Utilizing Decision Tree Implementation And Provider Education To Improve Colorectal Cancer Screening Orders: A Quality Improvement Project, Alicia Kollar

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths (Jain, et al., 2022). Healthy People 2030 objectives include reducing the CRC death rate and increasing the proportion of adults who get screened (Healthy People 2030, n.d.). According to 2021 data, only 58.7% of adults are screened with a Healthy People target of 68.3%. Healthy People states that there are effective screening tools to detect colorectal cancer early, and people are more likely to survive it (Healthy People 2030, n.d.). Purpose: This quality improvement (QI) project aims to implement an …

Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing Student Works

ntroduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson

The Eleanor Mann School of Nursing Student Works

Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.

Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.

Results: In a comparison …

The Case For Crisaborole, Chelsea Carnes

MSN Capstone Projects

To begin, topical corticosteroids (TCS) have been the standard first-line treatment medication for atopic dermatitis (AD) since the Federal Drug Administration (FDA) approved them in 1955 (Siegfried et al., 2016). Given that evidence-based practice (EBP) usually changes every few years for many other issues, that is a long period of time. This long-standing standard unfortunately leads many clinicians to the classic “we have always done it this way” conclusion. However, with scientific advancement, there are many more treatments available for AD today. One that is particularly promising is crisaborole, which is currently available under the brand name Eucrisa.

This medication …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Initiating Culturally-Directed Education For Hispanic Adults With Type 2 Diabetes Mellitus, Marie Davis, Jennifer Smith, Mandy Horner

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

BACKGROUND:

The U.S. Hispanic population has the highest rate of Type 2 diabetes mellitus (T2DM), which is influenced by socio-economic status and language barriers. Current evidence suggests that the delivery of culturally-directed Diabetes Self-Management Education (DSME) with the use of an interpreter can reduce diabetes-associated complications.

LOCAL PROBLEM:

The project took place at a free clinic in North Carolina. The purposes of this project was to create a culturally-directed DSME bundle for Hispanic adults with the use of a Spanish interpreter to improve understanding of T2DM management.

METHODS:

The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was …

Antibiotic Stewardship In Patients With Viral Upper Respiratory Illness: Improving Quality Measures In Retail Health, Meredith A. Nolan, Robin Harris, Clay Smith

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

BACKGROUND: Millions of people will die from antibiotic-resistant bacterial infections in the next 30 years. Retail health providers are pivotal in this global epidemiological problem.

LOCAL PROBLEM: Setting included 15 retail health clinics operated by Vanderbilt University Medical Center in Middle Tennessee. Project examined provider education, patient engagement, and commitment to antibiotic stewardship, components of the CDC's Core Elements of Outpatient Antibiotic Stewardship framework. Specific aims were that providers would have a significant reduction in the percentage of antibiotics prescribed for viral illness over the study period.

METHODS: Using the Evidence-Based Practice Improvement Model, a Quality Improvement …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

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

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Development And Evaluation Of Trauma Informed Care Education For Licensed Nurses, Kristina O'Meara

Epsilon Sigma at-Large Research Conference

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. …

Health Literacy And Diabetes Outcomes In Adults With Type 2 Diabetes In Southwest Virginia, Casandra Reyes Arellano

Epsilon Sigma at-Large Research Conference

Purpose: To determine if a quality improvement project involving individualized, one-on-one Diabetes education will improve health literacy and Diabetes outcomes in adults with Type 2 Diabetes in a rural primary care clinic. Diabetes is a chronic condition affecting the United States with 9.6% of Virginia’s population living with Diabetes.

Aims: To improve patient’s Diabetes literacy scores, BMI, and Hemoglobin A1c levels through Diabetes education.

Processes: There are pre- and post-education phases. Data to be collected at the end of both phases consist of DNT15 scores, BMI, and A1c. In the pre-education phase, BMI was obtained, DNT15 was administered, and Diabetes …

Implementation Of Provider-Made Follow-Up Appointments For Depression In Primary Care, Rebecca Vaughn

Epsilon Sigma at-Large Research Conference

Implementation of provider-made follow-up appointments for depression in primary care

Rebecca Vaughn

College of Nursing, East Tennessee State University; Whitson Hester School of Nursing, Tennessee Technological University

Author Note

Rebecca Vaughn https://orcid.org/0009-0007-0731-3316 College of Nursing, East Tennessee State University

There are no conflicts of interest to disclose.

Corresponding concerning this manuscript should be addressed to Rebecca Vaughn

108 Reed Mill Lane Monroe TN 38573

Zrev2@etsu.edu

Abstract

Depression is a common condition diagnosed and managed in primary care.

Follow-up is inconsistent and low in these settings, creating a gap in care that

impacts management, adherence to treatment, and patient outcomes. The …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Impact Of Processed Food On Heart Health, Elizabeth Moxley

Faculty Peer-Reviewed Publications

Impact of Processed Food on Heart Health

March 14, 2024|Elizabeth Moxley

Cardiovascular disease (CVD), particularly atherosclerotic cardiovascular disease (ASCVD), remains the leading cause of death on a global scale.^[i],[ii] CVD is also the leading cause of death in patients with type 2 diabetes (T2D), specifically in low- and middle-income countries.^[iii] In spite of the improvement in ASCVD outcomes in recent decades, pervasive levels of ASCVD morbidity and mortality continue to be unfavorable.^[iv] According to the American Heart Association,⁵ effectively promoting dietary improvements and engagement in regular physical activity help prevent the ongoing risk …

Policy Review And Recommendation: Full Practice Authority For Nurse Practitioners In The Southwestern United States, Sara J. Rowe

Student Scholarly Projects

This policy analysis investigates the benefits of full practice authority (FPA) for Nurse Practitioners (NPs) in the Southwestern United States, using Arizona as an FPA model and California and Tennessee as comparison states. The PICO question that directed the project is: for NPs practicing as advanced practice nurse practitioners within the Southwestern United States region (P), does a comprehensive policy recommendation for FPA for NP-led clinics in the secondary education space (I) compared to existing variable approaches within the region (C) improve access to care and direct or indirect patient outcomes as endorsed by the literature (O)? A comprehensive literature …

A Global Perspective On Intersecting Social And Systemic Barriers Experienced By Grandparent-Caregivers: A Qualitative Systematic Review, Schola N. Matovu, Deborah M. Whitley, Heather M. Young

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Globally, many grandparents are taking on the caregiving role for their grandchildren without public or government interjection of support, particularly financial assistance for basic needs such as housing, health care and living expenses. This paper aimed to broaden understanding of social and systemic barriers experienced by grandparent-caregivers across the globe. Of the 2,828 relevant grandparent caregiving studies identified in the literature, 34 representing eight countries met our inclusion criteria to answer the research question and the focus of this paper: What are the social and systemic barriers experienced by grandparent-caregivers across the globe? We utilized Noblit’s and Hare’s (1988) meta-ethnography …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Ethnic Minorities And Family Health History: An Autoethnography Of Guyanese Americans And Kidney Disease, Dhaneesha R. Bahadur

Dissertations, Theses, and Capstone Projects

Exploring family health histories (FHHs) has emerged in recent years as an inexpensive genomic tool in public health. Families and clinicians can also use them to uncover family histories and experiences, which could inform better lifestyle choices to prevent or delay the onset of diseases. Exploring family health histories focuses on an individual’s genetic makeup and considers differences in lifestyle and environment. Despite national campaigns, it is an underutilized tool that could lead to engagement in effective strategies and better health outcomes. One important and serious condition that families should be more aware of is chronic kidney disease (CKD). One …

Garden-Based Nutrition Education May Lead To Increased Dietary Knowledge In Low Income Hispanic School Children, Larry Bui

Nursing | Senior Theses

Background: Childhood obesity is a pressing public health concern in the United States, with rates continuing to increase in recent years. This problem disproportionately affects Latino children as well as those from low socioeconomic status. It is well established that nutrition knowledge deficiencies and resulting poor dietary habits are some of the most common contributing factors to childhood obesity. Garden-based nutrition education programs have been introduced to remedy this knowledge deficit; however, a gap remains regarding whether this model can be viable for low-income, culturally diverse populations.
Aim: This literature review investigates the importance of diet in reducing childhood obesity …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Senior Theses

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …