13th Annual Meridian Nursing Research and Evidence Based Practice Conference 2017 General Guidelines for Abstract Submission

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1 Hackensack Meridian Ann May Center for Nursing 13 th Annual Meridian Nursing Research and Evidence Based Practice Conference Instructions for Submission All author information and abstract contents must be entered using the Meridian Health Nursing Abstract Submission web page. The deadline for abstract submission is Thursday, October 12, 2017, 5:00 PM. You will receive notification by Thursday, October 19, Each abstract should follow the specified format based on its type: Evidence Based Practice (Example on page 3) Quality Improvement (Example on page 4) Original Research (Example on page 5) We recommend that you prepare your abstract as a Word document first and check the word count. Then copy and paste into the required fields. The abstract submission can only be accessed from Intranet or Internet directly. Please do not type the section titles of your abstract. Abstract should NOT include any protected health information (PHI), for instance, patient name or medical record number (for full PHI list, please call Ann May Center). The limit for the whole abstract (including title, author information and abstract contents) is 300 words. The online submission can only take plain text. You cannot submit images, graphs, or tables. You will have a chance to preview your abstract before submitting the abstract. Multiple submissions from an author are welcome. Each abstract should be submitted separately. Institute/Affiliation Information: o If authors come from different department or institutes, details of individual affiliation should be provided. Abstract Learning Objective o This learning objective should NOT be the objective of your project or research study but rather what the participant will learn as a result of viewing your poster. o The objective must be observable and measurable using a measurable verb such as discuss, describe, identify, explain, or compare. o Write one learning objective for your poster; for example: The participant will be able to describe five interventions for fall prevention.

2 Select poster style (hanging on wall or standing on tabletop) as well as type of abstract: Evidence-Based Practice (EBP) (example page 3) o Abstract Objective o Problem/PICO Question Should use Population, Intervention, Comparison and Outcome format o Appraisal of evidence o Outcome Quality Improvement (QI) (example page 4) o Abstract Objective o Background o Aim Statement o Methods o Results o Lessons Learned Original Research: (example page 5) o Abstract Learning Objective o Background/Purpose Brief background information or literature review explaining the reason the research was conducted. o Methods Design, sample, setting, procedure o Results Include statistical findings if applicable o Conclusions o Implications If you have any questions, please contact the Ann May Center at or

3 ABSTRACT #1 Sample Format for Evidence-Based Practice FOLLOW THE X S Kathleen Sullivan, RN, MSN, BC, Clinical Nurse Educator, Kathleen Russell-Babin, MSN, RN, NEA-BC, ACNS-BC, Senior Nurse Manager Jersey Shore University Medical Center, Neptune, NJ Abstract Objective: Participants will be able to discuss how an interdisciplinary team established the best evidence for naso-gastric tube insertion process. PICO Question: In the adult medical/surgical patient population how best to prevent patient harm from aspiration in the naso-gastric tube insertion process? Appraisal of Evidence: We conducted a literature search using the PICO question about the safest method to verify nasogastric tube placement after a blind insertion at the bedside. Twenty articles were evaluated for inclusion. Eight of the twenty articles were reviewed using the MAARIE Tool, a tool that evaluates single research studies on a set of standard criteria. These studies warranted further evaluation by the biostatistician, who developed an evidence summary table. Outcomes: The findings indicate that the historically practiced methods of auscultation for air insertions and visual inspection of the color of aspirates are not supported by research in patient safety. X-ray confirmation is reported as the gold standard in confirmation of placement. The findings were presented at many multidisciplinary meetings. This resulted in changes in policy, computerized documentation screens and education in order to produce an environment of reduced harm for our patients. 3

4 ABSTRACT #2 Sample Format for Quality Improvement TEACHING TEAM INTEGRATION IN THE RECOGNITION AND REPORTING OF PATIENT SAFETY EVENTS Nancy Nurse RN, Hackensack Meridian Health System Abstract Objective: Participants will be able to explain how implementation of patient safety rounds as a quality improvement project resulted in increased physician reporting of safety events. Background: Medical errors are a public health problem in the United States. In addition, errors in pediatric patients are significantly underreported. The HMH patient safety pathways emphasize the role of residents and faculty in recognizing and reporting safety events. Our baseline data demonstrated that physicians were the least likely to report finding only 4% of the entries were from physicians. Aim Statement: We planned to increase physician recognition and reporting of safety events on pediatric services by 50% over a 9 month period. Methods: We used the model for improvement and serial PDSA cycles to test changes that we predicted would improve physician recognition and reporting of events. The primary outcome measure was the percentage of total pediatric event reports entered in the electronic event reporting system by physicians (residents or faculty). Individual PDSA cycles studied secondary or process measures to assess tests of change or inform subsequent change cycles. Initial teaching team process changes included text message prompted Patient Safety Rounds on teaching services and an inpatient ward superintendent rotation with core patient safety responsibilities. We predicted that routine patient safety rounds would improve event recognition by improving communication around patient safety topics and that the superintendent rotation would improve event reporting through the integration of reporting in resident workflow. The IHI assessment scale for collaboratives has been used to track progress throughout the project. Results: Physician reporting increased significantly in the initial 5 months of the project exceeding the improvement goal set in our aim statement (5 month mean 16%; range 2% [month 1] to 27% [month 5]). Patient Safety rounds and the superintendent rotation were tested in months 1 and 2, and the superintendent rotation was implemented in month 3. Process measures indicate continued patient safety discussions on rounds (38 to 58%) after initial test cycle, a significant increase in resident event reporting in the electronic event reporting system, but unchanged faculty reporting rates. Qualitative data collected during cycles suggest that accessibility, complexity, and knowledge of the electronic reporting system may be a barrier to physician reporting. After 5 months the project scores a 3.0 to 3.5 (modest improvement to improvement) out of 5 on the IHI assessment scale due to completion initial PDSA cycles and change in outcome measure. Lessons Learned: Incorporating patient safety discussions and event reporting into teaching team workflow can increase physician event reporting. Physician buy in is critical. Identification of a strong physician champion was critical to the success of the project. 4

5 ABSTRACT #3 Sample Format for Original Research ASSESSMENT OF THE PATIENT-CENTERED AND FAMILY-CENTERED CARE EXPERIENCE OF TOTAL JOINT REPLACEMENT PATIENTS USING A SHADOWING TECHNIQUE Ulanda Marcus-Aiyeku, DNP, MSN, RN, NE-BC (1) Clinical Program Manager, Total Joint Replacement Service Line; Margaret DeBari, DNP, MSN, MA, RN-BC, NE-BC (1) Nurse Manager; Susan Salmond, EdD, RN, ANEF, FAAN (2) Executive Vice Dean and Professor (1) Jersey Shore University Medical Center, Neptune, New Jersey, Orthopedics (2) Office of the Dean, Division of Nursing Science, Rutgers School of Nursing, Newark, New Jersey Learning Objectives: The participant will be able to describe the shadowing technique to assess the centered care experience of patients and family in a clinical setting. Purpose: In 2030 when baby boomers reach 65 years of age and represent 18% of the population, 67 million adults will have a diagnosis of arthritis increasing the demand for total hip and knee arthroplasty. With the growing emphasis on patient and family centered care, the aim of this project was to assess the patient experience of patients and families throughout the entire spectrum of the total joint replacement service line. Methods: A shadowing methodology, as defined by the Institute of Healthcare Improvement, was utilized. Eight patient/family groups undergoing total joint replacements were shadowed. The mapped care experienced included time, caregiver, activity, shadower observations, and impressions. Results: Findings revealed inconsistencies in the delivery of patient-and-family centered care. Communication and interactions were predominantly provider-centric, with a focus on care routines versus the patient and the family. Medically directed care was anticipated. Conclusions: The shadowing methodology is an ideal way to assess the patient experience and the organization's progress in adapting a Patient and Family Centered Care (PFCC) framework. By using study data findings changes were implemented to enhance the patient and family centeredness of care. Six months after study completion patient satisfaction increased by 25% and remained stable for the following two quarters with overall satisfaction at 92%, and likelihood to recommend at 100%. This was followed by Joint Commission awarding certification to the hip and knee programs. Implications: A PFCC culture is a value that must be embraced and evidenced in the everyday interactions of the team. The CMS is placing a stronger focus on patient and family centeredness and tying patient satisfaction directly to clinical reimbursement. A review of the financial impact on patient satisfaction by partnering with rehabilitative therapy and case management would demonstrate the benefit of a PFCC culture 5