LAIR: Lenoir-Rhyne Academic Institutional Repository
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198 research outputs found
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Aromatherapy: Reducing Anxiety and Nausea in the Perioperative Setting
Get PDFThe aim of this project is to educate care providers in the use of aromatherapy to reduce the symptoms of nausea and/or anxiety in the perioperative setting and introduce protocols for the documentation of aromatherapy use
Picture of Me: Life-Story Work Made Accessible
Get PDFAim: The goal of this project was to determine if a dementia-focused quality improvement (QI) project entitled Picture of Me (POM) could increase direct care providers’ (DCPs) knowledge about individual residents and if this increase in knowledge would also improve their perceptions of personhood of the long-term care (LTC) resident with dementia. Background: A key aspect in the delivery of quality dementia care is the person-centered care approach which is an approach that involves recognizing the person with dementia as a unique individual with a distinctive life story. Direct care providers report barriers to providing this care that include the inability to secure needed information, lack of mechanisms for communicating information, and lack of the time available to do either. Systems need to be created that support communication processes to facilitate the exchange of person-centered information to direct care providers and staff. The Picture of Me (POM) quality improvement (QI) project is designed as a cost-effective, concise, and accessible way to collect and display life story information about LTC residents with dementia. Method: A convenience sample of 22 direct care providers who worked in the memory care unit of a long-term care facility in rural North Carolina were recruited to participate in this mixed-methods project conducted over a three-month period. The primary outcome measure was an increase in DCPs’ knowledge about individual resident’s life story. The secondary outcome measures were an improvement in perceptions of personhood in the care of LTC residents with dementia and an increase in staff satisfaction with caring for these residents. Results: One hundred percent of the participants completed the all surveys, and the Picture of Me project increased DCPs' knowledge as well as changed perceptions and opinions of personhood in the care of LTC residents with dementia. Conclusion: Picture of Me boards improved DCPs' knowledge of residents with dementia and their life story as well as improved DCPs perceptions of the residents by provoking thoughtful conversation, increasing convenience of information availability, facilitating the use of relevant calming techniques, and changing situational perspective in regard to everyday care practices. Keywords: long-term care facility; life-story work; person-centered care; dementia; direct care provider
A Faith-Based Healthcare Intervention to Address Social Isolation and Loneliness in Older Adults
Get PDFThe goal of this quality improvement project was to determine if a nurse practitioner could utilize virtual, faith-based spiritual resources for socially isolated older adults to reduce loneliness and improve their quality of life. A volunteer sample of 16 adults over the age of 55 was recruited from local communities to participate in this 2-month intervention and follow up. The primary outcome measures were a reduction in social isolation and loneliness as indicated by the De Jong Gierveld scale and improved quality of life as measured by the World Health Organization quality of life scale brief version
A Quality Improvement Program the Using Ready, Set, Baby Curriculum During the Baby Friendly Designation Process
Get PDFAbstract Objective: To evaluate the effects of the Ready, Set, Baby (RSB) program based on staff satisfaction and knowledge of perinatal education during the Baby Friendly Hospital Initiative (BFHI) designation process, and to evaluate program effect on maternal knowledge and confidence in initiating and maintaining a breastfeeding relationship. Design: A mixed-method quality improvement program. Setting: A rural obstetrics and gynecology office and its affiliated labor, delivery, recovery, and postpartum unit, which accommodates approximately 400 births per year. Participants: A convenience sample of 26 physicians, nurse practitioners, registered nurses, and a lactation consultant employed by the obstetrics and gynecology office and hospital, and 23 expectant mothers who were established patients at the obstetrics and gynecology office participated. Interventions/Measurements: RSB was implemented for staff and mothers with complementary education to reinforce learning. Staff satisfaction with perinatal educational processes, documentation of required education in the electronic health records, and self-reported staff knowledge regarding BFHI practices were evaluated for primary outcomes. Secondary outcomes included maternal knowledge of BFHI perinatal practices and increased confidence in initiating and maintaining a breastfeeding relationship. Results: There were significant improvements for staff satisfaction and documentation outcomes. Expectant mothers had increased knowledge of and confidence in using perinatal practices to facilitate breastfeeding. Conclusion: RSB is valuable for increasing staff satisfaction and maternal learning objectives during the Baby Friendly designation process. Keywords: breastfeeding; perinatal education; quality improvement; Baby Friendly Hospital Initiative; “Ready, Set, Baby.
A Program to Improve the Assessment of a Child for Attention Deficit Hyperactivity Disorder
Get PDFAbstract Problem: Due to the number of children diagnosed with ADHD, increased risk of these children having co-morbidities, and insufficient documentation of the DSM-5 criteria for an ADHD diagnosis, an ADHD program was developed for a child presenting for an initial ADHD evaluation. Methods: A mixed method design utilizing a retrospective chart review evaluated the system change and provider adherence by percentage of DSM-5 criteria met prior to and after the implementation of the ADHD program. A thematic analysis identified the recruited participants’ satisfaction of the ADHD program. Findings: The two-tailed Mann-Whitney U test was significant based on p < .001. Providers met 100% of the DSM-5 criteria after implementation of the ADHD program in the EHR, compared to 50% prior to implementation. The thematic analysis identified recruited participants were satisfied with the ADHD program which provided a more standardized means of documenting the DSM-5 criteria for ADHD. Conclusions: The ADHD program, increased provider’s adherence and consistency to the DSM-5 criteria decreasing the use of the unspecified ADHD ICD-10 code, allowing the provider to develop a more successful plan of care for patients between the ages of five and 18. Keywords: attention deficit hyperactivity disorder, assessment tools, assessment methods, assessin
Utilization of Ketorolac for Pain Control During Nephrostomy and Nephroureteral Stent Exchange: A Quality Improvement Study
Get PDFPatients with nephrostomy/nephroureteral stents undergo exchange procedures every six to eight weeks to maintain patency. This procedure is commonly performed with moderate sedation using opioid medications. These medications are not without risks relating to maintenance of airway and rate of breathing. A quality improvement study was conducted to evaluate the effectiveness of adding ketorolac to a reduced amount of opioid administration during this procedure to examine pain scores. Pain scores were measured by the Visual Analogue Scale during the pre procedure, during procedure and post procedure periods. Ketorolac has shown to be effective in other areas of pain management but there was a gap in research related to this procedure. Six of the ten patients required half of the previous total of opioids. Four of the ten patients received the full dose of opioids. There were no significant differences between these groups in pre procedure pain score or the post procedure pain score. The patients receiving half the dose of opioids were able to achieve similar pain control compared to those patients receiving the full dose
Implementation of a Program to Screen for the Social Determinants of Health in Primary Care
Get PDFThe goal of this quality improvement project was to integrate and evaluate the screening of
social determinants of health into a primary care practice and incorporate the screenings into the
electronical health record. The primary outcome measure was documentation of social
determinants of health in the electronic health record. The secondary outcome measure was to
provide patients with resources and document resources were given. The participants included
one provider and two medical assistants within a clinic. A chi-squared test of independence was
used to measure the improvements in screening and documentation of social determinants of
health. Content analysis was used to evaluate participant responses about the project. Descriptive
statistics was used to illustrate the results of each social determinant of health
Preoperative Obstructive Sleep Apnea Screening using the DOISNORE Survey: A Quality Improvement Project in an Ambulatory Surgery Center
No full textThis is a quality improvement project conducted in an ambulatory surgery center. The purpose of this project was to increase adherence to preoperative sleep apnea screening guidelines. Preadmission nurses received an educational intervention and were instructed to implement routine sleep apnea screening on all preadmission patients over the age of 18 for three months. At the conclusion of the project, we found routine sleep apnea screening increased identification of at risk patients. Routine screening rates increased by 17% following completion of the intervention
Human Papillomavirus (HPV) Prevention Program: An Initiative to Improve Gardasil Vaccination Rates Ages 26-45 Years
Get PDFRecent changes to Gardasil vaccination guidelines have created a need to improve provider and patient education related to Human Papillomavirus (HPV), as well as the implementation of tools to increase HPV vaccination uptake, particularly the usage of EHR reminder systems
A Primary Care Initiative to Reduce Falls Among Community Dwelling Senior Adults
No full textA program based on the Centers for disease Control and Prevention's STEADI initiative was introduced into a small rural primary care center to reduce the risk and sequelae of falls among senior adult patients. The program increased the screening, assessment, and interventions ordered for older adults