication inside and outside the interventional radiology (IR) department.

Methods and materials: The electronic health record (EHR ...


Utilizing Tracer Methodology To Evaluate The Effectiveness Of A Hospital Antimicrobial Stewardship Program, Christine Smyth 2021 The University of San Francisco

Utilizing Tracer Methodology To Evaluate The Effectiveness Of A Hospital Antimicrobial Stewardship Program, Christine Smyth

Doctor of Nursing Practice (DNP) Projects

Antimicrobial resistant organisms are a growing threat in the United States and globally. It has become the expectation that healthcare institutions, including hospitals, contribute resources to create and maintain antimicrobial stewardship programs to decrease antimicrobial resistance, improve patient outcomes, and decrease the spread of multi-drug resistant organisms. The methods utilized to evaluate antimicrobial stewardship at hospitals often only evaluate outcome measures and fail to capture knowledge of the hospital antimicrobial stewardship program among prescribers, clinical pharmacists, and nurses, as well potential barriers to antimicrobial stewardship among healthcare providers. The purpose of this Doctor of Nursing project is to implement and ...


Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers 2021 Seton Hall University

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual ...


Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky 2021 University of Nebraska Medical Center

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a ...


Comparison Of Mortality Data From Nebraska’S Rural & Metropolitan Health Districts, Claire Figi 2021 University of Nebraska at Omaha

Comparison Of Mortality Data From Nebraska’S Rural & Metropolitan Health Districts, Claire Figi

Theses/Capstones/Creative Projects

As there has been minimal research done on the correlation between communities identified as rural or metropolitan and their mortality rates, this research aims to provide baseline evidence that mortality rates associated with non-infectious and infectious diseases are connected to an area’s rural or metropolitan classification. This study analyzed public data from the Nebraska Department of Health and Human Services and the Center for Disease Control to compare mortality rates related to the top two causes of death in both rural and metropolitan health districts of the state of Nebraska, United States. This data was then compared to mortality ...


Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher 2021 University of South Dakota

Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher

Honors Thesis

Infertility is a health problem that affects approximately 7 million women in the United States (Ethics Committee of the American Society for Reproductive Medicine, 2015). Due to the high costs of reproductive medicine and infertility treatment, these services tend to be expensive and have limited accessibility without full insurance coverage. Emerging literature outlines the disparities in access to proper treatment for reproductive complications. These existing studies highlight that many minority populations in the United States experience increased challenges regarding access to reproductive medicine and infertility treatment. Among these minority groups are Hispanic women, who are more likely to require reproductive ...


An Evaluation Of The Effectiveness Of A Unique Patient Experience Response Program That Provided Virtual, Visual And Emotional Connectivity To Patients And Families During The Covid-19 Crisis, Diane Burshtein, Donna Powers 2021 Catholic Health

An Evaluation Of The Effectiveness Of A Unique Patient Experience Response Program That Provided Virtual, Visual And Emotional Connectivity To Patients And Families During The Covid-19 Crisis, Diane Burshtein, Donna Powers

Patient Experience Journal

In April 2020, the New York State Department of Health issued guidelines regarding suspension of hospital visitation due to coronavirus disease 2019 to protect staff and patients and prevent spread of the virus. Recognizing that patients would need extraordinary emotional support as they faced this frightening journey, two hospitals from a health system in the national epicenter provided avenues to bridge gaps in connectedness and communication. Our program provided virtual, visual and emotional connectivity by utilizing repurposed staff to serve as patient experience ambassadors. This program reduced the burden on clinical staff while preventing furlough. A descriptive correlational study was ...


The Influence Of Covid-19 Visitation Restrictions On Patient Experience And Safety Outcomes: A Critical Role For Subjective Advocates, Geoffrey A. Silvera, Jason A. Wolf PhD, Anthony Stanowski, Quint Studer 2021 Auburn University / Patient Experience Journal

The Influence Of Covid-19 Visitation Restrictions On Patient Experience And Safety Outcomes: A Critical Role For Subjective Advocates, Geoffrey A. Silvera, Jason A. Wolf Phd, Anthony Stanowski, Quint Studer

Patient Experience Journal

With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care partners in an effort to reduce further spread of the virus. While there is foundational research on the impact of family and care partner presence on the experience of patients and patient safety outcomes, the actions driven by the pandemic allowed for a real-time comparison of the impact of family or care partner presence or lack thereof ...


Dnp Final Report: The Impact Of The Care Coordination Management Tool On Children With Special Health Care Needs, Keisia N. Sobers-Butler, MS, BSBA, RN, CMCN 2021 University of Texas at Tyler

Dnp Final Report: The Impact Of The Care Coordination Management Tool On Children With Special Health Care Needs, Keisia N. Sobers-Butler, Ms, Bsba, Rn, Cmcn

DNP Final Reports

Children with Special Health Care Needs (CSHCN) population, account for 30% of spending or $233.5 billion of the costs (Bui et al., 2017). Identifying barriers to care in the CSHCN population can be multi-faceted and complex incorporating high utilization of time, and clinical resources. This project aims to evaluate the impact of care coordination, and utilization on the CSHCN population through a Patient-centered Medical Home, use of embedded case management assessing this population through using the evidence-based Care

Coordination Management Tool (CCMT). CSHCN (N=117) and families were assessed using the CCMT at every interaction from September 1, 2020 ...


Compliance In Fall Prevention In Dementia Vs Non-Dementia Nursing Home Units, Garima Shrestha 2021 Mississippi University for Women

Compliance In Fall Prevention In Dementia Vs Non-Dementia Nursing Home Units, Garima Shrestha

Merge

The student nurse researcher performed a research study to determine if there was a difference in the compliance of fall prevention interventions between dementia and non-dementia nursing home units. The student nurse researcher hypothesized the dementia nursing home units would be more compliant with fall prevention interventions than the non-dementia nursing home units. In contrast, the null hypothesis stated there would be no statistically significant difference in the compliance of fall prevention interventions between the dementia and the non-dementia nursing home units. The Fall Prevention Intervention Checklist was used to assess environmental fall hazards in occupied resident rooms. Of the ...


Perioperative Family Updates Reduce Anxiety And Improve Satisfaction: A Randomized Controlled Trial, Lindsay S. Howe, Daniel Wigmore, Nathaniel Nelms, Patrick Schottel, Craig Bartlett, David Halsey, Martin Krag, David Lunardini, Robert Monsey, Bruce Beynnon, Michael Blankstein 2021 Larner College of Medicine at the University of Vermont

Perioperative Family Updates Reduce Anxiety And Improve Satisfaction: A Randomized Controlled Trial, Lindsay S. Howe, Daniel Wigmore, Nathaniel Nelms, Patrick Schottel, Craig Bartlett, David Halsey, Martin Krag, David Lunardini, Robert Monsey, Bruce Beynnon, Michael Blankstein

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to determine if standardized updates at specific perioperative events affect anxiety and satisfaction of the family members and if the length of surgical procedure affects the satisfaction with updates.

Methods: This study was a randomized control trial. In the control group, surgeons communicated with the family only once near the completion of the procedure. In the intervention group, families received electronic updates at 3 significant perioperative events during the procedure. A postoperative survey rating family member satisfaction and anxiety levels, using a Likert scale of 0–5, was administered.

Results: Mean level of overall satisfaction did ...


O4: Using Principles Of Continuous Improvement To Impact Hospital Consumer Assessment Of Healthcare Providers And Systems (Hcahps) Scores Through Pharmacy-Driven Interventions, Brittany Harnicher, Bertha Castrellon, Dongkoo Khang, Monique Gurney, Rick Carlson 2021 Roseman University of Health Sciences

O4: Using Principles Of Continuous Improvement To Impact Hospital Consumer Assessment Of Healthcare Providers And Systems (Hcahps) Scores Through Pharmacy-Driven Interventions, Brittany Harnicher, Bertha Castrellon, Dongkoo Khang, Monique Gurney, Rick Carlson

Annual Research Symposium

Purpose

Intermountain Healthcare’s operating model is one of continuous improvement. This model was used to identify barriers and develop pharmacy-driven interventions to improve the communication about medicines domain scores within the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This survey offers objective and meaningful information that is important for consumers and creates incentives for hospitals to improve quality of care. This study took place at Riverton Hospital, a 97-bed community hospital that is part of the Intermountain Healthcare system in Utah.

Methods

We reported scores from the surveys between January 1, 2020 and September 30, 2020 ...


O3: Current State Of Malpractice Litigation In Orthodontics, Hamid Pour 2021 Roseman University of Health Sciences

O3: Current State Of Malpractice Litigation In Orthodontics, Hamid Pour

Annual Research Symposium

No abstract provided.


A Safety Program In A Tertiary Care Center Emergency Department: An Evidence-Based Project To Increase Safety Event Reporting And Improve Frontline Staff Perceptions Of Hospital Management’S Response To Safety Events, Elizabeth Anne McMaster 2021 University of St. Augustine for Health Sciences

A Safety Program In A Tertiary Care Center Emergency Department: An Evidence-Based Project To Increase Safety Event Reporting And Improve Frontline Staff Perceptions Of Hospital Management’S Response To Safety Events, Elizabeth Anne Mcmaster

Student Scholarly Projects

Practice Problem: The lack of a non-punitive safety culture with a healthcare organization is associated with decreased safety event reporting, reimbursement rates, and staff satisfaction.

PICOT: The PICOT question that guided this project was: In emergency department frontline staff, does hospital management involvement in a safety event program, contrasted with no safety event program, improve frontline staff’s reporting of safety events and perceptions of hospital management’s response to safety events management involvement over four weeks?

Evidence: Three overlapping themes that guided this project included: improving organizational culture, open communication, and leadership support in promoting patient safety.

Intervention: A ...


Improving Emergency Department Throughput: Using A Pull Method Of Patient Flow, Jeffrey Collins 2021 University of St. Augustine for Health Sciences

Improving Emergency Department Throughput: Using A Pull Method Of Patient Flow, Jeffrey Collins

Student Scholarly Projects

Practice Problem: Overcrowding in the emergency department (ED) has been shown to increase the length of hospital stay, adversely impact patient outcomes, and reduce patient satisfaction. Problems with overcrowding and throughput are often thought of as an ED-specific inefficiency; however, the issue is indicative of hospital-wide inefficiencies.

PICOT: The PICOT question that guided this project was “For ED patients admitted to the medical-surgical unit at an acute medical center, will the implementation of a pull model for patient flow, when compared to the current push model, reduce admission delay and length of stay (LOS) within six weeks of implementation?

Evidence ...


Patient Satisfaction With Noise, Robert W. Kentner II 2021 University of St. Augustine for Health Sciences

Patient Satisfaction With Noise, Robert W. Kentner Ii

Student Scholarly Projects

Practice Problem: Noise on hospital units can interfere with patient rest, timely recovery, and statisfacton with care. Improvements in the reduction of hospital noise levels lead to improved patient satisfaction and improved rest. Patients were surveyed on their satisfaction with noise during the day and at night.

PICOT: In Acute Care Patients (P), does the implementation of a noise reduction program (I) compared to no noise reduction program (C), affect patient satisfaction with noise (O) over a six-week period (T)?

Evidence: Studies show that many hospitals have noise levels that exceed the World Health Organization’s recommended standards for noise ...


Intrapartum Guidelines For Nurse Midwives, Tanya Owens 2021 Georgia College

Intrapartum Guidelines For Nurse Midwives, Tanya Owens

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Intrapartum Guidelines for Nurse-Midwives

Abstract

Intrapartum clinical practice guidelines for certified nurse-midwives (CNMs) can improve quality of care and patient outcomes. Such improvements, however, often relate to the level of rigor in guideline development to assure quality and utilize the most recent and best evidence. This quality improvement project, introduced in three phases, aims to align existing clinical practice guidelines with national clinical practice guidelines and standards of care for certified nurse-midwives providing care in an intrapartum hospital setting. Phase One of this project will review existing clinical practice guidelines for midwifery care, accomplished by appraising 28 intrapartum guidelines. Phase ...


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