The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen

Doctor of Nursing Practice (DNP) Projects

Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).

Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.

Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …

Enhancing Transgender Informed Healthcare For Nursing Students: An Educational Intervention, Olivia Bass

Doctor of Nursing Practice (DNP) Projects

Background: Limited teaching of transgender related healthcare competencies is seen in baccalaureate nursing curriculum, resulting in inadequate preparation of healthcare providers to care for this population of patients. This discord can prevent transgender patients from seeking healthcare and affect access to needed services. Purpose: The purpose of this DNP project was to educate accelerated Bachelor of Science in Nursing students at an institute of higher education on providing culturally responsive healthcare for transgender patients. Methods: An in-person educational intervention focused on improving clinical and cultural knowledge for transgender patients was implemented and evaluated. A pre-intervention survey and post-intervention survey …

Building Excellence Through Shared Governance And Continuous Process Improvement, Deborah Reitter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained.

Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils …

A Quality Improvement Project To Assess The Value Of Pharmacogenomic Testing In Adults Diagnosed With Major Depression, Ileana Miranda Velazquez

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Treatment of major depression follows the guidelines from evidence-based medicine established algorithms; however, 50% of patients diagnosed with major depressive disorder do not respond to their first medication trial, and 70% may go through four treatment attempts before achieving remission.

Purpose: To demonstrate the value of pharmacogenomic testing as a treatment-guidance technology in patients with resistant depression and assess healthcare providers' motivation to adopt the technology.

Methods: A retrospective chart review of (N = 73) patients' treatment response measured by the pre-post PHQ-9 depression scale after pharmacogenomic guided medication intervention with descriptive statistics and paired t-test. The …

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

Creating A Thriving Informatics Culture, Nicholas Webb

Doctor of Nursing Practice (DNP) Projects

Nurses thrive best when they are empowered to make decisions that can positively impact healthcare delivery. Knowledge and application of nursing informatics principles can influence clinical, quality, operational, and financial outcomes in ways that were not available in previous professional nursing generations.

If nursing informatics is the solution, what is the problem? A survey regarding use and attitudes about nursing informatics was taken of chief nurse executives (CNEs) at an integrated, not for profit healthcare system in the Northern California region, where the author oversees the electronic health record (EHR). The results were surprising. Half said they did not know …

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 …

Implementation Of Pressure Injury Prevention Intervention In A Long-Term Care Facility, Alfred Owusu-Ansah

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Pressure injuries (PIs), formerly known as pressure ulcers, affect approximately 2.5 million people in the United States and cost the American healthcare system more than $11.6 billion annually. The goal of this project was to reduce the pressure injury incidence rate at the project site by 50% within a period of six months.

Methods: The purpose of this project was to evaluate the impact of implementation of PI prevention measures in a medium-sized long-term care facility in central Massachusetts. The project utilized parts of the MISSCARE survey and AHRQ checklists as a pre-test. Collection of data from nurses …

Improving Intimate Partner Violence Screening Practices Among Postpartum Nurses, Robin Mills-Humphreys

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of the Literature: Intimate partner violence (IPV) during pregnancy is a global public health issue that has negative outcomes on both an individual and a societal level. Health care providers play a pivotal role in providing services to women experiencing violence during pregnancy. Regardless of the setting, barriers to IPV screening exist among healthcare providers. Review of the literature examined the existing IPV screening practices and screening barriers among healthcare providers to better understand the relationship between barriers and frequency of screening for IPV. Purpose: The purpose of this DNP project was to enhance …

Increasing Utilization Of Motivational Interviewing To Promote Pediatric Oral Health, Ulyses Reamico

Doctor of Nursing Practice (DNP) Projects

Prevalence of early childhood caries (ECC) remains high even in developed countries such as the United States. An interprofessional education (IPE) project between University of San Francisco (USF) School of Nursing and Health Professions and the University of the Pacific (UoP), Arthur A. Dugoni School of Dentistry was initiated four years ago to enhance nurse practitioner (NP) and dental students’ pediatric oral-systemic health assessment and health promotion communication skills. Since then, USF NP students received pediatric oral health assessment training and spent clinical rotations at UoP to provide pediatric oral care alongside dental students. This doctor of nursing (DNP) project …

Increasing Nursing Policy And Advocacy Engagement, Marketa Houskova

Doctor of Nursing Practice (DNP) Projects

At present, professional nursing does not benefit from strong policy development and advocacy influence in the United States. This project focused on CA nursing policy development and advocacy influence deficit among new members of a statewide professional nursing association. There are nearly 457,000 licensed registered nurses (RNs) in CA (BRN, 2019) and around 3.8 million RNs in the United States (AACN, 2019) making CA RNs twelve percent of the national nursing workforce. Yet only five percent of RNs serve on hospital boards, and legislative efforts to advance important nursing issues such as full practice authority for advanced practice RNs in …

Human Trafficking Recognition And Response Training For Sexual Assault Nurse Examiners In New Hampshire Emergency Departments, Carolyn L. Noyes

Doctor of Nursing Practice (DNP) Projects

Human trafficking is a pervasive yet under-recognized public health epidemic. Traffickers use various forms of manipulation to control their victims for the benefit of the trafficker with little regard for the victims’ well-being. This leads to victims of human trafficking suffering short- and long-term health problems. Trafficking victims may subsequently access healthcare during their time in captivity as a result of a direct harm caused to them due to their victimization from neglect, injury or disease. Unfortunately, victims often do not see themselves as victims or are too afraid to let their healthcare provider know that they need help. Warning …

Transforming Nursing Preceptors By Developing Emotional Intelligence, Michael Francis

Doctor of Nursing Practice (DNP) Projects

Changing the process of professionally developing nursing preceptors to meet the growing and changing needs of the nursing profession is critical. This evidence-based project leveraged an advanced preceptor education program for inclusion of basic emotional intelligence tenets and transitioning them into preceptor self-awareness, leadership recognition, and return on human capital investment. A large integrated healthcare system in Northern California identified a strategic need for preceptor development and within the system two acute care hospitals and one home health/hospice agency were selected to participate. The intervention included the development of a six-hour curriculum delivered through an interactive and innovative in-person learning …

Business Intelligence Competencies: Making Healthcare Data Come Alive, Christina Bivona-Tellez

Doctor of Nursing Practice (DNP) Projects

Business Intelligence Competencies: Making Healthcare Data Come Alive While a wealth of healthcare related data exists, nurse leaders (NL) have yet to understand its implications and adopt analytical skills to lead in the transformation of care delivery. Information science is at a new frontier for nursing to embrace. It is critical for nursing leadership to advance and support business intelligence (BI) and interactive data visualization (IDV) skills across the organization and advocate for greater engagement of nurses in health system decision making. With these new tools and competencies, nursing and other health professions can innovate best practices, providing enhanced quality, …

Mindfulness-Based Stress Reduction (Mbsr) In Reducing Stress In Nursing Students: An Integrative Review And Toolkit, Donna J. Petko

Doctor of Nursing Practice (DNP) Projects

Background: Across the country, nursing students are experiencing alarming amounts of stress. While stress is a common phenomenon, it has been shown to negatively impact nursing student performance and general health. One solution to this issue is mindfulness-based stress reduction (MBSR). Reported effects of MBSR include stress reduction; mindfulness; improvements in self-esteem; increase in general health; a decrease in anxiety; and an increase in empathy. Because MBSR is not widely included in nursing curricula, students are not learning stress reduction techniques needed to manage daily stress. Purpose: To address this gap, a DNP project was implemented at a university site. …

Utilizing Tiger Competencies To Improve Informatics Practice, Kwun Ying M. Fung

Doctor of Nursing Practice (DNP) Projects

Nursing Informatics (NI) is quickly becoming an essential part of nursing. From the classroom, to the bedside, and to the boardroom, nurses across the nursing continuum are expected to use NI in their practice with the hopes of delivering better quality care to their patients. However, the training and education of NI provided to all levels of nurses is unable to keep up with the pace of technology. This project seeks to improve the NI competency of the nursing workforce at a pediatric hospital through an educational course using NI competencies identified by the Technology Informatics Guiding Educational Reform (TIGER) …

The Creation And Implementation Of A Transgender Cultural Competence Nursing Education Toolkit, James Bl Donovan

Doctor of Nursing Practice (DNP) Projects

Healthcare disparities in the transgender populations have been linked to lack of healthcare provider cultural competence (IOM, 2011; Bradford et al., Harbin et al., 2012; Eliason, Dibble, & DeJoseph, 2010; Lim, Brown, & Jones, 2013). Prior research has identified that healthcare providers receive little, if any, transgender cultural competence training during their formal education. A survey of nursing educators at the University of San Francisco School (USF) of Nursing and Health Professions suggested that few educators are providing transgender content or understand the unique healthcare needs of that population. A literature review concluded that little is known about the best …

Improving Compliance With Healthcare Associated Infection (Hai) Practice Guidelines To Reduce The Acquisition Of Hais, Nelia Bruce

Doctor of Nursing Practice (DNP) Projects

Healthcare Associated Infections (HAIs) have been estimated to be in the millions, directly associated with 99,000 deaths and costing nearly $28 to $33 billion in excess health care costs each year (AHRQ, 2011; Scott, 2009). The literature indicates that healthcare workers are aware and understand that their patients are susceptible to HAIs and that they themselves can affect patient outcomes. However, despite this awareness and the existence of evidence based HAI guidelines there are clear gaps between what is recommended and practiced, greatly impacting the acquisition of HAIs. The objective of this capstone project was to assess for gaps between …

Adoption Of Innovation: Impact Of Rituximab (Rituxan®) Faster Infusion On Oncology Nurses' Perceptions, Practice, And Resource Utilization, Keith Dawson

Doctor of Nursing Practice (DNP) Projects

The translation of advances in clinical research into clinical practice in a manner that provides benefits while reducing potential harm is a challenge within the health care delivery system. Data from a phase III multicenter clinical trial led to the 2012 US Food and Drug Administration (FDA) approval of a 90-minute infusion of rituximab (Rituxan) starting at Cycle 2 for patients with non-Hodgkin’s lymphoma who did not experience a Grade 3 or 4 infusion-related adverse event during Cycle 1. The 90-minute rituximab faster infusion will result in a significant change in how nurses in the United States have been administering …

Communication And Teamwork Focused Simulation-Based Education For Nursing Students, Jared M. Kutzin

Doctor of Nursing Practice (DNP) Projects

Simulation has become a common teaching method for healthcare providers, including nursing students. Until recently, the focus of simulation for nursing students has been on clinical skills. This study used a compilation survey to determine if knowledge and attitude scores improved in the bachelor degree nursing student after exposure to a simulation-based teamwork and communication training. Participants were 51 students from the senior leadership course of a bachelor’s degree in nursing program at a university in New Jersey. Control participants received normal clinical rotations with faculty led discussions, and intervention participants received a 4-hour simulation, focused on teamwork and communication. …