Medicine and Health Sciences Commons^™

Increasing Nurse Awareness Of A Breastfeeding And Substance Use Disorder Guideline To Improve Rates Of Breast Milk And Skin To Skin Usage: A Quality Improvement Initiative​, Makenna R. Black, Alexandria L. Tasket, Megan L. Young, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Neonatal opioid withdrawal syndrome (NOWS) is related to opioid exposure in utero, and cases of NOWS have been increasing. In Tennessee in 2020, 824 newborns were born with NOWS. NOWS treatment involves pharmacological and nonpharmacological treatment. Breastfeeding, a nonpharmacological treatment, decreases the need and length for pharmacological treatment, the length of stay, and NOWS symptoms. Skin-to-skin may also reduce symptoms of NOWS. This quality improvement (QI) project involved implementing an Opioid Use Disorder Toolkit from the Tennessee Initiative for Perinatal Quality Care (TIPQC) and specifically educating staff nurses in a Women and Infant’s Department in a regional medical center on …

Quality Of Care Improvement: A Process To Standardize Handoff Communication Between Anesthesia Providers And Post-Anesthesia Care Unit Nurses, Maria Chernyak, Courtney Posten

DNP Scholarly Projects

Introduction: Transition of care is the process in which sending provider teams and receiving provider teams release the care of the patient from one provider team to the next utilizing a communication process. Review of the literature has identified several different protocols in place to systematize communication among providers, however, there is no standardized instrument or process that encompasses the post-anesthesia transfer of care process. Our project goal is to develop a standardized evidence-based handoff communication instrument to be utilized during the transition of care process between anesthesia care teams to the post-anesthesia care (PACU) teams to improve quality of …

The Impact Of Increased Interdisciplinary Communication On Hospital Admission Rates In The Geriatric Population: An Integrative Review, Molly K. Langston

Doctoral Dissertations and Projects

The medical complexity of geriatric residents puts them at an increased risk of hospital readmissions related to coronary artery disease, myocardial infarction, chronic obstructive pulmonary disease, and diabetes, along with other chronic diseases. Geriatric residents of assisted living, skilled nursing, and memory care facilities should hold a particular interest to stakeholders, as the simple intervention of increasing early communication and correspondence regarding chronic diseases can have a great impact on quality improvement outcomes as well as financial burden of the institution. Additionally, interdisciplinary communication can be individualized to meet the needs of each geriatric resident in order to reduce the …

Pressure Injury Prevention: A Quality Improvement Project Utilizing Incontinence Care Education, Laura Renner, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: Evaluate whether the initiation of incontinence care education can improve pressure injury knowledge by an average of 5% in post-test scores over 1 month. Design: Theoretical Framework: Lewin’s Three-Step Model for Planned Change and Evidence-Based Practice Improvement Model. Setting/Local Problem: A 20-bed acute care geriatric unit in a large metropolitan hospital in middle Tennessee with inappropriate use of incontinence management products. Participants: Nurses and nursing assistants employed at the project site. Intervention/Measurements: An educational tool was developed to improve knowledge on pressure injury prevention through incontinence management. A pre-test and post-test were conducted immediately before and after educational tool …

Mentorship In Retail Health - A Quality Improvement Project Initiative, Judith Thigpen

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Nurse practitioners (NPs) practicing in retail health face issues that complicate provision of care including isolation, lack of support staff, and non-clinical administrative and business duties. To address this, a national retail health company implemented a mentorship program for newly graduated, newly hired NPs. This quality improvement project will facilitate the implementation and evaluation of this mentorship program in one of the company’s regions in Georgia.

AVAILABLE KNOWLEDGE: Literature suggests that NPs believe that a mentor can help contribute to professional development, counter stress and anxiety, provide support, increase job satisfaction, and guide in critical decision making.

AIMS: 1. …

Implementation Of Delirium Bundle On A Hospital Medical/Surgical Unit To Help Decrease The Prevalence Of Delirium, Sanusi Mohammed

Doctor of Nursing Practice Scholarly Projects

Description of the Problem: Delirium is defined as a constellation of symptoms that includes disturbance in attention or awareness, change in cognition, language and perceptual disturbances that develops over a short period of time. Delirium mostly affects adult patients with risk factors including history of dementia, early cognitive impairment, dehydration, and infections. This quality improvement project was implemented on one hospital unit at a large tertiary hospital in the Boston area. This unit has one highest rate of delirium in the entire hospital system. Delirium is associated with high rate of morbidity and mortality. Also, this syndrome leads to longer …

Increasing Advance Directive Rates In Primary Care: Implementation Of A Redesigned Form, Abbie Cheatham, Samereh Abdoli

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Less than half of individuals 65 and older have completed an advance directive despite evidence to their benefit. Lack of advance directives can have emotional and financial consequences for the family and individual. A major barrier to advance directive completion is the high literacy level most state sponsored forms are written at, with the average form written at a high school level. Methods: This quality improvement project was a three-month trial to increase the number of advance directive rates at a primary care clinic in the Knoxville area. Five Wishes, written at an 8th grade reading level was …

Creating A Pre-Illness Covid-19 Action Plan: A Web-Based Public Education Initiative, Brian S. Hustad

DNP Research Projects

Abstract

Background: The COVID-19 pandemic took the world by storm in the beginning stages of 2020. Public health agencies were overwhelmed, undermanned, and therefore slow to respond. Information began to flow at an unprecedented rate. Yet, very limited resources were put into place to present this information or to instruct the public on evidence-based prevention, treatment, or care at home during active infection.

Intervention: A project website was created and accessed through a QR code on the project flyer or by entering the URL into any browser. Participants were able to access three evidence- based video modules, which introduced the …

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 …