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Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention

Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention would reduce burnout levels among registered nurses (RNs) working in in-patient settings. Methods: Participants enrolled in nursing programs from a local university were recruited for the project with the following inclusion requirements: (1) RNs working in an in-patient setting, (2) aged 18 years old or older; (3) fluent in the English language. Participants completed a pre-survey and then enrolled in a free mindfulness application via their phone or computer. Participants listened to one ten-minute mindfulness session for a consecutive ten days and then completed a post-survey. Results: Data collected from the pre and post surveys included the use of the following valid and reliable instrument tools: Copenhagen Burnout Inventory, Brief Resiliency Coping Scale, and Short Form Health Survey. Data was analyzed using descriptive statistics and the Wilcoxon Signed Ranks Test. The analyzed data showed that there was statistical significance in decreased burnout levels, increased resiliency, and increased health perceptions of the participants. Conclusion: By finding ways to cope with the experience of burnout in nurses, nurses’ mental health wellness can improve in order for nurses to continue to be an integral part of the healthcare system.
Created2022-05-06
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Description
Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as

Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.
Created2022-04-30
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Description
Medicare implemented a yearly Annual Wellness Visit (AWV) to improve quality patient care through early detection of declining health. However, there has been only partial provider participation since its inception, which potentially delays treatment and negatively impacts patient outcomes. The aim of this quality improvement project was to assess the

Medicare implemented a yearly Annual Wellness Visit (AWV) to improve quality patient care through early detection of declining health. However, there has been only partial provider participation since its inception, which potentially delays treatment and negatively impacts patient outcomes. The aim of this quality improvement project was to assess the feasibility of implementing a standardized electronic AWV template into private primary care practices to improve the consistency of delivery and documentation. The project designer utilized the theory of transitions (TOT) to facilitate the project execution. An electronic Excel-based template was designed to capture and calculate all aspects of the AWV, including billing codes, to allow for ease and consistency of use within a small primary care practice over two weeks. A provider performed the AWVs using the electronic template after completing a hands-on tutorial and reviewing an educational handout. Data were retrieved from a 7-question, 5-point Likert scale questionnaire given to the provider to assess the effectiveness of the electronic template versus a paper assessment. The results of this study indicated overall satisfaction with using leveraged technology to provide consistency of AWVs to improve patient outcomes, provider satisfaction, and increase revenue through uniform charting and billing. The outcomes of this project provide a basis of existing evidence for using standardized methods to perform and track Medicare AWVs.
Created2022-04-29
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Description
Background: An evidence-based project was performed to train and increase skills among healthcare providers to perform advance care planning. Training decreases barriers and improves attitudes and confidence to perform advance care planning. Advance care planning can include the Physician Order for Life-sustaining Treatment, an out-of-hospital order that directs emergency medical

Background: An evidence-based project was performed to train and increase skills among healthcare providers to perform advance care planning. Training decreases barriers and improves attitudes and confidence to perform advance care planning. Advance care planning can include the Physician Order for Life-sustaining Treatment, an out-of-hospital order that directs emergency medical services of a patient’s wishes. Internal evidence found that many providers are unfamiliar with the Physician Order for Life-Sustaining Treatment form. The Theory of Planned Behavior was used to guide the project. Objectives: To improve advanced care planning processes in a healthcare organization. Design: A quality improvement project was performed at a medical center with outpatient provider groups. Virtual training was provided by the Arizona Hospital and Healthcare Association on the Physician Order for Life-Sustaining Treatment. Participants completed a three-part survey to measure skills for advance care planning after a training event. Setting/Subjects: Five (n=5) American palliative and primary care providers at a medical center. Measurements: The East Midlands Evaluation Toolkit is a validated survey tool that measures confidence and competence in advance care planning after training. Results: Descriptive statistics, Friedman’s test, and the Kruskal-Wallis test were used for data analysis. Results provided evidence to the healthcare facility that there is a significant need to train their healthcare professionals on advance care planning. Conclusions: Recommendations are made to focus research on larger studies looking at the types of advance care planning, and differences in disciplines and specialties.
Created2022-04-29
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Description
Sexually transmitted infections (STIs) are a variety of infections caused by pathogens acquired and transmitted through sexual activity (World Health Organization [WHO], 2021). STIs are associated with an increase in chronic pelvic pain, pelvic inflammatory disease (PID), infertility, and pregnancy complications (Centers for Disease Control and Prevention [CDC], 2021e). A

Sexually transmitted infections (STIs) are a variety of infections caused by pathogens acquired and transmitted through sexual activity (World Health Organization [WHO], 2021). STIs are associated with an increase in chronic pelvic pain, pelvic inflammatory disease (PID), infertility, and pregnancy complications (Centers for Disease Control and Prevention [CDC], 2021e). A clinical decision support (CDS) tool provides assistance to healthcare providers to use a logical, step-by-step method in patient management by incorporating different reminders or guidelines into practice. The purpose of this project is to assist healthcare providers to manage positive STI results per the CDC guidelines via a CDS tool. A CDS tool for positive STI management was implemented as a system wide practice change. A retrospective chart audit revealed the CDS tool was used 49% of the time. When the CDS tool was utilized, documented partner treatment, screening for additional STIs, documented follow-up, condoms offered, provider discussion of screening of other STIs, and treatment of the STI all increased. This project displays that utilization of a CDS tool can improve the management of positive STIs in a women’s healthcare setting.
Created2022-05-05
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Description
Primary care providers (PCPs) are frequently the first line of treatment for suicidal ideation (SI) patients. Many PCPs report low self-efficacy in treating suicidal patients, leading to inappropriate treatment plans or avoidance of discussing SI. This quality improvement project based on the Uncertainty Reduction theory aimed to evaluate PCP's perceptions

Primary care providers (PCPs) are frequently the first line of treatment for suicidal ideation (SI) patients. Many PCPs report low self-efficacy in treating suicidal patients, leading to inappropriate treatment plans or avoidance of discussing SI. This quality improvement project based on the Uncertainty Reduction theory aimed to evaluate PCP's perceptions of an SI treatment algorithm and its impact on self-efficacy. Secondary aims included assessing PCP's confidence in treating suicidal patients and current treatment practices. A pre- then post-intervention survey design was utilized. All PCPs treating patients in a military medicine clinic were invited to participate in the project. Participants were sent a recruitment email containing the suicidal ideation treatment algorithm and a link to a survey developed with Qualtrics software. Participants were asked to review the SI algorithm, answer the baseline survey questions, and complete a second eight-week survey. For human subjects' protection, the survey responses were anonymous. Demographic data collected included years of clinical experience and licensure type. The data were evaluated with Intellectus software. Due to limited participation, N=4, there was insufficient data to determine the significance of implementing the SI algorithm in a primary care clinic. Central tendencies showed that most providers (n=3, 75.00%) felt less than confident treating suicidal patients. Half of the providers asked non-mental health patients about suicide less than 40% of the time (n=2, 50.00%). The data suggest that PCPs feel uncomfortable treating suicidal patients and may benefit from additional resources and training in this area.
Created2022-04-26
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Description
Aim: To evaluate the impact transformational leadership (TFL) behaviors and What Matters to You conversations have on RNs finding meaning and joy in work (MJW) and turnover. Background: The nursing profession is plagued by burnout - a precursor to loss of MJW. Loss of MJW was exhibited as low

Aim: To evaluate the impact transformational leadership (TFL) behaviors and What Matters to You conversations have on RNs finding meaning and joy in work (MJW) and turnover. Background: The nursing profession is plagued by burnout - a precursor to loss of MJW. Loss of MJW was exhibited as low morale and increased turnover among acute care RNs at a small hospital in Southwest Arizona. Addressing loss of MJW aligns with caring for the caregiver, the fourth aim of the quadruple aim initiative. Methods: This was a quasi?experimental mixed methodology evidence-based project. The target populations were core RNs and leaders working in the intensive care unit, care unit, and emergency department. Intervention was multimodal – survey using Meaning and Joy in Work Questionnaire, TFL education, and steps one and two of the IHI four steps for leaders model. Results: Final sample was 18 RNs. Statistical analyses did not reveal significant impact; pre- and post-survey MJWQ scores remained above four. Themes from the What Matters to You conversations included making a difference, coworkers/connections, staffing, and negativity. Turnover trended positively in two of the three units. Conclusion: This project heightened awareness about MJW and illuminated the impact TFL behaviors can have on RNs finding MJW and turnover. The coronavirus pandemic and acute nursing shortage were significant limitations of the project. Implications: Healthcare organizations are encouraged to view MJW as a system asset, embed it in their cultures, invest in innovative solutions, and continually evaluate outcome measures of MJW.
Created2022-04-28
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Description
Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events

Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events to obtain these unmet primary care services. Community services events effectively disseminate health-related material and provide access to vital medical services. Currently, community services strive to bridge the gap between underserved individuals and primary care clinics by providing participants referrals for low-fee or free clinics to establish ongoing care. A lack of data exists on whether these events sufficiently impact the participants to motivate them to follow-up with a health care clinic. A critical appraisal of evidence showed that follow-up adherence rates are remarkably improved by directly referring participants to a primary clinic during a community services event. This paper explores the effect on health outcomes and health disparities when establishing connections between community services participants and ongoing healthcare services.
Created2021-04-22
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Description
Purpose: To assess the burnout levels of mental health workers and to evaluate the effectiveness of promoting self-care practices in improving their well-being and resiliency. Background and Significance: Burnout is highly prevalent among mental health workers due to the nature of their work and the population of patients they serve. Turnover has been

Purpose: To assess the burnout levels of mental health workers and to evaluate the effectiveness of promoting self-care practices in improving their well-being and resiliency. Background and Significance: Burnout is highly prevalent among mental health workers due to the nature of their work and the population of patients they serve. Turnover has been a significant problem within this specialty for decades. Before the COVID-19 pandemic, the mental health workforce was projected to experience shortage by 2025. The pandemic will likely worsen this. Evidence from literature supports the effectiveness of promoting self-care towards the development of resiliency and well-being in addressing burnout among healthcare workers. Methods: The Maslach Burnout Inventory – Human Services Survey (MBI-HSS) was used to assess the burnout levels of mental health workers in a psychiatric hospital in Arizona pre- and post-intervention. Educational modules were provided for each participant to review. They were asked to perform at least one self-care activity and to utilize the tools in the Provider Resilience application every week for four weeks. Results: Pre-intervention surveys indicated moderate levels of emotional exhaustion (m=20.71) and depersonalization (m=9.29) and high levels of personal accomplishment (m=28.71). Improvements were seen on emotional exhaustion (m=18.86), depersonalization (m=6.43), and personal accomplishment (m=33.86) were seen post-intervention. Conclusion: Although the results were not statistically significant due to small sample size, the improvements seen on two out of three components of burnout (emotional exhaustion and depersonalization) indicated that awareness of burnout levels and self-care practices contribute to improving the well-being of mental health workers.
Created2021-04-26