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Procalcitonin As A Prognostic Indicator Of Risk For Sepsis In The Neonate, Tara L. Cecil, Intermountain Healthcare, Janine Marie Saulpaugh, Paul Repass Iii Umberger

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Introduction. Procalcitonin (PCT) is a biomarker that rises at the onset of bacterial infection while remaining relatively low in other inflammatory processes. Diagnosing serious bacterial infection (SBI) in neonates presenting with fever without a source (FWS) is challenging and utilizing PCT can improve this process. This paper presents a synthesis of the evidence supporting PCT as a prognostic indicator in neonates.

Methodology. A comprehensive literature review was conducted to develop practice recommendations. A guideline, the Intermountain Healthcare Care Process Model (2013), was modified to include PCT, which was then validated by a panel of clinical experts.

Results. Evidence supports the …

Implementation Of Wound Education, Dawn Heapy, Lyndsi Hall

Group: Nebraska Methodist College

The need for a uniform curriculum on wound care is evident in many healthcare settings. The purpose of this project was to determine the need for uniform wound care education; for example, wound staging, appropriate dressings and differentiation of different types of wounds. The project shows how providing an educational wound care curriculum impacts knowledge and confidence in wound management. Improved wound care knowledge and confidence has been shown to improve patient outcomes and help reduce healthcare expenditures regarding wound care (Martinengo et al., 2019).

A pre and posttest was given to 35 participants to determine the confidence level and …

Patient Education, Engagement, And Activation For Chronic Pancreatitis Patients And Care Partners, Christina Sailors, Tara Whitmire

Group: Nebraska Methodist College

Background and Review of Literature: Chronic pancreatitis is a progressive disease with significant symptomatology, which can severely impact an individual's quality of life as well as their activities of daily living. The disease is difficult to diagnose and difficult understand.

Purpose: The purpose of this project was to develop and implement an individualized, face-to-face patient education, engagement, and activation session in effort to increase the level of patient and care partner knowledge of the CP disease process, improve patient and care partner expectations of care management, and increase patient and care partner involvement in their own car.

Methods: Ten-item surveys …

Preventing Type 2 Diabetes In Native Americans Through Nutrition, Dana M. Griffin, Dorothy Sansom

Group: Nebraska Methodist College

Diabetes is a chronic condition that disproportionately affects the Native American population. A means of improving the outcomes was through an education program aimed at a younger target population. The purpose of this project was to determine if nutritional knowledge can reduce the risk of Type 2 diabetes in the Native American population. Changes in dietary habits can reduce the risks of Type 2 diabetes for high risk populations like Native Americans. Having knowledge of nutrition can assist people in making educated choices in deciding what foods to consume. Determining nutritional knowledge by implementing a test followed by a dietician …

Effect Of A Multimodal Intervention On Advance Directive Completion Rates, Maria B. Douthett

Group: Nebraska Methodist College

Advance care planning (ACP) could be working better both in the primary and hospital settings. When a patient is admitted in the hospital, there are several questions asked during admission regarding ACP but little screening on ACP is done in the primary care setting. Existing research supports ACP as a benefit to quality of death and health care costs, however, there is limited research on how to apply it in the primary care setting. Most of the research regarding ACP and end-of-life (EOL) care focuses on the process in the hospital or in nursing homes.

The goal of this project …

Cultural Competence And Awareness Among Nursing Students In A Mid-Western State, Ethel Leon

Group: Nebraska Methodist College

The United States patient population continues to become more racially and culturally diverse. When it comes to healthcare, there are differing values, beliefs, and culture with this diversity. The purpose of this study was to determine if implementing a cultural education intervention would improve nursing students’ cultural competency and awareness among nursing students in a Midwestern college. Participants completed a pre-test survey designed on Google Forms utilizing the Cultural Competence Self-Assessment Checklist (CCSAC) tool followed by administration of the educational video intervention. CCSAC tool is a 36-item questionnaire that was developed to measure the constructs of cultural awareness, knowledge, and …

Complex Illness Support Alongside Standard Oncology Care, Kimberly A. Bland

Group: Nebraska Methodist College

Aim. To evaluate the effect of Complex Illness Support alongside standard oncology care for patients with incurable cancer on symptom control, patient satisfaction with care, and chemotherapy utilization within 30 days of death.

Design. This was a descriptive study to evaluate the effect of Complex Illness Support alongside standard oncology care for patients with incurable cancer on symptom control and patient satisfaction with care. Additionally, the use of chemotherapy within 30 days of death was evaluated using inferential statistics.

Method. A convenience sample of consecutive patients with incurable cancer who presented through a lung cancer clinic in a Midwestern urban …

Reliably Assessing Dyspnea In Non-Communicative End-Of-Life Patients, Laura A. Thomas

Group: Nebraska Methodist College

Problem: Will education provided to nurses at a Midwest community hospital about the Respiratory Distress Observation Scale (RDOS) result in increased knowledge on how to assess patients who are unable to self-report dyspnea?

Intervention: Dyspnea is a common and distressing symptom which occurs in critically ill and end-of-life patients. Due to sedation and physiological changes which occur during critical illness and the dying process, many patients are unable to communicate dyspnea. The Respiratory Distress Observation Scale (RDOS) is the only evidence-based tool available to assess dyspnea in uncommunicative end-of-life patients. A pre-intervention survey was sent to participating oncology nurses to …

The Effectiveness Of Newborn Safety Information And Acknowledgement In Preventing Inpatient Newborn Falls, Carrie L. Dahl

Group: Nebraska Methodist College

Newborn falls can occur in the immediate postpartum period. The purpose of this capstone project was to evaluate the effectiveness of the Newborn Safety Information and Acknowledgement tool in impacting inpatient newborn falls in the postpartum setting. The literature indicated health care settings that used a safety contract in their newborn fall prevention programs had success in decreasing or eliminating in-hospital newborn falls. A mixed methods design, Evidence-based Practice (EBP), Quantitative Descriptive and Qualitative Case Study designs were utilized to address three outcomes. The primary target population was postpartum newborn fall case events and postpartum nursing staff documentation on the …

Emergent Symptom Identification Intake Form For The Urgent Care Clinic, Jennifer Van Meeteren

Group: Nebraska Methodist College

Urgent Care Clinics are a rapid growing sector of healthcare providing convenient access for acute care needs. This convenient care model with lower cost than going to an emergency department has led to increased volumes and longer wait times. The added demand on urgent care clinics, calls for a way to rapidly identify emergency symptoms and patients who require transfer to a higher level of care. This quality improvement project tested the effects of an Emergent Symptom Identification Intake Form on time from patient registration to provider evaluation and overall throughput time for individuals requiring transfer to the emergency department. …

Dream Day, Laurie Christensen, Meg Kinney

Group: Nebraska Methodist College

The purpose of this project was to examine the result that a career fair could have on the self-determination of the student members of the Tribe.

Problem: The problem is that there is a lack of diversity among the health care personnel at Tribal hospitals which is contributing to poorer health outcomes.

Intervention: This project utilized Self-Determination Theory to guide the process for practice improvement with the student members of the Tribe using an interventional career fair called Dream Day.

Measures: The survey measured the impact of Dream Day using 10-item Self-Determination Scale on the student's perception of their own …

Reducing The Intake Of Red And Processed Meats In Food Pantry Consumers, Lisa J. Lehr, Jeannie Hannan

Group: Nebraska Methodist College

Background: Nutrition interventions prevent chronic disease and improve health outcomes. Often, these affect socioeconomically advantaged populations disproportionately, widening the gap in health disparities. Of the interventions studied, those with several approaches attempting to reach a smaller target were most effective. Targeting people in their natural environment has been proven effective to increase the power of education. Purpose: The purpose of this project was to assess whether an evidence-based educational nutrition intervention that involved visual cues within the pantry setting, samples of plant-based food, and an educational nutrition resource pack designed for low income populations would affect the protein intake habits …

Maintenance Copd Medication To Reduce Readmissions And Improve Quality Of Life, Lisa Ann Minahan

Group: Nebraska Methodist College

Purpose: This study examines COPD patients' quality of life after using maintenance inhaler for one year and investigates the effects of maintenance COPD therapy related to exacerbation-related hospital readmissions.

Methods: This capstone project emerged from a larger COPD study. The design was a retrospective longitudinal descriptive project. This descriptive project followed individuals with COPD over time regarding their health status and attitudes towards their quality of life. Participant's quality of life was measured with the St. George's Respiratory Questionnaire for COPD (SGRQ-C). The information obtained from the SGRQ-C questionnaire was analyzed using SPSS software.

Data regarding COPD readmissions was obtained …

Improving Safe Skin Behaviors In High School Freshman, Kelsie Sue Scheer

Group: Nebraska Methodist College

OBJECTIVE: Sun exposure is common among teenagers but teenagers also have poor sun protection strategies. Sun exposure during adolescence or teenage years is associated with an increased risk of skin cancer later in life. Research suggests that adolescence and childhood are optimal periods to provide information regarding skin cancer and implement a primary prevention program. This project investigates whether or not providing education on skin cancer and safe sun behaviors increases knowledge among high school freshman at a rural Midwestern High School.

METHODS: Pretests/posttests were administered to students before education was provided and after education was provided. The pretest/posttest …

The Impact Of A Virtual Poverty Simulation On Undergraduate Nursing Students' Attitudes, Beliefs, And Awareness, Kimberly A. Sullivan, Alice Kindschuh

Group: Nebraska Methodist College

Purpose: The purpose of this project was to determine the impact of a virtual simulation on undergraduate nursing students’ attitudes, beliefs, and awareness of poverty. Methodology: The SPENT virtual poverty simulation was conducted in a small private college located in the Northeast. The program was implemented during a Community Health nursing class with 22 students. Participating students were given a pre- and post-questionnaire to assess how the implementation of a virtual poverty simulation impacts undergraduate nursing students’ attitudes, beliefs, and awareness of poverty. Implications/Conclusion: There was no statistically significant results obtained from pre to post test results. Two-tailed t-tests were …

The Effect Of An Enhanced Recovery Protocol In Bariatric Surgery Postoperative Pain, Brittani A. Seagren

Group: Nebraska Methodist College

Pain management in bariatric surgery patients is challenging because of multiple factors including chronic pain conditions, perception differences, and varied impacts of pain medications. As a result, postoperative pain tends to be poorly managed leading to increased opiate consumption in this population (Raebel et al., 2013). The enhanced recovery protocol is a newer multimodal postoperative management protocol with demonstrated improved pain control in abdominal surgery patients (Thompson et al., 2012). It has also been shown to be safe in bariatric surgery patients (Awad et al., 2012). In order to study its effects as a pain management protocol in bariatric surgery …

Blood Glucose Sample Collection In The Post-Operative Coronary Artery Bypass Patient, Andrea Thomas, Margaret Kinney

Group: Nebraska Methodist College

This paper looks into the methods used to collect blood glucose samples in the post-operative coronary artery bypass patient. Current practice is waking a patient hourly to obtain blood via a finger prick. This project revolved around a change to this process to optimize the amount of sleep a patient was able to get post-operatively while still maintaining hourly blood glucose sample collections. SafeSets were used to collect blood samples, and a retrospective chart analysis was done to compare the intervention group to the pre-intervention group. Data resulted in approximately the same amount of blood glucose checks post-operatively, collected differently …

Sleep Hygiene Education For Rural Adults, Amber R. Rogers, Linda Carol Hughes

Group: Nebraska Methodist College

This is a DNP Capstone paper. This DNP project examined what effect a community based sleep hygiene education program had on the quantity and quality of sleep in rural adults. Participants received a 45 minute oral PowerPoint presentation on sleep hygiene and were given an educational handout. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to subjectively evaluate a participant's sleep habit pre- and post-intervention (Buysse et al., 1989). Strong evidence suggests that the sleep hygiene intervention improves the overall PSQI global scores and overall quality of sleep. A paired sample t test was calculated to compare the means …

Sepsis In The Elderly, Esthefany Estrada

Group: Nebraska Methodist College

Sepsis has come to affect many populations and age groups, especially in the elderly population. This disease has caused many deaths as its signs and symptoms present so vaguely. The purpose of this project was to improve sepsis education in the elderly community for a way to decrease hospital admissions and even death. Fifteen individuals participated in this project and completed the pre-intervention survey and post-intervention survey after receiving education on sepsis in the elderly population. The population participating in the survey were in the age range of 60-85 years of age. Independent samples t-tests were used to compare pre- …

Best Practice Tool Kit For Implementation Of A Patient Education Program For Congestive Heart Failure Education, Sarah Poe, Lyndsi Hall

Group: Nebraska Methodist College

Problem: Congestive heart failure (CHF) is a challenging health concern and generates a multitude of issues including increased mortality rates and hospital readmission rates, and drastically decreases the quality of lives for patients affected with this health issue. This project was designed to investigate whether or not patients receiving care within a large cardiology clinic in the Midwest gained increased knowledge and disease management skills regarding their diagnosis, prognosis, dietary and activity guidelines, as well as symptom recognition and management when participating in CHF education classes provided by a designated CHF nurse educator over a four-week period.

Intervention: The CHF …

Parkinson's Disease And Computer-Based Cognitive Training, Ashley N. Macdonald

Group: Nebraska Methodist College

There is an abundance of evidence supporting the positive impact that physical, cognitive, and speech interventions have on improving or delaying motor and non-motor symptom progression of Parkinson's Disease (PD). Developing a program that fully encompasses the needs of the PD populations in rural states is imperative, especially with the growing number of PD patients throughout the United States. Cognitive training was implemented for one individual who had previously engaged in the Lee Silverman Voice Treatment program (LSVT Big and LSVT Loud) with the goal to utilize computer-based cognitive training with BrainHQ for at least 15-30 minutes per day for …

Resilience: An Essential Skill In Critical Care Nursingâ, Jayne Nelson

Group: Nebraska Methodist College

Background and Review of Literature: Burnout syndrome has been a struggle for critical care nurses for decades. Burnout syndrome causes significant mental stress, job dissatisfaction, depersonalization, and reduced personal accomplishment. Resiliency is the process of returning back to a normal state of functioning after an adverse or stressful event occurs. Higher levels of resiliency have been found to combat burnout syndrome and reduce critical care nurses levels of anxiety, depression, stress, and job dissatisfaction.

Purpose: The purpose of this project is to develop an evidence-based education module that will teach critical care nurses resiliency skills, increase implementation of resilience interventions …

Awareness Of E-Cigarettes And Association Of Use Among High School Students, Kimberly A. Sullivan

Group: Nebraska Methodist College

Background: According to the 2018 National Youth Tobacco Survey (NYTS) data, e-cigarette use among high school and middle school students has increased at an alarming rate between 2017 and 2018, with a reported 3.8 million youth currently using various types of e-cigarette products (U.S. Food & Drug Administration, n.d.). As of February 18, 2020, a total of 2,807 confirmed hospital cases of severe respiratory illnesses and 68 deaths have been reported to the Centers for Disease Control and Prevention (CDC) from all 50 states, the District of Columbia, and two United States territories (Centers for Disease Control and Prevention, n.d.). …

Purposeful Rounding And Improved Patient Care: An Evaluation Of Nurses’ And Nursing Assistants’ Perceptions Of Purposeful Rounding And Intervention To Improve Practice, Bernadine Ihediohanma, Valerie Lynn Anderson

Group: Nebraska Methodist College

Purposeful rounding has gained acceptance in academic literature regarding its clinical benefits in patient optimal outcomes. A Mid-Atlantic regional hospital implemented hourly rounding a few years ago, but it has not been successfully sustained. Hospital administrators desired to improve practice with consistent implementation. The purpose of this project was to implement a structured purposeful rounding intervention on a medical-surgical inpatient unit aimed to improve nurses’ and nursing assistants’ perceptions of purposeful rounding, thereby decreasing patient fall rates, and improving patient satisfaction. A process improvement initiative was implemented. A baseline organizational assessment was completed on a 30-bed medical-surgical unit of the …

The Effect Of An Acuity Tool On Job Satisfaction For Medical-Surgical Nurses On A Medical-Observation Unit, Danielle Rischling, Alice Kindschuh

Group: Nebraska Methodist College

Background and Review of Literature: Job satisfaction and nursing stress are important aspects for an organization to investigate to reduce the amount of turnover and improve patient outcomes. Acuity tools can be used to help equally distribute patient acuity amongst staff to reduce nursing stress, increase patient safety, and improve nursing job satisfaction.

Purpose: The purpose of this study was to implement Harper and McCully's Patient Classification acuity tool on a medical-observation unit at an urban acute care hospital to improve nursing job satisfaction, nursing stress, and nursing perception of patient safety as evidenced by evaluating pre and post-survey data. …

Helping With Adherence To Low Sodium Diets For People With Heart Failure, Melissa Ernesti

Group: Nebraska Methodist College

There are almost 6.9 million people in the United States living with heart failure and about 800,000 of these people are hospitalized each year. Heart failure has an economic burden of $43.6 billion. Heart failure is among the top 10 causes of hospitalizations and about 1 in 5 of patients are readmitted within 30 days of being discharged from the hospital. Hospitals are penalized when Medicare patients with the diagnosis of heart failure return to the hospital withing 30 days of discharge. Following a low sodium diet is part of the treatment plan to manage heart failure.

Problem: When patients …

Building Culturally Competent Care Into Healthcare Curriculum, Devon Wilhelm-Mcmullen

Group: Nebraska Methodist College

The goal of this project was to enhance awareness and improve the quality of care provided to the marginalized LGBTQ+ community. It developed and assessed the effectiveness of a learning module in improving healthcare provider knowledge and cultural competence for providing care to the LGBTQ+ community. The intervention was conducted at an academic school of nursing and allied health in the Midwest, targeting participants enrolled in a master's level program for care coordinators. The study employed a pre-and post-test design, utilizing surveys, a PowerPoint presentation, and a discussion group as part of the intervention. Surveys were used as measurement tools …

The Impact Of Peer Mentorship On Stress In Students In An Educational Doctorate Healthcare Program, Abigail Holzwarth, Valerie Anderson

Group: Nebraska Methodist College

Graduate students face many challenges throughout their education. Stress is commonly associated with higher education, which can be related to meeting the demands of a rigorous educational program, as well as demands in their personal and professional lives. The negative impact that stress can have on academic success, emotional well-being, physical health, and mental health is well-demonstrated in research. Educational institutions should provide resources for students that offer various methods of support to guide them through their education. Peer mentorship programs have been found to be effective means to meet this need for students. This capstone project examined the impact …

Opioid Use Disorder Education For Student Nurse Practitioner, Priscilla L. Hussain

Group: Nebraska Methodist College

Expansion of opioid use disorder (OUD) care is direly required of United States, and student nurse practitioners (NPs) are capable of assessing and addressing OUD in their clin- ical settings. However, academic programs for student medical doctors and NPs lack ad- equate training for such large-scale epidemic. This capstone project recruited 7 student NPs to participate in an interactive learning module prepared by the Centers for Disease Control and Prevention’s (CDC’s): “Module 5: Assessing and Addressing Opioid Use Disorder”. Overall, student NPs found the module useful in increasing knowledge and ability to diagnose and treat OUD. It is time academic …

Limited English Proficiency (Lep) Identification In Emergency Departments, Gena Popken

Group: Nebraska Methodist College

Problem: Individuals who present to the emergency department for care are initially met by registration personnel or a nurse depending on route of patient arrival. Patients who present to the emergency department that do not speak English fluently, or at all, may have communication barriers that result in delay of registration and care, and could be placed at an increased risk for poorer health outcomes. The problem statement guiding this project was, does educating emergency room staff on Limited English Proficiency (LEP) improve the identification of patients seen in the ER compared to current admission procedures?

Intervention: The intervention for …