Medicine and Health Sciences Commons^™

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

The Impact Of Remote Video Monitoring On Costs And Patient Outcomes, Karen Wyche Latham Msn, Rn, Nea-Bc, Cenp

Doctor of Nursing Practice Projects

Background: Reducing patient falls remains a challenge for many acute care hospitals. Sitters (1:1 observation) are often utilized as an intervention to mitigate this. This costly intervention has drained both personnel and financial resources, forcing hospitals to find less costly alternatives to achieve the same safety outcomes. Remote video monitoring technology (RVM) is an innovative technology that supports the monitoring of multiple patients by one observer from a remote location and is an effective alternative in reducing patient falls and/or injury and associated costs.

Aim: The goal of this evidence-based practice initiative was to evaluate the effectiveness of RVM compared …

Impact Of An Automated Text And Phone Call Post-Discharge Follow-Up Program On Patient Satisfaction Scores And 30-Day Hospital Readmission Among Adult Patients, Michael Clarke

Doctor of Nursing Practice Projects

Background: The Center for Medicare & Medicare (CMS) withholds reimbursement from hospitals that fail to meet established benchmarks for the rate of 30-day hospital readmission and patient satisfaction.

Objective: This project aimed to improve patient satisfaction scores and decrease 30-day hospital readmissions among adult patients at the project hospital by implementing an automated phone call and text message post-discharge follow-up program.

Methods: This quality improvement project utilized a Plan-Do-Study-Act (PDSA) method. Program participants’ 30-day readmission data and patient satisfaction scores were collected and analyzed throughout the 90-day project and up to 30 days after the project ended. Program participants received …

Implementing A Diabetes Prevention Program At A Community Pharmacy, Monica A. Geiger Msn, Rn

Doctor of Nursing Practice Projects

Background: Hispanics are 70% more likely to be diagnosed with diabetes and twice as likely to experience complications related to this disease than non-Hispanic whites (CDC, 2021). Currently there is consistent evidence supporting that community-based educational initiatives called cultural and linguistically appropriate services (CLAS) have a significant impact on Body Mass Index (BMI) in Hispanic populations. The CLAS standards are intended to advance health equity, improve quality, and help eliminate health care disparities. Yet, CLAS has not been implemented in some areas in Dallas, Texas.

Purpose: To implement a community-based educational program based on CLAS to increase participants’ knowledge regarding …

Roadmap To Reduce Barriers To Medical Aid In Dying For Rural Coloradans: A Health Policy Analysis And Advocacy Campaign, Ashley D. Fry Msn, Apn, Agacnp-Bc, Achpn

Doctor of Nursing Practice Projects

No abstract provided.

Implementing A Teamstepps® Approach With An Interdisciplinary Team To Increase Successful Post-Surgical Discharge Efficiencies, Ann Marie Moynihan Msn, Aprn, Nea-Bc, Onc

Doctor of Nursing Practice Projects

Background: Communication breakdowns contribute to discharge delays in the acute care settings. TeamSTEPPS® is and evidence-based program that seeks to optimize patient outcomes by improving communication and teamwork.

Objectives: The primary aim of this Quality Improvement (QI) project was to increase by 5% the number of patients discharged by noon. The secondary aims of this project were to improve the interdisciplinary team's communication and to improve workforce efficiencies and use of staff time.

Methods: A pre and post intervention design was used to collect and analyse the rate of successful discharges by noon, in addition to evaluating the interdisciplinary team’s …

Depression Screening In Hematology/ Oncology Outpatient Clinic, Nikki Marshall Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Oncology patients have multiple factors that can lead to depression, such as treatments, end-of-life decisions, stressors from home, pain, financial responsibilities, and transportation needs. If depression goes unaddressed, it can diminish the quality of life in oncology patients.

Objectives: (1) The purpose of this evidence-based practice (EBP) project is to improve Hematology/ Oncology (HEM/ONC) patient quality, with improved screening (PHQ-9 screening tool) and identification as well as referral for adult patients (18 and older). (2) Assess the knowledge, perception of depression, and confidence level of utilizing the PHQ-9 screening tool in the hem/onc outpatient clinic staff. (3) To increase …

The Oncology Clinical Trial Nurse Complex Design And Role Comprehension Training Evaluation Project, Pamela Herena Msn, Rn, Ocn

Doctor of Nursing Practice Projects

Background: The oncology Clinical Trial Nurse (CTN) plays a significant role in conducting clinical trials; however, the role comes with many challenges. These difficulties are related to the expanding landscape, advances in cancer research, complex trial designs, and the lack of role definition leading to role confusion and limited role comprehension.

Aims/Objectives: The project’s purpose was to develop a training program specific to complex clinical trial design, cancer disease overview and the oncology clinical trial nurse role. The aim focuses on the evaluation of the program by clinical trial research leaders.

Methods: A non-probability convenience snowball sampling method was used …

Improving Mental Wellness In Clinical Staff: Using Respite Rooms And Mindfulness Strategies In Ambulatory Care Settings, Whitney Hodges Shanley

Doctor of Nursing Practice Projects

Background: Diminished physical and mental wellness of clinical staff leads to poor patient health outcomes and high turnover rates. Providing designated quiet spaces to practice mindfulness can be beneficial to the overall health of healthcare workers, thus, improving compassion fatigue, job satisfaction, and retention of clinical staff.

Aim: This project implemented a respite room in an ambulatory care practice to improve clinical staff’s self-reported ratings of compassion fatigue, compassion satisfaction, and intent to leave their job.

Methods: This quality improvement project used a pre- and post-test design to compare clinical staff ratings of compassion fatigue (burnout and secondary traumatic stress), …

Management Of Stage I And Stage Ii Labor Arrest Disorder To Reduce Primary Cesarean Section Birth Rate For African American Women, Ariam Yitbarek Mha, Bsn, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Background: Cesarean section delivery rate in the United States has reached an alarming rate of over 30%. African American women experience a higher cesarean birth rate compared to Caucasian Women. The repeat c-section rate for all patients is greater than 80%. These findings underscore the need for intervention to reduce primary cesarean section deliveries in African American Women.

Objective: This quality improvement project aimed to implement caregiver education on the ACOG/SMFM definition of the first and second-stage labor arrest disorder to reduce primary cesarean section birth for African American women.

Method: This pre-and post-intervention quality improvement project was conducted on …

Implementation Of Collaborative Care Intervention Within A Fqhc To Achieve Uniform Data System (Uds) Measure Of Depression Remission, Rasha A. Kafi Msn, Rn, Fnp-C

Doctor of Nursing Practice Projects

Background: Depression is one of the most common and treatable mental health conditions. Untreated depression causes emotional suffering, reduced productivity, lost wages, increased comorbidity risks, and increased healthcare costs.

Purpose: The purpose of this project was to implement Collaborative Care Interventions (CCI) to achieve the Uniform Data System (UDS) Measure of Depression Remission.

Aims: The AIMS of this project were: (a) Increases the percentage of nursing staff compliance and completion of the educational training; (b) increases nursing staff knowledge of recognition of depression signs and symptoms, early identification of depression, and administration to all adult patients; (c) Increase the percentage …

Cultivating Unit-Based Leaders Through A Tiered, Structured Mentorship Program, Brittney Daley Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Succession planning and mentorship is an essential need in developing future nursing leaders. The IOM and published literature strongly support the importance of mentorship programs in nursing (IOM, 2021). The current succession plan and mentorship program is not sufficient.

Purpose: The purpose of this project was to create and implement an evidence-based, 3-tiered unit-based leadership mentorship program (LMP) for bedside registered nurses to support growth and professional development between tiers over a 4-month period.

Aims/Objectives: Using the completion of a pre and post survey the mentee was assigned a tier from novice to experienced leaders. Through the program, the …

Impacts Of Emotional Intelligence Skill Development Training On Nurse Leaders, Denise A. Holyoak Dnp, Rn, Ccrn-K, Nea-Bc

Doctor of Nursing Practice Projects

Background: Emotional intelligence (EI) skills are recognized as an essential tool for leaders’ success in their organization. Research shows that an EI skill development training program is effective at improving this skill set of nurse leaders and thus positively influence individual and organizational outcomes.

Aims: The purpose of this evidence-based practice (EBP) project was to design an EI skill development curriculum for frontline inpatient nurse managers and to evaluate its impact on three aims: EI skill scores of nurse managers, patient satisfaction scores related to nurse communication and nurse manager leadership communication scores.

Methods: Eleven inpatient nurse managers from a …

Addressing Verbal Aggression To Reduce Workplace Violence Against Nurses, Rebecca Harris

Doctor of Nursing Practice Projects

Background: Almost three-quarters of non-fatal workplace violence-related injuries requiring time away from the workplace occur in the healthcare and social services sector. More than 90 percent of assaults against nurses are from patients. Verbal aggression was correlated with physical violence and could contribute to nurses’ stress and dissatisfaction and compromise patient care. Policies and guidelines addressing verbal aggression against nurses are often unclear and not well-supported by evidence. This can leave nurses unprepared to recognize and respond to verbal aggression or threats of physical harm without compromising their safety.

Aim: This health policy analysis aimed to explore a range of …

Using Community-Based Participatory Research To Tailor A Diabetes Education Program To An At-Risk Black Church Congregation In The Mid-Atlantic, Samantha A. Mielke

Doctor of Nursing Practice Projects

Background: Prediabetes and diabetes continue to have a high disease burden in the United States (Lin et al., 2018). Many individuals are unaware of their glucose state or the impact impaired glucose can have on their quality adjusted life years and cost of living. The Centers for Disease Control and Prevention (CDC) has underscored the importance of decreasing the incidence of diabetes and has resources available. Still, many communities, particularly minority populations, can benefit from tailoring programs to their specific populations, where typical approaches may not be as beneficial (Joo & Liu, 2020). Additionally, Black American (BA) congregations often have …

Implementation Of A Transitional Care Model To Decrease Readmissions For Ischemic Stroke And Tia Patients, Sarah Baskind Msn, Fnp-Bc, Cnrn, Scrn

Doctor of Nursing Practice Projects

Background: Poor continuity of care after hospitalization can increase the risk of adverse health outcomes such as unplanned readmissions for stroke and transient ischemic attack (TIA) patients. Transitional care models (TCMs) can be used to improve the coordination of care post-discharge.

Objectives: The purpose of this doctoral Quality Improvement (QI) project was to develop, implement, and evaluate a TCM for ischemic stroke/TIA patients over a 3-month period. This project had four aims: 1) to decrease the unplanned 30-day readmission rate, 2) for all eligible patients to be enrolled after discharge, 3) to have all enrolled participants receive all components, and …

A Community Educational Intervention To Improve Firearm Safety Behavior In Families, Elizabeth G. Choma Msn, Rn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background: Every day in America children, are injured or killed from the accidental shooting of firearms. Additionally, few households with children report storing all guns unloaded and locked up. Recent evidence supports education on safe firearm storage as an effective intervention in promoting firearm safety in families with children. However, Pediatric healthcare providers often do not have enough time for firearm education during well visits.

Objective: This Quality Improvement (QI) project aimed to use an educational intervention with statistics on firearms in children and implemented the Asking Saves Kids (ASK) campaign to assess and improve firearm safety behaviors in families …

Program Evaluation Of Leader Rounding In Emergency And Trauma, Allen Fasnach Msn, Rn

Doctor of Nursing Practice Projects

Background: Patient satisfaction scores are an area of priority for hospitals throughout the United States because of their association with quality outcomes for the patients (Davenport, O'Connor, Szychowski, Landry, & Hernandez, 2017). This healthcare organization implemented the practice of nurse leader rounding over the last five years with the goal of leaders rounding on 75% or greater of the units' populations without any organizational sustainment or achievement of upper decile patient satisfaction scores.

Aims: The aim of this project was to utilize the Centers for Disease Control Framework for a Program Evaluation to evaluate the redesigned leadership rounding program for …

Ventilator-Associated Pneumonia Bundle Compliance: A Quality Improvement Project, Keesha L. Holmes Msn, Fnp, Ne-Bc

Doctor of Nursing Practice Projects

Background: In many hospitals, patients requiring mechanical ventilation are managed in an intensive care unit (ICU) or a unit that requires a higher level of care compared to a medical-surgical unit. Patients on mechanical ventilation are susceptible to acquiring ventilator-associated pneumonia (VAP) if precautionary measures are not taken.

Aims/Objectives: The purpose of this quality improvement project was to assess if after an identified group of critical care registered nurses (RN) participated in an education session on ventilator-associated pneumonia and ventilator-care bundle (VCB) interventions, would their knowledge be enhanced, would the RNs implement the knowledge learned into their practice, and if …

The Impact Of Mentorship On Nurses’ Level Of Self-Efficacy And Motivation To Pursue Board Leadership Positions, Amy K. Mccarthy Msn, Rnc-Mnn, Ne-Bc

Doctor of Nursing Practice Projects

Background: Nurses comprise the largest component of the healthcare workforce and possess a unique understanding of healthcare operations and patient care. On average, the proportion of nurses serving on hospital boards range from 2 to 6%, with the proportion of physicians averaging 20%. Over the last decade, much attention has been placed on emphasizing the importance of a nurse’s presence on boards. Despite these initiatives, nurses continue to display an overall hesitancy towards board service.

Objectives: The aim of this project was to implement an evidence-based mentorship program to address barriers to board leadership and increase overall self-efficacy and motivation …

Preventing Failure To Rescue: Implementation Of An Early Warning Score System, Caitlyn Holloway Msn Rn Ccrn-Cmc Pccn Tcrn

Doctor of Nursing Practice Projects

Background: Hospitalized patients are at inherent risk of complications and further clinical deterioration, even in the presence of advanced medical interventions and expert caregivers, with the most significant risk being failure to rescue. Early Warning Score (EWS) systems allow for earlier, more effective identification of clinical deterioration than traditional medical emergency team (MET) systems and provide an opportunity to reduce failure to rescue events and improve patient outcomes.

Objective: The purpose of this quality improvement project was to implement an EWS system that allowed bedside caregivers to improve patient outcomes through reduction of failure to rescue events and improvement of …

Implementing Sskin Bundle For Pressure Ulcer Prevention In Long-Term Care Facility, Funmilayo Oni

Doctor of Nursing Practice Projects

Background: Pressure ulcers are a major challenge in long-term care (LTC) facilities. Adult patients in LTC setting are at risk for developing pressure ulcers due to chronic medical conditions and comorbidities. Preventing the onset of these wounds is more cost-effective than treating pressure ulcers.

AIM/Objectives: The primary objective was to decrease the number of pressure ulcers by 50% within a three-month period. Secondary objectives were to achieve 100% compliance with completion of mandatory staff education, score on the posttest questionnaire, and compliance with mandatory staff documentation as instructed by the SSKIN protocol.

Methods: This DNP Project used a pretest and …

Improving Screening For Sleep Disturbance In Patients With Parkinson’S Disease, Jenny Nguyen Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Sleep disturbance (SD) is one of the most common and debilitating non-motor manifestations of Parkinson’s disease (PD). SD intensifies the disease-related disabilities of motor and non-motor symptoms. In spite of this, it is often under-recognized and underaddressed by healthcare professionals. The Movement Disorder Society recommends the Parkinson’s disease Sleep Scale (PDSS – 2) be used to screen and measure severity of overall sleep problems in this patient population.

Objectives: The purpose of this quality improvement (QI) project is to increase the utilization of the PDSS-2, a standardized approach to assessment of sleep difficulties. This can facilitate identification of individual …

Antibiotic Stewardship For Asymptomatic Bacteriuria In Older Adults Residing In Long-Term Care At End-Of-Life, Kimberly Madison Agpcnp-Bc

Doctor of Nursing Practice Projects

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in older adults is challenging due to their atypical presentation. There is a critical gap in practice to adhere to clinical guidelines advising against treating ASB with antibiotics.

Objectives: The purpose of this Quality Improvement project was to implement an antibiotic stewardship program at a hospice organization to standardize judicious use of antibiotics at the end-of-life. The outcome measures were designed to evaluate clinician knowledge, prescribing policies and practice changes, the completeness of documentation, the appropriate usage of antibiotics, and clinician antibiotic use attitudes and beliefs.

Methods: Hospice clinicians …

Structured Type 2 Diabetes Education To Improve Self-Monitoring Blood Glucose, Self-Care Management, And Diabetes Knowledge In A Multicultural Family Practice Clinic, Deedee Foster Fnp-C

Doctor of Nursing Practice Projects

Background: The family practice providers at the family medicine residency clinic (FMRC) have neither sufficient time nor continuity of care to provide diabetes education to effectively reduce A1c levels. The FMRC has 500 multicultural type 2 diabetes patients with an A1c >7% that has increased by 23.2% in the previous five months. Multiple studies have demonstrated that structured diabetes education can significantly decrease blood glucose readings, improve self-care management, and diabetes knowledge to attain optimal glycemic control.

Objectives: To implement an evidence-based practice (EBP) project in the FMRC to improve participants blood glucose readings, self-care management, and diabetes knowledge.

Methods: …

A Telehealth Blood Pressure Education Program On Hypertension Knowledge, Selfcare, And Behavior, Cheynnie N. Burnett Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypertension poses a significant risk for morbidity and mortality. Regular blood pressure monitoring, medication compliance, and/or lifestyle modifications have shown to improve control. Digital communication in healthcare, such as telemedicine provides patients and primary care offices an opportunity to improve access to care and education.

Objectives: This Quality Improvement (QI) Project aimed to answer the question: In adult patients with a diagnosis of hypertension, what is the effectiveness of implementing an evidence- based telehealth blood pressure management program in a primary health care setting, when compared to baseline, on blood pressure knowledge, management, and self-care over a nine- week …

A Certified Nurse Program: Mitigating Barriers To Certification, Kymberlee Cox Msn, Rn, Npd-Bc, Pccn-K

Doctor of Nursing Practice Projects

Background: Certification recognizes a nurse's specialized knowledge, skill, and expertise. It has been linked to positive patient, nurse, and organizational outcomes. Recognizing these advantages, the nursing department set a goal to increase certification rates. However, perceived barriers to certification existed, and rates remained unchanged. A program was needed to overcome these obstacles.

Aims/Objectives: To develop and evaluate a Certified Nurse Program that addresses the perceived barriers to certification by proactively supporting, preparing, and recognizing nurses who pursue and maintain a specialty certification.

Methodology: A 200-bed Maryland suburban hospital adopted the program. Initiatives for certification support, preparation, and recognition were implemented. …

A Quality Improvement Initiative To Redefine Nurse-Led Discharge Interventions In A Skilled Nursing Facility (Snf) On All-Cause 30-Day Re-Admission Rates Using The Re-Engineered Discharge (Red) Program, Ruby Panju-Merali Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: The growing population of people over the age of 65 years with surmounting medical complexities resulting in hospital re-admissions poses significant challenges for the healthcare system. Re-Engineered Discharge (RED) has demonstrated interventions inclusive of nursing driven discharge planning to successfully decrease hospital readmissions in Skilled Nursing Facilities (SNF).

Purpose: This aim of this quality improvement initiative was to improve discharge efficiency by implementing a modified version of RED to evaluate the effect of centralizing nursing in education and discharge processes and influence on all-cause 30-day readmission rates.

Methods: A pre and post intervention design was utilized for patient chart …

Implementation Of A Standardized Handoff Tool For The Transition Of Care Of Adult Liver Transplant Patients, Suzanne Robertazzi Msn, Anp-Bc

Doctor of Nursing Practice Projects

Background: The transfer of care of the adult liver transplant patient from the inpatient to the outpatient setting has increased in complexity and has the potential to lead to errors and adverse events.

Objective: This pre-post design quality improvement project implemented a hand-off communication tool to improve adult liver transplant patient outcomes when transitioning from the inpatient to outpatient setting.

Methods: The hand-off tool was based on Illness severity, Patient summary, Action list, Situation awareness, and Synthesis (I-PASS). An EMR chart review was completed on discharged liver transplant patients 3 months (N=28) prior and 4 months (N=36) after I-PASS implementation. …

Effect Of A Web-Based Educational Intervention In Improving Depression Knowledge And Help-Seeking Behaviour In Women, Chibuzo Efuribe Rn Msn Fnp-Bc

Doctor of Nursing Practice Projects

Background: Depression is of global concern and one of the leading causes of disability in the United States. Based on a needs assessment conducted in a faith-based organization, we noticed a gap in depression knowledge, an unwillingness to seek help, and a lack of open dialogue among the women. Studies have shown that low depression literacy impedes early recognition, prevention, and willingness to seek help (Brijnath et al., 2016; Reavley et al., 2014).

Aims: This study aimed to evaluate the effects of web-based educational intervention in improving depression knowledge and help-seeking behavior among women in a faith-based organization.

Methods: Using …