An Evidence-Based Teaching Plan To Increase Awareness Of Certified Registered Nurse Anesthetists To Patient Safety Threats Due To Provider Fatigue And To Offer Effective Strategies To Mitigate Fatigue, Tieneasha Hines, Lisa Alexander

DNP Scholarly Projects

The mental, physical, and emotional effects of stress and fatigue pose significant patient safety risks resulting from impaired concentration, coordination, and overall productivity in certified registered nurse anesthetists. Fatigue is commonly experienced by nurse anesthetists. Fatigue is an occupational hazard that affects not only nurse anesthetists but also patients, colleagues, and other healthcare stakeholders. Certified registered nurse anesthetists are most affected by fatigue due to the prolonged duration of extensive patient monitoring during surgical and complex medical procedures. Due to their central role in ensuring patient safety and comfort during surgery and other procedures requiring anesthesia, certified registered nurse anesthetists …

Quality Of Care Improvement: A Process To Standardize Handoff Communication Between Anesthesia Providers And Post-Anesthesia Care Unit Nurses, Maria Chernyak, Courtney Posten

DNP Scholarly Projects

Introduction: Transition of care is the process in which sending provider teams and receiving provider teams release the care of the patient from one provider team to the next utilizing a communication process. Review of the literature has identified several different protocols in place to systematize communication among providers, however, there is no standardized instrument or process that encompasses the post-anesthesia transfer of care process. Our project goal is to develop a standardized evidence-based handoff communication instrument to be utilized during the transition of care process between anesthesia care teams to the post-anesthesia care (PACU) teams to improve quality of …

Educational Modules On Pediatric Cardiac Care For Host Nurse Training During Surgical Mission Trips: A Quality Improvement Project, Maria Arlene Gapac Lemin

DNP Scholarly Projects

Numerous health care organizations conduct international surgical mission trips to treat pediatric patients with congenital cardiac disorders in countries unable to provide complex surgical interventions locally without support. This doctoral student’s experience on numerous mission trips provided the opportunity to evaluate the expertise of circulating and scrub nurses in host countries. Based on this assessment, a knowledge and skill gap was identified and suggested that an educational intervention might benefit host nurses. The purpose of this doctoral project was to develop evidence- and theoretically-based educational modules for local nurses to improve perioperative nursing practice in meeting the needs of their …

Early Intervention Referral Process Improvement In Primary Care Pediatrics: An Evidence-Based Algorithm, Katherine G Mcmahon Thompson

DNP Scholarly Projects

Early Intervention programs provide evidence-based services to children with developmental delay from 0 to 3 years of age. Many children eligible for Early Intervention programs are not successfully referred to services provided by health care professionals for evaluations. The purpose of this doctoral project is to describe the evidence-based steps in a referral algorithm for early intervention evaluation to increase referrals by primary care health care providers and to increase evaluation rates of referred children. A draft algorithm was based on content analysis of empirical and theoretical literature. Experts in early intervention primary care services reviewed the draft algorithm, rank …

Educational Plan For Certified Nursing Assistants In Long-Term Care Facilities On Assessing Pain Of Residents With Dementia, Rachel Lynn Spoon

DNP Scholarly Projects

Certified nursing assistants employed in long-term care agencies may have little education on the assessment of pain experienced by residents with dementia. The purpose of the Doctor of Nursing Practice Project was to develop an evidenced-based teaching plan for certified nursing assistants caring for residents with dementia in long-term care settings. The plan includes content on dementia, dementia symptoms, pain indicators, and pain assessment in residents with dementia, non-medicinal management strategies, and communication strategies for referring assessment findings to licensed practical and registered nurses. Supplemental PowerPoint™ slides were developed that match the teaching plan. The draft teaching plan was judged …

An Evidence-Based Questionnaire To Assess Influenza Vaccine Adherence In Young Adults Ages 19 To 25 Years, Tricia A. Gill

DNP Scholarly Projects

Young adults ages 19 to 25 years in the United States are at increased risk for influenza because their annual flu shot adherence is the lowest out of all age groups. Their non-adherence and increased potential for illness have a very great impact on contacts, including family, friends, coworkers, their children, and people in the community. The purpose of this Doctor of Nursing Practice Project is to create an evidence- and theoretically-based questionnaire aimed at assessing flu vaccine adherence in young adults ages 19 to 25 years in a primary care practice with the future objective of reducing the overall …

Evidence-Based Trigger Videos Related To Distractions And Safety Threats To Anesthesia Care In The Operating Room, Alexandra Kendall, Dominique Sturdivant, Lynne Miller

DNP Scholarly Projects

Intraoperative distractions are considered exceedingly detrimental to the quality of anesthesia care. Distractions in the operating room (OR) cause an array of negative effects for healthcare providers and can represent major patient safety risks. At this time, there is no formal training for anesthesia providers targeting the impact of distractions or educating providers about the risks to their patients.

The primary aim of this project was to develop four trigger videos that will be utilized in future research to increase anesthesia providers’ awareness of the threats to patient care and quality of care that result from disruptions secondary to distractions. …

Improving Medication Education On An Infectious Disease Unit For Hospitalized Patients At Discharge: A Quality Improvement Project, Kristin L. Pilong

DNP Scholarly Projects

Medication education by nurses during patients’ hospital stay is an important component of patient care. Nurses’ knowledge of specific medications and the resources that support teaching patients about medications may play a key role in increasing their satisfaction with the hospitalization experience. This quality improvement doctoral project created and validated evidenced-based cognitive aids for nurses to support this process. The project is part of a quality improvement initiative at a hospital in South Jersey to create and validate cognitive aids for 5 high frequency medications prescribed for patients prior to discharge from the hospital The cognitive aids focused on three …

Effects Of Education On Correcting Misconceptions And Acceptance Of The Influenza Vaccination Among A College Campus, Travis E. Fairbanks

DNP Scholarly Projects

Educating patients on the influenza vaccination is an important goal for health care providers. It fosters a working relationship between provider and patient and allows patients to make an informed decision on their health care needs. The percentage of individuals who receive the influenza vaccine in the United States has been consistently below goals set by the committee for Healthy People 2020. This DNP scholarly project aimed to determine whether the introduction of education was effective at increasing individuals’ choice to vaccinate against the influenza virus among college campus students. The study was a non-experimental, non-randomized control trial that utilized …

Implementing Faculty Development Modules To Increase Readiness For Addressing Social Determinants Of Health, Implicit Bias And Equity In Course Content, Claudia Ngafeeson

DNP Scholarly Projects

Implicit bias is viewed as an unconscious and involuntary attitude that lies below the surface of consciousness but can influence behavior, and cognitive processes (Maina et al., 2018). Social determinants of health are considered to be the conditions in which people are born, grow, live, work, and age; these circumstances are usually shaped by the distribution of money, power, and resources at global, national, and local levels, which in turns determines the distribution of the value of medical care. Existing literature on implicit bias has been fragmented in different fields such as; cognitive psychology, business ethics, and higher education, but …

Implementation Of An Advanced Operating Room Schedule To Increase Compliance With Clinical Practice Guidelines For Preoperative Antibiotic Selection And Timing: A Quality Improvement Project, Shelby Lynne Adams

DNP Scholarly Projects

Surgical site infection (SSI) is a major cause of morbidity and mortality in operative patients worldwide. The American Society for Health-System Pharmacists (ASHP) published the most recent clinical practice guidelines for antimicrobial prophylaxis in surgery. These guidelines are based upon the available evidence and provide a standardized approach for the safe and effective selection, dosing, and administration of antibiotics for the prevention of SSI (Bratzler et al., 2013). This Doctor of Nursing Practice (DNP) project aimed to determine if incorporating an advanced operating room (OR) schedule, inclusive of ASHP presurgical antibiotics, increased compliance with ASHP standards of antibiotic selection and …

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Scholarly Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

Educational Process Improvement Program For Novice Anesthesia Providers Learning Safe Management Of The Anesthesia Workstation, Robert M. Vitale, James Mahon

DNP Scholarly Projects

Patient safety is at the cornerstone of the delivery of quality anesthesia. A historically pervasive patient safety threat related to the field of anesthesia has been the anesthesia workstation. Although anesthesia delivery improvements are based on refining physical engineering principles, they are also based on preventing human error. This DNP project uses an educational process improvement design to generate an evidence-based simulation educational activity for novice anesthesia providers to better prepare themselves for the reality of anesthesia workstation malfunction and human error.

The Creation Of An Evidence-Based Educational Intervention For Preceptor Development Of The Novice Certified Registered Nurse Anesthetist, Kathleen Yoka, Nathalie Anderson

DNP Scholarly Projects

Novice certified registered nurse anesthetists (CRNA) are responsible for precepting student registered nurse anesthetists (SRNA) while simultaneously caring for patients in the operating room (OR). SRNAs rely on CRNAs for the majority of clinical training by preceptorship. Well-defined best precepting practices do not exist. The ability to teach others is a learned skill, and the lack of such skill can lead to undue stress for both the novice CRNA and the SRNA. This may lead to reduced job satisfaction of the CRNA and diminished educational experience of the SRNA. The primary purpose of this Doctor of Nursing Practice (DNP) project …

Perioperative Protocol To Prevent Emergence Delirium In Patients With Post-Traumatic Stress Disorder, Audrianna Bustos, Roxanne Sambuca

DNP Scholarly Projects

Introduction: Ten percent of adults will experience post-traumatic stress disorder (PTSD) at some point during their lifetime, 50% of which remain untreated and undiagnosed. Perioperative management of the patient with PTSD may create significant challenges for the anesthesia provider. Patients with PTSD are more likely to experience emergence delirium (ED), which poses a significant safety threat to patients and staff. Screening for PTSD is routine in the veteran population but has not yet translated into common practice. To our knowledge, no protocol currently exists for anesthetic management of patients with PTSD. Routine screening for PTSD in the preoperative period and …

Effects Of Evidence-Based Discharge Instructions On Follow-Up With A Healthcare Provider In Patients Presenting With Mtbi-Like Symptoms To A Health Clinic At A Rural Sports Camp In The Pacific Northwest In The U.S., Eva G. Bergner

DNP Scholarly Projects

Mild traumatic brain injury (mTBI) is a major public health burden affecting both children and adults in the U. S. (Sarmiento et al., 2019; Schuchat, Houry, & Baldwin, 2018). The management of mTBI at summer camps is not well characterized in the literature. Epidemiologic studies on summer camps have reported that 25% of all injuries were to the head, face and/or neck (Kolberg et al., 2020; Robinson, Arbogast, Garst & Corwin 2019). The purpose of this project was to evaluate the impact of evidence-based instructions for follow-up with a healthcare provider in patients presenting with mTBI-like symptoms to a health …

Psychological Safety In Pre-Licensure Nursing Simulation, Lauren Rickman

DNP Scholarly Projects

Background

Simulation-based experiences (SBEs) allow learners to use clinical decision-making, clinical judgment, and hands-on skills to analyze and respond to realistic clinical situations in a controlled, interactive environment. Psychological safety (PS) is essential for increasing a learner's engagement in an SBE. Psychologically safe learning environments allow students to feel valued and comfortable speaking up and taking risks without consequences to themselves or others, promoting learning and innovation. Measuring PS may help simulation faculty improve their learning environment by supporting learning-oriented behavior and boosting students' clinical competency.

Purpose

The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to …

Compassion Satisfaction, Burnout, And Secondary Traumatic Stress Among Heart Transplant Nurses In A Hospital Setting, Marissa Potts

DNP Scholarly Projects

Abstract

Purpose: The purpose of this study was to assess whether or not, and the degree to which compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) are present among inpatient acute-care heart transplant nurses. Perceived presence of other contributing factors that contributed to CS, BO, and STS was also assessed.

Design: A cross-sectional survey-based mixed methods study with an explanatory sequential design was used to assess baseline levels of CS, BO, and STS and identify any other factors at work or home that may impact these constructs.

Methods: A Qualtrics survey was sent to potential participants. A convenience …

A Quality Improvement Project To Examine The Impact Of The Use Of Structured Diabetes Educational Materials For Medical Personnel, Alina Jaffer

DNP Scholarly Projects

With the immigrant population increasing in the United States, the demand for healthcare providers who can provide culturally appropriate care and intracultural communication has increased. Compared to individuals born in the United States, immigrants with diabetes are less likely to meet the standardized targets for diabetes management, resulting in disparities in diabetes-related complications. The problem is the lack of evidence-based patient education for all people, including immigrants who do not speak English as a first language. The purpose of this project was to assess whether or not language-specific structured diabetes educational material for healthcare personnel use would increase the efficacy …

Adverse Childhood Experiences Screening In Adulthood: Knowledge, Attitudes, And Self-Efficacy Among Tennessee Nurse Practitioners, Megan M. Wanca

DNP Scholarly Projects

Despite the prevalence of adverse childhood events (ACEs) and the relationship with negative health outcomes in adults, research shows clinical use of ACE screening is low among healthcare providers including nurse practitioners (NPs). The scholarly project’s purpose was to examine how Tennessee NP knowledge, attitudes, and self-efficacy influence intentions to screen for ACEs related to childhood trauma or abuse in adult patients. Using the Information-Motivation-Behavioral Skills Model as the theoretical framework, a cross-sectional and exploratory design assessed the association of NPs’ ACE screening knowledge, attitudes, and self-efficacy on the NPs’ intention to screen for ACEs in adult patients. A reliable …

Examining Nurse Engagement In Antimicrobial Stewardship At Long-Term Care Facilities, Mosam S. Patel, Kathryn L. Dambrino, Olivia Bahemuka, David Phillippi

DNP Scholarly Projects

Background: The World Health Organization stated that antimicrobial resistance is one of the top 10 threats to global health. To combat antimicrobial resistance, antimicrobial stewardship (AMS) programs were developed. Efforts to engage nurses in stewardship efforts have been limited. Bedside nurses are in an optimal position to help decrease antimicrobial use, which is especially relevant in long-term care facilities where up to 75% of antibiotic use is deemed unnecessary or inappropriate. The purpose of this Doctor of Nursing Practice scholarly project was to examine factors that influence nurse engagement in AMS at long-term care facilities in Tennessee. Methods: A …

Interprofessional Socialization Of Nursing Students After Participating In Interdisciplinary Rounds In An Intensive Care Unit, Ashlyn S. Upshaw

DNP Scholarly Projects

Background: Nursing engagement in interprofessional collaboration leads to safe and quality healthcare for patients. In order to effectively engage in interprofessional collaboration, nursing students must socialize among healthcare providers from various disciplines. Purpose: The purpose of this project was to examine pre-licensure nursing students’ beliefs and attitudes towards interprofessional socialization and collaboration following their participation in interdisciplinary rounds in an intensive care unit (ICU) setting. Methods: A mixed-methods, cross-sectional design was used to collect data from undergraduate nursing students at a private university. Following an ICU clinical rotation, participants completed the Interprofessional Socialization and Valuing Survey-21 (ISVS-21) …

A Peer-Led Evidence-Based Contraceptive Counseling Initiative, Megan K. Tenbarge

DNP Scholarly Projects

The experience of sexual health and wellness varies for newly independent college freshman. For reproductive-age women, gaps in knowledge and self-efficacy overlap with barriers accessing contraception and reproductive health care contributing to high-risk behavior and poor sexual health outcomes. Community-based participatory research was used to develop and implement a peer-education program targeting sorority women on a college campus in the Southeastern United States in the fall semester of 2021. Two senior nursing majors completed continuing education to be empowered as peer-educators using The University of California San Francisco Beyond the Pill framework. They engaged directly with nursing faculty stakeholders and …

Relationship Between Perceived Coping Capability And Levels Of Academic Self-Efficacy In First Year Prelicensure Nursing Students, Amy Charlton

DNP Scholarly Projects

Academic self-efficacy and coping capability impact student persistence. Nursing education programs can identify students' experiences to encourage students to persist and potentially impact the national nursing pipeline. More research was needed to examine the relationships between entering nursing student demographics, academic self-efficacy, and student coping capability. First-semester prelicensure nursing students (N = 240) were surveyed to determine any significant relationship between perceived academic self-efficacy and perceived coping capability using a quasiexperimental, descriptive, correlational design. Based on the Nursing Universal Retention and Success (NURS) model, the project investigated the relationships between student profile characteristics, student affective factors, academic outcomes, and professional …

Nurses' Implicit Attitudes Regarding The Lgbtq Population, Carolyn Howard

DNP Scholarly Projects

Health inequities such as chronic medical conditions, mental health disorders, substance abuse, and suicide are prevalent in the LGBTQ population, resulting in part from minority stress, stigma, discrimination, and isolation. Studies showed mixed results regarding nurses’ and other healthcare professionals’ attitudes toward these individuals. Relatively little research has focused specifically on nurses, and most studies have centered on healthcare professionals’ explicit attitudes. Given the lack of studies on nurses and implicit bias, more research is needed on nurses’ implicit attitudes regarding LGBTQ patients. Using a retrospective design with secondary data from Project Implicit, the study compared United States (US) nurses’ …

Belmont University Covid Surveillance And Containment: An Evaluation Of Program Effectiveness, Morgan A. Lambrecht

DNP Scholarly Projects

In the early days of the Coronavirus (COVID) pandemic, members of university communities faced elevated risk of contracting COVID because they live and work in congregate settings, with shared living and dining arrangements. By the Fall 2020 semester, with limited information regarding the transmission of COVID, a quick, but comprehensive strategy was needed to allow students to return to university campuses, while maintaining a safe environment for students, faculty, and staff. The purpose of this project was to determine the effectiveness of the COVID surveillance and containment measures implemented in the 2020/2021 academic year for the residential campus community at …

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Scholarly Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

An Evidence-Based Teaching Plan For Novice Certified Registered Nurse Anesthetists On Medication Shortage Safety Threats And Management, Daniel Worley, Beata Zimmerman

DNP Scholarly Projects

Shortages of anesthesia medications pose significant risks to patient safety. Despite this, no standardized educational program was located to regularly update practicing anesthesia providers nor was this topic identified by the Council on Accreditation of Nurse Anesthesia Educational Programs as a requirement for nurse anesthesia training programs. The purpose of this project was to develop an evidence-based Teaching Plan for novice certified registered nurse anesthetists. A directed content analysis identified key themes from relevant literature. Themes included counts and patterns of medication shortages, lack of alternatives, impact on patient safety, professional concerns related to changes in practice, quality concerns, characteristics, …

Reducing Central Line-Associated Bloodstream Infections At A Rural Midwestern Hospital Through An Evidence-Based Nurse-Led Practice Change Intervention, Crystal B. Lavalley

DNP Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) are responsible for increased patient morbidity, mortality, and healthcare costs, despite being a preventable harm (Barnes et al., 2015; Furuya et al., 2016). Evidence-based (EB) research suggests that the use of central line bundles is the most effective way to reduce CLABSIs in hospitals (Barnes et al., 2015; Furuya et al., 2016). Researchers have also found a statistically significant correlation between nurse compliance with bundle components and CLABSI rates (Aloush & Alsaraireh, 2018; Furuya et al., 2016). The purpose of this study was to determine if a nurse-led collaborative that focused on CLABSI reduction using …

Perception Of The Benefits Of An Interprofessional Communication Offering Among Nurse Residents, Emily Fritz

DNP Scholarly Projects

Abstract

Interprofessional communication occurs at all levels during the provision of health care. Studies have shown that ineffective communication between healthcare providers often results in delayed treatments, misdiagnoses, medication errors, patient injuries, or even death. A nurse residency program is a professional development program designed to help develop and support new nurses through their transition from student nursing, into professional nursing. Communication skill development is an important aspect of the nurse residency program. The purpose of this study was to explore the question: Do nurse residents, who were enrolled in a local nurse residency program between August 2019 and August …