Digital Commons Network^™

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 …

Improving Suicide Risk Screening In A Pediatric Outpatient Clinic, Annie Bowman

Group: Nebraska Methodist College

Objective: The purpose of this project was to determine if implementation of an educational intervention for clinical providers and staff on the Ask Suicide Screening Questions (ASQ) tool improved knowledge and confidence on suicide risk screening in a pediatric ambulatory setting. Participants: Behavioral health clinic in which 9 participants completed pre survey and 8 participants completed both pre and post survey (N = 8). Study Method: Pre and post test design with intervention of an online education presentation for staff and clinicians in the behavioral health clinic. A 12 item pre and post-test survey was created to assess participant …

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. …

Fourth Trimester Support, Morgan Krohn

Group: Nebraska Methodist College

Problem: In postpartum mothers seen in a clinic setting, does implementation of the fourth trimester support increase maternal feelings of support?

Intervention: This project intended to measure perceived feelings of support in mothers during the fourth trimester participating in a facilitated support program. Due to circumstances at the implantation site, this project was unable to be implemented and redesigned as a toolkit for healthcare organizations that desire to implement a fourth trimester program to improve maternal support through facilitated patient education and support groups. A pre and post-test was designed to measure participants' feelings of support during the fourth trimester …

Vitamin B12 Screening And Treatment In Patients Taking Metformin, Ashlee Denny

Group: Nebraska Methodist College

Background: Long-term metformin therapy is linked with the potential side effect of vitamin B12 deficiency. Although screening is recommended, there is no standardized screening guideline. Vitamin B12 deficiency is frequently unrecognized. An electronic medical record-based alert may lead to more identification and better patient outcomes.

Purpose: The purpose of this project was to determine the impact of focused education on clinician perceptions about the importance of using an electronic medical record-based alert to ensure routine vitamin B12 monitoring in type II diabetic patients prescribed metformin.

Methodology: The organization site for this doctoral project was a single, stand-alone, primary care clinic …

Improving Patient Education To Increase Nurses’ Confidence, Aisha N. Washington

Group: Nebraska Methodist College

Effective patient education is something every interdisciplinary healthcare team member should aim for at each educational session. When patients understand the intended education, their ability to manage their chronic conditions at home is greatly affected. Patients have difficulties comprehending critical information more commonly than they should. Bedside nurses in the acute care hospital setting spend more time with patients than do their physicians and do much of the patient teaching. However, many nurses do not feel confident in implementing effective patient education. A structured patient educational tool was created for this project for nurses to implement when educating patients using …

Effect Of A Journal Club On Nursing Faculty Readiness To Address Incivility, Kim Perry

Group: Nebraska Methodist College

Victims of incivility in nursing programs experience negative physical and mental effects and may respond to uncivil treatment with uncivil behavior in return. Incivility disrupts learning and leads to student and faculty attrition. Students may continue uncivil behavior as nurses, resulting in uncivil workplaces and patient harm. Faculty development is recommended to prepare nursing faculty to address incivility, but few studies examine the effectiveness of faculty development programs on faculty readiness. This project examined the effect of attending a journal club presentation on readiness of nursing faculty to address incivility in a BSN program. Faculty of a single BSN program …

Importance Of Patient Education On Hemoglobin A1c And Dietary Modifications, Joseph Giramata

Group: Nebraska Methodist College

Research shows that only less than 25% of adult patients who are being treated for diabetes can recall their previous and most recent hemoglobin A1c levels. It is the providers' role to educate adult patients at every visit about their hemoglobin A1c levels and the benefits related to knowing the levels coupled with increase in physical activities and a plant-based diet. The purpose statement guiding this project is: In medical providers caring for adult patients diagnosed with DM2, does provider education on hemoglobin A1c and dietary modifications affect medical providers management of DM2? The project consisted of an educational intervention. …

Implementation Of An Intubation Checklist, Ashley Klepinger, Maureen Marzano

Group: Nebraska Methodist College

The issue that this capstone project addressed was the use of a standardized checklist during rapid sequence intubation (RSI). To address this problem, the purpose is to address the effectiveness of utilizing a standardized checklist during intubation in preventing complications associated with rapid sequence intubation such as oxygen desaturation or systolic hypotension. To gather data, a thorough review of current literature was reviewed. This data lead to three themes in the literature: implementation of a rapid sequence checklist, safety related to intubation, and complication of intubation. These themes will be useful for understanding the effectiveness of a standardized checklist during …

Optimizing Access To Pediatric Specialty Care, Ricardo Perez

Group: Nebraska Methodist College

The science of optimizing access and wait times is still evolving. Many confounding factors influence the capacity of health systems to offer appointments in a timely manner. Timely access to care is a determinant of medical outcomes and patient satisfaction. The purpose of this project was to develop a standardized approach for the structure of centralized services based on the patient scheduling needs for individual specialty clinics. This process improvement project utilized quantitative data to measure changes in scheduled appointment utilization, within three pediatric specialty clinics after 45 days of implementationThe science of optimizing access and wait times is still …

Improving Confidence And Perceptions Among Nurses Using A Clinical Decision Tool For Wound Care Management, Candice Schnoor, Valerie Anderson

Group: Nebraska Methodist College

Background and purpose: Wound care can vary among all health care providers, which is why it is important to limit practice variations by using clinical decision-making support tools. Education for wound care is very limited among health care providers, and the purpose of the paper is to examine if confidence and perceptions among nurses increases when using a clinical decision support tool for wound care management.

Methods: The clinical decision-making tool, recognized as the TIME CDST, focuses on tissue, inflammation/infection, moisture balance and edges of the wound to properly manage wound care patients. An education session was recorded for day …

Evaluating Heart Failure Readmissions, Katie E. Bedard

Group: Nebraska Methodist College

Problem: In heart failure patients that were readmitted within 30 days of discharge, does identifying demographic and individual characteristics provide data that can enhance discharge education and planning for future prevention of readmissions? Intervention: Hospital readmissions related to heart failure greatly affect patients' disease prognosis, health maintenance, and overall quality of life. Frequent readmissions to the hospital can increase morbidity and mortality significantly. To identify common characteristics among readmitted heart failure patients a retrospective chart review was completed.

Measures: Patients readmitted to the hospital within 30 days with a primary diagnosis of heart failure were assessed. Patient's age, gender, zip …

A Need For Nurses, Danielle Krohn, Hilary Applequist

Group: Nebraska Methodist College

Nurse residency programs were designed with the intent of assisting nurses with the transition into a new area of practice. These programs are common in acute care settings; however, implementation has been slow to move into long-term care. The purpose of this project was to complete a community needs assessment to determine whether the community nursing home would be interested in implementing a nurse residency program within the next year. The assessment was completed with surveys distributed to various nursing home stakeholders. Survey results concluded that the current nurse orientation process, nurse recruitment, and nurse turnover rates were important items …

Assessment Of Nursing Knowledge In Palliative Care, Yen Nguyen, Hilary Applequist

Group: Nebraska Methodist College

Background: Acute care nurses are challenged in caring for chronically and terminally ill patients. Many nurses do not have the knowledge or comfort level in handling ethical challenges or palliative care (PC) discussions with patients and their families. Understanding the palliative care approach can help acute care nurses increase their palliative care knowledge and promote the use of the palliative care team.

Purpose: The purpose of this project is to assess palliative care knowledge in nurses at a Midwestern acute care hospital, prior to and after an educational intervention. By performing this comparison, a determination will be made on whether …

Reducing The Cesarean Rate In Ntsv Births, Micah Vande Vegte

Group: Nebraska Methodist College

Problem: A cesarean section is a lifesaving procedure for both mothers and neonates when vaginal birth is no longer a safe option. Nonetheless, there has been an extraordinary rise in cesarean rates as well as remarkable variation among hospital systems, individual physicians, and even labor and delivery nurses. Creating awareness of the problem and providing education to the nursing staff regarding labor support techniques can make significant decreases in the cesarean section rates.

Intervention: L&D nurses were educated on non-pharmacologic comfort measures. A presentation, lasting approximately one hour, was presented by the project lead during a mandatory staff meeting on …

Scenario-Based Learning For Forensic Nurse Examiners, Lauren Awe, Valerie Anderson

Group: Nebraska Methodist College

Problem: Approximately 53 million American women have faced a form of violent sexual crime during their lives. Victims often report experiencing further trauma by a healthcare professional who does not have specialized training.

Intervention: Scenario-based trainings prove beneficial in helping handle and address challenging individuals or conversations, in addition to being made aware and addressing one’s own biases. Participation in these trainings have a positive effect on participants’ attitudes, beliefs, and behaviors, in addition to increasing confidence in their roles and improving patient outcomes.

Measures: The Likert Scale, utilizing a zero to five scale, with zero being “not at all” …

Quality Of Care For Cancer Patients, Chanda R. Anderson

Group: Nebraska Methodist College

Research has shown that patients treatment plans depend on open and honest communication from their providers regarding their health care. Providers felt that it is important to have early end of life discussions with cancer patients. Some of the barriers to having early end of life discussions with cancer patients were comfort level, lack of training in medical school, and lack of communication skills. Cancer patients felt that there are gaps to receiving quality of care, some of these gaps included comfort level, open and honest communication, and knowledge level of diagnosis. The data collection and analysis has shown that …

The Effects Of Racial Battle Fatigue In Students Of Color: Increasing Awareness And Improving Coping Skills, Meyokia Smith

Group: Nebraska Methodist College

Students of color who attend predominately white institutions have reported experiencing racism, discrimination, or racial microaggression which has led to physiological, psychological, or behavioral stress responses coined as racial battle fatigue (RBF), a newer term describing these effects. This project sought to understand students of color's experiences of RBF through a focus support group while formulating coping mechanisms to assist students of color who may face RBF to build resiliency. The focus support group discussion concentrated on three main themes: Racial Battle Fatigue Awareness, Racial Battle Fatigue Experience, and Coping and Racial Battle Fatigue. Results from this study sought to …

Determining The Impact Of Using A Social Determinants Of Health Screening Tool In Identifying Unmet Needs, Barriers To Care, And Basic Awareness Of Social Resources, Maelene Schuhmacher-Omar, Kari Wade

Group: Nebraska Methodist College

The purpose of this project was to determine if conducting a short, social determinants of health (SDOH) assessment identified one or more unmet needs, one or more barriers to care, and to assess basic awareness of social resources. Conditions affecting people where they work and live have a strong influence on health outcomes. Social complexity, meaning having one or more unmet need, is directly related to poorer health outcomes. Individuals marginalized by poor social capital, health inequities and ongoing disparities, especially those in low income populations, experience higher morbidity and mortality. These unmet needs also affect the shared-decision making process …

Advocate Perception Of Forensic Nursing Care, Shelley Hultman, Jillian Krumbach

Group: Nebraska Methodist College

Problem: The original problem being addressed by this project was does trauma informed education for forensic nurse examiners improve victim advocates perception of care delivered to patients within 6 weeks? However, after staffing changes within the coordinating agency of victim advocates, the problem statement was adapted to address in forensic nurse examiners, does trauma informed education improve awareness and perception of trauma based care concepts.

Intervention: The project was initially designed to evaluate victim advocates perception of care provided by FNEs after receiving education regarding trauma informed care through an educational module. However, due to the change at the coordinating …

The Impact Of Health Partner Participation In Cardiac Rehabilitation On Health Partner Knowledge Of Cardiac Disease Risk Factors, Nathan T. Shank

Group: Nebraska Methodist College

Background: Cardiac disease remains the top cause of mortality and morbidity in the United States. In order to achieve optimal long-term outcomes, people who have experienced an acute cardiac event must undergo several lifestyle and behavioral changes. With the importance of social support on health, it is equally important for a person's identified health partner to learn the recommended lifestyle changes that promote good health in post-acute cardiac patients. Many of these behaviors can be learned through participation in a cardiac rehabilitation program, but few studies have been performed on the benefits that a spouse receives from attending cardiac rehabilitation …

Improving Awareness Of Recommended Preconception Health Behaviors To Improve Birth Outcomes, Colleen Hobbs

Group: Nebraska Methodist College

Maternal and infant mortality rates are higher in the United States than any other developed country. Black women and infants are more likely to die from complications of pregnancy and childbirth than any other racial group. Nearly half of all pregnancies in the United States are unplanned. Women of color and those of lower socio-economic status are more likely to have an unplanned pregnancy, a contributing factor to poor birth outcomes. The prepregnancy health of both parents has a direct impact on maternal and infant health during the pregnancy and after delivery. For this project, patients of childbearing age receiving …

Improving Quality Of Life: Efficacy Of Pregabalin And Gabapentin In The Fibromyalgia Patient, Jeanette Kennedy

Group: Nebraska Methodist College

Background and Review of Literature: Fibromyalgia (FM) is a chronic disease that is characterized by widespread pain and several associated symptoms such as non-restorative sleep, fatigue, poor physical condition, impaired cognition, stiffness, depression, and balance impairment. Most FM patients are taking at least one prescription medication. Less than 50% of FM patients report being somewhat satisfied with their current treatment. This lack of evidence alone expresses the need for more research to support which prescription medications are essential.

Purpose: The purpose of this project was to determine whether pregabalin or gabapentin is more effective to manage the symptoms for women …

Constipation Management In Congestive Heart Failure Patients, Jordan Radel

Group: Nebraska Methodist College

Constipation within congestive heart failure patients admitted to the hospital poses a significant health burden, decrease in quality of life, and potential for complications. Based on a review of literature, nursing staff are the front line of patient care for these patients and can provide individualized nursing assessments that target constipation risk factors, potentially decreasing the risk and prevalence. A nursing led Cardiac Constipation Management Tool provides an effective means of risk assessment assigning appropriate categories of constipation risk, and ultimately leading to provider notification, designated constipation order set activation, and therefore decreased constipation rates. Upon admission the tool was …

Prenatal Education To Improve Reporting Of Postpartum Depression, Shanda Hensley, Whitney Robertson

Group: Nebraska Methodist College

Postpartum depression (PPD) is a concerning medical condition that many women experience after delivery. In its mild form, it is manageable but in its more serious state, expert consultation may be needed for evaluation and treatment. Existing literature focuses on the prevalence of the condition, stigma that exists, and postpartum depression education. The exact prevalence of postpartum depression may be unknown due to lack of reporting symptoms, like other mental health condition. The purpose of this capstone project was to determine whether prenatal education improved knowledge and comfortability with reporting symptoms. Implementation of the project included presenting education to pregnant …

Postpartum Depression Screening In The Neonatal Intensive Care Unit, Angela Zavala, Tara Whitmire

Group: Nebraska Methodist College

Background and Review of Literature: Postpartum depression (PPD) is recognized as a maternal mental health condition that can occur during pregnancy or in the postpartum period. Mothers of infants hospitalized in the neonatal intensive care unit (NICU) are at a particularly increased risk for developing PPD. Risk factors are multifactorial and if undiagnosed can lead to serious consequences for mother, infant and the family unit.

Purpose: The purpose of this project was: 1) to assess the incidence of PPD with interval screening compared to one-time screening in NICU mothers using the Edinburgh Postnatal Depression Scale (EPDS), and 2) to determine …

Reducing Readmissions Through Medication Reconciliation Program In Primary Care, Joseph Anthony Anthone, Tara Whitmire

Group: Nebraska Methodist College

Background: Hospital readmissions are a major expenditure within our healthcare system. Poor medication adherence and literacy greatly increases the risk of readmission. To combat this problem insurance payors incentivize prompt and effective post discharge medication reconciliation and education.

Objective: To develop and implement a protocol in a primary care clinic utilizing a proven medication assessment tool to improve patient understanding resulting in improved readmission outcomes, medication literacy, and self-management regarding patient medication adherence.

Methods: The project was conducted in two parts over a six month time frame. Initially, data was collected using web-based insurance portals for a two months for …

Impacting Practice Through Change: Implementing Cardiopulmonary Resuscitation Into A Nebraska School’S Curriculum, Samantha Renter

Group: Nebraska Methodist College

Cardiopulmonary resuscitation is a life-saving technique that serves importance in many emergencies, in which someone’s breathing, or heartbeat has stopped. Despite strong evidence proving that basic life support (including cardiopulmonary resuscitation) improves survival rates after cardiac events, current studies show that there is a significant lack of knowledge regarding typical signs and risk factors associated with serious medical conditions (Enizi et al., 2016). Alarmingly, only a small percentage of the United States (U.S.) population knows how to administer CPR; indicating that the widespread implementation of CPR training will benefit high school students while impacting the broader U.S. public. In the …