Medicine and Health Sciences Commons^™

Impact Of Mindfulness-Based Interventions On Nursing Burnout: An Integrative, Lily Myo

DNP Qualifying Manuscripts

Burnout in the nursing profession is prevalent and can be a significant burden for not only the individual nurse but to patients and the healthcare system at large. Burnout is considered by the World Health Organization as an occupational phenomena specifically resulting from chronic workplace stress that has not been successfully managed, and is not related to other life events. Given the need for support among registered nurses in reducing consequences of burnout and the emerging data about mindfulness based practices as a tool to enhance resilience, this integrated review seeks to understand if education on mindfulness based interventions can …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Rashid

DNP Qualifying Manuscripts

Schizophrenia cases and their associated healthcare costs have drastically increased over time in the U.S. Antipsychotic non-adherence is a primary contributor to the high rates of relapse and rehospitalization among the schizophrenic adult population. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underemployed in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses are in a great position to address these barriers as they serve as mediators between providers and patients. This literature review aims to discover evidence that LAI education …

Education And Training On Naloxone Administration For Healthcare Professionals: An Integrative Literature Review, Remigus C. Nwaokoro

DNP Qualifying Manuscripts

Abstract

Background: Healthcare professionals’ lack of knowledge and confidence in administering naloxone affects their willingness to inform at-risk patients about its use in the event of an overdose. The lack of understanding and confidence in using naloxone delays efforts to inform at-risk patients about this life-saving treatment for opioid overdose. This integrative literature review aimed to answer the following question: Do increased education and training enhance healthcare professionals' knowledge and confidence in administering naloxone and decrease the rate of opioid overdose fatalities?

Methodology: A comprehensive search of the literature (2019 and 2024) was conducted to identify studies of education …

An Integrated Review: Outpatient Care And Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

DNP Qualifying Manuscripts

Abstract

In the pediatric population, comprehensive cancer treatment and its associated side effects significantly impact their physical and emotional well-being. Though chemotherapy drugs are valuable agents against cancer cells, they also damage healthy dividing cells, such as bone marrow, thus weakening the immune system. Febrile neutropenia (FN) and associated infections remain the most critical complications of the extensive chemotherapy regimen and can threaten life if not appropriately addressed. Appropriate primary evaluation and treatment of FN in children with cancer includes administering proper broad-spectrum antibiotics. Ongoing research has focused on improving quality of life (QoL); yet, FN has persisted as the …

Assessing Nursing Deployment Readiness-A Literature Review, George Mcenroe

DNP Qualifying Manuscripts

Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, military vehicles and aircraft, mass casualty care, and military-specific skills. Many Air Force nurses work in low acuity roles and do not maintain the clinical competency and skills necessary if called upon to deploy. A deployment notification may happen with little notification, limiting the opportunity for a quick “ramp-up” of critical skills. Maintaining deployment and clinical readiness is an ongoing …

Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward

DNP Qualifying Manuscripts

Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

Implementation Of An Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias in healthcare delivery is the unconscious prejudice individuals might feel about another person or group. All healthcare providers are susceptible to implicit bias which can negatively influence patient-provider communication. Implicit bias is linked to disparities in maternal health outcomes. According to the CDC, the maternal mortality rate for non-Hispanic Black women is 2.9 times higher than the rate for non-Hispanic White women (Hoyert, 2022).

Problem: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to manage IB during clinical rotations and post-graduation, thus, are at …

Mental Health Navigators Bridging The Gap Of Care, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Individuals with schizophrenia are most vulnerable at time of discharge due to risk factors that lead to relapse, re-admission, suicide and/or danger to others. A successful discharge process can decrease overall care costs, promotes team collaboration, supports the therapeutic relationship between client and care provider, and helps the client to reach autonomy and self-efficacy. This DNP is a quality improvement project that aims at educating Mental Health Navigators about symptoms of schizophrenia, medications management, and community resources. Effectiveness of the educational intervention will be assessed as the differences between the pre- and post-test assessment score on insight or lack of …

Introducing Motivational Interviewing Skills To Community Health Workers, Stella Antony

DNP Qualifying Manuscripts

Abstract

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, unhealthy eating habits, lack of access to health care, poor socioeconomic status, lack of health insurance, cultural and language barriers, and lack of health literacy. Local Problem: The population in Fresno and Tulare Counties in Central Valley, California is underprivileged, lacks access to proper health care and has higher rates of …

Promoting Mindfulness Based Self-Care In Healthcare Staff, Harkirat K. Bajwa

DNP Qualifying Manuscripts

Background: Healthcare personnel (HCP) like physicians, nurses, advanced practice nurses etc. are at high risk of stress, burnout, and compassion fatigue (CF). Nearly half of the physicians and one-third of the nurses experience burnout in the United States. The physical and mental health of HCPs is impacted by burnout and CF, leading to increased practice errors and decreased patient safety.

Local Problem: HCPs have poor knowledge about mindfulness and its benefits. Mindfulness-based self-care measures are not promoted in HCP.

Methods: An extensive database search was done to find evidence about using mindfulness-based strategies to relieve burnout, stress, and compassion fatigue …

The Threat Of Hospital Wastewater: An Evidence-Based Call To Action, Ann P. Nguyen

DNP Qualifying Manuscripts

Introduction: Hospital wastewater carries a unique composition of pollutants, a burden that includes high chemical and biological residuals. These pollutants are discharged into sewage treatment plants and natural environments where they contaminate human water sources and larger ecosystems. Water treatment plants are not designed to treat the high loads of biomedical waste and persistent organic compounds found in hospital wastewater and therefore pollutants survive in conventionally treated water. Evidence of contaminated soil, municipal wastewater, surface water, ground water, and even drinking water have been demonstrated in studies conducted around the world highlighting the ubiquity of the problem. Hospital effluent as …

Utilizing Telehealth To Decrease Hospital Readmissions For Heart Failure Patients, Madison Geib, Jo Loomis

DNP Qualifying Manuscripts

Abstract

Background: Without proper education, heart failure (HF) is very difficult to manage. A lack of education and proper management of HF can lead to frequent hospital readmissions, decreased quality of life, and early morbidity and mortality.

Objective: Through literature review, this paper aims to identify the benefits of implementing telehealth education for HF patients in order to decrease hospital readmissions.

Methods: A range of relevant articles were analyzed and summarized in this literature review. An extensive literature search was performed and systematic reviews, meta-analyses, critically appraised research studies, qualitative, and peer-reviewed research studies were included.

Results: Ten articles met …

Implicit Bias Training In The Student Nurse Practitioner’S Curriculum, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to address poor health outcomes related to healthcare biases. This literature review examines the evidence for effective IB training methodologies.

Methods: CINAHL, Fusion, PubMed, Google Scholar, and Cochrane Database of Systematic Reviews were searched for peer-reviewed articles published between 2010 and 2022. The identified studies were critically appraised using the Johns Hopkins Nursing Evidence-Based Practice Level and Quality Guide Tool.

Results: Six articles were identified as eligible. Five studies implemented implicit bias training for graduate nursing students and …

Decreasing Restraint Use By Utilization Of Agitation Assessment And Verbal De-Escalation Strategies In An Inpatient Non-Psychiatric Hospital, Kiera Paulo

DNP Qualifying Manuscripts

Background: This paper reviews the literature on ways to decrease the use of restraints in hospitals – specifically the use of agitation assessments and verbal de-escalation to be implemented in healthcare facilities to decrease the number of restraints being used to manage undesirable patient behavior and workplace violence incidents. Problem: Restraints have been shown to impede the nurse-patient relationship and cause emotional and physical trauma to staff and patients. They are no longer considered preferred management and in some circumstances can be considered abuse. Intervention: Agitation assessments and verbal de-escalation have been shown to produce less aggressive behavior and decrease …

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Background

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Latinas therefore have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice students and Community Health Workers (CHWs) of the Central Valley of California …

Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann

DNP Qualifying Manuscripts

Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. …

Mentoring Infection Preventionists: An Infection Prevention Practice Fellowship Program, Sejal Naik

DNP Qualifying Manuscripts

Background: The COVID-19 pandemic created enormous demands on infection preventionists (IPs). It seriously taxed IPs and required hiring new IPs to support these demands. It is highly competitive to hire experienced IPs, and it can take up to two years for new IPs to demonstrate proficiency before pursuing their certification. A gap analysis revealed that current infection prevention (IP) programs did not provide formal training or mentoring.

Methods: The fellowship program will use the Association for Professionals in Infection Control and Epidemiology (APIC) competency model to train and build IP competency. The APIC accelerated training program will provide training to …

Mental Health Navigators Bridging The Gap Of Care For Clients With Schizophrenia: A Review, Valentina Loreto-Ashley, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Background: Schizophrenia is a thought disorder. As such it affects an individual level of function, and often leads to acute hospitalization. When clients with schizophrenia disorders are discharged, they are a great risk for suicide and danger to others. Services aimed at bridging patients from an acute facility to their community setting could be essential in helping the client in treatment to reach functional recovery and avoid relapse.

Objective: This article explores the role of mental health peer navigators in improving treatment adherence for adult clients with schizophrenia spectrum disorder being discharged from a psychiatric facility into their unique community …

Reducing 30-Day Hospital Readmission Among Mentally Ill Homeless Men With Substance Use Disorder, Chibuogwu Ugbana

DNP Qualifying Manuscripts

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men is greater than that of the overall population. Substance use disorders co-occur with high prevalence in patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health behavior, and medication non-compliant, resulting in hospital readmission.

Problem: In an acute care psychiatric facility in Northern California, the greatest readmission after inpatient hospitalization occurs at 53.9% in a week and 74.8% in two weeks of discharge. For homeless individuals, substance use disorder complicates personal problems and decreases the likelihood of a long-term …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

DNP Qualifying Manuscripts

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy.

Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care and has higher rates of health disparities. The Save the Children organization’s Community …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

Mental Health Screening After Trauma: A Concise Review, Christine Mcgahey

DNP Qualifying Manuscripts

OBJECTIVE: To gain a better understanding of the value of mental health screening for PTSD risk in hospitalized trauma survivors.

DATA SOURCES: Studies were pooled from a literature search performed on the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and the Cochrane Database of Systematic Reviews.

STUDY SELECTION: Relevant studies published between 2015 and 2022 in English, excluding traumatic injuries incurred during combat.

DATA EXTRACTION: Ten articles were selected for inclusion in this review.

DATA SYNTHESIS: There is a significant and widespread mental health burden following traumatic injury. Early screening to quantify the risk for PTSD can …

Environmental And Occupational Health Risks: Educating Undergraduate Student Nurses For Best Practice, Dorinda A. Mercado

DNP Qualifying Manuscripts

The environments we inhabit, whether homes, schools, workplaces, or the communities that envelop them, are replete with ubiquitous health risks that we routinely ignore to avoid analysis paralysis from worries. Environmental risks are hidden in food, drink, household and personal care products, furniture, and building materials; chemical hazards and physical residues of modern living contaminate air, water, and soil. Occupational hazards are prevalent in workplaces as diverse as agriculture, highways, and hospitals. A recent study by the Centers for Disease Control and Prevention (2022) found that out of 2,310 urine samples taken from a group of Americans from the United …

Psychobiology Of Resilience, Rosarina A. J. Pelikan

DNP Qualifying Manuscripts

Nurse managers experience high levels of stress due to the complex bureaucratic and chaotic nature of the job, which can lead to burnout. In nurse managers, burnout negatively impacts the ability to meet the strategic goals of the quadruple aim: patient quality, patient satisfaction, cost savings, and employee well-being. Strategies to address burnout include minimizing or removing unnecessary causes of stress and provide the skills to protect against burnout. Resilience is a competency nurse leaders must have to withstand overwhelming job-related stress. Resilience-enhancing strategies have psychobiologic underpinnings and can be easily incorporated into nurse managers’ work schedules.

Implementing Nurse Extracorporeal Membrane Oxygenation Specialists To Maintain A Sustainable Program, David L. Boyd

DNP Qualifying Manuscripts

Extracorporeal membrane oxygenation (ECMO) offers hope for patients with acute respiratory distress syndrome when other treatment methods fail. However, ECMO requires continuous hourly management leading to extremely high operating costs. With the onset of the COVID-19 pandemic, the high number of patients on ECMO led to a significant increase in the costs when using perfusionists to manage ECMO. Switching to a nurse-driven model resulted in a 52% decrease in costs related to the hourly management. Changing to a nurse-driven program provided increased nursing support and sustainability, and with determination and support, other ECMO centers can change to nurse-driven programs too.

The Community Health Worker: Improving Prenatal Health In Rural And Minority Populations, Deirdre A. Martinez

DNP Qualifying Manuscripts

The United States continues to have an unacceptably high rate of preventable deaths among pregnant and new mothers—the highest rate among developed countries. Pregnancy outcomes are especially poor in minority, rural, and medically-underserved populations, with lack of access to healthcare being identified as a primary factor in poor pregnancy outcomes and pregnancy-related deaths. It is imperative that action be taken to reverse this disturbing trend. Introduction of the Community Health Worker (CHW) into the multidisciplinary healthcare team is a solution that results in increased access to healthcare, along with many other positive health outcomes, and is one way in which …

Using Group Interviews To Innovate The Selection Process For New Graduate Nurses, Karen T. Descent

DNP Qualifying Manuscripts

A pilot program in two hospitals using a group interview approach for new graduate nurse selection enabled multidisciplinary leadership participation. The interview process incorporated structured behavioral and scenario-based questions. The pilot shortened the traditional one-to-one interview process by 70% and improved retention one year from hire by 17.5%.

Nurses Partnering With Technology To Predict The Patients' Risk Of Falling Using Artificial Intelligence, Ann Aquino

DNP Qualifying Manuscripts

Artificial intelligence's influence on human lives has captured the attention of healthcare professionals around the globe. There is high optimism for healthcare transformation for better and more efficient care delivery using technology in a highly complex work environment. Because of machine-learning models, predicting the likelihood of harm, such as a fall, is possible. Artificial intelligence (AI) calculations create predictive analytics that can be an objective mediator between the patients' clinical presentation and the nurse's judgment. Further, standardization of documentation is made possible because of the technology behind AI. Information models create a clinical support system that guides nurses in preventing …