Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Career Counselors Addressing Social Determinants Of Mental Health In Rural Communities, Kaprea F. Johnson, Alexandra Gant-Howrey, Bisola E. Duyile, Lauren B. Robins, Natese Dockery

Counseling & Human Services Faculty Publications

Career counselors practicing in rural communities must understand and address social determinants of mental health (SDOMH). This conceptual article details the relationships between SDOMH domains and employment and provides evidence-based recommendations for integrating SDOMH into practice through a rural community health and well-being framework. Description of the adaptation of the framework for career counselors in rural communities, SDOMH assessment strategies and tools, and workflow adjustments are included. Conclusions suggest next steps for practice and research.

An Inquiry Into The Accessibility Of Campus Recreation For College Students With Disabilities, Kayla B. Abrahamson

Graduate Theses, Dissertations, and Problem Reports (ETD)

University recreation centers are identified as the main sources of physical activity for college students. However, an estimated 68% of college students with disabilities (SWD) use their campus recreational facilities less than five times per year (Yoh et al., 2008). Structural and programmatic accessibility barriers may account for low facility use and corresponding low physical activity levels among college SWD. An accessibility assessment of facilities and programming is warranted to identify priority areas for barrier removal. This collective case study evaluates the accessibility of three campus recreation facilities at 4-year public universities in the southeast U.S. Adopting a mixed-method approach, …

Improving Empathy With Simulation: A Quality Improvement Project, Jami Layne

Doctor of Nursing Practice Projects

This study examines the effectiveness of simulation-based training in enhancing empathy levels among undergraduate nursing students. A lack of empathy can negatively impact the healthcare outcomes of patients (Levett-Jones et al., 2019). Improving the empathy levels of nursing students can improve patient outcomes and impact student learning outcomes such as the student’s ability to think critically and improve communication and social skills (Chua et al., 2021; Ferri et al., 2017; Hakansson Eklund et al., 2019; Koukourikos et al., 2021). The purpose of the quality improvement project was to improve empathy levels in undergraduate associate degree nursing students and increase the …

Work Characteristics, Workplace Support, And Mental Ill-Health In A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Nicola Cherry, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, Jean-Michel Galarneau, France Labrèche, Shannon Ruzycki, Tanis Zadunayski

Études primaires

Objective The aim of the study was to identify determinants of mental health in healthcare workers (HCW) during the COVID-19 pandemic. Methods A cohort of Canadian HCW completed four questionnaires giving details of work with patients, ratings of workplace supports, a mental health questionnaire, and substance use. Principal components were extracted from 23 rating scales. Risk factors were examined by Poisson regression. Results A total of 4854 (97.8%) of 4964 participants completed ratings and mental health questionnaires. Healthcare workers working with patients with COVID-19 had high anxiety and depression scores. One of three extracted components, 'poor support,' was related to …

Harnessing The Power Of Complementarity Between Smart Tracking Technology And Associated Health Information Technologies: Longitudinal Study, Youyou Tao, Ruilin Zhu, Dezhi Wu

Publications

Background: Smart tracking technology (STT) that was applied for clinical use has the potential to reduce 30-day all-cause readmission risk through streamlining clinical workflows with improved accuracy, mobility, and efficiency. However, previously published literature has inadequately addressed the joint effects of STT for clinical use and its complementary health ITs (HITs) in this context. Furthermore, while previous studies have discussed the symbiotic and pooled complementarity effects among different HITs, there is a lack of evidence-based research specifically examining the complementarity effects between STT for clinical use and other relevant HITs. Objective: Through a complementarity theory lens, this study aims to …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

The Clinical Inquiry Process Diagram (V. 5), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated edition of The Clinical Inquiry Process Diagram improves on the 2023 version. It provides a depiction of the steps involved in the clinical inquiry process, covering research, performance improvement, and evidence-based practice. The revisions in this version emphasize the importance of alerting users to the iterative nature of clinical inquiry and the ongoing need to assess the situation or patient based on evolving evidence. It's crucial to recognize that the clinical inquiry process does not follow a linear, sequential progression. Instead, individuals may find themselves concurrently addressing different aspects of the process or revisiting prior steps as they …

Assessing Providers’ Readiness To Integrate Mat Services In A Primary Care Setting, Carmen Ingram-Thorpe

Theses and Dissertations

Opioid use disorder is a growing concern in the United States. Despite medication-assisted treatment (MAT) being a more effective treatment option than behavioral treatment alone, primary care providers’ rate of adoption and utilization of MAT has not matched the demand of the opioid crisis. The largest barrier facing our local community is the availability of organizations and providers that can and will actually provide MAT services. The purpose of this study was to identify factors that impact primary care providers’ readiness to treat individuals with opioid use disorder (OUD) using MAT. This study used the ADKAR model as framework, which …

The Anatomy Of Physician Fulfillment: Strategies Beyond Burnout, Brook Hale

Antioch University Dissertations & Theses

The persistent tension and power struggle between healthcare executives and physicians is a prevalent issue in healthcare organizations, often leading to a culture of organizational mistrust. This dynamic stems from perceived conflicting goals: executives are frequently seen as primarily focused on financial outcomes, while physicians are viewed as resistant to change. This study explored how physician fulfillment is experienced at work, with the ultimate goal of identifying potential interventions to bridge the gap between these groups. There is vast research and literature available regarding burnout in healthcare; this research focused on understanding what physicians find fulfilling in their work and …

Advanced Practice Providers In Emergency Medicine, Matthew Kalonick

Physician Assistant Scholarly Project Papers

The emergency department is at the core of healthcare in western medicine. It is commonly the first site of patient contact prior to admission or surgical intervention. Management of admission and discharge from the ED is integral to efficient flow of hospital operation. The critical operation of the ED has long acted as a barrier for the application of advanced practice providers (nurse practitioners and physician assistants) from being heavily utilized in this setting. As healthcare costs, physician shortages, and the acceptance of APPs has increased over time, EDs have increased their utilization of APPs. However, there remains concerns regarding …

Standardizing Nasogastric Tube Securement: A Quality Improvement Initiative, Shannon Lee Thompkins

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: At a large academic medical center located in the northeastern United States, nasogastric tubes (NGT) were traditionally secured with tape. The institutional policy was nonspecific with no written procedure. The inconsistent use of nasal bridle securement devices (NBSD) and predominant use of tape has the potential to lead to a high rate of NGT dislodgement.

Background: NGT complication and dislodgement rates range from 2%-36% (Gimenes et al., 2019). Stabler et al. (2018) report 29%-63% NGT dislodgement rates in critically ill patients. Patients with intracranial hemorrhage dislodge NGTs in 25% of patients (Rahman et al., 2022)

Available Knowledge: Based on …

Relationships Among The Concepts Of Organizational Theory And Nurse Burnout Before And After Covid-19, Bridget M. Webb

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nurse burnout is a global health priority that has been compounded by Coronavirus 2019 (COVID-19). Organizational theory states that nurse burnout is directly impacted by operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. The purpose of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination), operant mechanisms (nurse characteristics, nurse specialization), and outcomes (nurse burnout) before and after COVID-19.

Research Question: The specific aim of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination) and operant mechanisms (nurse …

Relationships Between Nursing Students’ Attitudes Toward The Nursing Profession, Fear Of Covid-19, And Intolerance Of Uncertainty: A Cross-Sectional Study, Banu Terzi, Fatma Azizoğlu, Çağla Seven

Makara Journal of Health Research

Background: Nursing students were caught unprepared for the COVID-19 pandemic. Both the inability to control the epidemic and the interruption of education caused students to experience fear, anxiety, and uncertainty. This study investigates the relationships between nursing students’ attitudes toward the nursing profession and their fear of COVID-19 and intolerance of uncertainty.

Methods: This cross-sectional study included 727 nursing students who were members of the Student Nurses Association and who volunteered to participate in the research. Research data were collected using the Student Information Form, The Fear of COVID-19 Scale, the Intolerance of Uncertainty Scale (IUS-12), and the …

Clinical Leadership In Athletic Training, Tyler G. Vannucci, Lindsey E. Eberman, Matthew J. Rivera, Matthew J. Drescher, Justin Young, Kenneth E. Games

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical leadership behaviors demonstrated by nurses delivering patient care are associated with improved patient outcomes and increased job satisfaction. Clinical leadership behaviors have not been studied in athletic training; therefore, the purpose of this study was to investigate athletic trainers’ frequency of demonstrating these behaviors. Method: Participates completed an electronically distributed survey consisting of demographic variables, the Clinical Leadership Survey (CLS), and the Global Rating of Clinical Leadership Scale (GRCLS). Results: We found statistically significant differences between the CLS score of those in a supervisory role (M = 65.3 ± 5.4) and those who are not (M = 63.5 …

Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji

Master's Projects and Capstones

Mentoring Nurses After Specialty Training or Orientation in Labor and Delivery

Abstract

Background: The setting for this project was a northern California hospital-based healthcare system referred to as “Hospital KV.” Hospital KV is a non-profit, integrated hospital that operates to improve the community’s health. Hospital KV’s maternal child health (MCH) department comprises a labor and delivery(L&D) unit, a mother and baby unit (MBU), also referred to as a postpartum unit, and an intermediate nursery (IMN).

Problem: The hospital KV MCH department faced the challenge of a nursing shortage. The nursing shortage was associated with substantial challenges to Hospital KV, its …

Improving Access To Early Interventions For Prediabetic Patients, Kimberleigh M. Telling

Doctor of Nursing Practice Projects

Approximately 88 million Americans, or nearly one-third of the population, have prediabetes. This condition has a high rate of progression to type 2 diabetes, reaching 70%. However, early identification, diagnosis, and participation in lifestyle interventions can effectively reduce the risk and promote euglycemia. Regrettably, 85% of those with prediabetes are unaware. The goal of this quantitative quality improvement project was to enhance the use of the prediabetes diagnosis code by primary care providers, who play a crucial role in preventing type 2 diabetes. The purpose was to improve access to early intervention for individuals with prediabetes, following the guidelines of …

Implementing A Foot Screening Project For Diabetic Patients In An Assisted Living Facility, Beatrice L. Bailey

Doctor of Nursing Practice Projects

Diabetes impacts around 422 million individuals globally, resulting in 1.5 million reported annual deaths. Type 2 diabetes affects approximately 35.4% of the population in the United States, with 1.4 million new cases identified each year. When not managed properly, diabetes can spiral into a long list of complications. Among the various challenges in diabetes management, foot complications stand out as significant and often avoidable. Without proper attention, these complications can lead to severe health issues. To address this concern, this project focuses on resolving standard foot inspection practices within an assisted living facility in central Mississippi. The goal is to …

Improving Outcomes For Women Following Gynecological Surgery Through Implementation Of Multimodal Analgesia As Part Of An Enhanced Recovery After Surgery (Eras) Protocol, Shannan M. Case

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has been a continuous public health crisis, as opioid-associated overdose has become one of the leading causes of death. The risk of opioid misuse increases following exposure to opioids perioperatively. As a result, anesthesia providers are facing a significant shift in practice to decrease opioid administration while adequately managing perioperative pain. While opioids have historically been the mainstream for perioperative pain management, multimodal analgesic (MMA) regimens as part of Enhanced Recovery After Surgery (ERAS) programs are being utilized as alternative methods. With these programs, opioids are reduced by administering non-opioids with neuraxial and …

Conflict Resolution In Healthcare: The Vital Role Of Developing Conflict Management Skills Among Nurse Leaders, Kris Maddalena

Doctor of Nursing Practice Projects

Nurse leaders at the unit level play a vital and indispensable role in acute care settings. Their influence extends beyond administrative tasks, as they significantly impact crucial factors such as nurse retention rates, patient outcomes, and the overall work environment of the unit-level teams. Effective unit-level leadership has been consistently associated with improved outcomes, increased job satisfaction, and decreased turnover among nurses (Aiken et al., 2011). This DNP project is focused on enhancing conflict management skills among unit-level nurse leaders in an acute care setting. The project followed a quality improvement sequence, which included obtaining a needs assessment for unit-level …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

Block Charting For Hemodynamic Unstable Patients, Tasha Walker

Student Scholarly Projects

Practice Problem: The intensive care unit poses many challenges for nurses. Nurses are placed in a position to decide on dosing and administration, which could conflict with their scope of practice, and documentation needs to coincide with orders. The accuracy of nursing documentation plays a vital role in measuring the outcomes, and failure to document accurately could result in noncompliance with scope of practice or a medication error.

PICOT: For intensive care nurses (P), how does block charting of vasoactive medications (I) compared to current documentation practices (C) affect the accuracy of nurses' documentation (O) within 4 weeks?

Evidence: Nursing …

Swimming Together Upstream: How To Align Mlp Services With U.S. Healthcare Delivery, William M. Sage, Keegan D. Warren

Faculty Scholarship

Medical-legal partnership (MLP) embeds attorneys and paralegals into care delivery to help clinicians address root causes of health inequities. Notwithstanding decades of favorable outcomes, MLP is not as well-known as might be expected. In this essay, the authors explore ways in which strategic alignment of legal services with healthcare services in terms of professionalism, information collection and sharing, and financing might help the MLP movement become a more widespread, sustainable model for holistic care delivery.

Utilizing A Validated Screening Tool And Treatment Protocol For Managing Agitation And Violence In A Psychiatric Emergency Services Unit, Zarah Ashcroft

Doctor of Nursing Practice

Background and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and …

Staff Education Project To Decrease Variations In Surgical Optimizations, Shelly Bressoud

Walden Dissertations and Doctoral Studies

No abstract provided.

Transformational Leadership Training For Leaders, Kristie M. Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Clinical Practice Implementation To Address Ascvd Risk: A Practice Change In Primary Care, Elizabeth Wooten

Student Scholarly Projects

Practice Problem: Heart disease stands as the leading cause of mortality in the United States. While healthcare providers strive to identify and optimize prevention strategies, particularly in high-risk patient populations, notable gaps in care persist, notably in the management of modifiable risk factors such as low-density lipoprotein cholesterol (LDL). By harnessing the power of artificial intelligence (AI) integrated software within clinical settings, we can revolutionize the landscape of this devastating chronic disease.

PICOT: The PICOT question that guided this project was: In Primary Care Advanced Practice Providers (APP) caring for high-risk and/or very high-risk patients with atherosclerotic cardiovascular disease (ASCVD) …

The Implementation Of A Diabetic Foot Screening Tool Into A Primary Care Practice, Joanna P. Barnett

Doctor of Nursing Practice Projects

Inconsistent guidelines and nonadherence to diabetic foot screening recommendations are ongoing problems. This project aimed to promote the prevention of diabetic foot complications by detecting complications early and determining who is at high risk. An educational intervention provided for clinicians addressing the importance of foot assessments and the use of a diabetic foot screening tool was provided. After the education was provided, a pre-and post-test comparison was assessed for increased knowledge. Due to a small sample size and the need to assess results quickly, the plan-do-study-act method guided the project. Post-intervention, the goal was to have four providers increase the …