Family Medicine Commons^™

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Implementing An Antibiotic Stewardship Education Program To Decrease Antibiotic Prescriptions In An Urgent Care Clinic, James Gramling

Doctor of Nursing Practice Projects

Antibiotics are often prescribed for respiratory infections. These infections often have a viral rather than a bacterial source. Overuse of antibiotics is associated with increased potential for adverse effects, increased healthcare costs, and increasing antibiotic resistance. The purpose of this DNP project was to determine if implementing an antibiotic stewardship program at an urgent care clinic would decrease the number of antibiotic prescriptions written for acute respiratory tract infections. An educational session consisting of didactic and PowerPoint presentations was provided to each provider at the urgent care clinic. Medical records were reviewed for four weeks after completion of the session …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli

Evidence-Based Practice Project Reports

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …

Keeping Primary Care Providers Informed About Detecting Skin Cancer In Young Adults, Riley J. Spears

Evidence-Based Practice Project Reports

Skin cancer is a common, life-threatening disease that affects anyone, regardless of age or skin color (American Cancer Society [ACS], 2020). The incidence of melanoma is on the rise for young adults, with an estimated 2,400 new cases for individuals aged 15 to 29 (ACS, 2020). Although skin cancer is highly preventable, clinical guidelines are inconsistent regarding skin cancer screening. The purpose of this evidence-based practice (EBP) project was to determine if the implementation of the INternet curriculum FOR Melanoma Early Detection (INFORMED) program would improve primary care providers’ (PCPs’) confidence about skin cancer and the number of completed and …

The Use Of Automated Text Messaging As An Intervention For Smoking Cessation, Oluwasayo Sinkaiye

Evidence-Based Practice Project Reports

Tobacco smoking is a widespread problem that affects the adult population in the United States (U.S.). In 2018, about 14 of every 100 adults in the USA aged 18 years or older were cigarette smokers (Centers for Disease Control and Prevention [CDC], 2020). Tobacco smoking is associated with chronic disease conditions that have serious health implications including cancer, heart disease, diabetes, and chronic obstructive pulmonary disease (COPD) (CDC, 2020). The purpose of this evidence-based practice project (EBP) was to determine the effectiveness of an automated text messaging application (SmokefreeTXT) for smoking cessation in a primary care setting for adult cigarette …

Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula

Evidence-Based Practice Project Reports

Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Evaluating The Use Of Telehealth To Manage Hypertension In Primary Care, Alexandra M. Wiesner

DNP Projects

Background: Hypertension remains one of the most common chronic conditions in the United States leading to several health complications and immense financial burdens, yet it remains grossly undertreated despite the availability of evidence-based treatment options. The 2017 guidelines from the American College of Cardiology and American Heart Association recommended the use of home blood pressure monitoring with a telehealth component as an adjunct to regular hypertension treatment; however, implementing this into practice can be difficult depending on the setting, available resources, and the knowledge and skills of the providers. Aims: The purpose of this investigation is to evaluate patient adherence …