Medicine and Health Sciences Commons^™

Promoting Awareness In Nurses: Developing Culturally Competent Hair Care Education To Eliminate The Equity Gap For Bipoc Children In Inpatient Settings, Sharlene S. Lansiquot

Doctor of Nursing Practice Projects

Problem

A survey that was administered to staff members on nine units at a pediatric hospital assessing their awareness of hair care for Black, Indigenous, and people of color (BIPOC) indicated a lack of awareness. This impacts the fundamentals of nursing care, which encompasses cultural sensitivity and promoting health equity. In this survey, 12.18% (n=52) of the 427 patients on the nine participating units between December 12, 2023, and January 19, 2024, identified as BIPOC. Although this was the case, the survey sent out on December 12, 2023, to staff members on nine units which included 491 nurses, with 104 …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …

Implementing Delirium Prevention Strategies To Reduce The Need For 1:1 Observation In A Palliative Care Unit, Natalyn Finley

Doctor of Nursing Practice Projects

Background: Delirium is a common complication within the palliative care community that is preventable. Delirium is a condition characterized by confusion and disturbed thought processes. One to one observation was the facility’s intervention used to prevent delirium. The best intervention is non-pharmacological interventions.

Purpose: This quality improvement (QI) project aimed to reduce 1:1 observation hours without increasing patient safety issues.

Methods: The Doctor of Nursing Practice (DNP) student educated nursing staff about the American Nurses Association’s (ANA) evidence-based interventions to help decrease delirium. The staff received the ANA interventions form and the Confusion Assessment Method (CAM) tool. The DNP student …

Implementation Of Depression Screening For The Puerperal Woman During The Fourth Trimester, Ashley Tidwell Bowlin

Doctor of Nursing Practice Projects

Background: Postpartum depression is a mental illness that most commonly develops in the first twelve weeks postpartum, known as the “fourth trimester.” Nationally, one in five women suffers from postpartum depression, with 50 percent going undiagnosed and untreated due to fear of stigmatization and lack of consistent screenings among healthcare providers.

Purpose: The evidence-based Doctor of Nursing Practice quality improvement project included screening for postpartum depression between seven to 14 days postpartum to increase the identification of women likely to have postpartum depression before their scheduled postpartum visit over six weeks.

Methods: The project used a quantitative design as the …

Implementing Bedside Shift Reporting On An Adult Medical-Surgical Unit: An Evidence-Based Intervention For Inpatient Fall Reduction, Halie Blackerby

Doctor of Nursing Practice Projects

Background: Patient falls are a continuous issue in healthcare facilities because they increase patient length of stay and hospitals receive no reimbursement for these falls from insurance providers. Falls are a patient safety issue and can result in long-lasting damage for patients in the healthcare facility, including fear of ambulation. Falls in a facility can impact a facility’s ability to meet strategic planning goals and receive state and federal funding.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce inpatient falls during shift change by implementing an evidence-based bedside shift reporting (BSR) protocol.

Methods: Quantitative data …

Strengthening Medication Adherence In African Americans Diagnosed With Hypertension, Daphne James

Doctor of Nursing Practice Projects

Background: African Americans have a high rate of hypertension, which varies by region. Additionally, African Americans struggle to understand the risks of uncontrolled high blood pressure and the necessity of medication adherence in lowering strokes, heart attacks, and quality of life.

Purpose: The project aims to implement a patient education program to improve medication adherence and blood pressure control for African American patients in a primary care setting.

Methods: Twenty African Americans ages 18–65 with hypertension (130/80 mm Hg or above) and six months of nonadherence participated in this project. The pre-, mid-, and post-questionnaires assessed medication adherence and blood …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Improving Early Detection And Treatment Of Chlamydia By Implementing A Routine Chlamydia Screening And Testing In Females Between The Ages Of 18–24, Isabelle Vikumitsi

Doctor of Nursing Practice Projects

Background: Chlamydia Trachomatis is the most frequently reported bacterial sexually transmitted infection in the United States. One in 20 sexually active females between the ages of 15 and 24 have chlamydia. Most people with the infection are asymptomatic and do not seek treatment. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy, leading to higher medical costs.

Purpose: The project aimed to implement early screening for chlamydial infections in the young adult population to increase early detection of the disease.

Methods: A pre-post design was used for this project to compare chlamydia diagnosis rates …

Ekg Is Key: A Quality Improvement Project To Decrease Door-To-Ekg Time In A Rural Emergency Department, Amanda Southwell

Doctor of Nursing Practice Projects

Background: Electrocardiograms (EKGs) are the priority when evaluating patients with chest pain who present to the Emergency Department (ED). The American Heart Association and other governing bodies suggest a 10-minute door-to-EKG (DTE) time. The target facility displayed a delay in DTE times.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to decrease the average DTE time for patients over 18 years old with chest pain who presented to the ED registration area.

Methods: The DNP project consisted of an EKG suite to perform EKGs near the ED registration/triage area. Registration and ED staff were educated on …

A Quality Improvement Project: Improving The Clinical Practice For Assessing Hemoglobin A1c On Admission In Diabetic Ketoacidosis Patients Admitted To The Intensive Care Unit, Tiara Lawson

Doctor of Nursing Practice Projects

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

Reducing The Incidence Of In-Hospital Cardiac Arrests (Ihca) By Utilizing Infographics, Alexis Morgan Pope

Doctor of Nursing Practice Projects

Background: In-hospital cardiac arrests (IHCA) have negative outcomes on patients and can prolong hospitalization or lead to death. The rate of IHCA has been increasing over the past few years in the United States. A medical intensive-care stepdown unit in a level three trauma center has an incidence of IHCA above the national average and a survival-to-discharge rate less than the national average.

Purpose: The project aimed to improve patient outcomes and reduce the rate of IHCA by placing infographics containing evidence-based practice in the unit with the highest incidence.

Methods: A pre-post implementation quality improvement design was used to …

Standardization Of Chlorhexidine Gluconate Bathing: A Quality Improvement Project In Central Line Bloodstream Infection Prevention, Faustina Muruako

Doctor of Nursing Practice Projects

Background: Central Line-Associated Bloodstream Infections (CLABSIs) are severe healthcare-related infections that can lead to sepsis, organ failure, and even death. Several healthcare agencies provide guidelines to prevent CLABSIs, with Chlorhexidine Gluconate Bathing (CHGB) as one of the preventive measures for individuals with central venous lines (CVL).

Purpose: The Doctor of Nursing Practice (DNP) project aims to standardize CHGB procedures for maintaining CVLs on a specific unit for CLABSI prevention through evidence-based practice.

Methods: A quality improvement project was implemented at a Central Alabama hospital to standardize CHGB procedures for CVL patients utilizing a CLABSI unit champion monitoring system to establish …

Increasing Lung Cancer Screenings In A Family Medicine Clinic, Ashley Williams

Doctor of Nursing Practice Projects

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Although lung cancer screening is an established guideline for intervention in primary care, eligible patients do not receive it. Patients at high risk of developing lung cancer are aged 50 to 80 and currently smoke or have quit smoking within the last 15 years. Obtaining an annual low-dose computed tomography for patients at high risk of developing lung cancer helps detect lung cancer earlier and, therefore, improves patient outcomes.

Purpose: The Doctor of Nursing (DNP) project aimed to increase lung cancer screenings in patients at high risk of developing …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Implementing An Insomnia Assessment And Management Algorithm In A Rural Pirmary Care Clinic, Rebekah Gaffin

Doctor of Nursing Practice Projects

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

Hepatitis C Management For Individuals In Custody, Oluronke D. Akinola

Doctor of Nursing Practice Projects

The hepatitis C virus (HCV) is a pathogen that spreads through blood and causes hepatitis C disease, a liver infection. Early infection symptoms are rare, making it a silent killer. HCV, the chronic liver disease accounts for half of all hepatocellular carcinoma cases and is the leading cause of liver transplantation in the US. This quality improvement project aimed to create an educational toolkit for the Department of Correction staff working with individuals in custody refusing HCV treatment. The education tools comprised an infographic flyer (English and Spanish) to teach individuals in custody about HCV treatment and a PowerPoint presentation …

Increasing Oral Health In A Midwest Elementary School: Quality Improvement Project, Dee Young

Doctor of Nursing Practice Projects

Marginalized communities experience barriers to accessing oral healthcare in the United States (US). Due to this, many children are left to use the emergency department (ED) for dental care. The purpose of this Doctor of Nursing Practice (DNP) project was to improve oral health services access in children at one suburban Midwest elementary school. The objectives of this project were: a) to improve the efficiency of students registering in Fall 2023 to access available oral health exam services, b) to increase the number of students who receive an oral health exam compared to the number in the previous school year. …

Evaluation And Education Of Enhanced Recovery After Surgery Protocols For Total Knee Arthroplasty, Lauren Hunt, Jessica Prost

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) utilizes a multimodal, multidisciplinary perioperative protocol to minimize hospital length of stay, surgical complications, readmissions, and patient hospital costs (Frassanito et al., 2020). The protocols were initially established for abdominal and colorectal surgical patients; however, ERAS protocols are now widely used in other areas, including orthopedic surgery (Kaye et al., 2019). To achieve the maximum benefits, ERAS protocols must contain preoperative, intraoperative, and postoperative components. A rural critical access hospital in Eastern Illinois, Crawford Memorial Hospital, serves numerous patients requiring total knee arthroplasties (TKA). While the providers utilize some aspects of ERAS protocols for these …

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Nurse Anesthesiology Education For Regulators, Jonathan Alvarado, Kevin Stein

Doctor of Nursing Practice Projects

Governmental and regulatory entities like the state board of nursing have an active role in regulating all nursing fields, including anesthesiology. The lack of a required nurse anesthesiology representative on the board presents a potential knowledge gap related to anesthesiology practice. Board members and staff must make decisions related to nurse anesthesiology that may cause anxiety due to its complexity. The lack of education in this area allows one to make wrong decisions or spend extended time looking for the correct information.   The main objective of this project was to provide an educational module on nurse anesthesiology practice to the …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …