Medicine and Health Sciences Commons^™

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …

Opioid Overdose Prevention And Naloxone Training Among College Students, Mackenzie Thode

DNP Scholarly Projects

Background: Opioid abuse is a serious national crisis affecting both public health and economic welfare across the United States. In Tennessee, more than 1,800 overdose deaths were reported in 2018, with nearly 20% of those deaths occurring in Davidson County alone. The number of overdose deaths in Nashville has steadily risen amidst the COVID-19 pandemic by approximately 32% since 2019 to a total of 619 fatal overdoses in 2020, making it the city’s deadliest year on record. Review of evidence: Research shows that intranasal (IN) naloxone training is an effective approach to combating the opioid overdose crisis and can be …

Integrating The Concept Of Trauma Into An Undergraduate Nursing Curriculum, Jacey Walker

DNP Scholarly Projects

Adverse childhood experiences, or ACEs, are early childhood traumas such as abuse, neglect or household dysfunction that can cause chronic physical and mental health problems across the lifespan. Approximately 61% of the adults in the United States have experienced ACEs. The prevalence of ACEs among nurses is at least comparable to population prevalence, and rates may be higher in subpopulations of individuals who work in helping professions. The stressful and highly interpersonal nature of nursing work may exacerbate and compound the health impacts of a nurse’s underlying ACEs, affecting not only the nurse’s health, but also his or her work …

Impact Of A Telephone-Based Care Management Program On Health Outcomes For Patients With Type 2 Diabetes And Hypertension, Abbegail Miller

DNP Scholarly Projects

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) were the 7th leading cause of death in the United States, accounting for over 160,000 deaths annually. Complications related to T2DM and HTN are preventable with lifestyle modifications and medications. However, research has shown that lack of patient self-management, poor medication adherence, and physician time restraints limit disease improvement. A telephone-based care management program (CMP) provides a solution to meeting patient needs. Purpose: The purpose of this scholarly project was to evaluate individual biomarkers for glycemic and HTN control, as well as self-monitoring of blood glucose (SMBG) over one year of …

Self-Reliance And Self-Efficacy As Determinants Of Mental Health Treatment Seeking Intention In A Sample Of Student Service Members/Veterans, Leigh Holdsambeck

DNP Scholarly Projects

Problem Statement: High rates of mental illness and poor treatment seeking have plagued the military for decades. As an organization that demands resilience, sacrifice, strength, and courage from its members, many servicemembers develop deep-seated self-reliance and self-efficacy. Though essential in many critical situations, these traits often complicate a servicemember's willingness to seek care for a mental health concern. Student servicemembers/veterans (SSM/Vs) are at an increased risk for poor mental health outcomes owing to the compounded stressors of military service and academia. Purpose: To measure the impact of elements of military service, namely self-reliance and self-efficacy, on mental health …

Exploring The Impact Of Care Delivery On Families Of Children With Medical Complexity, Shelby Pawlowski

DNP Scholarly Projects

Background: Children with medical complexity (CMC) are considered most medically fragile and require the most health care needs. Medical care for CMC is described as fragmented, uncoordinated, and crisis-driven with a tendency to over-medicalize the child and under-support the family. The intimate link between caregiver and child health supports further exploration of factors that may influence family health-related quality of life (FHRQOL) in families of CMC. Purpose: The purpose was description of the population of CMC receiving rehabilitation services in the community setting and exploration of the impact of a comprehensive outpatient rehabilitation facility (CORF) on FHRQOL. Review of Evidence: …

Rn Perception Of Resources, Communication, And Leadership During Covid-19 And The Impact On Rn Satisfaction And Turnover In A Multi-Hospital System, Gina Bullington

DNP Scholarly Projects

Abstract

While RN retention has been a perennial challenge, COVID-19 has exacerbated the problem. The project’s purpose was to study RNs’ perception of communication, resources, and leadership during COVID-19, and the impact on RN turnover in a multi-hospital system. 3280 RNs’ engagement survey responses and turnover percentages from pre-COVID-19 (November 2019) were compared to engagement survey responses and turnover percentages 12 months later (November 2020). 90% (n = 2963) were female and 43% (n = 1396) were between the ages of 25 and 39 years. The majority of RN respondents were employed 1-9 years (59%, n = 1934). …

The Health Impact Of Intensive Case Management On Women With Oud And Their Infants, Shannon Rappe

DNP Scholarly Projects

Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this study was to evaluate program outcomes of postpartum women with OUD and the health outcomes of their infants when engaged in an intensive case management program postpartum. The study was a retrospective review of secondary data collected on 221 postpartum mothers and 225 infants of mothers who …

A Quality Improvement Project To Improve Communication And Reduce Hospital Readmissions, Mackenzie Thomas

DNP Scholarly Projects

Background: More than 25 million people are readmitted to the hospital within 30 days of nursing home admission. With most nursing home patients receiving Medicare, Medicaid, or other publicly funded services, readmissions significantly burden the healthcare system. Poor communication within nursing homes may contribute to poor health outcomes and unplanned hospital readmissions. Purpose: To reduce readmission rates at two skilled nursing facilities by improving staff communication through consistent use of the INTERACT STOP AND WATCH (SW) tool. Design: The quality improvement project reviewed all admissions, transfers, and readmissions occurring before and during the project to determine the impact of the …

Implementing The Quality Of Care Partnership To Reduce The Cost Of Screenings For Sexually Transmitted Infections On A Southeastern College Campus, Amy Guidera

DNP Scholarly Projects

College students are a priority preventative healthcare population that can engage in high risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the …

Examining Health Disparities Among Lesbian, Gay, Bisexual, Transgender, And Queer/Questioning Adults In Davidson County, Tennessee, Samantha Anticuar

DNP Scholarly Projects

Background: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals experience increased risks for health disparities and discrimination compared to non-LGBTQ individuals, yet there is limited research in southern populations. Purpose: The purpose of this scholarly project was to examine if LGBTQ individuals had increased health disparities compared to non-LGBTQ individuals in Davidson County, Tennessee (TN). Methods: A quasi-experimental design (N = 1,704) used the 2019 Nashville Community Health and Well-being Survey for analysis. Results: Findings suggested LGBTQ individuals had increased odds of not having health insurance (p = .009, adjusted odds: 6.84), poor mental health (p …

Triage Process In Primary Care Clinics, Ashley Vasilik

DNP Scholarly Projects

Skillfully applied triage techniques can make the difference between rapid, appropriate, cost effective care and poor outcomes at increased cost. While triage has been well documented in emergency departments, military, and natural disasters, it is far less well-understood in the primary care setting. Appropriate, accurate triage and disposition in primary care can improve patient outcomes and reduce unnecessary emergency department visits. This may have an impact on emergency department over-crowding. This exploratory, qualitative, descriptive study examines the triage process of six primary care clinics in Tennessee and Alabama. Interviews with participants were conducted between September and November 2020. Donabedian’s SPO …

Debriefing Among Hospice Professionals During A Pandemic, Holly Knott

DNP Scholarly Projects

Abstract

Background: Because hospice professionals are repeatedly exposed to death, they are at a higher risk of developing compassion fatigue (Alkema et al., 2008). Over time, compassion fatigue may result in burnout, potentially causing a depletion of professionals in the hospice field (Gallagher, 2013; Haddad & Toney-Butler, 2020). While the hospice industry cannot afford to lose professionals to burnout, stress from a rapidly growing elderly population and work challenges related to the COVID-19 pandemic potentially place hospice professionals at an increased risk. Reflective debriefing has been recommended to provide emotional support to battle job dissatisfaction, compassion fatigue, and burnout (McIntosh, …

Decreasing Clabsi Among Cancer Patients: Daily Observed Chlorhexidine Gluconate Baths, Cody Tripp

DNP Scholarly Projects

Background: Research suggests that daily bathing with chlorhexidine gluconate (CHG) among cancer patients can decrease rates of central line-associated bloodstream infections (CLABSI). Literature supports the premise that the highest rates of patient compliance using CHG baths occurs with direct RN assistance or observation of the bath. Methods: Nurses employed on a hematology/oncology unit in Middle Tennessee were surveyed about their perception of how many CHG bath were not occurring on a given day and then educated via an online module, on the efficacy of daily CHG baths. Approximately two months after the preliminary survey and educational module, RNs were surveyed …

Assessment Of Postpartum Nurses' Knowledge And Teaching Habits Of Maternal Morbidity And Mortality, Mikayla Dodson

DNP Scholarly Projects

The postpartum period is a joyous time of mother-infant bonding, but it can also be a risky time for women. Despite the education that is provided to postpartum women after birth, many women are still questioning whether or not the signs and symptoms they are experiencing are sufficiently alarming to alert a health care provider. Any delay in seeking care can contribute to poor health outcomes and even maternal mortality. Registered nurses oftentimes provide the bulk of discharge education to postpartum patients. When their knowledge or confidence levels regarding specific topics are low, this can negatively impact the education they …