Digital Commons Network^™

The Effects Of Post-Discharge Phone Calls On 30-Day Readmission Rates In The Older Adult Population, Amy Salyer

DNP Projects

Abstract

Objective: The purpose of the project is to develop a specialized and evidenced-based transitional care program including post-discharge phone calls for the older adult population within the University of Kentucky Good Samaritan Hospital system.

Background: Problems in the post-discharge period such as failure to communicate/understand discharge instructions appropriately and lack of timely follow-up appointment with primary care physician lead to increased readmission rates. Utilizing post-discharge phone calls will facilitate prompt communication with the patient after discharge ensuring full understanding of the plan of care.

Aim: Assess the readmission rates of those who received post-discharge phone calls compared to those …

A Risk Reduction Education Intervention For Cardiovascular Risk Factors Among College Students, Mary Suzanne White

DNP Projects

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the U.S. Although cardiovascular disease is often associated with middle aged and older adults, modifiable CVD risk factors are also present in young adults.

PURPOSE: The purpose of this pilot study was to determine whether a cardiovascular risk reduction educational intervention delivered via Facebook is feasible and effective for modifying risk factor reduction such as decreased body mass index and increased fruit/vegetable consumption among college students.

METHODS: This study involved the use of pre-test and post-test surveys modified from the Behavioral Risk Factor …

Nurse Executive And Middle Management Leadership Competency Assessment Within A Multi-Hospital System, Rachel Inyama

DNP Projects

BACKGROUND: Nursing leaders face increasing pressure to meet multiple outcomes and maintain standards of care while protecting the organization from potential financial consequences if standards or goals are not met. To meet the mounting demands, both nurse executives and middle management leaders will require the development of new skill sets not historically included in the job description.

PURPOSE: The purpose of this study was to assess the competencies of nursing leaders at the executive and middle management levels within Norton Healthcare.

METHODS: This study was a descriptive cross-sectional survey design to measure Chief Nursing Officer and Nursing Director leadership competencies. …

The Effect Of Obstructive Sleep Apnea Screening On Outcomes Of Adult Surgical Patients In A Suburban Hospital, Candice Gray-Cunningham

DNP Projects

Background: Obstructive sleep apnea (OSA) characteristics are present in up to one-quarter of the U.S. adult population (Fernandez-Bustamante, Bartels, Clavijo, Scott, Kacmar, Bullard, Moss, Henderson, Juarez-Colunga, & Jameson, 2017). It is estimated that 80-90% of patients with moderate to severe OSA have never been diagnosed (Chung, Abdullah, & Liao, 2016a). The high prevalence of OSA combined with low diagnosis rates give rise to an environment with considerable surgical risk, including respiratory failure and cardiac arrhythmias (Kaw, Chung, Pasupuleti, Mehta, Gay, & Hernandez, 2012). Guidelines have been established by the Society of Anesthesia and Sleep (SASM) for preoperative OSA screening in …

Change In Falls And Sitter Cost Post Implementation Of Remote Centralized Video Monitoring In Hospitalized Adult Patients, April Nicole Dougherty

DNP Projects

PURPOSE: Falls are the leading cause of injury in hospitalized patients. Patient sitter programs are proven to be an effective way to reduce falls in hospitalized patients. Innovative technologies have been examined that provide a safe and cost-effective way to reduce sitter costs and prevent falls. An innovative technology option is a remote centralized video monitoring system containing one video monitoring technician watching and verbally redirecting multiple patients at one time using mobile cameras. The purpose of this project is to evaluate the implementation of a remote centralized video monitoring system for adult patients in the acute care hospital setting. …

The Effect Of An Education Plan On Nursing Intervention Compliance With Inpatient Post-Operative Colorectal Surgical Patients Using Enhanced Recovery After Surgery (Eras) Protocols, Jennifer Austin

DNP Projects

Abstract

BACKGROUND: Compliance with the enhanced recovery after surgery (ERAS) protocols for colorectal surgery patients in the post-operative inpatient setting is low, creating a gap in successful outcomes of the program.

OBJECTIVE: The purpose of this project is to evaluate the impact of an education plan on inpatient nursing staff. A second purpose of the study is to examine the relationship between ERAS and specific post-operative nursing interventions linked to length of stay (LOS).

METHODS: A prospective cohort study analyzing the effect of a knowledge to action (KTA) education plan on nursing compliance with ERAS protocols was conducted on bedside …

Development Of Unit-Specific Educational Interventions For Inpatient Palliative Care Needs, Michael S. Myers

DNP Projects

Purpose: The purpose of this project is to determine the need for palliative care at Norton Women’s and Children’s Hospital as well as assess the knowledge and attitudes of the healthcare workers in that facility concerning palliative and end of life care. Methods: For the purposes of this study, the units of the hospital were divided into four categories: intensive care unit (ICU), progressive care unit (PCU), oncology, and medical surgical. A needs assessment of each type of unit was conducted in two parts. The first part was a retrospective chart review to determine the volume of patients on each …

Impact Of A Change In The Assistant Nurse Manager Model On Satisfaction And Work Engagement, Frank Wilson

DNP Projects

PURPOSE: The purpose of this study was to assess the effectiveness of the Assistant Nurse Manager (ANM) model at Norton Hospital through an evaluation of job satisfaction, work engagement, and leader opinions about the ANM model.

CONCEPTUAL FRAMEWORK: Kurt Lewin’s Change Theory was used as the conceptual framework. Lewin’s Change Theory has three stages: unfreeze, change/transition, and refreeze.

METHODS: This study employed a descriptive, cross-sectional design.

RESULTS: This study included 27 participants [eight Nurse Managers and 19 ANMs]. The mean satisfaction level with being a nurse leader was 5.0 for nurse managers and 4.2 for ANMs (range 1-6). The mean …

The Effect Of Computed Tomography Perfusion (Ctp) Scans On Acute Ischemic Stroke Patients At A Comprehensive Stroke Center, Sarah Holloway, Sarah Elizabeth Holloway

DNP Projects

Objective: The DEFUSE 3 and DAWN trials have revealed that stroke patients may be eligible for mechanical thrombectomy up to 24 hours from symptom onset with appropriate perfusion imaging. The purpose of the study is to evaluate the impact CTP imaging will have patient selection and outcomes at a Comprehensive Stroke Center.

Methods: This study is a retrospective and prospective chart review comparing acute ischemic stroke patients evaluated for mechanical thrombectomy utilizing CT angiogram verses CT perfusion imaging from January 1, 2018- June 30^th 2019 at a Comprehensive Stroke Center.

Results: Of the 129 patients who received CTAs, 36 …

The Effect Of Provider Education On Copd Screening Rates In The Primary Care Setting, Kelli Craig

DNP Projects

BACKGROUND: Chronic Obstructive Pulmonary Disease is one of the leading causes of morbidity and mortality in the United States. With early detection, COPD is a treatable disease, highlighting the need for an effective screening measure. The COPD Population Screener Questionnaire (COPD-PS) is a valid, accurate questionnaire that can identify individuals likely to have COPD.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy and screening rates of COPD using the COPD-PS screening tool among primary care providers.

METHODS: This study was a single-center, pre/post implementation study to evaluate …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

The Effect Of An Emotional Intelligence Training Program On Use Of A Transformational Leadership Style Among Nurse Managers, Audrey Frias

DNP Projects

Background: Leaders with high levels of emotional intelligence have been associated with transformational leadership styles, which have been found to directly impact leader effectiveness. Emotional intelligence training has been deemed the most effective method for improving nurse manager emotional intelligence and transformational leadership by providing participants with the tools they need to be successful.

Conceptual Framework: Transformational leadership was used as the conceptual framework for this study and is defined as ‘‘a leadership process that is systematic, consisting of purposeful and organized search for changes, systematic analysis, and the capacity to move resources from areas of lesser to greater productivity …

Evaluating The Use Of Stopcocks For Lab Collections From Central Venous Access Devices Related To Central Line Associated Blood Stream Infections, Heather Hollingsworth

DNP Projects

PURPOSE: Central line associated blood stream infections pose a threat to patient safety and are costly to healthcare systems. Heath care professional frequently access central venous access device (CVAD) to obtain blood samples for laboratory analysis. A commonly accepted procedure practice involves exchanging 3-4 syringes during the collection process. Each time a syringe is exchanged during the lab collection process the opportunity for bacteria to be introduced into the bloodstream exists. Decreasing the number of times a CVAD is accessed removes opportunities for bacteria to be introduced to the line thus decreasing the risk of infection. Due to the occurrence …

Tobacco Screening Among Adults In Primary Care: Evaluation Of The Use Of The 5a’S Framework For Treating Tobacco Dependence, Alexis Owens

DNP Projects

Abstract

Background: Tobacco use in the United States is the chief cause of preventable disease and death. Preventing and identifying tobacco use through screening and education is essential to assist users to quit and to decrease overall tobacco associated health risks.

Purpose: The purpose of this study was to assess the integration of the 5A’s tobacco engagement framework into the workflow at one Primary Care Center. Study objectives included determining baseline tobacco screening data prior to 5A’s education, providing providers and support staff education on the 5A’s process, reviewing and interpreting pre/post data of the 5A’s process, and identification of …

An Assessment Of The Effectiveness Of A Safety Strategy Training Program On Knowledge Retention In New Nurses, Annette Mtangi

DNP Projects

Purpose: The purpose of this study was to assess the effectiveness of a lecture-based safety strategy training program on new nurses’ level of knowledge about how to reduce errors when providing patient care.

Conceptual Framework: Patricia Benner’s Novice to Expert model of knowledge and skill acquisition in nurses was the conceptual framework used for understanding how nurses acquire knowledge, skill and experience as well as their propensity for error at different stages of development.

Methods: This was a quasi-experimental pre-test, post-test assessment of the current lecture format. The instrument used was a survey that asked demographic, safety strategy knowledge, and …

Evaluation Of Adolescent Adherence Treatment Following An Emergency Department Visit, Marcus Seaton

DNP Projects

Mental Health disorders affect 1 of 5 youth in the United States and are chronic conditions that affect adolescents’ ability to function at home, school, work, and with interpersonal relationships. Follow up adherence is imperative to ensure treatment goals are met. The purpose of this Doctor of Nursing (DNP) project was to examine factors associated with adherence to outpatient mental health (MH) treatment following an emergency department (ED) visit among adolescents admitted to an ED of a large hospital in a multi-system healthcare organization located in a metropolitan area of the southeastern United States (U.S.). This DNP project aims were …

Parental Knowledge Of Car Seat Safety, Breanne P. Webb

DNP Projects

Background: Injuries sustained from motor vehicle accidents are one of the leading causes of death in children every year. In one year, more than 618,000 children 0-12 years of age rode in vehicles without the use of a proper restraint device at least some of the time. Of the children ages 12 years and younger who died in a motor vehicle accident in 2016 (for which safety restraint use was known), 35% were not buckled up (Centers for Disease Control and Prevention, 2017).

Purpose: The purpose of this project is to evaluate parental knowledge and understanding of car seat and …

Incidence And Treatment Of Acute Sinusitis In Two Outpatient Primary Care Settings And Provider Challenges In Treating Adult Sinusitis, Britney Nicole Perkins

DNP Projects

Abstract

BACKGROUND: Nationally, approximately one third of antibiotics are currently being prescribed unnecessarily. Antibiotic misuse can result in disability, longer hospital stays, increased costs to organizations, antibiotic resistance and death.

PURPOSE: The purpose of this project was two-fold: (1) explore current management of acute adult rhinosinusitis in an outpatient setting (2) assessing providers perceptions on the barriers to preventing antibiotic misuse.

METHODS: A retrospective chart review of 150 charts was performed to examine prescribing practices by providers treating rhinosinusitis at two primary care practices. An interview was conducted with the practice providers on barriers for compliance in antibiotic stewardship.

RESULTS: …

Advance Directives For Older Adults In Primary Care: An Intervention To Promote Screening And Documentation, Kathryn Bower

DNP Projects

Background: Advance care planning is the process of making decisions about the healthcare one wishes to receive should they become unable to make decisions for themselves, including the development of advance directives and designation of health care surrogates. Advance care planning is universally supported by governing bodies and professional organizations; however, less than one-third of Americans have an advance directive or designated health care surrogate.

Purpose: The purpose of this project was to assess primary care provider attitudes and knowledge of advance care planning and to increase screening for and documentation of advance directives and/or health care surrogates …

The Effect Of Implementation Of A Nurse Manager Orientation Program On Nurse Manager Competency And Empowerment, Erin Coogan

DNP Projects

Background statement: Based on the role the nurse manager plays in improving quality outcomes, promoting staff and patient satisfaction, and creating the culture of the unit, it is vital that proper training is provided to new nurse managers to increase their competency and sense of empowerment.

Theoretical/Conceptual Framework: The theoretical/conceptual framework that provided the base for this study was Bandura’s theory of Self-Efficacy. A sense of accomplishment and overall well-being of a person is affected by a strong sense of efficacy.

Purpose Statement: The purpose of this project was to evaluate the effectiveness of a mandatory systemized nurse manager orientation …

Are Nurses High Risk For Experience With Behavioral Health Problems?, Farrah Alayne Thornsberry

DNP Projects

Abstract

Behavioral health problems impact approximately 19% of the United States population and nurses are not exempt from these experiences. In fact, nurses may be at higher risk for developing a behavioral health issue than the general public. The purpose of this study was to identify specific demographic, work-related, and behavioral variables associated with substance use and personal experience with any mental and or behavioral health problems among nurses in an academic healthcare system. Being female, younger in age, higher level of education and increased use of alcohol were risk factors associated with self-reported experience with behavioral health problems. Additionally, …

What Is The Prevalence Of Adhd In Children Who Were Diagnosed With Neonatal Abstinence Syndrome? A Retrospective Chart Review., Scott Graham

DNP Projects

Background: Neonatal abstinence syndrome (NAS) is the set of signs and symptoms present in a newborn whose mother was addicted to drugs while pregnant. NAS can occur due to sudden withdrawal from several drugs, including opioids, benzodiazepines, methamphetamines, and caffeine. It can cause many different issues in the newborn, including diarrhea, tremors, fever, and seizures. While these specific signs and symptoms are self-limited, research is showing that these children grow in to childhood and adolescence with increased risk of Attention-Deficit/Hyperactivity Disorder (ADHD), autism, motor dysregulation, and other cognitive and behavioral sequelae.

Purpose: The purpose of this project was to establish …

An Evaluation Of Preexisting Psychiatric Diagnosis: Patient Outcomes In An Intensive Care Setting, Nicole R. Ryan

DNP Projects

Abstract

BACKGROUND: Mental health is a state of well-being in which an individual is able to acknowledge ability levels, cope with the normal stresses of life, be a productive member of society and contribute to the community. An important consideration for DNP prepared nurses is implementing principles of the Collaborative Care Model as a guiding framework to improve access to evidence-based mental health care in a medical care setting.

PURPOSE: The purpose of this DNP project was to examine the demographic, clinical and treatment characteristics of patients with both medical and psychiatric diagnoses admitted to an Intensive Care Unit (ICU) …

Staff Perception Of Workplace Violence In The Ed: Implementing Egress Education And Cue Recognition, Kelsey Jobe

DNP Projects

Purpose: The purpose of this DNP project was to examine staff perception of workplace violence before and after an educational intervention provided to bedside staff members in the ED of a Level-1 trauma center. The project focused on assessing the impact of an educational intervention on staff perception of WPV related to safety and overall awareness.

Methods: This project was a single site project designed to examine the impact of an educational intervention using egress education and cue recognition in the ED setting using a pre- and post-survey. The survey examined staff perception of safety related to WPV before and …

Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant

DNP Projects

BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.

PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 …

The Effects Of Screening Tool Of Older Persons’ Prescriptions On Potentially Inappropriate Prescribing In Elderly Inpatients, Jamie Leigh Edmiston Franks

DNP Projects

Objective: The purpose of this project is to educate providers and implement the use of the Screening Tool of Older Persons’ Prescriptions (STOPP) on patients 65 and older admitted as inpatients at Owensboro Health and reduce potentially inappropriate medications (PIMs).

Background: Polypharmacy, the use of multiple medications or medications that are not medically necessary, is a persistent and growing problem for elderly patients in the United States. Polypharmacy has become synonymous with medications that are considered potentially inappropriate in individuals 65 or older. PIMs may be medications that, in the elderly, have deleterious effects, no indication, are used for treatment …

The Effects Of Compassion Fatigue On Burnout Among Inpatient Psychiatric And Intensive Care Unit Nurses, Amita Madan Neidlinger

DNP Projects

PURPOSE: This DNP project is relevant to nurses of the psychiatric and Intensive Care Unit (ICU) setting, as high stress environments may produce higher rates of compassion fatigue and burnout. Investigation of these areas may help illuminate unnecessary healthcare costs that are associated with these phenomena. This DNP project is important to the University of Kentucky’s healthcare system, its patients, and nurses. Increased absenteeism and increased medication errors are positively associated with the prevalence of compassion fatigue and burnout in nurses. Outcomes from this project will allow identification of unnecessary healthcare costs and encourage administrators to focus on reducing nurse …

Increasing Smoking History Documentation And Lung Cancer Screening Orders In A Primary Care Clinic, Tabitha M. Caudill

DNP Projects

BACKGROUND: In 2018, there were approximately 234,030 new lung cancer diagnoses and 154,500 lung cancer deaths in the United States. Kentucky leads the nation in new lung cancer cases each year. The USPSTF estimates that 10% to 12% of lung cancers detected by routine screening would not have been detected until the cancer advanced; therefore, the USPSTF recommends yearly lung cancer screenings using low dose CT (LDCT) scans of the chest for patients 55 to 80 years old who have a 30 pack-year smoking history and are currently smoking or have quit within the last 15 years.

PURPOSE: …

Nurse-Led Positive Psychology Intervention Is Feasible In Patients With Heart Failure, Erin Taylor

DNP Projects

Introduction:  Prevalence of heart failure (HF) in the US is projected to rise 46% by 2030, resulting in more than 8 million people with HF.  Negative psychologic states including depression and pessimism (negative future expectations) have been linked with poor cardiovascular outcomes, including HF.  Despite the fact that optimism (positive future expectations) and other positive affective states have been associated with superior outcomes, there has been little focus on interventions designed to increase positive psychological states in patients with HF.

Objective: To test the acceptability and feasibility of a nurse-led positive psychology intervention, Best Possible Self (BPS).

Methods: A convenience …

Evaluating The Feasibility Of Outpatient Iv Diuretic Therapy For Patients With Decompensated Heart Failure, Christina Thompson

DNP Projects

Heart failure is a prevalent chronic disease that contributes to many hospitalizations that may not always be necessary. Evidence supports that patients who present to the Emergency Department in fluid overload can be treated in the outpatient setting when only IV diuretic is warranted. Both decreases in costs and improved outcomes have been reported, yet there has been little movement toward providing outpatient diuresis versus hospitalization. The purpose of this DNP project was to evaluate the feasibility of an outpatient option for IV diuretic therapy for patients with acute decompensated heart failure experiencing symptoms of fluid overload. This descriptive study …