Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
Southern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21 AngelesADVANCE CARE PLANNING IN A SKILLED NURSING FACILITY: A QUALITY IMPROVEMENT PROJECTA DOC TORAL PROJECTSubmitted in Partial Fulfillment of the RequirementsFor the degree ofDOCTOR OF NURSING PRACTICEByDane ShoemakerDoctoral Project Committee Approval:Joy R. Goebel. RN. PhD. FPCN. Committee Chai Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21r Kholoud Hardan-Khalil. RN. PhD. CCRN. Committee Member43221ABSTRACTAll increasing number of deaths in the United States are taking place in post-acuShoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
te and skilled nursing facilities (SNF) and the trend is expected to continue. Demand for higher quality care al the end-of-life (EoL) calls lor improSouthern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21 the completion of the Physician's Orders for Life-Sustaining Treatment (POT.ST) form.Die purpose of the pro ject was to improve ACP activities in a large post-acute care facility located in Southern California. The aims were (1) to describe the current state of ACP practices, (2) to develop and imp Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21lement a PC-centered training program for licensed and non-licensed nurses, and (3) to evaluate the effectiveness of the intervention on ACP.Die projeShoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
ct employed an observational pre-posttest design. Nurses (licensed and non-licensed) were provided a class on PC concepts including EoL care and documSouthern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21. Pre-post-intervention chart audits evaluated POT.ST completeness.POLST forms horn patient's charts (n - 60). licensed registered nurses (?7 - 10). licensed vocational nurses (w - 26), and non-licensed clinical nursing assistants (fl - 50) comprised the sample for this project. Post-intervention ch Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21art audits for POLS 1 completeness increased from 52% to 62% (a 1O-percentage point increase). Licensed nurses and unlicensed CNA’s post-test mean scoShoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
res on PC knowledge, skills and attitudes improved (mean 3.71 [SD .43] to mean 4.17 [SD .49]. mean 3.76 [SD .65] to mean 3.90iii[SD .70]. respectivelySouthern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21 percent (w = 19) of the participants showed marginal KSA decrements (range differences -1.11 to -0.04).Implementation of PC-based trainings improves nursing KSA related to palliative and EoL care across nursing levels. PC trainings may improve completeness of POLST documentation. The decrements in Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21KSA scores suggest that trainings may sensitize nurses to challenges in providing palliative and EoL care. This project demonstrates the feasibility oShoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
f implementing a facility wide PC educational program to a population who frequently lack access to evidence-based PC and EoL information.ivTABLE OF CSouthern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21OF FIGURES................................................. viiiACKNOWLEGEMENTS................................................... LxBACKGROUND......................................................... 1Problem Statement.............................................. 2Purpose Statement................ Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21.............................. 3Supporting Framework........................................... 3Stakeholders.........................................Shoemaker_35 2018-05-17 Shoemaker DNP FINAL_5_21
.......... 6LITERATURE REVIEW.................................................. 7Advance Care Planning and POLST Documentation.................. sAdulSouthern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. Los Southern California csư DNP ConsortiumCalifornia State University. Fullerton California State University. Long Beach California State University. LosGọi ngay
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