Medicine and Health Sciences Commons^™

The Impact Of Patient And Provider Education On Statin Therapy Initiation And Adherence In Type Ii Diabetics, Jane Harlan Bsn-Rn, Lindsey Jacobsen Bsn-Rn, Emily Easterly Bsn-Rn, Mitch King Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus (T2DM) is a common, chronic disease that increases the risk of coronary artery disease and stroke fourfold, which makes protecting cardiac function a priority. The American Diabetes Association (ADA) and American Heart Association (AHA) recommend the prescription of statins to reduce cardiovascular complications. Unfortunately, provider and patient adherence to this recommendation is poor.This study aimed to determine if shared-decision making and patient follow-up within a 6 month period of being newly diagnosed with T2D has an effect on the initiation rate of statin therapy.

Methods

In this retrospective study we requested data from the University …

Implementation Of A Continuing Education Module On Triage Practices For Pediatric Emergency Room Nurses, Catherine Nicholson, Lindsey Lakas, Marian Malone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: More than 35 million U.S. children visit the emergency department (ED) each year. Triage is the family’s first interaction with the healthcare team and a crucial component of care that directs the course of the ED visit. The use of standardized triage protocols, like the Emergency Severity Index (ESI) algorithm, is shown to improve overall patient health outcomes in the pediatric ED. For triage algorithms to be safe and effective, continuing education for pediatric ED nurses is important.

LOCAL PROBLEM: Patients at a local pediatric emergency department are being inaccurately triaged - assigned a higher or lower acuity level …

Implementation Of Standardized Contraceptive Education To Improve Larc Initiation In Postpartum Individuals, Gracie E Clayton, Melissa M. Hessock, Amanda Flood

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Approximately 50% of pregnancies in the United States are unintended, leading to negative health, psychosocial, and financial outcomes. Supported methods for preventing unintended pregnancies are promoting education and access to highly effective contraceptive methods, including long-acting reversible contraceptives (LARCs). Studies demonstrate counselor knowledge and bias contribute to underutilization of LARCs, highlighting the need for standardized education.

LOCAL PROBLEM: The setting for this practice improvement project was a rural obstetrical unit in Tennessee where there was no standardized postpartum contraceptive education. Rates of contraceptive use at postpartum discharge were low. The purpose of this project was to implement …

Reducing Hopelessness In Patients With Parkinson’S Disease: Educational Intervention, Kara R. Callear, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Reducing Hopelessness in Patients with Parkinson’s Disease: Educational Intervention

BACKGROUND: Parkinson’s disease (PD), features several non-motor manifestations, including cognitive dysfunction, which impacts patients and their families. Depression, hopelessness, and anxiety are all prevalent in the psychiatric conditions of PD. In fact, at least 50% of those diagnosed with PD will experience some sort of depression, hopelessness, or anxiety disorder after diagnosis (Ray & Agarwal, 2020). The specific purpose of this project was to help patients with PD diagnosis feel less hopeless and more resilient when coping with their symptoms of PD.

LOCAL PROBLEM: The project setting was a …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Application Of Teaching Regarding Injury Appearance In Darker Pigmented Skin Patients: A Quality Improvement Project, Tiffany Akiba

DNP Projects

Significance and Background: The skin is the largest organ of our body, and skin injury prevention begins with accurately inspecting skin. Current practices stress on looking for any signs of redness which often signify that the skin is possibly injured or compromised. However, darker skin tones do not appear red when injured. Assessing for redness is a practice that is suited better for lighter skin tones.

Purpose: Provide education to providers on current skin assessment practices of darker skin tones.

Methods: The IHI Model of Improvement was used for this project, and the Plan-Do-Study-Act cycle was used to test for …

Screening For Maternal Postpartum Depression In The Pediatric Primary Care Setting: An Educational Project, Mischelle M. Young, Dr. Robert Cornette, Dr. Lisa Padgett

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

The birth of a baby can bring about an array of powerful emotions that range from joy and excitement to feelings of anxiety, worry, and depression. A majority of mothers experience postpartum baby blues which normally begins 2-3 days after delivery and can last for up to 2-3 weeks, but some mothers experience a more severe form known as postpartum depression (PPD). PPD can be mistaken for baby blues at first, but the signs and symptoms do not diminish and can continue to worsen. Postpartum depression signs and symptoms include withdrawing from friends and family, severe mood swings, excessive …

Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective

To improve cultural competency levels of registered nurses on the Mother/Baby unit by educating nurses.

Background

Demographics are shifting in the U.S. with an increase in minority populations. Research has revealed insufficient education or a complete absence of education, resulting in nurses that are not equipped to adequately care for culturally diverse patients.

Methods

The Evidence-Based Practice Improvement (EBPI) Model guided the development and implementation of the project. A cultural competence education module was developed utilizing resources from the U.S. Department of Health and Human Services. Outcomes were measured using a pretest/posttest design tool, the Inventory for Assessing the …

Cocreation In Health Workforce Planning To Shape The Future Of The Health Care System In The Philippines, Harvy Joy Liwanag, Jhanna Uy, Mary Ruth Politico, Mary Joy Padilla, Ma. Catherine Arzobal, Kaycee Manuel, Angeli Loren Cagouia, Pretchell Tolentino, Annika Frahsa, Kenneth Ronquillo

Health Sciences Faculty Publications

Background

The Philippines passed landmark legislation in 2019 on universal health coverage, including reforms in the development of its health workforce, an essential building block of responsive health care systems.

Health Workforce Planning Cocreation Process

We based our planning process on a model of cocreation defined as sharing power and decision making to solve problems collaboratively and build consensus around action. Through cocreation with policy makers, researchers, and other stakeholders, we performed projection studies on 10 selected health professions and estimated the need for primary care at national and subnational levels, which was the most extensive health workforce projection carried …

Educational Intervention To Increase Confidence And Knowledge Of Pediatric Nurses Caring For Pediatric Mental Health Patients, Alexa M. Wroblewski, Allyson Neal, Janie R. Holmes

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Given the rise in the mental health crisis, there is an increase of non-psychiatric nurses caring for pediatric mental health patients. This crisis leads nurses to experience feelings of doubt, hopelessness, stress, and insecurities in caring for this population. These feelings, combined with a lack of support and training, create a powerlessness loop of care. Local problem: In a Pediatric ICU, there is a lack of training and resources available to the nurses caring for pediatric mental health patients. Despite the lack of training, 35% of total admissions in 2020 were pediatric patients experiencing an acute mental health crisis. …

Reducing The Stigma Of Nurses In Recovery: Substance Use Disorder And Alternative-To-Discipline Program Education For Nurses, Daniel Paul Del Toro, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Decades of previous studies suggest that approximately 10-15% of all actively licensed nurses in the United States may be impaired by or in recovery from alcohol or other drug addiction. As a result of the COVID-19 pandemic, medical professionals are experiencing unprecedented amounts of stress, fatigue and emotional distress that when coupled with poor coping mechanisms and easily accessible addictive substances may result in an increased risk for developing substance use disorder. By providing education to nurses regarding substance use disorder (SUD) and alternative to discipline programs (ADP), previous studies have shown that the risk of nurses developing SUD can …

Pharmacists Role In Preventing Drug Abuse, Renae L. Wilson

College of Pharmacy Student Research

In 2019, there were approximately 332,000 pharmacists active in the US workforce, Data USA, 2019. A survey of 1,700 American adults, discovered, that 34% of Americans still rely on healthcare providers such as pharmacists, for information in relation their health, KRC Research, 2018. Pharmacists are one of the three most trusted health care professions and were found to be the second most trusted source for health information by Americans in 2005. Blendon et al., 2006 found, that information from pharmacist was trusted by 67%, of participants in their survey. One of the oaths pledged by pharmacist is, ‘ …

Pediatric Palliative Care Training To Advance Nurses’ Knowledge And Increase Patient Referrals, Whitney Lynn Stone, Lisa Merritt, Tammy Childers

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: The purpose of this evidence-based practice quality improvement project was to implement an educational intervention to improve pediatric palliative care services in a Pediatric Intensive Care Unit (PICU). The goal was to improve nurses’ knowledge of palliative care and increase the number of palliative care consults.

Methods: Educational sessions were created using the End-of-Life Nursing Education Consortium (ELNEC) Pediatric Curriculum. Participants included 46 PICU nurses. Knowledge of palliative care was measured at three timepoints; pre-, immediately post- and four weeks post-intervention. The number of palliative care referrals were measured at two timepoints; three months pre- and three months post-intervention. …

Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: By reviewing multiple studies related to the treatment of patients with new diagnoses of diabetes, this scoping review will endeavor to determine which interventions, when implemented for patients over 50 years old which are newly diagnosed with type 2 diabetes, can decrease the likelihood of hospital readmission related to diabetes within 90 days when compared with those patients who did not receive or participate in follow-up.

Methods: For resources to be eligible to review they had to be from 2015 or after. Studies selected included patients over the age of 50 newly diagnosed with type 2 diabetes subject to …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

The Use Of A Peanut Ball During Labor In Nulliparous Term Singleton Vertex Pregnancies To Decrease The Primary Cesarean Rate: An Evidence-Based Practice Improvement Project, Megan Elizabeth Honaker, Tracy L. Brewer, Melissa Nursing Hessock

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Current statistics indicate cesarean section rates in nulliparous term singleton vertex (NTSV) pregnancies, a singleton first pregnancy > 37 weeks’ gestation in a vertex position, of 32.8% and rising. A peanut ball, a tool used to optimize pelvic opening and fetal head rotation, can decrease labor length and cesarean section rates. The aim of this evidence-based practice improvement project was to reduce the cesarean rate in NTSV pregnancies by 1% within three months. The project occurred in an urban 12-bed labor and delivery unit in Middle Tennessee. Participants included laboring women meeting NTSV criteria. METHOD: Plan- do- study- act cycles …

White Coats For Black And Indigenous Lives, White Coats For Black And Indigenous Lives Coalition

Coalition Demands

A presentation that was shared at the WC4BIL General Body meeting on Monday,12 April. The presentation was initially given at the Health Professions Symposium on Saturday, March 6th, 2021.

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Healthstream Orientation Assignment Process Improvements, Mary Jane Krebs, Melissa Gattine, Hannah Pelletier

MaineHealth Maine Medical Center

Problem/Impact Statement: The Training and Development Center (TDC) has seen increased use of HealthStream Learning Center (HLC) for new user assignments. In CY 2017 there were 359 new students from 64 departments with 89 different job titles. This volume requires significant resources to manually add orientation assignments, with risk of error in student entry and assignment accuracy.

Survey Of Certified Asthma Educator (Ae-C) Pharmacists – Who Are They And How Is This Credential Being Used?, Timothy R. Hudd, Susan G. Bollmeier, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

Objective: A survey was developed and distributed to pharmacists who have earned the certified asthma educator credential (AE-C) to assess asthma education services provided and their perceived value of the AE-C.

Design: A 28 item survey was developed, pretested and distributed electronically.

Participants: 224 AE-C certified pharmacists practicing within the United States were invited to participate.

Main Outcome Measures: Information pertaining to the level of education, professional affiliations, and practice setting was collected along with other demographic attributes.We also inquired about the types of asthma education services provided, related clinical activities, and whether AE-C pharmacists or …

International Classification Of Diseases, Tenth Revision, Clinical Modification And Procedure Coding System And Clinical Documentation Improvement, Margaret L. Possel

Applied Research Projects

Today, the International Classification of Diseases, Ninth Revision, Clinical Modification is more than 35 years old and there is a great need for the United States of America to implement the International Classification of Diseases, Tenth Revision. The International Classification of Diseases, Tenth Revision has two parts: The International Classification of Diseases, Tenth Revision, Clinical Modification for diagnosis codes and The International Classification of Diseases, Tenth Revision, Procedure Coding System for inpatient procedure codes. Both classification systems incorporate greater specificity, clinical data, and information relevant to ambulatory and to managed-care encounters. With the greater specificity, it is imperative for …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

Identifying Inaccuracies On Emergency Medicine Residency Applications., Eric D Katz, Lee Shockley, Lawrence Kass, David Howes, Janis P Tupesis, Christopher Weaver, Osman R Sayan, Victoria Hogan, Jason Begue, Diamond Vrocher, Jackie Frazer, Timothy Evans, Gene Hern, Ralph Riviello, Antonio Rivera, Keith Kinoshita, Edward Ferguson

Department of Emergency Medicine Faculty Papers

BACKGROUND: Previous trials have showed a 10-30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. METHODS: This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans …