Geriatric Nursing Commons^™

Physician Orders For Life-Sustaining Treatment (Polst) Utilization In A Skilled Nursing Facility: An Educational Quality Initiative, Ryan Hazley Bsn, Rn, Dnp Student, Karl Steinberg Md, Cmd, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff …

Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam …

Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno

Master's Projects and Capstones

The focus of this CNL project is quality improvement using high quality hourly rounds to achieve improved patient satisfaction and communication with nurses. It was determined by reviewing survey results that patient satisfaction and nurse communication is below National levels. Data shows that rounds are not being done well on a medical unit before the improvement project. It is proven that patients receive and perceive higher quality care and communication with increased nurse presence at the bedside. The population of the medical unit has high numbers of confused/dementia, and dual-diagnosis patients. It was determined that the unit would benefit from …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas

Master's Projects and Capstones

Bedside shift report is a complex process, which involves the transition of care from one clinician to another. The Agency for Healthcare Research and Quality (AHRQ) (2013) reported that approximately 70% of patient adverse events are attributed to communication failures between healthcare providers. Nurses remain inconsistent with information sharing during bedside shift report leading to communication gaps. The object of the clinical nurse leader (CNL) internship project is to provide true patient-centered by standardizing bedside shift report by implementing a nursing report sheet and addressing patient needs. The project was conducted in a level-one trauma center in San Diego, CA …

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …

Treatment-Related Decisional Conflict, Quality Of Life, And Comorbid Illness In Older Adults With Cancer, Jeannette Kates, Phd, Msn, Gnp-Bc

College of Nursing Posters

As the aging population in the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults are confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. In their current research agenda, the Oncology Nursing Society identified the need for research related to multiple comorbidities in older adults with cancer. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional …

Preserving Dignity In The Long Term Care Of Actively Dying Residents, Libby-Rose Cronican

All College Thesis Program, 2016-2019

As one goes through the process of aging and approaches death, they experience a series of losses: from the loss of physical or mental ability to the ultimate loss of life. These losses make the individual vulnerable to harms that can come from a variety of sources. One source is found within the everyday interactions of long-term care nurses and aides with their elderly, dying residents. Creating this harm stems from a poor nursing practice where the nurse or aide fails to recognize and promote the resident’s dignity and autonomy. The normal notion of dignity and autonomy does not encompass …

Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication …

Antimicrobial Stewardship: Incentives And Barriers To Implementation In Skilled Nursing Facilities, Gloria M. Escalona

Doctoral Projects

This study was part of a quality improvement effort of a Skilled Nursing Facility (SNF) to develop and establish an antimicrobial stewardship program to comply with recently enacted California State Senate Bill 361 (SB 361), which went into effect January l, 2017 (Skilled nursing facilities, 2015). The division of the facility into two sections, one staffed largely by Licensed Vocational Nurses (L VNs) and another staffed largely by Registered Nurses (RNs) provided an study opportunity that easily differentiated the licensed nurses. This study used three methods: 1) an educational intervention to licensed nurses, 2) a post-educational intervention survey of licensed …

Older Adults’ Response To Adverse Opioid Related Events: A Secondary Analysis, Sarah R. Coughlin

Honors Scholar Theses

Background: Many older adults suffer from chronic pain, a disease treated with opioids. Older adults are also highly susceptible to opioid ADEs. Research addressing older adults’ self-management of opioid ADEs is lacking.

Objectives: This study compared the opioid ADE profile found by the present research to those previously reported in the literature for older adults. It also described how older adults respond to opioid ADEs and the resulting outcomes.

Method: The study utilized a secondary analysis design to examine 15 opioid ADE cases from a pilot study that described older adults’ responses to analgesic ADEs.

Results: Neurological ADEs, including dizziness …

Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver

The Qualitative Report

The issue of the literature review remains a conundrum and a controversy within the discourse on grounded theory methodology. Grounded theory researchers are expected to minimize preconceptions to ensure the concept of interest is grounded in data, yet at the same time are required to evaluate existing literature to support institutional ethics and scientific review of the research proposal. In addressing this dilemma, we espouse that literature review in grounded theory should comprise a multistage nonlinear approach to the literature and introduce a framework for novice grounded theory researchers. This framework offers a reflexive, dynamic and integrative process for conducting …

Relationship Between Physical Activity And Risk Of Falls In Elderly Of West Marin, Chelsey White, Crystal Hunter, Fasha Ruys-Solorzano, Nancy Hunt, Shay Mozzetti, Nima Tso, Nicholas Ward, Tony Guevara, Kayla Kinsman, Dolma Tso, Sadaf Sardar, Halina Truong

Scholarly and Creative Works Conference (2015 - 2021)

Background: Fall injury is a leading cause of death and disability among older adults (Alamgir, 2012). Fall injury may result in fractures, infection and fear of movement. By reinforcing engagement in muscles used during balance and walking, seniors may avoid unnecessary falls within their homes and the community.

Setting/Target Population: West Marin is the largest rural area of Marin County, California and includes seven unincorporated communities. A large percentage of the elderly population who reside in West Marin live alone--thus suffering from isolation. Within the rural, isolated communities of West Marin, the rate of falls among the elderly …

Promoting Influenza Immunizations For Seniors In South Central Kentucky, M. Susan Jones, Matthew L. Hunt, Sujaya Thogaru

Nursing Faculty Publications

No abstract provided.

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …

Disability In Long-Term Care Residents Explained By Prevalent Geriatric Syndromes, Not Long-Term Care Home Characteristics: A Cross-Sectional Study, Natasha E. Lane, Walter P. Wodchis, Cynthia M. Boyd, Thérèse A. Stukel

Dartmouth Scholarship

Self-care disability is dependence on others to conduct activities of daily living, such as bathing, eating and dressing. Among long-term care residents, self-care disability lowers quality of life and increases health care costs. Understanding the correlates of self-care disability in this population is critical to guide clinical care and ongoing research in Geriatrics. This study examines which resident geriatric syndromes and chronic conditions are associated with residents’ self-care disability and whether these relationships vary across strata of age, sex and cognitive status. It also describes the proportion of variance in residents’ self-care disability that is explained by residents’ geriatric syndromes …

Religious/Spiritual Coping In Older African American Women, Danice B. Greer, Willie M. Abel

The Qualitative Report

The purpose of this study was to identify religious/spiritual coping behaviors of African American women with hypertension (HTN) and explore how religious/spiritual coping influences adherence to high blood pressure (HBP) therapy in older African American women. A mixed-method research design guided this study. Twenty African American women with primary HTN were enrolled in this study using a mixed methods concurrent triangulation design. Data collection included physiologic, descriptive, and sociodemographic data. Adherence was measured using the Hill-Bone Compliance to High Blood Pressure Therapy scale (Kim, Hill, Bone, & Levine, 2000), and religious/spiritual coping was evaluated with the Brief Religious/Spiritual Coping scale. …

Care Coordination In Bone Health Screening Between Individual Behaviors And Health Care Services Among Korean-American Women Across Three Age Groups, Young-Shin Lee

Asian/Pacific Island Nursing Journal

Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care …

Adult Qdts, Chinese, Marianne E. Weiss, Binghua Wang

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …