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Articles 1 - 30 of 37
Full-Text Articles in Medicine and Health Sciences
Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn
Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn
Doctor of Nursing Practice Final Manuscripts
Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.
Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …
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
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, …
Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint
Doctor of Nursing Practice Final Manuscripts
Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.
Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …
Better Sleep, Brighter Mornings: A Sleep Hygiene Protocol For Older Adults As A Quality-Of-Life Enhancement, Melissa Baltazar
Better Sleep, Brighter Mornings: A Sleep Hygiene Protocol For Older Adults As A Quality-Of-Life Enhancement, Melissa Baltazar
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to emphasize the importance of and educate patients on primary prevention techniques for sleep hygiene to use as a tool to enhance quality of life by increasing patient’s self-reported sleep quality.
Background: Sleep patterns change as we age, however, aging itself is not necessarily a cause of sleep problems. Sleep is one of the most important activities for a person’s health and overall well-being. A growing body of literature shows that not enough sleep and poor sleep quality is associated with hypertension, heart disease, stroke, diabetes, …
Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska
Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska
Doctor of Nursing Practice Final Manuscripts
Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.
Purpose: The purpose of this evidence-based practice project was to implement a …
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Doctor of Nursing Practice Final Manuscripts
Acute care nurses caring for end-of-life (EOL) patients often feel unprepared for and undereducated about this high-need population. According to current literature, many nurses lack adequate training in providing EOL care. This project aimed to improve symptom management of dying patients by providing acute care nurses education about EOL symptom assessment and medication use for symptom management. The revised Iowa model, which emphasizes clinician involvement, guided this evidence-based practice project. Sixteen acute care nurses received 30-minute in-person education, consisting of instruction in EOL symptom assessment and management via use of the CARES (comfort, airway, restlessness, emotional, self-care) tool and basic …
Treatment Evaluation Of Iron Deficiency Anemia In Women Of An Underserved Community, Bukola Olusanya
Treatment Evaluation Of Iron Deficiency Anemia In Women Of An Underserved Community, Bukola Olusanya
Doctor of Nursing Practice Final Manuscripts
Background/Purpose: Iron deficiency anemia (IDA) is the most common micronutrient deficiency globally. More than 20% of women experience IDA during the reproductive year. As the first-line treatment in IDA, oral iron supplement (IOS) is associated with gastrointestinal side (GI) effects, and it is often a barrier to achieving normal hemoglobin (Hb) and serum ferritin (SF) levels. Ineffective treatment fueled by a lack of guidelines increases the dilemma of dosing frequency in primary care, leads to poor quality of life, and increases the burden of anemia.
Intervention: Evidence showed that intermittent OIS is as effective as daily dosing. It is associated …
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher
Doctor of Nursing Practice Final Manuscripts
Pancreatic cancer remains one of the most complex and lethal diseases worldwide with surgical resection as a major treatment choice. Although surgery may be one of the only options for advanced pancreatic cancer, it is not without a lengthy hospital stay, a long list of possible postoperative complications, and an increased risk for readmission after discharge. Enhanced recovery after surgery (ERAS) programs have been implemented for years in other surgical services for cancer care. These programs have now been extended and researched to include patients undergoing surgery for pancreatic cancer. These programs are designed to assist patients and their families …
Development Of A Nurse Practitioner Driven Program For Cardiology Providers To Increase Knowledge And Awareness Of Neurodevelopmental Assessment Needs In Children With Congenital Heart Defects, Michele Readman
Doctor of Nursing Practice Final Manuscripts
Children diagnosed with congenital heart defects are at increased risk for neurodevelopmental delays. Timely referral of patients to a neurodevelopmental clinic for initial evaluation and referrals to support services can improve learning outcomes, provide early intervention for neurodevelopmental disorders, and mediate factors affecting low quality of life. Nationally, a substantial proportion of pediatric cardiologists are not referring children for neurodevelopmental evaluation. A review of patient referrals to a Cardiac Neurodevelopmental Clinic within an urban children’s hospital demonstrated an opportunity to improve provider awareness and knowledge of referral recommendations. Using the Iowa Model of Evidence-Based Practice to Promote Quality Care, an …
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
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 …
Deprescribing In The Hospice Population, Who Is Eligible And Who Is Agreeable: A Quality Improvement Project, Ashlee Nicole Smith
Deprescribing In The Hospice Population, Who Is Eligible And Who Is Agreeable: A Quality Improvement Project, Ashlee Nicole Smith
Doctor of Nursing Practice Final Manuscripts
Current evidence recommends and supports deprescribing medications to reduce polypharmacy in the hospice population. The project aim was to determine accurate percentages of deprescribing at three time periods: before hospice admission, at hospice enrollment, and four weeks post hospice enrollment. This project was a retrospective review of the medication administration record (MAR) of patients admitted into Sharp Hospice from a Sharp Healthcare facility. Sharp Hospice, in California, USA, admitted 164 patients during August 2020. Of those, 34 patients were eligible for inclusion in this retrospective quality improvement review. Prior to discharge from a Sharp facility, the percentage of target medications …
Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht
Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht
Doctor of Nursing Practice Final Manuscripts
Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.
Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy
Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy
Doctor of Nursing Practice Final Manuscripts
About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …
Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek
Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek
Doctor of Nursing Practice Final Manuscripts
Eczema, or atopic dermatitis, is a complex and chronic condition that affects approximately 10% of children throughout the United States (Brown et al., 2018). The American Academy of Allergy Asthma & Immunology (AAAAI) (2017) estimates the average cost of eczema management for each patient is approximately $3,302 per year. The complex nature of atopic dermatitis indicates a need for individualized treatment plans. Research has shown that standardized patient teaching, written education materials, and Eczema Action Plans (EAP) reinforce patient teaching, parental understanding, and improve quality of life. This evidence-based practice (EBP) project introduces the use of a written Eczema Action …
Sunscreen Use And Screening In College Athletes: An Evidence-Based Pilot Project, Nicole Brustkern Bsn, Rn, Cpn, Sharon Boothe-Kepple Phd, Msn, Fnp-C, Phn (Chickasaw)
Sunscreen Use And Screening In College Athletes: An Evidence-Based Pilot Project, Nicole Brustkern Bsn, Rn, Cpn, Sharon Boothe-Kepple Phd, Msn, Fnp-C, Phn (Chickasaw)
Doctor of Nursing Practice Final Manuscripts
Background: Melanoma is the third most common cancer in individuals ages 15 – 29. The greatest risk for melanoma is ultraviolet (UV) radiation from the sun. Collegiate athletes are exposed to 1,000 more sun hours per year than the average adult, placing them at higher risk for melanoma. Evidence supports sunscreen education and screening to promote protective behaviors in young adults.
Objective: This evidence-based pilot project implements the standardized screening of sunscreen use and sun protective behaviors in women’s soccer players ages 18 to 21 years old at the University of San Diego.
Methods: The Sun Exposure and Protection Index …
Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd
Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd
Doctor of Nursing Practice Final Manuscripts
Purpose of Project: The ultimate goal of this short-term pilot project is for
overweight or obese osteoarthritis patients to increase their knowledge on the benefits of
weight loss and physical activity. Research shows that for every kilogram of weight lost,
2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to
thirty to fifty percent and improve quality of life. Following education from the provider,
patients will understand the correlation of osteoarthritis symptom management with
weight loss.
EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based
Practice to Promote Quality Care. This addresses …
Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel
Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel
Doctor of Nursing Practice Final Manuscripts
Abstract
Background
Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.
Methods:
Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Doctor of Nursing Practice Final Manuscripts
Abstract
The literature is clear that the diagnosis, treatment, and plan of care for hypertension in adults should rely, at least in part, on ambulatory blood pressure. Using in-office blood pressures alone risks inaccurate measurements and can result in inappropriate treatments. Many clinics, however, do not adhere to this recommendation and will fall back on clinic readings which puts the patient at risk of mismanaged hypertension and polypharmacy. This project was formulated to identify the extent to which hypertensive patients were diagnosed and managed without the use of home blood pressure monitoring in a small local community clinic. This …
Impact Of Psychotropic Medications On Electrical Cardiac Conduction In The Emergency Department: A Best Practice Review, Juliann Hatt
Impact Of Psychotropic Medications On Electrical Cardiac Conduction In The Emergency Department: A Best Practice Review, Juliann Hatt
Doctor of Nursing Practice Final Manuscripts
Abstract Background: The effects of psychotropic drugs on cardiac repolarization have increasingly gained attention in research and clinical practice over the last 2 decades. The absolute risk of cardiac arrhythmia, such as the polymorphic ventricular tachycardia, Torsades de Pointes (TdP), is low (14 per 10,000 patients/year) and sudden cardiac death as a consequence of all cardiac arrhythmias is less frequent (Braillon et al., 2017). TdP can occur at therapeutic doses of second-generation antipsychotics and antidepressants and with a corrected Q-T (QTc) interval >500 ms. Many psychotropic medications can delay cardiac repolarization thereby producing prolonged QTc in the electrocardiogram (ECG). Emergency …
Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …
Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Nienke Sahelijo Bsn, Rn, Dnp-Fnp Student, Kori Fitzgerald Dnp, Fnp-C, Joseph F. Burkard Dncs, Crna
Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Nienke Sahelijo Bsn, Rn, Dnp-Fnp Student, Kori Fitzgerald Dnp, Fnp-C, Joseph F. Burkard Dncs, Crna
Doctor of Nursing Practice Final Manuscripts
Objectives: Palliative care services constitute a vital part of the oncology treatment plan. Much of the suffering associated directly with cancer itself or as a result of treatments can be mitigated with the early incorporation of palliative services. Unfortunately, access to palliative care remains elusive due to a lack of qualified providers. This evidence-based project was implemented in an effort to address gaps in care for advanced cancer patients. The goal was to provide telehealth visits for follow-up of stable patients to manage symptoms and psychosocial challenges with equivalent or improved satisfaction as compared to their last in-office visit …
Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti
Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti
Doctor of Nursing Practice Final Manuscripts
Abstract
Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a …
Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez Bsn, Rn, Dnp - Fnp/Agnp Student
Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez Bsn, Rn, Dnp - Fnp/Agnp Student
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led standardized dry skin protocol for outpatient geriatric patients to promote overall well-being and improve quality of life.
Background: Current literature supports using the dry skin protocol to help primary care teams identify patients that require xerosis cutis skin care, particularly of the lower extremities. The primary focus of this project will be timely detection of patients with the dry skin condition that will be identified with the standardized Overall Dry Skin (ODS) scale. When the patient meets the ODS criteria, a timely discussion will be …
Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose
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 …
Comprehensive Sleep Apnea Screening In Veterans With Posttraumatic Stress Disorder, Richard W. Schulz
Comprehensive Sleep Apnea Screening In Veterans With Posttraumatic Stress Disorder, Richard W. Schulz
Doctor of Nursing Practice Final Manuscripts
Objectives: Recent studies have shown a higher prevalence of sleep apnea in veterans with Posttraumatic Stress Disorder (PTSD). It is estimated that 69 to 83% of veterans have Obstructive Sleep Apnea (OSA) while 80 to 90% are undiagnosed or untreated. Untreated OSA can lead to severe chronic medical conditions as well as impairment of neurocognitive and fear extinction processing potentially decreasing responsiveness to trauma focused therapy. Despite the widespread dissemination of knowledge regarding the negative effects of OSA, many veterans are not screened. The goal of this project is to increase the rate of identifying veterans who are high-risk for …
Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Kori Fitzgerald Bsn, Rn, Phn, Fnp/Dnp Student
Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Kori Fitzgerald Bsn, Rn, Phn, Fnp/Dnp Student
Doctor of Nursing Practice Final Manuscripts
Title: Utilization of Telehealth for Palliative Care Follow-up Visits
Background: A vital part of cancer management is the implementation and integration of palliative care, to prevent and relieve suffering and to improve quality of life for patients with serious chronic illness. However, access to palliative care services continues to be inadequate. There is a nationwide shortage of skilled palliative providers and the supply is insufficient to meet the growing demand.
Purpose of Project: Implementing telehealth visits with palliative care patients with advanced cancer at the UCSD Moores Cancer Center has the potential to maintain patient satisfaction with …
Reducing Pediatric Asthma Visits In The Emergency Department, Kathleen Grimley Ahn
Reducing Pediatric Asthma Visits In The Emergency Department, Kathleen Grimley Ahn
Doctor of Nursing Practice Final Manuscripts
Purpose/Aims: The purpose of this project was to reduce the number of unnecessary pediatric asthma management visits to an urban emergency department (ED) by performing a brief action plan for improved National Heart, Lung, and Blood Institute (NHLBI) guideline adherence. This plan was shared with parents during an NP-initiated follow-up phone call.
Rationale/Background: Inadequate outpatient management of pediatric asthma can result in avoidable visits to the ED. Acute exacerbations comprise a large portion of pediatric asthma patients seeking care in the ED. Reasons for persistent under-utilization of outpatient care for asthma management in primary care settings are multifactorial. Daily symptom …
Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio
Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio
Doctor of Nursing Practice Final Manuscripts
The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardized the utilization of an adult traumatic brain injury neuroimaging guideline among advanced practice providers in a rural emergency department. Neuroimaging, specifically computed tomography (CT) scans, help to identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical exam, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase healthcare costs and pose potential cancer risks from radiation exposure. Eight advanced practice providers (i.e., nurse practitioners, …
Implementing Awhonn’S Evidence Based Guidelines For Managing The Second Stage Of Labor, George S. Knapp
Implementing Awhonn’S Evidence Based Guidelines For Managing The Second Stage Of Labor, George S. Knapp
Doctor of Nursing Practice Final Manuscripts
Objective: To improve cesarean rates without worsening perineal tissue integrity or neonatal 5 minute Apgar score. Design: Quality improvement project evaluated with descriptive statistics. Setting: A 24-bed perinatal floor at a general acute care hospital in San Diego County California. Patients: Nulliparous term mothers with a vertex singleton pregnancy (NTSV) with or without epidural anesthesia (EA). Intervention/Measurements: To implement the Association of Women’s Health, Obstetrical, and Neonatal Nurses’ (AWHONN) evidence based clinical practice guidelines, Nursing Care and Management of the Second Stage of Labor and Nursing Care of the Woman Receiving Regional Analgesia/Anesthesia in Labor and measure the outcomes of …
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidenced-based project was to increase chlamydia pre- screening and screening in women under age 25 presenting with urinary symptoms. Interventions included chlamydia pre-screening alerts embedded into the electronic medical record. Three-month evaluation showed a chlamydia pre-screening rate of 100% and an increase in chlamydia screening by 9%.