Digital Commons Network^™

Cultural Competency Training For U.S. Army Security Force Assistance Brigade (Sfab) Brigade Medical Teams, Jacob Blount

Doctor of Nursing Practice Projects

The United States Army began standing up Security Force Assistance Brigades (SFAB) in February 2018. The Brigade Medical Team (BMT) is an 11-person, interdisciplinary Army National Guard team. National Guard Soldiers only have one weekend per month and two weeks of annual training per year to develop/maintain cultural competence. The researcher investigated the efficacy of the Cross-Cultural Competence Trainer (3CT) V2 course to develop and maintain cultural competency in BMT personnel. Pre-test results were obtained from three military medical personnel and a post-test immediately after the course. Participants completed a longitudinal test 28-31 days after the post-test. There was a …

Development And Implementation Of An Orthopedic Enhanced Recovery After Surgery Protocol, Beth Mccoy

Doctor of Nursing Practice Projects

Abstract

As life expectancy rates have grown and individuals desire a more active lifestyle the number of total hip arthroplasty and total knee arthroplasty surgeries performed has grown significantly. Enhanced recovery after surgery (ERAS) protocols have been shown to decrease the financial impact and improve patient outcomes in total joint surgeries. After a literature review a multidisciplinary team met and developed an ERAS protocol for total joint replacement surgeries to be implemented at a 250-bed community hospital in central Illinois. After an eleven-question pre-test was given to 34 participants consisting of perioperative nursing staff, anesthesia, and surgeons assessing their knowledge …

Implementation Of Enhanced Recovery After Surgery (Eras) Protocol After Cystectomy: A Quality Improvement Project To Evaluate Bowel Function With Implementation Of Eras Protocol, Weruche Agube

Doctor of Nursing Practice Projects

Abstract

The purpose of this Quality Improvement project was to develop and implement an enhanced recovery after surgery (ERAS) protocol for cystectomy patients at a regional hospital in central Illinois. Specific goals included reducing patient’s length of hospital stay, reducing occurrence of postoperative ileus after surgery as well as educating the nurses involved in patient care about effective implementation the protocol. An educational presentation and knowledge assessment via testing was developed and subsequently presented to the nurses both inpatient and outpatient at the host facility. A specific protocol was crafted after discussion with stakeholders and the ERAS protocol was finalized …

The Effect Of An Online Mental Health Promotion Program During Covid-19, Juliana Maldonado

Doctor of Nursing Practice Projects

Background

The negative impact of Coronavirus 19 (COVID-19) on mental health has been observed through the pandemic. People have had to adapt to a new norm of social distancing, wearing a mask, and abstaining from big group gatherings. These changes have impacted all levels of society and the rise of mental health care continues to grow as COVID-19 continues at this time. Mental health promotion strategies may be enhanced through the use of telehealth.

Purpose

To determine if a six-week online mental health promotion intervention would improve the GAD-7 scores of participants.

Methods

This project utilized a quantitative quasi-experimental pre-test/post-test …

The Effect Of An Online Educational Intervention On The Community Knowledge Of Physical Health, Mental Health And Self-Efficacy During The Covid-19 Pandemic, Kerstin Ashby Ferguson

Doctor of Nursing Practice Projects

Background

Community health education during times of pandemic is of utmost importance to disseminate information regarding safety precautions, educate the public regarding the disease process, and provide accurate health information during a time when individuals are specifically vulnerable to inaccurate sources of information. During the COVID-19 pandemic, physical gatherings were highly restricted; therefore, it became important to incorporate technology into the educational process.

Purpose

The purpose of this project was to determine if a thirty-day, online community health education program would increase the health knowledge and self-efficacy of participants.

Methods

This project utilized a quantitative quasi-experimental pre-test/post-test design from a …

Nurse Champions For Medication Reconciliation: Making A Difference, Stacey Waters

Doctor of Nursing Practice Projects

Background: Medication reconciliation creates a significant safety risk when patients transition from one care environment to another. This is especially true for older adults who may have multiple medications, poor health literacy, or multiple providers. During care transitions, collecting accurate information about previous medication regimens can be a challenge. If providers are unskilled at eliciting the needed information, discrepancies can result, leading to medication errors, poorer outcomes, or patient harm. These discrepancies, if unresolved, can follow the patient throughout hospitalization and back into the outpatient setting, leaving patients unable to manage their care at home safely.

Purpose: The objective …

The Effect Of A Provider Education Program On Antibiotic Overuse In Acute Sinusitis, Shawna Berg

Doctor of Nursing Practice Projects

Background: Acute sinusitis is a typical patient diagnosis encountered in the outpatient setting. Inappropriate antibiotic prescribing is a well-documented concern. The overprescribing of antibiotics is associated with increased antibiotic resistance, cost, and adverse side effects. Despite the research, improper prescribing of antibiotics continues to be problematic.

Purpose: A provider education program was implemented at three separate urgent care centers for healthcare providers concerning antibiotic stewardship. The objective was to evaluate the effectiveness of a provider education program to examine changes in the immediate antibiotic prescribing habits.

Design Method: A pretest-posttest quasi-experimental design with provider educational intervention was implemented concerning antibiotic …

The Evolution Of Nursing Leadership: Novice To Expert, Yolanda Chandler

Doctor of Nursing Practice Projects

The nurse leader is critical in staff development, contentment, retention, patient safety, quality of care, and achievement of organizational goals. Nurse leaders in a managerial role must lead, oversee, delegate, guide, and support staff nurses. They are expected to demonstrate clinical competence, make decisions, communicate effectively, be visible and approachable, and empower others. Some skills learned as a charge nurse can help the new manager adapt to the role, but many healthcare organizations offer a novice nurse manager a limited orientation.

Purpose: Effective nursing leadership requires nurse managers to have clinical experience, think critically, motivate others, communicate and delegate constructively, …

Can We Talk? Bridging The Communication Gap Between Nurses And Providers, Jolie Wildinger

Doctor of Nursing Practice Projects

Background: Effective communication is the key to successful relationships and improving patient care. Effective and efficient communication is also essential in producing a healthy self-confidence and knowledge base, which is needed by nurses and physicians who are providing daily care to patients.

Purpose: The purpose of this performance improvement project is to increase the communication competence and self-awareness of staff nurses during intraprofessional interactions with the healthcare providers.

Methods: A quasi-experimental quality improvement process that included a pre and post-survey alongside an educational program to arm nurses with information and communication techniques needed to help build relationships to foster effective …

Improving Patient Follow-Up For Laboratory Testing Using Telephone Calls As An Intervention: A Quality Improvement Project, Jill Gray

Doctor of Nursing Practice Projects

Background: Today, in the United States, 74,273 individuals are actively waiting for an organ transplant. Of those, approximately 8,000 need a liver transplant. With the increased need for an organ transplant, the use of increased risk donors is on the rise. In these patients, it is imperative to monitor for the transmission of HCV, HBV, and HIV.

Purpose: Increase compliance for monitoring transplant recipients who receive organs from increased risk donors for HCV, HBV, and HIV.

Design method: In order to measure the outcomes of this project, the following instruments were used: parametric testing and paired t-test. Parametric …

Evaluation Of Obstructive Sleep Apnea In Veterans With Coexisting Psychiatric Symptoms, Zenith Perpignani

Doctor of Nursing Practice Projects

Abstract

There is a growing body of evidence that suggests a correlation between post-traumatic stress disorder (PTSD), nightmares with broken sleep, obstructive sleep apnea (OSA), and worsening of symptoms by OSA, Veterans who received treatment at a Midwest Veteran Affairs (VA) Center for Behavioral Health were often subject to variable wait times between scheduling of behavioral health and primary care providers (PCP). The purpose of the doctoral project was to reduce a Veteran's wait time for evaluation by a PCP after having been identified as at risk for OSA during routine psychiatric evaluation. The project examined Veteran's reports and measures …

Patient Assessment And Provider Education Regarding Antibiotic Use In The Treatment Of Viral Uris In The Urgent Care Setting, Ashlee Schoby, Candra D. Hulskotter

Doctor of Nursing Practice Projects

Improving Antibiotic Stewardship Through the Use of Patient Assessment and Provider Education Regarding Treatment of Viral URIs in the Urgent Care Setting

Candra Kronewitter and Ashlee Schoby

Date of Award

Spring 5-2020

Document Type

DNP Project

Project Team Faculty Member

Mary Zerlan, CRNA, DNP, APN

Project Team Faculty Member

Kay Gaehle, PhD

Keywords

Antibiotics, Antibiotic stewardship, URIs, Upper respiratory infections, Urgent care, ABUSE screening tool

Abstract

Antibiotic-resistant bacteria is a growing problem in the United States. The misuse or overuse of antibiotics is being considered the leading cause. Nearly 2-million individuals are infected with resistant bacteria yearly, and antibiotics prescribed …

A Pilot Of Prenatal Transitional Care Services In The Urgent Care Setting, Alexandra Huddleston, Gloria Pryzgoda, Tiffany Hazel

Doctor of Nursing Practice Projects

Established prenatal care leads to better outcomes and reduced healthcare expenditures. Inadequate prenatal care is associated with numerous risks. Many women face a variety of barriers that contribute to inadequate prenatal care. The purpose of this project was to create and pilot a new transitional care protocol to improve the referral rate of pregnant patients to establish prenatal care at a midwestern physician services (MPS) women’s health care clinic after a MPS express care visit. An extensive literature review was conducted, and a streamlined referral process linking pregnant patients to obstetric care was created to address identified barriers. The referral …

Laryngotracheal Stenosis, Kelsey Stuckey

Doctor of Nursing Practice Projects

Laryngotracheal stenosis (LTS) is the luminal compromise at the laryngeal, subglottic, or tracheal level (Gelbard et al., 2014). Various etiologies for LTS exist. Endotracheal cuff over-inflation, inappropriately sized endotracheal tubes, and sudden movements of the tube contribute to injury, as well as anatomical differences(Cardillo et al., 2010; Divatia & Bhowmick, 2005; Medina et al., 2009; Miñambres et al., 2009; Nikolovski et al., 2019; Zaghi et al.,2016). The influence of estrogen may contribute to the development of LTS in women during the third through fifth decades Dedo & Catten, 2001; Poetker et al., 2006; Valdez & Shapshay, 2002). The project goal …

A Difficult Vascular Access Algorithm Using Intraosseous Devices In The Elective Pediatric Surgical Population, Cory R. Austin

Doctor of Nursing Practice Projects

In pediatric patients undergoing elective surgery, anesthesia is commonly induced via mask inhalation followed by peripheral IV placement before proceeding to airway management. However, IV access is often unpredictable and difficult to obtain in pediatric patients, with attempt success between 35% to 74%. During IV attempts, many dangerous clinical situations can occur amid limited options to deliver necessary medications. Failure to attain IV access may ultimately require extremes such as CVC placement or procedure cancellation. In this project, a difficult vascular access algorithm including intraosseous devices as an alternative was developed based on current evidence, existing algorithms, and implementation site …

Addressing Hypertension Health Literacy In Black Individuals Who English Is Their Second Language, Uche Olateru

Doctor of Nursing Practice Projects

Hypertension is a primary preventable risk factor for cardiovascular disease. Despite advances in preventive and treatment measures, related to blood pressure control, the prevalence of hypertension in the United States remains high among Black People of immigrant and non immigrant communities. Healthcare is increasingly complex, and health literacy problems have increased due to demands by healthcare stakeholders for patients to assume a more independent role in taking charge of their health. A quality improvement project was conducted in a Faith based community to improve the knowledge of participants about hypertension. The objective of this project was to enhance lifestyle management …

Improving Outcomes For Patients With Osa Receiving Anesthesia, Natalie Bram

Doctor of Nursing Practice Projects

Obstructive Sleep Apnea (OSA) is a dangerous sleep disorder that is rising in prevalence, afflicting 29.4 million Americans or 12% of the U.S. population (AASM, 2017). Although OSA has the ability to negatively impact postoperative outcomes, numerous patients remain undiagnosed, unidentified, and improperly treated for OSA at the time of surgery (Baugh, 2013; Opperer et al., 2016). Evidence supports the STOP-BANG questionnaire as an effective, easy to use, and highly sensitive tool for screening patients for OSA (Chiu et al., 2016; Dolezal et al., 2011; Lakdawala, Dickey, & Alrawashdeh, 2018).

A 137-bed hospital had no standing preoperative protocol for the …

Fascia Iliaca Blocks For The Treatment Of Hip Fractures In The Emergency Department, Megan Hahn

Doctor of Nursing Practice Projects

Due to the aging population, the number of falls are increasing, leading to an increased number of individuals with hip fractures presenting in emergency departments (ED). Opioids are often administered for intraoperative pain related to hip fractures, which may result in a number of adverse effects, especially in the elderly. There is strong evidence suggesting that the use of fascia iliaca blocks (FIBs) in the ED can minimize opioid use, and improve patient outcomes and recovery. FIB is a compartment block that delivers local anesthetic around the lumbar plexus to provide analgesia associated with hip fractures.

The purpose of this …

Preventing Substance Use Disorder In Anesthesia Providers, Tyson Rogers

Doctor of Nursing Practice Projects

Developing substance use disorder is considered one of the most serious occupational risk factors for anesthesia providers. The purpose of this project was to identify the prevalence and risk factors of substance use disorder within the anesthesia community and to signify the importance of early education and awareness to help prevent the development of substance use disorder through early education, identification, and awareness. The project consisted of an educational PowerPoint that was placed on Southern Illinois University Edwardsville’s (SIUE) wellness website within Black Board. The third-year nurse anesthesia students at SIUE were sent an email on how to access the …

Improving Emotional Intelligence Skills In Student Registered Nurse Anesthetists, Kathryn M. Gratza

Doctor of Nursing Practice Projects

Becoming a certified registered nurse anesthetist (CRNA) involves didactic and clinical course work that challenges the student’s cognitive, mental, and emotional well-being. Standardized cognitive factors, such as grade point average, are utilized for nurse anesthesia program admission, but those factors do not take into account the student’s emotional intelligence. The ability to manage one’s emotions has a positive correlation with academic success (Beauvais, Stewart, DeNisco, & Beauvais, 2014) and has been correlated with greater success in nurse anesthesia programs (Collins, 2013).

The goal of this doctoral project was to increase the emotional intelligence of first-year students in the nurse anesthesia …

Development Of An Emergency Preparedness Protocol In An Office Setting, Amanda Burgesen

Doctor of Nursing Practice Projects

Office-based practices are not as stringently regulated as hospitals or ambulatory surgical centers. The lack of government oversight places the responsibility heavily on office-based practitioners to properly exercise their professional ethics to ensure their patients are receiving the highest quality of care while remaining safe. The purpose of this quality improvement project was to develop and implement an emergency activation protocol for a local gastroenterologist office in Southern Illinois that promotes emergency preparedness. The emergency activation protocol provided recommendations for staff training on emergency preparedness, mock codes, checking the crash cart, monitoring of the patient, medications available, and equipment that …

Developing The Pedis Pediatric Obstructive Sleep Apnea Screening Tool, Steven Sumpter

Doctor of Nursing Practice Projects

Obstructive sleep apnea (OSA) is the most common type of apnea in the pediatric population. Its prevalence is 0.7%-3.0% (Garcia et al., 2016). The dangers of OSA are multiplied in conjunction with anesthesia because anesthesia resembles a state of sleeping, relaxing the airway, and requiring more intense airway monitoring. Childhood OSA includes increased risk for developing neurocognitive impairment, behavioral problems, failure to thrive, hypertension, cardiac dysfunction, systemic inflammation, and increased healthcare costs (Kothare et al., 2015). A perioperative pediatric OSA screening tool is necessary to reduce airway risks. The PEDIS screening tool is a brief, efficient, and evidence-based tool capable …

Developing Multi-Modal Education For Obstetric Critical Care Nurses, Colette Henke, Rebecca Kojak

Doctor of Nursing Practice Projects

The maternal morbidity and mortality rates in the United States continue to outpace other industrialized nations. Across the United States, a variety of obstetric critical care programs have emerged to address the unique healthcare needs of the high-risk obstetric population. One teaching and specialty hospital in a Midwest metropolitan city responded to the needs of high-risk obstetric patients by developing a critical care program within its service line. Because high-risk obstetric patients present with multi-faceted and complex needs, this program represented varied nursing expertise, including obstetric and intensive care specialties. Because care was delivered within the ICU setting, nurses from …

Enhancing The Success Of Underrepresented Nursing Students: Developing A Posture Of Cultural Humility, Diane Debra Saleska

Doctor of Nursing Practice Projects

Background: Educators who actively explore ways to facilitate positive perceptions of comfort, satisfaction, and cultural humility lead to strong student-educator relationships and optimal student outcomes (Abdul-Raheem, 2018). Active exploration requires a posture of cultural humility. Perceiving faculty as academic stewards of the learning environment, this project focuses on faculty development to increase awareness of systemic bias, micro-inequalities, and personal bias that exist in nursing education. Increased awareness through humility allows faculty to develop a more engaging, welcoming, and culturally sensitive learning environment for underrepresented nursing students.

Purpose: The purpose of this DNP project study is to determine if faculty perception …

Implementation Of Supplemental Oral Anticoagulant Education To Promote Medication Adherence, Blake Cory

Doctor of Nursing Practice Projects

Proper adherence regarding high-risk medications such as oral anticoagulants (OAC) is essential for reducing the incidence of adverse events such as thrombosis or major bleeding when dosages are missed or inappropriately administered.

The goal of this project was to reduce these events by supplementing current educational practices at a metropolitan cardiac electrophysiology office with new medication education protocols, the development of specific medication informational handouts, and provider training. Providers and staff were provided with medication specific education for Vitamin K Antagonists (VKA) such as warfarin and Non-Vitamin K Agonists (NOACs) such as dabigatran, rivaroxaban, and apixaban for those patients initiating …

Infusion Of Cultural Humility In Hospice Care: Effects Of A Cultural Humility Training And Simulation Exercise On Hospice Employees, Sarah Jones

Doctor of Nursing Practice Projects

Not available

Effectiveness Of A Delirium Prevention Initiative On An Inpatient Neuroscience Unit, Teresa Cyrus, Brenda Hall, Rebecca Wenthold

Doctor of Nursing Practice Projects

The MIND project is an Interprofessional Evidence-based Clinical Scholar project aimed at delirium prevention for acute care neuroscience patients. The MIND Project stands for Meeting the Inpatient Needs of Delirium and included three objectives. The first objective was to increase nurses’ knowledge of delirium prevention and improve their confidence in identifying delirium. The second was to design a volunteer program to assist health care staff in preventing delirium. The third objective was to establish an ongoing monitoring approach for ensuring continued improvement in preventing delirium.

Crna To Cvicu Rn: Implementation Of A Standardized Patient Handoff Checklist For Post-Surgical Heart Patients, Ashley Mcgrath

Doctor of Nursing Practice Projects

Patient handoffs occur when the information and responsibility of the patient is transferred from one health professional to another. Ineffective communication during the critical postoperative phase of the transfer of care (TOC) has been associated with extended hospital stays, increased healthcare costs and patient dissatisfaction. In 2007, the Joint Commission National Patient Safety Goals proclaimed the importance of a standardized handoff process for effective handoffs. The purpose of this quality improvement doctoral project was to assess if the utilization of a standardized TOC checklist from the operating room to the cardiac intensive care unit (CVICU) for post-heart patients improved communication …

Implementation Of Crisis Checklist For Local Anesthetic Systemic Toxicity (Last) In The Parturient Patient, Annelise Contino

Doctor of Nursing Practice Projects

The chief anesthesiologist at a large hospital in Illinois requested education and a checklist on the treatment of Local Anesthetic Systemic Toxicity for the medical team involved in the care of parturient patients. The implementation of The Stanford Anesthesia Cognitive Aid Group checklist for LAST and an educational session was completed for all staff involved in the care of the parturient patient. A PowerPoint presentation was utilized to educate on the early recognition and treatment of LAST. The presentation was implemented at the obstetrics department staff meetings and the monthly anesthesia department meeting. A pretest was completed prior to education …

Implementation Of A Provider In Triage Program In A Level Iii Emergency Department, Rachel Parmer Mph, Msn, Fnp- Bc

Doctor of Nursing Practice Projects

Background: This project implemented a Provider in Triage (PIT) system in a small emergency department (ED) in Washington State. The employment of a PIT to decrease patient waiting time and improve ED flow was supported by a literature review. A needs assessment was conducted, which indicated potential benefit from a PIT system, particularly because several ED metrics are worse than national average.

Aims/Objectives: This project aimed to develop, implement, and evaluate a PIT system by employing ED Advanced Practice Clinicians (APCs). The objectives consist of evaluating the impact of a PIT system on the percentage of patients who leave without …