Digital Commons Network^™

Emr Templates For Age-Appropriate Well-Child Pediatric Visits, Alison Drerup, Kelsey Piper

Doctor of Nursing Practice Projects

The world of pediatric medicine is continually evolving. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) regularly update guidelines to have the most current information available to providers and their patients. The overwhelming majority of primary care offices have transitioned to electronic medical records (EMRs) for charting purposes. Templates included in EMRs ease the workflow and documentation process for providers. In the primary care setting, templates include essential information discussed at well-child visits, such as developmental milestones, vaccination schedules, and anticipatory guidance. The project’s purpose was to update the age-specific well-child templates at …

Promoting Mental Health And Well-Being Among Undergraduate Nursing Students: A Practice Guideline, Armen Mailyan

DNP Projects

Poor mental health and well-being among undergraduate nursing students negatively affects social dynamics, communication, decision making, and stress management, thus compromising the quality of healthcare delivery and patient care outcomes. It is imperative that nursing programs support students to develop positive self-care, resilience, and mental health skills while in school to foster their well-being, enhance their academic success, and to promote high-quality, patient-centered care in their future practice. The purpose of this Doctor of Nurse Practice (DNP) project was to develop a mental health and well-being practice guideline with a comprehensive set of evidence-based interventions for academic nursing programs to …

Embracing Technology To Optimize Patient Repositioning, Michelle Gideon

Doctoral Dissertations and Projects

An evidence-based quality improvement approach was used for this project. The aim of the project was to examine the effect of the use of a patient monitoring system on the rate of change in pre-existing pressure injuries; for those that spend time in the intensive care unit (ICU). A patient monitoring system can provide real-time feedback on the frequency and angle of a patient’s repositioning. Additionally, the project looked at the ability of such a system to generate reports on staff compliance with patient repositioning. Data were collected for 8 weeks prior to implementation and 8 weeks after implementation of …

Prevalence And Prevention Of Pressure Injuries In Residents Over The Age Of 65, Bao Vo, Trista Theimer, Joe Nordstrom

Celebrating Scholarship and Creativity Day (2018-)

Pressure injuries are an ongoing problem for people over the age of 65 who have chronic comorbid conditions. Many interventions have been implemented to decrease pressure injuries. Pressure injuries cause pain and can lead to medical issues including sepsis and death. The cost of pressure injuries is high due to the medical complications that result from the pressure injury. Client repositioning is an extremely important intervention to prevent pressure injuries. Risk assessment is also important in order to identify clients at risk to support early interventions. This quality improvement project focused on educating staff and implementing best practices to prevent …

A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

Impact Of Baby Friendly On Exclusive Breastfeeding: Befriending Baby Friendly, Constance Z. Townson

MSN Capstone Projects

Unless you have personally breastfed a newborn baby or tried to help a struggling breastfeeding mother, chances are you would think breastfeeding is not only natural but comes easily. Breastfeeding is indeed a natural progression following delivery; however, various things can play a role in the success of a mother and newborn baby trying to breastfeed. Issues such as feeding position, waking a sleepy newborn, mothers not recognizing newborn hunger cues, a full day of well-meaning visitors impeding skin-to-skin time with mom, or delayed feedings are just a handful. Sometimes, breastfeeding is so difficult that moms who want to breastfeed …

Increased Venous Access With Ultrasound Guided Ultralong Iv Placement, Daniel Purifoy

MSN Capstone Projects

Maintaining intravenous (IV) access is a vital part of providing care in critical care areas of nursing. It allows for continuous therapies, blood draws, complicated scans, and emergency treatment when needed. There are current procedures for obtaining IV access that are guaranteed to have a successful attempt and placement of a long catheter in a deeper vein. Patients that have been determined to have difficult venous access have proven to lose access quickly with an IV catheter of less than 3.18cm in length (Moy & Keeyapaj, 2017). These difficulties can cause monetary loss to the patients and hospitals, and damage …

Evidence-Based Practice - Oral Mucositis Prevention In Chemotherapy Patients: A Benchmark Project, Carrie Davenport

MSN Capstone Projects

The purpose of this implementation project is to help decrease the rates of mucosal barrier injuries (MBI’s) and oral mucositis (OM) in patients receiving chemotherapy on the oncology unit. In 2022, it was reported that seven MBI’s occurred on an oncology unit in a large county hospital in an urban area. This secondary infection has the potential to increase morbidity, increase treatment costs, lengthen hospital stays, and can have a devastating impact on quality of life (Correa et al., 2019). There is currently no protocol in place at the proposed location for this intervention that will help reduce this potential …

The Impact Of Kangaroo Care On Exclusive Breastfeeding In Premature Infants, Colleen Larue

MSN Capstone Projects

This benchmark project emphasizes the crucial imperative of promoting exclusive breastfeeding among preterm and low birth weight infants in neonatal intensive care units (NICUs). Despite the well-documented benefits, exclusive breastfeeding rates remain disappointingly low. This evidence-based project focuses on early intervention through kangaroo care to bolster exclusive breastfeeding rates, with the overarching aim of enhancing infant outcomes and mitigating risks of mortality and morbidity. Engaging key stakeholders, including NICU leadership, nursing staff, lactation consultants, and families, is paramount for the successful implementation of the program. The project presents a detailed implementation plan encompassing various phases, from admission procedures to sustainability …

Preventing Illness Though Nutrition, Olivia R. Mccarter

Research & Creative Achievement Day

This is a series of Tik Tok videos that were made to educate people on how to prevent certain illnesses such as diabetes and cardiovascular disease, through nutrition. The series had different types of videos such as recipes and different grocery store items that aid in preventing illnesses while also teaching the benefits of heart healthy nutrients. Each video was sent to a registered dietitian to get further helpful information and approval of content.

Faith Community Nursing Case Study: Share Grant Procurement During The Covid-19 Epidemic, Deborah J. Ziebarth, Deborah Fell-Carlson, Marcy Shanks

International Journal of Faith Community Nursing

A group of faith community nurses (FCNs) in rural Oregon joined together to form the Faith Community Health Network (FCHN). They applied for and received a grant to provide care coordination services to the residents of Lebanon and the greater Linn County. This case study is used to present the FCHN’s journey from coalition to a funded non-profit during the COVID-19 pandemic and the grant, “Rebuilding the Bridge Between Healthcare and Faith Communities” they received from the Intercommunity Health Network Coordinated Care Organization. The grant’s intent was to support the FCNs to expand their network, document electronically, and provide care …

Educating Outpatient Clinic Nurses In The Management Of Diabetes, Deborah O. Yisa

Doctoral Dissertations and Projects

Diabetes mellitus must be carefully managed and cared for to reduce complications and enhance quality of life. Nurses are essential to the treatment of people with diabetes, so they must have up- to-date knowledge and expertise in diabetic education. The significance of diabetic education for nurses, its effect on patient outcomes, and techniques for boosting nurses' competency in diabetes care are critical to positive patient outcomes and are all explored in this academic research. The results suggest a notable disparity between the participants' knowledge ratings before and after the intervention, confirming that all 13 participants benefited from the diabetic self-management …

A Strategic Plan For The Development Of A Model Of Care For Post Operative Bariatric Patients In Rural Utah, Cris R. Chamberlain

Doctoral Dissertations and Projects

The delivery of health care for postoperative bariatric patients remains a challenge in rural settings, often leading to varied patient outcomes and inefficient resource allocation. This study aims to develop and implement a strategic model of care for postoperative bariatric patients at Castleview Hospital in Rural Utah. Grounded in the Iowa Model of Evidence-Based Practice, this initiative focuses on creating a cohesive and comprehensive postoperative care pathway, tailored to the unique patient demographics and facility constraints of a 39-bed hospital serving 35-45 bariatric patients annually. Methodology includes ethical considerations, secured through CITI training and pending IRB approval, robust data collection …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Implementation Of Vinyasa Yoga For Adults Experiencing Anxiety, Megan K. Malyuk

Theses and Graduate Projects

Anxiety disorders are the most prevalent mental illness in the United States (US) and holistic treatment approaches, such as vinyasa yoga, are often practiced to alleviate the severity of symptoms (The Anxiety and Depression Association of America, 2020). A comprehensive literature review including evidence-based research, Metis-based knowledge, and personal accounts are used to support this scholarly project. Jean Watson’s Theory of Human Caring is explicated and synthesized as a theoretical framework. Methodology and evaluation of the scholarly project are described, analyzed, and reflected that vinyasa yoga has a positive impact on individuals who experience anxiety. This scholarly project was implemented …

Implementation And Evaluation Of Iron Deficiency Anemia Content In Prenatal Education Classes, Jasmine N. Walker Bsn, Erin M. Morris Bsn, Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn, Mary K. Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this quality improvement project is to provide and increase educational awareness and knowledge regarding iron deficiency anemia (IDA) in pregnant patients at an urban primary care clinic in Memphis, TN. This project is intended to decrease the number of individuals with IDA in pregnancy while decreasing the occurrence of IDA-related complications in pregnancy. The study aimed to introduce a cost-effective approach to help decrease or eradicate complications related to IDA during pregnancy.

The World Health Organization (WHO) estimates the prevalence of anemia-complicating pregnancies to be more than 40 percent. Pregnant women with IDA residing in low …

Strategies Over Knowledge: Training Gaps Present In Caring For Patients With Autism Spectrum Disorder For Pediatric And Student Nurses, Jasmine E. Johnson

Honors Thesis

With Autism Spectrum Disorder (ASD) prevalence ever increasing among the pediatric population, nurses can expect to see an increase in the number of autistic patients within their clinical practice settings. Previous researchers have shown that pediatric nurses are required to overcome many barriers when working with autistic patients, and adequate training is necessary to achieve genuine patient-centered care. However, parents have reported less than optimal care received by their children with ASD within the healthcare system. Therefore, research is needed to determine where training could be improved for this patient population. This study aimed to identify where training deficits are …

A Patient Centered Quality Improvement Education Program Designed To Improve The Health Of Patients Living With Uncontrolled Hypertension In A Primary Care Setting, Alia Jamison-Dinowitz

Doctor of Nursing Practice Projects

Cardiovascular disease is the leading cause of death in the United States and it negatively contributes to poor health outcomes (Martinez-Garcia et al., 2018). Within the Antelope Valley in Lancaster California, 30.3 % of city residents have a hypertension diagnosis (Los Angeles County of Public Health, 2017). Much like the city at large, hypertension is a critical issue at AV Pediatrics and Family Medicine (AV Peds). This issue is driven by a variety of factors including a lack of understanding about hypertension and medication compliance, and a lack of understanding about healthy lifestyle choices. Providers at AV Peds have seen …

Evidence-Based Strategy To Improve Delirium Detection In Elderly Postsurgical Patients, Aimee Baker

Doctor of Nursing Practice Scholarly Projects

Postoperative delirium (POD) is a serious adverse outcome that frequently affects older adults. Patients experiencing POD are at greater risk for postoperative mortality, increased length of hospital stay, functional decline, and increased cost of care. Current global population trends indicate that the population of adults over the age of 60 years old will double over the next thirty years. Recent guidelines call for hospitals to implement routine delirium assessment to improve early intervention. Nursing delirium assessment tools are a critical resource for early delirium identification. Nursing delirium assessment tools are often highly sensitive and specific for delirium when used in …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson

The Eleanor Mann School of Nursing DNP Capstone Projects

Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.

Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.

Results: In a comparison …

A Quality Improvement Project To Promote Awareness And Knowledge Of Nutrition As An Adjunctive Treatment Option For Chronic Insomnia, Sara J. Weelborg

Doctor of Nursing Practice Projects

Background

Insomnia is difficult to treat resulting in adverse outcomes. Traditional treatments are not always safe or accessible. Evidence, not readily available to providers, supports the adjunctive use of nutrition to ease symptoms.

Problem

Literature recommends the Mediterranean Diet for insomnia. A nutrition education module for psychiatric nurse practitioners (n=4) was created by a multidisciplinary committee to increase knowledge and comfort. Pre-post Likert-scale tool, multiple choice test, and interview questions were used to measure educational benefits.

Outcomes

All participants demonstrated knowledge acquisition (range 11% to 100%), increased intention to use information (range 9% to 43%), and positive feedback about nutrition …

2023 Nursing Annual Report, Children's Health System Of Texas

2023

No abstract provided.

The Significance Of Palliative Care Education And Areas For Improvement, Lindsey Bunday

Honors Projects

Palliative care is vital in prioritizing quality of life for patients with serious illnesses. Such care is crucial to help patients understand their prognosis, address needs, and meet goals of care. However, physician shortages, improper utilization, and non-standardized medical curriculum amplify the gaps in care and demonstrate significant room for improvement. Innovative curriculum and opportunities for knowledge advancement can refine education and improve patient care.

Implementation Of A Human Trafficking Screening Tool In An Immigrant Services Organization, Cassandra Cooper

DNP Projects

Background

Human trafficking (HT) is a public health problem that advances the spread of disease and mental health issues and affects vulnerable populations including immigrants. HT screening tools are more reliable than clinical judgment in identifying HT victims, as even victims themselves are sometimes unaware of their own victimhood. To reduce the instances of victims being missed, HT screening tools have been validated to identify victims without the influence of personal bias.

Project Goals

1. Choose and implement a HT education module for staff.

2. Implement the AHTST for all new arrivals and from the months of November 2023 through …

Prenatal And Postnatal Disparities In Very-Preterm Infants In A Study Of Infections Between 2018–2023 In Southeastern Us, Robin B. Dail Phd, Rn, Faan, Kayla C. Everhart Phd, Rn, Victor N. Iskersky, Weili Chang, Kimberley Fisher, Karen Warren Phd, Rn, Heidi J. Steflik, James W. Hardin Ph.D.

Publications

Background: The birthrate of Black preterm (BPT) infants is 65% higher than White preterm (WPT) infants with a BPT mortality that is 2.3 times higher. The incidence of culture-positive late-onset sepsis is as high as 41% in very-preterm infants. The main purpose of this study was to examine thermal gradients and the heart rate in relation to the onset of infection. This report presents disparities in very-preterm infection incidence, bacteria, and mortality data amongst BPT and WPT infants. Methods: 367 preterms born at < 32 weeks gestational age (GA) between 2019–2023 in five neonatal intensive care units (NICUs) were enrolled to study the onset of infections and dispositions; REDCap data were analyzed for descriptive statistics. Results: The 362 infants for analyses included 227 BPTs (63.7%) and 107 WPTs (29.6%), with 28 infants of other races/ethnicities (Hispanic, Asian, and other), 50.6% female, mean GA of 27.66 weeks, and 985.24 g birthweight. BPT infants averaged 968.56 g at birth (SD 257.50), and 27.68 (SD 2.07) weeks GA, compared to WPT infants with a mean birthweight of 1006.25 g (SD 257.77, p = 0.2313) and 27.67 (SD 2.00, p = 0.982) weeks GA. Of the 426 episodes of suspected infections evaluated across all the enrolled infants, the incidence of early-onset sepsis (EOS) was 1.9%, with BPT infants having 2.50 times higher odds of EOS than WPT infants (p = 0.4130, OR (odds ratio) = 2.50, p_or = 0.408). The overall incidence of late-onset sepsis (LOS) was 10.8%, with LOS in 11.9% of BPT infants versus 9.3% (p = 0.489, OR = 1.21, p_or = 0.637) of WPT infants. BPT infants made up 69.2% of the 39 infants with Gram-positive infections vs. 25.6% for WPT infants; 16 infants had Gram-negative culture-positive infections, with 81.2% being BPT infants versus 18.8% being WPT infants. Of the 27 urinary tract infections, 78% were in BPTs. The necrotizing enterocolitis incidence was 6.9%; the incidence in BPT infants was 7.5% vs. 6.5% in WPT infants. The overall mortality was 8.3%, with BPTs at 8.4% vs. WPT infants at 9.3%, (p = 0.6715). Conclusions: BPTs had a higher rate of positive cultures, double the Gram-negative infections, a much higher rate of urinary tract infections, and a higher rate of mortality than their WPT counterparts. This study emphasizes the higher risk of morbidity and mortality for BPTs.

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Nursing Care Regarding Social Determinants Of Health For Breastfeeding In Mothers And Infants, Natalie Jefson

Senior Honors Theses

Breastfeeding is incredibly important to the health and well-being of the mother-infant dyad. Because of this, there are both world-wide and national recommendations and guidelines for breastfeeding in the United States. Although many women choose to initiate breastfeeding, the percentage of women who continue breastfeeding for the recommended duration does not meet the Healthy People goal for the United States. Many factors influence this early breastfeeding cessation, including physical and socioeconomic barriers. Certain populations face increased barriers to reaching these goals related to social determinants of health which can and should be addressed by nurses through preventive measures and education.