Medicine and Health Sciences Commons^™

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Meaningful Recognition And The Effect On A Medical-Surgical Unit's Staff Satisfaction And Retention, Lindsey Greene

MSN Capstone Projects

The current state of the American healthcare system is riddled with challenges. Nurse administrators are faced with the formidable tasks of decreasing operating costs; improving the patient experience; delivering high-quality and safe patient care; and decreasing the mounting rates of nurse turnover. Nurse leaders must understand the complexities of their work environment, including the key drivers for nurse satisfaction and retention. In 2005, the American Association of Critical Nurses developed six standards for creating a healthy work environment. (American Association of Critical Care Nurses, 2016). An adult, medical-surgical unit at a South Texas hospital was faced with rising rates of …

Transformational Leadership - An Integrated Evidence Review, Marta L. Hudson

DNP Qualifying Manuscripts

Abstract

For chief nurse executives to survive in contemporary healthcare organizations must cultivate nurse leaders who are poised to produce nurse job satisfaction and subsequently, patient outcomes, including quality and patient safety. The article describes an integrated evidence review of the relationship between transformational leadership and nurse job satisfaction. The author identifies implications for practice and further research.

Evolving Nurse Leadership Role In 2020, Nasreen Rafiq, Farida Bibi Mughal

School of Nursing & Midwifery

No abstract provided.

Organizational Strategies To Promote Nurse Resilience In The Acute Care Hospital Inpatient Setting: An Integrative Review, Marcia A. Depolo

Doctoral Dissertations and Projects

Nurses practicing in acute care hospital environments are exposed to constant stressors from a variety of sources. Workplace stress can lead to unhealthy coping behaviors, illness, and burnout, with intent to leave the organization or the nursing profession altogether. Resilience-building strategies can be employed to foster coping, improve nurse wellbeing, increase job satisfaction, promote retention, and enhance quality patient outcomes. This integrative review provides a synthesis of scholarly publications on nursing resilience from January 2014 through October 2020. Themes to promote nursing resilience occurred at three levels: personal or individual, unit or group, and organizational. This paper will provide a …

Nursing Leadership During Covid-19: Enhancing Patient, Family And Workforce Experience, Anne Aquilia, Karen Grimley, Barbara Jacobs, Maryellen Kosturko, Jerry Mansfield, Charlotte Mathers, Peggie Parniawski, Laura Wood, Victoria Niederhauser

Patient Experience Journal

The global COVID-19 pandemic has challenged nurse leaders in ways that one could not imagine six months ago. Along with ongoing priorities of providing high quality, cost-effective and safe care, nurse leaders are also committed to creating environments that support excellence in patient and family experience. This article will provide exemplars of how nurse leaders used decisive decision-making, adapted to novel situations and issues, ensured reliable and safe delivery of care and engaged patients, families and their workforce to create excellent experiences of care during the pandemic. Throughout this crisis, nurse leaders have learned how to grapple with quick and …

Preceptor Education And Structured Onboarding Process, Charles Morato

Master's Projects and Capstones

Problem: Staff nurse retention is an ongoing problem for this intensive care unit (ICU). Through exit interviews from staff who left, inadequate onboarding and education made them feel unprepared for their job and not part of the team. The preceptors on the unit have never been trained on the roles and responsibilities of being a preceptor. The current onboarding process consists of pairing new hires with a preceptor who either happens to be willing to do it that day or someone who has been there the longest. There is no consistency or personalizing the orientation information to the new hire. …

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …

Implementation Of A Wellness Program For Emergency Department Medical Professionals., Madeleine Chesney

Doctor of Nursing Practice Papers

Background: Current data from the ANA HealthyNurse Survey 2018-2019 states that 70 percent of nurses that were surveyed report putting the health, safety, and wellness of their patients before their own. Additionally, in a study conducted between 2011 and 2017 of over 5,000 physicians less than 50 percent stated that they had enough time for their personal and family life. This data supports the urgent need to focus on the promotion of self-care and wellness for medical professionals. Objective: The purpose of this quality improvement project was to provide an opportunity for emergency department medical professionals to work toward improving …

Increasing Access To Medicare Annual Wellness Visits In Primary Care; Utilizing Registered Nurses As Part Of An Interdisciplinary Team Based Approach, Iyo Kubota

Doctor of Nursing Practice (DNP) Projects

Background: In order to provide evidence-based preventive care to the aging population, Medicare began providing free annual wellness visits (AWVs) to its beneficiaries in 2011. The AWVs are a great opportunity for primary care providers to develop personalized preventive care as well as health promotion. However, many primary care practices especially those with limited resources struggle to incorporate AWVs into their busy primary care practice. Centers for Medicare and Medicaid Services allows other providers than physicians, NPs and PAs to perform those visits including registered nurses, health educators, and registered dietitians.

Methods: A pilot project was conducted with 12 patients …

The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts

Evidence-Based Practice Project Reports

Substance use disorders are a worldwide problem, according to the Center for Disease Control (CDC) there were 70,237 drug overdose deaths that occurred in the United States in 2017, of which 47,600 were opioid related. Illinois had a 14.3% increase of opioid deaths from 2016-2017 (CDC, 2017). Numerous interventions exist to address this health concern, yet evidence shows that Motivational Interviewing (MI) was the most efficient and effective way to promote behavioral change. The purpose of this EBP project was to provide evidence that MI increased referrals and promoted compliance with appointments to treatment programs. The sample for this project …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

Self-Management For Individuals Using Long-Term Urinary Catheterization, Lisa Krabbenhoft

Theses & Dissertations

Many individuals with adult neurogenic lower urinary tract disorder require long-term urinary catheterization for bladder management. The daily use of urinary catheterization increases the risk for chronic complications including catheter associated urinary tract infections. Previous studies have used self-management interventions to reduce chronic complications in the community setting. However, there are limited intervention studies focused on reducing chronic complications after discharge from a rehabilitation hospital. The purpose of this dissertation study is to examine the feasibility and impact of a self-management intervention on individuals after leaving rehabilitation hospital for home within the community.

This dissertation comprises two studies, the first …

Preventing Substance Use Disorder In Anesthesia Providers, Tyson Rogers

Doctor of Nursing Practice Projects

Developing substance use disorder is considered one of the most serious occupational risk factors for anesthesia providers. The purpose of this project was to identify the prevalence and risk factors of substance use disorder within the anesthesia community and to signify the importance of early education and awareness to help prevent the development of substance use disorder through early education, identification, and awareness. The project consisted of an educational PowerPoint that was placed on Southern Illinois University Edwardsville’s (SIUE) wellness website within Black Board. The third-year nurse anesthesia students at SIUE were sent an email on how to access the …

A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). …

A Multifactorial Intervention To Reduce Weight Bias In Healthcare Providers, Rose M. Flinchum

Evidence-Based Practice Project Reports

No abstract provided.

Does Access To Telephone Counseling Improve Smoking Cessation In Disadvantaged Populations?, Karin Warden-Thomas

Evidence-Based Practice Project Reports

Tobacco usage leads to the development of a multitude of diseases. Years of research have shown that evidence-based interventions such as counseling and pharmacotherapy increase smoking quit rates. Studies have demonstrated that either proactive or reactive telephone counseling has been beneficial in providing long term smoking abstinence particularly in disadvantaged populations (Haas et al., 2015). The purpose of the project was to improve smoking cessation by facilitating access to telephone counseling using an electronic medical order. The Stevens Star Model of Knowledge Transformation (Stevens, 2004), was the framework employed to support the process for change. This evidenced-based project occurred at …

Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free

Evidence-Based Practice Project Reports

Childhood obesity is one of the most chronic childhood illness worldwide (Centers for Disease Control and Prevention [CDC], 2019; World Health Organization [WHO], 2019). The prevalence of childhood obesity has been described as one of the most common chronic childhood conditions (CDC). The purpose of this evidence-based practice (EBP) project was to reduce the BMI scores of obese children using a multi-component intervention program that incorporates healthy eating, physical activity, and family involvement. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was used to facilitate the implementation of this EBP project. The synthesis of the appraised literature established that utilizing …

The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur

Evidence-Based Practice Project Reports

In the US, overweight and obesity are growing concerns, as both can have life altering consequences if not prevented or treated. Since 2000, there has been nearly a 10% increase of adults who are obese, from 30.5% (85.8 million) to 39.8% (93.9 million) in 2016 (CDC, 2017). These conditions are preventable with early intervention and motivation. Obesity statistics are especially of interest during the transition to young adulthood. The purpose of this project was to improve student outcomes by identifying barriers, effective strategies, and healthy choices that would ultimately impact weight, increasing healthy food choices, and decreasing overall BMI in …

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper

Evidence-Based Practice Project Reports

Breast cancer is the most frequently diagnosed cancer among women in Indiana and the United States (Indiana Cancer Organization, 2019). An estimated 268,000 new cases of invasive breast cancer were diagnosed and 41,760 women died due to breast cancer in 2019 (ACS, 2019). Substantial breast cancer-related morbidity and mortality disparities persist among the underserved. Disparities in breast cancer outcomes are due to lower mammography screening rates, lack of timely follow-up of abnormal results, and lack of timely treatment initiation among women with breast cancer (Highfield et al., 2015). The purpose of this evidence-based practice project was to address low mammography …

A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold

Evidence-Based Practice Project Reports

Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed …

A Protocol To Increase Referral Rates To Diabetic Education, David M. Rokser

Evidence-Based Practice Project Reports

In 2015, approximately 30.3 million Americans, including 10.5% of the population of Minnesota, had been diagnosed with diabetes mellitus (American Diabetes Association, 2019). Increased risk of diabetic complications including neuropathy, retinopathy, nephropathy, cardiovascular disease, and chronic wounds has been associated with an elevated hemoglobin A1C (HgA1C). Formal diabetic education has been shown to be a cost-effective intervention to reduce HgA1C. The Office of Disease Prevention and Health Promotion published an objective within HealthyPeople 2020 that seeks to increase the percentage of diabetics receiving formal diabetic education in the United States from 46.9% of adults to 58.4%. The purpose of this …

You're Not Forgotten: Effects Of Screening For Postpartum Depression Within A Pediatric Setting, Marrisa S. Culver

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is depression that occurs in women following childbirth occurring during the postpartum period and affects 1 in 7 women (The United States Preventive Services Task Force, 2019). The American Academy of Pediatrics [AAP] (2019), recommends that pediatric healthcare providers utilize their position to screen for PPD. The purpose of this evidence-based practice (EBP) project was to implement a PPD screening intervention within a pediatric healthcare setting using the Edinburgh Postnatal Depression Scale (EPDS). The Academic Center for Evidence-Based (ACE) Practice Star Model guided this EBP project with evidence-based interventions developed after a comprehensive literature search. Implementation of …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Take A Shot: The Effect Of A Multicomponent Strategy To Increase Meningitis B Vaccination Rates, Valerie Cline

Evidence-Based Practice Project Reports

Neisseria meningitidis is the major cause of invasive meningococcal disease (IMD) (Peterson et al, 2018). Approximately 10-15 percent of IMD cases result in debility including neurological impairment, amputation, and death (Peterson et al, 2018). Outbreaks of IMD are sporadic and unpredictable. The incidence of IMD varies geographically, but serogroup B has become more prevalent in recent years. Meningitis-B (Men-B) has been the cause of several university outbreaks on different US college campuses since 2013.The purpose of this project was to implement an intervention at a midwestern university student health center to help students understand the risk of the disease and …

Efficacy Of A Mobile Application In A Chronic Kidney Disease Population, Jennifer R. Zamora

Evidence-Based Practice Project Reports

Chronic kidney disease (CKD) is associated with high healthcare costs, poor health outcomes and low quality of life (Donald et al., 2018). The US CKD prevalence is 15%, costing Medicare $79 billion in 2016 (United States Renal Data System, 2018). Self-management could reduce CKD burden (Jeddi, Nabovati, and Amirazodi, 2017). Mobile technology offers a low-cost, ease-of-access platform for chronic disease self-management (Whitehead & Seaton, 2016), potentially slowing disease progression and improving health outcomes (Jeddi, 2017). The purpose of this project was to utilize a CKD-specific mobile application, CARELogiQ, to facilitate symptom management; increasing patient satisfaction and decreasing hospitalizations and ER …

Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger

Evidence-Based Practice Project Reports

Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …

The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong

Evidence-Based Practice Project Reports

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et …