Digital Commons Network^™

Increasing Utilization Of Motivational Interviewing To Promote Pediatric Oral Health, Ulyses Reamico

Doctor of Nursing Practice (DNP) Projects

Prevalence of early childhood caries (ECC) remains high even in developed countries such as the United States. An interprofessional education (IPE) project between University of San Francisco (USF) School of Nursing and Health Professions and the University of the Pacific (UoP), Arthur A. Dugoni School of Dentistry was initiated four years ago to enhance nurse practitioner (NP) and dental students’ pediatric oral-systemic health assessment and health promotion communication skills. Since then, USF NP students received pediatric oral health assessment training and spent clinical rotations at UoP to provide pediatric oral care alongside dental students. This doctor of nursing (DNP) project …

Larc Method Appropriateness In Substance Use Treatment: A Quality Improvement Project For Integrated Care, Malia Johnson Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Neda Afshar Dnp, Fnp-C, Msn, Cgrn

Doctor of Nursing Practice (DNP) Projects

Problem: Individuals with substance use disorder (SUD) have disproportionately higher rates of unintended pregnancy when compared to the general population, estimated to be 85% (Heil et al., 2011). Not only are poor maternal and fetal outcomes associated with unplanned pregnancies, but pregnancies in women with SUD are further complicated by additional risks and adverse outcomes (Black & Day, 2016).

Context: Addiction treatment centers and programs are primed with opportunity to offer family planning services, when contact with medical providers is increased for substance use treatment. In response to the opioid crisis and unprecedented rates of unintended pregnancy, this project …

Improving Chronic Hepatitis B Virus Screening At A Safety-Net Primary Care Clinic, Uwaezu J. Umeh

Doctor of Nursing Practice (DNP) Projects

Hepatitis B Virus (HBV) is a type of virus that affects the liver. Chronic hepatitis B is usually asymptomatic and many HBV carriers remain unaware of their viral status, thereby may unknowingly transmit the disease. If left untreated or undetected, it could lead to cirrhosis, hepatocellular carcinoma or mortality. Although this virus is endemic in some parts of the world such as Asia and Africa, it is important to note that HBV has become a global problem. The Centers for Disease Control and Prevention (CDC) in conjunction with the United States Preventive Services Task Force (USPSTF) estimates that about 700,000 …

Burnout, Depression And Suicide Prevention For Nursing Staff In High-Intensity Settings, April Ritchie

Doctor of Nursing Practice (DNP) Projects

Nurses working in high-intensity settings experience burnout at higher rates than in other nursing areas. Burnout in healthcare is a problem estimated as high as 70% by the Agency for Healthcare Research and Quality. Burnout can lead to depressive symptoms, which can lead to suicidal ideation in affected healthcare providers, which makes early identification and treatment of utmost importance to the mental and physical wellbeing of these nurses.

The purpose of this project is to examine burnout in nursing staff working in high-intensity areas of the hospital in order to help identify burnout and/or depressive symptoms before they lead to …

Implementation Of A Simulation-Based Interprofessional Patient Safety Program, Mariko Nowicki

Doctor of Nursing Practice (DNP) Projects

Problem: Despite mandatory biannual patient-safety training at hospitals in Japan, medical adverse events continue to increase. However, many such events are preventable through adherence to standard practices of safe patient care.

Context: A lecture-based educational approach is inadequate to develop patient-safety competency in clinical educators or clinicians. Participation in simulation-based interprofessional patient-safety training programs can enhance knowledge, skills, and attitudes to promote patient safety culture and enhance patient outcomes.

Interventions: An evidence-based train-the trainer-patient safety program was conducted using simulation for interprofessional healthcare educators to serve as safety champions.

Measures: Three outcome and three process measures geared toward self-evaluation and …

Improving Access To Youth-Friendly Health Services In A Rural California Community, Elena Higley

Doctor of Nursing Practice (DNP) Projects

Adolescents and young adults experience relatively high rates of preventable morbidity and mortality due to injuries, mental health disorders, suicide, substance use, and reproductive health issues. It is paramount for healthcare providers to address risky behaviors early to thwart future adverse outcomes. Rural communities especially struggle with meeting the healthcare needs of their youth because there are fewer resources specifically dedicated to serving adolescents and young adults. This issue is evident in Grass Valley, California, a rural community in Nevada County, an area located in the foothills of the Sierra Nevada mountains. In response to limited access to youth-friendly healthcare …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

The Development And Implementation Of Nurse-Managed Community-Based Medication Assisted Treatment Services For An Underserved Non-Metropolitan Northern California Community, Lauren Knapp

Doctor of Nursing Practice (DNP) Projects

Abstract

Objectives: The purpose of this Doctorate in Nursing Practice (DNP) project was to improve health outcomes among underserved residents of Nevada county by increasing access to inter-professional team-based medication assisted therapy (MAT) for opioid use disorder. The over-arching goal of this DNP project was to develop evidence based, interdisciplinary, nurse-managed MAT services through the initiation of the pilot program for the newly developed MAT patient delivery system and the development of evidence-based nurse practitioner process protocols.

Methods: This DNP project involved the coordination of an evidence-based, structured, nurse-managed MAT group on Wednesdays at Community Recovery Resources (CoRR) Grass Valley. …

Improving Nurse-Physician Collaboration: Building An Infrastructure Of Support, Marshall Blue

Doctor of Nursing Practice (DNP) Projects

Abstract

Healthcare organizations have come to realize the 21st century brings many challenges. First and foremost is the challenge of improving patient satisfaction with their health care and their associated experience accessing this complex system. Other challenges are incorporating the patient perceptions of delivering high quality, safe, equitable care to the surrounding community while demonstrating cohesive teamwork. Healthcare professionals and organizations must find an effective and efficient pathway to provide excellent care to the patient within an extremely competitive market. Current research demonstrates a patient perceives they are receiving exceptional care when interdisciplinary conversations are noticed between the nurse and …

Burnout, Depression And Suicide Prevention For Nurses In High-Intensity Settings, April Ritchie

Doctor of Nursing Practice (DNP) Projects

Problem: Burnout in healthcare has been reported as high as 35% for hospital nurses in acute care and occurs at higher rates in high-intensity settings. Burnout can lead to depressive symptoms, which can lead to suicidal ideation in affected healthcare providers and warrants further attention.

Context: Studies indicate that identification and interventions can help improve burnout; therefore, nurses in the emergency department (ED), intensive care unit (ICU), labor and delivery (L&D), and neonatal intensive care unit (NICU) completed education, surveys, and tools to identify and treat the problem.

Interventions: Nurse education on burnout, depression, and suicide was completed, and …

Suicide Education To Support Caregivers In Their Abilities To Care For Suicidal Individuals, Cassandra Lipa

Doctor of Nursing Practice (DNP) Projects

Purpose: Suicide is a preventable act of lethality yet still remains a public health concern. Suicide can affect individuals from a variety of backgrounds and does not discriminate against age, gender, ethnicity, income, or occupation. Efforts to prevent suicide often focus on supporting the suicidal individual however there is a lack of available resources that focus on supporting those closest such as caregivers. Caregivers can play a pivotal role in their loved one’s trajectory towards recovery. The purpose of this project was to provide caregivers with a suicide toolkit that encompasses basic education, approaches to supporting a loved one who …

Human Trafficking Recognition And Response Training For Sexual Assault Nurse Examiners In New Hampshire Emergency Departments, Carolyn L. Noyes

Doctor of Nursing Practice (DNP) Projects

Human trafficking is a pervasive yet under-recognized public health epidemic. Traffickers use various forms of manipulation to control their victims for the benefit of the trafficker with little regard for the victims’ well-being. This leads to victims of human trafficking suffering short- and long-term health problems. Trafficking victims may subsequently access healthcare during their time in captivity as a result of a direct harm caused to them due to their victimization from neglect, injury or disease. Unfortunately, victims often do not see themselves as victims or are too afraid to let their healthcare provider know that they need help. Warning …

The Implementation Of A Faith-Based Heart Healthy Education Program For Latinos In Miami, Florida, Cassandra Zacke

Doctor of Nursing Practice (DNP) Projects

Background: Cardiovascular disease (CVD) has been identified as a leading cause of mortality in the Latino population in the United States. Studies conducted in faith-based settings demonstrate effectiveness in improving the promotion of lifestyle changes.

Methods: This project was a four-week faith-based educational intervention for Latinos meeting weekly at a faith-based organization in Miami-Dade Florida. Classes focused on cardiovascular disease prevention and risk reduction and included PowerPoint presentations, fotonovellas, and interactive activities offered in English and Spanish. Participants were asked to complete cardiovascular disease knowledge questionnaire before and after the educational classes based on the National Institute of Health’s …

Incorporating Complementary Alternative Methods In The Management Of Chronic Pain Into A Primary Care Practice In New York, Vladimir Sher

Doctor of Nursing Practice (DNP) Projects

Background: Pain is a physical, emotional, and psychological symptom that causes discomfort and leads to physiological consequences that can damage tissue, alter neurological pathways, and cause severe psychological distress. The combined use of complementary and alternative medicine (CAM) therapies can reduce pain and lead to an improvement in patient health. Purpose: The purpose of this quality improvement project/evidence-based practice intervention was to review concepts related to pain and analyze the current use of music and massage CAM therapies in a primary care setting.

Methods: The Gate Control Theory was used in this project describing pain as "a category of …

Improving Mental Healthcare For Older Adults: Community Based Screening For Social And Emotional Loneliness And Major Depressive Disorder, Eunice Kowalczyk

Doctor of Nursing Practice (DNP) Projects

Abstract

Purpose: Major depressive disorder (MDD) is a devastating mental health disorder affecting older adults that is often misdiagnosed or untreated due to a lack of screening and the stigma that MDD symptoms are a normal and expected part of aging. The goal of this quality improvement (QI) project was to implement a community-based screening intervention to identify community-dwelling older adults at risk for or suffering from MDD, and facilitate further evaluation and care.

Methods: Participants were community dwelling older adults, age 56 and older, in Massachusetts. Two screening tools were administered in two sites that screened for social and …

Simulation-Based Mental Health Nursing Education, Deanna Dubay

Doctor of Nursing Practice (DNP) Projects

• DNP Project Goal: Provide a simulation-based mental health nursing education experience to pre-licensure nursing students prior to participating in a mental health clinical rotation to reduce anxiety and increase confidence in therapeutic communication and care of the patient with mental health needs.
• Background and Review of Literature: Research suggests nursing students feel anxious about participating in mental health clinical rotation and have decreased confidence in treatment and communication with patients.
• Methods: A quality improvement project was conducted utilizing seven nursing students from a BSN program. The participants engaged in a simulation-based mental health nursing education experience, which …

Mitigating Prescription Opioid Risk: Prescription Drug Monitoring Programs, Brenda Vigue

Doctor of Nursing Practice (DNP) Projects

Background: Opioid-related morbidity and mortality is a serious public health issue in the United States. Prescription Drug Monitoring Program (PDMP) review prior to prescribing opioids has consistently been recommended as best practices for risk mitigation, however, access/utilization of this monitoring program remains low.

Methods: This quality improvement (QI) project for improved PDMP utilization employed a pre-post survey design in a random sample of Advanced Practice Registered Nurses in Arizona. Quantitative measures included online surveys with close-ended responses to salient items from the review of literature and best practices. A follow-up survey was requested of the participants who provided their …

A Public Health Initiative To Support The Development Of A Trauma Informed Care Culture In A Community Organization That Provides Services To Individuals With Developmental And Intellectual Disabilities, Lisa Coenen

Doctor of Nursing Practice (DNP) Projects

Background: Trauma informed care (TIC) is a socio-ecological theoretical approach for universal practice focus to improve HRQOL and wellbeing outcomes. There is a gap in TIC system implementation for vulnerable populations, including the ID/DD population.

Purpose: The purpose of this project was to transfer knowledge to a newly created TIC work group on the use of an existing TIC system implementation tool to plan, develop, and measure the level of TIC systems culture in their community organization.

Methods: Knowledge transference through the utilization of a TIC systems implementation process map, TIC education, and the facilitation of a …

Using Mobile Health To Improve Mild Depression Outcomes In Adult Primary Care, Michele Marek

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Mild depression is a common patient complaint in primary care, potentially impairing role function in multiple dimensions, with risk for escalation to severe Major Depressive Disorder (MDD), a chronic, recurring illness with multiple comorbidities at high emotional and economic cost to individuals, families, and society. Barriers to care include lack of access to Mental Health Specialists, financial constraints and stigma, all of which can cause escalation of symptoms to the point of disability and are magnified in underserved populations.

Purpose: The primary goal of this quality improvement (QI) project was to improve depression symptoms using the evidence-based mobile …

Promoting Sleep Health Through Identification And Management Of Obstructive Sleep Apnea, Melissa Vuolo

Doctor of Nursing Practice (DNP) Projects

Background: There is a high prevalence of obstructive sleep apnea in the United States, which left untreated can lead to increased cardiovascular risk. The current practice standard is to use a questionnaire to evaluate a patients’ sleep health, but this is not done regularly in every clinical setting. This DNP project aimed to bridge the gap in practice by implementing regular screening of obstructive sleep apnea in an urgent care center in Massachusetts.

Methods: This DNP project was conducted by having adult patients complete the Epworth Sleepiness Scale to determine the presence of a sleep health issue. The patients …

Reducing 30-Day Heart Failure Readmission Among Elderly Population In Long-Term Care, Nkechi Ukomadu

Doctor of Nursing Practice (DNP) Projects

Background: Heart failure is the leading cause of hospitalization in the United States and accounts for more than one million hospitalizations every year. Readmission within 30 days of discharge is an indicator used for measuring the quality of care for heart failure patient. Methods: The goal of this quality improvement project is to reduce the 30-day readmission rate of heart failure patients 60 years and older in a long-term care setting in Texas by using an evidence-based transitional readiness discharge checklist for heart failure. Interventions included staff education on the key components and on the checklist. A pre- and post-test …

Reducing 30-Day Heart Failure Readmission Among Elderly Population In Long-Term Care, Nkechi Ukomadu

Doctor of Nursing Practice (DNP) Projects

Abstract Background: Heart failure is the leading cause of hospitalization in the United States and accounts for more than one million hospitalizations every year. Readmission within 30 days of discharge is an indicator used for measuring the quality of care for heart failure patient. Methods: The goal of this quality improvement project is to reduce the 30-day readmission rate of heart failure patients 60 years and older in a long-term care setting in Texas by using an evidence-based transitional readiness discharge checklist for heart failure. Interventions included staff education on the key components and on the checklist. A pre- and …

Noncompliance With Type 2 Diabetes Mellitus In The African American Community, Comfort Boampong

Doctor of Nursing Practice (DNP) Projects

A Culturally-Tailored Diabetes Educational program designed to help increase knowledge in Type 2 Diabetes and enhance compliance with its management.

Reducing 30-Day Heart Failure Readmission Among Elderly Population In Long-Term Care, Nkechi Ukomadu

Doctor of Nursing Practice (DNP) Projects

Background: Heart failure is the leading cause of hospitalization in the United States and accounts for more than one million hospitalizations every year. Readmission within 30 days of discharge is an indicator used for measuring the quality of care for heart failure patient. Methods: The goal of this quality improvement project is to reduce the 30-day readmission rate of heart failure patients 60 years and older in a long-term care setting in Texas by using an evidence-based transitional readiness discharge checklist for heart failure. Interventions included staff education on the key components and on the checklist. A pre- and post-test …

Stress Relieving Lavender Aromatherapy For Inpatient Nurses, Kaneisha Deburgo

Doctor of Nursing Practice (DNP) Projects

Lavender essential oil as a form of aromatherapy is proven to be an effective way to relieve occupational stress among nurses, providing them with a healthy self-care outlet. The purpose of this DNP project was to decrease the stress levels of inpatient nurses by implementing lavender essential oil aromatherapy as a self-care initiative. Willing inpatient Registered Nurses within a fast-paced inpatient telemetry unit were given a vial that contained three drops of Young Living lavender essential oil enclosed within at the beginning of their shifts. The nurses were asked to carry it with them during their eight-hour shifts for three …

Prevention And Management Of Gastroesophageal Reflux Diseases (Gerd) And Peptic Ulcer Diseases (Pud’S) Among Bhutanese Refugees Utilizing Personalize Patient Education, Sharada Paudel

Doctor of Nursing Practice (DNP) Projects

Background: Bhutanese refugees in the United States frequently suffer from gastrointestinal diseases especially gastroesophageal reflux disease (GERD)and peptic ulcer disease (PUD) which may impact on their quality of life. Purpose: This DNP Project utilized individualized patient education to help improve knowledge on prevention and management of GERD to decrease exacerbations. Methods: Three sessions of individualized live patient education with 15 Bhutanese refugee patients living in Western Massachusetts were provided. Pre and post intervention surveys on patient's symptoms, quality of life, degree of patient knowledge about disease and self-care management and number of ambulatory care visits utilizing the GERD …

Utilizing Motivational Interviewing To Encourage Weight Loss In Primary Care, Wendy Sergeant

Doctor of Nursing Practice (DNP) Projects

Purpose and Background: The purpose of this project was to educate nurse practitioners (NPs) and nurses (RNs) to promote healthy changes in obese individuals using the principles of Motivational interviewing (MI). Obesity is a growing epidemic in the United States with two out of every three adults considered overweight or obese. Their health problems become costly and deadly. Ideally, RNs and NPs are the front line providers in this struggle of obesity because of their philosophy of health promotion. RNs and NPs can screen and address obesity through lifestyle counseling. Motivational interviewing, a proven and effective counseling method, is useful …

Reducing 30-Day Heart Failure Readmission Among Elderly Population In Long-Term Care, Nkechi Ukomadu

Doctor of Nursing Practice (DNP) Projects

Background: Heart failure is the leading cause of hospitalization in the United States and accounts for more than one million hospitalizations every year. Readmission within 30 days of discharge is an indicator used for measuring the quality of care for heart failure patients.

Methods: The goal of this quality improvement project was to reduce the 30-day readmission rate of heart failure patients 60 years and older in a long-term care setting in Texas by using an evidence-based transitional readiness discharge checklist for heart failure. Interventions included staff education on the key components and on the checklist. A pre- and …

Screening For Trauma In The Foster Care Community, Catrina Graham

Doctor of Nursing Practice (DNP) Projects

Children within the foster care community experience health disparities on a variety of levels, from physical and mental health conditions, developmental delay, and impaired social interactions. Many of these conditions can stem from the experience of trauma or adverse childhood events that color each component of their lives. For healthcare providers to be successful in the assessment and treatment of this community, an understanding of traumatic events and the delivery of trauma-informed care is essential. The complex needs of this community are such that the provision of healthcare must be specialized, multidimensional, and organized. The purpose of this project is …

Self-Management Of Dyspnea In Chronic Obstructive Pulmonary Disease Patients., Juliet Marcia Farrell

Doctor of Nursing Practice (DNP) Projects

Background: Patients with chronic obstructive pulmonary disease (COPD) exacerbation are reported to have a decreased quality of life relating to their health. In 2015 it was reported that over three million COPD patients died as a result of their disease. Although COPD patients are receiving medication, they still struggle with dyspnea as they carry out their daily activities.

Purpose: To implement an evidence-based educational program to assist COPD patients in self-management of dyspnea.

Methods: The DNP student obtained consent from prospective participants and assigned a unique identifier, which included his or her first and last initial and three digits. …