Medicine and Health Sciences Commons^™

Postpartum Hemorrhage: Improving Patient Outcomes With Improved Communication And Post-Drill Debriefing, Sheila L. Lafortune

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: A woman is at risk of dying from postpartum hemorrhage every four minutes. Maternal hemorrhage is found to be the direct cause of maternal mortality, overall accounting for 27% to 75% of maternal deaths worldwide. In the United States, 54% to 93% of maternal mortality could have been prevented. Postpartum hemorrhage remains among the top causes of pregnancy-related deaths worldwide. The purpose of this project is to educate providers of obstetrical care regarding best practices for effective communication during a postpartum hemorrhage by implementing a debriefing educational tool during postpartum hemorrhage mock code drills. Methods: The postpartum …

Standardizing Behavioral Health Triage: Using The Heads-Ed Tool, Sarah K. Peifer

Doctor of Nursing Practice (DNP) Projects

Background: In the past two years emergency departments across the country have experienced an increase in pediatric patients requiring behavioral health care. It is essential to provide efficient, early intervention to these vulnerable patients. The use of a standardized tool can improve management of pediatric patients and allow access to resources in a timely manner.

Purpose: To evaluate the implementation of the HEADS-ED in a community hospital ED, to provide rapid behavioral health assessment.

Methods: Education for staff was provided through various platforms and involved regular support for staff throughout the intervention. It was hypothesized that implementation of …

Elearning Module For Nursing Students To Improve Delirium Identification, Prevention, And Management, Shannon Baker

Doctor of Nursing Practice (DNP) Projects

Background and Review of Literature: Delirium is a serious, acute alteration in cognition and consciousness, which is common amongst older hospitalized patients and has an overwhelmingly negative impact on patient outcomes. Under-recognition by healthcare providers poses a barrier and contributes to poor patient outcomes, including increased morbidity and mortality.

Purpose: To reduce the incidence of delirium amongst acutely ill patients via internet-based education for student nurses on delirium prevention, assessment, and management.

Methods: An eLearning intervention consisting of a virtual lecture with an unfolding case study for undergraduate nursing students. This project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) …

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 …

Timely Transitioning To Hospice: A Needs Assessment With A Pace Program To Improve End Of Life Care, Kristina Kelley

Doctor of Nursing Practice (DNP) Projects

Background: Hospice care has been proven to improve patient outcomes at the end of life. However, patients frequently die without receiving hospice benefits. The challenge of transitioning patients from care with a life prolonging intent to a comfort focused approach can partly be attributed to poor prognostication or misconceptions about hospice. A Program for All Inclusive Care of Elders (PACE) in Massachusetts identified transitioning to hospice as an area for improvement. Purpose: To perform a needs assessment to gain understanding of the barriers to effective transitions to hospice and to provide education aimed at addressing those barriers. Methods: Subjects included …

Effect Of Provider Education On Pulmonary Rehabilitation Referrals And Discussions With Patients, Shannon Barry

Doctor of Nursing Practice (DNP) Projects

Background: Chronic obstructive pulmonary disease (COPD) is a chronic and debilitating disease from which 9% of the population suffers (CDC, 2013). Pulmonary rehabilitation (PR) is a well-documented evidence-based intervention for patients with chronic respiratory diseases, leading to better health outcomes for patients; however, PR is grossly underutilized in primary care (Rochester et al., 2015). Providers face many barriers which cause this gap between the evidence and clinical practice, such as a lack of understanding of the rehabilitation program and insurance coverage (Rochester et al., 2015).

Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to launch a …

Improving Discharge Planning And Education Of Nursing Students: A Collaborative Approach, Lea Dodge

Doctor of Nursing Practice (DNP) Projects

Nurses require training to provide discharge teaching yet nursing students are often not assigned the task of discharge teaching and are overwhelmed by the task once they enter the workforce (London, 2004). Few nursing programs provide opportunities for nursing students to participate in quality improvement projects. In an attempt to decrease post-discharge adverse events (AE) and increase exposure to discharge teaching and quality improvement by nursing students, 13 nursing students in a baccalaureate undergraduate nursing program assigned to a DEU in a sub-acute rehabilitation facility were provided with instruction utilizing the evidenced-based teach-back method. The nursing students conducted the discharge …