Now showing items 1-10 of 44
Pressure Ulcer Prevention: Innovation and Research Produce Positive Outcomes
Acquiring a pressure ulcer while in the hospital is a devastating outcome for the patient and their family. Pressure ulcer formation in the medical surgical patient population reflects a gap in practice because it is the ...
Bar Code Medication Administration-Clinic Orders (BCMA-CO) Increase Nurses' Satisfaction With The Medication Administration System - A Quality Improvement Project
Nurses’ satisfaction was compared before and after implementation of Bar Code Medication Administration- Clinic Orders (BCMA-CO) in a Veterans Affairs (VA) urgent care clinic. Results were significant, revealing increased ...
Interventions To Reduce Medication Errors
Medication errors are the most commonly identified errors occurring in every healthcare setting costing billions of dollars per year. They have the potential to cause death to a patient or increase hospital length of stay. ...
Decreasing Urinary Incontinence in the Home Health Setting
BACKGROUND: Urinary incontinence (UI) in the home care population poses a risk for complications and hospitalization. The aim of this project was to develop and implement a protocol for UI to promote continence in the home health agency UI population. METHODS: Data were collected from a convenience sample of 26 participants 80 years of age or older in a suburban midsized home care agency. All participants were diagnosed with UI as documeted in the Outcomes and Assessment Information Set (OASIS). OASIS question M1610 was used to identify patients with UI status, and M1650 was used, to identify UI frequency. The outcomes for these questions were assessed to examine chnage over time in UI status and frequency. INTERVENTION: Eligible patients completed a three-day bladder diary.Then, patient education was conducted on UI, risk factors, bladder training, pelvic floor exercises and hydration/nutrition parameters. Patients then completed three-day bladder diaries post intervention. RESULTS: At pretest, 100% of the participants were incontinent. At posttest, twenty four participants (92.3%) were incontinent. The results suggested that the median frequency of urinary incontinence declined overtime from 2 (range :1-4) at pretest to 1 (range: 0-4) at posttest. The decline was statistically significant (z = -3.83; p= CONCLUSIONS:The intervention had a positive effect on UI status and frequency. Future studies should examine changes in the UI complications and hospitalization rates....
Effectiveness of Motivational Interviewing-based telephone Follow-up in Diabetes Management
Diabetes mellitus is a chronic complex disease requiring persistent self-management by patients and ongoing support from the providers. The outpatient diabetes clinic of a teaching hospital in the Midwest has 78.3% patients with uncontrolled diabetes. The purpose of the project was to assess the effectiveness of telephone follow up using motivational interviewing techniques in improving glycosylated hemoglobin (HbA1c), glycemic control, and self-efficacy of patients with uncontrolled type 2 diabetes. The project involved 30 participants with uncontrolled type 2 diabetes who had a HbA1c 8% or above. The intervention included delivery of five motivational interviewing-based phone calls to the participants over 10 weeks. Patients had to attend diabetes self-management education group classes prior to the project. The diabetes empowerment scale-short form surveys conducted assessed the self-efficacy. Statistically significant improvements were noted in HbA1c levels, with a baseline HbA1c of 10.408% ± 1.71 and the post intervention HbA1c of 9.484% ± 1.62 (p = .008). The fasting blood glucose decreased significantly by 28.4%, pre-lunch blood glucose decreased by 29%, and the pre-dinner blood glucose decreased by 29% by the end of the study (p = .00). The body mass index improved slightly from 31.4 ± 6.1 to 30.37 ± 8.0 kg/m² (p = .26). Medication adherence improved significantly. The diabetes related self-efficacy also improved with the interventions. The motivational interviewing-based low-cost telephone follow-ups are effective approaches for improving HbA1c, glycemic control, and diabetes related self-efficacy of patients with uncontrolled type 2 diabetes mellitus....
Use of Point of Care Testing to Affect Clinician Treatment Decisions for Patients with Diabetes
This process improvement initiative implemented a policy for medical assistants (MAs) to perform and record point of care (POC) glucose test results in the electronic medical record (EMR), for all patients with diabetes ...
Electronic Health Record Template Customization and the Impact on Nursing Satisfaction and Documentation Compliance
Documentation is a crucial component of safe and effective patient care. A priority for health care organizations is to ensure their electronic health record (EHR) systems are used safely and effectively. They should be clinically operational, user-friendly, and suit the needs of the end user (HealthIT.gov, 2017). If EHR templates do not exist, are not customized to the needs of the user, or are not user-friendly, risks of failing to maintain proper documentation exist (Mosher, Lose, Leslie, Pennathur, & Kaboli, 2015). The purpose of this project was to develop and implement an EHR template for obstetrical and postpartum nurses to document postpartum hemorrhages (PPH) that progress to Stages 2 and 3. A customized template did not exist in the EHR to document this type of event. The template was created using information from the California Maternal Quality Care Collaborative (CMQCC, 2015) obstetric hemorrhage emergency management plan checklists. These checklists are evidence-based guidelines and are included in a policy at the project site. Everett Rogers’s diffusion of innovations theory served as the theoretical framework to guide the change. Data were collected from a researcher-designed survey and chart reviews. A convenience sample of nurses (N = 30) participated, and eight completed the survey. After template implementation, eighteen Stage 2 and 3 PPHs occurred, and the template was used twice. The template compliance rate was 11%. The project yielded several significant findings. Though not expected, a decrease occurred in the mean quantitative blood loss for Stage 2 and 3 PPHs post-template implementation. Results suggested that the creation of a customized EHR template had a favorable effect on nursing satisfaction and documentation compliance of an evidence-based obstetric hemorrhage care guideline. Substantial benefits can result when EHR technology is used to its fullest extent....
Overutilization of CT Scans of the Brain in Nursing Home Patients Post Fall
Manuscript contains abstract
A Bilingual Diabetes Self-Management Education Program for Hispanic Adults with Type 2 Diabetes Mellitus
The aim of this intervention was to determine whether diabetes self-management education will help Hispanics/Latinos with type 2 diabetes mellitus change unhealthy behaviors and effectively manage their disease. Healthcare ...
A Process Evaluation of an Outpatient Palliative Care Program: A Quality Improvement Project
Palliative care has evolved from providing care for patients near end-of-life into a specialized discipline focused on addressing the physical, emotional, social, and spiritual needs of patients throughout the trajectory of an illness. For patients with metastatic cancer, timely referrals to palliative care are essential in order to have a meaningful impact on their quality of life. Recommendations for screening patients for palliative care have been offered by professional organizations; however, screening all patients with metastatic cancer poses many challenges. This quality improvement project conducted a process evaluation of an outpatient palliative care program and evaluated the feasibility of utilizing a screening tool in an effort to readily identify patients with metastatic cancer that have palliative care needs in an outpatient cancer center. Although nurses’ compliance with the screening tool was less than expected, screening for palliative care needs in this setting resulted in more referrals to palliative care compared to physician referrals. Improvements in quality of life were found in patients who received a palliative care consultation and patients were very satisfied with the care provided by palliative care. The potential for financial improvements was observed as a result of this project. Key words: palliative care, metastatic cancer, screening, process evaluation...