Digital Commons Network^™

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …

Effects Of Education On Correcting Misconceptions And Acceptance Of The Influenza Vaccination Among A College Campus, Travis E. Fairbanks

DNP Scholarly Projects

Educating patients on the influenza vaccination is an important goal for health care providers. It fosters a working relationship between provider and patient and allows patients to make an informed decision on their health care needs. The percentage of individuals who receive the influenza vaccine in the United States has been consistently below goals set by the committee for Healthy People 2020. This DNP scholarly project aimed to determine whether the introduction of education was effective at increasing individuals’ choice to vaccinate against the influenza virus among college campus students. The study was a non-experimental, non-randomized control trial that utilized …

Implementing Faculty Development Modules To Increase Readiness For Addressing Social Determinants Of Health, Implicit Bias And Equity In Course Content, Claudia Ngafeeson

DNP Scholarly Projects

Implicit bias is viewed as an unconscious and involuntary attitude that lies below the surface of consciousness but can influence behavior, and cognitive processes (Maina et al., 2018). Social determinants of health are considered to be the conditions in which people are born, grow, live, work, and age; these circumstances are usually shaped by the distribution of money, power, and resources at global, national, and local levels, which in turns determines the distribution of the value of medical care. Existing literature on implicit bias has been fragmented in different fields such as; cognitive psychology, business ethics, and higher education, but …

Implementation Of An Advanced Operating Room Schedule To Increase Compliance With Clinical Practice Guidelines For Preoperative Antibiotic Selection And Timing: A Quality Improvement Project, Shelby Lynne Adams

DNP Scholarly Projects

Surgical site infection (SSI) is a major cause of morbidity and mortality in operative patients worldwide. The American Society for Health-System Pharmacists (ASHP) published the most recent clinical practice guidelines for antimicrobial prophylaxis in surgery. These guidelines are based upon the available evidence and provide a standardized approach for the safe and effective selection, dosing, and administration of antibiotics for the prevention of SSI (Bratzler et al., 2013). This Doctor of Nursing Practice (DNP) project aimed to determine if incorporating an advanced operating room (OR) schedule, inclusive of ASHP presurgical antibiotics, increased compliance with ASHP standards of antibiotic selection and …

Effects Of Evidence-Based Discharge Instructions On Follow-Up With A Healthcare Provider In Patients Presenting With Mtbi-Like Symptoms To A Health Clinic At A Rural Sports Camp In The Pacific Northwest In The U.S., Eva G. Bergner

DNP Scholarly Projects

Mild traumatic brain injury (mTBI) is a major public health burden affecting both children and adults in the U. S. (Sarmiento et al., 2019; Schuchat, Houry, & Baldwin, 2018). The management of mTBI at summer camps is not well characterized in the literature. Epidemiologic studies on summer camps have reported that 25% of all injuries were to the head, face and/or neck (Kolberg et al., 2020; Robinson, Arbogast, Garst & Corwin 2019). The purpose of this project was to evaluate the impact of evidence-based instructions for follow-up with a healthcare provider in patients presenting with mTBI-like symptoms to a health …

Improving Septic Patient Outcomes Through A Nurse-Led Quality Improvement Project In A Rural, Midwestern Hospital, Allyssa C. Sweers

DNP Scholarly Projects

Sepsis is a complex and costly problem that continues to afflict hospitals across the globe (Napolitano, 2018). If it is not identified quickly and treated promptly, sepsis will progress to septic shock and create an increased risk of mortality (Napolitano, 2018). The best way to improve patient outcomes is through early detection and precise treatment (Rello, Valenzuela-Sánchez, Ruiz-Rodriguez, & Moyano, 2017). Through staff education and clinical decision tools, such as checklists, septic patients are more likely to have a favorable outcome (Storozuk, MacLeod, Freeman, & Banner, 2019). The purpose of this DNP project was to decrease fluid resuscitation fallouts and …

Reducing Central Line-Associated Bloodstream Infections At A Rural Midwestern Hospital Through An Evidence-Based Nurse-Led Practice Change Intervention, Crystal B. Lavalley

DNP Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) are responsible for increased patient morbidity, mortality, and healthcare costs, despite being a preventable harm (Barnes et al., 2015; Furuya et al., 2016). Evidence-based (EB) research suggests that the use of central line bundles is the most effective way to reduce CLABSIs in hospitals (Barnes et al., 2015; Furuya et al., 2016). Researchers have also found a statistically significant correlation between nurse compliance with bundle components and CLABSI rates (Aloush & Alsaraireh, 2018; Furuya et al., 2016). The purpose of this study was to determine if a nurse-led collaborative that focused on CLABSI reduction using …

The Impact Of Early Goal Directed Sepsis Bundle Sets In The Emergency Department And The Impact Of Sep-1 Compliance Rates, Christie L. Ferrari

DNP Scholarly Projects

Sepsis is a medical emergency that is prevalent throughout hospitals everywhere. Due to the growing crisis, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Surviving Sepsis Campaign (SSC) adopted core measures for sepsis (SEP-1) which aim at improving overall compliance of evidence-based treatment standards for sepsis. The purpose of this Doctor of Nursing Practice (DNP) project was to determine if incorporating early goal directed sepsis bundles in a rural Midwestern ED was effective in increasing compliance with SEP-1 rates. The secondary purpose evaluated how nursing knowledge, awareness, and compliance with sepsis bundles affects SEP-1 compliance rates. …

Implementation Of An Evidence-Based Bundle To Reduce Hospital Acquired Pressure Injury Harm Rates In The Intensive Care Unit: A Quality Improvement Project, Jessica Tripp

DNP Scholarly Projects

A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based …

Evaluation Of A Hands-On Cooking Class And Its Effects On Self-Efficacy In Relation To Healthy Eating In Type 2 Diabetics, Codi A. Jenshak-Gorzinski

DNP Scholarly Projects

The prevalence of Type 2 diabetes is alarming and poses a great threat to U.S. national health. Chronic diabetes can lead to serious conditions such as heart attack and stroke, and can result in premature mortality (World Health Organization, 2018). Diabetes can be prevented or treated by eating a healthy diet. Cooking classes are a potential way to improve American’s knowledge of nutritional principles and help them become confident that they have the capacity to eat a healthy diet. The purpose of this DNP project was to determine if participation in cooking classes enhanced self-efficacy as it pertains to healthy …

Utilization Of The Calm Apparatus To Adult Men And Women With Atrial Fibrillation To Decrease Emergency Department Visits For Atrial Fibrillation, Ami Klein

DNP Scholarly Projects

The purpose of this project is two-fold. The first is to determine if the CALM APP use by adult men and women with atrial fibrillation (AF) will decrease anxiety. The second is to determine if decreased anxiety utilizing the CALM APP will deter admissions to the emergency department (ED) for AF in the first month post-catheter ablation of AF. The Zung SAS was used to determine the pre- and post-anxiety scores. The Seven Days of Calm (free app) was used to teach deep breathing and meditation. This study showed a moderate decrease in ED visits with use of the Calm …

Representation Matters: An Examination In To How The Patient Experience Is Impacted By The Inclusion Of Sexual Orientation And Gender Identity Questions On A Health History Intake Form, Meghan N. Digneit

DNP Scholarly Projects

The disclosure of one’s sexual orientation and gender identity (SOGI) status is an extremely personal decision subject to a variety of internal and external factors. The disclosure of this status in the healthcare setting is an important topic that continues to be subject to discussion, research, education, and mutual understanding between the patient and provider. The purpose of this DNP project is to explore how answering SOGI questions on a general intake form impacts patient attitudes regarding the impending visit. This was a mixed-methods research study that included demographic questions, nominal data in the form of yes/no questions, and two …

The Impact Of Participation In A Mentored Cycling Program, Dana Bolduc

DNP Scholarly Projects

Physical activity (PA) has the potential to have a positive impact on mental health conditions such as anxiety, depression and self-esteem. In particular, this project focused on self-esteem because low self-esteem can lead to increased risk of developing anxiety or depression. In contrast, high self-esteem can have a protective effect against anxiety and depression. Group PA programs combined with mentorship have been shown to build relationships and enhance self-esteem. The purpose of this DNP project was to determine the impact of participation in a rural midwestern, mentored cycling program on self-esteem in an at-risk adolescent population. Self-esteem was measured using …

Nitroglycerin Safety In Inferior St Elevation Myocardial Infarction (Stemi) Patients: A Retrospective Review, Olivia Montgomery

DNP Scholarly Projects

Nitroglycerin (NTG) is medication used to reduce chest pain (Boden et al., 2015) and is the suggested analgesic for angina associated with ST elevation myocardial infarction (STEMI) (de Alencar Neto, 2018). Due to the potential for right ventricular (RV) infarct and hemodynamic collapse in inferior STEMI patients (Nagam, Vinson, & Levis, 2017), the American Heart Association (AHA) recommends avoidance of NTG in patients with suspected RV infarct (Antman et al., 2004). The purpose of this DNP project was to explore the safety of NTG use in the treatment of patients diagnosed with STEMI by evaluating the effects of NTG on …

An Examination Of The Impact Of Health Literacy Assessment On Incarcerated Individuals With A Diagnosis Of Type 2 Diabetes, Josi Rotunno

DNP Scholarly Projects

Low health literacy levels limit healthcare outcomes in a variety of diagnoses. Having a low health literacy level can significantly impact an individual’s ability to manage their condition. Among these individuals are incarcerated individuals, who are especially vulnerable to low health literacy levels. Due to regulations of the correctional facility, along with the vulnerability of the population, it is often difficult to get approval for studies and to make changes within this setting[TMD1] . The stigma of incarceration, along with the difficulty in navigating the correctional setting regulations, often create barriers to making changes that could improve the health …

Effectiveness Of An Aquatic Exercise Program For Reducing Weight, Body Fat And Chronic Low Back And Joint Pain, Terilyn Darley

DNP Scholarly Projects

According to the World Health Organization (WHO), obesity has risen at an alarming rate and has reached epidemic proportions throughout the world (WHO, 2017). In the U. S., approximately 93.3 million U.S. adults are obese with an overall prevalence of 39.8 %. Chronic pain is another public health issue in the U.S, affecting almost 100 million people and is associated with significant annual healthcare costs and lost productivity (National Center for Complementary and Integrative Health [NCCIH], 2017). Exercise is considered one of the most effective prevention strategies for reducing obesity and has been documented to decrease chronic pain. The purpose …

Improving Satisfaction For Patients With Diabetic Foot Ulcer Using A Diagnosis Specific Written Education Packet, Douglas W. Kozeluh

DNP Scholarly Projects

Diabetes mellitus is a significant health care concern affecting 30.2 million Americans in 2015. One of the most common, costly, and serious sequela of diabetes is diabetic foot ulceration (DFU), which may lead to lower extremity amputation. Up to 50% of DFUs and lower extremity amputations can be prevented through effective patient education (PE). PE provided through written information is one intervention designed to improve patient understanding and self-management practices in order to reduce the risks and complications of DFU. The purpose of this Doctorate in Nursing Practice (DNP) project was to determine if implementation of a DFU specific written …

The Impact Of A Poverty Simulation On Baccalaureate Nursing Students’ Attitudes, Kristen Smith

DNP Scholarly Projects

Poverty is an ongoing issue in the United States, with major implications for the health of U.S. citizens. In order to provide compassionate care, nurses must understand their own attitudes towards those living in poverty. The purpose of this study was to evaluate for possible changes in attitudes towards poverty in junior level BSN students after a poverty simulation intervention. Participants were surveyed using the Yun and Weaver’s Short Form Attitudes towards Poverty (SFATP) tool, which looks three factors of poverty attitudes: personal deficiency, stigma, and structural perspective.

The Adult Learning Theory provided the theoretical framework for the study. This …

Implication Of Concussion Preventative Behavior Through Youth Education On Playground Safety, Bryan Harris

DNP Scholarly Projects

The concern with concussions has taken our society by storm as it relates to the health consequences either: acute, chronic, and/or later in life as a result of experiencing a single or multiple concussions. Research is thriving on concussion diagnosis, management, and treatment and will continue to do so in the years to come. Preventative measures in a variety of forms is the cornerstone for dealing with concussions at this time; with evidence showing formal educational programs are effective. ThinkFirst: National Injury Prevention Foundation, provides educational programs for first through eighth grade students on prevention of brain, spinal cord, and …

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski

DNP Scholarly Projects

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if …

The Impact Of A Poverty Simulation On Practical Nursing Students’ Attitudes Towards Poverty, Jaime Crabb

DNP Scholarly Projects

Poverty is a multi-faceted global problem. Nurses and providers are front-line caregivers for this vulnerable population. In order to provide effective care, individuals must understand their own attitudes towards poverty. The purpose of this study was to evaluate for changes in Practical Nursing students’ attitudes towards poverty with the use of a poverty simulation based upon the Experiential Learning Theory. Participants were surveyed using the Short Form Attitudes towards Poverty (SFATP) tool. The ELT espouses that the best learning occurs when students actively engage in an experience, reflect upon it, and then apply that learning to future experiences. Statistical significance …

Reducation Of Catheter-Associated Urinary Tract Infections Through A Nurse-Led Collaborative At A Rural Midwestern Hospital, Natalie Pianetto Buck

DNP Scholarly Projects

Catheter-associated urinary tract infections (CAUTIs) contribute to patient discomfort, complications, prolonged hospital stays, increased healthcare costs, and increased mortality (Agency for Healthcare Research and Quality [AHRQ], 2015). Despite the fact that these infections have proven to be preventable, CAUTI rates continue to exceed the national benchmark (Centers for Disease Control and Prevention, 2016a; Meddings et al., 2014). Evidence-based guidelines propose a bundle method is the most effective way to successfully reduce CAUTIs (AHRQ, 2015; Gould et al., 2017; Lo et al., 2014). The purpose of this research was to demonstrate whether a nurse-led collaborative, which bundled evidence-based interventions to reduce …

Moodle-Based Chlamydia Awareness Project To Increase Intention To Test In College Freshmen Males: A Dnp Scholarly Project, Adam Burri

DNP Scholarly Projects

In 2016, there were over 1.5 million cases of chlamydia reported in the United States with prevalence rates highest in people under 25 years of age (Centers for Disease Control and Prevention, 2017). Researchers have suggested that college aged adults (age 18-25) should be targeted for chlamydia educational programs because these individuals are lacking in knowledge about chlamydia prevention, infection, symptoms, and screening methods (Goundry, Finlay, & Llewellyn, 2013; Rutledge, Siebert, Chonody, & Killian, 2011). This scholarly project utilized a quasi-experimental, single-group pretest-posttest design and used a modified version of the Sex, Drugs, and Rock’n’Roll Questionnaire designed by Lim et …

Implementation Of A Scripted Debriefing Tool In Simulation-Based Nursing, Mary Kidd

DNP Scholarly Projects

In nursing education, simulation represents real patient scenarios that are designed to enable students to practice combining theoretical knowledge with clinical skills within a controlled environment (Bland, Topping, & Wood, 2011). Debriefing is a facilitated reflection of the simulation experience and is performed to uncover relationships among the events, actions, thought processes and outcomes with the intention of improving future practice (Cheng et al., 2014; Kolbe, Grande, & Spahn, 2015). Without proper debriefing, erroneous critical thinking, decision-making, and clinical judgement may go uncorrected, potentially negatively impacting patient care. There is an abundance of literature on debriefing methods; yet, empirical evidence …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

DNP Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

Preterm Labor Assessment Toolkit Implementation, Mandi Wilkins

DNP Scholarly Projects

ABSTRACT

PRETERM LABOR ASSESSMENT TOOLKIT IMPLEMENTATION

Mandi Mae Wilkins

Every year 10% of babies in the United States are born premature. Prematurity is the leading cause of infant mortality. Standardized preterm labor (PTL) assessment protocols reduced preterm birth rates, decreased costs, and resulted in more timely diagnoses and prevented the overtreatment of pregnant women who were not experiencing true preterm labor. At a Midwestern, Level II trauma hospital with regional neonatal intensive care unit and 700 annual deliveries, a Preterm Labor Assessment Toolkit (PLAT) was implemented and pre- and post-data garnered. The toolkit contained a provider algorithm and an order …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

DNP Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Advance Care Planning: Cardiopulmonary Resuscitation Education And The Veteran Population, Rhian Elizabeth Dalgord

DNP Scholarly Projects

Cardiopulmonary resuscitation educational tools are prevalent in the realm of advance care planning and shared decision making. However, tools developed specifically in the interest of veterans are lacking. This deficit impedes the advance care planning process. Easy-to-use advance care planning tools that meet specific population needs can result in a threefold higher rate of usage. The purpose of this DNP scholarly project was to evaluate the use of the Honoring Healthcare Choices CPR educational handout through administration of the iDECIDE CPR Decision Aid Acceptability questionnaire to veterans (N=70) residing in a veterans nursing home in the Midwest. The iDECIDE CPR …

Oral Health Literacy In Parents And Care Providers Of Young Children, Rachel Nye

DNP Scholarly Projects

Tooth decay ranks first as the most common chronic disease in childhood (U.S. Department of Health and Human Services [HHS], 2000). In addition to the morbidity directly related to cavities, there are a myriad of other systemic implications of this disease. The purpose of the study was to determine baseline oral health literacy levels for a sample of pediatric caregivers living in the Upper Peninsula and to determine the impact of a community based education program on these levels. The program was offered at three locations. A paired sample t-test of sixty-four complete data sets demonstrated a statistically significant increase …

Using Clinical Supervision To Improve Interprofessional Collaboration, Melissa Copenhaver

DNP Scholarly Projects

USING CLINICAL SUPERVISION TO IMPROVE

INTERPROFESSIONAL COLLABORATION

By

Melissa Copenhaver

Interprofessional collaboration (IPC) is important to the future of the healthcare system in that IPC is part of the solution for promoting better healthcare outcomes (Gilbert, Yan, & Hoffman, 2010; Reeves, Perrier, Goldman, Freeth, & Zwarenstein, 2013). Marshall (2011) notes that “interprofessional collaborative practice promotes team identity, conserves energy by a unity in direction, and invites harmony of efforts” (p. 158). The skills needed to engage in IPC are cultivated through interprofessional education (IPE) (Reeves et al., 2013). Currently, at Northern Michigan University (NMU), there are limited opportunities included in …