Medicine and Health Sciences Commons^™

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya

Master's Projects and Capstones

Abstract

Problem: Falls are considered never events, yet continuously occur in the inpatient setting. Falls,

especially falls with injuries, impact the patients, the staff, and the hospital. Falls cause extended lengths of stay, affect the morale of the patients and the staff, and are non-reimbursable events.

Context: There have been an increased rate of falls within a medical/surgical/telemetry unit

microsystem at a Northern California hospital despite standardized screening and prevention tools. The unit can house up to 52 patients and is the designated Covid unit of the hospital at the time of this project.

Interventions: The interventions include optimizing the …

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 …

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

Master of Science in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …

Diabetes Prevention Program, Ashley L. Stine

MSN Capstone Projects

The prevalence of diabetes in Texas has increased 40 percent over the last decade and will continue to rise as of 2019. New onset diabetes, chronic, and children with diabetes has significant rise in hospitalization rates. COVID and its restraints of limiting physical activity, restrictions of gyms and sedentary lifestyles. Chronic diabetics who were frequent flyer hospitalizations rates increase due to poor social support, mental health and stressors increased during COVID also. This diabetes prevention program that consists of 16wks for new and current diabetics would decrease complications of diabetes such as DKA, retinopathy, nerve pain, chronic pain, AMS, amputations, …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Increasing Healthcare Providers' Intent To Utilize Alternative And Complementary Pain Management With Their Patients, Holli Boyles

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project is to increase the willingness of healthcare providers to introduce alternative and complementary pain management to their patients. Two patient video tools were constructed and offered to healthcare providers to evaluate and potentially utilize the final products in their practice. One tool introduced music therapy, the other mindful meditation, along with resources for patients to investigate and learn from on their own. A total of seven healthcare providers responded to the project with a commitment to potentially utilize the final video and provided their feedback on the video tools. No changes were made to …

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judy E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary …

Advance Care Planning Evidence Based Practice Benchmark, Natalie K. Waggoner

MSN Capstone Projects

America is aging, with the estimated number of patients over the age of 65 to reach 72 million by 2030, approximately 20% of the population (Sade, 2012). This demographic shift characterized by an increasing elderly population has elevated the subject of death and dying to a crucial component of health care delivery. A study done by Silveira et al. (2010) demonstrated that 70% of individuals aged 60 and older were unable to participate in treatment decisions during their final days. However, most individuals in the United States have no advance directive.

The goal of this evidence-based practice intervention is to …

Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo

Student Scholarly Projects

Human trafficking (HT) is a federal and international crime and is regarded as one of the most pressing human rights issues. Adult and minor victims are trafficked by force (rape, beatings, confinement), fraud, and coercion resulting in profound physical and psychological injuries (Chisolm-Straker et al., 2019, p. 72; Department of Homeland Security, 2020; Vera Institute of Justice, 2014, p. 6). Most clinicians fail to recognize HT victims (Egyud et al., 2017; Leslie, 2018; Mason, 2018; McDow & Dols, 2020; Mostajabian et al., 2019; Patient Safety Monitor Journal, 2017; Stevens & Dinkle, 2020). This policy brief’s purpose is to provide health …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Type 2 Diabetic Education Benchmark Study, Amy Lynd

MSN Capstone Projects

Evaluating the implementation of verbal and written education on diet for newly diagnosed type 2 diabetics.

Implementation Of Comprehensive Footcare Program Within Primary Care, Moses Ademola-Ojo

Doctor of Nursing Practice

The incidence of diabetes and its complications is escalating, with over 34.2 million adults in the US having diabetes (CDC, 2020). Despite a decade-long decline in lower-extremity amputations, the incidence is growing (Nichols, 2019), with little emphasis on preventive foot evaluations within primary care. The purpose of this project was the implementation of a multi-faceted program aimed at early identification of lower extremity complications with focused patient education, improved assessment, and documentation, and referral for specialty care. The intervention process included staff training, patient education, foot examination, monofilament testing, pinprick tests, ankle reflex, and tuning fork test. Foot abnormality, loss …

Formalizing An Obstetrical Program For High-Risk Patients: Focus—Diabetes During Pregnancy, Valeria Jimenez

Doctor of Nursing Practice

Within the last 10 years, the number of pregnant women with gestational diabetes increased 56%, and the number of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (CDC, 2018). The management of a pregnancy complicated by diabetes involves a multidisciplinary approach, medical nutrition therapy, glycemic control, and occasionally, pharmacological therapies (Nurain et al., 2019). In 2017, the total cost of diabetes in the United States was $237 billion (Riddle & Herman, 2018). The purpose of this DNP project was to standardize a Federally Qualified Health Care’s (FQHC) High-Risk Obstetrical (OB) Initiative, which attempted to provide in-person …

Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue

Doctor of Nursing Practice

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …

Expansion Of A Comprehensive And Standardized Well-Woman Exam Program In A University-Based Clinic, Gabriela Trevino

Doctor of Nursing Practice

Background. Well-woman exams are an opportunity for women to receive focused screening, counseling, education, and care from a healthcare provider. Studies have found that 68% of women received well-woman exams between 2010 and 2016. During COVID-19 well-woman exams decreased by 80% in the United States. Standardized, comprehensive exams facilitate identification of the need for lifesaving care. Objective(s). The purpose of this quality improvement project was to expand a comprehensive and standardized well-woman exam program in a university-based clinic. Methods. Processes were implemented to promote well-woman exams, patient comfort measures, and completion of an evidence-based standardized comprehensive exam …

Discerning The True Dilemma Of Diabetes Among Hispanics, Ramon Ponce

Nursing | Senior Theses

There is a common misconception that the primary role of nurses is to follow doctors’ orders and treat patients who are currently suffering and experiencing pain. Chronic illnesses such as diabetes can be prevented and better managed if the population who is greatest at risk is better informed and educated on the disease. Different cultures and ethnicities have different foods that unfortunately puts them at risk to get diabetes. Hispanics typically follow a diet that is high in carbohydrates, saturated fats, and sugars that greatly contribute to the development of diabetes. Often, Hispanics are not educated enough to comprehend the …

The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray

Nursing | Senior Theses

Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …

Medication Reconciliation In The Elderly, Tina L. Coen

MSN Capstone Projects

Medication reconciliation is a practice that is underutilized in hospitals and primary care settings, and as a result the geriatric population is experiencing frequent ER visits and hospital readmission's. The geriatric population is subject to injury due to medication errors more than any other group. Medication reconciliation is an important part of safely caring for the geriatric population and can decrease the number of inappropriate medications that are prescribed. (Moro, 2016)

Improving The Early Detection And Management Of Peripheral Artery Disease In Patients With Diabetes Within The Primary Care Setting, Julyssa Amanda Rodriguez

Doctor of Nursing Practice

Background. Diabetes is a significant risk factor for peripheral artery disease. Individuals with diabetes, greater than 50 years of age, having at least one other risk factor should be screened for peripheral artery disease with an ankle brachial index. Purpose. Improve detection and management of peripheral artery disease in persons with diabetes within primary care. Evidence. Individuals with diabetes and peripheral artery disease have an increased risk of adverse cardiac and limb events, impairing the patient’s quality of life and causing long-term disability (Berger & Newman, 2020). Methods. During a 10-week period, these processes were implemented: (a) screening all patients …

Stress As A Contributing Factor For Pediatric Obesity: Literature Review And Internship Experience, Jessica Handley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article is an examination of how stress drives diet and physical activity behaviors that contribute to pediatric obesity in the United States. An increasing rate of childhood obesity is being reported in the United States and therefore a multitude of studies and reviews have been conducted on the topic. This review of the literature systematically analyzes how stress, diet, and physical activity behaviors contribute to this rising rate of pediatric obesity. An analysis of the chosen articles for review indicates that stress and its counterpart (resilience) tend to be driving forces in how American children and adolescents participate in …

Bullying Experiences Among Families And Children With Autism Spectrum Disorder, Developmental Delay, Or Varying Ethnicities, Emma Humphrey

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Bullying perpetration in schools is a significant problem within the United States that has shown to increase mental health issues and adverse outcomes in children. The purpose of this extended literature review is to evaluate the significance of bullying in children with developmental delay (autism spectrum disorder) and majority and minority ethnic groups. The review of literature analyzes implications of bullying within these vulnerable populations and the family factors associated with peer victimization. An analysis from twenty peer-reviewed chosen articles reflects heightened levels of bullying, mental health problems, and negative experiences of all researched populations. The increased amount of victimization …

Cardiac Rehabilitation Benchmark Study, Catherine Cottle

MSN Capstone Projects

This benchmark study attempts to evaluate the effectiveness of cardiac rehabilitation in reducing mortality and hospital readmission rates of post-myocardial infarction patients. Several peer-reviewed articles were reviewed assessing the efficacy of cardiac rehabilitation. It was discovered that cardiac rehabilitation reduced several negative effects regarding heart disease, including the reduction of mortality and hospital readmission rates.

Development And Implementation Of An Evidence-Based Guideline For Spinal Cord Injury/Disorder Patients Requiring Colonoscopy, Tanya D. Young

Student Scholarly Projects

Practice Problem: Colorectal cancer is one of the leading causes of preventable cancer death in the United States. Spinal cord injury/disorder (SCI/D) patients present with unique challenges for maximizing bowel prep and successful attainment of screening and therapeutic colonoscopy procedures. Current practice for bowel prep regimens does not take into consideration the specific needs of the SCI/D population resulting in significant patient dissatisfaction.

PICOT: The PICOT question that guided this project was in adult patients with spinal cord injuries/disorders requiring colonoscopy (P), how does the development and implementation of evidence-based guidelines for the care of the spinal cord injury/disorder patient …

Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson

Electronic Theses and Dissertations

Abstract

Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …

Loneliness, Social Isolation, And Their Connection To Overall Health Across The Lifespan, Paige Miller

Senior Honors Theses

Due to recent circumstances, the incidence of loneliness and social isolation has skyrocketed. Fortunately, there have already been countless studies examining the longer-term implications of these two factors on health. Loneliness and social isolation have been found to impact cardiovascular health, stress response, immune function, resilience, mental health, attachment, spiritual health, and many other determinants of health. A variety of research was examined outlining the psychological implications of loneliness and social isolation. These factors also influence physiological processes and can exacerbate a variety of diseases. After presentation of this evidence, a collection of possible interventions will be discussed, and their …

Improving Data Collection And Documentation In A Post-Discharge Follow-Up Phone Call Program, Lindsay Horihan, Tasha Flicek

Nursing DNP Projects

Purpose and Rationale: The purpose of this project is to improve a post-discharge follow-up phone call program by creating evidence-based methods of collecting, documenting, and analyzing data that will provide insight of the program’s impact on patient and process outcomes. There was sufficient evidence to support the use of follow-up phone calls as an effective method to limit hospital readmissions within thirty days of being discharged. The literature also revealed patient and process outcomes to be measured as a final step in the program and to provide data for ongoing process improvement. Practice Change and Implementation Strategies: The current phone …

Breaking Down The Impact Of Resilience On Mental Health: An Analysis Utilizing The Resilience Scale For Adults, Sydney K. Cook

The Journal of Purdue Undergraduate Research

Resilience is the capacity to recover quickly from difficulties, and previous studies have determined that resilience has a relationship with mental health. However, the association of each aspect of resilience on mental health, depression, and adverse childhood events (ACEs) have not been closely examined. Discerning which aspects of resilience are associated with mental health issues, depression, and ACEs can help psychiatric nurses determine effective treatments and interventions for at-risk patients.

One hundred ninety-five community-dwelling participants (ages 18 to 89) were invited to Purdue University in Indiana and Scripps College in California for the study. Participants completed the Resilience Scale for …

Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic

Electronic Thesis and Dissertation Repository

Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …

The Effects Of A Faith-Based Diabetes Program For African Americans, Pandora Goode

International Journal of Faith Community Nursing

Purpose: The purpose of the study was to pilot test the effectiveness of a diabetes self-management program for African Americans with Type 2 Diabetes (T2D) in a group format in a faith-based setting. The rationale for the study was to create appropriate diabetes education in response to the growing diabetes prevalence among African Americans. The investigator hypothesized that after completing a 12-week program, participants would have improved diabetes knowledge, self-management practices, hemoglobin A1C, and an increase in self-efficacy. By reaching these goals, this program would contribute to one of the Healthy People 2020 objectives of increasing the proportion of …