1697 research outputs found
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Reducing Catheter-Associated Urinary Tract Infections in the Intensive Care Unit
Full text linkProblem: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Despite established prevention guidelines, inconsistent practices in catheter removal and gaps in daily necessity reviews persist. At the project site’s 24-bed ICU, the CAUTI rate was 1.9 per 1000 catheter days, which exceeds the national benchmark of 1.0. Gaps in consistent assessment of necessity and delays in removal contributed to an elevated infection risk.
Aim of the Project: This project aimed to reduce CAUTI rates in the ICU through evidence-based interventions focused on daily catheter necessity assessments and nurse-driven removal protocols.
Review of the Evidence: The current evidence supports the necessity of daily catheter assessment and nurse-driven removal as key interventions to reduce CAUTI rates. Implementing a bundled approach that combines education, standardized tools, and timely feedback has been shown to improve adherence to best practices and reduce infection rates.
Project Design: This quality improvement project used the Plan-Do-Study-Act (PDSA) framework and OhioHealth Change Management (OHCM) model to guide an eight-week intervention. Baseline data and readiness assessments informed implementation. CAUTI rates, catheter utilization, and compliance with assessment and removal protocols were measured both before and after the intervention.
Intervention: The intervention included staff education on CAUTI prevention strategies, implementation of a standardized catheter necessity assessment tool incorporated into daily workflow, and a nurse-driven removal protocol. Real-time audit tools were provided to track compliance, inform PDSA cycles, and provide feedback, promoting sustained adherence.
Significant Findings/Outcomes: The intervention led to a reduction in CAUTI rates, improved accuracy and consistency in catheter necessity documentation, and increased nurse engagement in catheter management. Process measures demonstrated sustained improvements in compliance, and balancing metrics confirmed that there were no adverse effects from early catheter removal.
Implications for Nursing: This project highlights the crucial role of nurse-led interventions in reducing CAUTI rates, enhancing patient safety, and fostering a culture of accountability. Embedding nurse-driven protocols into ICU workflows fosters sustainable practice change and supports the achievement of institutional quality and safety goals. Ongoing education, leadership support, and continuous monitoring are key to sustaining improvements
Patient-Centered Approach to Decrease Length of Stay
Full text linkProblem: Unmet social needs contribute to hospital readmissions and extended inpatient stays, placing strain on care coordination and hospital throughput. Social Determinants of Health (SDOH), such as housing instability, lack of transportation, or food insecurity, are often unaddressed in clinical workflows. At the project site, a gap in effectively integrating SDOH into the discharge planning process led to delayed discharges and increased length of stay (LOS). Additionally, 41.20% exceeded the Geometric Mean Length of Stay (GMLOS), surpassing the organizational benchmark of 40.17%. Gaps in standardized assessment and communication of SDOH data limited the ability to plan timely discharges and connect patients with needed resources.
Aim of the Project: To improve discharge planning and reduce the percentage of patients exceeding GMLOS by increasing the completion and discussion of SDOH assessments during Multidisciplinary Rounds (MDR).
Review of the Evidence: Literature supports integrating SDOH screening into clinical practice to address barriers to discharge and reduce avoidable hospital utilization. Evidence also emphasizes that standardized communication of social risk data among care teams improves coordination, reduces readmissions, and supports patient-centered care.
Project Design: A quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) model and the OhioHealth Change Management (OHCM) framework guided implementation and evaluation. The initiative took place in a 24-bed medical-surgical unit.
Intervention: The Core 5 SDOH assessment tool was implemented at admission, and SDOH findings were integrated into daily MDR. Staff were trained in identifying social needs, documenting findings, and initiating referrals.
Significant Findings/Outcomes: Post-implementation, 63% of patients had completed SDOH assessments, and 72% of completed assessments were discussed in MDR. Six patients screened positive, and all received care management consults. While GMLOS increased slightly to 41.55%, MDR efficiency was maintained at an average of 1.69 minutes per patient. The project identified workflow inconsistencies and underreporting of social risks, signaling areas for future improvement.
Implications for Nursing: This initiative demonstrates the feasibility and clinical value of embedding SDOH assessments into nursing practice and interdisciplinary care. Nurses play a vital role in identifying social barriers early and advocating for appropriate interventions. Standardizing SDOH workflows enhances care coordination, supports equity, and improves readiness for discharge contributing to more efficient and holistic patient care
Implementing a Fast-Track Pathway for Low Acuity Patients to Reduce Patient Length of Stay in the Emergency Department
Full text linkProblem: Overcrowding and prolonged wait times in emergency departments (ED) negatively affect patient safety, outcomes, and satisfaction. Hospital A, a Level 1 trauma center with over 52,000 annual ED visits, consistently exceeded the national ED length of stay (EDLOS) benchmark of 6 hours, averaging 6.7 hours, with left without being seen (LWBS) rates at 2.89%, surpassing the 2% target. Low-acuity Emergency Severity Index (ESI) level 4 and 5 patients contributed to congestion due to inefficient triage processes and lack of alternative care pathways, delaying timely access to care.
Aim of the Project: The project aimed to implement an evidence-based fast-track pathway to reduce EDLOS, door-to-provider times, and LWBS rates for low-acuity ESI level 4 and 5 patients, improving patient throughput and ED efficiency.
Review of the Evidence: A systematic literature review identified fast-track pathways as effective strategies to reduce wait times, LOS, and LWBS among low-acuity patients (Adriani et al., 2021; Faber et al., 2023). Ten high-quality studies, including systematic reviews and quality improvement projects, supported the use of designated care areas, triage redesign, and staff engagement to improve ED throughput and patient outcomes.
Project Design: This quality improvement (QI) project utilized Plan-Do-Study-Act (PDSA) cycles and the OhioHealth Change Management (OHCM) Model to guide iterative process refinements. Stakeholder collaboration, process mapping, and continuous performance monitoring were integral to the intervention\u27s success. Intervention: Over 12 weeks, a fast-track pathway for ESI level 4 and 5 patients was implemented, including dedicated treatment spaces, modified triage processes, role delineation, and real-time data tracking. Staff training emphasized unconscious bias awareness and social determinants of health (SDOH) screening to promote equitable care delivery.
Significant Findings/Outcomes: Post-intervention, EDLOS decreased by 7% and discharge LOS by 8%. LWBS rates reduced from 2.89% to 1.65%, with fast-track LWBS at 0.66%. Door-to-provider times improved by 4.6 minutes. Fast-track utilization averaged 31%, peaking at 41% during high-volume periods.
Implications for Nursing: Nursing leadership is essential in improving ED efficiency, triage accuracy, and equitable care. Fast-track pathways offer a sustainable solution to reduce overcrowding, enhance patient experience, and optimize ED operations
The Impact of Mindful Self-Care Behaviors on Burnout Among Registered Nurses in NYC’s Busiest Borough Post Pandemic
No full textResearch studies on mindfulness and burnout remain scarce among registered nurses (RNs). This research study conducted a predictive quantitative analysis among RNs in the critical care and medical surgical units, and emergency departments in hospitals within New York City’s (NYC’s) busiest borough. The study explored the predictability of the interrelated variables of mindful self-care behaviors including mindful relaxation, physical care, self-compassion and purpose, supportive relationships, supportive structure, and mindful awareness, as indicated on the MSCS-Brief, on burnout among RNs. The work-related version of the Burnout Assessment Tool 23 (BAT-23) provided the quantitative measurement. The research question was, “How do mindful self-care behaviors or practices predict feelings of burnout among RNs in hospitals within NYC’s busiest borough?” Research participants (N = 98) completed a survey questionnaire comprised of items to evaluate frequency of mindfulness and burnout in RNs. The survey responses were the primary data used to calculate multiple regression analyses on how mindfulness predicts perceptions of burnout for RNs. Results suggested that moderate to high levels of mindfulness namely mindful awareness, mindful relaxation, and physical care, had significant statistical predictive effects on the incidence of burnout among RNs. The remaining predictor variables had no statistical significance. The statistically significant predictors of mindfulness predicted burnout in RNs. Further exploration of mindfulness and burnout is warranted. These results, however, supported the use of the statistically significant mindfulness activities as complementary considerations for healthcare administration when promoting vital wellness programs, and when implementing policies that support the overall well-being of RNs
A Qualitative Study on Supplier Diversity: Expanding Beyond Compliance through Leadership Commitment to Deliver Sustainable Outcomes and Create Value
No full textBackground: Supplier diversity practices evolved from the early beginnings of the Small Business Administration (SBA) being established by Congress in 1953 as an independent federal government agency, to protect the interests of small businesses and help strengthen the economy. The topic of supplier diversity, and its alignment with corporate vision and objectives, have progressively been important since President Nixon signed Executive Order 11458 in 1969 and established the Minority Business Development Agency. The literature showed the topic has grown in relevance with more stakeholder awareness of corporate social responsibility. Study: The research explored scholarly context from a conceptual framework aimed at understanding the roles of leadership commitment and organizational structure in driving inclusivity in supply chain management, and the related stakeholder impact. The shift from a regulatory and compliance requirement focus to effective supply chain management practices suggested corporate willingness to engage minority- and women-owned business enterprises – and provided the basis to also explore the benefits and value from supply chain diversification. Methodology: The study utilized a general qualitative research approach using semi-structured interviews with corporate professionals in supply diversity program offices and supply chain management functions. The study was designed to explore the problem related to the topic of how supplier diversity practices can expand beyond regulations and compliance through leadership commitment and deliver sustainable outcomes while creating value. Findings: The study results showed that with effective leadership commitment strategies, including efficient organizational structure, long-term benefits and sustainable value are generated from diverse and inclusive supply chains
Journal 2
Full text linkThis journal documents an exercise science field experience in a multidisciplinary sports management workplace, highlighting observations across chiropractic medicine, physical therapy, and occupational therapy. The author reflects on professional behaviors, therapeutic interventions, and the impact of healthcare policies—particularly insurance constraints—on patient care. The journal also outlines personal goals for improving medical terminology and interdisciplinary communication, emphasizing the importance of precise language for clinical proficiency and professional development. [Abstract generated by AI.
The Effect of Basic Instruction for Improving Parent Perception of Acceptable Conduct at Youth Sports Events
No full textThe purpose of youth sports is to teach the fundamentals of various sports, good sportsmanship, and the essential function of participating on a team. The observation of poor sportsmanship and aggressive acts of violence have become common sights to on-looking adults who attend youth league sporting events (Tremblay, 2003). Poor parental conduct may cause an uncomfortable relationship between the parent and their student athlete(s) and discourage the child from participating (Jeanfreau, Holden, & Esplin, 2020). Parental misconduct at youth league sporting events gained much attention recently. Among other issues, parental misconduct has led to a shortage of qualified referees willing to officiate youth and high sports (Eilerson, 2017). Parental misconduct can be found in all forms of social media and news articles, ranging from verbal to physical aggression.
This study tested whether brief instruction on parental misconduct at youth sporting events has any effect on the perceptions currently held by parents of youth league athletes. The parents were surveyed to determine their views about behaviors and what is considered acceptable at youth league events as well as what is viewed as aggression at such events. Participants were given examples of good and bad cases of parental conduct at youth league sporting events and asked to consider how each person involved in the scenario might feel or perceive the situation. The parents were then given a post-survey which helped measure if the instruction had any effect on their perceptions of parental misconduct at youth sporting events. At the conclusion of the study, there were findings that suggested that it was possible that the instruction had some impact on the participants’ perceptions of parental misconduct
A Quantitative Analysis of Grit and Burnout Among Social Workers Well-Being
No full textBurnout among social workers continues to be a concern, worsened by job demands and emotional stressors. Grit is the passion and persistence toward long-term goals and has been identified as a possible protective factor against burnout. The study aimed to evaluate the relationship between burnout, grit, and well-being among licensed social workers in the United States.
Using a quantitative correlational cross-sectional design, data was collected from 355 licensed social workers utilizing the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the Grit Scale, and the World Health Organization-Five Well-Being Index (WHO-5). The study addressed three research questions:
What is the relationship between grit and burnout among social workers?
How do social workers’ burnout symptoms and level of grit impact their overall well being?
Are social workers with high levels of grit less likely to experience burnout?
Statistical analyses included simple linear regression, Pearson correlation, one-way ANOVA, and Fisher’s Least Significant Difference were conducted to evaluate the relationship between burnout, grit, and well-being.
Findings revealed a significant inverse relationship between grit and burnout, suggesting that social workers with grit report lower levels within the burnout subscales of emotional exhaustion and depersonalization. Grit was found to increase well-being, suggesting organizations should promote resilience and job satisfaction.
Results from the study indicated the need for organizations to develop interventions to increase resilience, decrease burnout, and improve overall job satisfaction in the social work field. These findings could assist in creating policies and training to promote balanced careers in social work
The Impact of Annual Preventive Visits on Long-Term Patient Outcomes
No full textNational policies and state Medicaid programs have removed financial barriers and increased incentives to expand the utilization of preventive services in the U.S. However, utilization of annual preventive visits and other preventive services remains low for many populations. Numerous research studies have shown the short-term benefit of annual preventive visits that lead to higher utilization of other preventive services such as vaccinations and cancer and chronic disease screenings. The literature on the long-term benefits of annual preventive visits remains sparse and primarily focused on young children and Medicare-enrolled adults. This study aims to fill in part of that gap by analyzing the long-term health outcomes of annual preventive visit utilization for older children and working-age adults enrolled in Medicaid. Utilizing administrative enrollment and claims data, the researcher completed a propensity-score matched case-control study to determine the impact of annual preventive visits on acute care and emergency care utilization as well as total costs of care. The study found that utilization of annual preventive visits was associated with significantly lower acute inpatient care utilization. However, there was not a significant reduction in emergency care utilization or total costs of care among participants with annual preventive visit utilization versus those without it. This study provides evidence of the long-term benefits of annual preventive visit utilization among older children and working-age adults enrolled in Medicaid. Further research should continue exploring the benefits of preventive care for this population
Rendering of Phillips Hall, undated
No full textThis photo features a group looking at a rendering of Phillips Hall before construction.https://fuse.franklin.edu/phillipshall/1004/thumbnail.jp