Medicine and Health Sciences Commons^™

Dorsogluteal Intramuscular Injection Depth Needed To Reach Muscle Tissue According To Body Mass Index And Gender: A Systematic Review, Pamela Strohfus, Sara Palma, Chelsea Tindell Wallace

Nursing Faculty Publications and Presentations

Aims and objective(s)

The objective of this systematic review was to determine the needle length required to reach the dorsogluteal muscle based on body mass index and sex. Our aim was to provide evidence-based recommendations to current intramuscular injection guidelines from the result(s) of this review.

Background

Studies worldwide are documenting reduced medication effectiveness due to improperly placed dorsogluteal intramuscular injections because of incorrect needle length, wrong site selection and/or obesity. Current intramuscular injection guidelines lack specific instructions according to weight or sex. While there are similar concerns with other injectable sites, this review focuses solely on adult dorsogluteal intramuscular …

Optimizing Electronic Medication Prior Authorization: Reducing Prescription Delays, Arnold Butiu

Doctor of Nursing Practice Projects

Background: Within the United States, chronic disease in children has doubled over the last 20 years. Many diseases defined as chronic (attention deficit, epilepsy, and diabetes) require daily medication regimens for optimal management. To be covered by insurance, many of these medications require prior authorization (PA) from the patients’ pharmacy benefits policy. Delays in processing and receiving PA orders can lead to worsening disease and inadequate disease management.

In 2014, a pediatric academic medical center in the Midwest found that processing medications from prescription order to PA approval took nurses an average of over 90 hours. In August 2020, the …

Implementing An Evidence-Based Fall Prevention Plan To Address Unintentional Hospital Falls On A Medical/Surgical Unit, David Haskell

Doctor of Nursing Practice Projects

Background: Falling in the hospital setting is a leading cause of death and disability for patients. For many health care organizations, patient fall prevention strategies have become a priority focus to improve patient outcomes and associated costs.

Project Design: The project was designed to implement a quality improvement project on an adult medical/surgical unit, providing educational activities to nursing staff, and applying a standardized fall prevention plan of care “toolkit” for fall prevention interventions.

Results: Audits completed on 863 patient admits to a 36-bed Medical/Surgical unit during the three-month timeframe, showed the implementation of the project resulted in the creation …

Developing A Standardized Process For An Effective, Evidence-Based Fall Management Program To Reduce Falls In A Nursing Home Setting, Katrina K. Little

Doctor of Nursing Practice Projects

Background: Falls among the elderly population, aged 65 years and older, are a significantly growing public health problem. For elderly people residing in residential care facilities and facility administrators, falls are of great concern due to the post-fall associated consequences. Preventing resident falls in long-term care is a priority to reduce injuries and associated costs.

Project Design: This evidence-based quality improvement (EBQI) pilot project focused on fall prevention and was conducted on 1 unit (3 long-term care hallways) at a facility that provides both long-term care (LTC) and short-term rehabilitation services in Utah County, Utah. Interventions chosen for the Falls …

Mindfulness-Based Stress Reduction To Decrease Burnout In Emergency Nurses: A Quality Improvement Project At An Academic Medical Center, Desireé M. Mccue

Doctor of Nursing Practice Projects

Nursing burnout, categorized by increased emotional exhaustion (EE), depersonalization (DE), or decreased personal achievement (PA), is rising in the United States. Emergency Department (ED) nurses at an academic medical center in the western United States experience burnout related to workplace violence and trauma exposure exacerbated by a global pandemic. Burnout can lead to adverse health impacts for nurses, increased institutional costs, and adverse patient outcomes.

Improving mindfulness or awareness of the present can reduce burnout in ED nurses. A mindfulness pilot project was conducted with staff nurses (n=20) and nurse leaders (n=4) in the ED. Participants attended Mindfulness-Based Stress Reduction …

A Pilot Program To Improve Patient And Family Experience Scores And Quality Of Care Of The Hispanic Population In An Urban Pediatric Emergency Department., David C. Kruger

Doctor of Nursing Practice Projects

Problem Description: Emergency Department (ED) patients express decreased patient and family experience (PFE) scores when they feel disrespected (such as experiencing long wait times), experience ineffective communication, or have difficulty accessing care. These issues could lead to inequalities and adverse health care outcomes, especially among those of different races and ethnic backgrounds. The goal of this quality improvement (QI) project was to evaluate the PFE scores and the quality of care of the Hispanic population at a thirty-five-bed emergency department within a freestanding pediatric, academic medical center located in a large urban area.

Rationale: The theoretical framework guiding this QI …

A Chronic Obstructive Pulmonary Disease Pilot Using Risk Stratification To Improve Resource Allocation And Reduce Readmissions, Linda Gould

Doctor of Nursing Practice Projects

Background: Chronic Obstructive Pulmonary Disease (COPD) impacts 250 million people, is associated with high hospital readmission rates, and costs over $50 billion annually. Purpose: Apply risk stratification identifying higher risk patients to prioritize complex, time-consuming interventions and resources. Methods: Patients hospitalized with COPD were risk stratified using PEARL. Moderate-high risk patients were referred to specialty nurse practitioners, who used real-time interventions and motivational interviewing during intense weekly visits over 30 days targeting self-management, patient-specific risks, and resources. Results: No patients were readmitted or died during the pilot using risk stratification with patient-specific tertiary preventive care to …

Implementing Sexual Health Education For At-Risk High School Students In A Faith-Based Setting: A Pilot Project, Neva R. Fuentes

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STI) are a global issue that persist, causing significant negative health outcomes like cancer, adverse reproductive issues including infertility, and death (CDC, 2019a; Office of Women’s Health [OWH], 2019; WHO, 2019). In the United States, youth ages 15-24 years old make up 50% of the more than 20 million newly diagnosed STI’s each year (CDC, 2019a). Young women, adolescents (Slater & Robinson, 2014), minority populations (Mermelstein & Plax, 2016), and high school dropouts (Anderson & Pörtner, 2014) are even more disproportionately affected. Access to comprehensive health information and vaccines are well documented effective STI prevention methods …

Improving Access And Delivery Of Mental Health Care To Veterans Through A Care Coordination Pilot At A Texas Department Of Veterans Affairs Hospital, Jacqueline Buval

Doctor of Nursing Practice Projects

Background: Mental health (MH) disorders are among the leading cause of disabilities in adults, with an even greater prevalence among Veterans who served in combat. Forty percent of troops returning from combat zones report suffering from post-traumatic stress disorder (PTSD) or depression and 33% report trouble accessing MH care. Access to care is directly influenced by care coordination procedures in health care systems. If care coordination is poor or lacking, patients remain in settings that are inappropriate for their level of care. Implementing a care coordination program can improve care transitions, provide the necessary support for patients to successfully …

Deploying A Validated Postnatal Depression Screening Tool & Guideline To Improve Evidence Based Screening For Postpartum Depression In Ambulatory Care, Debbie Ketchum

Doctor of Nursing Practice Projects

Problem Description: Postpartum depression (PPD) is a significant public health problem that is potentially disabling and can be life-threatening. It is one of the most common diagnoses for maternal morbidity and mortality, affecting one in ten women in the United States. Currently, there is no universal process for the identification of PPD within the ambulatory clinics in this regional health system caring for obstetrical patients. A quality improvement project was developed and implemented with a pilot group in the ambulatory setting.

Rationale: Without a standard process for screening, patients and their newborns may be at increased risk for detrimental consequences …