Medicine and Health Sciences Commons^™

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Human Trafficking Awareness Among Psychiatric Hospital Nursing Staff, Donna J. Czech, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Human trafficking is a public health crisis on a global, state, and local level. Victims of human trafficking are a vulnerable population who pass-through healthcare systems unrecognized by nurses and other healthcare professionals due to a lack of awareness about identifiable signs, symptoms, and circumstances. Nurses are in a crucial position to assess trafficking victims for a referral. The purpose of this evidence-based practice (EBP) pilot project was to understand nurses’ knowledge and awareness on human trafficking and assess the perceived ability to identify trafficked individuals in a psychiatric care setting for screening and potential referral. Nurses received an online …

Recognizing Delirium In The Picu: An Evidence-Based Practice Improvement Project, Abigail Begovich, Tracy L. Brewer, Jennifer G. Tourville Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Introduction: Pediatric delirium is underrecognized in the pediatric population and can lead to increased length of stay, hospital costs, and post-traumatic stress disorder (PTSD). Using a standardized screening tool to assess for delirium is an easy way for bedside nurses to evaluate patients and intervene as necessary. This quality improvement project aimed to implement the Cornell Assessment of Pediatric Delirium (CAPD) and complete a delirium screening on applicable patients once a shift > 85% over four months.

Methods: Between January 2020 to May 2020, bedside nurses completed a delirium screening assessment on applicable patients, first on paper and then …

Implementation Of Standardized Hereditary Breast And Ovarian Cancer (Hboc) Risk Assessment And Genetic Referral, Melissa M. Hessock, Tracy L. Brewer, Sadie Hutson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: To increase identification and genetic referral rates for women at risk of Hereditary Breast and Ovarian Cancer (HBOC).

Design: Evidence-based practice improvement initiative

Setting/Local Problem: Private suburban OB/GYN practice in Tennessee with no standardized process for HBOC risk assessment or genetic referral.

Participants: Women age 18 or older, presenting for routine well-woman visits.

Intervention/Measurements: Using PDSA (plan-do-study-act) cycles, a familial risk assessment tool was selected, and a clinical decision-making algorithm for risk assessment and genetic referral was designed and implemented for use in well-woman encounters. Pre-implementation and post-implementation risk identification and referral rates were …

Mammography Screening Practices And Health Beliefs Of Women In East Tennessee, Peggy A. Johnson

Doctoral Dissertations

Abstract One of every eight women in the United States will be diagnosed with breast cancer in her lifetime. Although early detection of breast cancer is the most effective method of assuring survival, many women throughout the country do not avail themselves of this advantage. This study examined mammography screening practices of women age 55 and older who attended senior citizen centers in rural, non-metro, and metro counties in the areas designated by the Tennessee Department of Health as the Eastern Grand Division of Tennessee. Data was collected from four hundred women from fourteen counties in East Tennessee using the …

Gender And Posttraumatic Stress Disorder Screening In The Military: A Measurement Study, Mark Allan Oliver

Doctoral Dissertations

The Primary Care Posttraumatic Stress Disorder (PC-PTSD) screen (Prins et al., 2003) is used by the Department of Defense to identify military members who are at increased risk of PTSD. This screen has been offered to all returning deployers since 2005. However, validation studies of PC-PTSD scores from military samples have seldom employed a significant number of female subjects and no published studies have examined it for gender bias. Ruling out bias is important because routine under-identification of PTSD risk in any group could result in hindered access to needed assessment and/or care. With the current proportion of military females …