Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

The Impact Of Healthcare Interprofessional Education On Collaboration., Mya Winjum

Theses/Capstones/Creative Projects

Interprofessional relationships are important to the productivity of healthcare teams, especially as collaborative approaches become increasingly common in the healthcare setting. This paper focuses on the impacts of interprofessionalism and interprofessional education on healthcare teams collaborations. Drawing from a mixed-methods approach, data was gathered through an online survey and interviews conducted at the UNMC GOODLIFE Clinic, a student-run clinic. Findings reveal differences in perceptions between post-graduate professionals and students regarding the role and importance of interprofessionalism. While professionals demonstrate an understanding of IP collaboration, students express a need for more comprehensive IPE. Barriers to effective teamwork, such as professional hierarchies …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Neurodiagnostic Program Director Perceptions On Low Enrollments, Daniella Krantz

Student Dissertations

Higher education enrollments have trended downward over the last several years and fallen further due to the impact of the COVID-19 pandemic. The problem addressed in this study was low student enrollment in neurodiagnostic programs in the United States, resulting in an increasing shortage of neurodiagnostic professionals working in the field. The purpose of this descriptive qualitative study was to explore the perceptions of neurodiagnostic program directors and their views on the low enrollments in neurodiagnostic programs in the United States. A descriptive qualitative design was used to understand the perspectives of these program directors. Human capital theory, the theory …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Spencer Forest

Master's Projects and Capstones

Problem: This quality improvement project aims to increase SEP-1 sepsis bundle compliance among nursing staff at a 16-bed emergency department through targeted continual staff education on sepsis screening and best practices. Currently, the unit is experiencing cases of sepsis fallout and is not meeting the 90% threshold on three treatment metrics as defined by the institutional sepsis bundle time goals. Bundle compliance that adheres to the time goals decreases incidences of sepsis fallout and overall days in the hospital, while increasing positive patient health outcomes.

Context: A microsystem assessment was completed along with a staff gap survey to determine areas …

Support Their Sleep: Enhancing Nurses' Knowledge And Implementation Of Non-Pharmacological Sleep Protocols To Improve Patient Rest, Recovery, And Reduce Cognitive Impairment., David C. Barry

Master's Theses and Capstones

Background: Sleep and rest play an influential role in promoting recovery and healing in humans. Hospitalized patients are at risk for altered sleep from hospitalization, illness, and stimulation from a hospital environment. Non-pharmacologic interventions preformed by nurses can help to improve sleep and sleep environment for patients.

Local problem: There was no protocol or available information regarding patient sleep promotion for nurses to references when caring for patients.

Methods: Nurses in the microsystem (n=8) were administered a pre/post questionnaire containing Likert scales and a short quiz containing knowledge-based questions. Questionnaires were distributed to nurses prior to and after …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Nurse-Led Education On Oral Chemotherapy Medications, Carmen Lucia Glick Alonso

Master's Projects and Capstones

Problem: Breast cancer is one of the leading causes of cancer death among women in the United States. Annually, around 264,000 breast cancer cases are diagnosed in women and 2,400 in men (Centers for Disease Control and Prevention, 2022). According to the American Cancer Society, the risk of a woman in the United States being diagnosed with breast cancer in their life is around 13% (2022).

Context: Along with a cancer diagnosis comes the need to introduce patient education about new oral chemotherapy treatments. As a treatment team member, the oncology nurse plays a vital role in this …

Lgbtq+ Health Disparities: Healthcare Intervention, Kara Steinbrecher

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has carried the burden of countless health disparities throughout its history tied to discrimination, bias, prejudice, and stigma. LGBTQ+ individuals are disproportionately at higher risk for substance abuse, sexually transmitted diseases, cardiovascular disease, mental illness, suicide, and unequal access to healthcare, related to social stigma and bias that exists in healthcare itself. The purpose of this systematic literature review is to analyze existing health disparities among the LGBTQ+ population in the United States and the efficacy of various interventions of health care professionals to reduce them. Twenty-one articles from multiple online …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Ophthalmic Nursing Education: The Key To Unlocking Patient Access To Retina Services, Jacob P. Mcginnis

Master's Theses and Capstones

Background: Ophthalmology, the medical field dedicated to the human eye and visual system infrequently uses nurses due to a lack of nursing knowledge about ophthalmology.

Local Problem: An ophthalmic microsystem in the Northeastern United States is experiencing increased demand for services and decreased access to their retina section. The microsystem does not utilize nurses in the clinic because of education and training barriers. The specific aim of this quality improvement (QI) project is to increase nursing knowledge about ophthalmology from baseline to an overall passing score of 80%.

Methods: This QI project sought to see if registered nurses could …

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Developing Competencies For Public Policy Advocacy: A Comparative Case Analysis, Amy L. Lewis

Electronic Thesis and Dissertation Repository

While health care and social service students in Ontario are expected to graduate with competencies in policy advocacy, the lack of knowledge and skills negatively impacts their participation as licensed providers. This study used an exploratory, comparative case study methodology with a critical theory lens to identify the process of how community-based organizations engaged in public policy advocacy to create educational competencies for undergraduate curricula. Eight organizational leaders participated in semi-structured interviews that were transcribed and analyzed both inductively and deductively using major concepts from Kingdon’s multiple streams theory to distinguish the policy advocacy process and Bloom’s taxonomy to identify …

Ppe Compliance And Knowledge Among Healthcare Staff, Beatrice Hagert, Nicole Krummel

Nursing DNP Projects

Abstract

Problem: One of the most important steps in infection prevention is the use of personal protective equipment (PPE) to protect patients and staff from infectious agents; yet, research indicates that PPE compliance remains suboptimal in many healthcare institutions.

Purpose: To identify the effect of a multidisciplinary education campaign on PPE compliance and knowledge among healthcare workers (HCWs) on a rehabilitation unit of a large, midwestern teaching hospital.

Methods: This project utilized pre-intervention observational audits and a survey to determine baseline PPE compliance and knowledge on the piloted units. A post-intervention survey was sent to HCW to assess for a …

Sepsis Screening Education, Brittany R. Horn

Doctor of Nursing Practice Scholarly Project

Sepsis is a significant burden to the healthcare field with 1.7 million Americans annually diagnosed with this condition. Earlier diagnosis and treatment are the most effective ways of reducing morbidity and mortality related to sepsis. The current sepsis screening tool in place at Stormont-Vail Hospital, in Topeka, Kansas, is the systemic inflammatory response (SIRS) criteria; however, this screening tool has proven to be less effective than other screening tools available. The screening tools proven more effective than the SIRS criteria, are the quick sequential organ failure assessment (qSOFA) and the sequential organ failure assessment (SOFA). For this project, nursing staff …

Education For Health Care Providers: Medical Cannabis, Morgan C. Rohl

Theses and Graduate Projects

Health care providers are consistently unaware of the implications, efficacy, and resources correlated with medical cannabis and cannabidiol. Thus, patients are uninformed about medical cannabis as a treatment option for their qualifying conditions. Informative educational sessions present a method to facilitate specialty knowledge development regarding medical cannabis and cannabidiol. In this scholarly project, six nurse practitioners and two allied staff members, attended a PowerPoint presentation followed by an open discussion regarding cannabinoids. Examination of post-presentation survey results indicated that felt more informed about the physiology and efficacy of cannabidiol, more aware of the resources for them, and had increased comfort …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Developing An Evidence-Based Mentorship Program For New Graduate Nurse Practitioners, Matthew R. Guy

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose. Excessive job turnover in the novice nurse practitioner (NP) population is a stressful phenomenon for providers, adversely affecting institutional financial performance, and has the potential to lead to poorer health outcomes for the individuals we serve. The purpose of this investigation was to assess the need for the establishment of a structured mentorship program for new graduate nurse practitioners. As an aspect of an institutional quality improvement project, the overall goal is to reduce new graduate NP employment turnover.

Methods. A literature search was conducted in order to appraise and synthesize available knowledge regarding employment turnover and mentorship programs …

Development Of Unit-Specific Educational Interventions For Inpatient Palliative Care Needs, Michael S. Myers

DNP Projects

Purpose: The purpose of this project is to determine the need for palliative care at Norton Women’s and Children’s Hospital as well as assess the knowledge and attitudes of the healthcare workers in that facility concerning palliative and end of life care. Methods: For the purposes of this study, the units of the hospital were divided into four categories: intensive care unit (ICU), progressive care unit (PCU), oncology, and medical surgical. A needs assessment of each type of unit was conducted in two parts. The first part was a retrospective chart review to determine the volume of patients on each …

Graduate Interprofessional Education And Collaborative Practice Experiences: A Phenomenological Inquiry, Jaime Sand

Boise State University Theses and Dissertations

Healthcare reform and the complexities of the healthcare system and chronic disease conditions call for collaborative interdisciplinary team-based care. To enhance these collaborative efforts, universities and facilities are promoting the need for students and professionals to learn and work with others from different healthcare disciplines in an interprofessional manner. Four graduates of undergraduate programs in health sciences, nursing, radiologic sciences, and respiratory care sat for multi-series interviews using a phenomenological approach to share their experiences in interprofessional education and collaborative practice. Participant responses were grouped into themes around the development of a professional identity through personal, educational, and professional healthcare …

Development Of A Delirium Educational Program For Hospital Medicine Providers, Lindsay Erin Stone

Nursing Masters

Hospital medicine providers were surveyed to evaluate baseline delirium attitudes and behaviors. An educational program was then shared, and a follow up survey was given to determine if their delirium attitudes and practices were impacted by the educational intervention. Follow up survey results indicated that providers perceived more of a change in their attitudes than practices, and overall found the education to be useful and felt more confident in treating delirium as a result.

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …