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Increasing the HPV vaccination rate in a family practice: A quality improvement project
(2017-05-19)
The purpose of this DNP project was to identify barriers in a family practice setting to recommending the HPV vaccine and to use this information to develop a practice protocol to enhance the delivery of the vaccine ...
Breastfeeding and the Baby-Friendly Hospital Initiative: A quality improvement project
(2016-09-21)
The purpose of this DNP project was to provide support for nursing staff to feel empowered and motivated to provide new mothers with the support they needed to have a positive breastfeeding experience for their babies and themselves. Adult Learning Theory and the Rosswurm and Larrabee Model for Evidence-based Practice provided the framework for the project. A quasi-experimental study design was used to evaluate if the implementation of an educational intervention decreased barriers and improved nurses’ self-confidence in supporting mothers in the decision to breastfeed their infants. The project took place on the birthing center at a regional hospital in a Midwest state where approximately 120 infant deliveries occur monthly. The project director (PD) distributed an anonymous pre-intervention survey to all nursing staff in the birthing center by email using Qualtrics survey system to identify barriers that occurred when nurses tried to assist and educate a breastfeeding mother and to rate their self-confidence in assisting mothers. The PD recruited nursing staff for a breastfeeding taskforce through face-to-face communication and email separate from the survey. The breastfeeding taskforce, led by the PD, met to review survey data and brainstormed how to address identified breastfeeding education and support barriers. The taskforce developed two standardized staff education documents to address these barriers. Three months following the implementation of the newly written staff education, the PD distributed an anonymous post-intervention survey to all nursing staff by email that contained the same questions as in the pre- intervention survey. The PD analyzed the pre and post intervention survey data to determine if there was a decrease in barriers and increase of self-confidence in the nurses’ ability to assist patients with breastfeeding and support other nurses in the process. This information was shared with the taskforce to decide if any revisions in the written process were needed. No revisions were deemed necessary by the taskforce.
As a result of the findings of the breastfeeding taskforce and the PD, an algorithm titled. When Baby Does or Doesn’t Latch and a staff education sheet Nipple Shields 101 were created. When Baby Does or Doesn’t Latch was developed using Baby Friendly Hospital Initiative’s guidelines and the hospital’s hypoglycemia policy to provide nursing staff with a resource to use when babies are not breast or bottle feeding well. Nipple Shields 101 was created to give staff members a resource to use when assisting a patient that needs to use a nipple shield in order to help the baby to latch. Data gathered from the pre- and post- intervention surveys did show a statistically significant increase in the self-confidence the nursing staff felt when helping patients and each other with breastfeeding skills. Limitations on the study of outcomes for the project included time constraints, small survey sample, lack of ability to compare pre- and post-intervention survey results by person due to anonymity, and possible discrepancies in meaning of survey questions between PD and the survey participants....
Recommendations for breast feeding mothers after anesthesia: A quality improvement project
(2017-06-26)
Quality improvement projects aim to address a clinical issue and subsequently improve patient care. Projects may improve or promote safe care, interpersonal care aspects, and life quality.1 The clinical issue addressed by ...
Treating depression and sleep impairment to improve pain levels and quality of life for patients with sickle cell disease: A quality improvement project
(2017-05-19)
Background: Vaso-occlusive crisis (VOC) pain is both an acute and chronic factor for patients with sickle cell disease (SCD). Acute, recurrent, and unrelenting pain is often joined by other affective disorders that impact pain chronicity, and some patients with sickle cell disease have depression and/or sleep disturbances that may impact pain levels and quality of life.
Aim: The purpose of this quality improvement project is to improve the process of assessment and treatment of depression and sleep disturbance in patients admitted to Bridgeport Hospital, Bridgeport, CT with VOC. The goal of this project is to improve overall pain levels and quality of life for patients with SCD through efficient and effective evaluation and treatment for depression and sleep disturbance.
Method: An interdisciplinary team, led by the palliative care (PC) advance practice registered nurse (APRN), used the Stetler Model to guide the process of translating existing research regarding the impact of depression and sleep impairment on pain and quality of life in patients presenting with VOC, into evidence-based practice. The team created the Guideline for the Evaluation and Treatment of Depression and Sleep Impairment in Sickle Cell Disease. Patients were assessed, offered treatments and reassessed during the project period.
Results: Both depression and QOL scores showed significant improvement by the end of the project. Significant correlations were found between pain, depression and sleep; depression, pain, sleep and QOL; sleep, pain, and depression; and QOL and depression. Patient admissions as well as average length of stay decreased over the course of the project.
Limitations: The small convenience sample size limits the generalizability of the results to other practice sites. Patients who were not readmitted during the project timeframe were lost to follow-up, and were not reassessed to determine the effects of treatment recommended by the guideline.
Conclusions: Interdisciplinary teams are effective in creating a guideline to assess and treat depression and sleep impairment and their effects on pain and QOL in patients with SCD.
Implications for Practice: PC APRNs provide support and symptom management to patients with life-limiting and serious illnesses, including patients with SCD, as a means of improving QOL. This project has significance for APRNs in both palliative care and specialty SCD/Hematology care as a means to translate existing research into evidence-based practice; as well as provide an efficient and effective means to evaluate and treat depression and sleep impairment and their impact on pain and quality of life....
Simulation to improve the clinical nursing instructor's teaching of ethics to students in the clinical setting
(2016-08-11)
Ethics knowledge and skill is crucial to the discipline of nursing and is considered foundational knowledge for nursing practice (American Nurses Association [ANA], 2001). Nurses who assume roles in clinical teaching may ...
The relationship between nursing skill mix, nurse sensitive patient outcomes and patient satisfaction
(2016-06-09)
Literature Review: Hospitals are the largest components of the United States healthcare system, and are encountering pressure to provide better quality care and reduce cost. The Patient Protection and Affordable Care Act ...
National institutes of health stroke scale certification improved assessment and care of veterans: A quality improvement project
(2016-12-13)
This pilot project sought to fill the gap in practice that included a lack of early recognition, assessment skills and practice guidelines for the care of stroke patients, improving patient care and hand off communication. ...
Bridging the gap in the continuum of care for spine surgery patients: A quality improvement project
(2017-03-24)
The purpose of this paper is to discuss the inadequate communication between patient settings and the practice settings, review the literature regarding communication and risks of readmission for spine surgery patients, ...
How high! Decreasing blood pressure in men aged 45-65 in primary care: A quality improvement project
(2018-05-15)
Purpose: Hypertension is a health issue that affects many people worldwide. The Memphis area has many people who have been diagnosed with hypertension and experience poor outcomes. A local Memphis primary care clinic allowed ...
An obstetrical emergency management quality improvement project
(2015-10-22)
Obstetrical emergencies occur in approximately 5% of births necessitating immediate interventions to prevent catastrophic consequences. A knowledge deficit specific to obstetrical emergencies was the impetus for this ...