Digital Commons Network^™

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …

Mentorship Program Including Alumni, Nicole Brainin

Doctor of Nursing Practice Projects

The landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program's impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and …

Development Of High-Fidelity Simulations For Srnas: Airway Fire And Venous Air Embolism, Ashlyn Russo, Brooke Skaggs

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) must swiftly recognize and treat high-risk, low-incidence complications in a high-stress environment. Most SRNAs do not experience high mortality or rare emergencies throughout their training. This project involves developing and implementing two high-fidelity simulations for airway fire and venous air embolism (VAE) to help SRNAs improve their skills in a safe learning environment. Objectives for this project include examining current evidenced-based literature to determine the efficacy of high-fidelity simulation on the SRNA’s knowledge and performance post-simulation, determining the incidence, pathophysiology, and treatments for airway fires and VAE, creating two high-fidelity simulation scenarios, and integrating the …

Educating Srnas On Barriers And Facilitators Of Clinical Learning, Mesud Dedic, Richard Heuermann

Doctor of Nursing Practice Projects

A national survey of 143 Student Registered Nurse Anesthetists (SRNAs) conducted by Clancy and Bruinius (2022) revealed that factors impeding effective SRNA clinical education include unstable preceptorship, hostile environments, limited autonomy, and heavy didactic burdens. Clancy and Bruinius (2022) also found that facilitators of SRNA clinical education include rapport with preceptors, effective feedback, strong clinical site orientation, and beginning of day discussions. This project aimed to enhance second-year SRNAs' clinical success by mitigating these evidence-based barriers and employing these evidence-based facilitators by developing a presentation for SRNAs and assessing its effectiveness through a pre-implementation survey and post-implementation survey. The literature …

Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Text-Based Reminders: Pathways To Improve Hemoglobin A1c And Fasting Blood Glucose Levels Of People With T2 Diabetes Mellitus, David Bamidele Alao

Doctor of Nursing Practice Projects

Background

Research studies have shown that self-monitoring blood glucose levels is a cornerstone in DM management. Various studies have shown that a text message intervention effectively reminds people with T2 Diabetes Mellitus (T2DM) to check their blood glucose levels at home. Text message reminders successfully encourage medication adherence, blood glucose self-monitoring, and lifestyle changes (Xiqian et al., 2019). Through the beneficial effects on HgbA1c and blood glucose, text-based reminders have been demonstrated to improve blood glucose self-monitoring, essential to managing diabetes.

Purpose

This project aims to evaluate the effects of the 12-week text-based reminder intervention on the patient's blood sugar …

The Early Prevention Of Diabetic Foot Ulcers, Aruodo Ukpai

Doctor of Nursing Practice Projects

Frequent and proper foot exams and foot care are fundamental in decreasing the incidence and morbidity of diabetic foot ulcers, yet many patients are still not screened at appointments or educated on the importance of foot exams. This research planned to address the lack of foot care education and foot assessments amongst patients with Type 2 diabetes. Past research done on this focused on providing education to diabetic patients either at home or in a setting where patients can come and receive the education. To our knowledge, no research has been done on the use of video teaching to provide …

Cardiovascular Disease Improvement Project, Deglan K. Mccrystal

Doctor of Nursing Practice Projects

Health prevention promotes positive healthcare outcomes by identifying risk factors associated with a disease process in its early stages to halt or slow its progression. Preventions, like routine screenings, facilitate the identification of risk factors or the initiation of treatment of a disease. Identifying risk factors, which often go unrecognized, helps to manage conditions like cardiovascular disease before it progresses in severity. Early treatment options or identifying risk factors that lead to cardiac disease positively impact healthcare costs by reducing the number of hospital visits, emergency services, and the need for costly long-term care. Prevention increases the quality of disease …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Introducing Mental Health Resources To Nurse Practitioner Residents, Tiffanie Bailey

Doctor of Nursing Practice Projects

This DNP Project identified the increased need for mental health resources after the COVID-19 pandemic. Studies showed the rate of anxiety, depression, and substance use has also been on the rise since the beginning of the pandemic. As the impact of the COVID-19 pandemic began to devastate the country mentally and physically, it became quickly apparent that additional resources to provide support for those suffering from mental illness were essential. This project aimed to introduce a Mental Health First Aid course within the Residency Program at the Center for Family Guidance. Participants were asked to complete a pre-test indicating their …

A Review Of The Effects Of Different Types Of Stigmas On The Retention Rates Of Patients In Medication-Assisted Treatment And How To Combat The Problem, Pamela Cox

Doctor of Nursing Practice Projects

It is difficult to turn on the news without hearing about the opioid epidemic or a recent opioid overdose. There is hope because there is a treatment to help prevent this epidemic. That treatment is known as medication-assisted therapy (MAT), where patients can present and, if they meet the criteria, can be given a prescription for buprenorphine/naloxone combination medication. Treatment with buprenorphine/naloxone has been shown to be highly effective treatment for substance use disorder (SUD). Even though it has been proven that this combination works, less than 20% of patients diagnosed with SUD present for treatment. This study focused on …

Determining The Need For 23-Hour Observation Following Transforaminal Lumbar Interbody Fusions: A Patient Perspective On Recovery At Home, Lacey Irias

Doctor of Nursing Practice Projects

Minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (TLIF) is becoming more frequently performed in ambulatory surgery centers (ASCs). Subsequently, patients are scheduled for an option to undergo a 23-hour observation which requires staff preparation. The preparation increases costs and creates a shortage during a standard daytime shift which can reflect negatively on patient care. Most patients elect to be discharged the same day, on account of experiencing minimal pain and seeking the comfort of their own home. The goal of this DNP project was to assess the necessity of scheduling a patient 23 hours for observation following a …

Mental Health And The Black Church: Decreasing The Division In Divinity, Latonya Gray

Doctor of Nursing Practice Projects

Racial disparities in mental health care persist for Black Americans, with only one in three who need treatment receiving it. The care they do receive is often of a poorer quality than that of other groups. Faith communities serving Black members could help address this gap by partnering with mental health professionals to meet congregants' needs. With mental health now at the forefront of public discourse, considering the specific needs of the Black community is critical. Black Americans face disproportionate mental health burdens but are more likely to seek counsel from clergy due to cultural stigma. Educating clergy on mental …

Increasing Organ Donation In A University Setting, Zachary Hatton

Doctor of Nursing Practice Projects

The literature shows a strong correlation between education on organ donation and increased organ donation registration. Society has depicted a description of organ donation that is hostile and untrue. Increasing organ donation registration with knowledge sets the foundation of a grassroots movement to increase understanding and change society’s viewpoint(s) on organ donation. An education session on organ donation was developed and presented to the targeted population of 18–24-year-old students at a university in the foothills of the Appalachian Mountains. The focal point of the presentation was to dispel myths, educate on facts, and create a better understanding of organ donation …

Bridging The Gap: Strategies To Enrich The Clinical Experience Of Undergraduate Nursing Students To Improve Clinical Judgment Skills, Gabrielle Hope

Doctor of Nursing Practice Projects

Introduction: The lack of competent clinical judgement among new graduate nurses contributes to poor patient outcomes, negatively impacting patient satisfaction scores, and subsequently raising the cost of healthcare for consumers. This project explores how reflective journaling and cooperative learning activities contribute to the development of critical thinking of nursing students during their Nursing Fundamentals clinical practicum.

Methods: Seventeen students enrolled in a private university nursing program were selected as the sample. The students were introduced to the recommended learning strategies and invited to anonymously participate in a pre-survey and post-survey. The surveys were identical in content and consisted …

Improving Parental Communication With Adolescents About Sex, Amanda Blanton

Doctor of Nursing Practice Projects

In 2018, 68 million people in the United States were infected with a sexually transmitted infection. Of those 68 million, 26 million cases were newly diagnosed, and of that 26 million, half were youth aged 15-24 (Centers for Disease Control and Prevention [CDC], 2022a). The approaches to educating our youth about sexual health are inconsistent, leading to misconceptions about the dangers associated with risky sexual behavior. However, parents have the upper hand in discussing sexual health information with their children by being the child’s first contact and source of information. Teens who report talking with their parents about sex are …

Improving Sexually Transmitted Infections (Sti) Education And Access To Education For Healthcare Workers In A Rural Ambulatory Clinic, Savannah Elmore

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) are prevalent across the United States, with one in five people diagnosed in 2018, resulting in nearly $16 billion in medical costs. The prevention and treatment of STIs have been identified as a priority area for improvement, with healthcare providers playing a critical role in education, diagnosing, and treating STIs. The aim of this capstone project was to improve STI education and access to education for healthcare workers in a rural ambulatory clinic. Through a needs assessment and the development of objectives and a timeline, the project identified and addressed gaps in STI education and resources, …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley

Doctor of Nursing Practice Projects

Background: Formal education for type 2 diabetes mellitus (T2DM) patients is essential, especially in rural areas where diabetes is approximately 17% higher than in urban areas (Bolin & Ferdinand, 2018). In 2019, diabetes was listed as the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before 70 years (American Diabetes Association, 2021). According to the American Diabetes Association (2021), approximately 550,149 people in Alabama, or 14.1% of adults, have been diagnosed with diabetes. An additional 119,000 people in Alabama have diabetes but are unaware, significantly increasing their risk of complications (American Diabetes Association, …

Physical Exercise As A Lifestyle Modification To Lower Blood Pressure In Hypertensive Females With A Body Mass Index Greater Than 25, Kacee Pee

Doctor of Nursing Practice Projects

Background: Hypertension affects many Americans nationwide and, if untreated, can cause heart attack, stroke, and chronic kidney disease. Hypertension (HTN) accounts for about 1 in 5 deaths of U.S. women and is a greater burden for women than men (Wenger et al., 2018). Women who are overweight increase their risk of developing hypertension. Lifestyle modifications, such as diet and exercise, are the first-line treatment for hypertension. Physical exercise is a crucial component of lifestyle therapy for the primary prevention and treatment of hypertension. Several studies consistently demonstrate the beneficial effects of exercise on hypertension, with reductions in both systolic and …

Utilization Of A Simulation Electronic Documentation Model For Healthcare Providers To Reduce Documentation Errors In A Hospital Setting, Icy Moton-Hale

Doctor of Nursing Practice Projects

Background: Electronic health records (EHRs) are commonly used within healthcare systems across the United States. Although EHRs were developed to provide safe delivery of care, poor documentation quality remains a problem. Poor HER documentation can negatively affect many patients’ health outcomes.

Purpose: The purpose of the DNP project was to determine the degree to which using a simulated electronic documentation model to train nurses in an acute care unit would decrease documentation errors and missed care and decrease missed opportunities for patient education in EHRs.

Methods: The theoretical framework was underpinned by the Donabedian model, positing that factors associated with …

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …

The Implementation Of The Pressure Injury Prevention Protocol To Reduce The Incidence Of Hospital-Acquired Pressure Injuries In A Va Medical Surgical Unit, Nekia Whitlow

Doctor of Nursing Practice Projects

Background: The clinical gap in service addressed in the DNP project was hospital-acquired pressure injuries. A hospital-acquired pressure injury (HAPI) is a local injury to the skin and underlying tissue during an inpatient hospital stay. The injury is caused by pressure, shear, or both (The Joint Commission (TJC), 2022). The development of a HAPI can result from other factors, such as advanced age, immobility, perfusion issues, nutritional status, illness severity, and chronic conditions (Rondinelli, Zuniga, Kipnis, et al., 2018). Immobile or sedated patients in the intensive care units are the most at risk because they have medical conditions that prevent …