Geriatric Nursing Commons^™

A Systematic Review Of Recruitment For Older Chinese Immigrants Into Clinical Trials, Wen-Wen Li, Yuaner Wu, Angela Chia-Chen Chen

Asian/Pacific Island Nursing Journal

Purpose: To identify barriers and discuss strategies for recruitment of older Chinese immigrants into clinical research studies.

Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). PubMed, WEB of Science, CINAHL Plus, and the Cochrane Central Register of Controlled Trials were searched from 2001 to 2014. Empirical studies with Chinese immigrants aged 60 or older were identified and analyzed. Numerical analysis, such as calculation of response rates as indexes for recruitment outcomes, was conducted. Content analyses for recruitment barriers were abstracted.

Results: Thirteen studies of 4753 subjects were analyzed. Response rates ranged from …

Lived Experiences Of Individuals With End-Stage Renal Disease On Peritoneal Dialysis, Jessica W. Airheart

Nursing Theses and Capstone Projects

End-stage renal disease (ESRD) is a prevalent condition among the elderly population in the United States. ESRD is the most feared stage of chronic kidney disease (CKD), as it is a terminal diagnosis requiring long-term management. Peritoneal dialysis (PD) is the most common method of home-dialysis treatment for individuals with ESRD. The purpose of this research is to gain insight into patient experiences of integrating PD therapy into daily lifestyle for a selected sample of people diagnosed with ESRD and currently on PD therapy. The research questions addressed include: how decisions about ESRD treatment options are made, choosing between PD …

Hope And Health Related Quality Of Life Of Older Women Who Have Had Heart Attacks, Alice Mary Kelly-Tobin

Dissertations, Theses, and Capstone Projects

Background: Heart disease is the number one cause of death and leading cause of disability in adults in the United States. Coronary heart disease (CHD) is the most common form of heart disease with heart attack as its acute manifestation. Health Related Quality of Life (HRQoL) is a multidimensional concept of self-perception of physical, emotional health, and overall sense of well-being. Hope, an inner process focusing on maintaining physical and mental well-being, is considered necessary for survival of chronic illnesses, such as CHD.

Method: Women age 65 and older who have had heart attacks (N=91) volunteered to participate in this …

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Final Manuscripts

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy behavior …

Implementing Ways To Reduce Catheter-Associated Urinary Infections (Cautis), Maryam Keyhani

Master's Projects and Capstones

Abstract

Center for Control and Disease Prevention (CDC), estimates that 40% of all Urinary Tract Infections (UTIs) are related to Hospital-acquired Infections (HAIs) (CDC, 2013). The Facility where the project was done consists of oncology, orthopedic, medical-surgical, telemetry, incentive care, and step-down units. This hospital with 242 licensed beds has approximately 51,571 ER visits and a total of 10,606 admissions per year.The prevalence of Cather-associated Urinary Tract Infections (CAUTIs) on the 4th floor, the medical-surgical unit with 42 beds was significantly higher than other units. The hospital goal is to increase patient safety and satisfaction as well as reduce and …

Reducing The Incidence Of Hospital-Acquired Pressure Ulcers By Enhancing The Role Of Unit-Based Skin Champions, Anne V. Loewenthal

Master's Projects and Capstones

Reducing the Incidence of Hospital-Acquired Pressure Ulcers by Enhancing the Role of Unit-Based Skin Champions

Abstract

Hospital Acquired Pressure Ulcer continues to be an alarming issue in today’s healthcare systems. Often preventable, it is a significant nursing role and a frequently used benchmark for quality care. Studies have shown that hospital-acquired pressure ulcer (HAPU) complications have been associated with “up to 60,000 deaths each year in the United States” (AHRQ, 2014). A major health problem, it presents grave consequences on the patient’s well-being, significant treatment and recovery delays, increase length of inpatient stays, and have become a “never” event from …

Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Reducing hospital readmissions has become a national priority for health care institutions. Telephone follow-up, a cost-effective intervention, has been used with varying degrees of success in reducing 30-day readmissions for heart failure (HF) patients. However, little is known about interventions directed toward HF patients discharged to skilled nursing facilities (SNFs). The purpose of this project was to test the effect of telephone follow-up with SNF staff by an advanced practice nurse (APN) on 30-day readmission rates. A one-time call to SNF staff was made by the APN to review key components of HF management. Readmission rates for the intervention …

Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Heart failure readmissions are a common and costly issue. Poor transitions of care as patients move from one setting to another are thought to be a major contributor to this growing problem. For those patients discharged to skilled nursing facilities (SNFs), poor transitions can be especially problematic. Telephone follow-up by nurses is a cost effective intervention commonly used to improve communication and coordination of care, thought little is known about interventions directed at patients discharged to SNFs. The purpose of this review is to evaluate the evidence regarding nurse led telephone follow-up in the transition of care process and …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority …

Development Of A Social Marketing Plan To Decrease Long Term Care Nurses Use Of Unnecessary Pharmacological Interventions To Address Residents' Behavioral Disturbances, Kela Spikes Bickham

Doctoral Projects

Seventy-six percent of long term care (LTC) residents display behavioral disturbances associated with psychiatric disorders, including dementia, which “often occur in clusters and include depression, psychosis, aggression, agitation, anxiety, and wandering” (Agency for Healthcare Research and Quality [AHRQ], 2014 para. 2; Perkins, 2012). Forty percent of LTC residents with behavioral disturbances receive pharmacological treatments to manage their behavioral disturbances, but these medications have limited efficacy and significant adverse effects (Gustafsson, Karlsson, & Lövheim, 2013). This remains important because the population, ages 65 and older (approximately 88% of all LTC residents), represent the most vulnerable to the effects of pharmacological interventions …

Impact Of Nursing Interventions On Positive Confusion Assessment Method (Cam) Scores, Katie Halsell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Delirium occurs in patients of all ages, especially in the older adult population. Symptoms vary from patient to patient, and delirium is often misdiagnosed. Patients with delirium have a higher cost of care and a longer length of stay in the hospital. Delirium is a stressful event for both the nurse and the patient, resulting in poor patient outcomes. The Confusion Assessment Method (CAM) tool is used to diagnose delirium in confused patients; a positive CAM score indicates delirium. Nursing interventions are used to treat delirium. Interventions used range from non-pharmacologic measures to use of pharmacological measures and restraints. This …

The Effects Of Congestive Heart Failure On Quality Of Life: As Evaluated By The Minnesota Living With Heart Failure Questionnaire, Diana G. Gonzalez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Congestive heart failure (CHF) is a chronic disease that impairs the quality of life (QoL) of patients and is associated with both high hospital readmission rates and healthcare resource utilization such as emergency services. This study proposed use a student led transitional care program in providing home care to NYHA functional class II and III CHF patients. It evaluated the impact of the program on their quality of life as measured by the Minnesota Living with Heart Failure Questionnaire© (MLWHFQ), the percentage of patients requiring readmission to the hospital within 30 days of initial hospitalization, and healthcare utilization. Thirty-six …

The Effects Of Patient Education And Knowledge Of Chf Patients As Evaluated By The Paksac Survey, Nabil Tovar

The Eleanor Mann School of Nursing Undergraduate Honors Theses

After diagnosis, management of congestive heart failure (CHF) can pose quite a struggle to many patients, since it requires that lifestyle changes be implemented into their daily life. Patients require the sufficient knowledge and education in order to best manage symptoms and improve their quality of life after being diagnosed. Use of Patient Knowledge of Self-care activities in Congestive Heart Failure^© (PaKSAC) survey in transitional care programs could identify patient gaps in knowledge, as well as decreasing acute care service use. The purpose of this research study was to investigate the knowledge level of CHF patients at the time …

The Effect Of Music Intervention On Cam Scores Of Hospitalized Older Adults Experiencing Delirium, Mae Lavente Dizon

Doctoral Projects

Older adults are vulnerable to developing while hospitalized is delirium. Research has shown that non-pharmacological interventions are effective in managing delirium and should be the first-line of treatment; however despite this, nurses fmd it difficult to address delirium. The purpose of this research study is to examine the effectiveness of classical music intervention in hospitalized older adults experiencing delirium by evaluating their Confusion Assessment Method (CAM) scores. A pre-and-post study design to compare the CAM scores of patients before and after music intervention was implemented. Study participants were patients 65 years and older identified to be experiencing delirium by a …

A Comparison Of Educational Approaches To The End-Of-Life-Nursing Education Consortium (Elnec) Course, Jennifer L. Bodine

Doctoral Projects

Purpose: The purpose of this project was to compare the effectiveness of two different educational approaches to teaching the End of Life Nursing Education Consortium course.

Background: Terminally ill patients frequently visit the emergency department for palliative care. However, various references show that staff does not have the knowledge base necessary to provide quality end-of-life care in the emergency setting.

Method: Participants from the emergency department at a Level I Trauma Center were recruited. A quantitative, cross-sectional pilot study was conducted to investigate whether lecture or lecture with simulation was more effective in increasing the knowledge base of participants regarding …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 who received standard …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …