School of Nursing Capstones
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Item Improving Newborn Car Seat Safety Before Hospital Discharge [paper](2019-05) Mowry, Shelby; Willson, Pamela; Dolan, DianaBackground: A significant cause of infant and childhood injuries and mortality is motor vehicle accidents. Assessment and remediation studies have determined there are many common errors parents make regarding positioning of a newborn in a car safety seat (CSS). A multi-phased project was undertaken to determined CSS misuse rates at baseline and after implementing newborn CSS positioning educational strategies among parent/newborn dyads at a large urban 60-bed postpartum unit. Method: A 12 registered nurse trained quality improvement team using a 7-point checklist, based on positioning recommendations from the American Academy of Pediatrics, conducted dyad assessments at baseline and phase I (N=192). In phase I, a step-by-step CSS positioning educational pamphlet was added to mothers’ discharge teaching. In phase II, a CSS positioning YouTube demonstration video was designed, developed and evaluated by registered nurses working in the field of maternal-child health. Phase II data collection metrics included website viewing and educational tool evaluation of the CSS parental video in continuation of the Plan-Do-Study-Act process. Results: At baseline CSS 7-point criteria was met by few (n=20; 20.8%) dyads with most dyads (n=76) demonstrating one or more positioning errors. Shoulder-strap misalignment was the highest criteria missed. After education, CSS criteria was met by 67 (69.8%) dyads. For phase II, the video was evaluated by 14 registered nurses, the rubric scores ranged from 92 to 100, with a mean score of 96.79%. Nurses determined the CSS educational pamphlet and video to be useful tools in parental education. Conclusion: CSS positioning education at the point of care supports parent safety behaviors. At this facility, nursing staff are poised to implement video applications in their patient education. However, further study would be necessary to measure pamphlet versus video education effectiveness.Item Inpatient Outsourced Dialysis: Scorecards Usefulness and Usability for Monitoring Patient Safety [paper](2019-05) Wendl, Stephanie; Willson, Pamela; Dolan, DianaBackground: Dialysis services are expected to meet quality metrics as conditions of coverage for The Joint Commission. The use of scorecards improved the ability to monitor quality in areas for infection prevention and safety. A two-phase quality improvement project was undertaken to evaluate the perceived usefulness and usability of Dialysis Service Scorecard (DSS) among 12 regional hospital partners. Methods: In phase I the DSS was designed, developed, and piloted. Five key Joint Commission metrics were assessed. Scorecard data collection, staff training, report building, and six-month outcomes were presented to the leadership team at the pilot facility. In Phase II regional leader teams were surveyed to determine the DSS's perceived usefulness and usability for monitoring safety quality indicators using a 20-item electronic survey. Results: Responder roles ranged from Nurse Executives to Infection Preventionists at both urban (n=8) and rural (n=2) hospitals. The majority of hospitals (n=7) were urban facilities with less than 500 hundred beds. Most (90%) leaders reported previous use and 60% found the Dialysis Service Scorecard "extremely useful". Conclusion: Dialysis Service Scorecards readily identify areas that are lacking in quality performance standards providing hospital leaders with a valuable quality performance management tool.Item Preventative Effects of Cranberry Products Against Urinary Tract Infections in Healthy, Immunocompetent Women [paper](2019-05) Cordova, Trianna; Henninger, Angela; Reckson, Samantha; Benavente, ViolaUrinary tract infections (UTIs) are commonly diagnosed in an estimated 300 million women per year around the world. Annual health care costs for diagnosis and treatment of UTIs in the United States is approximately $1.6 billion. Previous research suggests cranberry products, a complementary and alternative medicine (CAM), provides protection against UTI recurrence in women. A demand for alternative, cost-effective methods for UTI prevention is needed due to rising antibiotic resistance rates. In this cross-sectional study, the specific aims examined women’s use, knowledge of, and attitudes toward CAM, and the use of cranberry products to prevent UTIs. An online self-administered questionnaire, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), was distributed to a convenience sample of healthy women 18 to 65 years of age who attended Texas State University. Findings revealed 27% of women have used CAM in the past, but only 9.2% are currently using it. The most common types of CAM used are vitamins and herbal supplements (61%), meditation/mindfulness (48%), yoga (35%), and acupuncture (22%). The HCAMQ survey scores indicated a more positive attitude towards CAM and holistic health (HH). About 60% of women admitted to using cranberry product to prevent UTIs with positive results in 82% of them. Although 73% of participants believe CAM is worth trying, 82% of them believe more testing is needed and 67% believe CAM can be dangerous because it prevents patients from seeking traditional treatment for their illnesses. Increased patient education is needed to change attitudes and increase usage of CAM.Item Impacts of Mindfulness and Physical Activity on Depression [paper](2019-05) Monceaux, Julianna; Yepez, Marissa; Ulliman, Jennifer; Parajes, Kristen; Kim, Son ChaeDepression will be the leading cause of disease burden across the world regardless of age, gender, or income. Physical activity and mindfulness are non-pharmacological treatments that have been shown to decrease depressive symptoms. However, research studying the correlation between dispositional mindfulness and physical inactivity on depression is limited. The purpose of this study was to explore health status and healthy behaviors and determine the predictors of depression severity. A non-experimental cross-sectional study was conducted with 179 adult participants. They completed self-reported questionnaires using a web-based or paper-and-pencil survey in two private clinics located in Austin and Corpus Christi, Texas. The study questionnaires included the Patient Health Questionnaire (PHQ-9), International Physical Activity Questionnaire (IPAQ), Five Facet Mindfulness Questionnaire- Short Form (FFMQ-SF), and the 4-item Behavior Risk Factor Surveillance System (BRFSS). Descriptive statistics, bivariate Pearson’s correlations, and hierarchical multiple regression procedures were utilized. More than half of the participants (59.2%) had mild to severe depressive symptoms over the past two weeks. The participants also reported an average of 2.8 days and 5.6 days of poor physical and mental health during the past month, respectively. The significant predictors for depression severity were mindfulness (β= -0.45; p <0.001) and sitting minutes per day (β= 0.18; p = 0.005). Providers may consider routine depression screening and implementation of mindfulness-based therapies and physical activity to minimize predictors of depression severity.Item Preventative Effects of Cranberry Products Against Urinary Tract Infections in Healthy, Immunocompetent Women [poster](2019-05) Cordova, Trianna; Henninger, Angela; Reckson, SamanthaUrinary tract infections (UTIs) are commonly diagnosed in an estimated 300 million women per year around the world. Annual health care costs for diagnosis and treatment of UTIs in the United States is approximately $1.6 billion. Previous research suggests cranberry products, a complementary and alternative medicine (CAM), provides protection against UTI recurrence in women. A demand for alternative, cost-effective methods for UTI prevention is needed due to rising antibiotic resistance rates. In this cross-sectional study, the specific aims examined women’s use, knowledge of, and attitudes toward CAM, and the use of cranberry products to prevent UTIs. An online self-administered questionnaire, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), was distributed to a convenience sample of healthy women 18 to 65 years of age who attended Texas State University. Findings revealed 27% of women have used CAM in the past, but only 9.2% are currently using it. The most common types of CAM used are vitamins and herbal supplements (61%), meditation/mindfulness (48%), yoga (35%), and acupuncture (22%). The HCAMQ survey scores indicated a more positive attitude towards CAM and holistic health (HH). About 60% of women admitted to using cranberry product to prevent UTIs with positive results in 82% of them. Although 73% of participants believe CAM is worth trying, 82% of them believe more testing is needed and 67% believe CAM can be dangerous because it prevents patients from seeking traditional treatment for their illnesses. Increased patient education is needed to change attitudes and increase usage of CAM.Item Behavioral Cuing: Improving Hospital Visitor Hand Hygiene Behaviors [poster](2019-05) Sumner, LaurenBackground: Visitors hand hygiene (VHH) prior to entering intensive care (ICU), telemetry, and intermediate care units is crucial in preventing spread of infections. During the influenza 2018-2019 outbreak, 50% of units' population tested positive for the influenza viruses; adding to the hospital acquired infection rates of the three units. An Agent-Based Model of infection spread approach was used with the goal of preventing infection transmission by hospital visitors in three high risk care units. Specifically, a visitor low dose educational intervention consisting of visual static and verbal cuing was undertaken to improve VHH behavior. Method: A four-week, pre-post-observational design (N=635) was completed by trained observers during day and nigh shifts for a large tertiary hospital to determine VHH rates. Strategies of visual static cuing included educational posters and patient door signage and verbal cuing to wash and/or sanitize hands by health care workers. Results: VHH adherence for the ICU was very low at baseline; out of 228 consecutive observations 20% (n=46) adherence was found. After behavioral cuing intervention, 407 observations resulted in 42% adherence to hand washing behaviors. Conclusion: Low does educational cuing strategies increased VHH behaviors. However, additional public education is needed to decrease infection spread from community sources.Item Improving Newborn Car Seat Safety Before Hospital Discharge [poster](2019-05) Mowry, ShelbyBackground: A significant cause of infant and childhood injuries and mortality is motor vehicle accidents. Assessment and remediation studies have determined there are many common errors parents make regarding positioning of a newborn in a car safety seat (CSS). A multi-phased project was undertaken to determined CSS misuse rates at baseline and after implementing newborn CSS positioning educational strategies among parent/newborn dyads at a large urban 60-bed postpartum unit. Method: A 12 registered nurse trained quality improvement team using a 7-point checklist, based on positioning recommendations from the American Academy of Pediatrics, conducted dyad assessments at baseline and phase I (N=192). In phase I, a step-by-step CSS positioning educational pamphlet was added to mothers’ discharge teaching. In phase II, a CSS positioning YouTube demonstration video was designed, developed and evaluated by registered nurses working in the field of maternal-child health. Phase II data collection metrics included website viewing and educational tool evaluation of the CSS parental video in continuation of the Plan-Do-Study-Act process. Results: At baseline CSS 7-point criteria was met by few (n=20; 20.8%) dyads with most dyads (n=76) demonstrating one or more positioning errors. Shoulder-strap misalignment was the highest criteria missed. After education, CSS criteria was met by 67 (69.8%) dyads. For phase II, all of the nurse evaluators considered both tools useful and would welcome both types of CSS education on the unit. Conclusion: CSS positioning education at the point of care supports parent safety behaviors.Item Obesity and Sedentary Lifestyle as Predictors of Anxiety and Depression [paper](2019-05) Boykin, Caitlin; Seidel, Sandra; Webre, Ginger; Kim, Son ChaeThere is a high prevalence of psychological distress and obesity with subsequent chronic disease in the United States. The aim of this study was to explore the relationships among obesity, physical activity, and health status and to determine predictors of psychological distress among adults in a community setting. A cross-sectional study using a web-based survey was conducted among 226 adults aged 18 years or older. The questionnaire was a self-report tool utilizing the four items from the Behavioral Risk Factor Surveillance System, 14-items Hospital Anxiety and Depression Scale, International Physical Activity Questionnaire- SF, and demographic data. Descriptive statistics, Kendall’s Tau test, and multivariate logistic regression procedures were performed. Two-thirds of participants were either overweight or obese, and one-fifth reported poor or fair health status. Positive predictors of anxiety and depression were sedentary lifestyle or sitting more than 360 minutes per day (OR=2.21 vs OR=2.11, respectively), obesity (OR=1.96 vs OR=2.50) and Caucasian ethnicity (OR=3.41 vs OR=3.99). The odds of anxiety and depression were nearly double for those who are sedentary or obese. Providers could encourage maintaining a healthy weight and sitting less than six hours per day. Periodic screening for psychological distress may be beneficial.Item Evaluating the Effectiveness of the Personal Diabetes Questionnaire in the Primary Care Setting [paper](2019-05) Wisco, Carolyn; Urbanosky, Staci; Fisher, Roger; Benavente, ViolaType 2 diabetes mellitus (T2DM) is a chronic illness managed daily by patients themselves. Poorly controlled diabetes is associated with micro- and macrovascular complications leading to increased morbidity. The Personal Diabetes Questionnaire (PDQ) is a reliable and valid tool that has not been tested in primary care and provides a comprehensive evaluation of knowledge, perceived barriers, and motivational aspects in T2DM self-management. The study aims were to evaluate T2DM self-management of patients in primary care as measured by the PDQ and explore the relationships between perceived barriers and readiness to change and patient self-reported glycated hemoglobin values (HbA1c). A cross-sectional, pilot study was conducted in a convenience sample from south central Texas, N=11. The PDQ assesses four behavioral domains by 13 subscales: blood glucose control, diet, medications, and physical activity. The SPSS software was used for statistical analysis and correlation coefficient techniques were applied to determine significant associations between study variables. Overall, subscales demonstrated good internal consistency (Cronbach’s α=0.56-0.82). No statistically significant correlations existed between HbA1c and participant perceived barriers or readiness to change. Participants were reportedly preparing or actively trying to lose weight and perceived few barriers to completing self-care activities. While participants reported well managed diabetes, their self-management was suboptimal regarding diet behaviors, glucose monitoring, and physical activity. Participants reported optimal diabetes medication adherence. The PDQ remains a valuable tool that can be used by primary care providers to facilitate optimal, patient-centered self-management evaluation and education and minimize diabetes complications.Item Evaluating the Effectiveness of the Personal Diabetes Questionnaire in the Primary Care Setting [poster](2019-05) Wisco, Carolyn; Urbanosky, Staci; Fisher, RogerType 2 diabetes mellitus (T2DM) is a chronic illness managed daily by patients themselves. Poorly controlled diabetes is associated with micro- and macrovascular complications leading to increased morbidity. The Personal Diabetes Questionnaire (PDQ) is a reliable and valid tool that has not been tested in primary care and provides a comprehensive evaluation of knowledge, perceived barriers, and motivational aspects in T2DM self-management. The study aims were to evaluate T2DM self-management of patients in primary care as measured by the PDQ and explore the relationships between perceived barriers and readiness to change and patient self-reported glycated hemoglobin values (HbA1c). A cross-sectional, pilot study was conducted in a convenience sample from south central Texas, N=11. The PDQ assesses four behavioral domains by 13 subscales: blood glucose control, diet, medications, and physical activity. The SPSS software was used for statistical analysis and correlation coefficient techniques were applied to determine significant associations between study variables. Overall, subscales demonstrated good internal consistency (Cronbach’s α=0.56-0.82). No statistically significant correlations existed between HbA1c and participant perceived barriers or readiness to change. Participants were reportedly preparing or actively trying to lose weight and perceived few barriers to completing self-care activities. While participants reported well managed diabetes, their self-management was suboptimal regarding diet behaviors, glucose monitoring, and physical activity. Participants reported optimal diabetes medication adherence. The PDQ remains a valuable tool that can be used by primary care providers to facilitate optimal, patient-centered self-management evaluation and education and minimize diabetes complications.Item Inpatient Outsourced Dialysis: Scorecards Usefulness and Usability for Monitoring Patient Safety [poster](2019-05) Wendl, StephanieBackground: Dialysis services are expected to meet quality metrics as conditions of coverage for The Joint Commission. The use of scorecards improved the ability to monitor quality in areas for infection prevention and safety. A two-phase quality improvement project was undertaken to evaluate the perceived usefulness and usability of Dialysis Service Scorecard (DSS) among 12 regional hospital partners. Methods: In phase I the DSS was designed, developed, and piloted. Five key Joint Commission metrics were assessed. Scorecard data collection, staff training, report building, and six-month outcomes were presented to the leadership team at the pilot facility. In Phase II regional leader teams were surveyed to determine the DSS's perceived usefulness and usability for monitoring safety quality indicators using a 20-item electronic survey. Results: Responder roles ranged from Nurse Executives to Infection Preventionists at both urban (n=8) and rural (n=2) hospitals. The majority of hospitals (n=7) were urban facilities with less than 500 hundred beds. Most (90%) leaders reported previous use and 60% found the Dialysis Service Scorecard "extremely useful" and 40% found the DSS "useful". Conclusion: Dialysis Service Scorecards readily identify areas that are lacking in quality performance standards providing hospital leaders with a valuable quality performance management tool.Item Bedside Educational Tool: Improving Patient Education and Nursing Documentation [poster](2019-12) David, Katie; Dolan, Diana; Willson, PamelaBackground: The aim of the Bedside Education Tool (BET) project was to increase patient discharge knowledge by expanding Krames© Patient Education (Krames) selections recorded in the Electronic Health Record (EHR). Methods: A descriptive pre- post-comparison evidence-based improvement project was undertaken to determine if cueing with a collaborative patient point-of-care educational tool facilitated nurse-patient education and discharge documentation. Three instruments were used: 1) BET Sheet, 2) Nurse Usability and Usefulness Survey, and 3) the patients EHR Discharge Record education section. Nursing staff were educated regarding documentation of Krames selections in the EHR. EHR record audits (N=230) were reviewed; 101 pre-implementation records and 129 post-implementation records. Results: Nurses on the selected medical-surgical unit, (N=37, 90.24%) participated in the BET project after education. BET project HealthStream education was completed. EHR Krames documentation increased 153% and the number of Krames items selected per patient increased 229% after the BET implementation. Conclusion: In hospitalized patients, the introduction of a patient-nurse bedside education collaborative tool (BET) increased collaborative patient-centered education and Krames education selections recorded in the EHR discharge plan.Item Implementation of a Quality Incident Review Team: Effects on Reporting and Resolution [poster](2019-12) Burgoon, CourtneyBackground: Incident reporting systems (IRS) are used for gathering data to improve knowledge and decrease errors in the hospital. There is an established need for reporting, with available research focused on patient safety culture, barriers to reporting. Process improvement methods to increase incident reporting, and follow-up for of incidents is lacking in literature. Method: In April, an Interdisciplinary Quality Incident Review Team (QIRT) was implemented. The QIRT, involved education of staff and managers, incident assignment, and follow-up for resolution. Three measurement times were (1) Baseline (pre-implementation –January through March 2019), (2) 3-month post-implementation data (April through June 2019), and (3) 6-months post-implementation. Results: Implementation of the QIRT and associated interventions resulted in an increase in overall reporting of patient safety incidents. During the implementation measurement period, there was a 29% increase over the pre-implementation period, and a 37% increase during the post-implementation period. Nursing incidents had the largest decrease in resolution days to an average of 11 in the post-implementation period. Conclusions: Implementation of the QIRT, increased incident reporting in all areas. Nursing incidents showed the only significant decrease in resolution time. Limitations included involvement of leadership in morning huddles, and knowledge of new leaders in use of the IRS, may have impacted the ability for some managers to complete their incidents.Item Results Pending Unit: Improving ED Flow and Patient Satisfaction [Poster](2019-12) Hartman, Amy; Willson, Pamela; Dolan, DianaIntroduction: Emergency departments (ED) are often faced with long wait times and lengths of stay, which leads to unsatisfied patients. A Results Pending Unit can improve the ED workflow and lead to shorter wait times and lengths of stay. Patient satisfaction can be affected by the shorter time frames spent in the ED. Methods: A pre- and post-implementation comparison study was undertaken to evaluate the ED workflow and patient satisfaction ratings after implementation of the RPU on October 15, 2019. Administrative computer-generated reports and Press Ganey scores were collected and analyzed to determine baseline metrics prior to implementation, and then re-evaluated post implementation to determine results. Results: Outcomes of workflow and patient satisfaction were analyzed post-implementation of the RPU. With the implementation of the RPU, ED workflow was improved through decreased wait times and LOS. Patient satisfaction scores increased for Overall impression of the ED but did not show an improvement post-implementation of the RPU. Conclusion: The goal of meeting the national average wait time and length of stay was obtained by implementing an RPU. The facility patient satisfaction of 87.4% for Overall Assessment was met. The goal set for improvement post-implementation of the RPU.Item Quality Improvement: Outcomes of Huddle Education for Titratable Sedating Medications [paper](2019-12) Ee, Alisa; Dolan, Diana; Willson, PamelaBackground: Nurses have a profound responsibility to act in the best interest of their patients. One way they care for their patients responsibly in the critical care setting is by routinely assessing and administering medications according to the provider order. Simultaneously, nurse leaders have a commitment to educate bedside nurses on how to care for patients in with evidence-based practices. In order to reveal nurse behaviors in the critical care setting for the assessment, documentation, and administration of sedating medications, this study seeks to determine how to improve compliance among bedside nursing staff. Purpose: The purpose of this study was to investigate how implementing education for Intensive Care Unit (ICU) nursing staff at a hospital in central Texas improved quality of patient care, as measured by the assessment, documentation, and administration of titratable sedating medications. Methods: In a cohort study of hidden social patterns, the frequency of nurses administering and titrating medication according to the provider order, and the frequency of documentation of appropriate assessment was measured pre- and post- education intervention to all nurses in the coho1t. Titration of sedating medications was only documented in paper charting "flow sheets." After assessing the sedation score of the patient, nurses who deemed it appropriate to increase or decrease sedating medications were then to document the change in dosage administered, as well as the subsequent sedation score on paper. Results: The population considered in this project included a total of72 male and female, ranging from age 21 to 56. The racial groups included were Caucasian, African America, Asian, and Hispanic. Prior to the educational intervention, dayshift compliance with sedation documentation was 62.69 percent and nightshift compliance was 63.04 percent. After the educational intervention, dayshift compliance with sedation documentation was 74.68 percent and nightshift compliance was 61.82 percent. Dayshift compliance with titration of medication according to provider order was 72.22 percent and nightshift compliance was 90.10 percent. Following the intervention, dayshift compliance with medication titration was 82.61 percent, and nightshift compliance was 70 percent. 100 percent compliance (defined as a nurse documenting sedation 100 percent of opportunities to chart) with sedation documentation was 41 percent and compliance with medication titration was 60 percent. After the educational intervention, 55 percent of nurses were 100 percent compliant with sedation documentation and nurses were 64 percent compliant with 100 percent medication titration. Conclusions: The risks associated with implementing this educational intervention are lost time and money for hours paid to attend the education intervention. Increasing medication knowledge and documentation skills improved the quality of nurses' medication management. Ongoing monitoring of compliance might be measured with leadership unit rounding.Item Results Pending Unit: Improving Emergency Department Flow and Patient Satisfaction [paper](2019-12) Hartman, Amy; Dolan, DianaIntroduction: Overcrowding and boarding patients in the emergency departments (ED) leads to unacceptable patient care and staff productivity. When there is poor patient flow through the ED the following negative outcomes occur: increased patient wait times, increased lengths of stay (LOS), and poor patient satisfaction scores which affects the units benchmark metrics. A Results Pending Unit is a physical space in the ED that includes a dedicated nurse where discharged patients can wait for test/lab results prior to leaving the ED (StudorGroup, 2019). The purpose of this study was to determine the impact of implementation of a Results Pending Unit (RPU) for patients waiting in the ED at a rural 125-bed facility with 16 ED beds would improve patient flow (wait times and lengths of stay), and patient satisfaction with ED experience. Methods: A pre-implementation and post-implementation comparison study was undertaken to evaluate the ED workflow and patient satisfaction ratings after implementation of the RPU. Two weeks after the opening of the RPU, data from administrative computer-generated reports was analyzed to evaluate ED patient flow by wait times and lengths of stay. Press Ganey surveys were evaluated for the month of October to determine if the RPU improved patient satisfaction scores. Results: Outcomes of workflow and patient satisfaction were analyzed post-implementation of the RPU. With the implementation of the RPU, ED workflow was improved through decreased wait times and LOS. Patient satisfaction scores increased for Overall impression of the ED but did not show an improvement in the Arrival portion of the survey post-implementation of the RPU. Conclusion: The goal of meeting the national average wait time and length of stay was obtained by implementing an RPU. While not a direct measure, the facility patient satisfaction goal for “Overall Assessment” increased by 3.1%. The patient satisfaction goal for “Arrival” did not show improvement in the overall goal after implementation of the RPU.Item Bedside Educational Tool: Improving Patient Education and Nursing Documentation [paper](2019-12) David, Katie; Willson, Pamela; Dolan, DianaBackground: The purpose of the Bedside Educational Tool (BET) project was to increase patient discharge knowledge by expanding Krames education selections recorded in the discharge and maintained in the Electronic Health Record (EHR). Methods: A descriptive pre- post-comparison evidence-based improvement project was unde1iaken to determine if cueing with a collaborative patient point-of-care educational tool facilitated nurse-patient education and discharge documentation. To establish a baseline, chart audits of patients discharged from a 32-bed medical-surgical unit within a large 378 bed acute care hospital for a consecutive 18-day period was performed. Three instruments were used in this project 1) Bedside Educational Tool (BET), 2) Nurse Usability and Usefulness Survey, and the 3) Patients Discharge Record from the hospital. Implementation consisted of initiation of the BET sheet and nursing education regarding documentation of Krames selections. Audited discharge records compared the Krames education selections in the EHR from 101 pre implementation charts to 129 post-implementation charts. Results: All nurses on the pilot unit 41 (100%) participated in the implementation of the BET. 37 (90.24%) nurses on the unit participated in the BET project HealthStream education. EHR Krames educational documentation increased after implementing the BET tool by 96% and the number of Krames items selected per patient increased 229%. Nurses surveyed found the BET tool both easy to use and successful in the development of the collaborative patient-centered education. Conclusions: In hospitalized patients, the introduction of a patient-nurse bedside education collaborative tool (BET) increased collaborative patient-centered education and the Krames education selections recorded in the discharge plan and the final EHR.Item Health Literacy and Health Behaviors in Adults [paper](2019-12) Hamilton, Rebecca; Barlow, Vanessa; Qiu, Shan; Debault, Jon; Kim, Son ChaeHealth literacy is fundamental to healthcare as it requires individuals to actively participate in decision-making and illness management. Low health literacy leads to increased medical errors, poor use of health services, improper management of health conditions, inadequate self-care skills, and longer and more frequent hospitalizations. This cross-sectional study aimed to assess the health literacy levels in adults and explore the relationships among health literacy, health- related behaviors, and health status. A convenience sample of 230 adults completed online survey or paper-and-pencil survey from October 2019 to November 2019. The study survey included Health Literacy Questionnaire, health status items from Behavior Risk Factor Surveillance System, and International Physical Activity Questionnaire-SF. About a quarter of participants rated their general health status as poor or fair. The mean scores for basic health literacy and advanced health literacy were 3.00 and 2.83, respectively. There were significant differences in health literacy scores among educational level, ethnicity, and body mass index (p <0.05). Simultaneous multiple regression analyses showed that sedentary lifestyle measured by sitting minutes per day was a positive predictor of days of poor physical health (β=0.21; p=0.001) and days of poor mental health (β=0.18; p=0.005). Basic health literacy was a negative predictor of days of poor physical health (β= -0.29; p=0.001) and days of poor daily activities (β=-0.22; p=0.015). In the primary care setting, health care providers are responsible for educating patients on health-related concepts to heal or prevent illnesses. With an understanding of the health literacy needs of certain patient populations, healthcare providers can tailor the education to the literacy needs of individual patients.Item Outcomes of Huddle Education for Titratable Sedating Medications [poster](2019-12) Ee, Alisa; Dolan, Diana; Willson, PamelaThe purpose of this study was to investigate how implementing education for Intensive Care Unit (ICU) nursing staff at a hospital in central Texas improved quality of patient care, as measured by the assessment, documentation, and administration of titratable sedating medications.Item An Interprofessional Quality Incident Review Team: Effects on Reporting and Resolution [paper](2019-12) Burgoon, Courtney; Dolan, Diana; Willson, PamelaBackground: Since the Institute of Medicine's (IOM) report, To Err is Human, there has been increased focus on patient safety, to include use of incident reporting systems for gathering data to improve knowledge and decrease e1rnrs in the hospital. With increased pain and suffering, and cost associated with errors, the justification for these processes are clear. It is known that underreporting of incidents continues. There is a need for reporting systems, with available research focusing on organizational safety culture, ba1Tiers to reporting, and the acceptance of reporting systems in practice. Process improvement methods to increase incident reporting, and resolution of incidents is lacking in literature. Method: A descriptive repeated measures quality improvement project was undertaken at baseline, 3-months, and 6-months post intervention. Quality metrics were number of patient safety incidents and time to resolution of incident review. The intervention consisted of the development of An Interdisciplinary Quality Incident Review Team (QIRT) at a 147 bed acute care hospital in central Texas, U.S. A. The QIRT process, involved education of staff and managers on the new processes of reporting, evaluating, and completing incident reports. Results: Implementation of the QIRT process resulted in an increase in overall reporting of patient safety incidents in the categories of medication errors, hospital, nursing, and safety. At 3- months and 6-month post intervention, incident reports increased by 41% (n=21) and 59% (n=30). Hospital Incidents made up greatest increase in rep01i types, while Medication Errors had the fewer rep01is. Time to resolution of Nursing Incident reviews had the largest decrease in resolution time with an average of 11 days. Nursing Incident reporting demonstrated that consistency lead to sustainability over time, as the number of reported incidents continued to increase during the 6-month follow-up. Conclusions: Implementation of the QIRT, including educational materials and expectations for nursing staff and managers, increased incident reporting in all areas. Education regarding rep01iing, awareness ofrep01ied events, and follow-up from the QIRT were shown to increase reporting across the organization. Nursing incident rep01is were the only category where the time from the incident was reported, to resolution of the incident in the rep01iing system decreased.