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The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter 2022 University of San Francisco

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …


Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, McKinley J. Waugh, Tracy L. Brewer, Lisa Wagoner 2022 University of Tennessee, Knoxville

Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, Mckinley J. Waugh, Tracy L. Brewer, Lisa Wagoner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, …


Jam – Winter 2022, Rafat Jan, Edwin van Teijlingen, Kiran Mubeen, Abeer Musaddique 2022 Aga Khan University

Jam – Winter 2022, Rafat Jan, Edwin Van Teijlingen, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.


Retention Of New Nurses In The Cardiovascular Operating Room, Hannah Shufeldt 2022 Southern Illinois University Edwardsville

Retention Of New Nurses In The Cardiovascular Operating Room, Hannah Shufeldt

Doctor of Nursing Practice Projects

Background

In January of 2020, a hospital in Springfield, Illinois started the year with seven full-time circulating nurses in the cardiovascular operating room (CVOR). Three of those nurses left before the end of the year and an additional four nurses were hired. In January of 2021, the CVOR began the year with eight nurses. Five of these nurses left by the end of the year and seven more were hired, one of which left before the end of 2021. This department has struggled to retain nurses, with a turnover rate of 42.9% in 2020 and 62.5% in 2021.

Purpose

The …


Assessment Of Caregiver Burden In A Memory Loss Clinic, Andrea Perkins 2022 Southern Illinois University Edwardsville

Assessment Of Caregiver Burden In A Memory Loss Clinic, Andrea Perkins

Doctor of Nursing Practice Projects

Background: Over 131,000 people in Illinois identify themselves as caregivers of someone with memory loss. The family caregiver may provide care including, but not limited to, assistance with activities of daily living, financial responsibilities, behavior management, and scheduling, and transportation to medical appointments. The care provided by the caregivers may lead to caregiver burden symptoms of depression, anxiety, and perceived stress. Purpose: Health care providers at a central Illinois memory clinic are not currently completing formal assessments of caregiver burden. This quality improvement project was done to determine if the current memory loss program services provide enough support …


Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon 2022 Southern Illinois University Edwardsville

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …


Increasing Hpv Vaccination In Adolescents, Emily Martin, Emily Hartmann 2022 Southern Illinois University Edwardsville

Increasing Hpv Vaccination In Adolescents, Emily Martin, Emily Hartmann

Doctor of Nursing Practice Projects

Human papillomavirus virus (HPV) is a sexually transmitted disease that can negatively affect both males and females by leading to cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancer. Vaccinating against HPV using the Gardasil vaccine is an effective method to prevent HPV, however, vaccination rates are still unacceptably low in adolescents ages 11 to 14. Pediatric providers should encourage and strongly recommend HPV vaccines to all adolescents. Addressing and easing parental hesitancy is a key component to improving vaccine acceptance. The setting for the project was a rural pediatric office in southern Illinois where HPV vaccination rates are lower than …


Implementation Of Written Discharge Instructions For Common Diagnoses In The Urgent Care Setting, Melissa Kulp, Kristin Elmore 2022 Southern Illinois University Edwardsville

Implementation Of Written Discharge Instructions For Common Diagnoses In The Urgent Care Setting, Melissa Kulp, Kristin Elmore

Doctor of Nursing Practice Projects

Abstract

Discharge instructions are an important tool providers use to communicate information to patients about their medical diagnosis after they return to their home environments. When patients understand and follow discharge instructions there are improved outcomes, fewer callbacks, and decreased return visits. The purpose of this quality improvement project were (a) to develop and distribute discharge instructions at or below a sixth-grade reading level, (b) on common diagnoses appropriate for a rural community, (c) decreased the need for subsequent office visits, and (d) decreased call volumes at a rural walk-in clinic. A large-scale literature review was conducted to determine the …


Cost-Benefit Analysis Of A Pediatric Patient Blood Management Program, Karen D. Gibbs 2022 The Texas Medical Center Library

Cost-Benefit Analysis Of A Pediatric Patient Blood Management Program, Karen D. Gibbs

UT SON Dissertations (Open Access)

Introduction

Red blood cell (RBC) transfusions can be a life-saving and important intervention used to replace blood loss or manage anemia, but they also come with risks from transfusion-associated adverse events (TAAEs). Patient blood management (PBM) involves a multidisciplinary approach to optimize care of patients who may need a transfusion, including blood conservation modalities, patient-centered decision making, among others. The impact of PBM in the pediatric setting is not well understood, particularly the impact on TAAEs and the economic impact of these programs.

The following specific aims were pursued: (1) To investigate the effect of a PBM program on transfusion …


Decreasing Seclusion And Restraint Events Among Clients Within An Inpatient And Crisis Stabilization Behavioral Health Facility, Karen Lee Richards 2022 University of San Francisco

Decreasing Seclusion And Restraint Events Among Clients Within An Inpatient And Crisis Stabilization Behavioral Health Facility, Karen Lee Richards

Doctor of Nursing Practice (DNP) Projects

Background: Despite global shifts in behavioral health treatment, changes regarding use of seclusion and restraint (S/R) continues to be extremely slow. Local Problem: Increasing S/R events and subsequent staff injuries and financial burden. Methods: A quality improvement project providing education in trauma-informed care (TIC), sensory modulation (SM), and S/R debriefing (S/RD). Interventions: Education and training for S/RD, TIC, and SM using a variety of materials and methods over a 6 to 12-month period was provided to staff within a 16-bed inpatient adult psychiatric health facility (PHF) and a crisis stabilization unit (CSU). Because of positively affecting the use of S/R, …


Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill 2022 University of San Francisco

Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: South Asians from Bangladesh, Pakistan, and India have a higher prevalence of diabetes than the general global population and are also more susceptible to developing diabetes due to biological and lifestyle factors. The South Asian diet is high in refined grains and monounsaturated fatty acids, increasing the risk of diabetes.

Local Problem: Congregants of a Sikh gurdwara (place of worship) lacked knowledge of diet and lifestyle in relation to preventing and managing diabetes. Many senior congregants have been diagnosed with diabetes or are at high risk of developing the disease.

Methods: Knowledge of diabetes prevention and management were …


Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman 2022 University of San Francisco

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …


Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary 2022 University of San Francisco

Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary

Doctor of Nursing Practice (DNP) Projects

Abstract

This paper describes a DNP project that was designed to address the issue of rural mental telehealth implementation barriers. One of the main barriers to rural telehealth programs has been a technical infrastructure incapable of adequately hosting the telehealth programs. Low-Earth orbit (LEO) internet technology has emerged as a way to solve the rural telehealth conundrum by offering an improved rural technical infrastructure. An integrated review was completed based on the following PICOT question: In rural providers, how does an educational outreach compared to no educational outreach affect provider adoption of new technologies? The evidence showed educational sessions as …


Oleoresin Capsicum Gel: Enhancing Safety For The Home Health Clinician, Lilly Dickens 2022 University of San Francisco

Oleoresin Capsicum Gel: Enhancing Safety For The Home Health Clinician, Lilly Dickens

Doctor of Nursing Practice (DNP) Projects

Problem: Home health clinicians (HHC) are at high risk for workplace violence. Providing necessary health care alone in unpredictable and remote environments are associated with poor outcomes from physical violence. Background: Pepper spray is known for its active ingredient, oleoresin capsicum (OC), as a self-defense tool. OC gel is used worldwide as a non-lethal incapacitating agent. There is an opportunity to expand workplace violence prevention (WPV) in home health by training and allowing HHCs to carry OC gel. Intervention: This DNP QI project implemented a safety intervention for HHCs, including nurses, aides, medical social workers, physical therapists, occupational therapists, and …


Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee 2022 The University of San Francisco

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 …


Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara 2022 The University of San Francisco

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …


Implementation Of Staff Education To Standardize Use Of Positions During The First Stage Of Labor, Kelsey Jo Koch 2022 The University of San Francisco

Implementation Of Staff Education To Standardize Use Of Positions During The First Stage Of Labor, Kelsey Jo Koch

Master's Projects and Capstones

The aim of this project was to assess whether supplemental education on labor positioning for Labor and Delivery nurses would increase the nurses’ confidence in utilizing patient positioning to promote fetal descent and progress labor. Previous research suggests that upright, mobile positions during the first stage of labor have various benefits, including reduced cesarean rates, shorter lengths of labor, and less epidural usage. However, a major barrier to maximizing these benefits is a gap in knowledge among Labor and Delivery nurses, resulting in inconsistent use of various positions. This improvement project addresses this problem at a large community hospital in …


The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta 2022 University of San Francisco

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 2022 University of San Francisco

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 2022 University of San Francisco

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 …


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