Faculty Bibliography

This case study will describe the journey of a patient admitted to an urban, tertiary medical center for bariatric surgery and the unexpected challenges encountered by the clinical staff in caring for him. Despite having awell-established bariatric surgical program, it took only one patient who deviated from the "norm" to cause thestaff to reexamine the way that bariatric patients are cared for in the facility, particularly with regard to their mobility and safe patient handling needs. The lessons learned from this experience and the patient’s own perspective have enabled a more informed approach to how bariatric patients are cared for throughout the hospital and led to an adjustment of protocols in this area of practice

The Centers for Medicare & Medicaid Services' regulations regarding nonpayment for hospital-acquired conditions such as pressure ulcers have prompted a marked increase in focus on preventive care. Our hospital also used this change in payment policy as an opportunity to strengthen our pressure ulcer prevention practices. We used an 8-spoke prevention wheel to develop and implement practice changes that reduced pressure ulcer incidence from 7.3% to 1.3% in 3 years. Because it is about the journey, we will describe the mechanisms we designed and implemented, and identify strategies that worked or did not work as we promulgated a quality improvement process for pressure ulcer prevention in our large urban hospital center.

Using their personal experience, the authors identify three key components to successfully completing a nursing doctoral program. The first component is asking the right questions to determine the doctoral degree best suited for the potential student. The second component is having a strategic plan that includes aspects such as financial considerations (research costs and potential financial support) and the development of a strong support system (specifically study pairs). The third component is the development of a systematic approach to completing the research, writing the dissertation, and completing the oral requirements. Addressing these areas will help students balance the many demands of doctoral study.