Medicine and Health Sciences Commons^™

Improving Obesity Management In Primary Care, Jeffrey M. Waddell

Doctor of Nursing Practice Scholarly Project

This project examined how advanced practice nurses (APNs) manage overweight and obesity in primary care. Not only were their general attitudes and beliefs toward overweight and obesity explored, but their beliefs about the treatment and management of obesity were also examined. The APNs’ knowledge and current practice with managing obesity in the primary care setting were evaluated. This project went on to examine the APNs’ awareness and utilization of clinical practice guidelines in managing overweight and obesity. Finally, the study asked about the perceived impact of a website designed to provide guidance managing obesity based on the American Association of …

Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton

Doctor of Nursing Practice (DNP) Projects

The demand for surgical services continues to increase, creating a strain in our healthcare system and causing increasing backlog hours for the operating room. Allowing nurse practitioners (NP) to function in an expanded role in the perioperative environment requires additional training beyond the generic NP program. With this additional training, the NP can function as a first assistant, providing delegated medical functions in the perioperative environment. An in-house NP registered nurse first assistant orientation program was developed based on the adult learning theory as a conceptual framework combined with the AORN perioperative standards as a foundation. The cost of using …

A Healthcare Provider Needs Assessment Regarding Transgender Patient Health For A Student Health Services Center, Dorothy J. Cochran

Dissertations

Objective: This study sought to identify education and training needs of university health service providers regarding transgender patient care. Transgender patients are a vulnerable population who tend to have negative health outcomes. Limited information exists regarding transgender patients and their providers at student university health services nationally.

Methods: The researcher conducted a one hour semi-structured focus group with the professional staff at a Midwestern state university health service. The focus group conversation was guided by a list of prepared questions but other issues were allowed to arise. Two readers qualitatively analyzed the focus group transcripts for predominant themes.

Participants: The …

Electronic Health Records And Patient Safeety: Nurse Practitioners’ Experiences In Clinical Practice, Lindsay Dixon, Karen Whitt

Journal of Undergraduate Research

The purpose of this project was to evaluate practicing nurse practitioners’ experiences and satisfaction with electronic health records (EHRs). In response to health policy initiatives and incentives, many healthcare organizations in the U.S. have recently implemented EHRs in clinical practice. Despite expectations that EHRs can improve patient safety, there is evidence that EHRs have the potential to contribute to adverse patient events and medical errors. Therefore, an urgent need to improve the safety of EHRs has been recognized. In June 2015, a study was conducted by Dr. Karen Whitt that invited nurse practitioners to share their experiences and satisfaction with …

Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)

Doctor of Nursing Practice Final Manuscripts

Background
Veterans are disproportionately affected by chronic pain. Conventional pain management lacks emphasis on self-care and relies heavily on prescription opioids. Primary care providers (PCP) are able to educate veterans on self-care management; however, frequent follow-up is needed to improve overall pain and quality of life.

Objective
To implement a Nurse Practitioner (NP) telephone follow-up guided by the 5A’s framework among veterans with chronic pain in a primary care setting. This pilot evidence-based project (EBP) aimed to improve follow-up of self-care management in order to decrease pain, increase quality of life, and decrease pain medication use.

Materials & Methods
The …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

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). …

Proper Prescribing Of Controlled Drugs: A Pilot Study Of A Web-Based Learning Modules’ Impact On Knowledge, Attitude, And Practice In New Graduate Nurse Practitioners, Shelly Duckett

DNP Scholarly Projects

Controlled substance abuse is a global epidemic. Several factors that influence health care providers prescribing habits have been presented in recent literature. However, the existing evidence primarily reflects the prescribing habits of physicians, while relatively little is known about the prescribing habits of nurse practitioners. The purpose of this project is to evaluate the impact of a brief web-based continuing education module targeting appropriate prescribing of controlled substances for recent graduate nurse practitioners. The project served to assess the provider’s knowledge, attitude, and practice compared to current integrated curriculum on prescribing and assess change in knowledge. Two online educational modules …

The Design Of An Evidence-Based Protocol For Primary Care Of Patients With Dementia, Kaitlin B. Demaagd

Doctoral Projects

Improvement in the effectiveness and optimization of care outcomes for patients with dementia in primary care is a national priority (American Medical Association-convened Physician Consortium for Performance Improvement [PCPI], 2014). Alzheimer’s disease affects more than 5 million Americans. Patients with dementia cost the nation $236 billion in 2016 (Alzheimer’s Association, 2016). In 2014, the PCPI developed ten evidence-based recommendations to address the gaps in outpatient dementia care called the Dementia Performance Measure Set (DPMS). An independently owned, non-system affiliated primary care practice identified the need to improve the quality of care they provide to their patients with dementia and their …

A Comparison Of Usage And Outcomes Between Nurse Practitioner And Resident-Staffed Medical Icus., Rachel Scherzer, Marie P Dennis, Beth Ann Swan, Mani Kavuru, David A. Oxman

College of Nursing Faculty Papers & Presentations

OBJECTIVE: To compare usage patterns and outcomes of a nurse practitioner-staffed medical ICU and a resident-staffed physician medical ICU.

DESIGN: Retrospective chart review of 1,157 medical ICU admissions from March 2012 to February 2013.

SETTING: Large urban academic university hospital.

SUBJECTS: One thousand one hundred fifty-seven consecutive medical ICU admissions including 221 nurse practitioner-staffed medical ICU admissions (19.1%) and 936 resident-staffed medical ICU admissions (80.9%).

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Data obtained included age, gender, race, medical ICU admitting diagnosis, location at time of ICU transfer, code status at ICU admission, and severity of illness using both Acute Physiology …

Community-Based Advance Care Planning Seminars: Increasing Knowledge In Decisional Adults, Molly Kuehl

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Healthcare workers care for patients with many comorbidities- many of whom enter the system without a clear understanding of their values and preferences. Private discussions about advance directives (ADs) are effective, but cost-prohibitive. Community-wide education campaigns may result in improved quality of life (QOL) (Blackford & Street, 2012a; Bomba & Orem, 2015; Pecanac, Repenshek, Tennenbaum, & Hammes, 2014; Wilson, Kottke, & Schettle, 2014). The purpose of this project was to determine whether community-based seminars about advance care planning (ACP) increase knowledge in decisional adults 18 and older. This project combined discussion format with an ACP presentation. The presentation was delivered …

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. …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …