Family Practice Nursing Commons^™

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Resilience 101: A Resilience Education Intervention For College Freshmen, Angie Childre

Graduate Research Showcase

This evidence-based project sought to evaluate resilience in freshmen college students enrolled in a Bridge scholar program (BSP) in a liberal arts university in the southeastern United States. The American College Health Association (ACHA) found that stress and anxiety were the top two indicators for impacting academics in 2019 and had been at the top since 2009 at the university of study (ACHA, 2019). The study used a pretest and posttest design method with the implementation of a five-week resilience education intervention. The research questions (Q1-5) were: Q1: What effect did the intervention have on BSP student's resilience? Q2: What …

Preventing Insulin Storage And Administration Errors, Makena Reddick

Scholars Week

■The research problem was discovered when nurses were observed storing and administering insulin improperly. The objectives of this project were to find the correct policies for these procedures, obtain research that backed these policies, and present this information to nurses to create a safer habit. In researching, it was found that reducing the physical distance between a person completing work and the materials required to do so increased compliance (Gibbs & McLernon, 2017). In a second study, the delivery of safe, effective and high-quality care for patients with diabetes in the community is dependent upon (district) nurses having appropriate knowledge …

Knowledge About Continuous Positive Airway Pressure Machine Usage Among Nurses At A Tertiary Hospital In Tanzania, Wilson Paulo Lomnyack, Tumbwene Mwansisya, Stewart Mbelwa, Kahabi Isangula, Zephania Saitabau Abraham

School of Nursing & Midwifery, East Africa

Introduction: Continuous Positive Airway Pressure (CPAP) provides an air pressure that maintains the patency of the airway in patients with a variety of breathing problems. Nurses provide the hour to hour management of patients who require CPAP. The aim of this study was to assess the knowledge of nurses about CPAP machine usage at the tertiary hospital in Tanzania which serves the largest number of patients who require CPAP.

Method: A hospital-based descriptive cross-sectional study was carried out from March to June 2019 at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac Institute (JKCI) where 149 nurses who consented …

Exploring Parent Perception Of Adverse Childhood Experiences Screening In Pediatric Primary Care: A Clinical Inquiry Project, Kathryn Stevens

The Eleanor Mann School of Nursing Student Works

This manuscript explores the incidence and implications of Adverse Childhood Experiences (ACEs) and outlines a project assessing parental perception of their own ACEs screening during their child’s wellness visit. ACEs are adversarial events occurring during childhood, which may be chronic or singular. Abuse, neglect, and household dysfunction result in negative outcomes, including compromised neurological development and cognitive behaviors, developmental delays, poor lifestyle choices, and reduced mental and physical health. Additionally, a growing body of literature supports the impaired parenting skills in those with a history of ACEs. This can perpetuate intergenerational trauma, deprived opportunities, and poor familial health. Despite the …

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 …

Health Care Initiative To Evaluate The Impact Of A Nurse Practitioner Led Community Wound Care Service On Emergency Department Utilization, Sherry Morrell

Electronic Thesis and Dissertation Repository

Nurse Practitioners (NP) diagnose and treat wounds and wound-related conditions based on their advanced scope of practice. An NP with graduate-level wound care education (NP(W)) gains additional knowledge and clinical experience to provide comprehensive wound care.

This research aimed to explore community patients’ access to wound care in Southwestern Ontario (Canada). A quality improvement project was initiated utilizing stakeholder feedback to develop and implement a 12-week pilot NP(W)-Led community-based wound care service; the NP(W) wound care practices, clinical outcomes, and adverse events were described. One hundred twelve participants attended the service over 117 visits. The NP(W) services included prescribing and …

Integration Of Kansas City Cardiomyopathy Questionnaire-12 In Clinical Practice, Norman Njihi

Dissertations

Abstract

Problem: Congestive heart failure (CHF) is a high symptom disease in which patients tend to decompensate frequently, most often leading to hospitalization and poor quality of life.

Methods: This project involved educating nurses about using patient reported outcome(PRO) tools with an emphasis on the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12). Pre and post surveys using a Likert scale tool designed by the author were used to determine if a change in knowledge occurred. Satisfaction of the providers was assessed using a survey, also designed by the author. A retrospective review of 13 patients was done to establish patients’ baseline KCCQ-12. …

A Watched Pot Never Boils: Attentive Care Needs No Timer, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the premise that length of patient consultation time is less important than what patients perceive happened during that time. Regardless of the time allotted to a clinical visit, health care providers should make efforts to address the emotional and psychosocial needs of their patients. As always, taking a little time to express empathy can make a big difference in patient satisfaction.

Contraceptive Accessibility And Reproductive Outcomes In Adolescents Seeking Care At School-Based Health Centers: A Systematic Review, Jamie Jenkins

All Graduate Theses, Dissertations, and Other Capstone Projects

Context: Adolescent pregnancy continues to be a public health concern in the United States. School-based health centers are an ideal setting for providing affordable, accessible, and confidential reproductive services for adolescents that can help prevent unintended pregnancies. However, there are great variations in the reproductive services offered at school-based health centers across the United States. Objective: This study aims to explore the question: Do school-based health centers that provide on-site contraception access have lower adolescent pregnancy rates and higher reported contraception use when compared to school-based health centers that do not provide on-site contraception? Methods: A literature …

Improving Food Insecurity Screening And Utilization Of Services For Veterans, Elizabeth Farah, Jason Garbarino, Mary Alberty

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: 27% of all veterans are food insecure. From 2018-2020, only 1% of veterans seeking care at the VA in White River Junction, VT were identified as food insecure. As a result, an overwhelming number of eligible veterans are not getting vital resources to become food secure.

Purpose: Provide education to interdisciplinary primary care teams about food insecurity, how to use the screening tool effectively, and what resources are available to veterans both within the VA system and in the community.

Methods: Quantitative data was obtained from the food insecurity screener to determine how many veterans were being screened positive …

Marijuana Vaping In Adolescents: Evaluating Provider Knowledge And Practices To Improve Screening And Referral To Treatment, Holly T. Whitcomb

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Vaping is a public health epidemic. Adolescents are using cannabis electronic vapor products at increasing rates. In teens, rising E-cigarette and vaping product use associated lung injury (EVALI), tetrahydrocannabinol (THC) intoxication and addiction are concerning. Primary care providers are in a unique position to screen and discourage adolescents from vaping, yet barriers to screening and referral to treatment exist.

Objective: This project provided education on vaping trends, Screening, Brief Intervention, and Referral to Treatment (SBIRT), and Screening to Brief Intervention (S2BI) with the goal of improving screening and brief intervention of at-risk adolescents among primary care providers.

Methods: The …

The Impact Of A Pediatric Home Visit Program: A Quality Assessment Analysis, Jenna Durkee, Jean Pelski Phd

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Bringing a newborn home from the hospital can be a time of excitement, but also stress for new parents. This can include financial strain, lack of sleep, and preparations necessary to care for their new arrival. During this transition time, home visit support has demonstrated decreased parental stress and increased confidence in their new parenting roles. In response to these benefits, a pediatric home visit program holds promise for new parents.

Purpose: This quality assessment project evaluated a pediatric office’s home visit program for parental role and pediatric office satisfaction. Based on the analysis, recommendations for improvement were provided. …

Routine Screening For Binge Eating Disorder In Primary Care, Chantel B. Tousignant, Rn, Dnpc, Jennifer Laurent, Ph.D., Aprn

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Estimated prevalence of Binge Eating Disorder (BED) in the United States is 2- 3%, and 5% in the primary care setting. BED is associated with multiple comorbidities and is therefore a public health concern. Effective strategies to improve screening, diagnosis and management exist, but are underutilized. This project aimed to enhance BED screening and diagnosis while optimizing disease management. Methods: Routine screening for BED was completed using the 7-Item Binge Eating Disorder Screener. Patients were screened regardless of visit type and follow-up was offered to those screening positive. BED prevalence was assessed pre and post-implementation. Surveys were used to …

Integrating Community Into Middle School Sexual Education, Sierra Miller, Margaret Aitken

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Problem Statement: Most middle school sexual education does not include parents or community members. Evidence shows family and community attitudes towards sex and sexuality are significant factors in adolescent risky sexual and health practices.

Background: Comprehensive sex education (CSE) reduces risky sexual practices and negative health outcomes. National and local organizations have identified CSE as a public health goal. CSE works best when culturally relevant and the community is involved.

Methods: Interviews with the health educator identified community needs. Resources were created in line with the current curriculum focusing on sex education, its importance, and how to talk about …

Implementing Tele-Coaching Diabetes Education To Improve Self-Care And Clinical Outcomes For Patients With Type 2 Diabetes, Sori Jung

DNP Research Projects

Abstract

Background: Type 2 diabetes (T2DM) requires initial and continuous patient education for lifelong management due to the complexity of the disease. However, diabetes education is not very well-supported in the office setting due to the providers’ limited time per patient. However, with the aid of technology-based intervention, patients can be more supported and educated, leading to better T2DM control.

Aims: The purpose of this scholarly project was to evaluate the effectiveness of diabetes education through tele-coaching in patients with T2DM for improved self-care and clinical outcomes, including hemoglobin A1c (A1c) and body mass index (BMI).

Method: A mixed-method, single …

Don't Miss These Patients! The Experience Of Working Full Time While Also Being A Caregiver, Debbie Conner, Alyncia Bowen

All Faculty and Staff Scholarship

The project sought to understand the experiences of working professionals who are also the caregiver for others with a health care issue. A caregiver in this research study is an individual who provides personal, financial, social, physical, and or psychological support from individuals other than themselves. It has believed that a significant number of professionals serve as a caregiver for individuals such as, but not limited to, a parent, partner, significant other, spouse or child.

Hypercoagulable State Of Covid-19, Amanda Martin

Nursing Student Class Projects (Formerly MSN)

From the data that has been collected and compiled on SARS-CoV-2, or Coronavirus disease 2019 (COVID-19), it has shown that there are unique qualities of the novel virus that leads to a hypercoagulable state in those diagnosed. To effectively treat those afflicted with this specific symptom of COVID-19, an understanding of the pathophysiology of the virus must be established to effectively treat and potentially prevent coagulopathy and the thrombotic events that can ensue. Gaining more insight into this will allow for standardized plan of care that includes appropriate predicative labs and effective prophylactic medications to be utilized in outpatient or …

Examining Relationships Among Person Factors, Psychosocial Factors, And Coping Patterns In People Living With Type 2 Diabetes Mellitus In North Central Appalachia, Melissa A. Mccoy

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetes is a complex, debilitating illness that imposes disease burden on the individual and society. T2DM is more prevalent in the Appalachian region than in any other Region of the United States. If diabetes is poorly controlled, patients are at risk for negative health outcomes. A gap exists in the literature related to understanding of the relationships among person factors, psychosocial factors, and coping patterns. Another gap in the literature is sex differences among these variables.

Purpose: The purpose of this study is to examining relationships among person factors, psychosocial factors, and coping patterns in people living with T2DM …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …