Digital Commons Network^™

Facilitating The Sustainability Of Health Behaviors In The Phase Iii (Graduated) Cardiac Rehabilitation Population, Andrea C. Lambe

Doctor of Nursing Practice Projects

Cardiovascular disease (CVD) develops in the setting of poor health behaviors often secondary to hypertension, dyslipidemia and hyperglycemia or diabetes (Spring et al., 2013). In the United States, it is estimated that health care costs associated with CVD management will triple to $818 billion in 2030 (Spring et al., 2013). Cardiac rehabilitation (CR) is a secondary/ tertiary prevention program aimed at reducing modifiable risk factors for CVD in a patient population who has already experienced a “qualifying” cardiac event and may be at an increased risk for sustaining another, possibly life-threatening, event (Lucan, 2010). Existing evidence points to a 45-47% …

Prehabilitation Impact On Post-Operative Risk, Readmission Rates And Patient Satisfaction, Pamela Fields

Doctor of Nursing Practice Projects

Background: Prehabilitation programs may improve 30-day readmission rates, post-operative infections and patient satisfaction in obese total joint replacement (TJR) patients. Joint replacement patients who participate in prehabilitation have improved physical function and patient satisfaction. In an effort to improve TJR patients’ mobility and recovery, a prehabilitation performance improvement project was implemented at a local wellness center.

Method: The Institute of Healthcare Improvement, Triple Aim Initiative (IHI, TAI) and Centers for Medicare and Medicaid (CMS) performance improvement goals provided the project foundation (IHI, 2015; CMS; 2015). The physical exercise routine utilized in this program was identified as appropriate for use with …

The Development And Implementation Of Hospital-Based Clinical Guidelines To Enhance Nursing Staff Efficacy In Glycemic Management At A Large Psychiatric Teaching Hospital, Cherno Bah

Doctor of Nursing Practice Projects

Background: This quality improvement project was conducted at the Colorado Mental Health Institute at Pueblo (CMHIP) in order to improve glycemic management. In psychiatric inpatient settings, proper glycemic management is inadequate which increases metabolic risk and poor patient outcomes. One way to address this problem is by using practice guidelines and education, which enhances nurses’ efficacy.

Purpose: The purpose of this project was to develop and implement a glycemic management guideline to enhance clinical nursing staff knowledge and confidence.

Method: Fifty-five clinical nursing staff attended an in-service and were asked to fill out a survey before and after the in-service …

Stress Reduction Program In A Military Clinic, Hyun-Ju Kang

Doctor of Nursing Practice Projects

Occupation-related stress has been a long-standing concern of the health care industry. Studies indicate that health care workers have higher rates of substance abuse and suicide than other professionals and elevated rates of depression and anxiety linked to job stress. In addition to psychological distress, other outcomes of job stress include burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and diagnosis and treatment errors. Mindfulness interventions, such as practicing yoga on a regular basis, have been found to be effective in reducing work-related stress by multiple researchers. The overall level of stress, anxiety and depression decreased after implementation of …

Implementation Of Community-Based Education To Promote Colorectal Cancer Knowledge And Screening Rates, Marsha Woodall

Doctor of Nursing Practice Projects

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second-leading cause of cancer death for both men and women in Kentucky and in the US. Although early detection and diagnosis greatly affect survival rates, only about half (58.2%) of the US population participates in screening (Screening Rates, 2016). Two of the previously reported barriers with colorectal cancer screening are provider neglect to fully educate patients on the need for screening and patient compliance with screening recommendations. The purpose of this capstone project was to implement community-based CRC education and screening. Watson’s Human Caring Theory and Prochaska and …

Bone Health Promotion For Youth: A Primary Care Intervention, Kay G. Wilson

Doctor of Nursing Practice Projects

Obese youth have high rates of vitamin D and calcium deficiencies and are at risk for developing osteoporosis. Clinical guidelines are needed in primary pediatric care services to promote bone-healthy behaviors. The aim of this project was to: a) implement the infrastructure and processes for physiological monitoring, consistent parameter-based vitamin D & calcium supplementation, family education, and coaching, and b) evaluate the impact of bone promotion changes on patients and parents and the primary care delivery system. The project outcomes included modest gains in bone health awareness among staff, patients, and families. In addition, modifications to clinical pathways and related …

Follow-Up Telephone Contact Following Discharge From Long-Term Acute Care Hospitals, Tonja Williams

Doctor of Nursing Practice Projects

Readmissions to acute care hospitals within 30 days post discharge are a burden to healthcare economy. Medicare Payment Advisory Commission (2007) estimated a cost of $12 billion dollars is spent each year on Medicare patients who are readmitted to an acute care hospital within 30 days post discharge. MedPAC (2007) estimated that 75% of those readmissions are avoidable. A review of the literature was conducted. Thirteen studies were reviewed and analyzed and the results of the literature review indicated there is evidence supportive of implementing telephone follow-up contact with patients discharged from the LTACH to assess for additional needs and …