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Evidence-Based Practice Change: Implementation Of A Collaborative Practice Model For Diabetes, Emma L. Edwards

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

Background: The prevalence of type II diabetes mellitus (T2DM) in the United States is high, especially in underserved populations. Many patients with T2DM do not receive the optimal interprofessional collaborative care that has been shown to improve outcomes. A model of care that incorporates these evidence-based recommendations is integral to improving the quality of diabetes care. A growing body of literature identifies the use of a provider-clinical pharmacist collaborative practice (P-CPCP) model of care as an effective, innovative, and evidence-based practice that will improve patient outcomes.

Purpose: In response to an identified need to improve T2DM patient care in an …

Enhancing Patient Education To Reduce Unnecessary Health Information Seeking Behavior After Cardiac Ablation, Carla Lockhart

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

Problem: Atria fibrillation (a-fib) is an irregular heart rhythm effecting approximately 2.7 to 6.1 million individuals annually (CDC, 2017), of which approximately 153 underwent catheter ablation by the electrophysiologist during 2018. Patients commonly experience concerns in the three months following surgery known as the "blanking period." Repeated unnecessary patient behaviors inclusive of phone calls, emails, consultations, and emergency visits are a common concern to healthcare providers.

Method: This project developed an enhanced educational tool and used a chart review of N=16 to measure health-seeking behaviors before and after exposure to the enhanced education tool. Frequencies were calculated and a chi-square …

Behavioral Health Integration In Primary Care: A Quality Improvement Project, Sarah Claussen

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

This quality improvement project aimed to identify and treat patients at risk for depression and anxiety, facilitating earlier entry into treatment through increased screenings during routine primary care visits. Utilizing screening tools such as PHQ-9, GAD-7, and C-SSRS ensured comprehensive mental health assessments. Implementation of the Collaborative Care Model at Priority Family Medical Clinic improved patient outcomes, satisfaction, and reduced healthcare costs, addressing disparities in access to behavioral health services. The project enhanced identification and management of depression and anxiety, leading to increased referrals to CoCM, psychiatric services, and medication initiation, highlighting the effectiveness of integrating mental health screenings for …

Implementation Of Depression Screening To Optimize Chronic Pain Management, Aaron B. Castle

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

Background: Chronic pain affects millions of people worldwide and the evidence demonstrates prevalent co morbidity of chronic pain and psychological issues such as anxiety, insomnia, and depression. The existence of psychological issues can have negative impact on pain management and compound the challenges inherent to successful management. Although clinical Practice Guidelines (CPG) recommend routine screening for depression, anxiety, and insomnia in all chronic pain patients, many primary care providers fail to routinely perform appropriate screening. The purpose of this project was to implement a practice change that would include screening for depression with chronic pain patients in a rural …

Diabetes: What Are The Barriers To Diet, Exercise And Medication Adherence In A Rural Southern Arizona Clinic?, Ambur Lindstrom-Mette

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

Purpose: To identify patient reported barriers to diet, exercise and medication adherence in adults who are diabetic patients in a rural Southern Arizona family practice clinic.

Data Sources: A cross-sectional, quantitative self-reported survey was conducted. The Environmental Barrier Assessment Scale was the used to collect data at routine office visits.

Conclusions: Patients consistently identified problems with health as a barrier to diet, exercise and medication adherence in diabetes. Further discussion with patients is warranted to assist patients and providers to understand what problems are occurring and what the solution may be to help overcome these barriers.

Implications for Practice: Identification …

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 …

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 …

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 …

Nursing Knowledge And Palliative Care, Kathryn Miller

Group: Nebraska Methodist College

Problem: Does education provided to oncology nurses about the ID-PALL screening tool result in increased knowledge on how to assess and identify palliative care needs in patients?

Intervention: This project was designed to educate nurses on palliative care topics and enhance their ability to assess and identify palliative care needs in their patients.

Measures: An online pre-survey and post-survey was used to determine the nurse's knowledge before and after the education was dispersed. The pre-survey was used to identify areas that were lacking and an educational presentation was created based off of this data. The post-survey with the same questions …

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 …

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 …

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 …

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. …

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 …

Autism Spectrum Disorder Care Provider Education Program, Valerie Lynn Anderson

Group: Nebraska Methodist College

With the rising prevalence of autism, access to health care services by the patient with autism spectrum disorder (ASD) is inevitable. Although a great deal of literature exists regarding autism, limited research has been conducted regarding nurse knowledge, competence and awareness when caring for the ASD population. Evidence suggests that minimal education is provided to front-line nurses on how to work with ASD patients. When nurses are put in a position to care for a patient without adequate knowledge and training, outcomes and safety are jeopardized. The Autism Spectrum Disorder Care Provider Education Program (ASDCPEP) was designed to address these …

Teaching Hands-Only Cardiopulmonary Resuscitation In A Rural High School, Emily Zoz

Group: Nebraska Methodist College

Objective: To measure the impact of a 30-minute hands-only CPR course on 24 junior and senior high school students' knowledge and willingness of CPR provision.

Methods: A pre- and post-intervention survey with both knowledge and willingness components was employed to assess the impact of the hands-only CPR education.

Results: An increase in knowledge level and self-rating of willingness to perform hands-only CPR from the pre- to post-intervention survey results was identified in the 24 student surveys that were evaluated. The results of the t-test demonstrated significant improvements between pre- and post-intervention surveys regarding hands-only CPR knowledge (M = 2 …

Advance Directive Protocol In The Primary Care Setting, Alexei Boettcher

Group: Nebraska Methodist College

Background and Review of Literature: Advance directives (AD) are documents that offer patients a way to avoid unwanted care in the event of a serious illness or incapacity. Studies demonstrate the care patients receive at the end-of-life is not often consistent with their preferences, as a result of suboptimal communication between the patient and provider as well as documentation of health care proxies and treatment preferences (Isaac & Curtis, 2016). The lack of a current formal protocol used by primary care providers regarding ADs, particularly towards the young adult patient population, resulting in insufficient discussions of patients’ wishes regarding end-of-life …

Implementation Of An Employee Mentorship Program To Reduce Burnout Levels In A Neuroscience Intensive Care Unit, Ryan Mahoney

Group: Nebraska Methodist College

Problem: In a Midwest academic health system a neuroscience intensive care unit (NSICU), had been seeing worsening scores on their biannual Employee Pulse Check Survey, which had revealed higher levels of staff burnout. The level of burnout had directly affected employee satisfaction, retention, and the hiring of many staff members.

Intervention: A peer mentorship program was developed and implemented over 6 weeks among the NSICU staff nurses with the aim of improving their level of burnout.

Measures: The ProQOL Health survey was utilized as a pre and post-intervention survey among the participants specifically utilizing the burnout section of the survey. …