Medicine and Health Sciences Commons^™

Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust

Electronic Theses and Dissertations

This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …

Advocating For Nurse Practitioner Independent Practice, Tamara Troyer Denlinger

Doctor of Nursing Practice Final Manuscripts

This project was an anonymous qualitative/quantitative survey of nurse practitioners in California to determine if passage of AB 890, which provides a pathway to independent practice, will result in more NPs choosing to practice independently after clinical hour requirements are met. Access to primary health care in California is projected to worsen over the next 10-15 years, particularly in rural areas, and an average of 44% of residents may be without enough access to care. Some areas in the state will be harder hit than others with Alpine, Calaveras, Glenn, and San Benito counties likely to be hardest hit by …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

Implementing Hand Hygiene Protocol For Direct Care Staff In An Inpatient Psychiatric Facility To Improve Hand Hygiene Compliance, Juliet Mkpuechina

Doctor of Nursing Practice Projects

Background: Handwashing with soap and running water is one of the most effective ways to prevent diseases and infections spread through touch. Hand hygiene refers to handwashing with soap, water, and other disinfecting agents to prevent infection. According to Chassin et al. (2017), hand hygiene compliance reduces healthcare-associated infections (HAI). Studies show that an increase in handwashing compliance can be correlated to a decrease in healthcare-associated infections. Studies have proven that though it is challenging to link hand hygiene to a reduction in healthcare-associated infections directly to improved hand hygiene compliance, many hospitals have seen a decline in HAIs as …

Utilization Of Remap Conversation Tool To Improve Advance Care Completion In The Home-Based Palliative Care Community Setting, Gwendolyn Starkey

Doctor of Nursing Practice Projects

Background: The World Health Organization and the American Society of Clinical Oncology guidelines endorses mandatory communication skills training in care goals for seriously ill patients (Back et al., 2019). In one survey of primary care providers (PCP), 68% reported no formal training to discuss advance care planning (Comer et al., 2020). Advance care planning is essential to manage chronic conditions in our growing aging population to provide the best patient care. This manuscript aimed to discuss best practices and techniques in advance care planning and optimize skills to provide patient-centered care conversations that honor patient wishes, reduce unwanted hospitalizations, and …

Development And Implementation Of A Standardized Protocol For Nurse Practitioners Working In An Aud Treatment Telehealth Program, Cj Dea

Doctor of Nursing Practice (DNP) Projects

Background

Alcohol Use Disorder (AUD) is a major public health concern in the United States. Ria Health is a growing telehealth provider delivering AUD treatment through pharmacotherapy combined with behavioral health counseling.

Local Problem

Ria Health employs six California licensed nurse practitioners, but two of them have not yet met all the California provisions to practice independently without protocols. Ria Health has not put any standardized protocols in place.

Methods

This DNP project involved the creation of an evidence-based standardized protocol for AUD. The Student Satisfaction and Self-Confidence in Learning questionnaire was disseminated to participating nurse practitioners to measure student …

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Nurse Practitioners' Adjustment To The Hospitalist Position: A Grounded Theory Study, Donna Tanzi

Dissertations, Theses, and Capstone Projects

Hospital based medicine is the fastest growing medical specialty in the United States. While most hospitalists are internal medicine residency graduates, most of these new internal medicine medical graduates are choosing not to enter hospital medicine, resulting in a growing hospitalist workforce shortage. To fill this staffing gap, nurse practitioners (NPs), some with no previous NP experience, are assuming hospitalist positions. As more NPs assume hospitalist positions, they face challenges adapting to the prevailing physician-based hospitalist model, such as attaining requisite medical knowledge and skills and establishing credibility and rapport with other care team members. Through a series of semi-structured …

Improving Healthcare Provider Knowledge Of Hospice And Palliative Medicine, Ashleigh T. Flora

DNP Projects

By addressing the diseases symptoms directly, palliative care improves patients feel and can participate in their life by providing indispensable holistic health management and support for patients and families. Hospice is the focused service of palliative care, provided by specially trained healthcare professionals. Evidence suggests that patients are poorly educated on chronic illnesses, providers are failing to have end of life discussions with patients, and providers are poorly educated as to services available to patients at end of life. This quality improvement project was designed to assess provider knowledge of hospice and palliative care utilization. Convenience sampling was used to …

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic

Electronic Thesis and Dissertation Repository

Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …

Promotion Of Heart Failure Self-Care In The Outpatient Setting, Meredith C. Lubas

Seton Hall University Dissertations and Theses (ETDs)

Medical management of chronic heart failure consists of a closely managed medication regimen, cardiovascular testing, interventions, and lifestyle modification, including self-care practices. While medication management, testing, and interventions have concrete guidelines, heart failure self-care education lacks solid guidelines and thus is often poorly defined and variable in practice. Outpatient heart failure treatment typically focuses on medication management more than self-care practices. This project addresses the current lack of heart failure self-care education in the outpatient setting.

For this project, a total of seven patients with heart failure with a reduced ejection fraction received a patient survey in order to assess …

Nurse Practitioner Opioid Prescribing And Safety Measure Utilization Patterns In Ontario: An Explanatory Sequential Mixed Methods Study, Gina Pittman

Electronic Theses and Dissertations

Background. There has been a rise in opioid-related hospitalizations, emergency department visits, and mortality due to opioid poisoning across Canada. There is a gap in research related to Nurse practitioner (NP) opioid prescribing and safety measure utilization patterns and sparse literature related to physician opioid prescribing (Pittman et al., 2020). Purpose. A mixed methods approach, specifically an explanatory sequential three-phase study, was undertaken to explore this topic. The initial phase was development of the quantitative survey, followed by collection and analysis of the quantitative data. A final qualitative phase added insight into the quantitative results. There were four objectives for …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …

Assessing The Perceptions And Attitudes Of Burnout Syndrome In Nurse Practitioners In Primary Care Settings, Keisha D. Mckinsey

Electronic Theses and Dissertations

The implications of workload and personal and patient-related burnout have been identified in numerous physicians’ studies. While burnout syndrome has become a subject of great interest for examining provider burnout to assess successful solutions, there is minimal research unique to nurse practitioners in primary care settings. This project was intended to determine the prevalence and effect of nurse practitioners’ burnout in primary care settings and make recommendations for improving nurse practitioners’ overall health and well-being. The key outcomes of concern for this project were, first, improvement in burnout scores on the Copenhagen Burnout Inventory tool pre- and posteducational intervention, and …

Health Care Initiative To Evaluate The Impact Of A Nurse Practitioner Led Community Wound Care Service On Emergency Department Utilization, Sherry Morrell

Electronic Thesis and Dissertation Repository

Nurse Practitioners (NP) diagnose and treat wounds and wound-related conditions based on their advanced scope of practice. An NP with graduate-level wound care education (NP(W)) gains additional knowledge and clinical experience to provide comprehensive wound care.

This research aimed to explore community patients’ access to wound care in Southwestern Ontario (Canada). A quality improvement project was initiated utilizing stakeholder feedback to develop and implement a 12-week pilot NP(W)-Led community-based wound care service; the NP(W) wound care practices, clinical outcomes, and adverse events were described. One hundred twelve participants attended the service over 117 visits. The NP(W) services included prescribing and …

Mentorship Experience Among Nurse Practitioners, Chelsea L. Noble

Doctor of Nursing Practice Scholarly Projects

Background and Review of Literature: The current literature provides the context of mentorship and its benefits across various disciplines. Nursing and medicine use mentorship frequently to guide each new generation of healthcare providers. There is a current lack of research focusing on nurse practitioners as it relates specifically to mentorship.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate mentorship in nurse practitioners and across subspecialties.
Methods: A descriptive correlational study was conducted. Data were collected using the Mentor Evaluation Tool (MET) and the National University Hospital Mentorship Evaluation (NUH ME) tool that were administered …

Providing Hispanic Immigrant And Migrant Health Care In America: Could Nps Be The Answer?, Hamabwe Kabwe

All Graduate Theses, Dissertations, and Other Capstone Projects

In recent years, the United States (U.S.) has seen an influx of Hispanic/Latino migrants/ immigrants fleeing their homes in South America, seeking opportunities for a better life in the U.S. Immigrants and their families often present to the U.S. with unique, unmet health care needs that ultimately impact the U.S. healthcare system and migrant health outcomes. Migration is a significant burden for the U.S. health care delivery system today and further magnifies known problems including inability to provide care to all because of lack of insurance for all, racial disparities in care outcomes, and unequal distribution of providers. There is …

Social Network Centrality, Social Construction Of Knowledge, And Nurse Practitioner Competency In Asynchronous Online Discussions Among Adult Gerontology Acute Care Nurse Practitioner Students, Sharon Schaaf

Organization, Information and Learning Sciences ETDs

The relationships between social network centrality, social construction of knowledge, and nurse practitioner competency among adult gerontology acute care nurse practitioner students participating in asynchronous online discussions were explored. Social network centralities (betweenness, in-degree, out-degree, closeness, and eigenvector) were determined through social network analysis. Social construction of knowledge was assessed by the Interaction Analysis Model (IAM). Nurse practitioner competency was evaluated using the Novice to Expert model. A retrospective exploration of an online discussion board from the College of Nursing at the University of New Mexico was conducted. The centralities of betweenness, closeness, and eigenvector demonstrated a significant relationship with …

Ultrasound-Guided Peripheral Intravenous Catheter Insertion For Nurse Practitioners, Alvin Joseph Abad

Doctor of Nursing Practice (DNP) Projects

Problem

Intravenous (IV) catheter insertion is a necessary skill in the emergency department (ED) for indications such as medications, fluids, and blood transfusions. Occasionally, patients present with difficult IV access (DIVA), requiring multiple insertion attempts and central venous catheter (CVC) placements. Due to the invasive nature of these procedures, patients can experience a great deal of pain and discomfort. Furthermore, although CVCs are necessary in critically ill patients that require hemodynamic monitoring or vasopressor infusions, they can cause several problems. For instance, central-line associated blood stream infections are some of the most common complications and result in increased costs and …

Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction And Reducing Turnover Rates Of Advanced Practice Providers, Christian Brooks

Doctor of Nursing Practice Scholarly Project

Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction and Reducing Turnover Rates of Advanced Practice Providers

Background: The CVS practice in a Midwestern state had a shift in morale and job satisfaction in their advanced practice providers (APPs). This shift lead to the high turnover rate of 35% in 2018. In an effort to bring a halt to the high turnover rate, and to continue the excellent patient care for which the hospital is known, hospital administration became involved and set up a committee to guide the development of a new CVS APP practice model. The goal was to develop …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Anne Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

A Nurse Practitioner-Led Group Advance Care Planning Program In An Independent And Assisted Living Community, Alexander Bustos

DNP Qualifying Manuscripts

It has been well documented that the majority of people want to spend their last days in the comfort of their own homes, free of pain, and off any dependent machine. , However, the majority of people have not documented these wishes or talked with their family or provider about end of life care (Hamel, Wu, & Brodie, 2017). The Patient Self Determination Act (PSDA), which took effect on December 1, 1991, was enacted to raise awareness and promote discussions between patients and providers about end of life (EOL) healthcare decisions. The primary care nurse practitioner is in a prime …

Defining Young Adulthood, Elena Higley

DNP Qualifying Manuscripts

Young adulthood is a unique developmental period that occurs between the ages of 18 and 25 years, during which there are key developmental tasks that allow the young adult to participate in self-exploration and identity formation. Currently, among various organizations there are differing definitions and age range inclusions for young adulthood, which cause confusion during program development, healthcare service delivery, and research. Young adulthood should be categorized separately from adolescence and adulthood, because young adults have lower rates of healthcare utilization and worse health outcomes related to preventable causes of morbidity and mortality than the surrounding age groups. Young adults …