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Improving self-management in a complex population through patient-centered education and interdisciplinary communication
(2016-10-19)
The residual cognitive and physical deficits of traumatic brain injury and stroke create unique challenges during rehabilitation. A microsystem assessment of an inpatient rehabilitation unit serving traumatic brain injury ...
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....
The 5As Model for Smoking Cessation: Engaging health care providers and overcoming barriers to change
(2016-09-21)
The purpose of this DNP project was to improve provider utilization of the 5As model for smoking cessation (asking, advising, assessing, assisting and arranging for follow up) for patients who smoke with every patient ...
Overcoming barriers and increasing confidence of providers and nurses in addressing overweight and obesity
(2016-09-22)
The purpose of this DNP project was to improve weight loss management by decreasing barriers and increasing health care provider and nurse confidence in addressing overweight and obesity with patients. The project took ...
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 ...
Change in culture: Addition of a clinical pharmacist to the emergency department antimicrobial culture review process
(2016-12-13)
Objective: To evaluate the effectiveness of a unit based pharmacist in assisting with antimicrobial selection of female patients discharged from the emergency department with a diagnosis of an uncomplicated urinary tract infection.
Setting: Academic-affiliated emergency department in Pittsburgh, Pennsylvania.
Methods: A retrospective chart review was conducted among 870 female patients who were discharged from the emergency department with a positive urine culture requiring antimicrobial therapy revision. The primary investigator abstracted specific medical record information to determine if a pharmacist-driven culture review resulted in a higher percentage of appropriate antimicrobial selection when compared to the standard nurse/physician driven-culture review. The revised antimicrobial therapy treatment plan was deemed appropriate or not based on the “International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Disease Society of American and the European Society for Microbiology and Infectious Disease”.
Results: A Chi-Square Test of Independence was conducted to evaluate the relationship between two categorical variables: (1) type of provider (physician/pharmacists) and (2) adherence to clinical practice guidelines (yes/no). The test emerged significant, C2 = 17.4, df= 2, p < 0.01. Thus, a significant relationship between type of provider and appropriate treatment was found. Specifically, 52.2% of physicians used the appropriate treatment whereas 84.4% of pharmacists used the appropriate treatment....
Laboring Down: A Pretest-Posttest Educational Study
(2016-12-19)
The primary aim of this study was to determine the effectiveness of an educational video in increasing labor and delivery nurses’ knowledge of laboring down. The secondary study aim was to determine if the educational intervention affected nurses’ anxiety levels when caring for patients who are laboring down. Nurses took an anxiety measure test and a knowledge test before and after watching the educational video. The results of the difference in knowledge pre-intervention to post-intervention achieved statistical significance (t = 3.22, df =14, p = .006). The mean number of correct answers increased from 5.87 (SD = 1.96) pre-intervention to 7.27 (SD = 1.83) post-intervention. The results of the difference in anxiety level pre-intervention to post-intervention did not achieve statistical significance. An educational video on laboring down effectively increased nurses’ knowledge; however, it was not effective in decreasing nurses’ anxiety level when caring for patients who are laboring down....
Undergraduate sorority students' perceptions of current body size, ideal body size, eating habits, and the relation to body image dissatisfaction
(2016-12-21)
Disordered eating patterns and body discontent are widespread in Western society, especially among young women. Many adopt the “thin ideal,” a belief that women should have very slender bodies with small ...
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. ...
Teaching critical thinking with problem-based learning
(2016-11-30)
Critical thinking (CT) capabilities are crucial for the contemporary nurse and vital for the delivery of safe patient care. As health care and technology continue to evolve, so must the teaching methods used by ...