Improving Communication Between The Emergency Department And Prehospital Emergency Medical Services Through The Use Of A Secure Messaging Application: A Quality Improvement Project, Jacob G. Petlon

Master's Theses and Capstones

Background: Communication between emergency medical services (EMS) and the emergency department (ED) is a key part of treating patients being transported by ambulance. This communication is moving away from traditional radio and cell phone calls to the use of secure text-based apps. These apps can generate metrics and provide real time location information that is not available using traditional methods. Increased use of these apps can improve communication between EMS and receiving EDs.

Local Problem: Wildcat hospital introduced the EMS communication app Twiage in May of 2023. There is low utilization of the app and some EMS and ED …

Resilience Training For Healthcare Professionals: A Literature Review, Michelle Dictor

Master's Projects

Purpose: An exploration of various resilience training programs to determine if there is a significant impact on the psychological resilience of health care professionals.
Method: An electronic systematic review using San Jose State University’s OneSearch database search engine was completed. The review contains published research articles between 2011-2022. Nine published articles were reviewed and used for this systematic review.
Results: There is limited data related to resilience training and resources in accredited nursing programs. Resilience training programs are both a feasible and acceptable way of building psychological resilience among interdisciplinary health care professionals.
Conclusion: Mindfulness-based resilience training programs can be …

Effectiveness Of Standardized Vs. Individualized Cancer Treatment Education, Jija Issac

Master's Projects

As the number of cancer diagnoses continues to increase and is expected to keep rising, it becomes imperative to explore avenues to optimize patient education. Research has consistently demonstrated that effective education plays a crucial role in improving patient outcomes. Through my previous experiences in various outpatient oncology infusion centers, I have observed significant variations in the methods employed for delivering patient education across different facilities. In this literature review, I explored the effects of standardized chemotherapy education and individualized chemotherapy education on patients in outpatient oncology clinics. The predominant themes across these studies encompass patient awareness of anticipated symptoms, …

Cultural Perspectives In Pain And Palliative Care, Loan Lagué

Master's Projects

Culturally and linguistically diverse (CALD) patients are constantly challenged by the different levels on which lack of cultural competency or bias occurs in healthcare. This literature review focuses on the healthcare providers’ experiences when providing pain and palliative care to CALD populations and explores the challenges that may result in health inequalities. A review of current literature was conducted using PubMed, CINHAL, Sage Journals, Ovid, and Science Direct electronic databases. Sixteen published articles between 2015-2023 were reviewed. Findings from this review identified factors that induce poor quality palliative, pain, and end-of-life (EOL) care among culturally diverse groups. Improving quality of …

The Effects Of Nursing Bedside Shift Report On Patient Safety And Satisfaction: A Systematic Review Of The Literature, Alyssa Wong

Master's Projects

Introduction: Nursing bedside shift report is a recommended strategy to promote the effective exchange of accurate patient information during the handoff process with the goal of decreasing communication errors and adverse patient events. However, adopting this handoff method into nursing practice has been challenging in the clinical setting. This systematic review aims to understand the rationale behind nursing bedside handoff by identifying the advantages and barriers to implementation and exploring how this affects patient safety and experience.
Methods: A systematic review was conducted by searching through electronic databases and Google Scholar to identify English-language peer-reviewed journal articles published between 2012 …

Implementing An Educational Intervention Aimed At Nursing Staff To Improve Patient Hand Hygiene, Bonita Moore

DNP Projects

Abstract

Background/Purpose: Healthcare organizations are responsible for ensuring that healthcare workers adhere to effective hand hygiene (HH) protocols, and ample research exists on the best methods for monitoring and encouraging compliance. Despite the importance of HH for infection prevention, there has been little focus on patient hand hygiene (PHH). The purpose of this pilot project was to focus on improving nursing staff’s knowledge and attitudes about PHH with the expectation of showing a correlation between these factors and an increase in the performance PHH.

Methods: The project used a quasi-experimental study that took place on one hospital unit at …

Effectiveness Of Self-Care Education On The Perceived Quality Of Life In Adults With A Tracheostomy, Elizabeth A. Bonnet

DNP Projects

Background: A tracheostomy is an operative procedure performed to create a stable surgical airway for patients with respiratory compromise due to a variety of clinical reasons. Living with a tracheostomy has tremendous impact on the patient as they experience alterations in their ability to eat, speak, breathe normally, and care for themselves. There is also a potential negative impact to their quality of life. Under ideal circumstances, the tracheostomy is a planned event and education is given to the patient prior to the procedure in an effort to lessen the impact and prepare them to cope with the expected life …

Improving Readmission Rates Through Warm Handoffs For Low Health Literacy Patients, Stephanie D. Poonawala

DNP Projects

Preventable readmissions are a significant cost burden to hospitals and healthcare systems and are associated with overutilization of healthcare services, suboptimal health outcomes, and reduced quality-adjusted life years (QALYs) for patients. Low health literacy is an independent patient risk factor for preventable readmissions following hospital discharge. Improving transitional care practices through targeted and timely communication with community-based healthcare providers, within the framework of Naylor’s Transitional Care Model, may reduce readmission rates for patients with low health literacy. An experimental pilot study was conducted on a standard medical-surgical unit to assess local levels of low health literacy among sepsis patients utilizing …

Staff Perceptions Of Workplace Violence In The Emergency Department; Increasing Safety Awareness And Education, Marissa Hibbs

DNP Projects

Purpose: The purpose of this project was to evaluate nursing staff perceptions of safety and workplace violence and increase safety awareness and knowledge in the emergency department of a level 1 trauma center.

Methods: This study was a single site project that used a descriptive non-experimental survey design to evaluate staff perceptions on workplace violence and safety before and after educational intervention. The study was broken down into three parts. After obtaining IRB approval, an invitation to participate in the pre-survey was distributed via email in a private electronic unit-based list server. Then an educational intervention on workplace safety and …

Evaluation Of A Discharge Clinic Implemented For Patients Without A Primary Care Provider Or Access To Their Primary Care Provider, Jessica Sass

DNP Projects

Background: Patients transitioning from an inpatient hospital stay to self-care responsibilities post-discharge are at risk for readmission resulting in increased cost and resource utilization. Care transition programs can result in cost avoidance and decreased resource utilization.

Purpose: The purposes of this project were to: (a) determine if implementation of a Discharge Clinic affected 30-day readmission rates in patients without a primary care provider, (b) ascertain if a visit by a paramedicine program paramedic impacted 30-day readmission rates in patients who missed their Discharge Clinic appointment, and (c) find out whether a second post-discharge phone call influenced 30-day readmission rates.

Method: …

Nursing Students' Competence With Anesthesia, Mallory Groover

Honors College Theses

Anesthesia management is diverse and complex. As a Registered Nurse (RN), it is imperative that the basic pathophysiology of anesthesia complications is understood in order to provide competent care. The effects of anesthesia can vary greatly depending on factors such as age, sex, health status, and lifestyle. Since there are several variables, it takes years of experience working with a diverse population to anticipate adverse effects and patient outcomes. Preparedness for anesthesia management could be improved through the use of simulations during nursing school relating to post-anesthesia care, as well as more in-depth lectures over the potential complications and pharmacodynamics …

Dedicated Vascular Access Team Benchmark Study, Rachel Davis

MSN Capstone Projects

Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages …

Registered Nurse-Led Annual Wellness Visits In Rural Health Clinics: A Program Evaluation Of A New Role, Tina Switzer

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

An Enhanced Enrollment Process To Impact Appointment Compliance In The Hf-Optimize Clinic, Carolyn Coons, Teri Diederich, Kyana Holder

Doctor of Nursing Practice Projects: College of Nursing

Background The HF-Optimize clinic showed improved utilization of guideline-directed medical therapy (GDMT) along with improved clinical outcomes from 2018 to 2020. Appointment compliance was poor with only 44% of patients completing all HF-Optimize visits. Missed appointments led to worse health outcomes, fragmented care, and provider inefficiencies. Interventions to improve appointment compliance are vital to improving heart failure outcomes. Objective The purpose of this quality improvement project is to evaluate the impact that an enhanced enrollment process has on appointment compliance in a culturally diverse, adult population referred to the HF-Optimize clinic at Nebraska Medicine. Methods This prospective quality improvement project …

Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee

Master's Projects and Capstones

Hospital acquired pneumonia’s (HAPs) are unfortunate and preventable events quality improvement efforts should focus on. At a Northern California Hospital, there was an unmet HAP rate goal of 2.3 (20 out of 8795 patients) against a target goal of 2. This increase in HAP rates, both non-ventilated and ventilated was a call to action to reduce HAP to the target goal. The quality improvement project specifically aimed to reduce HAP rates on medical-surgical units through an ultra-brief refresher on the hospital validated and endorsed ROUTE bundle. The education focused on oral care completed by the patient care technicians (PCT’s). The …

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Increasing Colorectal Cancer Screening Rates In The Psychiatric Inpatient Unit, Diane R. Ventura

Master's Projects and Capstones

Increasing Colorectal Cancer Screening Rates in the Psychiatric Inpatient Unit

Abstract

Problem: Colorectal cancer is one of the leading cancer deaths in the United States. The Psychiatric Inpatient Unit has a colorectal cancer screening compliance rate of 40% compared to the statewide average of 80%.

Context: The Psychiatric Inpatient Unit is a 58-bed inpatient intermediate care facility mental health program in Northern California. Upon review of the EMR, most PIU nurses give verbal instructions and patient education on colorectal cancer screenings when due. Still, no printed handout was provided to the patients upon review of the EMR.

Intervention: Review of …

Delirium And Staff Injury, John Olague Jr

Master's Projects and Capstones

Abstract

Problem: From April 2021 to January 2022 there were 17 cases of reported patient aggression and staff injury due to patients in the hyperactive state of delirium. In a stroke/tele unit, diagnosis of delirium was delayed due to subjective assessment from the confusion assessment method (CAM) tool. This delay allowed patients to reach the hyperactive state of delirium which poses a threat to patient and staff safety. An objective form of assessment for delirium was needed on this stroke/tele unit.

Context: Through a microsystem assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis, stakeholders in this performance improvement plan …

Standardizing Handoff Report In A Medsurg Telemetry Floor, Brandon Tyler Thompson

Master's Projects and Capstones

Problem: Hospital A’s 9^th floor telemetry units lacked a standardized method of handoff and required investigation. Current practices were evaluated, and an intervention was designed based on weak communication areas. Context: Using a 5 P’s assessment the key stakeholders included unit nurses, the nursing director, nurse educators, and unit nurse managers, and the patients were medsurg telemetry patients. The process included handoff in care and the pattern evaluated was methods of reporting with the purpose of providing high quality evidence-based patient centered care. A SWOT analysis revealed strong teamwork, interdisciplinary collaboration, and proficiency in health record technologies as strengths …