Medicine and Health Sciences Commons^™

Exploring Relationships Among Environmental And Intrapersonal Variables And Evidence-Based Practice Implementation, Amanda N. Canada

Nursing Theses and Dissertations

Evidence-based practice (EBP) is not consistently implemented within healthcare settings; although many organizations claim it is how they deliver care in the 21^st century. In a review of the literature, multiple intrapersonal variables were found to impact the inconsistency with which EBP is applied and the success of its implementation within nursing practice. Organizational culture and perceived stress can influence the uptake of EBP beliefs and can affect EBP implementation. Clinicians who have more confidence in their EBP knowledge and skills are expected to implement best practices. Underpinned by Social Cognitive Theory, a model was developed to guide study …

A Quality Improvement Initiative To Facilitate Provider Adherence To Type Ii Diabetes Mellitus Guidelines, Yazmin Valencia

Doctor of Nursing Practice

Background:A significant number of individuals with type 2 diabetes mellitus do not receive comprehensive diabetes care management to maintain optimal health.

Purpose:This project was designed to facilitate provider adherence to the type 2 diabetes mellitus evidence-based practice standards of care. A primary care practice needs assessment indicated opportunities to improve care management processes which promote adherence to current clinical practice guidelines.

Methods:This 10-week quality improvement project provided the clinical staff and provider with the necessary tools to implement best practices of diabetes care. Objectives assessed throughout project implementation included the design and use of an electronic health …

Health Professions Faculty Beliefs, Confidence, Use, And Perceptions Of Organizational Culture And Readiness For Ebp: A Cross-Sectional, Descriptive Survey, Kerry A. Milner, Holly B. Bradley, Tammy M. Lampley

Tammy Lampley

Background: Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP.

“Code Labor”: An Evidence Based And Interdisciplinary Approach To Managing Women Experiencing Precipitous Labor Outside Of The Labor And Delivery Unit, Rachel Wooten, Rachel Smedley

Research, Publications & Creative Work

Local Problem: Precipitous deliveries can incite adverse obstetrical events and poor outcomes. In one rural northern Alabama hospital, 75-100 babies are delivered monthly with an average of two precipitous deliveries occurring monthly.

Objective: The intent of the work was to address a cohort of obstetrical (OB) and emergency department (ED) nurses’ knowledge gaps regarding the care of women experiencing precipitous labor outside of the labor and delivery (L&D) unit. DESIGN A quasi-experimental design aimed at quality improvement at the healthcare system’s level was developed. A non-probability, quota sampling method was used to gather data.

Participants: Fifty-seven ED and OB RNs …

Prescribing Probiotics In Tandem With Antibiotics In A Pediatric Setting., Allyson Riggs

Doctor of Nursing Practice Papers

Gastrointestinal (GI) discomfort including antibiotic associated diarrhea (AAD) is a common side effect of antibiotic therapy. As antibiotic use continues to increase, more patients are affected by AAD. Significant evidence has been found on using probiotics for the treatment and prevention of GI distress and AAD. Provider education is needed in the clinical setting to share evidence and make recommendations on best practice. The goal of this intervention was to increase the rate at which providers prescribe probiotics in tandem with antibiotics, via increased provider education. A retrospective Electronic Health Record (EHR) review was conducted once before and once after …

Innovative Lesson Plans For Active Learning: Teaching Nursing Research And Evidence-Based Practice, Susan M. Strouse Phd, Rn, Genevieve B. Elrod Phd, Rn, Ocn, Karyn Butler Phd, Rn, Fpmhnp-Bc, Cnm, Chibwe Caroline Powell Bsn, Rn, Afokoghene Odhu Bsn, Rn

Karyn Butler, PhD, CNM

Innovative Lessons Plans for Active Learning: Teaching Research and Evidence-Based Practice is a resource in research and evidence-based practice for active learning in the undergraduate nursing classroom. It is meant to supplement any nursing research text. Designed to provide educators with creative teaching ideas, this text includes a variety of lessons on nursing research topics. Topics include bias, measurement, sampling, theory and more. Lessons provide active learning for in-class, hybrid, and online formats. Each lesson includes objectives, overview, and detailed steps. As an open access resource, the text is continuously in-process. Designed to be independent of any published text, the …

The Effect Of Home Blood Pressure Monitoring And Self-Titration On Achieving Blood Pressure Targets, Katina A. Varner

Evidence-Based Practice Project Reports

One-third of U.S. adults over the age of 20 are hypertensive, with an estimated cost of $47.5 billion in direct medical expenses and increased individual CVD risk (CDC, 2018). Routine office visits afford primary care providers a means of managing hypertension; however, time constraints limit the ability to accurately assess and track BP in most patients (Jung, 2015). The purpose of this project was to determine if implementation of HBPM and an algorithm for selftitration of antihypertensive medications increased the number of participants at guideline recommended BP goal over a 90-day period. The Health Promotion Model provided the theoretical framework …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

The Force Of Magnetism: Nursing-Library Collaborations To Support Magnet, Barbara (Basia) Delawska-Elliott, Helene Anderson, Marla London

Books, Presentations, Posters, Etc.

Background: The ANCC Magnet model is built on 5 Model Components and 14 Forces of Magnetism. The Components and Forces, including Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, New Knowledge, Innovation & Improvement, and Empirical Quality Results (Models), and Professional Development, Quality Improvement, Nurses as Teachers, and Quality of Care (Forces) encourage and recognize professional growth, care improvement, and knowledge dissemination. Familiarity with searching professional literature and information literacy are key skills needed to grow Magnetism. This presentation will describe a collaboration between Magnet leadership and the library to build programs designed to support Magnet values and outcomes.

Description: Magnet …

The Impact Of Evidence-Based Practice On A Culture Of Safety, Donald C. Hunt

Nursing Theses and Dissertations

Background: 210,000 to 440,000 deaths have been caused by errors in healthcare. Providers who are committed to core values that emphasize safety contribute to a “culture of safety.’ This culture is required for healthcare institutions to achieve high-reliability status demonstrating high potential for error but few adverse outcomes. There is little known about contributors to the culture of safety and the commitment of providers to its core values.

Purpose: To determine relationships among the predictors- EBP culture, individual evidence-based decision making, organizational implementation of evidence-based practice - and a culture of safety.

Design: Correlational Predictive Design.

Sample: Two-hundred seventeen nurses …

Meditation As An Intervention To Help College Students Cope With Stress, Marissa Bottos

Evidence-Based Practice Project Reports

According to the American College Health Association (ACHA) (2017), in a survey of 31,463 students, 31.7% stated that stress negatively impacts their academic performance (lower grades, dropped course, etc.). Additionally, 45.1% of the students stated they have more than average stress levels. The purpose of this evidence-based practice (EBP) project was to determine if mindfulness meditation was effective in helping college students cope with stress. Based on current evidence, Jon Kabat-Zinn’s online application for mindfulness meditation is supported as an effective way to help college students cope with stress (Regehr et al. 2013; Yusufov et al. 2018; Cavanagh et al. …

Application Of Beers Criteria And A Brown Bag Event To Increase Prescribing Safety In Older Adults, Kristen Garza

Evidence-Based Practice Project Reports

With older adults making up about 14.5% of the U.S. population, polypharmacy may be an unintended consequence of adhering to clinical practice guidelines (Kim & Luck Parish, 2017). Effective polypharmacy interventions are needed in the primary care setting to increase prescribing safety and lower the risk of adverse drug events among older adults. The application of the Beers criteria, in conjunction with a brown bag medication reconciliation event, was initiated as focused interventions for a private primary practice without electronic health records. Outcomes included medication reduction, identification of possible inappropriate medication, decrease of medication dosages, and identification of duplicate medication. …

Diabetes Shared Medical Appointment: An Evidence-Based Innovation Project, Mohamed Bojang

DNP Final Reports

The purpose of the evidence-based practice innovation project (EPIP) is to address uncontrolled diabetes by implementing an evidence-based shared medical appointment (SMA) intervention which based on the body of the evidence will help improve diabetes outcomes. A pilot implementation and retrospective chart review were conducted. Data was collected on outcome indicators such as blood pressure, lipid values, body mass index, A1C, and knowledge. The results of a pilot SMA implementation revealed that patients who participated in the weekly SMA saw an improvement in post-mean values compared to pre-mean values. Mean A1c dropped to 7.0% from 7.11%; systolic blood pressure improved …

Toward Reducing Stress And Anxiety In Nursing Students: Implementing An Evidence-Based Mindfulness Program, Susan Mckee

DNP Final Reports

Stress and anxiety are increasing in college students, especially in nursing students who complete didactic and clinical courses concurrently. Nursing students report feeling overwhelmed, with distress affecting academic performance and balance of school and personal demands. Mindfulness is an evidence-based method of reducing human suffering due to troubling conditions such as pain, chronic illness, or psychological issues including stress and anxiety. This paper addresses the state of the science of mindfulness and details the current mental health concerns of college students, specifically nursing students. The body of evidence, gathered through a systematic search, suggests that mindfulness reduces stress and anxiety …

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Nurse-Identified Patient Care And Health Services Research Priorities In The United Arab Emirates: A Delphi Study, Nabeel Al-Yateem, Muna Al-Tamimi, Maria Brenner, Hanan Al Tawil, Alaa Ahmad, Sharon Brownie, Shameran Slewa-Younan

School of Nursing & Midwifery, East Africa

Background: The need for improved research on ill health has been recognized internationally and locally in the United Arab Emirates (UAE). The UAE Nursing and Midwifery Council recently committed to enhancing the status and contributions of nursing in healthcare research across the UAE by establishing a National Committee for Research Development. This study using a Delphi method to identify research priorities from the perspective of nurses delivering frontline healthcare.

Methods: A two-phase Delphi design was implemented with 1032 nurses participating in phase one of the study and 1339 in phase two.

Results: The most important priority was patient safety and …

What? Not Another Fall!: Reducing Falls In The Neuroscience Patient Population, Elizabeth Plante

Nursing Posters

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.

Reducing Falls In The Neuroscience Patient Population, Elizabeth Plante

Nursing Posters

Purpose Statement:

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.

Midwives' Use Of Best Available Evidence In Practice: An Integrative Review, Annemarie De Leo, Sara Bayes, Sadie Geraghty, Janice Butt

Research outputs 2014 to 2021

Aims and objectives: To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care.

Background: Midwifery is a research‐informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice.

Design: A five‐step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search …