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Male Perspectives Of Lateral Violence In Nursing, Benita Kinard 2020 Walden University

Male Perspectives Of Lateral Violence In Nursing, Benita Kinard

Walden Dissertations and Doctoral Studies

Lateral violence is an intentional and harmful behavior in the workplace by one employee against another. In nursing lateral violence has impacted the performance of nurses as well as patient care. Research suggests that lateral violence behaviors are still prevalent in the nursing workplace and that there have been few interventions to change these behaviors or address the power dynamics that cause them. Though most of the research on lateral violence has been conducted on female nurses, the population of male nurses is growing. Thus, the purpose of the study was to explore lateral violence in the workplace from the ...


Nurse-Driven Protocol To Reduce Urinary Catheter Infections: A Quality Improvement Project, Sara Burrington 2019 The University of San Francisco

Nurse-Driven Protocol To Reduce Urinary Catheter Infections: A Quality Improvement Project, Sara Burrington

Master's Projects and Capstones

Costs of healthcare are astronomical, not only in the financial sense, but in many aspects of life for both patients and healthcare providers. Costs include those accompanying healthcare associated infections (HAI), where as a result of environmental factors, a patient acquires an infection during their admission. Since 2008, Medicare and Medicaid no longer reimburse hospitals for infections deemed ‘reasonably preventable.’ The biggest offender of this type of HAI is overwhelmingly, catheter associated urinary tract infections (CAUTI) (Kennedy, Greene & Saint, 2013). With approximately 31% of the inpatient population requiring an indwelling catheter at some point throughout their stay, risk of infection ...


Burnout, Depression And Suicide Prevention For Nursing Staff In High-Intensity Settings, April Ritchie 2019 The University of San Francisco

Burnout, Depression And Suicide Prevention For Nursing Staff In High-Intensity Settings, April Ritchie

Doctor of Nursing Practice (DNP) Projects

Nurses working in high-intensity settings experience burnout at higher rates than in other nursing areas. Burnout in healthcare is a problem estimated as high as 70% by the Agency for Healthcare Research and Quality. Burnout can lead to depressive symptoms, which can lead to suicidal ideation in affected healthcare providers, which makes early identification and treatment of utmost importance to the mental and physical wellbeing of these nurses.

The purpose of this project is to examine burnout in nursing staff working in high-intensity areas of the hospital in order to help identify burnout and/or depressive symptoms before they lead ...


A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson 2019 The University of Southern Mississippi

A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson

Doctoral Projects

Patients with obstructive sleep apnea (OSA) are at risk for perioperative respiratory and cardiovascular compromise (Opperer et al., 2016). Unfortunately, almost 90% of patients with moderate-to-severe OSA are not diagnosed and unaware of their disorder; however, they remain at increased perioperative risks (Singh et al., 2015). The STOP-BANG questionnaire was developed to meet the need for a reliable, concise, and efficient screening tool for OSA risk. The facility at which this project was conducted did not utilize a prescreening OSA risk tool. The facility not using a prescreening OSA risk tool is especially important because the State of Mississippi currently ...


Herpes Zostervaccine To The Homebound Elderly: Prevention, Protection, And Access To Care, Serena Arts 2019 University of San Diego

Herpes Zostervaccine To The Homebound Elderly: Prevention, Protection, And Access To Care, Serena Arts

Doctor of Nursing Practice Final Manuscripts

Herpes Zoster Vaccine to the Homebound Elderly: Prevention, Protection, and Access to Care

Purpose: To increase the administration rate of the Herpes Zoster (Hz) vaccine Zostavax by 10% for persons 65 years and older in a home-based primary care practice, utilizing Medicare part D.

Background: Persons in the United States (US) age 40 years and older show a 99% positive serology for Varicella, which causes Hz decades later. Zostavax has been shown to decease Hz by 51% and post-herpetic neuralgia by 67%.

Brief Description: The goal of Healthy People 2020 is to increase the vaccination rates of persons 65 years ...


Missed Shots: Increasing Flu Vaccine Documentation Utilizing A Clinical Reminder In A Student Health Clinic, Noelle Simms 2019 University of San Diego

Missed Shots: Increasing Flu Vaccine Documentation Utilizing A Clinical Reminder In A Student Health Clinic, Noelle Simms

Doctor of Nursing Practice Final Manuscripts

Objectives: The primary purpose of this evidence-based practice project is to increase influenza vaccination documentation in the student health setting utilizing a standardized clinical reminder.

Participants: 1,337 undergraduate and graduate students at a private university is Southern California.

Methods: A clinical reminder template was created and added to the intake form in the electronic medical record. The medical assistants complete the template with the patient. The provider then orders the vaccine or educates the patient based on the documented refusal reason.

Results: During the 10-week implementation period there was a 46% increase from baseline in flu vaccine documentation at ...


Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility Pilot Project, Joshua Aaron Carr 2019 University of San Diego

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility Pilot Project, Joshua Aaron Carr

Doctor of Nursing Practice Final Manuscripts

Labor pain is a significant source of anxiety for most pregnant women. Parturients who are excluded from epidural analgesia (EA), the most common and most effective technique to reduce this pain, deserve access to the next best choice. Remifentanil patient controlled analgesia (RPCA), due to its fast onset, short half-life and demonstrated effect at reducing pain and boosting satisfaction is the next best option when compared to EA. Adoption of this strategy represents an opportunity to help bring this evidence based technique into a mainstream health system. This project reports on the first stage of a pilot project to bring ...


A Pilot Project For School-Based Screening And Treatment Of Latent Tb Infection Among Freshman High School Students, Isis Cunningham 2019 University of San Diego

A Pilot Project For School-Based Screening And Treatment Of Latent Tb Infection Among Freshman High School Students, Isis Cunningham

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s tuberculosis (TB) incidence is 2.5 times higher than the national rate. Five cases of active TB in the county’s public high schools during 2018 demonstrated the need for prevention interventions in this setting.

Objectives: This evidence-based project aimed to increase awareness, screening, and treatment of latent TB infection (LTBI) in the school setting.

Methods: A one-time TB educational presentation was given to high school freshman students with a pretest and posttest. A TB risk assessment and consent was sent home with the students. For at-risk students, a confidential package was sent to the parents ...


Using Short Message (Sms) To Deliver Appointment Reminders And Reduce No-Show Rates: An Evidence-Based Practice Project, Fernando Serrano 2019 University of San Diego

Using Short Message (Sms) To Deliver Appointment Reminders And Reduce No-Show Rates: An Evidence-Based Practice Project, Fernando Serrano

Doctor of Nursing Practice Final Manuscripts

Background/Objectives: Missed appointments (MAs) are correlated with reduced treatment efficacy, increased financial burden on medical institutions, and early treatment terminations for therapy (DeFife, Conklin, Smith, & Poole, 2010). MAs occur for a variety of reasons including, but not limited to severity of illness, financial/geographic constraints, and forgetting the appointment (Filippidou, Lingwood, & Mirza, 2014). Appointment compliance within outpatient mental health clinics has a wide variance with some clinics reporting MAs ranging from 15% to 50% (Car, Gurol-Urganci, de Jongh, Vodopivec-Jamsek, & Atun, 2013).

With decreasing costs and a subsequent massive increase in mobile phone technology use by the general population, Short ...


Nurse Practitioner Led Identification And Treatment Of Knee Pain Severity Based On Evidence Classification Protocols, Mayra Padilla Arechiga 2019 University of San Diego

Nurse Practitioner Led Identification And Treatment Of Knee Pain Severity Based On Evidence Classification Protocols, Mayra Padilla Arechiga

Doctor of Nursing Practice Final Manuscripts

Title: Nurse Practitioner Led Identification and Treatment of Knee Pain Severity Based on Evidence Classification Protocols

Background: Knee pain has become the 10th leading office visit in the United States. Prevalence of knee pain has increased 65% in the past 20 years accounting for approximately 4 million clinic visits every year. One out of five men and one out of four women in the United States suffers from knee pain. Treatment protocols in actuality are based on physical therapy, pharmacological treatment, or surgical management. However, research has demonstrated that knee pain and progression of knee related illnesses may be ...


The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell 2019 University of San Diego

The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell

Doctor of Nursing Practice Final Manuscripts

The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control

Abstract

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.

Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to ...


Comprehensive Sleep Apnea Screening In Veterans With Posttraumatic Stress Disorder, Richard W. Schulz 2019 University of San Diego

Comprehensive Sleep Apnea Screening In Veterans With Posttraumatic Stress Disorder, Richard W. Schulz

Doctor of Nursing Practice Final Manuscripts

Objectives: Recent studies have shown a higher prevalence of sleep apnea in veterans with Posttraumatic Stress Disorder (PTSD). It is estimated that 69 to 83% of veterans have Obstructive Sleep Apnea (OSA) while 80 to 90% are undiagnosed or untreated. Untreated OSA can lead to severe chronic medical conditions as well as impairment of neurocognitive and fear extinction processing potentially decreasing responsiveness to trauma focused therapy. Despite the widespread dissemination of knowledge regarding the negative effects of OSA, many veterans are not screened. The goal of this project is to increase the rate of identifying veterans who are high-risk for ...


Shingles Vaccine: Identifying High Risk Groups In The Ibd Clinic Setting, Crystal Barajas 2019 University of San Diego

Shingles Vaccine: Identifying High Risk Groups In The Ibd Clinic Setting, Crystal Barajas

Doctor of Nursing Practice Final Manuscripts

Title: Shingles Vaccine: Identifying high risk groups in the IBD clinic setting

Background: The Inflammatory Bowel Disease (IBD) population is an immunocompromised patient population who is at risk for Herpes Zoster (HZ) due to their medication regimen, which further compromises their immune system. It can be difficult for patients to receive appropriate preventative health maintenance measures due to patients’ fears, primary care providers’ lack of knowledge, and gastroenterologists not addressing what may be considered primary care topics. Furthermore, evidence demonstrates that IBD patients have low vaccination rates despite insurance coverage.

Purpose of Project: (a) To increase awareness of the importance ...


Reducing Hospital Readmission Rates Via Np- Initiated Post Discharge Telephone Calls In Dialysis Dependent End Stage Renal Disease Patients, Fabiola Carapia 2019 University of San Diego

Reducing Hospital Readmission Rates Via Np- Initiated Post Discharge Telephone Calls In Dialysis Dependent End Stage Renal Disease Patients, Fabiola Carapia

Doctor of Nursing Practice Final Manuscripts

Purpose/Aim:To determine whether a nurse practitioner-initiated phone call, in addition to the standard transition-of-care (TOC) protocol, will reduce 30-day hospital re-admissions by 50% in patients with end-stage renal disease (ESRD) after an inpatient index hospitalization.

Background: $27 billion is spent annually by Medicare for hospital readmissions. Approximately $17 billion of this amount can be attributed to avoidable causes (Kauffman, 2016). Hospitals have been penalized for excessive readmission rates under the Hospital Readmissions Reduction Program beginning in 2012 (HRRP; Centers for Medicare & Medicaid Services [CMS], n.d.). Index hospitalization refers to the first time, in a series of hospitalizations, that a patient is admitted for a specific condition or diagnosis. Medicare beneficiaries with ESRD, acute myocardial infarction, congestive heart failure, and pneumonia are the most common causes of readmissions.

In 2010, the Affordable Care Act (ACA) set aside $10 billion to encourage health care providers to develop a TOC program to reduce readmission rates (Kamermayer, Leasure, & Anderson, 2017). Several programs were developed and implemented, including HRRP and the Transition of Care Intervention Program under the ACA. In 2015, the Centers of Medicare and Medicaid Services introduced the Equity Plan for Improving Quality in Medicare (CMS, 2015). Telephone follow up calls have been shown to reduce 30-day readmission rates (Briscoe, 2018).

Process: Data from a hemodialysis clinic in southern California was /.p[;analyzed for patients with index hospitalizations. In addition to the clinic’s TOC follow-up protocol, an NP-initiated ...


Reducing Ed Re-Admissions In Post-Op Neuro Patients Utilizing A Np Telephone Follow-Up Protocol, Katherine Curran 2019 University of San Diego

Reducing Ed Re-Admissions In Post-Op Neuro Patients Utilizing A Np Telephone Follow-Up Protocol, Katherine Curran

Doctor of Nursing Practice Final Manuscripts

Reducing ED Re-admissions in Post-Op Neuro Patients utilizing a NP Telephone Follow-up Protocol

Background

Post craniotomy patients discharging from the hospital to home, commonly present to the emergency department (ED) with incisional concerns. Complaints stem from minimal post-op education, poor incision management, and lack of knowledge relational to infection. Unanswered questions prior to discharge lead to unnecessary ED visits, anxious calls after discharge, and poor patient satisfaction. ED admissions lead to fortuitous costs that can be prevented through evidenced based interventions.

Purpose/Aim

Post craniotomy patients at a large hospital system in Southern California will have decreased ED visits correlated ...


Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr 2019 University of San Diego

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication ...


Music Therapy Assisted Childbirth In The United States: A Critical Literature Review, Sydney Mohr 2019 Lesley University

Music Therapy Assisted Childbirth In The United States: A Critical Literature Review, Sydney Mohr

Expressive Therapies Capstone Theses

Music therapy assisted childbirth is an approach of music therapy in which a licensed and credentialed professional utilizes music therapy interventions to address a variety of goals during childbirth. There is a lack of literature and missing knowledge on the topic, associated with an increased rate in traumatic birth cases, mothers with post-traumatic stress disorder, and postpartum anxiety and depression. The literature review provides a summary of the historical context of feminist theory and feminism, as well as brief descriptions of music therapy, guided imagery and music, and familiar music interventions. One of the primary goals of this type of ...


Current And Upcoming Stroke Research At Baptist Health, Amy K. Starosciak 2019 Baptist Health South Florida

Current And Upcoming Stroke Research At Baptist Health, Amy K. Starosciak

Amy K. Starosciak

No abstract provided.


Implementation Of Change Of Shift Huddles In An Urban Medical Center, Benson Kahiu 2019 Seton Hall University

Implementation Of Change Of Shift Huddles In An Urban Medical Center, Benson Kahiu

Seton Hall University DNP Final Projects

Since 1999 when the Institute of Medicine (IOM) highlighted medical errors in hospitals, healthcare leaders continue to pursue relevant and sustainable patient safety initiatives. Some of these initiatives include projects that increase accountability while encouraging enhanced teamwork and communication between team members. The lack of consistent communication results in decreased patient outcomes and patient dissatisfaction. Decreased camaraderie in organizations, results in fiscal waste associated with employee tardiness and call-outs. This paper reviews the process and impact of implementing change of shift huddles in an urban medical center. Literature reviews concluded that positive outcomes were associated with implementation of huddles during ...


The Fall Free Zone, Brendalyn Malimban 2019 University of San Francisco

The Fall Free Zone, Brendalyn Malimban

Master's Projects and Capstones

The fall prevention project is designed to decrease fall rates in the medical-surgical units by promoting accuracy in identifying fall risk patients and engaging patients in participating with their own safety. The project will follow Kotter’s change model to address the urgent need for reducing fall rates (Webster & Webster, 2018). A falls taskforce committee is already in place pursuing the goal mentioned. Engaging the staff members and leaders will be accomplished through reeducation of policies and procedures, admission process and the accurate use of the SCHMID Assessment Tool. These will take place during staff meetings, huddles and roving learning ...


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