Medicine and Health Sciences Commons^™

Asthma And Peak Flow Assessments Based On Nhlbi Asthma Guidelines, Julia Gliceria Almario Regalado

Doctor of Nursing Practice (DNP) Projects

Background: Asthma exacerbations are consequences of poor asthma control. Asthma guidelines-grounded interventions can improve adherence to asthma guidelines and assessments in primary care settings. The goals of asthma management are to optimize asthma control, minimize the risk of asthma exacerbations, and minimize the adverse effects of asthma medications.

Local Problem: A primary care practice in Northern California had frequent office visits for acute asthma symptoms. Ongoing asthma control monitoring is a key performance indicator of high-quality asthma care.

Methods: The quality improvement evidence-based observational project examined the effectiveness of interventions. The pre-and post-survey assessments collected clinician knowledge and adherence, and …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …

Assessment Of Conduct Disorder In Primary Care: Integrative Review, Chantel M. Kilford

DNP Qualifying Manuscripts

Conduct disorder and behavioral problems in children are the 6^th most prominent childhood health disorder within the United States of America. Early recognition and interventions have shown to improve outcomes and reduce lifelong adult sequela. Evidence suggests that primary care providers are not confident or knowledgeable about identification and assessment of the disorder. The manuscript examines the prevalence, co-morbidities, trajectories, mortality risk and outcomes of conduct disorder. Health disparities and diagnostic stigma are also addressed. Additionally, the manuscript provides primary care providers with evidence-based research and recommendations for prompt identification and screening. Conduct disorder has devasting individual, social, and …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Implementing Foot Care Program In A Rural Clinic, Maliheh Bakhshi

Doctor of Nursing Practice (DNP) Projects

Abstract

The prevalence of type 2 diabetes mellitus and its complications have increased in the United States (U.S.) in recent years. Patients with diabetes have a higher risk of foot ulcers due to diabetic peripheral arterial disease accelerated by the direct damage to the nerve and blood vessels in lower extremities by high blood sugar. Foot amputations, and frequent hospital admissions due to these and other diabetes complications are also increasing. Healthcare providers’ have a unique opportunity to prevent these complications and hospital admissions, and to promote patient wellness and physical well-being through the provision of timely education and direct …

Improving Wound Care Using The Time Framework, Pavel Kulikov

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach …

Implementation Of The Nurse Care Manager In Integrated Care: A Systematic Report, Elizabeth Adams

DNP Qualifying Manuscripts

Introduction: The collaborative care model (CCM) is an effective model for improving depression symptoms in patients in a primary care (PC) setting. An essential role in this model is the care manager (CM), and nurses have been effective in this role. However, there remains a question of how to best design, train, and implement this nurse CM role in PC.

Objectives: The purpose of this review is to provide readers with a critical description of what processes for training and implementation of a collaborative nurse CM role have been be successful in the literature, specifically as it pertains to supporting …

Establishing A Nurse Practitioner Residency Program In A Rural Federally Qualified Health Center: A Feasibility Analysis And Pilot Study, Seson Kahn Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Jodie Sandhu Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Projects

Abstract

Rural communities are disproportionately underserved and have been identified as a priority population to improve health outcomes and access to care (Agency for Healthcare Research and Quality [AHRQ], 2015). National organizations have recognized a deficit in primary care providers, recommended nurse practitioners (NPs) as a solution, and supported NP residency programs as a means to prepare and recruit qualified practitioners into communities (Institute of Medicine [IOM], 2010; The Patient Protection and Affordable Care Act [PPACA], 2010). However, there are only three primary care NP residency programs in rural California (National Nurse Practitioner Residency and Fellowship Training Consortium [NNPRFTC], 2015). …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Implementation Of An Evidence-Based Educational Workshop And Toolkit: Menopausal Women's Healthcare Needs For The Primary Care Provider, Pamela Doerr-Kashani Dnp, Rn

Doctor of Nursing Practice (DNP) Projects

This evidence-based change of practice project involved the development of an educational workshop for primary care providers (PCPs). The intent of the project was to improve PCP’s knowledge of menopausal health, and to create their comfort level when discussing menopausal healthcare with clients. The workshop Menopausal Women’s Healthcare Needs for the Primary Care Provider (Doerr-Kashani, 2014) was created in response to an identified gap in knowledge among PCPs nationally on menopause-related health issues. The workshop was designed as a resource to support PCPs to competently address women’s menopause-related health issues, and enable them to provide comprehensive, evidence-based care within the …