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Improving Compliance With Treatments For End-Stage Renal Disease Patients On Hemodialysis, Susan Blakeney

Doctoral Projects

According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three …

Using The Whole School, Whole Child, Whole Community Approach To Improve An Urban Early Learning Center Students’ Social, Emotional, And Physical Health And Wellness, Joelle Chateauneuf

Doctor of Nursing Practice Scholarly Projects

Background: Integrating school-based health education and models of healthy lifestyles in early childhood provides a foundation for lifelong health learning. Many chronic may be prevented or mitigated through early childhood health education. Early learning centers (ELCs) may be a perfect setting to enable young children to achieve their full potential.

Problem: In Boston, Massachusetts, there are differences in health experience across population groups. Children of color and lower socioeconomic challenges experience higher rates of chronic conditions.

Available Knowledge: Search of literature showed that school-based healthy lifestyle interventions improve healthy behaviors and can be taught to children as young as preschool. …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Stakeholder Perspectives On In-Home Passive Remote Monitoring To Support Aging In Place In The Province Of New Brunswick, Canada: Rapid Qualitative Investigation, Emily A. Read, Danie A. Gagnon, Lorie Donelle Phd, Rn, Fcan, Kathleen Ledoux, Grace Warner, Brad Hiebert, Ridhi Sharma

Publications

BACKGROUND: The province of New Brunswick (NB) has one of the oldest populations in Canada, providing an opportunity to develop and test innovative strategies to address the unique health challenges faced by older adults. Passive remote monitoring technology has the potential to support independent living among older adults. Limited research has examined the benefits of and barriers to the adoption of this technology among community-dwelling older adults. OBJECTIVE: This study aimed to explore perceptions of in-home passive remote monitoring technology designed to support aging in place from the perspective of older adults, their family or friend caregivers, social workers, and …

Improving Access To Non-Pharmacologic Integrative Pain Management Modalities In Sickle Cell Disease (Scd) Inpatients, Nicole Lincoln

Doctor of Nursing Practice Scholarly Projects

Background: Evidence suggests that non-pharmacologic therapies complement and work synergistically alongside traditional pharmacologic therapies for chronic pain and have a beneficial impact on the intensity of pain, improved quality of life and functional status. Sickle Cell Patients have complex pain and often feel stigmatized due to pain seeking behaviors. This project evaluates the effect of a clinical initiative stewarded by nurses and managed in the electronic health record. The project aims to improve access to preferred modalities for integrative pain management among hospitalized Sickle Cell Disease (SCD) inpatients.

Methods: The nurses received e-learning and in-person training on the use of …

Implementation Of Delirium Bundle On A Hospital Medical/Surgical Unit To Help Decrease The Prevalence Of Delirium, Sanusi Mohammed

Doctor of Nursing Practice Scholarly Projects

Description of the Problem: Delirium is defined as a constellation of symptoms that includes disturbance in attention or awareness, change in cognition, language and perceptual disturbances that develops over a short period of time. Delirium mostly affects adult patients with risk factors including history of dementia, early cognitive impairment, dehydration, and infections. This quality improvement project was implemented on one hospital unit at a large tertiary hospital in the Boston area. This unit has one highest rate of delirium in the entire hospital system. Delirium is associated with high rate of morbidity and mortality. Also, this syndrome leads to longer …

Transitioning Eating Practices Of Older Adults, Michelle Lajoy Jackson

Dissertations

Purpose: The purpose of this descriptive qualitative study was to explore what factors may have influenced the transition of an individual older adult’s eating practices over a lifespan and the impact participants perceived those factors currently had upon their nutritional health in older adulthood.

Background: The older adult population is recognized as one of the fastest growing populations in the United States. One of many growing concerns for this population is the impact of dietary practices on the morbidity and mortality of this aging population. There is limited research to date that has explored the transitioning of appetite …

Nurse Job Satisfaction In The Midst Of A Pandemic, Reynaldo Gonzales

Doctor of Nursing Practice Scholarly Projects

Strategies and intervention for nursing recruitment and retention are critical needs at the hospital unit management level especially during this time of coronavirus disease of 2019 (COVID-19) pandemic.

Research Question: What are the unit-levels of nurse job satisfaction among eight satisfaction dimensions (i.e., satisfaction with extrinsic rewards, scheduling, family/work balance, co-workers, interaction, professional opportunities, praise/recognition, and control/responsibility) in an acute medical-surgical unit?

Objectives The objective of this project is to systematically obtain unit-level input to explore nurses’ views and experiences as it relates to job satisfaction.

Methodology: This is a descriptive cross-sectional convenience study measuring job satisfaction among Registered Nurses …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

Development And Evaluation Of Enhanced Recovery After Surgery Protocols For General Abdominal And Orthopedic Surgery With Focus On Preoperative Hydration And Multimodal Management In Preoperative And Postoperative Phases, Kristin Wolff, Sadie Spilker

Doctor of Nursing Practice Projects

Enhanced Recovery After Surgery (ERAS) is described as an evidence-based, patient-centered, interdisciplinary team developed protocol utilized to decrease the patient’s stress response to surgery, maintain preoperative physiologic function, and expedite recovery (American Association of Nurse Anesthetists [AANA], 2017). Existing evidence displayed the benefits of utilizing ERAS protocols in various surgical procedures, including general and orthopedic cases. Studies showed one must employ the preoperative, intraoperative, and postoperative components of the ERAS protocols to achieve maximum benefits. A critical access hospital in Illinois utilized some components of ERAS protocols, mainly the intraoperative portions, but lacked the full utilization. Goals of the review …

Implementation Of Community Health Workers To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss. Black and Latina women have been identified by the Center’s for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Black and Latinas therefore have poor birth outcomes. With the implementation of nurse trained Community Health Workers (CHWs), the impacts within the community includes decreasing health care costs, adopting healthier choices for mother and child, and providing support and …

A Descriptive Study On The Perceived Barriers To Academic Progression From Lpn To Rn, Rebekah B. Snyder

ATU Theses and Dissertations 2021 - Present

The significance of seamless academic progression has been emphasized in the nursing profession for more than a decade. A significant amount of research has been conducted on the transition from registered nurse (RN) to a Bachelor of Science in Nursing (BSN) prepared nurse in order to identify potential barriers to progression: yet a significant literature gap exists for the transition from licensed practical nurse (LPN) to RN. The purpose of this quantitative descriptive study was to identify what perceived barriers practical nursing students and recent practical nursing graduates identify as potentially hindering academic progression to a registered nursing program. Data …

Establishing A Neonatal Peripherally Inserted Central Catheter (Picc) Team, Rebecca Hunt

Doctor of Nursing Practice Projects

Infants admitted to the neonatal intensive care unit (NICU) have a plethora of diagnoses, including prematurity and newborns with genetic, neurological, surgical, and cardiac problems. The nature of these disease processes usually precludes enteral feedings and providing the infant with appropriate nutrition and hydration is a priority. This requires central venous access and peripherally inserted central catheter (PICC) placement allows for a reliable route of administration for intravenous nutrition and medications. The purpose of this project was to develop a nurse-led neonatal PICC team to provide timely placement of PICC lines while maintaining cost-effectiveness and maintaining a minimal number of …

Introduction Of Enhanced Recovery After Cesarean Section (Erac) Protocol, Kwame Adu-Affum

Doctor of Nursing Practice Projects

Cesarean section is one of the most performed in-patient surgeries worldwide (Wilson et al., 2018; Liu et al., 2020). Births by cesarean section have been increasing globally. Cesarean birth rate has remained above 31% in the United States, even with the consistent two percent decrease in birth rate per year (Martin et al., 2019). Illinois has also maintained a high cesarean birth rate above 30% (Hamilton et al., 2021). Cesarean patients experience inflammatory and neurohormonal changes with many adverse effects in direct response to surgical stress (Mullman et al., 2020). The post-cesarean physiological effects, including pain, reduced gastric motility, pulmonary …

Computer-Based Learning Module: Local Anesthetic Systemic Toxicity, Nhan Nguyen

Doctor of Nursing Practice Projects

Local anesthetic systemic toxicity (LAST) is the result of rapid absorption of local anesthetics (LAs) into the systemic circulation resulting in toxic plasma levels of the drugs. With the advent of ultrasound-guided regional anesthesia and improvements in injection techniques, the incidence of LAST has decreased significantly over the years. Even though LAST is rare, it is a potential, life-threatening complication associated with any administration of LAs. Providers and staff members taking care of patients receiving LAs should be astutely aware of potential complications so that LAST signs and symptoms can be recognized, and treatments can be implemented as swiftly as …

Perioperative Tube Feeding Guidelines For The Pediatric Burn Patient, Jordan Swanberg

Doctor of Nursing Practice Projects

Pediatric burn patients require an astronomical amount of nutritional support to promote wound healing and prevent unwanted side effects. These patients often require multiple surgeries, and consequently, when following standard NPO guidelines, these patients go for hours without any nutritional support. For this reason, a protocol was implemented on how to administer tube feedings throughout the perioperative process safely. The purpose of this project was to give a PowerPoint presentation to the providers that tested their current knowledge on how to manage tube feedings in the operative setting best. A single group design consisting of CRNA’s and an anesthesiologist was …

Implementation Of Depression Screening In A Nursing Home, Titilayo Raji

Doctor of Nursing Practice Projects

Abstract

Background/Introduction

Unidentified and untreated depression among nursing home residents leads to poor quality-of-life and substantial healthcare dollars are utilized for care management. Use of validated instruments and routine screening provides opportunity for early detection and treatment.

Purpose

The purpose of this project was to educate employees of a nursing home on the use of the Geriatric Depression Screening (GDS) tool, implement it on two units of the nursing home, and evaluate the feasibility and acceptability of this quality improvement project.

Method

An educational presentation was delivered to introduce the implementation plan, GDS screening tool, and protocol for data collection. …

Best Practice In The Perioperative Anesthetic Management Of Infants With Gastroschisis, Emily R. Lester

Doctor of Nursing Practice Projects

Gastroschisis, a severe abdominal wall defect, occurs in approximately 1 in every 2,000 fetuses. Despite care advancements, gastroschisis is associated with significant morbidity and mortality including prolonged time to tolerance of enteral feeds, prolonged ventilator support, and increased intensive care unit length of stay and hospital costs. A recent practice change in the care of infants with gastroschisis at a tertiary care facility in central Illinois lead to the request for an integrative review of the available literature and subsequent development of a comprehensive guideline discussing best-practice perioperative recommendations pertinent to the care of infants with gastroschisis. Through review of …

Anticipatory Guidance For Parents/Caregivers Of Pediatric Patients Ages 0-12 Months, Cody Palmer, Anna Hagnauer

Doctor of Nursing Practice Projects

Anticipatory guidance is defined as proactive counseling for caregivers regarding various aspects of childcare and development. This project sought to improve the process and delivery of anticipatory guidance for infants aged 0-12 months at one rural pediatric primary care clinic. An extensive literature review was undertaken to determine current recommendations for anticipatory guidance topics pertinent to pediatric patients aged 0-12 months. Additional research explored the efficacy of various educational formats to provide teaching. Written educational materials were updated and edited to be visually appealing and understandable, and educational videos were created. Written materials and educational videos were provided to parents/caregivers …

Implementation Of Routine Screening With Patient Health Questionnaire 9 (Phq-9) Of Adults With Crohn’S Disease, Jo A. Muller-Krause

Doctor of Nursing Practice Projects

Introduction: Mild levels of depression have been measured with screening tools at rates of 15-24% in adults with Crohn’s disease (CD). The spectrum of the impact of depressive symptoms is measurable and documented for those with CD. Patient perspectives support the integration of psychological care, and the Patient Health Questionnaire 9 (PHQ-9) is a well validated tool for the measurement of depressive symptoms.

Purpose: Increase depression screening of adult CD patients in the outpatient gastroenterology clinic and evaluate the provider perspectives regarding PHQ-9, depression, and CD.

Conceptual Framework: The Johns Hopkins Nursing Evidence Based Practice (JHNEBP) Model was selected as …

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …

Utilizing A Personal Health Coach In The Management Of T2dm, Emily Killebrew, Matthew Huelsman, Verah Bonareri, Terri Furfaro

Doctor of Nursing Practice Projects

Management of type 2 diabetes mellitus (T2DM) can reduce hemoglobin a1c values and ultimately reduce the risk of morbidity and mortality. Many adults live with uncontrolled T2DM due to a lack of knowledge of disease management. The purpose of this project was to evaluate the implementation of a personal health coach for the management of T2DM in adult patients. An extensive literature review was conducted, and the use of the Diabetes Management Self-Efficacy Scale (DMSES) was chosen to evaluate participants’ self-efficacy regarding their T2DM. Adult patients aged 21-75 with a diagnosis of T2DM and a hemoglobin a1c >7 in a …

Establishing Guidelines To Promote Best Practice For Common Ailments In School-Based Health Clinics, Kaitlin Sweeney, Rachael Schaefer

Doctor of Nursing Practice Projects

The COVID-19 pandemic exposed the gap in access to medical care of school-age children and identified a need for community-based health clinics to aid in its minimization. Evidence shows the creation of school-based health clinics (SBHCs) in public school districts provides a pathway for students to receive high-quality care in an easily accessible manner. Therefore, patient care guidelines for common ailments seen in SBHCs for a local federally qualified healthcare center (FQHC) were developed in conjunction with the FQHC goal to build and operate a SBHC located in southern Illinois. Eight guidelines were created to analyze the most common chief …

Reducing Errors Through Implementation Of Standardized Electronic Order Sets In The Intensive Care Setting, Mary Slusser

Doctor of Nursing Practice Projects

Healthcare facilities are constantly chasing through striving to meet interoperability and meaningful use requirements while still advancing the field through the concepts of evidence-based practice and value-based delivery modules. Healthcare facilities can encourage the healthcare team by utilizing computerized physician order entry using standardized ordersets. An orderset is a series of recommended orders based on different diagnoses, conditions, or treatments. It was noted that several errors and delays of care were occurring related to the paper process at a small Midwestern hospital. The purpose of this quality improvement project was to convert the remaining paper ordersets to electronic ordersets in …

Reflective Journaling Intervention To Impact Self-Awareness, Professional Health, And Overall Well-Being In Nurses, Brittany M. Langan, Katherine Keppen

Doctor of Nursing Practice Projects: College of Nursing

Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being.

Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration: An Integrative Review, Purnima Krishna

DNP Qualifying Manuscripts

Purpose/Objectives: This review evaluates the published studies on how post-acute care collaboration ensures a continuum of care and reduces heart failure (HF) readmissions.

Primary Practice Setting: An integrated literature review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. PubMed and Cumulative Index to Nursing and Allied Health were searched for the keywords heart failure AND (post-acute care OR transitional care OR skilled nursing facility OR rehabilitation facility OR home health agency) AND (readmission) AND (care coordination OR collaboration OR interprofessional OR partnerships). Seventy-nine studies were returned, and a reverse reference search yielded four …

Blue Zones: Unlocking Key Themes In The Centenarian's Life, Grace Beer, Grace O. Beer

Honors College Theses

Longevity has been sought after in certain areas of the world, and there are specific regions where this has been achieved. There is an American average life expectancy of 72 years old, but individuals in “Blue Zones” here in America and other areas of the world are expected to and have proven to live well beyond 100. The areas of Okinawa, Sardinia, Nicoya, Ikaria, and Loma Linda are classified as Blue Zones, and there could be more of an understanding of how these people live the way they do to have such healthy physical outcomes. To deeply understand the strategy …

Empower You: An Adult Type 2 Diabetes Mellitus Management Program With Utilization Of A Mobile Phone Application, Kelsey Jahn

Evidence-Based Practice Project Reports

In 2018, 34.2 million Americans had diabetes and there continues to be 1.5 million Americans diagnosed with diabetes every year (ADA, 2018). Due to this increasing prevalence, self-management of type 2 diabetes mellitus (T2DM) is essential to disease management. The PICOT question for this project was: In adults with T2DM with a hemoglobin A1C (HbA1C) greater than 8% in a diabetes specialty clinic (P), what is the effect of a multimodal smartphone application (I) compared to prior nonuse of the application (C) on average blood glucose readings (O) over an 8-week period (T)? The project was completed in a large, …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder

Evidence-Based Practice Project Reports

Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin …