Digital Commons Network^™

Screening For Social Determinants Of Health Screening In The Primary Care Setting: A Quality Improvement Project, Arifa Khan

DNP Projects

Significance and Background: Social determinants play a major role in the overall health of our nation. While screening for social determinants of health (SDOH) in the primary care setting is encouraged, there is no streamlined process in place. Studies have determined that improved SDOH screenings can result in better patient outcomes and a decrease in healthcare costs. A protocol to improve SDOH screenings was needed to guide patient outcomes at a Federally Qualified Health Center (FQHC) in Connecticut.

Purpose: Deliver education to providers and healthcare staff across the health system on significance of social determinants of health and PRAPARE screening …

Implementing The Phq-9 Tool To As A Standard Of Practice In A Mental Health Setting: A Quality Improvement Project, Gabriella Laferriere

DNP Projects

The objective of this project was to implement the Patient Health Questionaire-9 (PHQ-9) tool as a standardized protocol for depression screening on patients being treated at an outpatient mental health facility in Central Connecticut, where there was no depression screening protocol in place. The clinical question being asked was, is there any correlation between use of the PHQ-9 tool and changes being made to a patient’s depression treatment plan?

Methods: A data collection form was completed by the psychiatric nurse practitioner on each patient who met the following criteria: Depression and/or anxiety was the patient’s primary diagnosis and patient was …

Implementing Teach Back Heart Failure Education To Improve Self-Care And Reduce Re-Hospitalization: A Quality Improvement Project, Sweata Patel

DNP Projects

Heart failure (HF) is a major health concern. External evidence supports the use of the teach-back method for patient education to promote self-care behaviors in patients with HF which may also reduce rehospitalizations. Patients with HF at one home health agency in New England participated in the quality improvement project which consisted of delivering 20 minute weekly standardized teach-back educational sessions covering topics of HF self-care over six weeks. The existing patient education materials and two new resources, Medication Tracker and Self-Check Plan for HF management, were reviewed. Three questions from the Self-Care of Heart Failure Index were asked during …

The Impact A Nurse Recruiter Has On Nursing Staff Shortages And Nurse Manager Satisfaction In An Acute Psychiatric Facility, Johna Arnett

DNP Projects

Abstract

Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction.

Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two …

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Reducing Nursing Documentation Burden: Evaluation Of An Electronic Health Record Optimization Plan, Jessica Collins

DNP Projects

Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR.

Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

The Effect Of An Intervention To Improve Screening For Opioid Use In Patients With Post Traumatic Stress Disorder, Tammy Swartz

DNP Projects

Background: Rates of post-traumatic stress disorder (PTSD) were reported to be higher during COVID-19 than during any other epidemic in history. Patients diagnosed with PTSD are at an increased risk of experiencing opioid use disorder (OUD). Early detection, prevention, and treatment are essential to prevent OUD.

Purpose: The purpose of this project was to determine if education aimed at increasing nurses’ knowledge increased patient screenings for OUD.

Methodology: A baseline chart audit was performed to determine the number of patients seen in the emergency department with PTSD who also were evaluated for OUD. Two hundred and forty emergency department registered …

Implementation Of An Evidence-Based Bundle To Educate Nurses In The Care Of Adult Post-Transplant Diabetes Mellitus Patients, Christine Slaughter

DNP Projects

Background: After solid organ transplantation, between 10-40% of patients develop post-transplant diabetes mellitus (PTDM) due to the immunosuppression regimen, infection, stress response and pain. Hyperglycemia events are common and managing glycemic targets is critical to decrease the likelihood of graft failure and mortality.

Purpose: To determine the impact of an evidenced-based bundle education strategy on the perceived confidence/knowledge of nurses and on their documentation compliance in the care of adult solid organ post-transplant diabetes mellitus patients.

Methods: A single group, pretest-posttest design was implemented to evaluate the effectiveness of the electronic educational program on the nurses perceived confidence/knowledge regarding glycemic …

Implementation Of An Education Intervention Aimed At Intensive Care Unit Providers To Improve Knowledge Of And Screening For Cognitive Impairment Related To Post-Intensive Care Syndrome, Terry Harrod

DNP Projects

Abstract

Background: Post intensive care syndrome is a condition that can lead to a range of physical,

cognitive, and psychiatric issues and is frequently undiagnosed. Educating Nurse Practitioners,

Physician Assistants, and Physician Fellows who work in the ICU about post intensive care

syndrome and a cognitive screening tool like the MoCA can significantly enhance their

understanding and ability to diagnose a component of this syndrome.

Purpose: The purpose of this project was to evaluate the effect of an educational intervention

regarding post intensive care syndrome among ICU nurse practitioners, physician assistants, and

physician fellows treating patients within the ICU.

Methodology: …

The Effects Of An Educational Intervention On Nursing Knowledge Of Post-Operative Care Of Patients After Minimally Invasive Esophagectomy Surgery, Kelli Curry

DNP Projects

Abstract

Background: Minimally invasive esophagectomy surgery is commonly performed by thoracic surgeons on patients with esophageal cancer. The post-operative care of these patients is meticulous and follows a protocol developed by the thoracic surgeons at the University of Kentucky. At UK Chandler Medical Center, concerns have been raised regarding nurses’ lack of education of the protocol, and therefore decreased implementation. Increasing nursing knowledge pertaining to this protocol by performing educational in-services periodically and standardizing and implementing formal education as part of nursing orientation will decrease the knowledge gap and improve patient outcomes and increase utilization of the post-operative protocol.

Purpose: …

The Effect Of An Educational Intervention On Early Mobility Compliance In Oncology Nurses, Jonathan A. Hacker

DNP Projects

Background: Geriatric adult patients admitted into acute care hospital settings are at risk of functional decline in their capacity for activities of daily living and independent ambulation. Many of these patients fail to achieve pre-hospitalization levels of function and continue to decline, requiring additional support and care after discharge. Current literature supports early mobilization and ambulation during hospitalization. However, ambulation and patient mobilization has been shown to be the most missed item of nursing care. There is a gap in literature and patient outcome data regarding the impact of early mobilization on medical-surgical patient populations.

Purpose: The purpose of this …

New Crew Nights: The Impact Of A Nurse Leader Led Mentorship Series On Perceived Competency In The Novice Nurse, Taylor C. Bergman

DNP Projects

Abstract

Background and Purpose: Nursing leaders across the United States are seeking to recruit and retain new graduate nurses as a national nursing shortage widens at an alarming pace. Healthcare systems are tasked to strengthen the skill set of novice nurses as they seek to meet the care needs of acutely ill patients and rebuild a skilled workforce for future years. This study evaluated the impact of a four-part mentorship series for novice nurses on perceived strengths in competency, communication, wellbeing, and teamwork.

Methods: In this quality improvement project with pre-intervention/post-intervention assessment, a sample (n=14) of medical surgical nurses with …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Improving Structural Empowerment Through The Co-Creation Of A Professional Governance Program Of Nurse Managers And Front-Line Nurses, Michelle Van Outer

DNP Projects

Abstract

Background: Professional governance is a model in healthcare systems where nurses are involved by participating in decisions that lead their practice. Participation in professional governance has been shown to improve nursing practice, employee satisfaction, nursing autonomy, and patient outcomes.

Purpose: The purpose of this study is to evaluate nurses’ perceptions of empowerment when front-line nurses are involved with their nurse managers in the design and structure of an inpatient state psychiatric hospital’s professional governance program.

Conceptual Framework: Kanter’s theory of empowerment will guide this project. As individuals feel more empowered, the success of the organization increases. Kanter suggests that …

The Effects Of Yoga On Anxiety And Sleep Quality Levels Among College Students, Larisa Lucas Mullins

DNP Projects

Background: College students have poor sleep quality due to a newfound sense of freedom, exposure to new influences, or poor sleep hygiene (Dinis & Barganca, 2018). Specifically, evidence supports a correlation between sleep latency in onset or lack of nighttime sleep and increased anxiety (Dinis & Barganca, 2018). Yoga has been shown to decrease anxiety, stress symptoms, and depression (Mullen et al., 2021). Teaching yoga techniques and encouraging routine yoga practice to college students may improve sleep quality and decrease anxiety.

Purpose: This project's purpose was to evaluate the effect of yoga education and videos on sleep quality and …

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …

Improving Education On Routine Echocardiograms In Reducing Right Sided Heart Failure When Managing Vv- Ecmo Patients, Ashley Williams

DNP Projects

Background: Patients who are placed on veno- venous extracorporeal membrane oxygenation (VV- ECMO) are at high risk for developing right sided heart failure. An echocardiogram is essential for diagnostics and recovery in ECMO patients and should be a standard of care when managing this patient population. More research is needed to understand the effect of reducing right sided heart failure using routine echocardiograms. Purpose: The purpose of this study is to evaluate if there is a significant difference in outcomes of VV- ECMO patients who received routine echocardiograms compared to those who did not, and appropriately manage once RV dysfunction …

Evaluating The Effect Of Sleep Hygiene Education On Sleep Quality Among First-Year College Students, Caroline Lowe Cunningham

DNP Projects

Abstract

Background: The American Academy of Sleep Medicine recommends college students should get seven to nine hours of sleep each night. Only one-third currently meet this recommendation. Poor sleep negatively affects academic performance, mood, and interpersonal relationships. Sleep hygiene is recommended to improve sleep quality and quantity.

Purpose: The purpose of this DNP project was to determine the effect of implementing a sleep hygiene educational intervention in classes intended for first-year college students at the University of Kentucky.

Methods: This quasi-experimental project utilized the Pittsburg Sleep Quality Index to assess participants’ sleep before an in-person sleep hygiene education and after …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

Enhancing Communication Between Nurses And First Call Providers Using A Secure Chat Algorithm, Karen Hilt

DNP Projects

BACKGROUND: Healthcare requires quality multidisciplinary communication for patient care. Secure Chat is a feature within the Epic electronic health record to facilitate communication without violating Health Insurance Portability and Accountability Act (HIPPA). An algorithm to streamline communication utilizing this feature is needed to improve patient care.

PURPOSE: The purpose of this study was to determine, develop, implement, and evaluate a communication protocol between nurses and first call providers. The overall goal was to improve the knowledge, attitudes, efficacy, and address barriers with communication of nursing staff and providers through efficient messaging embedded within Epic, electronic health record

CONCEPTUAL MODEL: …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice

DNP Projects

Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

The Impact Of An Educational Training To Front-Line Nurses And Providers To Reduce Seclusion And Restraint: Assessing Knowledge, Practices, And Attitudes, Kevin Bryant

DNP Projects

Background: The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. Although it is typically agreed that such measures should be used as a last resort in patient care, the majority of nurses feel that seclusion and restraint are necessary interventions in managing adverse behaviors of mental illness. There is a lack of data examining front-line nurses’ and providers’ knowledge, practices, and attitudes toward the use of seclusion and restraint following the use of a targeted educational training.

Purpose: This project aimed to evaluate the impact of a web-based educational intervention on the knowledge, …

The Effect Of An Employee Recognition Program For Clinical Registered Nurse Retention At Eastern State Hospital, Kristi Richmond

DNP Projects

Abstract

Background: Nurse executives want to build and retain teams capable of delivering high quality care. However, registered nurse (RN) turnover continues to jeopardize this goal. RN satisfaction has been associated with reduced turnover in the nursing field. Adequate staffing levels are linked to better patient outcomes, and employee recognition is a key factor in RN retention.

Purpose: The purpose of this study was to evaluate the effectiveness of utilizing an existing recognition tool for RNs at an inpatient state psychiatric hospital in the southeastern United States to determine level of job satisfaction, level of job loyalty, level of engagement, …