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Prescribed Pediatric Extended Care: A Program Evaluation On The Impact To Families Of Children With Medical Complexities., Jody Rogers

Graduate Theses, Dissertations, and Capstones

This is a paper about the impact of Prescribed Pediatric Extended Care (PPEC) on families of children with medical complexities.

Managing Risk And Knowledge: Frameworks To Guide Knowledge-Enabled Technology Transfer, Martin Lipa Dr, Anne Greene

Level 3

Technology transfer is not only about the transfer of technology, but also about the transfer of knowledge, as evidenced by definitions of KM within the biopharma industry and beyond. However, knowledge transfer is often not well structured and its effectiveness – in particular for tacit knowledge (i.e., know how) – is an opportunity for improvement which can lead to many benefits. This article profiles recent research into the topic of improving knowledge transfer during technology transfer and presents several recently developed frameworks for improving such. The article furthermore explains how the frameworks can be co-deployed in support of robust knowledge …

Fostering A Sense Of Belonging In Urban Extension For Internal And External Stakeholders, Ramona Madhosingh-Hector, Linda M. Seals

Journal of Human Sciences and Extension

In urban areas, the communities are as diverse as the issues, and different educational and engagement strategies must be deployed to support urban Extension clientele. Urban communities must connect with and feel a sense of “belonging” with Extension–this connection can strengthen Extension’s presence and value proposition to urban constituents. This study found that although Extension was engaged in efforts to support belonging, its efforts were hampered by a lack of collaboration and commitment to supporting a system-wide effort to change the culture. Intentionality, emotional intelligence, and dialogue were presented as strategies to foster a sense of belonging for Extension personnel …

Futuring Perspectives And Practices For Urban Extension, Julie Fox, Solomon Garner

Journal of Human Sciences and Extension

Extension is well-positioned to engage strategically with urban communities now and in the future. A century of collaboration and proven impact provides Extension with a valuable foundation focused on relevant service accessible to all people; applied science and co-discovery; respectful and inclusive engagement; and commitment to community well-being. An exploration of the literature on the future, from the Extension perspective and from external viewpoints, informs a contemporary approach to focus on the future of urban Extension. An interplay of Extension professionals with diverse community stakeholders and dynamic technologies bridges past perspective and current context with practical methods to address the …

Smiling Mind: A Mobile Based Application To Reduce Stress, Agnes Rodrigues

Doctor of Nursing Practice Final Manuscripts

It has been recognized healthcare professionals experience high levels of stress at work with many working in environments characterized by high productivity targets, overtime, customer aggression, continuous organizational changes, and employee shortages. Mindfulness-based interventions such as mobile based meditation applications have gained popularity in the workplace given their potential benefits in decreasing workplace related stress, their ease of use, and cost-effectiveness. The purpose of this evidence based project (EBP) project was to reduce perceived workplace stress and to increase mindfulness using a mobile meditation application. Employees of an outpatient psychiatric clinic used the mobile meditation application Smiling Mind to meditate …

Improved Monitoring Of Depression And Suicidal Ideation In Low-Income Adolescents Through Evidenced Based Provider Education, Sunday Adeyeye

Doctor of Nursing Practice Final Manuscripts

Background: Adolescents from low-income status experience more prevalent thoughts of suicide than their financially secure peers. Nearly 15% considered taking their own life. Suicidal ideation among adolescents in California ranges from 4% to 67%. Depression and suicidal thoughts are underdiagnosed among adolescents, with higher disparities among minority and lower socioeconomic backgrounds.

Purpose: This project involved consistent screening of high-risk adolescents for potential depression and suicidal ideation using a patient health questionnaire recommended by the U.S. Preventive Services Task Force screening.

Process: This project involved adolescents 12–18 years old who had visited a federally qualified healthcare center in San Bernardino, California. …

Exploring Extension Agent Capacity And Readiness To Adopt Policy, Systems And Environmental Change Approaches, Lisa T. Washburn, Heather Norman-Burgdolf, Natalie Jones, Lauren E. Kennedy, Soghra Jarvandi

Dietetics and Human Nutrition Faculty Publications

Introduction: Enhanced Extension outreach strategies combine traditional direct education programs with public health approaches like policy, systems, and environmental (PSE) change. However, the Cooperative Extension system and county-based Family and Consumer Sciences (FCS) Extension agents have historically prioritized direct education programming and diffusion of enhanced outreach strategies has varied. Extension personnel may lack capacity and readiness for successful PSE change implementation. This study explored perceived acceptability, capacity, and readiness for PSE change work among FCS Extension agents in two states.

Method: A survey was developed framed by selected domains from the Consolidated Framework for Implementation Research: Intervention Characteristics, Inner Setting, …

Psychosocial Distress Screening For Patients With Cancer: A Value-Based Approach To The Integration And Delivery Of Holistic Care, Candy Cheung

Doctor of Nursing Practice (DNP) Projects

Background: Patients with cancer (PWC) have a high prevalence of experiencing psychosocial distress as they bear the burden of the disease. Emphasis is needed on psychosocial care, as the COVID-19 pandemic negatively impacts mental health. Psychosocial distress screening is considered a standard practice by the National Comprehensive Cancer Network (NCCN), which recommends using the validated Distress Thermometer (DT) as a screening tool.

Local Problem: The DNP project ambulatory infusion clinic (AIC) site does not have a standardized distress screening tool for staff. There was a lack of awareness of an existing non-validated distress screening and little to no intervention or …

Integrating Culturally Tailored Interventions To Increase Cervical Cancer Screening: A Quality Improvement Initiative In A Primary Care Clinic, Marife Centeno Solomon

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: While the incidence of cervical cancer in the US has significantly decreased due to the utilization of vaccination and screening tests, Asian, Native Hawaiian, and other Pacific Islander women consistently have the lowest rate of cervical cancer screening, making them at risk for undetected cervical cancer disease.

Problem: The low cervical cancer screening uptake can be attributed to a knowledge deficit about cervical cancer and its screening and the importance of early detection. Being an immigrant and with limited English proficiency can hinder women of Asian, Native Hawaiian, and other Pacific Islander from getting screened for cervical …

Stop The Bleed And Seize Control: Educating Emergency Department Staff On Maternal Hypertension And Hemorrhage, Mayra A. Portillo-Guerra

Master's Projects and Capstones

Problem: A Not-for-Profit Hospital accredited by the Joint Commission was fined for not having a current policy or procedure set in place for the treatment of obstetric emergencies. This quality improvement project implemented a simulation and a training video to prepare Emergency Department (ED) nurses and clinical staff for the awareness of preeclampsia and postpartum hemorrhage (PPH).

Context: This quality improvement project was implemented in two different Emergency Room locations for this Not-for-Profit Hospital. One of the campuses does not have a Labor and Delivery (L&D) unit while the other one does. The overarching goal is to increase awareness of …

Effect Of Provider Education On Urinary Incontinence Knowledge And Assessment, Kendra L. Roloff, Patricia Parker, Rhonda Schafer-Mclean, Robert West

Cooper Rowan Medical Journal

Nearly 50% of women in the United States will experience urinary incontinence at some point during their lives. Urinary incontinence impacts multiple aspects of a woman’s life, yet remains underdiagnosed by primary care providers. The Women’s Preventative Service Initiative released a recommendation in 2018 to screen all women annually for urinary incontinence. The recommendation was in response to the lack of women who seek care for urinary incontinence.

The purpose of this project was to implement education and reminders for primary care providers, in order to improve urinary incontinence knowledge and assessment of women 18 years of age or older. …

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Evaluation Of An Educational Presentation On Improving Nursing Students’ Knowledge About Medication Reconciliation, My Trinh

Doctor of Nursing Practice Scholarly Project

Medication reconciliation is the process of comparing a patient’s medications that they are currently taking and comparing it with newly ordered medications or comparing the list to another source of information. It is completed to avoid and reduce the risk for potential adverse drug events, medication discrepancies, and improve communication between transition of care settings. Although people acknowledge and perceive the value of medication reconciliation as an important process in reducing medication errors and patient harm, healthcare team members including nurses may receive little formal training and education in school. The purpose of the Doctor of Nursing Practice (DNP) scholarly …

The Use Of Appreciative Inquiry In Identifying Pueblo Core Values, Kristyn N. Yepa

Doctor of Nursing Practice Scholarly Projects

This study used appreciative inquiry to identify core values or concepts essential to the Jemez Pueblo community to inform an evaluation framework used by community strength-based programs in Jemez Pueblo. Key informant interviews and a focus group were conducted in Jemez Pueblo with key program staff and tribal leaders. The audio recordings were transcribed and analyzed using inductive reasoning to identify core values. In addition, grounded theory was used to develop a conceptual model from the themes generated from the analysis. The PICOT question was, "Can the Appreciative Inquiry method help uncover core values of a Pueblo community?"

Conducting A Root Cause Analysis To Improve Intake Processes And Record Review In Home Health, Christina Guerrero

Doctor of Nursing Practice Projects

Minimization of adverse events, reduction of inpatient admissions, and prevention of polypharmacy within home health are of importance due to the increasing number of Medicare beneficiaries. In 2019, CMS reported 5,266,931 patients were served by home health agencies, accounting for 7,439,849 episodes of care. It is projected that the number of beneficiaries will rise from 54 million to more than 80 million by the year 2030. Medical errors are now the third-leading cause of death in the United States, surpassing diabetes, Alzheimer’s, and stroke. The Agency for Healthcare Research and Quality identifies a lack of institutional intake processes as the …

Dnp Final Report: Skilled Nursing Facility Readmissions: An Evidence-Based Telemedicine Innovation Project, Debra B. Graham

DNP Final Reports

Background: Nationally, 20% of patient readmissions occur within the first 48 hours after arrival to a skilled nurse facility (SNF), and 40-68% of these readmissions are potentially avoidable. Since 2016, the Centers for Medicare and Medicaid penalized SNFs when their return to hospital (RTH) percentages was above national benchmarks. The four SNFs in this project experienced rising transfer rates and diminished RTH percentages since 2017, despite using in-house providers Monday through Friday. Furthermore, there was no provision to address patients’ changes in conditions after hours.

Purpose: This evidence-based practice (EBP) project aimed to standardize the care provided to …

Introduction Of Semaglutide As An Effective Option For Obese Patients Motivated To Lose Weight, Crystal Garcia-Martinez

Cohort X

Obesity has become a global crisis with a tremendous impact on patients and costs reaching billions of dollars each year. Prevention and treatment of this condition will be crucial to ongoing efforts to prevent its long-term complications. Health care providers may have the opportunity to educate patients and address weight management issues before serious complications develop. The United States Centers for Disease Control and Prevention, the American Heart Association, and many publications in the medical literature focus on methods that might be used to target weight loss with diet and exercise. Unfortunately, many patients have had little to no success …

Thiazide-Like Diuretics As First-Line Treatment To Improve Blood Pressure Management, Raquel Okubo

Cohort X

Background: Thiazide diuretics are currently the first-line treatment for hypertension (HTN). This class of drugs includes hydrochlorothiazide (HCTZ) and the thiazide-like diuretic, chlorthalidone (CTDN). The quality improvement project began in the fall semester with a 10- day reflective practice log to assess my current practice. A review of the clinical practice log allowed me to evaluate my current practice and identify three opportunities to improve my practice. I developed three potential PICOT questions and selected one for the QI project with the guidance of my Doctor of Nursing Practice (DNP) chairperson. I performed a literature review to gather the best …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

Implementation Of A Polypharmacy Deprescribing Protocol Among Older Adults In A Community-Based Care Organization, Johanne Cazeau

Doctor of Nursing Practice Scholarly Projects

Background: Polypharmacy, defined as the use of five or more medications, has the potential to increase morbidity, mortality and decrease quality of life. Older adults are disproportionately affected by polypharmacy. Decreasing polypharmacy could prevent morbidity and mortality while saving millions of dollars annually. The use of the ARMOR tool has been shown to decrease polypharmacy and the prescribing of inappropriate medications among the elderly.

Local problem: There is a high prevalence of polypharmacy among older adult patients at the managed care organization where this quality improvement project was implemented. Among a panel of 30 members, almost all (n=29) were taking …

Dnp Final Report: Seal The Deal In Dementia Care, Christian D. Garrett

DNP Final Reports

Background: Individuals with dementia are often burdened with behavioral problems, which augment health care costs and burden of disease. Treatment of behavioral symptoms with pet therapy is acknowledged to be emotionally beneficial. Robotic pets have demonstrated similar promising effects without the undesirable outcomes of traditional pet therapy. Robotic pet therapy offers an effective replacement to traditional pet therapy.

Objective: The DNP scholarly project rigorously appraises the effectiveness of the SAR, PARO, an FDA approved biofeedback device, for non-pharmacological treatment of dementia-related symptoms.

Methods: An experimental design with repeated measures guided the study. Pre- and post- measures included reliable, valid tools …

From Liability To Asset: A Large Health System’S Approach To Transforming Hospital Food, Sven Gierlinger, Bruno Tison, Nicole Giammarinaro

Patient Experience Journal

Historically, hospitals are infamous for poor food quality. Valuing food as a tenant of health and well-being, Northwell Health, New York’s largest healthcare system, is transforming its hospital food program to become an asset and market competition differentiator. By focusing on structure, workforce, procurement and process, Northwell has improved patient experience performance “Quality of Food” by 61 percentile rank points within three years with minimal impact on budgetary cost.

Experience Framework

This article is associated with the Environment & Hospitality lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

• Access other PXJ articles related to this lens.
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The Quantitative Assessment Of Patient Satisfaction In The Covid-19 Epidemic Compared To The Epidemic-Free Period, Vesna Zupančič, Ajda Rogelj

Patient Experience Journal

Surveying patient satisfaction is considered an important part of any systematic program of quality assurance. Quality of healthcare service and patient satisfaction has been affected by the current COVID-19 epidemic. The purpose of the study was to determine how COVID-19 epidemic has affected patients in Slovenia as it is evident via permanently available questionnaire and from studying this data source to improve our response to future crises and to improve the resilience of healthcare systems. A secondary analysis of 12,756 completed questionnaires was performed via freely available patient satisfaction questionnaire in the period from October 2019 to June 2021. The …

Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas

DNP Final Reports

In modern times it is an expectation of students that technology be incorporated into how they receive their education. The COVID-19 pandemic brought to light how pure reliance on traditional face-to-face (F2F) learning can be detrimental to student learning. Many institutes of higher education had already implemented hybrid/blended learning prior to the pandemic and saw no difference in their NCLEX-RN pass rates. This evidence-based practice project gathered, reviewed, and synthesized evidence in order to determine if implementing different teaching strategies would maintain or improve student performance on both unit exams and end of course exit exams.

Evaluating Healthcare Leaders: A Competency Assessment Of Rural Healthcare Management Within The Midwest, Heather Winkler

Dissertations, Theses, and Projects

Rural healthcare facilities, which include critical access hospitals, are vulnerable to closure due to workforce shortages, low patient volumes, challenging payer and patient populations, and geographic isolation. Additionally, many rural communities entered the COVID-19 pandemic understaffed, under-serviced, facing inadequate healthcare infrastructures, and with limited clinical resources and equipment. This exploratory research aimed to measure the leadership competencies identified by the American College of Healthcare Executives (ACHE) of healthcare leaders working in rural hospitals and clinics within the Midwest. Having expert leadership skills and competencies can significantly impact how an organization succeeds, both for the patients, staff, and community. In contrast, …

Psychological Safety In Pre-Licensure Nursing Simulation, Lauren Rickman

DNP Projects

Background

Simulation-based experiences (SBEs) allow learners to use clinical decision-making, clinical judgment, and hands-on skills to analyze and respond to realistic clinical situations in a controlled, interactive environment. Psychological safety (PS) is essential for increasing a learner's engagement in an SBE. Psychologically safe learning environments allow students to feel valued and comfortable speaking up and taking risks without consequences to themselves or others, promoting learning and innovation. Measuring PS may help simulation faculty improve their learning environment by supporting learning-oriented behavior and boosting students' clinical competency.

Purpose

The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to …

Implementation Of A Decision Tree To Address Moral Distress, Tijuana Milton

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Healthcare workers (HCW) face daily challenges in the workplace environment. A relatively new problem called moral distress (MD) may present itself, but it may go unrecognized. The healthcare profession is being robbed of qualified personnel due to moral distress. The overall objective of this project was to help healthcare workers identify moral distress and seek resources to assist with the mitigation of moral distress. The outcome of this project demonstrated bedside HCWs showed higher levels of MD. Leadership must be intentional with providing education about the signs and symptoms of MD and assist employees to recognize and utilize available resources …

Development Of A Point-Of-Care Ultrasonography Workflow Within A Rural Clinic, Lauren Myers

Masters Projects

Abstract

Background and Objectives: Healthcare has revolutionized with advancements in ultrasound technology. Among these advancements and the increasing availability of imaging modalities is point-of-care ultrasonography (POCUS) technology.

Problem: While POCUS has gained considerable ground in primary care, infrastructure to support its utility is deficient. The purpose of this project was to design, pilot, and evaluate a POCUS workflow to facilitate technology utilization and increase access to care.

Methods: Program development and evaluation involves the design, implementation, and evaluation of an evidence-based workflow for POCUS technology. The project was intended to address the needs of individuals in a rural setting. Participants …

Implementation Of Daily Nhppd Calculator In The Acute Care Setting, Spencer Y. Cho

Student Scholarly Projects

Practice Problem: In the United States, it is estimated that hospitalized patients experience an adverse event that require a rapid response and/or code blue event in 3% to 18% of hospitalizations.

PICOT: In the adult medical-surgical inpatient (P), does the implementation of a daily NHPPD calculator (DNC) (I) compared to an annual staffing methodology for calculating NHPPD (C) reduce rapid response calls, code blue episodes, and unplanned admission to critical care (O) over 8 weeks (T).

Evidence: Seven studies provided evidence that implementation of staffing methodology, nursing surveillance, and nurse staffing that supports meeting targeted nursing hours per patient …