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 …

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 …

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 …

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 …

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. …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Methadone, Haley Pschirrer, Christy Tocco

Doctor of Nursing Practice Projects

This study investigates the efficacy of intravenous methadone as an alternative to traditional opioids for postoperative pain management following major surgeries. A comprehensive literature review, including randomized controlled trials, meta-analysis, and retrospective studies, was conducted. The findings highlight methadone’s effectiveness in reducing postoperative pain, with advantages over conventional opioids in various surgical scenarios. However, its use necessitates caution due to several potential risks. Methadone’s dual role as an opioid agonist and NMDA antagonist makes it effective in preventing the transition from acute to chronic postoperative pain, positioning it as a valuable tool in chronic pain management. Its cost-effectiveness further enhances …

Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

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 …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Development Of High-Fidelity Simulations For Srnas: Airway Fire And Venous Air Embolism, Ashlyn Russo, Brooke Skaggs

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) must swiftly recognize and treat high-risk, low-incidence complications in a high-stress environment. Most SRNAs do not experience high mortality or rare emergencies throughout their training. This project involves developing and implementing two high-fidelity simulations for airway fire and venous air embolism (VAE) to help SRNAs improve their skills in a safe learning environment. Objectives for this project include examining current evidenced-based literature to determine the efficacy of high-fidelity simulation on the SRNA’s knowledge and performance post-simulation, determining the incidence, pathophysiology, and treatments for airway fires and VAE, creating two high-fidelity simulation scenarios, and integrating the …

Educating Srnas On Barriers And Facilitators Of Clinical Learning, Mesud Dedic, Richard Heuermann

Doctor of Nursing Practice Projects

A national survey of 143 Student Registered Nurse Anesthetists (SRNAs) conducted by Clancy and Bruinius (2022) revealed that factors impeding effective SRNA clinical education include unstable preceptorship, hostile environments, limited autonomy, and heavy didactic burdens. Clancy and Bruinius (2022) also found that facilitators of SRNA clinical education include rapport with preceptors, effective feedback, strong clinical site orientation, and beginning of day discussions. This project aimed to enhance second-year SRNAs' clinical success by mitigating these evidence-based barriers and employing these evidence-based facilitators by developing a presentation for SRNAs and assessing its effectiveness through a pre-implementation survey and post-implementation survey. The literature …

Strategies To Reduce Ventilator-Associated Pneumonia Incidence In Mechanically Ventilated Pediatric Critical Care Patients: A Scoping Review, Morgan A. Moore Bsn, Rn, Kianna Cherry Bsn, Rn, Mallory Crenshaw Bsn, Rn, Rachel Kincy Bsn, Rn, Christen N. Parnell Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background

Ventilator-associated pneumonia (VAP) is a severe problem in pediatric intensive care units (PICUs), resulting in increased morbidity, mortality, duration of stay, and healthcare expenses. Traditional preventative measures are well-established, but the influence of ventilator filters in preventing VAP is unknown. The current evidence on the efficacy of VAP bundles and ventilator filters is variable and challenging to address. This scoping review aims to determine how VAP bundle compliance and ventilator filter utilization impact the incidence of VAP in mechanically ventilated pediatric critical care patients.

Methods

A scoping review was carried out per the Population, Concept, and Context (PCC) framework. …

Depression Screening In Type 2 Diabetes In Adolescent 12-18 Year Olds, Mykyla Coleman Bsn,Rn, Chelsea Conlee Bsn,Rn, Carol Gracia Msn, Aprn, Fnp-Bc, Emily Jennewine Msn, Aprn, Cpnp-Pc, Ibclc, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background

Although more commonly diagnosed in adults, type 2 diabetes is increasingly diagnosed in pediatric populations in the United States. Research suggests a correlation between depression and type 2 diabetes, however, a gap in research exists regarding depression and type 2 diabetes among pediatrics, specifically adolescents. This scoping review aims to address this gap by assessing the impact of depression screening on glycemic control in this specific population.

Purpose

The goal of the review is to contribute to the development of effective strategies for depressing screening in adolescents with type 2 diabetes, with the expectation this may positively impact glycemic …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Effect Of Certified Diabetes Clinical Education Specialists On Adults With Type 2 Diabetes, Rachel Faller, Tracy Gregory, Michelle Jones, Peyton Barnett, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus affects 13.1% of adults living in Shelby County and over 30 million adults in the United States. This chronic disease creates a higher risk of macrovascular and microvascular complications for this population resulting in poor outcomes if not properly managed. Improving glycemic control can help to improve the quality of life for people living with diabetes and reduce healthcare costs. Currently 20% of funds spent in the United States on healthcare is utilized for diabetic care. Certified Diabetes Care and Education Specialists (CDCES) primarily educate patients about managing their diabetes, including health promotion that can …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Improving Emergency Department Nurses Communication Self-Efficacy With Underrepresented Populations Through Cultural Humility Training, Nikki L. Graham

Doctor of Nursing Practice Projects

Problem Description: The chasm of health inequality for underrepresented populations in the United States is growing, despite advances in healthcare and increased life expectancy. Disparities span the age and healthcare continuum for underrepresented populations, with increased mortality and morbidity rates in nearly every category. Non-white residents in Cook County face the same challenges. Historical lack of trust creates a reluctance to seek healthcare among Black populations, but when they do, they are disproportionately dissatisfied with their care, receive less aggressive treatment, and report higher levels of uncontrolled pain. Nurses, as the largest body of healthcare professionals, are uniquely positioned …

A Patient Centered Quality Improvement Education Program Designed To Improve The Health Of Patients Living With Uncontrolled Hypertension In A Primary Care Setting, Alia Jamison-Dinowitz

Doctor of Nursing Practice Projects

Cardiovascular disease is the leading cause of death in the United States and it negatively contributes to poor health outcomes (Martinez-Garcia et al., 2018). Within the Antelope Valley in Lancaster California, 30.3 % of city residents have a hypertension diagnosis (Los Angeles County of Public Health, 2017). Much like the city at large, hypertension is a critical issue at AV Pediatrics and Family Medicine (AV Peds). This issue is driven by a variety of factors including a lack of understanding about hypertension and medication compliance, and a lack of understanding about healthy lifestyle choices. Providers at AV Peds have seen …

The Impact Of Hypertension Education On Knowledge And Management Of Blood Pressure, Nkechi Onwuemene Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The low rate of blood pressure management knowledge has been identified as an essential risk factor for uncontrolled hypertension (HTN). Providing an educational intervention for HTN management in a retail clinic setting will allow timely treatment of HTN and decrease the costs of associated health related complications.

Objectives: This project aimed to improve hypertension knowledge and blood pressure management in patients diagnosed with hypertension or patients with blood pressure readings that exceed the guidelines, seeking care in a retail clinic.

Methodology: A pre-post educational intervention was used in this evidence-based project. Following BP screening, 46 participants …

The Implementation Of A Post-Discharge Patient Education Protocol To Decrease Adverse Side Effects After Aesthetic Procedures, Natalie Boren Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Medical aesthetic procedures have become a common practice for individuals to partake in as the stigma around this specialty has lessened in recent years. Laser hair removal, in particular, has become more accessible and affordable to the general public, compared to years past when the treatment was considered more of a luxury. With the increased accessibility of laser hair removal, there has been an influx of individuals receiving laser hair removal, including Floridians. The heat and strong UV rays Florida weather has to offer, unfortunately, increases the risks of adverse reactions in people who get laser hair removal treatments. However, …

Mandating Trauma-Informed Care Education For Indiana Nurses: A Health Policy Analysis, Lori Hardie

Doctor of Nursing Practice Projects

Background: The prevalence of trauma exposure poses a significant concern for public health. Extensive research has established the correlation between trauma and adverse health consequences. Studies indicate that adopting trauma-informed care (TIC) can enhance satisfaction, communication, and overall patient health outcomes. However, the current state of TIC education in academic programs and professional practice settings needs to be improved.

Objectives: The goal of this policy analysis project was to devise specific language and strategies to promote the implementation of a TIC education mandate for Indiana nurses.

Methods: The design of this project was an analysis of governmental …

Text-Based Reminders: Pathways To Improve Hemoglobin A1c And Fasting Blood Glucose Levels Of People With T2 Diabetes Mellitus, David Bamidele Alao

Doctor of Nursing Practice Projects

Background

Research studies have shown that self-monitoring blood glucose levels is a cornerstone in DM management. Various studies have shown that a text message intervention effectively reminds people with T2 Diabetes Mellitus (T2DM) to check their blood glucose levels at home. Text message reminders successfully encourage medication adherence, blood glucose self-monitoring, and lifestyle changes (Xiqian et al., 2019). Through the beneficial effects on HgbA1c and blood glucose, text-based reminders have been demonstrated to improve blood glucose self-monitoring, essential to managing diabetes.

Purpose

This project aims to evaluate the effects of the 12-week text-based reminder intervention on the patient's blood sugar …