Medicine and Health Sciences Commons^™

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri

Doctor of Nursing Practice (DNP) Projects

Background

Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central …

Implementing An Infant-Driven Feeding Practice Model, Ann P. Nguyen

Doctor of Nursing Practice (DNP) Projects

Neonatal feeding practices have been the focus of many quality improvement studies due to large variations in care practices. Traditionally, the model for neonatal feeding has been a volume-based approach, one that focuses on a prescribed quantity consumed rather than the infant’s physiologic and developmental maturity (Fry et al., 2018). Recent literature has emphasized the benefits of a more developmentally supportive feeding approach in neonatal intensive care units (NICU), the infant-driven feeding model (IDF).

The IDF model focuses on individualized care, quality of the feed, and continuous assessment of feeding cues both before and during the feeding experience. Current literature …

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

Utilizing A Stress And Coping Model Into A Preventive Abusive Head Trauma Parent/Caregiver Educational Program, Camile Williams

Doctor of Nursing Practice (DNP) Projects

Abusive head trauma (AHT) is a serious form of child maltreatment that is the primary cause of fatal head injuries in children younger than 24 months and is the cause for over 50% of severe or fatal traumatic brain injury incidences. These injuries can be caused by impact, shaking, or the combination of shaking and impact. These multi-factorial injuries can cause intracranial and spinal damage, retinal hemorrhages, and fractures of ribs and other bones. The age and severity of injuries will be used to assess the diagnosis of AHT. When AHT occurs, it is often tied to the behavior from …

Mind Your Mama! Addressing Implicit Bias, Racism, Antiracism, And Reproductive Justice With Healthcare Providers To Improve Maternal Outcomes, Caroline Toby

Doctor of Nursing Practice (DNP) Projects

Background: Maternal health care providers’ implicit racial biases affect quality of care and have serious repercussions, including significantly increased rates of maternal mortality among Black women. Implicit bias training, particularly involving multipronged approaches stretched over time, is effective at increasing bias awareness and gaining practical skills to prevent bias from impacting patient care. Purpose: The purpose of this quality improvement project was to elevate implicit bias awareness and use of evidence-based strategies by resident physicians in order to decrease negative outcomes for Black women receiving maternity care. Methods: An educational intervention was implemented with obstetrics and gynecological residents in a …

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Quality Improvement: Intimate Partner Violence Screen In Nurse Home Visit Program, Masayo Nishiyama

Doctor of Nursing Practice (DNP) Projects

Purpose: Women are disproportionately impacted from intimate partner violence (IPV). Their children also experience long-term adverse consequences. Effective IPV prevention and intervention efforts are vital. This quality improvement project addressed the lack of an evidence-based IPV training and protocol in a nurse home visit program.

Methods: Stakeholder engagement and an evidence-based practice intervention were implemented. Training effectiveness was examined by the pre-post-training assessments; completed by 17 nurses. To measure the IPV practice change, 196 pre- and 107 post-intervention charts were reviewed.

Results: The training significantly increased nurse knowledge and comfort (t=5.9, p< .001). Only 22% of those referred due to recent IPV history were screened before the intervention; 65% after the intervention. Multivariate analysis of screening rates was performed; predictors included county, mental health status, education, subprogram, and IPV referral reason. Due to low power, a one-tail test was employed. One county was 14 times less likely to screen than the other county (p= .023). 93% of those referred due to IPV history were enrolled in the crisis response subprogram, only offered by the other county. Those referred due to IPV history were three times more likely to be screened (p=.042) than those referred for other reasons. There was no significant change observed on IPV disclosure and intervention practice.

Conclusions: The adoption of an evidence-based IPV training …

Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The importance of communication between nurses, patients, and their family members with respect to treating each other as partners in safety cannot be overstated. It is imperative that families and patients feel empowered to speak up and report clinical errors at any time and be able to communicate effectively to prevent harm and encourage communication.

Context: This is especially important in the acute care setting, where patients may be in contact with multiple people and processes daily. Attention to this safety partnership can be established through improvements in patient satisfaction scores, which are usually collected from patients and …

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Exploring The Value Of Group And Traditional Obstetrical Appointments To Reduce Health Disparity, Helene M. Holbrook

Doctor of Nursing Practice (DNP) Projects

Disparity in health outcomes is influenced by socioeconomic factors that may include access to important healthcare information in a culturally sensitive way. Can a group appointment model like the CenteringPregnancy model provide a more effective means for engaging Spanish-speaking pregnant women? Research studies using the group prenatal appointment model show increased pregnancy knowledge, readiness for labor and higher satisfaction compared with individual prenatal appointments. This paper discusses the importance of reducing disparities in birth outcomes using a group appointment model conducted in partial fulfillment for the Doctor of Nursing Practice degree.

Newborn Umbilical Cord Care: An Evidence Based Quality Improvement Project, Janeen Marie Whitmore

Doctor of Nursing Practice (DNP) Projects

No Abstract Available