Talking With Horses: Equine Assisted Activities To Promote Social Engagement In Individuals With Autism Spectrum Disorder, Amy Ezhaya

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this evidenced-based project is to gather data on how therapeutic horseback riding (THR) facilitates social engagement in individuals with autism spectrum disorder (ASD). The project aims to provide alternative treatment options and disseminate information to providers on the importance of community partnerships.

Background: In 2020, it was estimated that 1 in 54 children had ASD, which is a 170% increase since 2000. Often, those diagnosed with ASD also experience co-occurring mental health diagnoses placing a large burden of care on our healthcare system. THR is a growing alternative treatment option and has been found …

A Comparison Of Suprathel Burn Dressing Vs Standard Care On Length Of Hospitalization, Pain Scores, Opioid Use, Treatments, And Outcomes., Rakiema T. Sellars-Pompey, Anthonia Okoh

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced-based practice Doctor of Nursing Practice (DNP) project was to determine the impact and efficacy of using Suprathel artificial wound and burn dressing on patients treated at a UC San Diego Health Regional Burn Center for second-degree burns. The primary goal of this project will be to evaluate the impact of using Suprathel on hospital length of stay; compare wound infection rates, pain score, and morphine equivalent use; and to identify the cost-effectiveness of the Suprathel artificial wound and burn dressing.

Background: Burns are a global health concern causing significant morbidity and mortality, …

Implementation Of A Shared-Decision Making (Sdm) Approach In A Community Based Outpatient Mental Health Clinic, Alexa Vuylsteke

Doctor of Nursing Practice Final Manuscripts

Purposes/Aims: The purpose of this Doctor of Nursing Practice (DNP) project is to implement an evidence-based SDM approach in a culturally diverse community mental health clinic in order to increase patient-provider collaboration and improve patient autonomy and engagement in decision making processes of care in a mental health setting.

Rationale/Background: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), shared decision-making (SDM) is a collaborative communication approach between patient and provider that aims to help people in treatment work together to have informed, meaningful discussions about their health care decisions. SDM is an evidence-based approach to encourage and …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

The Lived Experience Of Patients With Clostridioides Difficile, Andrea Scherschel

Dissertations

Background: Clostridioides difficile (C. difficile) is the most common healthcare-acquired gastrointestinal infection in the United States. While there is a plethora of information on the treatment and diagnosis of C. difficile infection (CDI) in the literature, there is a paucity of research findings describing the lived experience of a person with the disease.

Objective: This study described the lived experience of patients who have had one or more CDIs.

Lines of Inquiry: There were two lines of inquiry for this study: (1) Describe the lived experience of having a CDI, and (2) determine if photo-elicitation as a research modality enhanced …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Nurse Practitioner's Perspectives On Human Trafficking In The Emergency Department; A Narrative Inquiry, Ann Gerhart

Dissertations

Background: Human trafficking (HT) is a global and domestic concern that impacts individuals, families, and communities. Over the last ten years, HT has become a significant public health concern intersecting with the health care community in various settings. HT abuse and oppression have both short- and long-term health consequences. Approximately 50 to 88% of trafficked individuals visit a health care provider, and 63% of those visits are evaluated in the emergency department (ED). Nurse practitioners (NPs) working in the ED interact with HT individuals but have not been represented in recent research scholarship.

Purpose: The purpose of this qualitative …

A Prescription For Exercise In Adolescents: A Pilot Project, Alexa Sikalis

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice project was to increase physical activity (PA) times in pediatric patients who were not meeting the recommended guidelines of 60 minutes per day of activity. The goal was to educate adolescents on the benefits of exercise in order to increase their overall PA, even if it did not meet the recommended 60 minutes per day. The implemented education was also intended to motivate patients to establish healthy habits and minimize risks of poor health outcomes.

Background: Adolescence is characterized by development of neuronal plasticity and establishment of behavioral patterns. PA …

The Effects Of Therapeutic Activities On Depression In The Long-Term Care Population, Stephanie Nacole Knowles

Doctoral Dissertations and Projects

Therapeutic activities are activities that encourage social interaction and promote cognitive skills. When these activities are put on hold for an extended period of time it can be detrimental to the Long-Term Care population. Depression related to social isolation has plagued the LongTerm Care population since the onset of COVID, causing increased sickness and in some situations death. The purpose of this integrative review is to determine the effectiveness of therapeutic activities in decreasing depression in the Long-Term Care (LTC) population. Literature was collected from 2018 through 2023 from the CINAHL database and analyzed using the PRISMA model. A total …

Diversity In Nurse Anesthesia Education: Understanding The Perspective Of Racial-Ethnic Minority Nurse Anesthesia Students, Lorette Osun, Jeannette Ineza

Doctor of Nursing Practice Projects

The idea that race is not an issue, everyone is treated fairly, and the denial of racial differences is an act to refute that racism still perpetuates nursing education. Racial-ethnic minority student registered nurse anesthetists (SRNA) face unique challenges in their didactic and clinical training, including microaggressions, discrimination, and bias, all of which white students do not have to face during their educational experiences (Carter & McMillian-Bohler, 2020). Our project sought to highlight the lived experiences of ethnic minority student registered nurse anesthetists in the United States to bring awareness and effectuate change in nurse anesthesia education. Our Qualtrics survey …

Improved Education For Caregivers Of Hospice Heart Failure Patients To Reduce Hospital Admissions: An Integrative Review, Sierra Spain Sanford

Doctoral Dissertations and Projects

Heart disease is the second-leading cause of death in the United States, excluding the COVID-19 pandemic. Despite being the leading cause of death, heart failure only comprises 15% of hospice deaths and remains the most likely to be discharged from hospice services due to acute hospitalizations compared to all other hospice diagnoses. This leads to low patient and family satisfaction as well as high medical costs. This integrative review synthesizes current published evidence highlighting the need to improve caregiver education for symptom management of terminal heart failure patients in hospice. The literature supports that improved caregiver education can lead to …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

The Importance Of Suicide Screening Training For Healthcare Providers As Part Of Suicide Prevention, Jennifer Maina

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Suicide is a major public health concern and was the 12th leading cause of death for all ages in 2020 in the United States. Suicide impacts relationships, families, and communities for a long time. Research shows that suicides are preventable and training healthcare providers on suicide prevention is part of the solution.

Search methodology: A computer-based search using CINAHL Complete, PubMed, and Cochrane was conducted with the following keywords; suicide prevention, gatekeepers’ training, healthcare providers or nurses, or community health public workers. Ten articles were selected and appraised using the John Hopkins appraisal tools.

Integrated review of the …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Development Of A Nurse Anesthesia Program Point-Of-Care Ultrasound Airway Examination Curriculum, Sarah Elyse Sandheinrich Butler, Colton Phillip Butler

Doctor of Nursing Practice Projects

Airway management is a critical and fundamental skill for anesthesia providers. Point-of-care ultrasound (POCUS) is an up-and-coming assessment technique that can provide critical information about a patient’s airway anatomy and may increase patient safety during anesthesia care. As a result, understanding the appropriate POCUS equipment, techniques, findings, and clinical implications for airway examination can become essential for safe and effective anesthesia practice. This project aimed to develop a clinical airway POCUS examination curriculum with detailed instructions on all aspects of appropriate examination equipment, set-up, technique, and implications for findings. The team designed the curriculum to incorporate it into the host …

Implementation Of An Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias in healthcare delivery is the unconscious prejudice individuals might feel about another person or group. All healthcare providers are susceptible to implicit bias which can negatively influence patient-provider communication. Implicit bias is linked to disparities in maternal health outcomes. According to the CDC, the maternal mortality rate for non-Hispanic Black women is 2.9 times higher than the rate for non-Hispanic White women (Hoyert, 2022).

Problem: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to manage IB during clinical rotations and post-graduation, thus, are at …

Using Critical Incident Debriefing After Code Blue Events To Support Registered Nurses, David L. Boyd

Doctor of Nursing Practice (DNP) Projects

Using Critical Incident Debriefing after Code Blue Events to Support Registered Nurses

Section I: Abstract

Background: During a code blue event (CBE), the environment becomes highly stressful and intense. Nurses rapidly transition from performing life-saving procedures on their patients to carrying out their usual duties. Without proper debriefing, nurses cannot properly process their emotions leading to increased burnout and secondary traumatic stress (Stamm, 2010).

Local Problem: In 2021, the nurses at Providence Saint John’s Health Center (2021a) responded to 110 CBEs, a 43% increase from 2020. Without a process for critical incident debriefing (CID), these nurses were exposed to trauma …

Trauma-Informed Treatment For Alcohol Use Disorder: Improving Long-Term Recovery, Aline M. Bales

Doctor of Nursing Practice (DNP) Projects

Background: This DNP project aimed to assess the feasibility of implementing trauma-informed care to Ria Health's telehealth AUD MAT recovery treatment model for patients with co-occurring PTSD, targeting high relapse rates due to cravings. Trauma-informed care addresses traumatic histories that can potentiate emotional dysregulation leading to maladaptive coping responses manifesting as cravings with addiction memory.

Methods: An integrated review assessed the prevalence of co-occurrence of AUD and PTSD, assessed interest in Ria Health patients, patients recruited from Ria Health if they mentioned cravings, offered concurrent trauma-informed care with medicated assisted treatment for 16-20 sessions, trauma-informed care used Polyvagal Theory techniques …

Therapeutic Gardening For Addiction Recovery, Hugo A. Rivera Lopez

Master's Projects and Capstones

Problem: The use of evidence-based alternative forms of therapy like horticulture therapy and therapeutic gardening is underutilized in substance use recovery programs in the United States. As the country continues to struggle with addiction, it is important that recovery programs look to and incorporate these alternative therapies into official curricula. Currently, 46.3 million individuals living in the United States are living with a substance use disorder (U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, 2022).

Context: The intervention was implemented at an all-male substance use treatment facility in San Jose, CA that houses up …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Gregory James Trevino

Master's Projects and Capstones

Problem: Providing high-quality sepsis care in a San Francisco Bay Area emergency department (ED) is an organizational priority, however Centers for Medicare & Medicaid Service (CMS) SEP-1 sepsis bundle compliance has decreased to an average of 79% compliance since October of 2022. It was revealed that CMS SEP-1 sepsis bundle compliance issues have resulted in increased patient fallouts.

Context: A microsystem assessment was conducted by the quality improvement team to help identify gaps in practice. After an assessment survey of nursing staff, it was revealed that barriers such as physician order sets, lack of communication, lack of staffing during peak …

Increasing Compliance Through Nurse Education On The Bundle, Zachary Harrison-Evans

Master's Projects and Capstones

In an effort to decrease complications and events connected to sepsis in the ED, there is room for improvement with relation to sepsis care and compliance rates. Timely sepsis management and gains in compliance/adherence rates are hindered by SEP-1 fallouts and requirements related to knowledge gaps concerning sepsis bundle procedures, nurses' attitudes about implementing the protocols, and disparities in nurse/physician order sets. It has been determined that the use of standardized protocols and order sets are not being utilized. This is a process gap and a critical area for improvement. Inadequate fluid and lactate documentation, a lack of education, and …

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …

Improving Patients' Perception Of Pain: An Evaluation Of A Nurse Practitioner-Led Chronic Pain Coaching Group, Suzanne A. Levy

Seton Hall University Dissertations and Theses (ETDs)

Background: The opioid crisis in the United States warrants an improved standard of practice for managing chronic pain. A large body of evidence highlights a positive correlation between health coaching focused on mindfulness-based interventions and its potential to improve the overall well-being of chronic pain patients. Currently, there are limited resources to address these patients' psychosocial needs, and the primary treatment plan consists of pharmacological management using long-term opioids. Project Aim: The 3M Chronic Pain Coaching Model is a 6-week coaching group focused on mindfulness, meditation, and motivation. This quality improvement project aimed to evaluate how a mindfulness-based chronic pain …

School-Based Development And Implementation Of Adolescent Mental Health Educational Toolkits, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

After the onset of the COVID pandemic, there were significant increases of adolescents with anxiety, behavioral and conduct problems. These disorders have devasting individual, social, and economic ramifications and school-based staff play a key role in identification, assessment, and treatment. Evidence suggested that healthcare providers, school counselors and teachers were not confident or knowledgeable about adolescent mental health. The purpose of the change in practice project was to increase knowledge and confidence among school-based healthcare providers, school counselors and teachers by providing an adolescent mental health tool kit. The toolkit focused on disruptive behavior and other prevalent mental health disorders …

Improving New Nurse Manager Orientation And Onboarding Program, Leanne E. Deegenaars

Doctor of Nursing Practice (DNP) Projects

ABSTRACT

Purpose: Identify and adapt the best evidence for nurse manager orientation and onboarding programs into practice. Assess the program's impact on job satisfaction and retention of new Nurse Managers (NMs) and Assistant Nurse Managers (ANMs).

Background: Constant turnover of ANMs and NMs within local and regional facilities is expensive and negatively impacts nursing leaders' work environment, job satisfaction, and patient outcomes.

Local Problem: The lack of formal orientation and onboarding at the focus facility impacts the retention and job satisfaction of NMs. The sunsetting of a regional hub model of new NM orientation and onboarding led to a just-in-time …

Determining Care Delivery Model Feasibility Using Discrete-Event-Simulation, Tanya Scott

Doctor of Nursing Practice (DNP) Projects

Background: The need for inpatient pediatric psychiatric services to address the growing issue of pediatric mental health in a multi-state integrated hospital enterprise is straining the system’s capacity to provide timely mental health care.

Local Problem: Lack of access to specialty pediatric psychiatric treatment for dual diagnosis medi-psychiatric care management is a patient quality and safety issue. Insufficient capacity contributes to longer emergency room boarding times and inpatient length of stay for patients who have a mental illness.

Methods: Use of digital simulation methodology to analyze the behavior of a dynamic event-driven care delivery workflow and to optimize quality patient …

Save The Children Community Health Worker Program – Adverse Childhood Events Prevention, Jieun Lee

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur between the ages of 0 to 17 in which are directly associated, in a dose–response manner, to many of the most common and serious health problems in the United States.

Local Problem: 62% of California residents have experienced at least one ACE, and 16% have experienced at least four ACEs. ACEs are linked to nine of the ten leading causes of death in the United States Adults with four or more ACEs are 37.5 times more likely to attempt suicide, 3.2 times more likely to have chronic lower respiratory …