Implementation Of Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

Doctor of Nursing Practice (DNP) Projects

Background: Implicit bias in healthcare delivery refers to the unconscious mental associations healthcare providers make about patients from various social groups. Numerous studies suggest implicit bias contributes to health disparities primarily amongst marginalized groups. Furthermore, patients report a lower quality of communication from healthcare providers with higher implicit racial bias. In 2021, Assembly Bill 1407 (Nurses: Implicit Bias Courses Act) was passed to address the negative impact of bias on patient outcomes and requires California nursing schools to provide implicit bias training for nursing students.

Problem: All graduate nursing programs do not provide implicit bias (IB) training. As a result, …

Supporting Mental Health In Children By Providing Basic Skills And Knowledge Of Mental Health To Middle-School Teachers, Mariaelena Falcon

Doctor of Nursing Practice (DNP) Projects

Background: Mental health first aid training in middle school is an effective way to help teachers gain the necessary knowledge and confidence needed to support students with mental health distress and provide early interventions.

Local Problem: Lack of mental health training may result in teachers facing challenges in identifying and addressing mental health issues among their students. Specific problems resulting from this include limited awareness, insufficient skills, and strategies to effectively communicate and engage with students in mental health distress, and stigma surrounding mental health may make teachers uncomfortable discussing mental health.

Methods: The project will take place at Harper …

Inclusive Education Is Power: Revising Sexual Health Education For People With Disabilities, Carly M. Tsuruda

Master's Projects and Capstones

For people with disabilities in the United States, comprehensive sexual health education is not always available. There are a number of reasons for the lack of comprehensive sexual health education, including excessive censorship and curriculum that is not representative of people with disabilities. Sexual health education and disability are both topics that have several preconceived notions attached to them, yet there is a dearth in resources that could provide accurate information to those both with and without disabilities. These preconceived notions that have been associated with these identity labels lead to negative health outcomes for people with disabilities such as …

A Public Health Educational Campaign For Sudden Unexpected Infant Death (Suid) Intervention, Elia G. Peralta Landeros

Master's Projects and Capstones

Purpose: The rate of infant mortality serves as a crucial indicator of the overall health of society (CDC, 2022). The five leading causes of infant mortality are birth defects, preterm birth, sudden infant death syndrome, injuries, and maternal pregnancy complications. The prevalence of infant mortality varies across states, with eastern states and minority-ethnicity infants having higher prevalence. This thesis proposes utilizing the Safe to Sleep framework to introduce Giving Breath, a public health education campaign that introduced breastfeeding as an intervention to Sudden Unexpected Infant Death (SUID).

Methods:

1. Analyze current and new policies' impact on women's rights to breastfeed …

Meet Me In The Middle: A Scoping Review On Understanding Adolescent Needs In Climate Communication, Gwendolyn Monica Hoff Anderson

Master's Projects and Capstones

The greatest effects of climate change are likely to be felt by youth. Young people are disproportionately affected by climate change due to their critical developmental stage and lack of power, and they experience both higher severity and prevalence of mental health issues related to climate change. Strong emotions have long been recognized as potential catalysts for action, or they may lead to paralyzing feelings of being overwhelmed. Climate communication is a critical tool to spark climate concern and encourage action. Activism, in turn, may help youth manage their anxiety about climate change. This scoping review examines emerging evidence on …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …

Reducing 30-Day Heart Failure Hospital Readmissions Through The Implementation Of A Telehealth Education And Screening Program, Madison Geib, Jo Loomis, Maria (Dupi) Gomez Cogan

Doctor of Nursing Practice (DNP) Projects

Heart Failure (HF) is a difficult disease to manage. It requires knowledge on weight monitoring, diet, exercise, medications, and symptom management. With this difficulty, there is a high incidence of HF patient readmissions into the hospital, especially in the first 30-days after discharge, showing that patients are not well equipped to manage their HF on their own at home. A review of the available literature found that some of the most common reasons for readmission include poor discharge planning, a lack of continuation of care, as well as a lack of education and adherence to their medications (Mathew & Thukha, …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Identity Formation And Role Expansion For Nurse Practitioner Residency Preceptors: A Qualitative Thematic Analysis, Angel Chen Kuo

Doctoral Dissertations

Employer-based nurse practitioner residency programs have been implemented to address the significant shortage of primary care providers in the community clinic settings. However, there continues to be a shortage of clinicians who serve as preceptors to nurse practitioner residents and students. Preceptors, also referred to as clinician educators, are essential in the training of learners and their socialization into the profession. Just as there is a shortage of clinicians of diverse backgrounds to reflect the population served in the community, there is also a significant shortage of preceptors of color to train learners from diverse backgrounds. The purpose of this …

Improving Elementary Nutrition Education Curriculum In San Francisco - A Program Analysis Of The Food Education Project, Audrey N. Chang

Master's Projects and Capstones

Childhood obesity and food insecurity are problems within San Francisco, California. The purpose of this program analysis is to assess the Food Education Project (FEP), which is one of many projects addressing nutrition education and the long-term public health impact is to solve the problems of food insecurity and childhood obesity. Through primary data collection, students shared their honest feelings about food and were able to openly discuss what they know and do not know about food. A literature review was conducted through research from various databases from the University of San Francisco to identify not only current interventions but …

Esp In Nursing: Building Communicative Competence For Internationally-Educated Nurses, Sami Vuong

Master's Projects and Capstones

The nursing shortage in the United States has been an ongoing issue due to nursing burnout and retirement. Together with the COVID-19 pandemic, it has further exhausted the healthcare system’s resources and healthcare providers. In order to sustain the healthcare system in society, a large number of internationally educated nurses (IENs) have been transferred to work in the United States. As a result of different nursing practices, cultures, and communication styles, many IENs experience language and cultural barriers at work. Difficulty in communication influences the quality of patient care provided, which can lead to negative health outcomes for patients and …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

Community Health Worker Program - Substance Use Disorder In Pregnancy, Alicia Claire Kletter Dnp

Doctor of Nursing Practice (DNP) Projects

Background Substance use disorder (SUD) in pregnancy is a concern for mother, baby and community. Healthcare policies are increasingly calling for diversification of the workforce to meet healthcare needs. Community health workers (CHWs) are understood from the literature to be effective at bridging the gap between patient and healthcare provider, especially for vulnerable populations. Local Problem California’s Central Valley is majority Latinx and faces challenges from poverty, lack of medical resources, unemployment and SUD at rates which are higher than other communities. Combine SUD with pregnancy and the need for robust social connections, psychological support, and physical healthcare become even …

The Use Of Simulation With The School Of Nursing And Health Professions (Sonhp) Prelicensure Students To Support Affirming Practice With Transgender Communities, Genevieve Charbonneau

Doctoral Dissertations

This dissertation investigates how prelicensure nursing students are prepared to address healthcare disparities with transgender patients, specifically through simulation scenarios at the University of San Francisco School of Nursing and Health Professions Simulation Center.

A critical review of current literature reveals how microaggressions against transgender communities create and sustain barriers to equitable healthcare. The qualitative study was designed to explore the lived experience of prelicensure nursing students who are actively seeking to understand the healthcare needs of transgender patients in the San Francisco Bay Area.

This was a qualitative research study including data that suggests that using simulation scenarios featuring …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Improving An Electrocardiogram Competency Assessment Tool For Registered Nurses, Laurel K. Ng

Master's Projects and Capstones

Abstract

Problem: Rapid and accurate interpretation of an EKG rhythm is an advanced-level competency required for all acute care nurses working in a cardiac monitored/telemetry unit. Observational data collected over a 4-month period by the facility clinical nurse educators identified that less than half of the nurses required to take the EKG exam passed on the first attempt.

Context: The education department at the facility onboards approximately 550-600 nurses annually for the 241-bed community hospital in the San Francisco Bay Area of Northern California, part of a larger healthcare organization.

Interventions: A total of 19 nurses from various …

Manager Onboarding To Improve Retention, Knowledge, And Confidence To Lead, Christine Asiimwe

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of this paper is to review the literature on manager onboarding best practices and their impact on turnover intention, knowledge, and confidence to lead teams in primary healthcare settings.

Background: Primary care onboarding is often insufficient due to competing operational priorities, time constraints, lack of mentorship, and cost. With primary care increasingly the setting for affordable, coordinated, end-to-end patient care, primary care managers must be well-prepared to lead the care team.

Methods: A review of the literature identified best onboarding practices associated with job satisfaction and turnover, reduced time to proficiency, increased knowledge, and confidence to lead. …

Eservice-Learning During Covid-19: How Community-Engaged Learning Courses At The University Of San Francisco Responded To The Pandemic, Erin I. Hassett

Master's Projects and Capstones

During the COVID-19 pandemic, universities and colleges had to quickly transition their courses from in-person to online. This switch to online learning heavily impacted community-engaged learning (CEL) courses because it meant that internships with community partners had to become remote as well as the coursework. The University of San Francisco (USF) requires their undergraduate students to take at least one CEL course during their four years there as a way to connect them to the school’s Jesuit Catholic values, so pivoting these courses to a remote setting and keeping them available to students throughout the pandemic was imperative. This paper …

Reducing Hospital Acquired Pressure Injuries Through A Standardized Prevention Bundle, Austin Lee Stoker

Master's Projects and Capstones

Abstract PROBLEM: Currently healthcare acquired pressure injuries (HAPIs) in the United States result in significant and unnecessary costs along with lost revenue for healthcare facilities. These costs are estimated to be between 9.1 and 11.6 billion dollars annually. Pressure Injuries (PIs) are directly associated with decreases in patient outcomes and are deemed preventable incidents. HAPI prevention can mitigate this clinical and financial problem for patients and organizations. CONTEXT: Unnecessary patient harm related to four HAPI occurrences in the last quarter on the 2B Medical Surgical Telemetry Unit in an integrated managed care delivery system continue to be of concern. Adherence …

Implementing Simulation In Icu New Graduate Nursing Orientation: Introducing Two Practice Innovations, Aiza Quinday Msn

Master's Projects and Capstones

A change project involving the use of innovative wearable simulation technology was integrated into the 12-week new graduate nurse ICU training program at one community hospital in Northern California. Project implementation was interrupted by the Covid-19 pandemic, so only the first pilot training session was conducted. Initial results from this training session suggest that the simulation training had a positive impact on the nurses’ ability to assess patient breath sounds and to recognize and treat a rapidly deteriorating patient. This training session also allowed the project team to identify additional areas of skill assessment and opportunities for improvement for the …

An Online Self-Directed Learning Module For Regional Stroke Survey Success, Winchell Rodriguez Kuttner

Doctor of Nursing Practice (DNP) Projects

The lack of a standardized education for stroke coordinators focusing on The Joint Commission (TJC) standards and requirements in preparation for the stroke program disease-specific care (DSC) certification survey every two years has led to undue added stress prior to survey. The development of tools and resources has been identified to address the current educational gap in stroke coordinator orientation. This project addressed the gap by creating an online, self-directed learning module to assist the stroke coordinators in knowledge acquisition of the stroke standards and requirements.

A stroke coordinator plays a critical role in stroke care delivery. An educational module …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

Move For A Healthy Mind: A Program Of Peer-Led Physical Activity For Adolescents With Depression And Anxiety, Emily Edwards

Master's Projects and Capstones

The following discusses adolescent depression and anxiety and the utilization of physical activity as an intervention or coping mechanism. Adolescents have been experiencing increased rates of anxiety or depression diagnoses over the past roughly two decades. Adolescence is, physiologically, a formative period in the developmental stage from childhood to adulthood. Current barriers to achieving optimal mental health among the adolescent population include the stigmatization of mental health issues, lack of education, socioeconomic status and healthcare access. Further, physical activity has been studied and identified to be an effective treatment for individuals experiencing depression and anxiety. In an effort to treat …

Academic Leaders And The Regulatory Orientation: New And Improved!, Annmarie Munana

DNP Qualifying Manuscripts

The purpose of this article is to describe the challenges and regulatory knowledge gaps present in academic nursing leaders, explore orientation as an evidence-based approach to support leadership transition, recommend guiding frameworks, and report on the usefulness of orientations to facilitate academic regulatory compliance knowledge.

During this time of yet another nursing shortage, and considering the aging population and nursing workforce, professional organizations and nurse leaders strive to develop innovative solutions to attract individuals to nursing. The shortage is also present amongst the ranks of nursing faculty and academic nurse leaders and the profession needs strong leaders at the helm …

Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen

Master's Projects and Capstones

Social inequalities are riddled with health disparities and outcomes leading toward lower life expectancy. Communities of color, low income, and rural neighborhoods lack the voice and resources to effectively oppose industrial settlement which would likely lead to the release of toxic wastes into the water, air and ground ultimately affecting residential health. Empowering members through community engagement is a relatively new strategic process where researchers are finding mutual benefits in design, implementation, and results. This study aims to identify and promote tools for community engagement within the scope of environmental justice by working with EPA geospatial screening tools and designing …

Improving Care Experience Of Total Joint Home Recovery Patients Through Nursing Education, Earvin Ledi

Master's Projects and Capstones

Problem: At a Northern California hospital (NCH), there is a current effort to ensure the perioperative patients are satisfied with their care. These patients receive the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey after surgery. The scores regarding discharge process and patient knowledge over the last five quarters have fluctuated between the 10th percentile and the 36th percentile. NCH relies on patient satisfaction scores to better serve their members.

Context: NCH understands the higher the scores, the more members they will retain and the higher the overall income. Based on the low OAS …

Implemented Nurse Education To Improve The Effective Use Of The Sapphire Pca Pump: Achievement Of Quality Pain Control, Fanta Keita Zable

Master's Projects and Capstones

The Sapphire ™ Infusion System Patient-Controlled-Analgesia (PCA) pump is a device that is used to administer high pain medication to manage a patient’s pain level after an invasive procedure such as surgery. In order to achieve this goal, nurses must be able to use the sapphire equipment efficiently to prevent medication overdose and underdose, as well as to preserve safety for both the patients and the nurses themselves. In addition, nurses must be able to document accurately on EPIC. The purpose of this project, led by the team of Clinical Nurse Leader (CNL) students from the University of San Francisco, …

Competency-Based Practicum Evaluation Tools For Family Nurse Practitioner Programs, Angelica Renteria

Doctor of Nursing Practice (DNP) Projects

Problem: Training family nurse practitioners (FNPs) was identified as a concern within a university MSN FNP program. A major gap identified was that student practicum evaluation tools needed to be competency-based.

Context: The paradigm shift from content-focused curriculum to competency-based curriculum has led to a refinement in program accreditation and increased national certification requirements.

Interventions: Revision (aligned with NONPF core competencies and AACN Master’s essentials), adoption, implementation, and evaluation of competency-based FNP practicum evaluation tools and training of faculty and preceptors to use the revised tools and one-minute preceptor model were the interventions in this project.

Measures: …

A Quality Improvement Project To Implement Shared Medical Appointments For The Management Of Type 2 Diabetes In Latino Patients, Denisse Maldonado

Doctor of Nursing Practice (DNP) Projects

Problem: Santa Rosa Community Health (SRCH) is one of the largest federally qualified health centers in Northern California, providing health care to more than 30,000 patients. More than half of the patients receiving care at the SRCH Lombardi site are Latino patients. Patients self-identify as Latino or other ethnicity on the initial health center registration form. SRCH serves 964 patients with diabetes. Due to limited access to appointments and resources, seeing a healthcare provider regularly can be difficult, posing a barrier to diabetes management. Patients with diabetes would greatly benefit from regular appointments with their primary care provider and resource …