Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Implementing Diabetic Eye Care Education For Healthcare Professionals, Misun Serena Moser

Doctor of Nursing Practice (DNP) Projects

Background: Diabetic retinopathy (DR) is the most common cause of diabetic eye complications and a leading cause of preventable vision loss in American adults. Skaggs et al. (2017) reported that DR screening prevents vision loss by 95%. The evidence reports that only 60% of people with diabetes have attended the recommended DR screenings (Flaxel et al., 2020). Emerging evidence supports patient education about diabetic eye care and its guidelines by health care professionals (HCPs) as the main facilitator to accomplish this goal (Khair et al., 2020; Moinul et al., 2020). Healthcare professionals are pivotal in encouraging or discouraging DR screening …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Implementing The Copm To Create Occupation-Based Interventions In Outpatient Adult Rehabilitation, Kelcee A. Bacon

Occupational Therapy Capstone Presentations

Worldwide, people continue to live longer, with the number of people over the age of 60 predicted to double by 2050; many of those people also have chronic diseases that could benefit from rehabilitation services. Outpatient rehabilitative services, including occupational therapy, have increased occupational performance, strength, mobility, and coordination for those diagnosed with musculoskeletal or neurological conditions. This capstone focused on three components: 1) in-depth clinical practice using occupation-based assessments and interventions with the adult population, 2) understanding the administrative roles of private practice therapists, and 3) creating educational materials to increase knowledge and skills surrounding outpatient occupational therapy for …

S.M.A.R.T. Program Implementation To Promote Engagement And Participation In A School Setting, Emily Mickelson

Occupational Therapy Capstone Presentations

The purpose of this capstone project is to educate educational professionals on multi-sensory approaches and to implement the Stimulating Maturity Through Accelerated Readiness Training (S.M.A.R.T.) program to increase students’ engagement in academic learning. This project used pre- and post-tests to determine baseline knowledge. The occupational therapy student participated in S.M.A.R.T. training, and the junior kindergarten students participated in eight-weeks of S.M.A.R.T. program implementation. The students’ pre- and post-test assessments were completed by the students one-week pre-intervention and following eight weeks of program implementation. The educational professionals’ pre- and post-test assessments were completed by the kindergarten teachers before and after receiving …

Development And Piloting Of Patient Education Material On Pharmacogenomic Testing, Louise Limoges

Human Genetics Theses

Pharmacogenomic (PGx) testing is increasingly utilized in patient care, with the potential to personalize the use of medication for individual patients. However, many barriers stand in the way of PGx testing becoming standard-of-care, including a lack of resources for patient education. The objective of this study was to develop and pilot a pre-test educational tool for clinical PGx testing and gather patient input. We designed a one- page, printed PEM which was piloted at a genetic counseling clinic in Cincinnati, Ohio. In total, 53 participants read the PEM and provided their feedback through a survey. The survey was designed to …

Association Between Depression And Coronary Heart Disease: A Cross-Sectional Study Using Behavioral Risk Factor Surveillance System (Brfss), 2022, Juliana Monono

Capstone Experience

Objectives: To examine the association of depression and coronary heart disease in U.S. adults.

Methods: This cross-sectional study uses the Behavioral Risk Factor Surveillance System (BRFSS), 2022 data for non-institutionalized U.S adults aged 18 and older. The exposure variable is depression, the outcome is coronary heart disease (CHD), and covariates are age, race, education, and physical activity. Performed univariate, bivariate, and multivariate analyses to assess the association between depression and CHD.

Results: The analytical sample size consisted of 427,217 individuals. A total of 88,841(20.7%) of the population reported having coronary heart disease, while 338,376(70.3%) reported having no …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

The Impact Of Healthcare Interprofessional Education On Collaboration., Mya Winjum

Theses/Capstones/Creative Projects

Interprofessional relationships are important to the productivity of healthcare teams, especially as collaborative approaches become increasingly common in the healthcare setting. This paper focuses on the impacts of interprofessionalism and interprofessional education on healthcare teams collaborations. Drawing from a mixed-methods approach, data was gathered through an online survey and interviews conducted at the UNMC GOODLIFE Clinic, a student-run clinic. Findings reveal differences in perceptions between post-graduate professionals and students regarding the role and importance of interprofessionalism. While professionals demonstrate an understanding of IP collaboration, students express a need for more comprehensive IPE. Barriers to effective teamwork, such as professional hierarchies …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Experiences Of Undergraduate Nursing Faculty Adapting To The Changes Of The Next Generation Nclex, Marlene Kilpack Whiteside

Walden Dissertations and Doctoral Studies

Undergraduate nursing faculty are responsible for preparing nursing students for patient care in a dynamic health care setting and are challenged with meeting the National Council Licensure Examination (NCLEX) change to the Next Generation NCLEX (NGN). The National Council of State Boards of Nursing recommended the incorporation of the Clinical Judgment Measurement Model (CJMM) and competency-based curriculum in preparation for NGN testing that began in 2023. Understanding how faculty experienced and adapted to changes in curriculum, patient-centered instruction, and NGN testing may help future nurse faculty in adapting. The purpose of this basic exploratory, qualitative study guided by the achievement …

Student Perspectives On The Adequacy Of Mental Health Curriculum Within The College Of Health And Human Services At Unh, Brianna Lee Meyer

Honors Theses and Capstones

This study aims to understand the confidence students in future healthcare oriented majors feel in regards to treating or interacting with individuals with mental health conditions. It also aims to understand the effect of students' in-major education, outside-major education, and lived experience on this confidence level. Students within the College of Health and Human Services at UNH were the participants who completed a short Qualtrics survey online. The survey collected data from Likert scales and short-answer questions. The Likert scales were then analyzed with a regression and descriptive statistics, while the short-answer questions were analyzed with thematic analysis. The study …

Nursing Education And Comfort Level In Caring For Patients With Eating Disorders, Jaylyn E. Jewell

Honors Theses and Capstones

Nurses are integral to providing care to patients with eating disorders, who often present to the generalized hospital setting related to physical complications from their disorder. Despite the vital role nurses play, a lack of education is cited. This project sought to assess knowledge on eating disorders of nurses at a local hospital through dissemination of a survey. A total of n=18 responses were gathered. Results supported the fact that many nurses have received inadequate education on eating disorders, and consequently have low knowledge and competency in the care of these patients. This project seeks to identify this lack of …

Increasing Breast Cancer Screenings In The New American Population, Tuhina Venkatayogi Mph, Bs, Rn, Erin Leighton Dnp, Aprn, Fnp-Bc

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Breast cancer poses a significant health risk globally, with routine screenings pivotal for early detection. The New American population in Vermont face many barriers to accessing mammogram screenings and have a 0% participation rate in breast cancer screening, thus necessitating targeted interventions. The purpose of this project was to improve mammogram participation among New Americans by at least 15% by January 2024.

Methods: The intervention at a New American clinic included an educational infographic presented during initial health center visits, supplemented by tangible pamphlets. Patient understanding was assessed through teach-back questions. Appointment scheduling was facilitated during the visit, with …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Enhancing Athletic Participation: Continuous Glucose Monitoring For Pediatric Type 1 Diabetes Athletes, Danielle Santiago

Nursing | Senior Theses

The difficulties that children and teenagers with Type 1 Diabetes Mellitus (T1DM) encounter are discussed in this thesis, with a focus on how fear of hypoglycemia (FOH) and actual hypoglycemia associated with this chronic illness affects their ability to engage in physical activities, especially organized sports. A common challenge for children diagnosed with T1DM is meeting the daily recommendation of 60 minutes of daily moderate to vigorous physical activity. The purpose of the proposed study is to evaluate if participation in structured exercise (physical education classes and after-school sports) increases among school-aged children who wear continuous glucose monitors (CGM) when …

Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana

Nursing | Senior Theses

Maternal mortality is a pressing, global concern that particularly affects African American women in the United States. African American women face disproportionately a high maternal mortality rate (MMR), with rates more than double that of white women. Preeclampsia emerges as the leading cause of maternal mortality in African American women, driving the need for targeted interventions. To address this issue, a proposed research study aims to investigate the impact of a nurse-led, waiting room, preeclampsia and aspirin effectiveness educational intervention on the knowledge and preeclampsia rates among African American women. The study draws upon existing evidence that supports the use …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Cervical Cancer Education & Prevention For Women In The Philippines, Kate Isabel Juanillo

Nursing | Senior Theses

Although cervical cancer is preventable, it continues to pose a significant health concern in the Philippines as evidenced by high cervical cancer diagnosis rates. The purpose of this quantitative study is to investigate low cervical cancer screening rates and the effectiveness of educational interventions in increasing awareness and screening rates. A literature review will examine topics such as low cervical cancer screening rates, cervical cancer screening methods, and barriers. This research proposal involves a quasi-experimental study that investigates education as an intervention for increasing cervical cancer awareness and cervical cancer screening rates. Fifty Filipino women will be randomly assigned to …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Teaching Cultural Humility Practices In Appalachia: The Value Of Conducting Conversations Based In Education, Bailey A. Riggs

Graduate Theses, Dissertations, and Problem Reports

Recent literature highlights the paradigm shift from utilizing cultural competence practices to cultural humility practices within the field of occupational therapy, and health sciences (Fisher- Borne, et al., 2015). The idea of cultural competency suggests that culture is unchanging, and individuals can master cultural knowledge. The perception of knowing culture can be perceived as an unwillingness to learn about culture. In contrast, cultural humility promotes the value of lifelong learning and introspection, encouraging greater self-awareness, reflection of personal biases, and recognition of power imbalances. This approach aims to better integrate educational approaches to serve diverse populations in a culturally affirming …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Benefits Of Patient-Centered Education For Type 2 Diabetes Mellitus, Paige Bortnick

Doctor of Nursing Practice Projects

Type 2 diabetes is a chronic, lifelong illness that affects millions of individuals in the United States. The rate of diabetes has doubled over the last 20 years in America and has climbed to be the seventh leading cause of death amongst Americans. The purpose of this project was to determine if participants in the target community demonstrated increased knowledge and awareness of diabetes after receiving education. A pre-intervention and post-intervention survey was given to determine if the education was effective. Data collected revealed an increased awareness and knowledge regarding the prevalence of type 2 diabetes, lifestyle, and diet modification.

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 …