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Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale 2016 University of Kentucky

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m2) seen by one surgical service over a two and …


Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard 2016 University of Kentucky

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …


Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews 2016 University of Kentucky

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …


Implementing Sbar Training With Acute Care Nurses, Maureen Murray 2016 University of Kentucky

Implementing Sbar Training With Acute Care Nurses, Maureen Murray

DNP Projects

Background In 1999, the Institute of Medicine reported 98,000 deaths in US hospitals due to medical errors. The Joint Commission posits 70% of sentinel events are rooted in communication errors. The US military and aviation industry had developed structured communication tools to reduce communication error and shared this with healthcare in the form of the Situation Background Assessment Recommendation (SBAR) tool. The Joint Commission recommends use of the SBAR tool.

Objective Formal training on SBAR was not present at one acute care facility, constituting a gap between evidence and practice. This practice improvement project aimed to close this evidence-practice gap. …


Do Call-Backs Help Patients Post Stroke, Taylor E. Clark 2016 University of Kentucky

Do Call-Backs Help Patients Post Stroke, Taylor E. Clark

DNP Projects

Aim and Objective: To determine if the implementation of a post-discharge call-back intervention for patients discharged home from the hospital after stroke was associated with a decrease in 30-day readmissions and improved patient satisfaction.

Background: Stroke is a leading cause of death and disability in the United States (American Stroke Association, 2015). Several studies have examined various post-discharge interventions, including a call to the patient and/or family after their return home, to determine the benefit to patients, if any (Zolfaghari, Mousavifar, Pedram & Haghani (2012). Understanding and anticipating patient needs and removing barriers post-stroke may decrease readmission rates …


Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas 2015 Seton Hall University

Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a Wellness program to address the health disparities in a vulnerable population. The population targeted was a local population that was served at a mental health facility for socioeconomically disadvantaged. The program focused on improving knowledge of cardiovascular health, empowerment and communication skills. Significance: The significance of the project is the improvement in ones wellness by provision of education, empowerment and communication skills. The attaining of these skills can translate into other areas of wellness and improved health outcomes. Populations at risk due to socioeconomic and racial differences can …


Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez 2015 University of San Francisco

Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez

Doctor of Nursing Practice (DNP) Projects

Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …


Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos MSN RN 2015 University of San Francisco

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …


Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias 2015 University of San Francisco

Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias

Master's Projects and Capstones

Purpose: The aim of the study was to identify barriers encountered by registered nurses (RNs) and nursing assistants (NAs) that prevent purposeful (hourly) rounding.

Background: The literature has shown that purposeful rounding improves patient outcomes and safety. However, few studies show the barriers encountered by nursing staff that hinder the purposeful rounding process.

Methods: A pre-post test design was implemented on a 25-bed oncology, urology medical surgical unit with a staff of 38 RNs, 9 NAs, and 4 Unit Secretaries (US). A pre-implementation needs assessment survey was completed by 55% (21/38) of RNs, 33% (3/9) of NAs, and 100% (4/4) …


Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens 2015 The University of San Francisco

Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens

Master's Projects and Capstones

The congestive heart failure patient faces many challenges after discharge from the hospital. Learning how to manage diet, medications, and other lifestyle changes needed for symptom management can lead to multiple readmissions and rapid progression of condition. Many patients feel overwhelmed at time of discharge from the hospital, and many miss key components in discharge instructions and education. The main objective of the organizations Heart Failure program is to educate patients who have been admitted into the hospital with systolic or diastolic heart failure. Within our team we set out to educate our patients and their families on reducing incidents …


Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata 2015 University of San Francisco

Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata

Doctor of Nursing Practice (DNP) Projects

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …


Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris 2015 The University of San Francisco

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …


Fall Reduction With Nursing Interventions, Sin Ting Chan 2015 The University of San Francisco

Fall Reduction With Nursing Interventions, Sin Ting Chan

Master's Projects and Capstones

The aim of the project is to reduce the patient’s fall rate in the medical surgical unit at an acute care hospital through improving the fall precaution process. The unit consists of 37 bed with a population of stroke, medical, and surgical patients. The focus of the nursing staff education using handouts, brochures, and poster will be based on the results from pre and post intervention audits. The goal of this fall reduction project is to have the nursing staff learn, review, and apply fall prevention interventions for fall risk patients in order to help reduce fall rate by 50 …


Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware RN, MSN 2015 The University of San Francisco

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …


N653 Fall Prevention Final Project, Sam Clark 2015 The University of San Francisco

N653 Fall Prevention Final Project, Sam Clark

Master's Projects and Capstones

N653 Fall Prevention Final Project

by Samuel K. Clark, RN

This project was done with patient safety in mind through the use of the most current EBP available.


Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard 2015 The University of San Francisco

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …


Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia 2015 University of San Francisco

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …


Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley 2015 University of San Francisco School of Nursing and Health Professions

Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley

Master's Projects and Capstones

Patient satisfaction scores regarding how effectively staff educates patients about possible side effects of new medications are not consistently above the national average at a large metropolitan hospital in California (MHC). The results of these patient satisfaction scores shed light on the need for evidence-based strategies to improve a patient’s perception of the medication education provided to them. The basis of the incentive to improve care is ultimately increased safety and better patient outcomes. From the Root Cause Analysis, it became apparent that a few common barriers need to be addressed, but the one most frequently reported by everyone that …


Videoconferencing For Improved Access To Care, Alana L. Hernandez 2015 University of San Francisco School of Nursing and Health Professions

Videoconferencing For Improved Access To Care, Alana L. Hernandez

Master's Projects and Capstones

The aim of this project is to increase the amount of education visits completed by pharmacy nurses in an outpatient infusion clinic for patients receiving 5-fluoracil chemotherapy. Two approaches have been applied: securing additional nursing staff; and implementing a telehealth delivery system that utilizes asynchronous video and videoconferencing. The intervention will employ an internet-based application to secure a videoconferencing session between patients and nurses that are 25 miles apart; and offer a patient education video that will be used and an adjunct to videoconferencing. Microsystem data obtained by auditing schedules and patient charts showed pharmacy nurses completed 0% of pharmacy-patient …


Student Nurse Behaviors And Barriers To Successful Completion Of The Traditonal Bachelor's In Science Of Nursing (Bsn) Program., Carri Shaw 2015 Western Michigan University

Student Nurse Behaviors And Barriers To Successful Completion Of The Traditonal Bachelor's In Science Of Nursing (Bsn) Program., Carri Shaw

Honors Theses

Change is often said to be the only constant in life. This holds true to the rapidly growing field of nursing. In order to meet the demands of new challenges that emerge in nursing, the way future nurses are educated also has changed. Not all nursing students find that the profession is for them. Therefore, some attrition from school is expected. This descriptive study will explore factors that the literature suggests are related to attrition at a mid-sized public university in the Midwest. A survey given to two different level nursing cohorts will give insight to pre-licensure nursing students’ experiences …


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