Family Practice Nursing Commons^™

The Relationship Between Patient Satisfaction With Nursing Care And Nursing Job Satisfaction, Natalie Leriger

Scholar Week 2016 - present

Patient satisfaction, which has become a priority for hospitals and an indicator of quality, is a result of a patient’s perception of care. The consequences of not adequately providing high levels of patient satisfaction can be enormously costly to the greater healthcare system. The literature provided evidence that effective patient satisfaction is multifactorial; one key factor noted was nursing care. This study examined the relationship between patient satisfaction with nursing care and nursing job satisfaction. The researcher employed a quantitative correlational research design to find further evidence of this potential relationship. Ninety-eight patients participated in the study, as well ...

The Lived Experiences Of Parenting Children With Food Allergies: A Phenomenological Study, Anne Zavell

Dissertations

This phenomenological study focuses on five mothers' experiences of the phenomenon of living with a diagnosed food allergy in the family. Attention is given to the contexts or situations that have typically influenced or affected their experiences, including the impact of the diagnoses, travel and restaurants, friendships, sibling relationships, and anxiety. There is a major emphasis on these mothers' experiences advocating for the needs of their children in schools, including their strategies, concerns, and frustrations. Policies related to food allergies are reviewed from the contemporary and historical perspectives, with recommendations for policy change. The lived experiences of food allergy mothers ...

Limitations Of Sensory Systems (Loss) Assessment, Clarissa E. Steffen Ed.D.

Faculty Scholarship

This checklist is designed to assess the degree of loss in families with children who experience sensory system impairments and in specific issues with limitations to insight and awareness of self and others. There are 100 items in the checklist and the lower the score the higher degree of loss experienced. This is a pilot paper for this assessment of losses experienced within families who have children with sensory limitations, and it is designed to gather input on the following factors.

Construct, Trait, Skills or Competency

Primary Factor

• Integrative Reason

Insight, awareness, clarity of thought

• Eco-System Development

Individuation, environmental ...

Processus Décisionnel Du Consentement Aux Soins Chez L’Adolescent Atteint D’Un Cancer : Une Perspective Triadique, Joséanne Desrosiers, Christine Genest, Ariane Ballard, Sylvie Le May

Science of Nursing and Health Practices - Science infirmière et pratiques en santé

Introduction. Obtaining consent to care in pediatric oncology is recognized as a complex decisional process on account of the multiple stakeholders involved. In Quebec, the process is complicated all the more by the fact that teenagers 14 years and over can, under certain circumstances, consent to care without parental approval. Objective. The aim of this study was to develop a conceptual model of the decisional process involved in obtaining consent to care for adolescents with cancer from the triadic perspective of adolescents, parents and pivot nurses. Method. Data were collected through individual semi-structured interviews and sociodemographic questionnaires. Interviews were transcribed ...

The Role Of An Advanced Practice Provider (App) And Its Relation To Physician Shortages And Rural Healthcare Survival: A State-By-State Analysis, Allen Anderson

Dissertations, Theses, and Projects

The extent that Advanced Practice Providers (APPs) are able to practice independently with a full scope of practice varies state-by-state. The purpose of this paper was to review how APPs could help in a number of different areas of healthcare. This analysis examines the state of rural healthcare and reviews physician shortage statistics and hospital closures by state. In the examination, it also evaluates which states have full scope, reduced scope, and restricted scope of practice laws and cross-references that with states that have experienced a hospital closure. Through case studies, this research finds that APPs can be an alternative ...

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted ...

Implementation Of A Nurse-Led Diabetes Self-Management Education (Dsme) Program In Primary Care, Jamie Lee

Nursing and Health Professions Faculty Research and Publications

Type 2 Diabetes Mellitus (T2DM) is a serious concern, that requires close monitoring and facilitation of self-management skills and strategies, as well as development of a sense of self-efficacy, in patients with this chronic disease. The development of nurse-led Diabetes self-management education (DSME) programs, combined with a multidisciplinary approach to care and management, is a safe and effective means of helping patients with uncontrolled T2DM to cultivate positive health behaviors, prevent long-term disability and effectively control blood sugars.

A DSME program like this was developed and implemented at Mercy Midtown Family Practice, for patients with a glycosylated hemoglobin (HbA1c) of ...

Implementation Of The Human Papillomavirus Vaccine Among Health Professions Students, Emeka C. Nnabuife

Doctor of Nursing Practice

The human papillomavirus (HPV) is the most widespread sexually transmitted infection in America. College-aged students are a high-risk group for HPV transmission, but their HPV vaccination rates are low. The purpose of this evidence-based project was to implement an HPV vaccination program at a health science center university student health clinic to increase vaccination rates to meet the guidelines of the American College Health Association (ACHA) and the Centers for Disease Control and Prevention (CDC). The objectives of this project were as follows: 1) to educate providers and staff on the importance of the HPV vaccine; 2) to increase HPV ...

The Implementation Of Obesity Guidelines In A Rural Clinic, Teresa M. Beard

Doctor of Nursing Practice

Background Over 36% of Americans are obese. It is estimated that, by year 2030, 51% of the population will be obese. With the increased prevalence of co-morbidities associated with obesity, it is important to gain control of this disease. Method The aim of this project is to implement the 2013 American College of Cardiology, American Heart Association Task Force on Practice Guidelines, and The Obesity Society Guidelines for the Management of Overweight and Obesity in Adults in order to identify those patients who require treatment for obesity and provide them with appropriate resources. The primary interventions are to provide color-coded ...

Assessing The Effectiveness Of A Quality Improvement Intervention To Decrease Missed Opportunities For Human Papillomavirus Vaccination At A Nurse Managed Health Center, Maria Medina-Calvo

Doctor of Nursing Practice

Purpose: To decrease the number of missed opportunities for human papillomavirus vaccine eligible patients seeking healthcare in a Nurse Managed Health Center. Background & Significance: Human papillomavirus genital infection has inflicted nearly 79 million Americans. Annually, about 14 million newly infected individuals are identified, with noted predominance in teens and young adults, and of this number approximately 19,200 females and 11,600 males receive a cancer diagnosis as a result of the human papillomavirus infection. The incidence of infections can be reduced with a human papillomavirus vaccine, but only about 63% of females and even fewer males initiate the human papillomavirus vaccine. Methods: A Nurse Managed Health Center assisting the underserved population, in a major southwestern metropolitan city was chosen to implement a Qualified Patient Prompter tool used to screen for human papillomavirus eligibility in all patients seeking healthcare in this Nurse Managed Health Center. A reminder card strategy was used at the end of the accepted human papillomavirus vaccine visit. Results: 334 patient records were reviewed and 135 were eligible to receive the human papillomavirus vaccine; 60 opted to receive it and 75 declined. Conclusion: A 100% of all patients seen were evaluated for human papillomavirus vaccine eligibility. The intervention decreased missed opportunities by 100%. Continued efforts will focus on increasing human papillomavirus vaccine acceptance rates. The Nurse Managed Health Center fully support the continued use of the Qualified Patient Prompter, which was effective within this population.

Establishing A Coumadin Clinic In A Rural Family Medicine Practice, Kathleen E. Zeledon

Doctor of Nursing Practice

Background. Coumadin is the most commonly prescribed oral anticoagulant worldwide and is safe and effective in the prevention and treatment of stroke and venous thromboembolism (Stoudenmire, DeRemer, & Elewa, 2014). Coumadin is dangerous when poorly managed due to high risk for bleeding and mortality. It is best managed using evidenced-based models of care such as point-of-care (POC) International Normalized Ratio (INR) testing (Garcia et al., 2008; Harrison, Shaw, & Harrison, 2015; Rossiter, Soor, Telner, Aliarzadeh, & Lake, 2013). Purpose. Establish a Coumadin Clinic in a rural family medicine practice with POC INR testing to improve anticoagulant management. Methods. A quality improvement project was conducted to implement all components of the Coumadin Clinic, to evaluate the time within therapeutic range (TTR) of INR for all patients on Coumadin therapy, and to evaluate patient and staff satisfaction. Components of the Coumadin Clinic were monitored for ...

Implementing The Hyperlipidemia Statin Use Guideline In Patients With Diabetes Mellitus, Ifeyinwa Eribenne

Doctor of Nursing Practice

Purpose. To implement an evidence-based hyperlipidemia guideline for statin therapy use with diabetic patients. Background. In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity for women and men with diabetes. Dyslipidemia is a modifiable risk factor for CVD and one of the leading drivers behind the development of coronary artery disease. In 2014, the American Diabetes Association issued a new recommendation guideline for using statins as a primary intervention for CVD in patients aged 40–75 with diabetes. Despite advances in prevention and treatment guidelines, the American College of Cardiology and ADA ...

Hiv Screening In Non-Pregnant Patients Age 13 – 64 Years Old In Primary Care Through The Implementation Of The Cdc Guidelines For Hiv Screening, Ashten M. Martin

Doctor of Nursing Practice

As many as 216,000 people living with HIV are unaware they have the disease. In order to combat the inadvertent spreading of HIV, the CDC recommends screening everyone 13 – 64 years of age. The purpose of this Quality Improvement project was to implement the 2015 Sexually Transmitted Diseases Treatment Guidelines as it pertains to HIV screening within a Southeast Texas rural health clinic. The objectives were 1) educating all staff and patients regarding the CDC recommendations for HIV screening, and 2) increase the number of eligible patients who were offered and received HIV screening. A colored checklist served as ...

Anemia Management For Patients Receiving Peritoneal Dialysis, Kenisha Marajah

Doctor of Nursing Practice

The purpose of this quality improvement project was to develop an anemia management evidence-based intervention for patients receiving peritoneal dialysis (PD) and to educate staff on implementation of the anemia management protocol in a PD clinic in a southwestern county in Texas. Anemia is a common complication of chronic kidney disease (CKD) resulting from the inability of the kidneys to produce erythropoietin needed for red blood cell production. Erythropoiesis-stimulating agents such as Aranesp or Epogen may be administered to dialysis patients to stimulate erythropoiesis in the presence of kidney disease. Iron storage and iron availability remains imperative in effectively stimulating ...

Incorporating Waist Circumference Screenings To Initiate Preventative Lifestyle Modification Education: A Feasibility Study For A Clinical Practice Change, Tracy Stahl

Doctor of Nursing Practice

INCORPORATING WAIST CIRCUMFERENCE SCREENINGS TO INITIATE PREVENTATIVE LIFESTYLE MODIFICATION EDUCATION: A FEASIBILITY PILOT STUDY FOR A CLINICAL PRACTICE CHANGE

An Abstract of the Scholarly Project by

Tracy Stahl MSN, FNP-C

The purpose of this study was to evaluate provider perceptions and willingness to incorporate adult gender-specific waist circumference screenings as a clinical practice change. The project was conducted at the 4-State Advanced Practice Nurses (APN) conference in March 2018. The study consisted of a two-part study that utilized a pretest, educational PowerPoint presentation, posttest, and eight-week posttest to determine self-reported provider practices. Part one of the study analyzed the pretest ...

Clinical Cues Of Suboptimal Glucose Homeostasis In Individuals Diagnosed With Type 2 Diabetes Mellitus: An Integrative Literature Review, Joel Hutson

Grace Peterson Nursing Research Colloquium

Background: General practice healthcare providers may not fully utilize all available subtle clinical cues (physical/behavioral signs and symptoms) when screening for diabetes, or when assessing for suboptimal control of glucose homeostasis.

Objectives: To assess the prevalence and utility of incorporating diabetic clinical cues into routine physical assessments and questionnaires of individuals with type 2 diabetes, and to compile a comprehensive list and questionnaire using clinical cues.

Methods: Utilizing the databases CINAHL Complete, PubMed, and Academic Search Complete, an integrative literature review of 78 studies was conducted using the key terms type 2 diabetes and clinical manifestations of diabetes.

Results ...

Eye Examination:Satisfying A Quality Care Measure In Diabetes, Meera Shekar

Dissertations

Abstract

Purpose: Diabetic retinopathy (DR), a microvascular complication occurs in patients with poorly controlled diabetes mellitus (DM). A known risk of increased visual impairment associated with DM occurs in patients when the glycosylated hemoglobin level (HbA1c) increases over 7.0%. Therefore, an annual retinal assessment as a quality care measure in diabetes management is necessary. The conducted study aimed to evaluate the documentation of an annual eye exam in all patients with DM in a private family practice clinic and to investigate any possible association between HbA1c level.

Method: This quality improvement study included a retrospective medical record review in ...

Nurse Practitioner Students: Providing Wellness Screenings To Underserved Older Adults, Rexanna Tatlock

Purdue Journal of Service-Learning and International Engagement

Rexanna Tatlock (BSN, RN, CCRN) received a BSN from Saint Francis College in 2003. As a registered nurse, she specialized in critical care nursing and eventually enrolled in the Adult Gerontology Nurse Practitioner master’s program in Purdue University’s School of Nursing in 2016. Upon graduation in May 2018, Rexanna has planned to focus on primary health care. The service-learning project provided primary care clinical experience, while meeting the needs of an underserved older adult population. This article will discuss the community partnership, a needs assessment, and a wellness screening offered to Fairington Apartments (FA) residents.

Women's Quality Of Life After Leaving An Abusive Relationship: The Effects Of Past And Ongoing Intimate Partner Violence, Mastery And Social Support, Diana Jaradat

Electronic Thesis and Dissertation Repository

Intimate Partner Violence (IPV) is considered a major stressor that threatens the lives of women globally. Although qualitative research suggests that IPV has substantial negative effects on women’s quality of life, few quantitative studies have examined the quality of life of women who have experienced IPV due, in part, to the lack of an appropriate, brief measure of QOL. Consequently, little is known about the contextual process by which IPV experiences affect women’s quality of life (QOL) after leaving an abusive relationship. Mastery and social support are two important resources that women may use to deal with IPV ...

Consistently Using A Transportation Department For Patient Discharge To Sustain Nursing Staffing Levels, Victoria Boutin, Joseph East, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Excellence

IMPROVING PATIENT FLOW BY UTILIZING A HOSPITAL TRANSPORTATION DEPARTMENT FOR DISCHARGES

Using a transportation department for transporting patients for discharge is the industry standard. At a large urban hospital, inconsistent use of this department has resulted in frontline caregivers (RNs) having to pick up this function, resulting in potentially unsafe staffing levels on the floor.

The goal of this quality improvement project was to improve the percent of discharges with the transport department from ≤10% to 70% by the end is fiscal year 2018 in an academic tertiary medical center.

Baseline metrics demonstrated the current state and a root cause ...