Medicine and Health Sciences Commons^™

Increasing Opioid Abuse Screening In Primary Care Clinic: An Evidence-Based Quality Improvement Project, Carlos Milla

DNP Projects

Introduction

To address substance abuse multiple organizations recommend increase drug abuse screening as part of routine health care. CAGE AID is five-question tool used to screen for drug and alcohol use, answering yes to two or more questions indicates further assessment is advised. Unfortunately, most primary care centers do not use screen for substance abuse using validated instrument tools such as the CAGE-AID tool.

Purpose

The purpose of this evidence-based practice (EBP) project is to implement the CAGE-AID Substance abuse screening tool by nurse practitioners students in a family clinic located in Bridgeport in order to increase to number of …

Implementing A Patient Reported Outcome Measure For Patient With Anemia Of Chronic Kidney Disease (Ckd) In The Outpatient Setting, Marissa Finger

DNP Projects

Introduction: Chronic kidney disease (CKD) is a growing public health concern in the United States. People with CKD suffer from many symptoms that cause distress and low quality of life (QoL). Research has found an association between symptom burden in patients with CKD and the disease's worsening progression. There is little data on ways to monitor and address CKD symptoms routinely.

Purpose: The purpose of this project was to identify symptoms related to advancing kidney disease using patient-reported outcome measures (PROMs) through IPOS-Renal survey and implement a nurse-driven protocol to manage patient reported symptoms.

Interventions/Setting: Over a three-month period at …

Improving Specialist Referrals In Outpatient Primary Care: An Evidence-Based Practice Quality Improvement Project, Kimberly Gaznabie

DNP Projects

Background: In the United States, more than a third of patients receive specialty referrals per year, constituting more than half of outpatient visits. Patients require efficient, immediate referrals for specialty-based treatment plans and the prevention of worsening conditions.

Purpose: This evidence-based practice improvement project aimed to improve the specialty-provider referral system for a community-based outpatient primary care clinic.

The Implementation Of A No-Show And Cancellation Policy In The Primary Care Setting: Quality Improvement Project, Dwayne Hall

DNP Projects

The purpose of this quality improvement project is to evaluate the implementation of a no-show and cancellation policy in an urban out-patient primary care setting. The high occurrence of patient no-shows and cancellations in primary care settings is a persistent problem affecting how efficiently healthcare is delivered. No-shows occur when a patient makes an appointment and does not attend the appointment. It diminishes the practice opportunity to schedule other patients in the missed appointment time slot, thus leading to a loss of revenue. It tends to affect practice resource allocation, thereby worsening the quality of healthcare services. The current problem …

Decreasing Time To Antibiotic Administration In Febrile Neutropenic Adult Oncology Patients In The Emergency Department: An Evidence-Based Quality Improvement Project, Kristin Murray

DNP Projects

Introduction—Significance and Background: Febrile Neutropenia (FN) is the most common and serious complication of hematopoietic cancers and in patients receiving chemotherapy. Patients in this immunocompromised state have weakened immunity to fight off infection and a mortality rate of almost 10%. Thus, Infectious Diseases Society of America has identified the single most important determining factor of outcomes is the timing of antibiotic (TTA) administration and has identified the gold standard to be 60 minutes. Current practice does not follow guidelines and the current policy does not address the urgency of antibiotic administration.

Purpose: The purpose of this project is to improve …

Increasing Patient Satisfaction Of Post-Cesarean Mothers: An Evidence-Based Practice Quality Improvement Project, Amanda Jones

DNP Projects

Introduction: The first hour after delivery, referred to as the “Golden Hour” or “Sacred Hour,” is when the mom, baby, and the support person get 1-hour of uninterrupted bonding time together. This time is critical because it promotes neonatal thermoregulation, decreases newborn stress levels, improves mother–newborn attachment, and encourages breastfeeding. Unfortunately, most cesarean births do not receive the Golden Hour and instead experience delayed bonding time.

Purpose: The purpose of this Evidence-Based Practice (EBP) project was to incorporate the Golden Hour for post-cesarean section mothers in a mid-sized community-based hospital in XXX, CT in order to increase patient satisfaction post-c-section; …

The Use Of Telemedicine In Primary Care To Improve Medication Adherence: Quality Improvement Project, Chadae S. Haffenden-Morrison

DNP Projects

Introduction: Lack of medication adherence, a major issue in healthcare, can be costly to the healthcare system and result in poor patient outcomes. Wong et al. (2020) noted that enhanced involvement with health care professionals using the Telemedicine platform can improve a patient’s medication adherence as well as decrease the use of emergency services and hospitalizations. Telemedicine allows the healthcare provider, to contact the patient through a mobile phone or computer to provide education and reinforcement regarding medication adherence.

Purpose: The purpose of this project was to improve medication adherence and health outcomes, by piloting a quality improvement project using …

Enhancing Depression Screening For The Adolescent Population In The Pediatric Emergency Department By Utilizing The Patient Health Questionnaire: A Quality Improvement Project, Chelsea Alvarez

DNP Projects

Background:

Mental health disparities make up 16% of the global burden of disease and injury in people ages 10-19. Many cases of mental health are unidentified and left untreated. Failure to address mental health disorders in children can lead to poor outcomes of health and well-being. Evidence-based practice supports the utilization of screening tools such as the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adolescents ages 12-18 years.

Objectives:

By implementing the PHQ-9 in the pediatric emergency department, the goals for this quality improvement project were to increase staff knowledge on the PHQ-9, improve staff screening compliance, and to …

Implementation Of A Nurse Driven Palliative Care Consult: A Quality Improvement Project, Socnite Sebourne-Francis

DNP Projects

Background: Palliative care consult (PCC) is an approach that can improve the quality of life and symptom management of patients facing life-threatening illnesses. At a 20-bed medical oncology unit in Connecticut, patients with poor prognosis and worsening symptoms have high re-admission rates within 30 days of post-hospital discharge; yet healthcare providers fail to initiate PCC.

Purpose: This project hypothesizes how implementing a nurse-driven PCC on admission or hospital stays compared to the timing of a physician to a physician PCC improves a plan of care for oncology patients? Will it result in a decrease in 30-day re-admission rates? The …

Improving The Quality Of Burn Care Through Implementation Of The American Burn Association Competencies, Laura Ritter

DNP Projects

Background and Significance: Specialty certification is an important method to demonstrate that nurses possess training, expert knowledge, and skill in a specialty field. The American Burn Association (ABA) and the Burn Nurse Competency Initiative (BNCI) developed 11 competencies that specify the training, expert knowledge, and skills that nurses require for all aspects of burn nursing practice. The ABA and Board of Certification of Emergency Nurses are in the process of developing a burn certification for nurses. They suggest that all burn units begin to adopt these competencies to ensure consistent and competent care.

Purpose: To adopt the ABA …

Pain Assessment Policy Update And Nursing Education On Best Practices For Pain Assessment: A Quality Improvement Project, Jennifer Zhang

DNP Projects

Significance and Background: Chronic pain assessment should focus on patients' functional status, quality of life (QOL), and pain control. A tool to assess pain intensity and biopsychosocial impacts of pain for patients with chronic pain was needed in a Federally Qualified Health Center (FQHC). The Defense and Veterans Pain Rating Scale (DVPRS) incorporates a numeric rating scale with four functional questions on pain interference on ADLs. DVPRS design stimulates communication between patients and providers about their pain, its impact on function, and state of mind. Treatments are focused on making the pain tolerable and optimizing patient function while avoiding unwanted …

Standardizing Naturalistic Teaching Opportunities For Problem-Based Learning In Diabetes Education: A Quality Improvement Project, Austin Mccaslin

DNP Projects

Significance and Background:

Poor diabetes management is linked to serious long and short-term health complications. Despite this, medication adherence is a significant problem in adolescents with type 1 diabetes. Management is further complicated by low socioeconomic status, even when mitigated by free healthcare, highlighting health literacy as a culprit of disparities. Evidence shows that a common barrier for adolescents is proficiency in dose determination. Carbohydrate counting is an integral skill, necessary for attaining glycemic control. At a homecare agency serving adolescents with poorly controlled diabetes by providing oversight of medication administration and education, it was noted that patients continued to …

Improving Heart Failure Patient Referrals To The Center For Advanced Heart Failure & Pulmonary Vascular Disease At Hartford Hospital: A Quality Improvement Project, Dawn M. Surprenant

DNP Projects

Significance and Background: According to the Health Resources & Services Administration (2021), health literacy is the degree to which individuals have the capacity to process and understand basic health information to make appropriate health decisions. Low health literacy is prevalent in populations such as older adults, minorities, and in individuals with lower socioeconomic status and living in medical underserved areas. Recommendations are to access health literacy in cardiac patients, especially in the acute care setting to improve health outcomes upon discharge.

Purpose: To determine whether a health literacy assessment in hospitalized congested heart failure patients, before discharge, will affect referral …

Non-Opioid Pharmacologic Agents In The Treatment Of Non-Cancer Chronic Pain In The Outpatient Setting, Diane Eannotti

DNP Projects

Opioid prescription related overdose deaths have increased substantially with evidence demonstrating only modest short-term benefits in chronic pain and thus represents the need to identify alternative treatments to opioids. A needs assessment performed for a federally qualified community health center revealed patients presently taking non-opioid pharmacologic agents in the treatment of chronic non-cancer pain (CNCP) needed additional education in managing multiple non-opioid medications. A targeted approach at improving patient experience and population health supporting the quadruple aim was undertaken with this project.

Purpose: The purpose of this quality improvement project consisted of performing medication management visits for 28 referred patients …

Implementing A Telephone Follow-Up Process For Patients With Poorly Controlled Type 2 Diabetes: A Nurse-Led Quality Improvement Project, Amber Gomes

DNP Projects

Background: Diabetes is the seventh leading cause of death in America with approximately 1.5 million people diagnosed yearly (ADA, 2020). The current problem in the practice setting is the lack of follow-up of patients with hemoglobin A1c’s (HbA1c’s) 9% or greater. The current workflow utilizes care coordinators to perform patient outreach to patients with diabetes and a HbA1c of 9% or greater. This workflow is not structured and consists of randomly selecting a patient with a HbA1c 9% or greater and placing one phone call to them to provide education.

Purpose: The purpose of the project was to develop and …