Digital Commons Network^™

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli

Doctor of Nursing Practice (DNP) Projects

Background: “Baby boomers” (born between 1946 and 1964) represent 15% of the total population of the United States (Population Reference Bureau, 2019), but 50% of its total healthcare expenses (Mattison, 2021). Growth of this population will have a corresponding rise in demand on healthcare resources. Replication of a geriatric inpatient care model (Palmer et al., 1994) was introduced in a large geographically and ethnically diverse integrated care delivery system.

Problem: The demographic for this small community hospital located in Northern California has a larger percentage of patients over the age of 65 compared to other facilities within this …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Regulatory Orientation To Support Transition To Academic Leadership, Annmarie Munana

Doctor of Nursing Practice (DNP) Projects

Background: As pre-licensure nursing education is burdened by levels of regulations and standards, it is important the academic leader understand regulatory compliance and the applicable federal, state, and local rules and laws. At a multi-campus university, the leader’s ability to address regulatory issues is critical to the program’s success.

Local Problem: The university’s campus leader regulatory orientation lacks consistency and standardization of content and resources. This situation results in campus leaders having varying degrees of knowledge and competency ensuring academic regulatory compliance.

Context: Regulatory compliance stems from external influences and multiple layers of regulations and accreditation. The university provides onboarding …

Building Excellence Through Shared Governance And Continuous Process Improvement, Deborah Reitter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained.

Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils …

Targeting Pre-Operative Booking Processes To Decrease Risks Of "Never Events", Rebecca Lynn Poths, Rebecca Lynn Poths

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Wrong patient, wrong procedure, wrong site, and wrong side surgeries are such egregious errors that are known as “never events.” Root cause analyses can pinpoint a failure yet do little to determine if corrective action has reduced the risk of recurrence.

Context: Monitoring surgical cases prospectively to identify weaknesses that could help identify specific risk factors to avert and move toward zero defects. The setting for this quality improvement project is a >300-bed Level III trauma hospital, where the risk of wrong-site surgeries and lack of standardized processes in the surgical pre-operative booking process was of concern to …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Successfully Spreading Improvement Work Using A Proven Framework, Rachel Lynn Wyatt

Doctor of Nursing Practice (DNP) Projects

Background: Hospital-acquired pressure injuries (HAPIs) are rising in the United States, increasing six percent between 2014 and 2017 alone (Agency for Healthcare Research and Quality [AHRQ], 2019). Approximately 60,000 patients die from complications related to HAPI annually (Padula & Delarmente, 2019).

Local Problem: In a Northern California Level II Trauma acute care hospital, HAPIs increased by 422% over two years, 2016-2018, with most of the HAPIs occurring in the Intensive Care Unit (ICU).

Context: This project sought to spread the Interventions by Braden Subscale protocol to seven medical-surgical units in the hospital using the Institute for Healthcare Improvement’s (IHI) Framework …

The Effects Of Naloxone Education Among Adults In Alameda County, Patricia Ronnica Tinglin

Doctor of Nursing Practice (DNP) Projects

Fatal opioid overdose is a growing concern in the United States (U.S.). The pharmaceutical companies assured the medical community that opioid pain relievers were not addictive. As a result, providers prescribed them at a significantly higher rate, which led to more extensive use of authorized and unauthorized opioid use before it was realized that they could be highly habit-forming (The U.S. Department of Health and Human Services [HHS], 2019). A growing body of evidence supports providing naloxone education as a means of harm reduction. The quality improvement project aims to implement educational sessions for adult patients seen at East Bay …

Using Simulation To Improve Covid-19 Code Blue Outcomes, Charity Shelton

Doctor of Nursing Practice (DNP) Projects

Background

Healthcare workers in the acute care setting must be ready to respond to emergencies at any given time. The recent COVID-19 pandemic put strains on the healthcare workforce that have brought challenges and new competencies for how healthcare workers safely respond to emergencies. To ensure healthcare workers maintain these competencies, specific training must occur to improve emergency response and outcomes. Specifically, there needs to be training for healthcare workers to respond to COVID-19 code blue emergencies safely and with skilled interventions.

Problem

A code blue in the acute care setting is a medical emergency that requires nurses, physicians, and …

Ghost Personal Experience Narratives, Jaclyn Malmrose

Final Projects

About Personal Experience Narratives on ghosts as told by members of the Church of Jesus Christ of Latter-day Saints

The Trial Of Anthony Sims, Jeff Winter

Capstones

This capstone is an investigation into the wrongful conviction of Anthony Sims.

Agency, Inclusion, And Empathy As Power: The Last Dispatch From My Ma In Engagement Journalism (And My Final Report), Jacqueline Neber

Capstones

My community practicum engaged New York's intellectually and developmentally disabled community, and their families, in the process of making the process of reporting abuse and neglect inside group homes more accessible and transparent. Serious abuse and neglect still happens in group homes for people with disabilities, which has led to death and serious injury, and reporting issues is not necessarily easy. After a year of listening to community concerns, I created a service journalism post that made reporting abuse and neglect easier for families and the public. And most prominently, I created "How to Stand Up for Yourself in Your …

The Drive For Disability, Aliyah Walker

Capstones

After recent inclusivity movements, the fashion industry had a reckoning that they need to do better when it comes to diversity. Size, age, and gender have started to have better representation in recent years; however, disability representation is still lagging. If the fashion industry wants to become truly inclusive, it needs to start representing disabled individuals positively and regularly both on the runway and in campaigns.

Link to Capstone Project: https://medium.com/@aliyah.walker83/the-drive-for-diversity-b29288adc482

Careless, Brenna Holland

Capstones

About This Project

I began working on this project six months ago, but my interest in the home care industry can be traced much further back. In the mid-aughts, my grandfather was diagnosed with Alzheimer’s. Hoping to live independently for as long as possible, he sought out the help of an in-home health aide. It was then that he learned he fell into a coverage gap; one that, even today, prevents many Americans from accessing home care services.

Faced with two options—father-son cohabitation or an institution—my grandfather moved in with my family, where he slipped into a catatonic depression prompted …

Are The Kids All Right? What Tv Shows Get Wrong About Teen Dating, Radhamely E. De Leon

Capstones

Dating culture and sexuality have changed so much for teens over the years but shows like Euphoria, Gossip Girl and Sex Education seem to stick to the same narratives and bad practices, even as consumers have voiced that they want more from show creators. This article explores how teens feel about the way popular television shows portray characters their age and the realities of teen dating. https://rdeleon915.github.io/capstone/

Venezolanos En New York, Mariel V. Lozada

Capstones

The process of developing a website with information about the bureaucratic process for the immigrants in the city, especially focusing on the Venezuelans and a five steps guide with the most basic information a newly arrived immigrant may need. The idea behind is to deliver useful content that would live in their inbox so they can revisit it easily anytime they want, even without having an internet connection, and, if the reader wants to deepen their knowledge, can visit the website for more in-depth coverage of these topics.

School Social Workers In Texas, Kayce Stevens

Capstones

School social workers in Texas are underfunded, under-appreciated, and overworked. I spent 18 months interviewing and getting to know school social workers across Texas to find out what their needs were. The main concerns I learned where: not many people know what school social workers do and that limits the resources they can provide, and there are not enough social workers in the schools across Texas which makes their workload unmanageable. I created one-pagers to distribute during the Texas legislative session on why the Texas Education Code should require all schools to provide social services. I also created a chatbot …

The Devotees To Disconnection, Keith Paul Medelis

Capstones

The richest and most connected people are paying to log offline, leaving the rest of us tethered to our devices. We want in on their secret. But at what cost?

Black Gold, Natalie Peart

Capstones

Jae Lee is an urban farmer and keeper of New York City soil. Lee spends her time working across gardens throughout New York City. At Phoenix Community Garden in Ocean Hill, Brooklyn, she devises a community composting plan and picks up food scraps from local cafes. She then takes those food scraps to Phoenix Community Garden where she and some of the garden members process those food scraps and turn it into "black gold" or compost. Lee believes that a large part of her role on earth is nourishing the soil. However, New York City gardens are not only inhabited …

An Online Hub For Queens Parents, Abe R. Levine

Capstones

I sought to build a common hub for parents across District 28 in Queens to connect with one another. I did this by creating a bilingual newsletter called the Queens Boletín. The goal of the Boletín was for parents to share and find resources, to advance the conversation on equity, and to build community.

Dear Maliha,, Na-Eela Djemil

Capstones

Dear Maliha is a short documentary film exploring the complexities of spiritual abuse through Maliha Fairooz. Spiritual abuse is a form of abuse that uses spiritual or religious beliefs to control or manipulate others. In some cases, spiritual abuse can be used to describe a religious leader who abuses their platform. But in Maliha’s story, we explore the concept of parental spiritual abuse. However, we learn more about this through Maliha Fairooz and the creative use of her journal.

For Maliha journaling is a form of therapy she uses to process her feelings and days. She also uses it as …

Caught In A Whirlwind: How A 17-Year-Old Received 50-To-Life For An Arson He Claims He Did Not Commit, Anna Deen

Capstones

Shortly after turning 17, Robert Webster was arrested for firebombing a drug witness’s home in Jamaica, Queens at the height of the crack epidemic in 1987. Convicted as a juvenile, he was sentenced 50-to-life for causing minor burns and property damage after the arson was linked, in the public eye, to the subsequent assassination of a young police officer.

Having maintained his innocence since the day of his arrest, Webster is now seeking clemency.

https://annadeen2.github.io/capstone/

Unbuilding: How Deconstruction Is Saving The Planet By Giving Building Materials A Second Life, Diana M. Ducroz

Capstones

In 2018, more than 600 million tons of construction and demolition (C&D) waste was generated in the United States, more than twice the volume of ordinary trash created by American households and businesses. Even though 80-95% of this concrete, asphalt, steel, wood, drywall, glass and brick can be reused, repurposed or recycled, a quarter of it – or 145 million tons in 2018 – ends up in landfills. Thirty million tons of wood alone – often sturdy, irreplaceable old-growth lumber – is being trashed every year.

Now, a budding ‘build reuse’ movement, made up of environmentalists, architects, historic preservationists, city …

The Pandemic Changed The Face Of Retail. Here’S How Center City, Philadelphia — The State’S Leading Job Market — Is Faring On The Road To Recovery, Francisco O. Velasquez-Turcios

Capstones

The pandemic changed the face of retail. Here’s how Center City, Philadelphia — the state’s leading job market — is faring on the road to recovery.

Link to capstone project: https://franvela033.github.io/Capstone/

Public Educators Shaking Up Classrooms, Elizabeth Richards

Capstones

Through feedback from the community, largely in the form of continued interviews and conversations with teachers about what they were looking for and how they consumed news, I learned that a newsletter was the best way to reach them.

Navigating the challenges of hybrid learning has meant for teachers multiple lesson planning, which has compounded the existing challenge of being incredibly busy and potentially overwhelmed. A newsletter that could arrive in an email inbox — a place where public teachers spend much of their time — could help bring information directly and prevent teachers from having to spend more time …

Xero Tolerance: A Critical Look At The Complicated Legacy Of Type O Negative, Brandon Futernick

Capstones

Type O Negative have been one of my favorite bands for nearly half my life. They were the soundtrack for some pivotal moments in my adolescence, and I’ve held them near and dear to my heart into my adulthood. But after some time away, revisiting their music in 2021 revealed some ugly sides to their lyrical content that gave me pause. So I conducted an in-depth, critical review of my relationship to their discography to see if I could reconcile my lifelong appreciation for them with some of their more problematic tendencies.

Link: https://brandonfuternick.medium.com/xero-tolerance-a-critical-look-at-typ-226f16682e50

Young People More Optimistic About Climate Crisis, Syed U. Haq

Capstones

This is story on how the youth today is feeling more ambitious about rectifying the mistakes the previous generation has made regarding climate. It takes the reader through a poll done by Generation Lab, about the optimism in the younger generation to tackle the climate crisis and what factors are in play in making them feel that way. It also provides three brief audio pieces from student activists, Anna Kathawala, from the local Fridays for Future, Mars Vazquez-Plyshevsky, who comes from a family of climate deniers, and Aderinsola Babawale, a local activist with Brownsville Green Justice. And of course, their …