Geriatric Nursing Commons^™

Cognitive Impairment And Depression In Hispanic And Non-Hispanic White Low-Income Older Adults A Cross-Sectional Study, Cecil Latta

Honors Undergraduate Theses

Hispanic older adults represent a growing population in the United States and may be disproportionately affected by cognitive impairment and depression. We theorize that cognitive impairment would be more prevalent in the older Hispanic community and would affect the levels of depression in both Hispanic and non-Hispanic Whites older adults. This cross-sectional study examined the association between cognitive impairment and depression in 157 older adults, including Hispanic (n = 91, 57.96%, age: M = 76.4, SD = 6.8) and non-Hispanic White (n = 66, 42.04%, age: M = 76.2, SD = 6.5). We used the Memory Impairment Screen to assess …

The Effects Of Nurse-Led Physical Activity On The Aging Population, Kaitlyn P. Carruba

Honors Undergraduate Theses

The aging population in the United States is increasing in proportion, yet older adults' physical activity levels have not increased much. The lack of physical activity leads to numerous health complications, such as an increased risk for cardiovascular disease, increased risk for falls and fractures, as well as lead to obesity and diabetes. Unfortunately, few healthcare facilities monitor or audit physical activity. Older adults are frequently placed on fall risk precautions, which heavily encourages a sedentary hospital stay. This commonly leads to older adults with declining abilities to accomplish their activities of daily living (ADLs) after hospitalization. Nurses, spending the …

Quality Of Life (Qol) Among Cataract Patients In A Selected Hospital, Mangaluru, Ashritha Mendon, Annmariya Babu, Ashmitha Rodrigues, Anupama Johnson, Ans Mariya Joy, Arya Raphel, Precilla Dsilva

Manipal Journal of Nursing and Health Sciences

Background and Aim: A cataract is a condition in which the typically clear lens of the eye or its capsule, which is a transparent membrane surrounding the lens, becomes clouded or opacified, making it difficult for light to pass through the lens and reach the retina. This study aims to assess the quality of life among patients diagnosed with cataract and to determine the association between Quality of Life(QOL) and baseline variables.

Materials and Methods: A descriptive study was conducted in a selected hospital in Mangaluru. The sample consisting of 152 subjects was selected by purposive sampling technique. The tool …

Tailored Activity Program For Ltc Residents With Dementia, Madison Olds, Rebecca King

Fall 2024 OTD Capstone Symposium

Nursing home residents with dementia diagnoses should have the opportunity to participate fully in community activities and receive the proper assistance and accommodations to do so. This project developed a tailored activity program to promote socialization, occupational justice, and quality of life for residents in an assistive living facility with various diagnoses. This program provides both environmental and activity adaptations to support full engagement for all participants regardless of any preexisting deficits.

Increasing Leisure Activity Participation And The Quality Of Life Of People With Dementia And Their Caregivers, Karla Vela, Rebecca King, Keegan Mckay

Fall 2024 OTD Capstone Symposium

The problems associated with the progression of dementia, such as increased stress, and a decrease in engagement in leisure activities and social participation have a negative impact on the patients’ and caregivers’ quality of life. In addition, there is limited research on the long-term impact of occupational therapy leisure activity programs on patients with dementia and their caregivers’ quality of life. A leisure activity program was created for people with dementia and their caregivers to improve their leisure activity engagement and quality of life. Overall, the participant’s and caregivers benefitted from this program and had positive opinions based on the …

Older Adult's Fall Prevention Program, Myles Butler, Rebecca King

Fall 2024 OTD Capstone Symposium

The decline in bodily functions with aging increases older adults' vulnerability to falls, which is a leading cause of death within this population. The poster presents an educational based fall prevention program focused on safety awareness and risk management for older adults. In conclusion, implementing a fall prevention program leads to increased awareness regarding risk factors that are detrimental to the safety and well-being of the older adult community

Improving Performance And Documentation Of The Bedside Mobility Assessment Tool, Joseph P. Chellew

Master's Projects and Capstones

Objectives: Decreased patient mobility is associated with negative health outcomes including decreased functional capacity, pressure injuries, deep vein thrombosis, and bloodstream infections (Yasmeen et al., 2020). Early and increased mobilization mitigates these complications and is associated with positive outcomes (Wang et al., 2020). The Bedside Mobility Assessment Tool 2.0 (BMAT) is a mobility assessment that guides the selection of equipment to safely mobilize patients (Boynton et al., 2020). Aim: This quality improvement project aims to increase BMAT documentation compliance by 10% in three medical-surgical units at Hospital A where only 31.3% of patients were assessed per day using the BMAT. …

Reducing Healthcare-Acquired Pneumonia In A Geriatric Long-Term Care Facility, Jacob R. Magsalin

Master's Projects and Capstones

Problem: Healthcare-acquired pneumonia (HAP) is a nosocomial infection that poses a serious threat in geriatric long-term care facilities due to its high morbidity and mortality.

Context: This evidence-based quality improvement project seeks to reduce the incidence of HAP in a geriatric long-term care facility in the San Francisco Bay Area by utilizing findings

from existing literature.

Interventions: Key interventions include improving and standardizing oral care techniques and promoting education on HAP prevention to allow patients and their families to be more proactive in preventing this complication.

Measures: Outcome measures include HAP diagnosis rates after implementation, any costs saved for the …

Enhancing Communication And Reducing Near Misses Through Comprehensive Handoff Tools At A Residential Nursing Facility, Sabrina Guralnik, Sophia Nguyen, Gabriela Benelyahu, Giselle Peyus

Master's Projects and Capstones

Our quality improvement project at Regina House addresses communication gaps during patient handoffs, which have led to missed or delayed care. The research underscores the critical role of effective communication in patient safety, particularly for vulnerable populations in nursing homes. Current handoff practices at Regina House are inconsistent, especially among Certified Nursing Assistants, resulting in frequent reporting errors and communication disparities.

To enhance patient safety and care continuity, this project introduces a standardized handoff tool and an incident reporting system, aligning with Regina House’s goal of improving care quality. Over three months, CNAs will receive training on the tool, with …

Implementing The Brief Confusion Assessment Method (Bcam) Delirium Screening Tool In An Emergency Department, Carolina Van Dalen

Master's Projects and Capstones

Problem: Persons with delirium have an elevated risk of falls. Thus, falls and delirium are inextricably linked. Both should be routinely screened for older adults.

Context: A 40-bed Emergency Department (ED) in the East San Francisco Bay area of Northern California and the first site among all acute care hospitals in the organization to implement the Brief Confusion Assessment Method (bCAM) delirium scoring tool within the Electronic Health Record (EHR).

Interventions: An EHR toolkit for delirium screening using bCAM was developed, tested, and implemented in the ED.

Measures: The outcome measure was the percentage of patients with a reported fall …

Optimizing Fall Prevention: A Quality Improvement Initiative To Enhance Documentation And Intervention Accuracy Using The Hester Davis Scale In Medical-Surgical Units, Kiana Conn, Brooklin Hunter-Johnson, Jashan Kahlon, Adrian Paz

Master's Projects and Capstones

Falls among hospitalized patients remain a critical safety concern, particularly in medical-surgical units caring for geriatric and oncology patients. This quality improvement project aimed to evaluate and address gaps in adherence to fall prevention protocols by utilizing the Hester Davis Scale (HDS) in two medical-surgical units at a large metropolitan hospital in Southern California. The project focused on auditing current practices to identify inconsistencies in documentation and intervention implementation, emphasizing areas such as bed alarm activation, fall risk signage placement, and armband use. Weekly audits were conducted from October 3 to October 29, 2024, to establish baseline data and inform …

Impact Of Training For Nursing Staff In The Prevention Of Hapis, Onyinye E. Ohia, Colleen A. Anthony

Master's Projects

Abstract

Background: The incidence of Hospital acquired pressure injuries (HAPIs) have remained a problem in healthcare despite concerted efforts by hospitals and other governmental agencies to eliminate the problem via policy and emphasis on safety. There is support in literature for the training of healthcare professionals as an important tool in the prevention and management of HAPIs. Despite the existence of studies that link training of nurses to a reduction in rates of HAPIs, evidence in support of that is still piecemeal; with poorly defined outcomes.

Aims and objectives: The aim of this integrative review is to identify …

Tackling Fall Risk In Geriatric Dementia Patients: The Impact Of Medication Reconciliation Relating To Polypharmacy & Falls, Jenl Khristen Ang

Nursing | Student Research Posters

Over half of the elderly population are taking three or more prescription drugs daily. For those aged 65 and older, polypharmacy, taking five or more medications, is common due to conditions like hypertension, heart disease, arthritis, and diabetes (CDC, 2019). Managing these medications can be challenging, especially for those with dementia, who may also take drugs for conditions such as diabetes or depression, which can worsen cognitive impairment (Chippa & Roy, 2023). The complex regimens and increased sensitivity to medications heighten the risk of adverse events, particularly falls, a major cause of injury, hospitalizations, and loss of independence in older …

Best Practice Toolkit For Nursing Staff Caring For Ventilated Patients, Erin Belisle

Student Scholarly Projects

Practice Problem: Best practice tool kits are used to guide better outcomes for ventilated patients and staff members. Many reasons can contribute to requiring a patient to be on mechanical ventilation, but the most common reasons are a trauma event and infection.

PICOT: The PICOT question that guided this project was: In critical care staff such as nurses, respiratory therapists (RT), and critical care providers caring for mechanically ventilated patients (P), what is the effect of implementing a best practice coordination toolkit (I) compared to standard care procedures (C) on the adherence to best practices by critical care providers (O)? …

Effectively Addressing Hospital-Acquired Pressure Injuries With A Multidisciplinary Approach, Nicki Roderman, Shandlie Wilcox, Andrew Beal

HCA Healthcare Journal of Medicine

Background

Hospital-acquired pressure injuries (HAPIs) result in patient harm, discomfort, and even death, with an estimated 2.5 million HAPIs occurring annually in the United States. These pressure injuries from prolonged pressure on the skin and deeper tissues cause reduced blood flow and the breakdown of skin and tissues, resulting in wounds. Additionally, these injuries contribute to longer hospital stays and increased health care costs. Hospitals have programs aimed at reducing HAPIs as well as ongoing surveillance to identify new trends early on. This ongoing monitoring revealed a trend early at our institution that HAPIs were 66% higher than the national …

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

Inpatient Falls: Epidemiology, Risk Assessment, And Prevention Measures. A Narrative Review, Taylor Locklear, Jeannie Kontos, Callaham A. Brock, Alexander B. Holland, Rachel Hemsath, Anna Deal, Shannon Leonard, Carsten Steinmetz, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such …

Combating Dehydration In The Dementia Patient, Crystal L. Widemon

MSN Capstone Projects

Dehydration is a prevalent global health issue impacting individuals across all demographics, with the elderly—especially those suffering from dementia—being particularly vulnerable. As the elderly population grows and dementia rates increase, addressing dehydration becomes crucial to reduce hospitalizations, mitigate healthcare costs, and enhance patient well-being. This executive summary outlines a proposed intervention aimed at improving fluid intake among elderly dementia patients residing in residential care facilities.

Research indicates that dehydration significantly impacts the health and financial costs associated with dementia care. Studies have shown that dehydration exacerbates cognitive decline and behavioral symptoms in dementia patients, leading to increased dependency and healthcare …

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

A Nursing Education Intervention For Delirium Prevention, Sarah Eckles

Doctor of Nursing Practice Projects: College of Nursing

Background

At a large, tertiary care hospital in the Midwest, it had been anecdotally noted that delirium or acute encephalopathy cases were increasing. Specifically, inpatient neurology consultations for delirium were on the rise. This data had been confirmed by hospital administration. Delirium has been identified as a well-known problem in elderly, hospitalized adults—most notably in elderly, postoperative adults. It can cause a cascade of additional complications for elderly patients. Delirium prevention is known to be the best method to combat delirium incidence. Prevention has been proven to occur by way of non-pharmacologic, early interventions by nursing. Bedside nursing staff must …