Medicine and Health Sciences Commons^™

Effectiveness Of An Instructional Program On Decreasing Fall Incidents In Geriatric Patients With Psychiatric Disorders, Maurice Washington

DNP Scholarly Projects

Falls occur in 25% of older adults, resulting in over 8 million fatal and nonfatal injuries. In addition to the human suffering, associated medical and legal costs amount to over 50 billion dollars a year. This study examines the impact on fall rates of an evidence-based fall prevention program provided to a multidisciplinary staff on a psycho geriatric unit in Philadelphia, Pennsylvania. Staff knowledge of effective fall prevention interventions was measured before and after their participation in an evidence-based instructional workshop provided by the Project Director using the Falls Prevention Knowledge Test by Dykes et al. (2019). While there were …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Implementation Of The Stop-Bang Screening Tool In The Primary Care Setting: A Quality Improvement Project, Thriciana Powell

DNP Projects

Significance and Background. There are approximately 25 million adults in the United States with obstructive sleep apnea (OSA). OSA is a sleeping disorder that is caused by periodic airflow blockage during sleep. It has been linked to numerous health problems and within the primary care setting OSA is not routinely screened for at visits. This leads to delayed diagnosis of a serious health issue and the potential for poor health outcomes. The STOP-BANG questionnaire (SBQ) is a simple eight-question tool that is used to screen patients for OSA. The STOP section focuses on snoring, tiredness, observed apnea, and high blood …

Staff Education On Workplace Violence And Prevention Measures, Fatu Koroma

Walden Dissertations and Doctoral Studies

Forensic nurses are essential in helping forensic mental health patients at an inpatient/outpatient forensic psychiatric health care facility. The practice gap that the forensic psychiatric health care facility experienced was a deficit in knowledge among forensic nurses on the importance of workplace violence and prevention. The practice-focused question guiding the project was to determine if education on the American Nurses Association’s workplace violence and prevention measures would increase forensic nurses’ and staff’s education scores. The purpose of the project was to close the gap by educating nurses and staff on measures to increase a safer environment. The instructional design was …

Diabetes Self-Management Education, Jean David Thomas

Walden Dissertations and Doctoral Studies

AbstractAccording to the World Health Organization, Type 2 diabetes mellitus (T2DM) is a chronic, metabolic disease that can lead to damage throughout the body and development complications if self-care management is not implemented. Studies have demonstrated a lack of preparedness of nursing staff on T2DM self-care. At the federally qualified health clinic where this Doctor of Nursing Practice project occurred, a gap in practice existed related to the use of outdated American Diabetes Association (ADA) guidelines and lack of patient education documentation on self-care management of T2DM. The purpose of this staff education project was to plan, implement, and evaluate …

Perinatal Nursing Education Related To Opioid Use Disorder, Britney Taniguchi

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) contributes to severe perinatal and neonatal morbidity and mortality in the United States, leading to alarming complications for pregnant women, mothers, and newborns. Complications the mother experiences with OUD include increased mortality, overdose, infections, endocarditis, narcotic bowel syndrome, and accident-related injury. Complications the newborn can suffer include neonatal abstinence syndrome, respiratory depression, microcephaly, and sudden infant death syndrome. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, this project aimed to plan, implement, and evaluate a staff education program on opioid use disorder. The staff education program was presented to 13 perinatal …

Staff Education: Improving Hypertension Management Among African American Adults, Marie Survie Tunis-Blanc

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is a frequent diagnosis in primary care settings and is disproportionately higher among African Americans. Observed in the clinic were frequent office visits by patients with uncontrolled blood pressure and nonadherence to medication in an outpatient cardiology clinic in Northeast New Jersey. Also, a knowledge gap was noticed among clinical staff on current HTN guidelines. An awareness of evidence-based guidelines was necessary to combat poorly controlled BP in the clinic. The purpose of this Doctor of Nursing Practice project was to create an education program on current HTN guidelines to bridge the knowledge gap among clinic staff. The …

A Staff Education Project On The Administration Of Clinical Practice Guidelines For The Treatment Of Obesity And Overweight Children And Adolescents, Emilia Ochiabuto Okoye

Walden Dissertations and Doctoral Studies

AbstractObesity among children and adolescents has reached epidemic proportions in the United States (U.S). Nurses in pediatric settings have a critical role to play in assessing and managing childhood obesity. The partner site for this project has a childhood obesity rate of 35% compared to the national average of 19%. However, the nursing staff lacked adequate knowledge, competence, and confidence in assessing and managing childhood obesity in line with the recommended guidelines. The problem was addressed by implementing the Clinical Practice Guideline for the Treatment of Obesity and Overweight Children and Adolescents via an education program. The program’s content was …

Staff Education Program To Reduce Burnout Among Health Care Professionals On A Long-Term Care Unit, Emelda Mati Che

Walden Dissertations and Doctoral Studies

AbstractBurnout negatively impacts the performance of health care providers, decreasing the quality of care provided to patients and affecting patients’ experience. This problem is evident in health care staff on long-term care units (LTCUs) as they strive to meet their patients’ chronic and acute care needs. Health care professionals often lack adequate knowledge on how to manage work-related stress and reduce the issue of burnout in this work environment. The health care professionals working on the LTCU at the local continuing care retirement facility were identified as lacking knowledge to manage work-related stress and burnout. Addressing this problem is essential …

Staff Education On Workplace Violence And Prevention Measures, Fatu Koroma

Walden Dissertations and Doctoral Studies

Forensic nurses are essential in helping forensic mental health patients at an inpatient/outpatient forensic psychiatric health care facility. The practice gap that the forensic psychiatric health care facility experienced was a deficit in knowledge among forensic nurses on the importance of workplace violence and prevention. The practice-focused question guiding the project was to determine if education on the American Nurses Association’s workplace violence and prevention measures would increase forensic nurses’ and staff’s education scores. The purpose of the project was to close the gap by educating nurses and staff on measures to increase a safer environment. The instructional design was …

A Staff Education Project On The Administration Of Clinical Practice Guidelines For The Treatment Of Obesity And Overweight Children And Adolescents, Emilia Ochiabuto Okoye

Walden Dissertations and Doctoral Studies

AbstractObesity among children and adolescents has reached epidemic proportions in the United States (U.S). Nurses in pediatric settings have a critical role to play in assessing and managing childhood obesity. The partner site for this project has a childhood obesity rate of 35% compared to the national average of 19%. However, the nursing staff lacked adequate knowledge, competence, and confidence in assessing and managing childhood obesity in line with the recommended guidelines. The problem was addressed by implementing the Clinical Practice Guideline for the Treatment of Obesity and Overweight Children and Adolescents via an education program. The program’s content was …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

The Psychological Impact Of Covid-19, Medina Marie Hudson-Odoi

Walden Dissertations and Doctoral Studies

AbstractEmployees from a large government agency were abruptly switched to telework for an extended period of time. There was no plan to address potential psychological stressors associated with the disruption of work-family-life balance that emerged as a result of COVID-19. A knowledge gap in how to support employees was apparent from discussions during team and administrative meetings. The project question explored whether the use of stress first-aid (SFA), an educational program, would enable employees to learn self-care strategies to address stressors in a less protected environment. The purpose of this DNP project was to provide a staff education awareness program …

Improving Advance Care Planning Among Native Americans, Jasjit Kaur Pataria

Walden Dissertations and Doctoral Studies

A staff education project was created in a tribal health system of primary care clinics to improve advance care planning (ACP) conversations between care providers and Native American tribal patients. ACP conversations and advance directive documentation occurrences were found to be low or negligible in the project site despite primary care clinics being an ideal place to start these conversations. The purpose of the staff education project was to improve the knowledge and attitudes of providers toward initiating ACP conversations in a rural underserved community of Native Americans. The knowledge-to-action model was used to frame the project. Pretests and posttests …

Educating Nurses On The Progression Of Chronic Kidney Disease, Andrea Georgia Mignott

Walden Dissertations and Doctoral Studies

AbstractThe increasing prevalence and incidence of chronic kidney disease (CKD) is a major healthcare burden in developed and developing countries. A gap in nursing practice was identified in a teaching and referral hospital located in Jamaica. Nurses in the organization lacked requisite knowledge and current evidence-based practice guidelines on CKD and therefore could not teach patients diagnosed with CKD. The purpose of this project was to educate nurses regarding the progression of CKD, with the aim of slowing the disease process. This Doctor of Nursing Practice project explored whether educating nurses on the progression of CKD would increase their knowledge …

Staff Education Program On Postpartum Depression Screening, Pamela Barstow

Walden Dissertations and Doctoral Studies

AbstractPostpartum depression (PPD) in the US is a serious health concern that negatively impacts an average of 11.5% of women, with 13.36% of women in Virginia in 2018 reporting PPD symptoms. Mothers experiencing PPD may have trouble bonding with their infants, which may negatively impact childhood growth and development. However, fewer than one-half of pediatricians screen mothers of infants for PPD. Literature supports staff education on PPD to promote the wellbeing of postpartum mothers and their infants. Using the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this Doctor of Nursing Practice project was to …

Educational Strategies For Healthcare Providers Of Postpartum Women With Substance Use Disorder, Agnes Denise White

Walden Dissertations and Doctoral Studies

AbstractProviding educational strategies to maternal-child staff members can improve their attitudes, perceptions, and stigma towards the childbearing age women who are substance users. In the United States, an increased number of pregnant women have substance abuse problems. It is important that the maternal child staff have the resources and are equipped to care for women who are substance users struggling with their addictions and motherhood. The purpose of this project was to determine whether an educational program provided to postpartum nurses increased knowledge on the special needs of the new mother with a substance abuse issue. The education of the …

Educating Nurse Practitioners To Avoid Urine Cultures To Prevent Overuse Of Antibiotics, Diane Evelen Deangelo

Walden Dissertations and Doctoral Studies

Unnecessary antibiotics are often ordered for positive urine cultures in long-term care (LTC) residents despite a lack of symptoms, indicating asymptomatic bacteriuria (ASB). Treating ASB with antibiotics can result in antibiotic-resistant organisms, allergic reactions to antibiotics, and secondary infections such as clostridium difficile. The purpose of this DNP project was to provide an evidence-based education intervention regarding management of ASB and UTIs with the hope of increasing the knowledge among nurse practitioners (NPs) that could be translated into practice and result in a decreased antibiotic use in LTC patients. The DNP project was grounded in Knowles’ adult learning theory and …

Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin

Walden Dissertations and Doctoral Studies

Medication reconciliation is a fundamental step in the delivery of safe care, because if it is not done correctly, it can set the stage for medication errors. Medication reconciliation has been shown to alleviate safety issues that lead to mortality, falls, and adverse drug reactions. The project question examined how in-service training can improve the knowledge of nurse practitioners and medical assistants about medication reconciliation. The project was guided by Knowles’ theory of adult learning and Rosswurm and Larrabee’s health belief model. A 1-hour educational module was prepared, and all participants completed the training prior to a discussion period. Sources …

Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio

Walden Dissertations and Doctoral Studies

Heart failure is a chronic health condition that can have devastating effects on thephysical and social well-being of patients. One critical component to heart failure treatment is understanding of the disease process and daily self-management for patients. The gap in practice at an acute care facility in the northwest United States was the lack of comprehensive discharge patient teaching to patients diagnosed with heart failure. The project explored if a heart failure education session for nurses would increase knowledge and competency on heart failure education. Knowle’s theory of adult learning was used to frame the project components. Thirty-one nursing staff …

A Formal Hcahps Teaching Program Targeting Communication Improves Hcahps Scores, Bobbie Davis

Master's Projects and Capstones

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey given to patients after discharge from an inpatient unit is a validate tool used to determine the level of patient experience. Organizations across the country, including the Northern California Academic Medical Center, have implemented many initiatives aimed at improving these scores. HCAHPS scores for the hematology/oncology unit at this medical center remain low even after previous education efforts. The aim of this quality improvement project was to improve the patient experience, as evidenced by HCAHPS scores, with the implementation of an HCAHPS teaching program for nursing staff, focusing on …

Comprehensive Staff Education And Implementation Of A Checklist Tool To Increase Staff Adherence To Pitocin Titration Protocols, Tara N. Cassell

Electronic Theses and Dissertations

This quality improvement project was designed to increase staff adherence to an existing Pitocin titration protocol used in a labor and delivery unit at a community hospital. In the current U.S. health care climate, safe patient care is paramount and the Institute for Safe Medication Practices identified Pitocin as a high-alert medication. Evidence-based practice recommends the use of a titration protocol to guide proper use of Pitocin. Prior research has shown improvements in patient outcomes when facilities implement Pitocin titration protocols, with staff adherence key to the successful implementation of evidence-based titration protocols, which may be improved with the use …

Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi

Walden Dissertations and Doctoral Studies

The impact of end-stage renal disease (ESRD) on healthcare costs is significant. In 2013, the cost of providing care for the ESRD patient population was 7.1% of total Medicare expenses. ESRD patients' non-adherence with the medical plan is a reason for the high cost of care and poor patient outcomes. Staff education can have a positive impact on patient adherence in terms of the management of chronic illnesses, such as ESRD. This DNP project was an education program for hemodialysis (HD) staff regarding empowering patients to learn about self-care strategies aimed at improving ESRD patients' adherence to fluid restriction and …

Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher

Walden Dissertations and Doctoral Studies

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change …

Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo

Walden Dissertations and Doctoral Studies

The healthcare sector experiences violence 4 times as much as any other civilian domain, including law enforcement and corrections facilities. The clinical practice problem addressed in this project was the lack of adequate healthcare workplace violence (HWV) prevention in a not-for-profit community hospital. The purpose of this project increase awareness of HWV prevention through the use of an education module. Rogers’ diffusion of innovation model served as the foundation for analysis of scores from pre- and posteducation tests. The practice-focused question asked if a module on HWV prevention based on current clinical practice guidelines and peer-reviewed literature would improve staff …

Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi

Walden Dissertations and Doctoral Studies

The impact of end-stage renal disease (ESRD) on healthcare costs is significant. In 2013, the cost of providing care for the ESRD patient population was 7.1% of total Medicare expenses. ESRD patients' non-adherence with the medical plan is a reason for the high cost of care and poor patient outcomes. Staff education can have a positive impact on patient adherence in terms of the management of chronic illnesses, such as ESRD. This DNP project was an education program for hemodialysis (HD) staff regarding empowering patients to learn about self-care strategies aimed at improving ESRD patients' adherence to fluid restriction and …

Improving Revenue Capture And Patient Safety In An Icu Setting, Natasha Stankiewicz, Laura Lewis, Jonathan Archibald, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

IMPROVING REVENUE CAPTURE AND PATIENT SAEFTY IN AN INTENSIVE CARE SETTING

Materials management department is responsible for restocking chargeable supplies in an intensive care unit (ICU) at an academic tertiary medical center. Staff confusion as to what items were considered chargeable often led to low supply par levels resulting in delays of critical patient care.

Using baseline metrics, a team of caregivers created several performance improvement goals to increase nursing compliance with appropriate supply charging. The results of a root cause analysis spearheaded the development of a KPI that encompassed staff education, lost charge tracking and charge supply labeling.

Post …

Proper Hand Hygiene Practice In The Clinic Setting, Wendy Middendorf

Nursing Posters

The use of proper hand hygiene in the clinic setting is critical for infection control and prevention of nosocomial infections.