Digital Commons Network^™

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

The Effect Of An Educational Workshop On Relational Aggression In An Acute Care Nursing Unit, Jennifer M. Dorsey

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of an educational intervention on relational aggression in an acute care unit using a pre and post questionnaire. The questionnaire was used to examine changes in Relational Aggression (RA) self-awareness before and after an educational video and to determine the effectiveness of an educational video compared to no educational materials on self-awareness of RA behaviors.

METHODS: This study was single site, quasi-experimental non-equivalent pretest posttest study at the University of Kentucky. Sample size for the pre-survey was 15 acute care nurses on the control and experimental units, completed between …

Evaluating Pre-Procedural Anxiety In Adults Undergoing Interventional Radiology Procedures, Rebecca Doll

DNP Projects

PURPOSE: The purpose of this study is to evaluate pre-procedural anxiety with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the adult population of the Interventional Radiology department at University of Kentucky Medical Center. The objective is to provide meaningful data to providers in this clinical area that could potentially facilitate better departmental workflow and also promote quality patient outcomes.

METHODS: A retrospective chart review, using a pre/post design, was used to evaluate the departmental implementation of APAIS. Case logs for the department were observed from January 2018 to June 2018 and then again, following APAIS implementation, from July …

Gun Violence Screening In The Adolescent Setting, Amy Burnett

DNP Projects

Objective: The purpose of this project was to implement a routine gun violence screening tool into practice in order to assess the need for this type of screening in the Adolescent Medicine Clinic at the University of Kentucky.

Methods: This study used a quasi-experimental one group posttest design to examine the impact of the implementation of a gun violence screening tool on the proportion of patients screened and the proportion of patients referred for intervention that screen positive.

Results: There were 44 adolescent patients that participated in this study (n=44). Twelve out of 44 participants screened positive, which means they …

The Effect Of A Provider-Based Educational Program On Knowledge, Attitudes, Self-Efficacy, And Order Rates Of Cologuard® In A Primary Care Clinic, Cassilly B. Besten

DNP Projects

BACKGROUND: Colorectal cancer is one of the most common and deadly cancers, particularly in persons greater than 50 years of age. Most colorectal malignancies are slow-growing, making regular screening increasingly important to decrease morbidity, mortality, and cost of treatment. Cologuard® serves as an effective and non-invasive colorectal cancer screening modality for average-risk adults.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy, and ordering rates of Cologuard® among primary care providers.

METHODS: This study was a single-center, pre/post implementation study of the effectiveness of a provider-based educational intervention …

Barriers To Screening For Intimate Partner Violence Among Aprns In Kentucky, Kathryn L. Strait

DNP Projects

Abstract

Purpose:Intimate partner violence (IPV) occurs in at least one in every four females and one in nine men across the United States (Smith et al., 2017). While the prevalence of IPV is considerably high, the screening rates for IPV in primary care specifically average less than 12% (United States Preventative Services Task Force, 2013). Methods: In order to identify how to overcome the barriers to screening including time, knowledge of IPV, access to community resources, gender identity/sexual orientation, accuracy and availability of screening tools, and reimbursement for advanced practice nurses in Kentucky, a survey was sent to …

The Effect Of A Child's Guardian's Health Literacy On Asthma Knowledge In Pediatric Patients, Sylvan Ryder

DNP Projects

PURPOSE: The purpose of this project is to determine if there is a correlation between a guardian’s health literacy and their knowledge of their child’s asthma management.

METHODS: This is a cross-sectional study conducted in the University of Kentucky Pediatric Pulmonology Clinic in Lexington, Kentucky. The analysis focused on how a parent’s health literacy level effected their asthma knowledge. The Rapid Estimation of Adult Literacy in Medicine-Short Form was used to measure health literacy. An asthma knowledge questionnaire with a Likert-scale design was used to measure asthma knowledge. The sample included eight parents of children with an asthma diagnosis collected …

The Effect Of A Focused Education Session On Continuous Renal Replacement Therapy (Crrt) Troubleshooting To Increase Knowledge And Self-Confidence In Icu Nurses., Lauren Nance

DNP Projects

PURPOSE: The purpose of this study was to determine if education focusing on continuous renal replacement therapy (CRRT) troubleshooting was effective at improving ICU nurses’ knowledge and self-confidence levels. It was hopeful that, following the educational intervention, ICU nurses would have an increase in knowledge and report higher self-confidence levels regarding troubleshooting CRRT.

METHODS: This study involved the use of a pre-post-test and questionnaire to evaluate the efficacy of an educational intervention on ICU nurses’ knowledge and self-confidence levels at Saint Joseph Hospital. The pre-post-test was used to evaluate knowledge levels, while the pre-post questionnaire was used to evaluate self-reported …

Evaluation Of An Online Lgbtq Patient Care Education Module For Primary Care Providers, Anthony C. Carney

DNP Projects

PURPOSE:

The purpose of this pilot study was to evaluate the effectiveness of an online educational module about LGBTQ healthcare topics for primary care providers in Kentucky. The study focused on the changes in knowledge, attitudes and self-efficacy in topics related to LGBTQ patients.

METHODS:

This study was a one-group pre/post intervention design to evaluate the knowledge, attitudes and self- efficacy of providers regarding primary care topics for the LGBTQ community before and after completing a training module on LGBTQ healthcare topics. Subjects were recruited via the KCNPNM Listserv over a 2-week period to participate in the interactive, online audio/visual …

Evaluating Depression Management In Primary Care, Danica Amos

DNP Projects

Background: Within primary care patients identified with depression often do not receive appropriate care (43%). Guidelines recommend combining pharmacotherapy and psychotherapy when possible and establishing follow up with patients to improve their response to treatment According to the APA, only 10% of patients receive combination therapy.

Purpose: The purpose of this study was to evaluate depression management practices in a primary care clinic, describe providers’ attitudes and skills related to depression treatment, and work with the healthcare team to identify strategies to improve depression management within the clinic.

Methods: A single site, descriptive study utilized a retrospective chart review of …

Evaluation Of A Diabetic Point Of Care Education In Primary Care, Mary Cho

DNP Projects

BACKGROUND: Diabetes education is the cornerstone of managing diabetes. The education can be delivered in group or individual sessions. Given that group classes are not always well received, a brief five-minute point of care education was developed and incorporated into patients’ routine diabetic appointment. The effectiveness of the method is yet to be determined.

PURPOSE: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness and acceptability of a recently implemented diabetes point of care education as compared to patients’ usual care in an urban primary care clinic.

METHODS: An outcome evaluation using a retrospective …

Current Assessment And Intervention Strategies For Childhood Obesity Used By Pediatric Care Providers, Jennifer Bivins

DNP Projects

Childhood obesity rates in the United States have tripled since the 1970s in the U.S. (CDC, 2018). Due to the persistent rise in obesity rate sin children and the possible health risks associated with obesity, it is important for pediatric providers to appropriately assess and treat childhood obesity. There is limited data on what pediatric providers in the primary care setting are doing to address this growing health problem. PURPOSE: The purpose of this study was to determine current assessment and intervention strategies for childhood obesity used by pediatric health care providers at the University of Kentucky, General Pediatric clinic. …

The Effect Of Long Acting Injectable Psychotropic Medication Provider Education On Advanced Practice Provider Knowledge, Andrew Makowski

DNP Projects

Schizophrenia is a debilitating disease that affects approximately 21 million people worldwide (APA, 2013). The gold standard of treatment of schizophrenia is antipsychotic medications. Unfortunately, approximately 50% of patients become non-compliant with their prescribed medications (Sadock, Sadock & Ruiz, 2015). The purpose of this DNP project was to determine the effect of implementing an education intervention regarding long acting injectable (LAI) antipsychotics on the knowledge of advanced practice providers working at a state psychiatric hospital. The advanced practice providers that participated in this DNP project completed a pre-education assessment, attended a brief educational session regarding LAI antipsychotics, and completed a …

The Effect Of A Patient Navigator Strategy On Colorectal Cancer Screening Completion In A Women’S Health Clinic, Martha Rosenthal

DNP Projects

Abstract

BACKGROUND: Colorectal cancer is the second leading cause of cancer related death in the US. Kentucky has one of the highest rates of the disease. Approximately 1/3 of the population has not completed screening for colon cancer as recommended by guidelines. Patient navigation is a strategy proposed to increase completion of screening in the primary care setting.

PURPOSE: The purpose of this quality improvement pilot project was to provide preliminary data on the impact of a patient navigation strategy to improve colon cancer screening completion in low risk individuals.

METHODS: Colon cancer screening completion using Colonoscopy or Cologuard testing …

An Evaluation Of Depression In Adolescents With Type 1 Diabetes Mellitus, Elleanor Gray

DNP Projects

Depression can significantly affect how adolescents with T1DM self-manage their disease. The combination of depression and diabetes is closely linked to reduction in self-care behaviors, poor treatment adherence, and sub-optimal metabolic control.

PURPOSE: The purpose of this study was to evaluate current screening for depression in adolescents with T1DM and determine the need for additional support or services to improve the quality of routine, follow-up diabetes care.

METHODS: A cross-sectional, retrospective review of electronic medical records was used to evaluate current practice of depression screening for adolescents with T1DM (11-21years) bring followed at a local pediatric diabetes center between April …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Emergency Room Services Used By Pediatric Patients Who Have An Established Primary Care, Rebecca J. Cooksey

DNP Projects

Background: The use of emergency room services for primary care issues is an ongoing problem. The incidence is higher in the Medicaid population and is associated with emergency room overcrowding and excessive medical costs.

Purpose: The purpose of this study was to explore the extent of and the details surrounding non-acute emergency room visits in a pediatric population within an urban primary care clinic.

Methods: This was a two-part descriptive study with both quantitative and qualitative components. A retrospective chart review of this facility’s ER data constituted the quantitative descriptive part of the study. The qualitative arm of the study …

The Effect Of An Educational Video On Device-Related Concerns In A Single-Center Left Ventricular Assist Device Population, Devan Costelle

DNP Projects

PURPOSE:The purpose of this study is to evaluate the prevalence of various concerns among left ventricular assist device (LVAD) patients and evaluate the effect of an educational video intervention on reducing those concerns in a single-center adult LVAD population.

METHODS:A 15-point LVAD Concerns Scale was created to evaluate the prevalence of specific device-related concerns. An educational video was created to address the concerns presented in the LVAD Concerns Scale. Data collection took place from November 2018 to February 2019. A cross-sectional, pre- post-test implementation study design was used to both identify various device-related concerns that exist among LVAD patients and …

Evaluation Of An Intervention To Improve Screening For Substance Misuse Among 12-21 Year-Old Patients In A Rural Emergency Department, Peyton Blanton

DNP Projects

Background: In 2014, over two million children between the ages of 12-17 years of age admitted to using illicit drugs (2.3 million) and alcohol (2.9 million) in the past month. The younger a person begins misusing substances the more likely they are to have serious health consequences. It is imperative that we screen, detect, and intervene early to decrease the burden of substance misuse and addiction. Screening Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based strategy used to identify adolescents who misuse substances. The CRAFFT tool is recommended for screening adolescents for substance misuse.

Purpose: The goal of …

The Effect Of A Simulation-Based Education Program On Nihss Accuracy And Inter-Rater Reliability Among Nursing Staff In The Neurological/Neurosurgical Intensive Care Unit, Amanda Novak

DNP Projects

PURPOSE: The purpose of this Quasi-experimental study was to examine the effect of a simulation-based educational NIHSS workshop on nursing accuracy and inter-rater reliability upon use of the National Institutes of Health Stroke Scale (NIHSS).

METHODS: This study was conducted in the Neurological/Neurosurgical Intensive Care Unit (ICU) at Baptist Health, a comprehensive stroke center located in Lexington, KY. The sample included 26 eligible nurses employed in the aforesaid unit. Nurses completed the NIHSS on a patient actor in a simulated scenario (this session was videotaped), a one-on-one debriefing with review of the videotape was conducted afterward, and then the nurse …

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 …