Digital Commons Network^™

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 …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …

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Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.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

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 …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Hand Hygiene For Health Promotion, Phyllis Knight-Brown

Doctor of Nursing Practice Projects

For many years public health organizations, such as The World Health Organization (WHO) and The Centers for Disease Control and Prevention (CDC), have stressed the need for proper hand hygiene. Proper hand hygiene requires a prescribed process to rid the hands of potentially infecting organisms by using soap and water (handwashing) or hand sanitizer (sanitizing). These processes need to be performed at critical times to promote infection prevention. Many studies have shown that hand hygiene is a learned behavior that becomes habitual over time, and behavior change mechanisms in addition to education are needed to affect a long-term change in …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Variables Related To Colon Cancer Screening Rates Among Male Veterans, Patricia D. Dotson, Dnp, Msn, Aprn

Doctor of Nursing Practice Projects

Background/Problem: The Center for Disease Control & Prevention (CDC) recommends colon cancer screening colonoscopy beginning at age 50 years and every 10 years thereafter. The purpose of this study was to compare differences in meeting the colorectal cancer (CRC) screening recommendations between male Veterans and non-Veterans and identifying any association among Veterans social economic status (SES).

Methods: A descriptive-comparative design was used to address the study question, aims and hypotheses, using the 2014 Behavioral Risk Factor Surveillance System (BRFSS) data. A national representative sample of 20,360 Veterans and 36,183 non-Veterans between 50-74 years, were included in analysis. The associations between …

Evaluation Of The Carestarttm Glucose-6-Phosphate Dehydrogenase (G6pd) Rapid Diagnostic Test At Community And Health Center Level, Cambodia, Bertha Nyagaya-Wojnarski, Dnp, Fnp-Bc, Mph

Doctor of Nursing Practice Projects

Background: Primaquine (PQ) is the only FDA-approved drug for radical cure of Plasmodium vivax (P.v) malaria, but treatment can result in life-threatening hemolysis if given to a glucose-6- phosphate dehydrogenase deficient (G6PDd) patient. Therefore, the G6PD status of the patient with P.v must be known prior to prescribing PQ. However, patient G6PD status in rural malaria endemic settings is generally unknown, illuminating the need for reliable point of care G6PD diagnostic tests as a prerequisite to safely administer PQ. To increase community PQ access in Cambodia, performance of CareStartTM G6PD rapid diagnostic tests (RDTs) needs to be evaluated in healthcare …

Cancer Screening Practices Among Sexual Orientation Groups, Scott Kilgore, Dnp, Msn, Bs, Rn

Doctor of Nursing Practice Projects

Background: Increasing cancer screening testing is a national health initiative to decrease the mortality rates of all Americans; however, cancer screening practices among sexual minorities have been understudied.

Objectives: To assess and compare breast, cervical, prostate, and colorectal cancer screening practices among straight, lesbian, gay, and bisexual individuals.

Methods: A descriptive-correlational study was conducted using data from the Center for Disease Control and Prevention 2014 Behavioral Risk Factor Surveillance System survey. Respondents who answered questions about their cancer screening practices and sexual orientation were included.

Results: This study identified disparities in breast cancer screening practices with bisexual women (81.9%) meeting …

A Comparison Of Influenza & Tdap Vaccination Rates By Characteristics Of Child-Bearing-Aged Women, Francis Connor, Dnp, Msn, Mph, Fnp-Bc

Doctor of Nursing Practice Projects

Background

The Advisory Committee on Immunization Practices recommend childbearing-aged women receive an annual influenza vaccine, one dose of Tdap instead of TD after 18 years of age, and one dose of Tdap during the 3^rd trimester of each pregnancy. Despite these recommendations, influenza and Tdap vaccination rates remain lower than current goals.

Objectives

The purpose was to assess influenza and Tdap vaccination rates among women of childbearing age by pregnancy status, age group, and race/ethnicity.

Methods

The retrospective secondary data analysis included a nationally representative sample of women aged 18 to 44 years from the 2014 Behavioral Risk Factors …

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 …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …