Digital Commons Network^™

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Ketamine Infusion Protocol & Patient Education Pamphlet For Complex Regional Pain Syndrome, Ricardo Aranda, Giles Howard

Doctor of Nursing Practice Projects

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD) and causalgia, is a debilitating neurological disease accounting for 1.2% of all chronic pain conditions, with eighty percent being severely disabled (Zhao et al., 2018). Altered pain pathways in CRPS patients result in resistance to traditional methods of analgesia, contributing to poor quality of life and unanticipated hospitalizations. Multiple meta-analysis studies suggest ketamine infusions effectively lower chronic pain scores in CRPS patients. Despite the evidence, a lack of standardized ketamine infusion protocols creates a barrier to provider implementation. This Doctor of Nursing Anesthesia project aimed to develop a …

What's In Your Nursing Labor Toolkit? Promoting Patient Satisfaction While Decreasing Cesarean Section Rates., Jennifer Isip, Damaris Peralta, Hannah Zions

Doctor of Nursing Practice Projects

Cesarean section is a complex surgical procedure with considerable risk for complications during and after surgery, increasing the likelihood of future pregnancy complications. It is crucial to properly educate patients and nursing staff regarding intentional maternal positioning to facilitate successful vaginal delivery through optimal fetal positioning in the vaginal canal throughout the labor process. This study reviewed 28 participants to determine if intentional maternal positioning can promote vaginal birth and increase patient satisfaction. Participants were pregnant women experiencing protracted labor/labor dystocia without a history of prior c-sections, uterine surgeries, or large gestational age (LGA) newborns. Patients who underwent primary cesarean …

Implementing An Insomnia Assessment And Management Algorithm In A Rural Pirmary Care Clinic, Rebekah Gaffin

Doctor of Nursing Practice Projects

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

Hepatitis C Management For Individuals In Custody, Oluronke D. Akinola

Doctor of Nursing Practice Projects

The hepatitis C virus (HCV) is a pathogen that spreads through blood and causes hepatitis C disease, a liver infection. Early infection symptoms are rare, making it a silent killer. HCV, the chronic liver disease accounts for half of all hepatocellular carcinoma cases and is the leading cause of liver transplantation in the US. This quality improvement project aimed to create an educational toolkit for the Department of Correction staff working with individuals in custody refusing HCV treatment. The education tools comprised an infographic flyer (English and Spanish) to teach individuals in custody about HCV treatment and a PowerPoint presentation …

Increasing Oral Health In A Midwest Elementary School: Quality Improvement Project, Dee Young

Doctor of Nursing Practice Projects

Marginalized communities experience barriers to accessing oral healthcare in the United States (US). Due to this, many children are left to use the emergency department (ED) for dental care. The purpose of this Doctor of Nursing Practice (DNP) project was to improve oral health services access in children at one suburban Midwest elementary school. The objectives of this project were: a) to improve the efficiency of students registering in Fall 2023 to access available oral health exam services, b) to increase the number of students who receive an oral health exam compared to the number in the previous school year. …

Evaluation And Education Of Enhanced Recovery After Surgery Protocols For Total Knee Arthroplasty, Lauren Hunt, Jessica Prost

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) utilizes a multimodal, multidisciplinary perioperative protocol to minimize hospital length of stay, surgical complications, readmissions, and patient hospital costs (Frassanito et al., 2020). The protocols were initially established for abdominal and colorectal surgical patients; however, ERAS protocols are now widely used in other areas, including orthopedic surgery (Kaye et al., 2019). To achieve the maximum benefits, ERAS protocols must contain preoperative, intraoperative, and postoperative components. A rural critical access hospital in Eastern Illinois, Crawford Memorial Hospital, serves numerous patients requiring total knee arthroplasties (TKA). While the providers utilize some aspects of ERAS protocols for these …

Creation Of An Educational Pamphlet For Patients Receiving Upper Extremity Peripheral Nerve Blocks, Elizabeth Hamlin

Doctor of Nursing Practice Projects

Upper extremity peripheral nerve blocks (PNB) are utilized in anesthesia as a sole anesthetic or in combination with another technique for pain management. Perioperative registered nurses (RN) are directly involved in PNB procedures, patient care, and patient education. Patients typically do not have access to anesthesia personnel to address questions and education preoperatively, leading to increased importance of patient education and educational resources concerning anesthesia. After a literature review, a PowerPoint presentation and patient education pamphlet were implemented at a surgery center in Edwardsville, Illinois. The PowerPoint presentation was created for RN education, and the pamphlet was utilized as a …

Introduction Of Osteoporosis Screening Within Orthopedic Clinics, Kimberly Dray

Doctor of Nursing Practice Projects

Abstract

Osteoporosis affects millions of Americans, causing life life-altering medical issues and an economic burden estimated to be over 17 billion dollars. Primary care providers are responsible for screening and early detection of osteoporosis; however, gaps have been identified. Orthopedic surgeons can screen during clinic visits to help close the gap. The purpose of this project was to introduce the usage of a screening tool in a large orthopedic clinic to improve detection. Participants were provided with education regarding osteoporosis and the screening tool with continued support throughout the 8-week study. Using the Simplified Calculated Osteoporosis Risk Estimation (SCORE) tool, …

Iron Deficiency Screening Implementation For Patients With Heart Failure Reduced Ejection Fraction, Rachel Kister, Brittany Beler, Nicholas Bauder

Doctor of Nursing Practice Projects

Heart failure with reduced ejection fraction (HFrEF) significantly impacts patients’ quality of life. Similarly, iron deficiency (ID) anemia decreases the patient’s oxygen levels and functional ability due to fewer red blood cells and less oxygen binding capacity. Patients with heart failure frequently have a commonly overlooked comorbidity of ID anemia, which impacts almost 50% of the ambulatory patient population. Patients with HFrEF and ID anemia have decreased exercise capacity, increased fatigue, reduced oxygenation due to low hemoglobin, and increased hospital readmissions. The end goal of this implementation project was to increase the number of times providers screened for ID anemia …

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Establishing Community Connections For A Mobile Health Clinic, Shunera Wells

Doctor of Nursing Practice Projects

Within the United States, there are many healthcare disparities. The supply and demand for mobile health have increased since the start of the COVID-19 pandemic. This project's purpose was to improve and develop partnerships between communities and a new mobile health clinic with the intention of increasing healthcare services availability. The new mobile health clinic is an extension of a well-established university brick-and-mortar clinic. A survey was sent to county housing authority residents to determine community healthcare needs for various services including preventative and acute care services. Residents filling out the survey provided information about the targeted patient population and …

Nurse Anesthesiology Education For Regulators, Jonathan Alvarado, Kevin Stein

Doctor of Nursing Practice Projects

Governmental and regulatory entities like the state board of nursing have an active role in regulating all nursing fields, including anesthesiology. The lack of a required nurse anesthesiology representative on the board presents a potential knowledge gap related to anesthesiology practice. Board members and staff must make decisions related to nurse anesthesiology that may cause anxiety due to its complexity. The lack of education in this area allows one to make wrong decisions or spend extended time looking for the correct information.   The main objective of this project was to provide an educational module on nurse anesthesiology practice to the …

Art Therapists’ Familiarity With And Beliefs About Twelve-Step Addiction Recovery Groups, David Brickhouse

Art Therapy Counseling Final Research Projects

This research proposed to study what art therapists know and believe about twelve-step addiction recovery groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA). The aim was to better understand the field’s familiarity with 12-step recovery, identify misconceptions about 12-step groups, and assess the comfortability of incorporating 12-step philosophy into clinical practice. Findings include that art therapists integrate 12-step into art making, are likely to refer clients to 12-step groups, and that higher familiarity with 12-step was associated with more positive perceptions and greater integration with clinical practice. The study participants also agreed that accessibility was …

Understanding Clay And Its Media Properties Through The Expressive Therapies Continuum, Anne Geisz

Art Therapy Counseling Final Research Projects

For centuries, clay has been used by civilizations to hold food, memories, and records of history. To this day, it is used by engineers, hobbyists, artists, art therapists and many more. This art based, heuristic study explores clay through the researcher’s ongoing practice with the material, within the framework of the Expressive Therapies Continuum (ETC) and examines how its unique media properties make it such a versatile material for both ceramic artists and art therapists. Results exhibit these unique media properties and clay’s ability to reach all levels of the ETC through collected data of images, journals, critiques, and notes. …

The Role Of Acculturation In The Professional Identity Of Art Therapy And Counseling International Students, Ana Marcela Tobar Chavez

Art Therapy Counseling Final Research Projects

In a country of immigrants, the concept of acculturation needs to be familiar to almost any professional in the mental health field and it is a reality for immigrants and international students. As international and immigrant students continue to join the Art Therapy Counseling profession, it is important to understand how acculturation plays a role in the development of their counseling professional identity. Unlike most master’s students in the art therapy counseling profession, international and immigrant students go through unique experiences such as being born and raised in a different country with difference in cultures, languages, and immigration statuses that …

The Relationship Between Eating Disorders, Attachment Styles And The Uses Of Art Materials, Tsai-Yu Chen

Art Therapy Counseling Final Research Projects

Previous studies showed that both eating disorder (ED) behaviors and attachment styles (ASs) could reflect on individuals’ uses of art materials. This mixed methods study aimed to explore the correlation between ED diagnoses and ASs, investigate clients’ selection of and familiarity with art materials, as well as understand how clients’ self-reports of media interactions match clinical observations. Participants were adults receiving residential care in an ED facility in Midwestern United States. Data were collected through surveys, chart reviews, and discussions with the participants’ therapist. The results of this study found a high prevalence (85%) of insecure attachment in the population. …

Melting Premenstrual Dysphoric Disorder/ Premenstrual Exacerbation Symptoms With Metalsmithing: A Group Process, Maureen Bella Russo

Art Therapy Counseling Final Research Projects

People experiencing Premenstrual Dysphoric Disorder/Premenstrual Exacerbation, PMDD/PME, frequently live with debilitating symptoms that can arrest their daily life functions (Barker-Smith, 2020). Finding art to process and transform painful emotions that align with PMDD/PME hormonal depression/anxiety, may assist in supporting people to keep choosing life, especially when these art practices involve group settings and community artmaking (Phillips & Rosal, 1989; Robb, 2022). Metalsmithing requires significant cognitive awareness and promotes mind/body connections in its elemental art form (Carlson, 2015). This proposal outlines a group process involving 8-12 people who will receive a beginner’s metalsmithing, 12-week studio art program at Hyde Park Arts …

Communication Beyond Words, Anna Brough

Art Therapy Counseling Final Research Projects

This research explores the definition and use of nonverbal communication within the therapeutic setting and the treatment of selective mutism by clinical providers. A phenomenological research method was used to interview three art therapists and two therapists without art therapy training. These interviews were used to explore their understanding and awareness of nonverbal communication within the context of providing treatment to clients with selective mutism. The analysis of participants’ discussions of their experiences of treating those with selective mutism revealed four major themes: Nonverbal Communication, Therapeutic Presence and Alliance, Art Materials and Interventions, and Culture and Society. Findings suggest no …

Mentorship Program Including Alumni, Nicole Brainin

Doctor of Nursing Practice Projects

The landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program's impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and …

Discharge Lounge Utilization, Jessica Goneh, Areo Comonal

Doctor of Nursing Practice Projects

Efficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative …

Emotional Intelligence And Srna Success Utilizing A Sim Experience, Melody Gassoway, Kaleigh Peters

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) face many challenges in meeting the rigorous demands of their doctoral-level training. Research demonstrates that high levels of emotional intelligence (EI) contribute to SRNAs’ academic and clinical success and improve patient safety and quality of care. Simulation is emerging as an educational tool to enhance the EI skills of students training in highly stressful professions and demonstrates promising benefits for SRNAs, such as improved decision-making, critical thinking, self-awareness, and self-regulation (Moriber & Beauvais, 2017; Dix et al., 2021). This doctoral project aimed to determine the efficacy of a high-fidelity simulation for strengthening the EI skills …

Qualitative Vs. Quantitative Train Of Four, Caleb Culbreath

Doctor of Nursing Practice Projects

The growing body of evidence linking residual neuromuscular blockade (NMB) to postoperative complications has underscored the need to integrate quantitative neuromuscular monitoring techniques into anesthesia practice. This study, conducted at a tertiary care center in southern Illinois, investigates the gap between current clinical practices and the latest evidence advocating for objective monitoring. The study utilized a non-experimental pretest-posttest design to evaluate an educational intervention's effectiveness in increasing anesthesia providers' knowledge of quantitative neuromuscular monitoring techniques and enhancing their awareness of the incidence and clinical implications of postoperative residual neuromuscular blockade. Analysis of the pretest and post-test responses revealed significant improvements …