Digital Commons Network^™

Crisis Standards Of Care And Covid-19, Sharon L. Farra, Sherrill Jeanne Smith, Laura M. Luehrmann, Craig Woolley

Nursing Faculty Publications

This is the sixth installment in the Shelter in Place (SiP) Lecture series. This installment deals with the impact and implications of the Shelter in Place order on differing populations. It discusses the details of Crisis Standards of Care from development to implementation.

Relief Of Procedural Pain In Infants And Neonates, Allye Camden

The University Honors Program

Procedural pain occurs in the hospital setting due to a variety of procedures and treatments conducted throughout a patient’s stay. Pain is often assessed in infants and neonates but is not always treated consistently due to the multiple number of pain relief methods. The objective of this literature review is to identify the most effective interventions to relieve procedural pain in infants and neonates. Forty articles were analyzed and synthesized to determine the best pain relief methods to use when providing nursing care to infants and neonates. Based on the results of the literature review, nutritive sucking, positioning techniques, and …

Evaluating An Evidence-Based Suicide Risk Assessment Intervention For An Inpatient Mental Health Hospital Unit, Tyler D. Green

Doctor of Nursing Practice Program Projects

Suicide is a worldwide problem that claims over 800,000 lives annually (NIMH, 2017; WHO, 2017). Almost one third of mental health professionals feel they have received inadequate training on suicide prevention (Jahn, Quinnett, & Ries, 2016). Asking mental health clients to agree to a no-suicide contract is a widely-used practice in the inpatient mental health care setting but lacks efficacy and can have ethical implications (Bryan et al., 2017). The NGASR was selected from a variety of suicide risk assessment tools for incorporation into a public inpatient mental health hospital unit in the Midwestern U.S.A. The NGASR is unique in …

Health Literacy: Approach To Colon Cancer In African Americans, Judith Jefferson-Gordon

Doctor of Nursing Practice Program Projects

Health literacy is vitally important for African-Americans (AA), with higher incidence and mortality rates of colon cancer compared to Caucasians nationally and in Ohio. Larrabee's Model for Change to EBP and Self -Efficacy Middle range nursing theory guided this DNP project. A retrospective chart review of AA patients with colon cancer was completed to determine types of teaching methods used by nurses during the clinical encounter. A convenience sample (8%) of AA patients received colon cancer care in the ambulatory setting at the healthcare facility in the Midwest. More than half were female and the remainder were male (65% vs. …

Evidence-Based Practice Change Proposal: Implementation Of A Transition To Practice Program For New Registered Nurse Graduates Beginning Practice In An Extended Care Facility, Gwendolyn A. Stevenson

Doctor of Nursing Practice Program Projects

The transition to practice (TTP) of new registered nurses has long been a concept of interest within the nursing profession as unsuccessful transition to practice impacts individual nurses, healthcare organizations, the nursing profession, and the quality of patient care. There has been a renewed focus on transition to practice as changes in the healthcare delivery system and nursing profession have highlighted the importance of successful TTP in ensuring quality patient care in all settings. With an increasing geriatric population and healthcare delivery shifting away from acute care settings, greater numbers of new registered nurse graduates are transitioning to practice in …

The Role Of Antibiotic Therapy In The Treatment Of Small Bowel Bacterial Overgrowth In Pediatric Patients With Short Bowel Syndrome, Christina Heinzman

Doctor of Nursing Practice Program Projects

Short bowel syndrome is the congenital or surgical alteration of the small bowel resulting in a shorter than normal length of small bowel. This condition affects approximately 20,000 people in the Unites States and is diagnosed in 3-5 times per 100,000 live births annually. Patients with short bowel syndrome are at risk for the development of small bowel bacterial overgrowth, a serious consequence caused by overgrowth of bacteria in the small bowel resulting in symptoms of abdominal pain, abdominal distention, feeding intolerance, malabsorption, weight loss and increased risk of metabolic acidosis. Clinical studies assessing the role of antibiotic therapy in …

Parent Education On Childhood Vaccinations: Implications For Nursing Practice, Kristen Sevier

The University Honors Program

Early childhood vaccination rates in Ohio have been stagnant in the past couple of years. The purpose of this project was to use current evidence regarding early childhood vaccination rates to identify how nurses can effectively educate parents to increase childhood vaccination rates. The findings from this project helped establish an educational brochure for pediatric nurses as a nurse-led intervention to address vaccination adherence among parents at the point of care. The ultimate goal is to improve vaccination coverage among early childhood populations in Yellow Springs, Ohio. The educational brochure was created and presented to pediatric nurse faculty at Wright …

Test Anxiety And Undergraduate Nursing Students: The Concept, Impact, And Interventions, Sarah Macadam

The University Honors Program

Test anxiety in undergraduate nursing students negatively impacts test scores and overall academic success. This project utilizes current literature to identify the concept of test anxiety, the impact of test anxiety on undergraduate nursing students, and interventions to help reduce test anxiety. Literature findings will then be included in an educational PowerPoint presentation given to an undergraduate nursing course at Wright State University.

Educational Strategies For Preventing And Managing Coronary Artery Disease (Cad), Anna M. Mills

The University Honors Program

Coronary artery disease (CAD) is a leading cause of death in the United States and many older people suffer from this disease (Luisi et al., 2015). It is vital that nurses understand the importance of education, good nursing care, and support in improving patient outcomes. Nurses care for patients with heart disease every day and it is important that nurses have a good understanding of the disease process, how to effectively educate patients, and how to care for them in hospital and community settings. The purpose of this project is to (1) perform a comprehensive literature review regarding prevention, education, …

Screening Mothers For Postpartum Depression At Well-Child Visits In A Private Pediatric Clinic: An Evidence-Based Practice Improvement Project, Cassandra R. Fishbein

Doctor of Nursing Practice Program Projects

Postpartum depression (PPD) affects approximately 10-15% of women and can have serious negative effects on mothers, infants, and families. PPD can persist throughout the first year after delivery when mothers no longer have consistent contact with their primary health care provider. The U.S. Preventive Services Task Force, the American Congress of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American Academy of Pediatrics recommend screening for depression when support systems are in place to ensure referral for further evaluation, diagnosis, and treatment. Pediatric providers have consistent interactions with mothers and infants during well-child visits. During this evidence …

A New Understanding Of Palliative Care, Sarah Gale

The University Honors Program

The purpose of this paper is to discuss palliative care and how it is relates to chronic illness. It will include the current problems with palliative care as it is associated with chronic illness. The significance to nursing will be indicated and a review of literature follow and then by a synthesis of the literature. A project proposal will follow the synthesis followed by an evaluation of the implemented project and conclusion.

Text Message Follow-Up Reminders In The Pediatric Urgent Care, Kimberly R. Joo

Doctor of Nursing Practice Program Projects

Follow-up care by a primary care provider (PCP) immediately following a visit to the pediatric urgent care is recommended by the American Academy of Pediatrics. Unfortunately, studies indicate that between 26-56% of patients do not complete a recommended follow-up appointment with PCPs. Communication in the form of reminders to parents, guardians, and patients over the age of 18 may have the potential to increase rates of follow-up appointments after an urgent care visit. Short Message Service (SMS) text messages have been shown to be an effective means of communication between providers and patients in multiple types of healthcare settings. The …

Easy Breathing For Elementary School Children With Asthma At Dayton Public Schools, Jeanine M. Bochenek

Doctor of Nursing Practice Program Projects

Approximately 8.4% or 6.4 million children are diagnosed with asthma in the United States. Asthma is a chronic and life threatening disease that cannot be cured but only managed. Asthma is also one of the most expensive conditions to manage, requiring direct health care services if not adequately controlled. Asthma symptoms and exacerbations are also the number one reason for school absences among children. The PICOT question that guided the review of the literature to answer the clinical question was: In children with asthma, how does a school-based self-management asthma education program compared to standard management affect school absences and …

The Use Of Hybrid Educational Method For Trauma Training Among U.S. Air Force Nurses, Karey M. Dufour

Doctor of Nursing Practice Program Projects

Trauma assessment is a core skill for all United States Air Force nurses. However, with the recent withdrawals from Iraq and Afghanistan, there are serious concerns about how Air Force nurses can maintain high-level trauma skills without the frequent exposure and opportunities in which to perform them. Although training affiliation agreements with local civilian trauma centers exist, it is difficult to routinely send nurses to receive training in these facilities due to time constraints. Simulation is a feasible way to provide essential training and allows participants to practice critical skills during reproducible scenarios in a realistic but non-threatening environment. Providing …

Getting It Straight To Advance Care Of Hospitalized Children: When To Choose Research, Evidence-Based Practice Or Quality Improvement, Tracy L. Brewer, Lisa English Long

Nursing Faculty Publications

Struggling to understand the difference in research, evidence-based practice and quality improvement? Come “get it straight” with the experts! There will be a question and answer session at the end of the presentation so that your questions can be answered live!

Objectives:

1. Differentiate evidence-based practice (EBP), research and quality improvement (QI).
2. Identify resources to support EBP, research, and QI in the clinical setting.

Does Interprofessional Education Change Student Attitudes About Interprofessional Learning And Patient Safety?, Deborah Poling, Dawn Labarbera, Mary Kiersma

Nursing Faculty Publications

INTRODUCTION The Fort Wayne Area Interprofessional Education Consortium (FWAIPEC) evaluated the outcomes of its educational initiative with a pre and post assessment utilizing the Readiness for Interprofessional Education tool (RIPLS). The seminar series was designed as a longitudinal team building experience to foster competency toward interprofessional collaborative practice.

METHODS Participants from pharmacy, physician assistant, nurse practitioner, nurse educator, nurse executive, medical and family practice residency programs were surveyed as part of the curriculum assessment.

RESULTS Primarily reflecting the required attendance of the pharmacy and physician assistant students, 122 participants completed both assessments (89.7% response rate). Wilcoxon signed rank tests were …

Improving Compliance With Clinical Practice Guidelines To Reduce Urinary Tract Infection In Long Term Care, Charman L. Miller

Doctor of Nursing Practice Program Projects

This evidence-based clinical change project addressed the clinical problem trigger of increased rates of urinary tract infections and related unplanned discharges in a rural Ohio nursing center. The clinical change involved the implementation of a nursing-driven protocol for suspected Urinary Tract Infection (sUTI) based on the American Medical Director’s Association Clinical Practice Guideline: Common Infections. An interdisciplinary team approach to evidence-based clinical change was utilized through use of the Iowa Model of Evidence-based Practice to Promote Quality Care. Both the process and the intervention were evaluated through analysis of outcome data including rates of urinary tract infection, compliance with the …

Alcohol, Tobacco And Illicit Drug Screening In Pregnancy, Lisa R. Jasin

Doctor of Nursing Practice Program Projects

Intrauterine substance exposure is a nationally growing problem. A steady increase in neonates with neonatal abstinence syndrome in the state of Ohio was noted. Prenatal substance use presents a significant burden to society. Of infants exposed to intrauterine opiates, 55-94 percent develop signs of withdrawal. For example, the estimated lifetime cost for a neonate with fetal alcohol spectrum disorder is $2 million. The purpose of this evidence based practice improvement project was to evaluate the utility of the 5Ps screening tool and brief intervention by community health workers during the first prenatal home visit. The Evidence-Based Practice Improvement (EBPI) model …

Use Of Change Agent To Facilitate Implementation Of Personalized Health Plans, Colleen Miranda

Doctor of Nursing Practice Program Projects

In 2015, the Centers of Disease Control and Prevention reported that the most common, costly but preventable health problems are heart disease, stroke, cancer, diabetes, obesity, and arthritis. Literature shows preventable chronic diseases have increased in the current healthcare system. Healthcare leaders are calling for a change in the current faulty healthcare delivery system to personalized healthcare. A patient-centered approach focuses on the health gains that can be made in the prevention and treatment of chronic disease with a higher level of patient engagement.

The Veterans Health Administration (VHA) is advocating patient-centered care (PCC) to focus on the health gains …

Nurse Rounding: An Evidenced Based Practice Report, Todd E. Tussing

Doctor of Nursing Practice Program Projects

Today’s healthcare environment is becoming increasingly competitive for patient volume and revenue dollars. The introduction of Value Based Purchasing by the Center for Medicare and Medicaid Services (CMS) links patient satisfaction and healthcare quality to government reimbursement. Patient satisfaction has been linked to increased market share, thereby, positively impacting revenue for healthcare organization and increasing the competitiveness between healthcare organizations. In addition, patient satisfaction has been linked to increased compliance with prescribed healthcare regimens leading to improved health outcomes.

Nursing leaders of today’s healthcare systems must develop strategies to increase patient satisfaction and improve the revenue streams for their organizations. …

System Base Practice As A Public Health Nursing Workforce Competency Requirement, Ann M. Stalter

Nursing Faculty Publications

This is an exhilarating time to be in public health! Internationally, the digital world has created an environment for the economic security needed to protect health and promote healing of all mankind. Globalization allows scientists to treat and track diseases in ways that have never been possible. In the United States (U.S.), the federal mandate for equal access to health care has opened a plethora of imaginary and tangible boundaries of which were antecedents to just about every–ism known to public health providers. With this exciting reform comes the need for workforce awareness and new ways of thinking and …

A Snapshot Of Synthetic Substances: Nursing Implications For Patients Suspected Of Psychoactive Drug Use, Tracy L. Brewer, Margie Collins

Nursing Faculty Publications

Learning Objectives:

• Define what are synthetic substances and their mechanism of action.
• Specifically focusing on synthetic cannabinoids
• Interpret psychological and physiological clinical presentation of patients after use of synthetic substances.

The Wright Tool Kit: Qsen Competency Integration In An On-Line Rn-To-Bsn Program, Ann M. Stalter, Patricia Martin, Ximena Chrisagis, Deborah Lee Ulrich, Kathy J. Keister

Nursing Faculty Publications

Colleges across the nation are working to transform nursing education and to integrate QSEN competencies into program curricula.

Maintaining The Vision In The Intensive Care Unit, Camille Leadingham

Doctor of Nursing Practice Program Projects

Background: Intensive care patients receiving mechanical ventilation have an increased chance for eye complications due to the inability to operate their own protective mechanisms resulting in dry eye.

Purpose: Develop and test an eye care protocol utilizing the evidence to prevent dry eye.

Method: In phase 1 retrospective data was collected on sedated and mechanically ventilated patients in the ICU (n=30) to determine baseline eye care practices and outcomes. Then the DEPP was developed based on the evidence. Finally data were collected prospectively (n=30) in the same patient population.

Results: From Phase 1 to Phase 2, eye crust cases diminished …

Nurses Perceptions Of Shared Governance Two Years Post Implementation Of A Councilor Shared Governance Model, Kathleen L. Wilson

Doctor of Nursing Practice Program Projects

Participation in shared governance councils can provide nurses with an opportunity for input into organizational policies that influence quality health care outcomes. Nurse leaders are diligently seeking a practice model that has a foundation of engagement of staff in decision making, quality outcomes, competency, evidence-based practice, shared power and job satisfaction. With the Patient Protection and Affordable Care Act (PPACA) of 2010, health care systems can expect an influx of some 30 million more patients (Pfeifer, 2013). In addition, mandated purchase of health care insurance will replace the fee for service model with one that ties payment to outcomes and …

Self-Care Of Heart Failure In A House Call Program, Becky Bryant

Doctor of Nursing Practice Program Projects

The incidence and prevalence of persons living with heart failure (HF) is growing in the United States. Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care of heart failure (SCHF) has been reported to decrease HF hospital admission rates. Elderly patients who are homebound do not have access to typical HF education and follow-up care. The purpose of this evidence-based practice (EBP) project was to implement a SCHF program intervention by nurse practitioners (NPs) with homebound elderly HF patients receiving home visits in a house call program. There were 18 sample …

Implementation Of A Total Knee Arthroplasty Evidence Based Practice Guideline Quality Improvement Project In A Va Orthopedic Surgical Setting To Reduce Surgical Infections, Paula A. Kimpton

Doctor of Nursing Practice Program Projects

The prevention of surgical site infections, specifically orthopedic surgery cases, has been cited as the most preventable source for morbidity and mortality for patients undergoing total knee arthroplasties (TKA). In the most recent Veteran Affairs (VA) National Surgery Office Quarterly Report (July 1, 2012 through June 30, 2013), a problem with surgical site infections was identified in patients with TKA surgery at Dayton Veterans Affairs Medical Center (VAMC). The Dayton VAMC had a 5.3% TKA surgical infection rate versus 1.3% nationally.

The purpose of this quality improvement project was to decrease post-operative TKA infection rates with utilization of evidence based …

The Impact Of Implementation Of An Evidence-Based Practice Model In A Long Term Acute Care Hospital, Michele L. Marshall

Doctor of Nursing Practice Program Projects

Inadequate and delayed implementation of current evidence into practice has contributed to medical errors, safety issues and patient deaths. The Institute of Medicine (IOM) has challenged the healthcare profession to achieve 90% of integration of current evidence into practice by 2020. The purpose of this doctoral project was to implement an evidence-based practice (EBP) model in a long-term acute care hospital as they began their journey in pursuit of Magnet recognition. Implementation of an EBP model, the Advancing Research and Clinical practice through close Collaboration (ARCC) model, involved conducting an initial organizational assessment of staff to understand the staff’s beliefs, …

Larckit: A Toolkit To Increase Prescribing Of Long Acting Contraceptives To Adolescent And Young Women In A Public Health Setting, Eva M. Fried

Doctor of Nursing Practice Program Projects

In an urban, publicly funded women’s health and family planning clinic, 56% of pregnancies were reported to be unintended. The clinic director decided to address this problem by focusing on providers’ contraceptive prescribing habits; especially contraceptive prescribing for women aged 15-25. The purpose of the evidence-based practice improvement (EBPI) project was to increase provider disclosure about longer-acting reversible contraception (intrauterine and implantable methods known as “LARC” methods). The goal of the EBPI project was to increase the percentage of contraceptive prescriptions that are LARC methods for women aged 15-25 years. The clinical question guiding the EBPI project was “Among healthcare …

Improvement Of Standardized Documentation Of Patients With Copd In An Acute Care Setting, Kimberly Biery

Doctor of Nursing Practice Program Projects

The purpose of this project was to improve patient clinical outcomes of average length of stay, mortality rate, and readmission within 30 days by increasing health care provider order set usage and documentation as it relates to patients with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Epic ™ computer based clinical documentation by healthcare providers at The Christ Hospital (TCH) was inconsistent. The PICOT question developed was: in the COPD population of an acute care hospital, how does standardized electronic COPD process measure documentation and order set usage compared to no COPD process measure documentation and order set …