Medicine and Health Sciences Commons^™

Improving Nurse Knowledge And Comfort In Advance Care Planning, Hajrudina Brkic, Marisia Young

Nursing DNP Projects

Objectives: The purpose of this project was to increase nurses’ knowledge and comfort level regarding advance care planning (ACP) in patients with a diagnosis of heart failure (HF) in a clinical setting.

Methods: A quasi-experimental design was used with a pre-and-post test administered to nurses prior to the beginning of a four-hour interactive class and immediately following the class. The data was analyzed using a 5-point Likert scale and paired t-tests were used to determine statistical significance. Statistical significance was set at 0.05.

Results: Of the eight nurses who participated in the interactive course, seven were female, one …

Patient Controlled Fluid Restriction Monitoring, Christina Tindel

MSN Capstone Projects

Patients are often placed under non-pharmacologic orders such as fluid restrictions during their hospital stay. The following article will discuss a plan to implement a change to have patients take a more active role in their plan of care by being the main ones to monitor their fluid intake.

Structured Discharge Education: A Benchmark Study, Michaela E. Place

MSN Capstone Projects

Patient satisfaction is a topic of interest in many clinical settings. There are many ways healthcare providers can attempt to promote patient satisfaction. One of the most important is to ensure comprehensive discharge instructions are given to patients, especially in the emergency department (ED). One particular study found that in patients discharged from the emergency department, approximately one-fifth experience negative health-related issues that result in readmission or return visits to the ED in the month post-discharge (Campione, Smith & Mardon, 2017). “To reduce the readmission rate, various discharge planning and patient education programs have been provided to the patients preparing …

Optimizing Screening Mammography: Educating Underserved Individuals With Limited English Proficiency, Yao Luo

Doctor of Nursing Practice (DNP) Projects

Problems: Culture and language may create huge barriers to the delivery of high-quality care for patients with Limited English Proficiency (LEP) who are seeking breast cancer care, especially in a population that consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 45 years of age.

Context: LEP patients’ inability to effectively communicate and inadequate knowledge about screening mammography have put them at great risk of receiving additional images during the exam, as well as brought a huge burden to technologists regarding breast positioning.

Interventions: A Doctor of Nursing Practice project was implemented to …

Improving Medication Communication Of Nurses To Patients In The Cardiac Procedure Unit, Jose Abrogar

Master's Projects and Capstones

Abstract

Problem: Effective communication about medications and their potential side effects is a significant indicator of safe patient care and improved health outcomes. The Cardiac Procedure Unit (CPU) of a large medical center in California recently received a low HCAHPS (CMS, 2019) score of one star (out of five) in the area of medication communication.

Context: The CPU is a microsystem that provides pre and post cardiac procedure care for patients of diverse backgrounds. It has a highly competent staff administering patient care. Current patient medication education faces challenges that hinder patient receptivity and thus understanding.

Intervention: The proposed project …

Total Joint Replacements And Prevention Of Surgical Site Infections, Mari Rearley

Nursing Student Class Projects (Formerly MSN)

Surgical site infections continue to be a leading cause of postoperative complications in hospitals across the nation. Although much progress has been made in preventing postoperative infections, it continues to be cost intensive within the medical institution. It also reduces patient satisfaction and quality of life. The majority of joint replacement surgeries are considered to be elective, which provides an opportunity to plan ahead to provide education to the patient and make other necessary changes to ensure high quality care is provided at all times. Each phase of surgery has the potential to greatly impact the desired outcome and improve …

Reducing Frustration With Wait Times Utilizing Technology And Education: A Patient Satisfaction Improvement Model, Tiffany Brown

Doctor of Nursing Practice (DNP) Projects

Problem: Patients spend considerable amounts of valuable time waiting to be seen by physicians in outpatient clinical settings. Many consider waiting as wasted time, inactive time, or as a lost opportunity which can cause frustration. Research suggests that long clinic wait times have a major impact on patients with cancer causing a significant amount emotional distress. Context: At the hospital and thoracic oncology clinic implementation site which is located in northern California, the target time for a New Patient Visit (NPV) is less than or equal to 90 minutes, and less than or equal to 60 minutes for a Return …

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). …

Barriers To Pregnancy Health Care Perceived By The Hispanic Community In The Northern Midwest, Anna King

Honors Program Projects

BACKGROUND: This study explored the barriers to pregnancy health care experienced by Hispanic women. Research has shown that Hispanic patients are less likely to have adequate health insurance coverage compared to the white population in the United States and frequently face communication barriers in health care, as interpretive services are underutilized. These barriers may cause the Hispanic population to delay seeking health care and can lead to poor health outcomes. This is especially a problem in pregnancy health care, where prompt prenatal care is essential in ensuring a healthy pregnancy and positive health outcomes in both mother and baby.

METHODS: …

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 …

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 …

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 …

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 …

Patient Education In The Hospital-At-Home Care Context, Heli Vaartio-Rajalin, Linda Nyholm, Lisbeth Fagerström

Patient Experience Journal

The objective of this study is to describe adult patients’ and their family caregivers’ experiences of patient education in the hospital-at-home care context. Methods included a cross-sectional descriptive study including three hospital-at-home units in Finland. Adult, non-palliative patients (n = 27) and their family caregivers (n = 18) were interviewed pairwise by telephone, and the data analyzed with inductive thematic content analysis. COREQ guidelines were used to plan and guide the study design. Results concluded both patients and family caregivers seemed to have quite similar knowledge expectations, which only differs slightly from findings in other in- or outpatient contexts. In …

Living Sweet: A Multi-Functional Mobile-Phone Application Strategy For Adults With Uncontrolled Type 2 Diabetes Mellitus, Chantel K. Anderson

Evidence-Based Practice Project Reports

Type 2 Diabetes Mellitus (T2DM), one of the most common chronic diseases, is increasing worldwide, and once diagnosed, lifetime self-management is critical to maintain glycemic control (Vermeire et al., 2005; American Diabetes Association (ADA), 2018). Management of T2DM has been acknowledged as challenging due to the need for strict lifestyle adaptations. From a public health perspective, uncontrolled diabetes leads to increased healthcare costs, secondary complications, and ultimately severe disabilities (ADA, 2018). The purpose of this evidencebased practice (EBP) project was to evaluate the effectiveness of a diabetes-specific mobile health application (MHA) on glycated-hemoglobin (HbA1C), self-care perception (SCP), and self-care behaviors …

Effect Of Lifestyle Modifications On Blood Pressure And Bmi In Overweight Or Obese Adults With Primary Hypertension, Mariska Vandenbergh

Evidence-Based Practice Project Reports

Hypertension (HTN) and obesity contribute to poor cardiovascular outcomes which can be managed with diet and exercise lifestyle changes. In addition, self-awareness (SA) of eating patterns can be a useful tool to promote adherence to lifestyle changes. The purpose of this project was to determine the effect of lifestyle education, the DASH diet, and tools to increase SA for adult clinic patients who were overweight with hypertension. The REAP and PIH tools were utilized to increase patients’ SA of their diagnosis and current dietary habits. A literature search over five databases was conducted and analyzed thoroughly. National guidelines strongly recommend …

The Use Of Ipad Tablets And Online Videos For Oncology Patient Education To Increase Patient Knowledge And Satisfaction, Tiffany Brown

DNP Qualifying Manuscripts

Abstract

Purpose/Objectives: To provide an overview of the efficacy of using iPad tablets and online education videos to provide cancer related patient education to increase patient knowledge and satisfaction.

Data Sources: A literature search for peer-reviewed articles from 2009-2019. Databases searched include Cochrane, CINAHL, and PubMed. English language terms utilized: waiting, patient experience, patient satisfaction, cancer, positive distraction, oncology, music, patient education, iPad, television, and online education. 10 articles will be utilized for this review.

Conclusions: Patient education videos by way of iPads are more effective in increasing patient knowledge and patient satisfaction when compared to the …

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

Epidural Education For Parturients Using A Video Teaching Tool, Matthew Moore

Doctor of Nursing Practice (DNP) Projects

Introduction: The use of epidural analgesia for labor pain is becoming more common across the United States. Laboring mothers report feeling under informed about epidural side effects and dissatisfaction with the timing of the information.Background: Providing appropriate and adequate education and informed consent for epidural analgesia can prove challenging, especially during labor. Nevertheless, it is important for women to understand the potential risks in order to make a fully informed decision. Purpose: The purpose of this Quality improvement project was to show evidence of the benefits for the use of an obstetric anesthesia video during the education process and …

Heart Failure Self-Care At Home, Dinah Warren

West Chester University Doctoral Projects

Abstract

This evidence-based quality improvement project was implemented to improve self-care behaviors in homebound heart failure patients. Heart failure is a complex disease with significant challenges for patients, caregivers, healthcare providers, and the healthcare system. Educating and engaging patients in self-care management skills can reduce the clinical and financial burden of this disease. Heart failure self-care management skills can decrease 30-day readmission rates, improve quality of life, and reduce mortality. The self-care management program was implemented over a 6-week period. The Self-Care of Heart Failure Index (SCHFI) was administered at baseline to assess self-care and reevaluated after 6-weeks. During the …

Providing Evidence-Based Education About Caring For Patients With Atrial Fibrillation, Rose M. Happy

Walden Dissertations and Doctoral Studies

Abstract In a multidisciplinary health care team, nurses are often the initial contact when patients present for clinical evaluation. Thus, it is of great importance that these nurses provide education to patients that is current and evidence-based. The target population of this project was nurses who care for patients with atrial fibrillation (A-Fib). The practice problem was the knowledge gap related to A-Fib. The purpose of the project was to provide an evidence-based, nursing education intervention to increase their knowledge. The practice-focused question sought to determine whether participation in the evidence-based education intervention increased nurses’ knowledge scores about providing care …