Medicine and Health Sciences Commons^™

Beyond The Physical Wounds: A Proactive Approach To Mental Health Recovery After A Traumatic Injury, Christine Mcgahey

Doctor of Nursing Practice (DNP) Projects

Beyond the Physical Wounds: A Proactive Approach to Mental Health Recovery After a Traumatic Injury

Background: Every year, millions of Americans incur a life-threatening traumatic event and are admitted to trauma centers to treat their acute physical injuries. While traumatic injury is closely associated with developing post-traumatic stress disorder (PTSD), patients are rarely evaluated for PTSD risk or educated about long-term psychological sequelae.

Local Problem: The predictive value of early screening to quantify PTSD risk in trauma patients is well documented in the literature. However, in a 241-bed Level II Trauma acute care hospital, there was no protocol to evaluate …

Mental Health Services: Reaching The Homeless, Gurdeep Mann

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with …

Improving Colorectal Cancer Screening In Primary Care, Bushra Iqbal

Doctor of Nursing Practice (DNP) Projects

Colorectal Cancer (CRC) is the second leading cause of cancer related deaths in the U.S., although it is preventable with adequate routine screening. Medically underserved minorities and immigrants require screening program awareness in their respective communities. The incidence of CRC remains markedly high despite the screening modalities among various populations. In the United States (U.S.), there were approximately 147,950 reported CRC diagnoses, 53,200 deaths, and over 35.2 cases per 100,000 in California alone reported in 2020 (Siegel et al., 2020). Healthcare providers can prevent colorectal cancer (CRC) through adequate routine screening. Various screening practices are widely implemented in primary cases …

Implementing A Diabetic Foot Care Program In A Virtual Primary Care Clinic, Zahra Naderi Asiabar

Doctor of Nursing Practice (DNP) Projects

Abstract

Background

Healthcare professionals (HCPs) have a key responsibility in delivering preventative and early intervention diabetes foot management within primary care. Diabetic foot ulcers (DFUs) are a major complication of diabetes and can lead to amputations and other wound issues.

Comprehensive care and treatment of diabetes are most effective when patients can access a supportive connection with providers. Before the pandemic, there were many reasons to utilize a technology-based distance approach to health care. The coronavirus pandemic in 2019 prompted additional reasons for the transition to distant care.

Problem

The yearly screening of a virtual foot exam on patients with …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Educating Providers To Screen For Post-Traumatic Stress Disorder, Alyssa Fraino

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this evidence-based change in practice is to increase the knowledge base of psychiatric providers in outpatient psychiatric settings, by educating clinicians regarding the significance of implementing a post-traumatic stress disorder (PTSD) screening tool during the initial evaluation of patients. This can help to identify patients with PTSD that may not have been identified on initial visit, and may otherwise go unrecognized or untreated for PTSD, without the inclusion of a PTSD screening tool.

Problem: Evidence suggests that PTSD is underreported and overlooked in most populations. However, there is no standardized practice surrounding the routine use of …

Identification Of Victims Of Human Trafficking: Leading Change Through A Global Pandemic, Connie Clemmons-Brown

Doctor of Nursing Practice (DNP) Projects

Human trafficking is a multi-billion-dollar global industry, generating $150 billion annually (International Labour Organization [ILO], 2014), and driven by the exploitation of victims of all ages, primarily for forced labor or commercial sex. Victims endure frequent and prolonged abuse, suffering illnesses, and injuries. When accessing the health care system, they often go unrecognized by health care providers and nurses. Recognition requires training to raise awareness and the right tools to capture the information necessary to identify victims and address opportunities to improve their safety, care, and support. The aim of this Doctor of Nursing Practice (DNP) evidence-based change project was …

Pre-Conception Screening Tool, Nnenna Abaeze

Doctor of Nursing Practice (DNP) Projects

Problem: Sexually active women between the ages of 14 and 44 are at risk of pregnancy. This risk puts these women at high rate of unintended pregnancies.

Purpose: Currently, there is a nationwide initiative, Healthy People 2030, to reduce the rate of unintended pregnancies. Pre-conception screening is a method of mitigating this concern. Women typically receive pre-conception screening from an obstetrician, whom they visit during their annual well woman visit. The primary care setting is unique because women typically visit a primary care provider more frequently than their obstetricians. Every visit to a primary care provider is an …

School-Based Mental Health Screening: Improving Outcomes Through Interprofessional Communication And Collaboration, Tiffany Gishizky

Doctor of Nursing Practice (DNP) Projects

For the adolescent population, the immediate impact a mental health disorder has on academics,relationships, and even suicide risk cannot be understated. Access to mental health care in low socioeconomic communities for adolescents is fraught with barriers. These include lack of transportation, lack of insurance coverage, fear of stigma, and a fundamental lack of knowledge regarding available resources. It is therefore a two-fold problem that exists for those in the care and observation of these adolescents; underutilization of appropriate routine screening and navigation to access care. This project aimed to remediate both of these issues at a high school located in …

School-Based Suicide Prevention Program Implementation: Improving Awareness Among Parents And Faculty, Nicole Neuman

Doctor of Nursing Practice (DNP) Projects

The health development and critical transition period of preteen to adolescence are subject to adverse experiences and prevalent risk behaviors that may negatively influence mental health. Emerging issues of depression and suicide among school-aged youths present a global epidemic. Well-designed interventions, such as school-based programs, align with national strategies and health initiatives to reduce suicide rates and facilitate treatment of concerning symptoms. Database searches for school-based, suicide, depression, prevention, and screening literature from 2012-2017 identified 12 relevant studies selected for review. Mental wellness and suicide prevention curricula must successfully improve wisdom, enhance coping skills/resilience, and foster relationships which support help-seeking …

Teaching A Primary Prevention Falls Program: Using The Stop Elderly Accidents, Deaths, And Injuries (Steadi) Toolkit, Janice Mark

Doctor of Nursing Practice (DNP) Projects

Problem: Falls in the community dwelling older adult (CDOA) are a growing health concern, placing large financial and social burdens. Primary care providers (PCPs) are not engaging in falls assessment and prevention activities due to the lack of knowledge and time. Context: Falls are the leading cause of fatal and nonfatal injuries, and is projected to worsen with the increase in the aging population. STEADI is a fall assessment and prevention toolkit created by the CDC to tackle this problem designed to address the knowledge and practice gaps of PCPs. Interventions: A DNP project was crafted and implemented to train …

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …