Digital Commons Network^™

Improving Healthcare Team Communication With Limited English Proficiency Families In The Nicu, Ivonne Mandell

Doctor of Nursing Practice Projects

Language barriers are common in healthcare settings, creating disparities in care between individuals with limited English proficiency and those with English proficiency. In the NICU setting, professional medical interpreters have been shown to improve parent/staff communication and increase parent satisfaction by allowing parents to ask questions and form trusting relationships with staff. Solid parent-provider communication can result in better health outcomes by increasing parental empowerment and participation in their child’s care. Despite the acknowledged advantages of using professional interpreters in healthcare settings, they are frequently under-utilized, even when readily available. The purpose of this project was to improve communication with …

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 …

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 …

Formalized Diabetes Education In A Safety-Net Clinic, Haley N. Wanic

Doctoral Dissertations & Projects

Uncontrolled diabetes mellitus in a Hispanic population can be helped through a quality improvement project focused on progressive verbal and written diabetes self-management education (DSME) Purpose of this article is to review the background, an organizational assessment, a literature review, results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included four patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, minimal workflow adjustments for providers, completed microalbumins, and written education given to patients. In conclusion, the quality improvement project showed positive trends in outcome measures over …

The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner

The Eleanor Mann School of Nursing DNP Capstone Projects

Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …

Health Disparities In Adults With Developmental And Intellectual Disabilities, Tulsi Patel

Nursing | Senior Theses

This paper reviews literature pertaining to the treatment of people with developmental disabilities. It will emphasize the inadequacies of health care in this population. The literature that will be discussed focuses on disparities in care via proxy, sociodemographic and clinical factors associated with disparities, assessing the needs of this population, the prevalence of disabilities in rural and urban settings, and the comparison of health disparities between adults with and without developmental disabilities.

For the purpose of this paper, a few terms will be defined. Developmental disabilities (DD) will be defined as “a group of conditions due to an impairment in …

Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante

Nursing | Senior Theses

As nurses we want to give our patients the best care. That is why trauma-informed care (TIC) is important to include into nursing practice. TIC is a fairly new idea that addresses a patient's whole past and present life. Incorporating it into nursing practice can benefit patients who have adverse childhood experiences and trauma. Adverse Childhood Experiences (ACEs) are traumatic events that occur to a person starting from birth to 17 years old. In a hospital setting an adolescent patient can be triggered if ACEs and trauma is not properly addressed. The long-term effects of ACEs can affect adolescents into …

No Pass Zone: A Quality Improvement Project, Casey St. John

DNP Projects

Introduction: Patient call-bell lights are a means for communication from a hospitalized patient's room to staff members. This DNP project involves staff and patients on a 28-bed pediatric medical-surgical unit. The aim was to implement a No pass Zone for patient call bell lights. Additionally, this project served to aid in increasing staff responsiveness to answer patients' questions and concerns.

Methods: Staff completed a Cornerstone education on the No Pass Zone. Data was collected from pre/post-implementation staff surveys and pre/post-implementation Press Ganey scores. Weekly staff audits on direct observation of staff response to patients' call-bell lights.

Results: A total of …

Improving The Quality Of Burn Care Through Implementation Of The American Burn Association Competencies, Laura Ritter

DNP Projects

Background and Significance: Specialty certification is an important method to demonstrate that nurses possess training, expert knowledge, and skill in a specialty field. The American Burn Association (ABA) and the Burn Nurse Competency Initiative (BNCI) developed 11 competencies that specify the training, expert knowledge, and skills that nurses require for all aspects of burn nursing practice. The ABA and Board of Certification of Emergency Nurses are in the process of developing a burn certification for nurses. They suggest that all burn units begin to adopt these competencies to ensure consistent and competent care.

Purpose: To adopt the ABA …

Factors Contributing To Nurse Burnout In Oncology, Caroline Withers

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Nurse burnout is a pressing concern for healthcare with significant implications for all areas of nursing and patient outcomes. However, the specialty of oncology experiences burnout differently than other specialties for a multitude of reasons. This literature review aims to determine factors that contribute to nurse burnout within oncology, and identify evidence-based prevention strategies. The twenty studies included in the review underscore the crucial role of management and leadership in the prevention of nurse burnout. Further education and research are needed to better understand causes of burnout, as well as proper interventions. Interventions need to be established on a hospital …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Evaluating Repetitive Transcranial Magnetic Stimulation To Reduce Opioid Cravings In Opioid Use Disorder, Cameron Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opioid Use Disorder (OUD) is a multi-faceted, complex ailment affecting many individuals and their families across the globe. Currently, there are multiple interventions used in the treatment of OUD, many of which are designed to reduce cravings for opioids. Cravings for opioids are a strong predictor of relapse in the disorder. However, many of the interventions used in clinical practice have inherent risks including a potential for abuse and diversion. Repetitive Transcranial Magnetic Stimulation (rTMS) is an outpatient procedure that may be effective in reducing cravings for opioids, thereby reducing relapse. Methods: This study employed a randomized, single-blind, experimental design …

Community Health Worker Intervention To Improve Hba1c In Adult Diabetic Patients, Megan Wojtko

Doctor of Nursing Practice Projects

Type 2 Diabetes Mellitus (T2DM) is a disease that disproportionally impacts patients with multiple socioeconomic barriers that are often difficult to address during a primary care visit. Several provider and practice-level barriers also exist including time limitations within the visit and lack of trained staff to help with patient education and case management. Uncontrolled T2DM leads to poor health outcomes and increased healthcare costs. Community Health Workers (CHW) are trained lay persons that can successfully address the patient’s unmet needs and assist with the provider’s recommendations. The purpose of this project was to explore if a CHW led intervention focused …

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard

DNP Final Reports

Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …

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 …

A Quality Improvement Project To Examine The Impact Of The Use Of Structured Diabetes Educational Materials For Medical Personnel, Alina Jaffer

DNP Projects

With the immigrant population increasing in the United States, the demand for healthcare providers who can provide culturally appropriate care and intracultural communication has increased. Compared to individuals born in the United States, immigrants with diabetes are less likely to meet the standardized targets for diabetes management, resulting in disparities in diabetes-related complications. The problem is the lack of evidence-based patient education for all people, including immigrants who do not speak English as a first language. The purpose of this project was to assess whether or not language-specific structured diabetes educational material for healthcare personnel use would increase the efficacy …

Interprofessional Socialization Of Nursing Students After Participating In Interdisciplinary Rounds In An Intensive Care Unit, Ashlyn S. Upshaw

DNP Projects

Background: Nursing engagement in interprofessional collaboration leads to safe and quality healthcare for patients. In order to effectively engage in interprofessional collaboration, nursing students must socialize among healthcare providers from various disciplines. Purpose: The purpose of this project was to examine pre-licensure nursing students’ beliefs and attitudes towards interprofessional socialization and collaboration following their participation in interdisciplinary rounds in an intensive care unit (ICU) setting. Methods: A mixed-methods, cross-sectional design was used to collect data from undergraduate nursing students at a private university. Following an ICU clinical rotation, participants completed the Interprofessional Socialization and Valuing Survey-21 (ISVS-21) …

African Americans In Home Health: Advance Care Planning And Acute Care Services Use, Sharon Bigger, Lee Glenn

Epsilon Sigma at-Large Research Conference

Background: Home health is the fastest-growing healthcare setting in the country. Through Home Health Value-Based Purchasing (HHVBP), the Center for Medicare and Medicaid Services (CMS) provides incentives or penalties to HHAs based on outcomes. Hospitalization and emergency department use are weighted heaviest as poor outcomes. HHVBP requires HHAs to report on whether they are engaging in advance care planning (ACP) conversations. For this study, ACP was defined as a conversation held in advance of a medical crisis with a loved one and/or a health care provider about goals; values; preferences for future medical treatments; and choice of a surrogate decision-maker. …

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

Mindfulness-Based Stress Reduction To Decrease Burnout In Emergency Nurses: A Quality Improvement Project At An Academic Medical Center, Desireé M. Mccue

Doctor of Nursing Practice Projects

Nursing burnout, categorized by increased emotional exhaustion (EE), depersonalization (DE), or decreased personal achievement (PA), is rising in the United States. Emergency Department (ED) nurses at an academic medical center in the western United States experience burnout related to workplace violence and trauma exposure exacerbated by a global pandemic. Burnout can lead to adverse health impacts for nurses, increased institutional costs, and adverse patient outcomes.

Improving mindfulness or awareness of the present can reduce burnout in ED nurses. A mindfulness pilot project was conducted with staff nurses (n=20) and nurse leaders (n=4) in the ED. Participants attended Mindfulness-Based Stress Reduction …

The Impact Of Student Trauma: A Quantitative Investigation On Secondary Traumatic Stress And It's Effects On Nursing Faculty, Devon L. Luthens

Education Doctorate Dissertations

The increase in student trauma and mental illness is putting direct care professionals such as educators at risk of secondary traumatic stress. The purpose of this quantitative survey method research was to explore how nursing faculty within the Minnesota State system were affected by their work with traumatized students and if they experienced significant distress or impairment. The theoretical framework guiding this dissertation was the McCann and Pearlman’s Constructivist Self Development (CSD) theory. There were two research questions that led this study: Does the amount of exposure to student trauma relate to the level of secondary traumatic stress experienced by …

The Impact Of Mentorship On Nurses’ Level Of Self-Efficacy And Motivation To Pursue Board Leadership Positions, Amy K. Mccarthy Msn, Rnc-Mnn, Ne-Bc

Doctor of Nursing Practice Projects

Background: Nurses comprise the largest component of the healthcare workforce and possess a unique understanding of healthcare operations and patient care. On average, the proportion of nurses serving on hospital boards range from 2 to 6%, with the proportion of physicians averaging 20%. Over the last decade, much attention has been placed on emphasizing the importance of a nurse’s presence on boards. Despite these initiatives, nurses continue to display an overall hesitancy towards board service.

Objectives: The aim of this project was to implement an evidence-based mentorship program to address barriers to board leadership and increase overall self-efficacy and motivation …

Community Isolation Project, Natalie M. Danhof, Lydia Santucci, Abigail Dempsey, Nathaniel Navarro, Ivy Mills, Samantha Thompson

Nursing Leadership in Community Engagement Projects

Introduction

The authors of this summary are nursing students at Seattle Pacific University, and the project goal is focused on understanding feelings of isolation in elderly communities and whether fostering social activities, such as Bingo, would improve social interaction between residents in this community.

For the past two years, the COVID-19 pandemic has altered various aspects of social interaction. From masking to social distancing, societal norms and expectations evolved in a manner that promoted isolation and minimal interaction to inhibit the spread of Covid infection between individuals. Of the general populace, the most vulnerable and at risk for infection are …

Supportive Neighborhoods, Family Resilience And Flourishing In Childhood And Adolescence, Sheila Barnhart, Molly R. Bode, Michael C. Gearhart, Kathryn Maguire-Jack

Social Work Faculty Publications

Flourishing is linked with health and well-being in childhood and adulthood. This study applied a promotive factors model to examine how neighborhood assets might benefit child and adolescent flourishing by promoting family resilience. Using data from the combined 2018 and 2019 National Survey of Children’s Health, structural equation models tested direct and indirect relationships between neighborhood physical environment, neighborhood social cohesion, family resilience, and flourishing among 18,396 children and 24,817 adolescents. After controlling for multiple covariates that may influence flourishing, the models supported that higher levels of neighborhood social cohesion were directly associated with higher levels of flourishing adolescents, and …

Descriptive, Comparative, And Correlational Study Related To End-Of-Life Care Prior To The Covid-19 Pandemic Outbreak (Time 1) And 12 Months Following Lockdown (Time2), Elizabeth Infante

Theses & Dissertations

Background

Palliative care has grown in its acceptance nationally and formed the base of a growing number of programs to provide care in a way that recognizes the importance of supporting people with chronic, debilitating, and life-limiting illnesses by focusing on “care” rather than “cure.” This special care warrants an understanding by all nurses and requires education across specialties and disciplines. Despite the increase of palliative care services in hospitals and other settings, long-term care and home care agencies continue to struggle with the education of staff and delivery of care to clients that incorporate the central tenets of what …

The Impact Of Nutrition Literacy And Neighborhood On Diet Quality In The Mexican Origin Population, Sylvia Pena

Dissertations (1934 -)

Introduction: Diet quality is a critical component in achieving optimal health outcomes. A poor diet can lead to various health complications including obesity, heart disease, and diabetes. Hispanic individuals have been found to have higher rates of obesity; therefore, it is critical that variables impacting diet quality be examined in this population. Available literature concerning nutrition literacy, neighborhood and diet quality have not been specific to subgroups of the Hispanic population, therefore, identifying how these factors influence the Mexican origin population is needed. The aim of this dissertation was to better understand the impact of nutrition literacy and neighborhood on …

Evidence-Based Best Practice For Discharge Planning: A Policy Review, Marissa Lewis

Student Scholarly Projects

Ineffective discharge planning produces poor patient healthcare outcomes, potential adverse events, and medical errors. A primary deterrent to successful discharge planning is communication, either within the interdisciplinary team or during handoff to the receiving transition of care facilities of home health, skilled nursing, or acute rehabilitation.

The purpose of the evaluation project was to determine if current policies, communication tools, and workflows of three healthcare organizations were based on evidence and make recommendations for policy revisions. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals Model (JHNEBP) was used with the Centers for Disease Control (CDC) Policy Process (POLARIS) …

Trauma-Informed Care In The Emergency Department, Kayla Kvell, Kristin Oscarson

Nursing DNP Projects

Introduction: This project aims to analyze the effectiveness of trauma-informed care (TIC) education on attitudes of registered nurses (RNs) and psychiatric associates (PAs) towards TIC. The purpose of this project was to educate ED (emergency department) RNs and PAs on the effects of trauma and increase attitudes towards implementing a TIC approach to care for mental health (MH) patients in the ED.

Method: This project followed a pre–post-survey design with quantitative data. Participants included RNs and PAs newly hired to the ED, and/or if they had no previous TIC education. Data were collected utilizing a 10-question Likert scale survey.

Results: …

A Challenging Yet Motivating Journey: The Experiences Of Young Adult Parents With Serious Mental Health Conditions In The Usa, Kathryn Sabella, Amanda Baczko, Ian A. Lane, Laura Golden, Emma Pici-D’Ottavio, Murron O’Neill

Faculty Publications (Peer-Reviewed)

In recent decades the average age of becoming a parent has increased, the rate of teen pregnancies has decreased, and a new developmental period of emerging adulthood is marked by diverse pathways into adulthood. Today, those who become parents in young adulthood (18–24 years old) and their children may be vulnerable to poor outcomes observed in teen parents (13–19 years old) of previous generations. Young adults with serious mental health conditions (SMHC) who encounter additional challenges navigating young adulthood and tend to parent earlier than their peers may be at particularly increased risk of poor outcomes. To date, little research …