Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, 2022 University of San Diego
Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare
Dissertations
Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …
Associations Between Concepts Of The Family Management Style Framework, And Measures Of Child Adherence To Treatment For Heterozygous Familial Hypercholesterolemia, 2022 University of Massachusetts Boston
Associations Between Concepts Of The Family Management Style Framework, And Measures Of Child Adherence To Treatment For Heterozygous Familial Hypercholesterolemia, Heather Harker Ryan
Graduate Doctoral Dissertations
Background: Heterozygous Familial Hypercholesterolemia (HeFH) is an underdiagnosed, autosomal dominant, monogenic condition affecting ~1:250 individuals in the United States (U.S.), resulting in cardiovascular events 10-20 years earlier than in unaffected peers.
Sample: Fifty-one parents of youth aged 2-18 years followed for HeFH in a pediatric specialty clinic.
Purpose: Assess parental perceptions of HeFH, child adherence to treatment, and parenting in HeFH-affected households.
Methods: A cross-sectional, descriptive, and correlational survey study congruent with elements of the Family Management Style Framework (FMSF). Pearson’s and Spearman’s correlations assessed linear relationships between parentally observed HeFH treatment adherence measures, parenting style, and parental perceptions of …
Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, 2022 Southern Illinois University Edwardsville
Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding
Doctor of Nursing Practice Projects
Nationwide, the volume of emergency department (ED) visits has steadily increased over the last several decades. This steady increase in volume frequently causes ED crowding and considerable delays in patient evaluation and treatment. Recently, teletriage has been used in emergency departments to evaluate less emergent patient needs while freeing up in-house providers to care for more critical patients. The goal of this DNP project was to develop a protocol for the utilization of teletriage in an Emergency Department in a level 1 trauma center in central Illinois using nurse practitioners to assess patients in the waiting room and order appropriate …
The Power Of Proactive Referrals: An Evidence-Based Practice Project To Improve Smoking Cessation Rates At A Community Health Clinic, 2022 University of San Diego
The Power Of Proactive Referrals: An Evidence-Based Practice Project To Improve Smoking Cessation Rates At A Community Health Clinic, Kristin Mcmahon
Doctor of Nursing Practice Final Manuscripts
Tobacco use is the leading cause of preventable morbidity and mortality in the United States today. Twenty percent of adults in the United States use tobacco costing the healthcare system approximately $225 billion annually in disease treatment. Most smokers want to stop smoking and most visit a healthcare provider each year making access to cessation interventions feasible. The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to increase smoking cessation among patients at a community health clinic by proactively linking patients to cessation counseling and support through implementation of the Ask-Advise-Connect model of smoking cessation. During …
Increasing Covid-19 Vaccine Awareness Among Hispanic Families: A Policy Perspective, 2022 University of San Diego
Increasing Covid-19 Vaccine Awareness Among Hispanic Families: A Policy Perspective, Allison Chico, Iris Vazquez, Claudia Aguayo, Jose Andres Rozo
Doctor of Nursing Practice Final Manuscripts
COVID-19 disproportionally affected Hispanic/Latinx populations exacerbating systemic health inequities. In San Diego County, 44.7% of COVID-19 cases are among Hispanic/Latinxs compared to 31.1% Whites. Community-centered, culturally tailored vaccine programs are essential to close the gap in COVID-19 disparities. This health policy project aimed to explore barriers to COVID-19 vaccination across Hispanics/Latinx in San Diego, communicate findings and seek assistance from elected officials, and collaborate with a community-based organization to provide vaccines utilizing the PRECEDE-PROCEED model. Our project utilized a multicomponent approach. We conducted a screening of 200 participants to identify common barriers for vaccine hesitancy among Hispanics/Latinx individuals across San …
Implementation Of Surgical Education Video To Burn Patients Before The Informed Consent Process, 2022 University of San Diego
Implementation Of Surgical Education Video To Burn Patients Before The Informed Consent Process, Brian Piatkowski
Doctor of Nursing Practice Final Manuscripts
Purpose: Before the initiation of this evidence-based Doctor of Nursing Practice (DNP) project, a systematic review of literature set forth by other researchers regarding the informed consent process was done. The literature showed patient satisfaction scores increased, while anxiety decreased regarding surgical procedures after using a multimedia educational tool. The first goal of the project was to determine any gaps in knowledge of the burn surgical patient population. The second goal of the project was to determine gaps in knowledge and comfort levels with providers obtaining informed consent. The third goal was to determine the efficacy of implementing a surgical …
Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, 2022 University of San Diego
Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska
Doctor of Nursing Practice Final Manuscripts
Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.
Purpose: The purpose of this evidence-based practice project was to implement a …
Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, 2022 University of San Diego
Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, Kelly Chambers, Megan Gilmartin, Martha Narasimhan-Narayanan
Doctor of Nursing Practice Final Manuscripts
In 2019, it was estimated there were 18 million avoidable emergency department (ED) visits, totaling $32 billion in unnecessary healthcare spending. Super-utilizers (SU), individuals that seek care in the ED 3 or more times per year, account for a disproportionately large segment of healthcare consumption and costs. These patients inefficiently access the healthcare system and often fail to get the follow-up care that could prevent them from repeat ED visits.
This evidence-based project aimed to reduce unnecessary ED visits by at least 25% annually and have no use of the ED during the intervention period, by implementing social and medical …
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, 2022 University of San Diego
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher
Doctor of Nursing Practice Final Manuscripts
Pancreatic cancer remains one of the most complex and lethal diseases worldwide with surgical resection as a major treatment choice. Although surgery may be one of the only options for advanced pancreatic cancer, it is not without a lengthy hospital stay, a long list of possible postoperative complications, and an increased risk for readmission after discharge. Enhanced recovery after surgery (ERAS) programs have been implemented for years in other surgical services for cancer care. These programs have now been extended and researched to include patients undergoing surgery for pancreatic cancer. These programs are designed to assist patients and their families …
Physician Orders For Life-Sustaining Treatment (Polst) Forms In A Primary Care Setting, 2022 University of San Diego
Physician Orders For Life-Sustaining Treatment (Polst) Forms In A Primary Care Setting, Elena Johns
Doctor of Nursing Practice Final Manuscripts
Purpose: To increase completed POLST forms among elderly patients aged seventy-seven and older with chronic/debilitating illnesses, by at least 50% in a Primary Care clinic setting, from September 2021 to January 2022. Background: The government pays for over two-thirds of healthcare costs for the elderly aged sixty-five and older. Furthermore, by ages seventy to ninety, medical spending more than doubles. Many elderly and chronically ill patients report that they would prefer less aggressive treatment and more comfort care measures. However, patients also report a lack of knowledge about their end-of-life (EOL) wishes particularly when it comes to completing the Physicians …
Prediabetes Education To Prevent The Progression To Type 2 Diabetes, 2022 University of San Diego
Prediabetes Education To Prevent The Progression To Type 2 Diabetes, Peggy Mata
Doctor of Nursing Practice Final Manuscripts
This Evidenced-Based Project (EBP) aimed to decrease the incidence of patients diagnosed with prediabetes converting to Type 2 diabetes. By utilizing the Diabetes Self-Management Education and Support (DSMES) program, the project will enhance patient knowledge of diabetes and self-care practices. Education in patients diagnosed with prediabetes in a small community clinic in Tijuana, Mexico.
Background: The American Diabetes Association (ADA) recommends that patients diagnosed with prediabetes attend Diabetes Self-Management Education and Support (DSMES) classes. DSMES focuses on the lifestyle management of diabetes, and it facilitates knowledge, skills, and abilities necessary for optimal self-care. The focus is on supporting patient empowerment …
Evaluating The Effectiveness Of Education On The Misuse Of Corticosteroids And Antibiotics For Treatment Of Acute Pharyngitis, 2022 University of San Diego
Evaluating The Effectiveness Of Education On The Misuse Of Corticosteroids And Antibiotics For Treatment Of Acute Pharyngitis, Samantha Kaikai
Doctor of Nursing Practice Final Manuscripts
Purpose: This evidence-based practice (EBP) project aims to pilot a nurse practitioner-driven education utilizing the American Family Physician guideline (AFP) “IDSA Updates Guideline for Managing Group A Streptococcal Pharyngitis.” Acute pharyngitis is a frequently observed condition in outpatient clinics, but its optimal management continues to be of concern due to the overuse of antibiotics and corticosteroid treatments. The AFP Guidelines for acute pharyngitis include using the Centor criteria to guide the plan of care and the evidence-based antibiotic therapy for patients who score >4 on the Centor criteria or test positive for the rapid point of care testing.
Background: In …
Identifying Elderly Patients At High Risk For Post-Operative Cognitive Dysfunction: A Clinical Perspective, 2022 University of San Diego
Identifying Elderly Patients At High Risk For Post-Operative Cognitive Dysfunction: A Clinical Perspective, Kelly Glas
Doctor of Nursing Practice Final Manuscripts
Background: The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. The geriatric patient population will likely require the use of surgical services at a higher rate than ever before. To best care for the elderly undergoing procedures with anesthesia, it is imperative to follow the most up to date evidence to avoid post-operative complications, and more specifically post-operative cognitive dysfunction.
Purpose: The purpose of this DNP evidence-based practice project is to identify patients that are at high risk for post-operative cognitive dysfunction prior to undergoing anesthesia. Post-operative …
Effects Of Telephone Follow-Up On Medication Adherence And Rapid Readmission Among Discharged Adults With Schizophrenia Spectrum Disorders (Ssds), 2022 University of San Diego
Effects Of Telephone Follow-Up On Medication Adherence And Rapid Readmission Among Discharged Adults With Schizophrenia Spectrum Disorders (Ssds), Romilynn Danko, Madalyn Cosensci
Doctor of Nursing Practice Final Manuscripts
High rates of 30-day readmission after acute care discharge are a big concern for patients with psychiatric disorders. These high rates not only reflect poor patient outcomes, but also result in higher hospital costs. For adults with schizophrenia spectrum disorders (SSDs), a review of current research shows that non-adherence to medication has been significantly associated with rapid readmissions and that using an intervention such as follow-up telephone calls after discharge can help prevent readmission through increased medication adherence. Using the Iowa model framework as a guide, the purpose of this evidence-based practice project was to pilot a post discharge procedure …
Implementing Adverse Childhood Experience Screening In An Intensive Outpatient Mental Health Program, 2022 University of San Diego
Implementing Adverse Childhood Experience Screening In An Intensive Outpatient Mental Health Program, Bryan Amaro
Doctor of Nursing Practice Final Manuscripts
Adverse Childhood Experiences (ACES) are linked to damaging events which happen to people when we are young (0-18). ACEs are connected to a phenomenon known as the toxic stress response which can later become the root etiology for many mental health, substance abuse and chronic medical health complications our society faces. ACEs affect all populations and do not discriminate across socioeconomic, racial, ethnic, gender, or geographic lines. Roughly two thirds of Americans have experienced at least one ACE. This project seeks to perform ACE screening at an Intensive Outpatient behavioral health center by screening for ACEs upon all admissions into …
Screening For Childbirth-Related Posttraumatic Stress Disorder Using The City Birth Trauma Scale: A Pilot Project, 2022 University of San Diego
Screening For Childbirth-Related Posttraumatic Stress Disorder Using The City Birth Trauma Scale: A Pilot Project, Meredith Kazato
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this project is to identify birthing people with childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms using the City Birth Trauma Scale (CBTS). Once identified, at risk birthing people will receive verbal education about CB-PTSD and a social work consultation, if necessary.
Background: A birth is deemed traumatic, and thus fulfills one of eight criteria of posttraumatic stress disorder (PTSD), when during labor, delivery, and/or immediately postpartum, the birthing person perceives themselves and/or their baby’s life to be in danger and/or are at risk of being critically injured. These events include but are not limited to emergency cesarean …
Improving Vaccination Rates Through Community Partnership, 2022 University of San Diego
Improving Vaccination Rates Through Community Partnership, Marissa Marquez
Doctor of Nursing Practice Final Manuscripts
IMPROVING VACCINATION RATES THROUGH COMMUNITY PARTNERSHIP
by
Marissa Marquez, DNP Student, FNP-C, MSN, MBA, RN, BSN
Clinical Mentor: Jill Milton, MSN, FNP-C
Joseph Burkard, DNSc, CRNA, AACN Health Policy Fellow
Purpose: The purpose of the quality improvement project is to improve the vaccination rates and vaccine series completion rates of school age children at Rosa Parks Elementary school through a targeted educational intervention.
Background: Under immunization among school-aged children is an ongoing challenge. Low rates of immunization can cause outbreaks of communicable disease, leading to preventable injury, loss of life, and burden to the healthcare system. Among other …
Increasing Mental Health Literacy In The Black Church, 2022 University of San Diego
Increasing Mental Health Literacy In The Black Church, Jonathan Allotey
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this project was to increase mental health literacy, assess stigmatizing attitudes, and increase help seeking behavior in leadership within an African American church.
Background: The Black church has historically been a central institution for community support and leadership within these churches are often ill equipped to address the mental health needs of congregants. African Americans underutilize mental health services and are reported to have more chronic mental illnesses. Lack of mental health literacy may result in difficulty recognizing the risk factors, signs, symptoms, and treatments related to specific mental illnesses.
Evidence Based Intervention and Methods: Participating …
Improving Discharge Outcomes: Telephone Follow Up For Heart Failure Patients, 2022 University of San Diego
Improving Discharge Outcomes: Telephone Follow Up For Heart Failure Patients, Ashley Fanjoy
Doctor of Nursing Practice Final Manuscripts
Congestive heart failure is one of the leading causes of hospitalization and readmission in the United States. The readmission rate at an acute care hospital in San Diego is 22%, and readmissions occur within an average of 6 days after discharge. The purpose of this pilot project is to improve discharge outcomes among heart failure patients using telephone follow up. The two objectives of this project are to reduce heart failure readmission rates over 3 months and improve patient knowledge to prevent decompensation, as rated by the Self Care of Heart Failure Index. Follow up calls were completed by the …
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, 2022 University of San Diego
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Doctor of Nursing Practice Final Manuscripts
Acute care nurses caring for end-of-life (EOL) patients often feel unprepared for and undereducated about this high-need population. According to current literature, many nurses lack adequate training in providing EOL care. This project aimed to improve symptom management of dying patients by providing acute care nurses education about EOL symptom assessment and medication use for symptom management. The revised Iowa model, which emphasizes clinician involvement, guided this evidence-based practice project. Sixteen acute care nurses received 30-minute in-person education, consisting of instruction in EOL symptom assessment and management via use of the CARES (comfort, airway, restlessness, emotional, self-care) tool and basic …