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- Description:
- Engaging patients in the delivery of care, specifically the importance of complying with the discharge instructions requires strategies to meet individual patient needs based on health literacy and motivation to learn. Literature findings suggest that by implementing evidence-based best practice strategies for patient/family centered medication education readmission rates will decrease. Nurse led strategies such as the "teach-back" method for discharge instructions was implemented. The project focused on a population of adult patients with Chronic Obstructive Pulmonary Disease (COPD). Patients and or their caregivers were able to demonstrate accountability for self-management prior to discharge from the acute care setting.
- Keyword:
- Teach-back education, Health and environmental sciences, COPD, and Self-management
- Subject:
- Nursing
- Creator:
- Betts, Veronica
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/23/2021
- Date Modified:
- 01/07/2022
- Date Created:
- 2014
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- Heart failure (HF) is a new epidemic in the United States (US) affecting more than six million Americans with over 500,000 new cases annually. HF is the number one cause for hospitalizations in the Veterans’ population 65 years and over (Baldonado et al., 2013). At one Veterans’ facility fifty percent of these patients are readmitted within six months of discharge because of non-adherence to a prescribed treatment plan, including follow-up using a telehealth approach. Nurses can play a significant role in preventing these re-hospitalizations by providing standardized care and discharge instructions to patients with HF. However, nurses may not have adequate knowledge and competencies related to HF self-management principles to deliver this standardized, evidence-based (EB) care and discharged instructions. The literature has shown that standardization of care using EB interventions improves patient outcomes. Implementing a clinical HF algorithm for nurses providing telehealth care is an effective method for standardizing that care for Veteran patients with HF. The purpose of this EB project was to improve Veteran patients’ outcomes by preventing hospital readmission and dropouts from the TH program using such a standardized algorithm. Keywords: heart failure, self-management, clinical practice guidelines, algorithm and nurses knowledge
- Keyword:
- Clinical practice guideline, Algorithm, Nurses knowledge, Health and environmental sciences, Social sciences, Heart failure, and Self-management
- Subject:
- Nursing, Economics, and Health care management
- Creator:
- Simmons, Coreen
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/23/2021
- Date Modified:
- 01/07/2022
- Date Created:
- 2015
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- Hospital readmissions have contributed to the increasing costs of healthcare. the reasons for readmissions are often varied and complex. Identifying high-risk patients upon their arrival to the emergency room should be a part of a hospital's readmission reduction strategy. This study will investigate whether the implementation of a risk stratification tool to identify high-risk patients admitted through the emergency department of a medical center in Northern New jersey will reduce the occurrence of hospital readmissions within thirty days of discharge. This project uses the LACE Tool to identify patients over age 65 with a diagnosis of congestive heart failure who are admitted through the emergency department and are at high risk for readmission. the LACE tool scores patients based on their risk level and enables hospital staff to allocate appropriate resources to improving patient outcomes and reducing readmissions. the utilization of this tool at the study location will potentially improve the institution's financial standing and improve Quality and Safety Report outcomes, which are made public by the Centers for Medicare and Medicaid Services.
- Keyword:
- Risk, Health and environmental sciences, Nursing, Readmissions, LACE tool, Case management, and Congestive heart failure
- Subject:
- Nursing
- Creator:
- Pizarro, Patricia A.
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/23/2021
- Date Modified:
- 01/07/2022
- Date Created:
- 2018
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- This study examines the impact of grit (Duckworth et al., 2007), demographic characteristics, and environmental pull factors on academic outcomes for nursing students at an urban commuter institution. Undergraduate baccalaureate nursing students (N = 243) completed a survey that collected demographic information, assessed environmental pull factors, and determined their grit score. Academic outcomes, cumulative grade point average, and average credit accumulation, were gathered from the student’s academic records. A series of multiple regressions were used to determine the significance of these variables in predicting academic outcomes. Findings indicated that age, number of children, and grit were predictive of average credit accumulation. These results provide suggestions on how institutions can support students and future research on the role of grit in academic success.
- Keyword:
- Academic outcomes, Grit, Student success, Nursing education, and Regression analysis
- Subject:
- Higher education and Nursing
- Creator:
- Jung, Christy
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/23/2021
- Date Modified:
- 01/07/2022
- Date Created:
- 2021
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- Polypharmacy is the concurrent use of multiple medications. Polypharmacy presents increased health risks and increased hospitalizations due to its synergistic effects particularly in the elderly population. In addition, there is a significant increase in health care spending. Polypharmacy is of special concern among elderly individuals because this practice can lead to other health risks, hospitalization and increased healthcare cost. The Centers for Medicare and Medicaid Services (CMS) estimates that polypharmacy costs the nation’s health plans more than $50 billion annually. Polypharmacy is linked to higher incidence of adverse drug reactions (ADRs), falls, hospitalization and behavioral incidents among the elderly especially if one or more of the medications is a psychotropic medication. The CMS has therefore established a guideline for the gradual dose reduction (GDR) of psychotropic medications. The aim is to reduce the negative effects of these medications on patients and thereby improve their general quality of life. This evidence based project examined the effects of the gradual dose reduction among residents between the ages of 65-75 living in a long-term care facility in the inner city of North-East Bronx. The project also evaluated the facility’s policy regarding GDR within this population and proposed ways to enhance the policy improve patient safety and reduce medication cost.
- Keyword:
- Elderly population, Health and environmental sciences, Inappropriate medication, Gradual dose reduction, Multiple medication use, and Polypharmacy
- Subject:
- Nursing
- Creator:
- Coker, Abimbola
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/22/2021
- Date Modified:
- 01/10/2022
- Date Created:
- 2016
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- Practice drift is a phenomenon that is slowly starting to gain attention in the health care community and nursing. The concept of practice drift includes practicing outside one’s scope of licensesure, failure to follow established rules and regulations, and deviation from policies and procedures, standards of care, and professional recommendations. As a result, cultural norms begin to take hold, and the drift can intensify, resulting in untoward outcomes and patient harm. A query of nurses at a comprehensive cancer center revealed drift happening routinely. Nurse members of a mature shared governance council structure reported drifting or observing drift in their practice setting. Despite tenure, academic preparation, and specialty certification, good nurses are drifting from the very protocols that are written and published to keep patients safe.
- Keyword:
- Practice drift, Health and environmental sciences, Drift to danger, Procedural drift, Nurses, Medical errors, and Practical drift
- Subject:
- Nursing and Health care management
- Creator:
- Browne, Kevin P.
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/22/2021
- Date Modified:
- 01/11/2022
- Date Created:
- 2019
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- The purpose of this quasi-experimental research design pre-test/post-test study was to determine if the non-pharmacological intervention of participation in an animal-assisted therapy group (AAT), held during the time when sundown syndrome occurs, had an impact on the number of associated behavioral and psychological symptoms of dementia (BPSD), the resident’s apathy, their quality of life, and the use of pharmacological interventions. A total of thirty-eight residents from a nursing and rehabilitation center were recruited to be part of the study. A retrospective chart review was conducted for descriptive demographics information, the number of behavioral and psychological symptoms of dementia (BPSD) the participant was experiencing, and the number of pharmacological interventions required for these behavioral disturbances. The intervention was a supervised AAT activity group that was held three to four days a week, for forty-five minutes over the course of six weeks. The assessment tools were the following: The University of California, San Diego (UCSD) Brief Assessment of Capacity to Consent (UBACC); the Mini-Mental State Exam (MMSE); Apathy Evaluation Assessment clinical version (AES-C); Quality of Life in Late-Stage Dementia (QUALID); and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). The findings, which were statistically significant, revealed that AAT was effective in reducing BPSD during sundowning, reducing the participants’ apathy improving and their quality of life. AAT also showed a statistically significant reduction in caregiver stress. This study contributes to the body of knowledge on non-pharmacological interventions for people with BPSD experienced during sundowning; decreasing use of pharmacological interventions for (BPSD); stabilization of the resident’s BPSD; and improving the resident’s apathy and their quality of life. Benefits from the AAT also extended to healthcare providers by decreasing the staff workload in managing the behavioral disturbances, decreasing stress, decreasing possible injury to staff, and improving performance.
- Keyword:
- Pet therapy, Health and environmental sciences, Sundown syndrome, Animal-assisted therapy, Behavioral and psychological symptoms, Dementia, and Non-pharmacological interventions
- Subject:
- Nursing and Therapy
- Creator:
- Cappetta-Jempolsky, Stephanie
- Owner:
- skushner@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 12/22/2021
- Date Modified:
- 01/11/2022
- Date Created:
- 2019
- Rights Statement:
- In Copyright - Educational Use Permitted
- Resource Type:
- Dissertation
-
- Description:
- Background: The COVID-19 pandemic reached the United States in March of 2020. America quickly led the world in the number of confirmed coronavirus cases, which contributed to hospital overflow and healthcare worker burnout. Many units that were not typically equipped for such critical cases were converted into COVID units, and there was a high demand for nursing support as the virus peaked. Objective: Since this study focuses on the self perceived mental health of the participants, the objective was to gather information pertaining to the lived experiences of these ICU nurses and how they feel/felt during the course of this pandemic. Materials and method: Using snowball technique, Intensive Care Unit (ICU) nurses who worked through the entirety of the COVID-19 pandemic will be interviewed through a Zoom call. They will be asked to describe their emotions while working on the front lines of the pandemic, and how those experiences have affected their mental health and their daily lives. Results: All nine nurses agreed that working through the COVID-19 pandemic was a stressful and confusing experience. All nurses felt like they weren’t able to provide proper care to their patients at the beginning of the pandemic and they felt lost. Now, all of the nurses feel more knowledgeable and more comfortable working with COVID positive patients. Four nurses sought out psychological support for their mental health, and one nurse considered it. Coping mechanisms varied from positive and negative habits, including cooking/baking, reading, sleeping, eating, smoking, drinking, talking to family, and talking to other nurses. Conclusion: ICU nurses face a great deal of pressure on a regular basis, and the outbreak of COVID-19 contributed to that stress leading many nurses to feel burnt out. The nine nurses that were interviewed had varying degrees of coping and psychological trauma.
- Keyword:
- coronavirus, Nursing, nurse burnout, mental health, COVID-19, and intensive care unit (ICU)
- Subject:
- Nursing
- Creator:
- Almontaser, Hannah
- Contributor:
- Prof. Sandra Horvat, Thesis Advisor
- Owner:
- lsquillante@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 06/09/2021
- Date Modified:
- 06/09/2021
- Date Created:
- Spring 2021
- Rights Statement:
- In Copyright
- Resource Type:
- Research Paper
-
- Description:
- The purpose of this research is to investigate the disease process of Multiple sclerosis (MS) through a review of the literature. Using multiple credited articles of research, this study analyzed the factors that lead to the diagnosis of MS. These factors include stages, genetics, environment, symptom analysis, diagnostic tests, and treatments. A combination of both genetics and environmental factors were found to play the greatest role in determining the origin of MS, yet cannot be identified as a definite influence. Because the exact cause of MS is still unknown, the treatment or “cure” is a mystery. However, with an increase in technology and treatment options, most individuals can manage their disease with medications and lifestyle changes in order to sustain a healthy long life. Further studies are needed to determine if a cure to MS can be developed.
- Keyword:
- literature review, disease origins, and Multiple sclerosis (MS)
- Subject:
- Nursing
- Creator:
- Lopez, Danielle K.
- Contributor:
- Dr. Michelle Romano, Thesis Advisor
- Owner:
- lsquillante@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 06/09/2020
- Date Modified:
- 06/09/2020
- Date Created:
- April 20, 2020
- Rights Statement:
- In Copyright
- Resource Type:
- Research Paper
-
- Description:
- The United States has the highest maternal mortality rate in the developed world. Over 700 mothers die each year from pregnancy-related complications, 60% of which are preventable. Numerous research studies support the increased integration of midwives in health care systems because it is key to producing optimal maternal-newborn outcomes. However, less than 10% of births in the United States are attended by midwives, compared to 50-75% of births in other industrialized nations, all of which demonstrating substantially lower maternal mortality rates. The practice of midwifery has been marginalized and delegitimized despite midwives producing similar or better outcomes than physicians with lower costs and less unnecessary medical interventions. Another advantage of utilizing midwives is their ability to reach socially disadvantaged groups, such as non-Hispanic black women who suffer the greatest number of maternal deaths. The historic shift away from midwifery and to medicine in the 20th century has been perpetuated by the fallacy that childbirth is a pathological process that only physicians are equipped to manage. This thesis focused on how women’s fears of childbirth and misperceptions of midwives have led to the normalcy of hospital, physician-attended births and may have subsequently elevated maternal mortality rates.
- Keyword:
- midwifery, obstetrics, and maternal mortality
- Subject:
- Nursing
- Creator:
- Hamdulla, Sabrina
- Contributor:
- Dr. Michelle Romano, Thesis Advisor
- Owner:
- lsquillante@saintpeters.edu
- Publisher:
- Saint Peter's University
- Date Uploaded:
- 10/23/2019
- Date Modified:
- 06/11/2020
- Date Created:
- May 2019
- Rights Statement:
- In Copyright
- Resource Type:
- Research Paper