1697 research outputs found
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Improving Pain Assessment After Bedside Percutaneous Endoscopic Gastrostomy (PEG) Placement
No full textProblem: Baseline audits at a 44-bed critical-illness recovery hospital showed low reliability in two post-PEG practices: (1) pain reassessment within 90 minutes of an intervention and (2) complete PEG-site documentation (skin, drainage, tube position/measurement). Baseline performance averaged 55% and 62%, both of which were below the organization’s 90% benchmark.
Aim of the Project: From May to July 2025 (12 weeks), improve on-time pain reassessment and ensure PEG-site documentation reaches at least 90%, maintaining this level for three or more consecutive weeks; monitor workload to prevent increases in perceived charting time and ensure safety by avoiding a rise in PEG-related events compared to baseline.
Review of the Evidence:
A 2020–2025 review of adult inpatient studies included nurse-led/inclusive strategies (simulation, required-field templates/prompts, audit, and feedback) that reported outcomes for documentation completeness, timely reassessment, or complication detection. Exclusions: pediatric-only, outpatient, non-empirical/commentary, pre-2020, or studies lacking those outcomes. Twelve studies met the criteria.
Project Design:
Unit-based QI across 11 weeks with two PDSA cycles; progress reviewed at the monthly quality meeting. OhioHealth Change Management guided stakeholder engagement, readiness, and reinforcement. Measures included outcome, process, balancing, and safety. Analysis used run-chart rules to detect shifts/trends and summarized the change from baseline.
Intervention: Simulation-based education with a midpoint booster; a required-field documentation template (≤90-minute reassessment and PEG-site elements with prompts); weekly feedback led by the project lead with real-time coaching; visibility boards.
Significant Findings/Outcomes: On-time pain reassessment improved from 55% to 85% (13/23 to 20/23); compliant documentation increased from 62% to 78% (14/23 to 18/23). One minor complication occurred: a brief decline followed by a rebound during a high-census week. Nurse workload remained stable.
Implications for Nursing: Reliability and timeliness improved without increasing workload; the ability to recover during census pressure was demonstrated. Sustainment focuses on leadership visibility, scorecards, automated prompts, and timely feedback. The model applies to similar post-procedure workflows
Enhancing Nursing Documentation Accuracy for Female External Urinary Collection Devices Through Structured Documentation Huddles
No full textProblem: Accurate documentation of female external urinary collection devices (EUCDs), such as the PureWick, is crucial for maintaining continuity of care and ensuring efficient resource utilization. However, inconsistent nursing documentation practices have led to gaps in regulatory compliance and communication among healthcare teams. Baseline data revealed frequent omissions and inaccuracies in female EUCD charting, indicating a significant practice gap that requires targeted improvement.
Aim of the Project: The purpose of the evidence-based practice (EBP) project was to improve nursing documentation accuracy for female EUCDs by implementing structured documentation huddles, thereby enhancing organizational compliance.
Review of the Evidence: A review of the literature revealed that structured communication interventions, including huddles, promote teamwork, accountability, and accuracy in documentation. Evidence supported the integration of real-time, collaborative approaches to documentation improvement, highlighting their effectiveness in addressing omissions and sustaining compliance across care settings.
Project Design: This quality improvement project applied the Plan-Do-Study-Act (PDSA) model within the framework of the OhioHealth Change Management Model. Weekly multidisciplinary huddles provided structured feedback and continuous evaluation of progress. Iterative cycles enabled the adaptation and optimization of the huddles throughout the implementation period.
Intervention: Structured documentation huddles, guided by Institute for Healthcare Improvement (IHI) strategies, where nurses reviewed documentation metrics, identified barriers, and discussed improvement strategies. Educational reinforcement and visual management boards were used to sustain engagement and accountability.
Significant Findings/Outcomes: Following implementation, documentation accuracy improved significantly across both day and night shifts. Missed documentation occurrences decreased, and compliance with organizational standards increased. The intervention proved to be both low-cost and high impact, with measurable improvements in patient safety, regulatory readiness, and operational efficiency.
Implications for Nursing: This project demonstrates the effectiveness of structured huddles in improving nursing documentation practices. Broader adoption can support nursing accountability, enhance communication, and may contribute to sustained improvements in documentation accuracy and overall patient care delivery
Implementing a Standardized SSRI Tapering Protocol in the Outpatient Setting
No full textProblem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.
Aim: The aim of the quality improvement (QI) project was to implement a standardized SSRI tapering protocol to improve documentation practices and increase patient education regarding SSRI tapering.
Review of Evidence: The current evidence supports a gradual tapering of SSRI medication. Additionally, current evidence supports the importance of clear patient education and follow-up planning in promoting patient-centered care and reducing the risk of withdrawal symptoms. Evidence-based practice emphasizes the importance of standardized approaches to promote consistent practices among providers while maintaining the flexibility to tailor plans to patient-specific needs.
Project Design: The project utilized a QI framework, the Plan-Do-Study-Act (PDSA) methodology, and the OhioHealth Change Management Model. In the quality improvement project, the data collection plan included an outcome measure, the consistent use of a standardized tapering protocol for SSRI medications, and three process measures: documentation of the tapering plan, patient education, and documentation of the follow-up plan.
Intervention: The intervention for this project included a standardized tapering protocol, provider education, and electronic medical record (EMR) streamlining and modifications to ensure consistency. Multiple PDSA cycles were conducted to refine the project implementation.
Significant Findings/Outcomes: The results revealed a significant improvement in compliance with process and outcome measures. The SSRI tapering protocol was used. After project implementation, tapering plan documentation was 100%, patient education documentation was 87.5%, and documented follow-up planning was 100%. These significant improvements demonstrated that the interventions led to increased adherence and enhanced provider practices.
Implications for Practice: Implementing a standardized SSRI tapering protocol improved consistency in provider documentation, patient education, and follow-up planning. Embedding the protocol into the EMR enhanced adherence to evidence-based practice, streamlined workflow, and supported sustainability. Improved documentation and standardized tapering fostered patient-centered care, promoted early recognition of withdrawal symptoms, and promoted safe care while potentially reducing adverse outcomes in medication tapering
Assessing the Readiness to Support Students with ASD: Perspectives of Community College Front-line Staff
No full textThere is an existing gap between enrollment and completion for college students with autism spectrum disorder (ASD) that is a cause for concern. Approximately 34% of ASD individuals of college age (18-26 years) are entering colleges and universities across the nation. Nonetheless, it is estimated that only 39% graduate with a certificate or degree. The challenges college students with ASD often face can be attributed to a lack of knowledge of neurological divergence by front-line staff in higher education. This study examines the perspectives of front-line staff on preparedness to support students with ASD, grounded on current literature, which suggests that there is a general lack of ASD knowledge and understanding. This generic qualitative research study used in-person interviews to explore the in-depth understanding of front-line staff’s preparedness for working with students living with ASD through diverse aspects of their lived daily experiences. The findings disclosed that community college front-line staff displayed through their own words and experiences that their knowledge is deficient in how to appropriately support students with ASD, which in turn causes them to feel unprepared. To mitigate the negative impacts of inadequately prepared front-line staff on students with ASD, including their belonging, confidence, and college success, the Higher Learning Commissions and College Administrations must prioritize evidence-based professional development initiatives that address these knowledge gaps
A Qualitative Case Study: Exploring an Offshoring Company’s Culture and Its Disconnection from Their Parent Company Through the Lens of the Trompenaars Hampden-Turner Cultural Dimensions Model and the Iceberg Theory
No full textBackground: There has been an increase in the prevalence of offshoring as an avenue for firms to gain a competitive business advantage while lowering costs. Similarly, there is a growing body of literature surrounding organizational culture and its impact on various facets of organizational reality. Literature on both subjects showed that they have grown in relevance and application in contemporary business environments.
Study: The study sought to understand the role of organizational culture in cross-collaboration efforts and understanding implicit cultural assumptions in organizations. Using the Trompenaars Hampden-Turner Dimensions Model and the Iceberg Theory as conceptual and theoretical frameworks, the study explored ways in which organizational culture can be mobilized to drive efficiency in offshoring efforts.
Methodology: The study utilized a qualitative case study using semi-structured interviews with employees of an offshoring company located within the Caribbean and Latin American region. The study aimed to explore the elements of the company’s culture relative to the dimensions of the Trompenaars Hampden-Turner Model and the Iceberg theory and how these elements can drive organizational efficiency.
Findings: The study results showed that communication, leadership, change management, cultural awareness, cultural intelligence, rewards and employee tenure and cross-collaboration issues were the elements of the Trompenaars-Hampden Turner Model and the Iceberg Theory that impact cross-collaboration issues in offshoring
An Exploration of Sexual Orientation/Gender Identity (SOGI) Data Collection and Use Among U.S. Healthcare Providers
No full textPatient demographics, health status information, and health history are essential data points to deliver complete and appropriate care. Patient data also includes sexual orientation and gender identity (SOGI), which informs providers about a patient’s individual needs, improves quality of care, promotes health equity, and increases visibility of the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community. SOGI is an essential health topic and it is an influencer of health status; however, discussing SOGI has historically been unrecognized or worse, disregarded. This study investigated the influencers of U.S. healthcare providers’ collection and use of SOGI data and the recommendations to increase these behaviors, to address an existing research gap. An exploratory qualitative study was conducted using semi-structured interviews with experts in LGBTQ+ health, health policy, and health equity. A conceptual framework composed of the Information-Motivation-Behavioral Skills (IMB) Theory and the Transtheoretical Model (TTM) provided the research lens. A five-phase process was utilized for coding and data analysis. Four categorical and substantiated findings included data weaponization and data governance, the influence of organizational structuring, intersectionality of identities, and training and resources. The implications were both practical and theoretical. The four areas of practical implications were government and policy, organizations and programs, providers, and patients. The coalescence of the study design, conceptual framework, and data analysis process was innovative and contributed to the versatility of qualitative exploratory studies in healthcare
Franklin Campus at Night, undated
No full textThis photo features a night view of campus, showing the clocktower, Alumni Hall, Fisher Hall, and the Student Services Center.https://fuse.franklin.edu/campusscences/1007/thumbnail.jp
Examining The Utilization Of Preventative Colorectal Cancer Screening Among Americans Since The Passage Of The Affordable Care Act From The Providers’ Point Of View
No full textThis dissertation investigates the impact of the Affordable Care Act (ACA) on the utilization of preventive colorectal cancer (CRC) screening among Americans under 65, focusing on healthcare providers\u27 perspectives. The ACA, a significant healthcare reform, aimed to expand access to preventive services, including CRC screenings, vital for early detection and improved outcomes. This study employed quantitative analysis with a component of qualitative analysis utilizing a modified version of the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) to gather quantitative and qualitative data from healthcare providers in Maryland, Virginia, and the District of Columbia. The quantitative analysis assessed changes in CRC screening rates, patient compliance, and the effects of ACA-related policy changes, while the qualitative analysis explored providers\u27 insights on barriers to screening, the role of patient education, and the overall effectiveness of the ACA in improving preventive care. Findings indicate a substantial increase in CRC screening utilization and frequency since the ACA\u27s passage, with healthcare providers perceiving significant improvements in patient access and compliance. However, the study also highlights ongoing challenges, including financial barriers and enhanced patient education. These insights are critical for informing future healthcare policies and practices to reduce disparities in CRC screening and improve overall preventive care outcomes. This research contributes to the growing body of literature on healthcare reform and preventive care, offering valuable perspectives from those directly involved in delivering care. The findings underscore the importance of continued efforts to address disparities and optimize the benefits of healthcare policies like the ACA
Group Therapy Proposal: Cognitive-Behavioral Therapy (CBT) Group for Anxiety and Depression Management
Full text linkThis group therapy proposal outlines an eight-week Cognitive-Behavioral Therapy (CBT) program designed for adults experiencing anxiety and depression. The group aims to provide a structured, evidence-based environment where participants develop coping skills, enhance emotional regulation, and improve interpersonal effectiveness through CBT interventions. Sessions focus on cognitive restructuring, behavioral activation, and mindfulness, with progress monitored via validated assessment tools and participant feedback. The plan emphasizes peer support, skill-building, and resilience within a safe group setting. [Abstract generated by AI.
