Digital Commons Network^™

Policy Analysis Of The Illinois Nurse Practice Act (Aprn Title Section 65/65-50), Sara Kim

Doctor of Nursing Practice Projects

Background

Physician groups claim allowing nurses to use the title "doctor" confuses patients. Nurses assert that the title is common to many disciplines, and nurses should be trusted like other professionals to identify their specialty to patients. Currently, qualified nurses in Illinois using the title "doctor" in clinical areas must introduce themselves to each patient in the following way: "Hi, I'm Dr. Smith, the nurse practitioner taking care of you today. I do not have a degree in medicine, and I am not a physician or medical doctor” (225 ILCS § 65/65-50).

Purpose

This project aimed to evaluate Illinois Nurse …

Development And Implementation Of An Enhanced Recovery After Surgery Protocol For Thoracic Surgery Procedures, Nicholas Collier

Doctor of Nursing Practice Projects

A high prevalence of lung and esophageal cancers leads to significant healthcare dollars utilized for treatment and management. Surgical resection is regarded as a key component for multidisciplinary treatment and management of these cancers. By standardizing multidisciplinary patient care and utilizing evidence-based practice, Enhanced Recovery After Surgery (ERAS) protocols for thoracic surgery have offered better outcomes with fewer complications and reduced healthcare costs. The anesthesia providers at the host facility were deficient in basic knowledge related to ERAS protocols and best practice management of thoracic surgery patients. The purpose of this project was to educate anesthesia providers on ERAS principles …

Postoperative Nausea And Vomiting Implications In Neostigmine Versus Sugammadex, Corey Lee Johnson, Colton Bradley James, Sarah Grace Traughber, Charles Anthony Walker, Dwayne Accardo Dnp, Aprn, Crna

Doctor of Nursing Practice Projects

Purpose/Background: Postoperative nausea and vomiting (PONV) is a frequent complaint in the postoperative period, which can delay discharge, result in readmission, and increase cost for patients and facilities. Inducing paralysis is common in anesthesia, as is utilizing the drugs neostigmine and sugammadex as reversal agents for non-depolarizing neuromuscular blockers. Many studies are available that compare these two drugs to determine if neostigmine increases the risk of PONV over sugammadex. Sugammadex has a more favorable pharmacologic profile and may improve patient outcomes by reducing PONV.

Methods: This review included screening a total of 39 studies and peer-reviewed articles that looked at …

Opioid Free Anesthesia To Prevent Post Operative Nausea/Vomiting, Aleksander Acred, Milena Devineni, Lindsey Blake, Cindi Dabney Dnp, Crna

Doctor of Nursing Practice Projects

Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice.

Methods In this scoping …

Implementing An Antibiotic Stewardship Education Program To Decrease Antibiotic Prescriptions In An Urgent Care Clinic, James Gramling

Doctor of Nursing Practice Projects

Antibiotics are often prescribed for respiratory infections. These infections often have a viral rather than a bacterial source. Overuse of antibiotics is associated with increased potential for adverse effects, increased healthcare costs, and increasing antibiotic resistance. The purpose of this DNP project was to determine if implementing an antibiotic stewardship program at an urgent care clinic would decrease the number of antibiotic prescriptions written for acute respiratory tract infections. An educational session consisting of didactic and PowerPoint presentations was provided to each provider at the urgent care clinic. Medical records were reviewed for four weeks after completion of the session …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Differences In Student Perceptions With Virtual Clinical Simulation, Melissa Wheeles

Doctor of Nursing Practice Projects

Background: Simulation has been a part of nursing education since its inception, with virtual clinical simulation gaining expanded use since the Coronavirus Pandemic. Once considered only a supplemental teaching method, this form of education has become an imperative means of program progression for nursing students when hospital clinical spaces are limited.

Purpose: The purpose of the study is to evaluate potential differences in nursing student perceptions of anxiety and self-confidence with clinical decision making in virtual clinical simulation compared to traditional face-to-face clinicals.

Design Methods: A descriptive, quantitative study using the NASC-CDM© tool completed by 5th (final) semester …

Preventing Complications Of Undiagnosed Diabetic Peripheral Neuropathy In Rural Healthcare Settings, Kendra Ward Harris

Doctor of Nursing Practice Projects

Background: Diabetic peripheral neuropathy (DPN) affects the lives of approximately 50% of all persons diagnosed with diabetes. Patients who are minorities, residents of rural communities, low income, or non-compliant with treatment, have a higher risk of developing DPN. The long-term effects interfere with the patient’s abilities to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.

Purpose: The purpose of this project was to use the Michigan Neuropathy Screening Instrument (MNSI) …

Can Provision Of Additional Education For Nursing Staff Increase Breastfeeding Knowledge And Feelings Of Self-Efficacy?, Akeba Deqwan Thompson

Doctor of Nursing Practice Projects

Background: Post-partum nurses are responsible for preparing new mothers with the necessary skills to feed and care for their infants and need proper education to effectively and confidently discuss feeding options with their patients.

Purpose: This quality improvement project aims to increase nursing knowledge of breastfeeding and their feeling of self-efficacy in promoting breastfeeding as an option to new mothers.

Design Methods: A quasi-experimental design including a pre-test/post-test used to quantify the effect of education on therapeutic communication, nursing responsiveness, and feelings of self-efficacy.

Conclusion: An overall increase in feelings of self-efficacy and knowledge of breastfeeding was noted amongst nursing …

Re-Educating Healthcare Workers In Long-Term Care Facilities To Improve Hand Hygiene Compliance, Jennifer A. Ukeje

Doctor of Nursing Practice Projects

Hand hygiene is one of the most significant measures for protecting nursing home residents from healthcare-associated infections (HAIs). An estimated 1.6 million to 3.8 million infections occur each year; of these infections, 32% of all healthcare-associated infections (HAIs) are urinary tract infections (UTI), 15% are pneumonia (lung infection), and 14% are bloodstream infections. The high incidence of HAIs in nursing homes is due to multiple factors such as understaffing, inadequately trained staff, staff to resident ratio, lack of antibiotics stewardship, and the increasing clinical complexity of the average nursing home. In addition, most long- term care (LTC) residents are older …

Hypertension Education And Management Intervention (Hemi) In The Urgent Care Setting, Conrad L. Cash

Doctor of Nursing Practice Projects

Background: Hypertension, being a very prominent disease, is a common problem found during urgent care visits. By beginning in the urgent care setting, hypertension management can be started early; thereby preventing complications from uncontrolled hypertension.

Purpose: This DNP project aimed to improve patient knowledge of hypertension and overall blood pressure readings by providing one-to-one provider-patient education.

Design Method: This DNP quality improvement project was a pre- and post-test design using quantitative data. The goal was to access if there was a change in patient education pre, post, and three months follow-up along with a change in blood pressure.

Results: …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Increasing Lung Cancer Screening Referrals In Patients With Tobacco Use Disorder, Emily Thornberry

Doctor of Nursing Practice Projects

Lung cancer in the United States is a substantial cause of mortality. According to the American College of Radiology’s Lung Cancer Screening Registry, only 1.9% of eligible patients were screened for lung cancer in 2016. The National Comprehensive Cancer Network and U.S. Preventative Services Task Force (USPSTF) guidelines recommend lung cancer screening (LCS) in high-risk patients. The USPSTF recommends screening current and former smokers aged 55-80 years who have smoked for 20 or more pack-years, and for former smokers, those that have quit within 15 years.

Unifying Vision: Strategies That Influence Nurse Self-Care Practices In Intensive Care Unit Nurses, Latoya Parks

Doctor of Nursing Practice Projects

Background: The notion of self-care should include more than physical health; the concept should also include emotional, mental, and spiritual self-care. Self-care behaviors are tailored to an individual's perceptions and values.

Purpose: The primary focus of this project aimed to improve nurse’s self-care practices. Through interviews with executive leadership at a large urban hospital, the project facilitator identified the need for easy access to self-care strategies for ICU nurses.

Design Method: The Plan-Do-Study-Act (PDSA) Model for Quality Improvement was used for this project. A systematic review of the literature was performed to ascertain the effectiveness of self-care strategies for …

Diabetes Education Empowerment Program (Deep): Evidence-Based Practice Measures For Self-Care Management, Nakeshia Rutledge

Doctor of Nursing Practice Projects

Background: Prediabetes and Type 2 diabetes (T2DM) are major health challenges among the patient population at a family medical clinic in northwest Alabama. Poorly managed T2DM can cause complications which could decrease individuals’ quality of life and lead to mortality.

Purpose: The purpose of this project was to assess the feasibility and efficacy of a self-management intervention aimed at empowering prediabetic and T2DM patients to achieve better diabetes management and glycemic control (hbA1c < 5.7 percent).

Design Methods: A mixed-methods design was utilized with pre/post-questionnaires for analysis of data collected before and after the implementation of an educational intervention on diabetes self-management …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Increasing Colorectal Cancer Screening Rates Through Education, Kayla Metz

Doctor of Nursing Practice Projects

Colorectal cancer is the second leading cause of cancer deaths in the United States. Adenomatous polyps cause 90% of colorectal cancer. These polyps can be identified before they become cancerous through numerous colorectal cancer screenings. There are many ways to help cover the cost of screenings or to make them no cost to patients, but the number of individuals who have ever been screened or who are current with screening recommendations remains low. This DNP project aims to provide education to providers and individuals regarding the various type of colorectal cancer screening options. A reduction in fears and improved knowledge …

Preventing Unplanned Pregnancies: The Impact Of Prevention Education, Eliza Dudley

Doctor of Nursing Practice Projects

Teenage pregnancy and unplanned parenthood are social issues in many communities, states, and developed and undeveloped countries. The impact of early, unplanned pregnancy is detrimental to the adolescent's health, mental health, and physical well-being. Teenage pregnancy may be considered a social issue that is often the result of inadequate sexual and reproductive education, both in adult parents and teenagers. Despite recent reductions in teenage pregnancies, in recent years, more than 20 million teenagers experienced parenthood before graduating from high school. Programs are needed to prevent the possible stigma, physical and emotional risks of unplanned teenage pregnancy, lower adolescent pregnancy rates, …

Decreasing The Impact Of Diabetes In The Adult And Older Adults Rural Health Population Utilizing Phone Calls As Part Of The Chronic Care Management Program, Adrienne Shambray

Doctor of Nursing Practice Projects

This quantitative study was developed in order to evaluate the impact of phone calls on patient outcomes using the Chronic Care Management program (CCM). In January 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the (CCM), with the goal of improving health and quality of care for high-risk patients. The administration and physicians at the clinic of focus for this project recognized a need for the facility to help improve and manage these patients’ care to prevent issues such as hospital readmission. This project aimed at following patients in the program with the chronic condition of diabetes mellitus …

Eras Protocol For Lower Extremity Orthopedic Procedures, Tyler Mcdonald, Joshua Vaughn

Doctor of Nursing Practice Projects

The demand for total knee arthroplasty (TKA) and total hip arthroplasty (THA) will continue to rise as life expectancy increases. Coupling increased age with the increased prevalence of both obesity and osteoarthritis, the need for total joint arthroplasties is likely to increase (Oseka & Pecka, 2018). The frequency of arthroplasty procedures and the associated recovery period lead to heavy economic demands felt by most healthcare systems (Stowers et al., 2016). To address this burden, enhanced recovery after surgery (ERAS) protocols have been implemented at institutions and are designed to improve patient outcomes while simultaneously limiting cost and reducing readmission rates …

Culturally Appropriate Health Education: Translation Of A Parturient Pain Relief Options Pamphlet Into French And Spanish, Francis Minor, Austin Cook

Doctor of Nursing Practice Projects

The rise of immigration worldwide introduces a diverse, multicultural population of patients seeking healthcare in the United States. Barriers to communication, both spoken language and culturally associated communication norms, limit immigrant women’s ability to seek, gain access, and follow through with perinatal care. In order to provide safe, effective, and culturally sensitive care, recognition of language and cultural differences of all individuals must be considered when providing patients with educational materials (Perera et al., 2012; Plumbaum et al., 2014). The aim of this project was to translate an existing pain relief options pamphlet into French and Spanish in order to …

Pediatric Concussion Clinic: A Needs Assessment, Carrie West

Doctor of Nursing Practice Projects

Abstract

Pediatric Concussion Clinic: A Needs Assessment

Concussions are a mild traumatic brain injury by a biomechanical force to the head. Concussion rates among youth are as high as 33 million per year worldwide. Most children recover within 4 weeks post injury; however, 30% of patients have delayed recovery. Recent studies have shown that evaluation by a concussion specialist within 1 week of injury results in quicker recovery. The purpose and goal of this project was to determine if there was a need for establishing a pediatric concussion clinic at Southern Illinois University Medicine. Study participants included pediatric providers from …

Developing A Peer Mentoring Program For Srnas, Morgan E. Fitterer, Miranda Portwine

Doctor of Nursing Practice Projects

Faculty of a nurse anesthesia program at a Midwestern University requested evidence of the impact a peer mentoring program could make in reducing stress levels for SRNAs. To better tailor a peer mentoring program, surveys were developed and distributed to the university’s SRNAs and to program directors of CRNA programs across the country.

Based on the literature, a survey was developed and distributed to 81 SRNAs at this university to evaluate their stress and their perceptions of the impact of peer mentoring on stress. Another survey was developed and distributed to 118 program directors to learn if they have a …

The Impact Of A Cultural Competence Assessment Tool On Teaching Strategies In The Dnp Curriculum At Southern Illinois University Of Edwardsville, Katarina Dobrosavljevic

Doctor of Nursing Practice Projects

Providing culturally competent and culturally congruent care to patients leads to better outcomes and reduction of poor outcomes due to health disparities. Providing care that is not culturally congruent can contribute to communication barriers, resulting in deficient diagnostic testing, miscommunication about etiologies, treatment plans that are not individualized, and discounting of patient's ideas. Individuals from diverse cultures face health disparities which contribute to inadequate care and poor outcomes. The purpose of this project was to survey former graduates of the Southern Illinois University of Edwardsville (SIUE) family nurse practitioner (FNP) program to assess their level of cultural competence and areas …

Increasing Patient Access To Medication-Assisted Treatment Programs For Opioid Use Disorder, Matthew J. Bednarchik

Doctor of Nursing Practice Projects

The project sought to explore the perceived need for Medication-Assisted Treatment (MAT) for opioid use disorder among primary care providers in a rural central Illinois county. This project’s primary goal was to measure the prevalence of OUD in the community and the likelihood of primary care providers referring to an outpatient MAT program. A secondary objective was to utilize the survey results as a tool for the development of a MAT program. A cohort of twenty-five primary care providers were invited to participate in a survey to assess the perceived prevalence of OUD as well as the need for increased …

Addressing Referral Discrepancies For Hyperglycemia Diagnosis Codes, Brooke Buffington, Aubrey Parnell, Abigail Brohammer

Doctor of Nursing Practice Projects

Diabetes mellitus and prediabetes affect 34 million and 88 million Americans, respectively. The early detection and management of elevated blood glucose levels is fundamental to preventing comorbid complications. While other countries have published referral guidelines, the United States is lacking in practice standards. At a central Illinois healthcare institution, the diagnosis code for elevated blood glucose (R73) was noted at a higher rate than endocrinology referrals. The purpose of this retrospective investigation was to explore the root causes of this disproportion through deidentified patient data. The average number of wait days for an endocrinology appointment was investigated and found to …

Improving Depression Awareness And Screening In A Community College, Shelly Baldwin

Doctor of Nursing Practice Projects

Depression is a serious and disabling mental health problem impacting nearly 265 million people worldwide. Approximately 17.3 million U.S. adults aged 18 or older suffered at least one major depressive episode in the last year. Of those afflicted, individuals 18-25 years of age had the highest prevalence of depression. Undiagnosed or untreated depression can lead to long-term disability or suicide which is the 2^nd leading cause of death for 10–34-year-old persons. Early recognition of depressive symptoms can improve long-term outcomes of individuals by enhanced connection to mental health services. The overall goal of this project was to improve depression …

Improving Patient Outcomes By Preventing Airway Injuries Associated With Video Laryngoscopes, Alexis Jones, Kay Williamson

Doctor of Nursing Practice Projects

Video laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH …

Media Use Management With Toddlers And Preschoolers: Introducing Screen Time Recommendations In Pediatric Primary Care, Kaitlyn Mcgough

Doctor of Nursing Practice Projects

As the field of technology has advanced, screens have become easier than ever to access both for adults and their children in the form of smartphones, tablets, laptops, televisions, and more. This advancement has brought on unforeseen challenges for families as they grapple with understanding and implementing healthy boundaries between their children and technology. By their second year of life, 50% of children will have interacted with some form of media, and research is beginning to reflect that there is a measurable effect of screen time on toddler development. The need for intervention has continued to grow, as children are …

Physical Well-Being And Healthy Lifestyle Options, Michael Perkins

Doctor of Nursing Practice Projects

Background

The AANA has identified stress management or wellness as a priority for all CRNA programs. The Health and Wellness Initiative put in place by the AANA in 2004 is a model designed for all SRNA programs and intended to address students’ participation in wellness events in order to combat stressors.

The primary purpose of this project was to gain information about the stress faced by SRNAs enrolled at a Midwestern University and to evaluate strategies that could help students properly deal with stress.

Methods and Evaluation

Fifty-five students participated in the survey, data were compared by year in the …