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.

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; …

No Pass Zone: A Quality Improvement Project, Casey St. John

DNP Projects

Introduction: Patient call-bell lights are a means for communication from a hospitalized patient's room to staff members. This DNP project involves staff and patients on a 28-bed pediatric medical-surgical unit. The aim was to implement a No pass Zone for patient call bell lights. Additionally, this project served to aid in increasing staff responsiveness to answer patients' questions and concerns.

Methods: Staff completed a Cornerstone education on the No Pass Zone. Data was collected from pre/post-implementation staff surveys and pre/post-implementation Press Ganey scores. Weekly staff audits on direct observation of staff response to patients' call-bell lights.

Results: A total of …

Operating Room Nurses Sleep Health: An Evidence-Based Practice Sleep Health Education Project, Gabriella M. Castignoli

DNP Projects

Background: "Sleep Health" is a new Healthy People 2023 priority due to notable poor sleep health across the nation, with more than 25% of U.S. adults reporting insufficient sleep. Adequate sleep is necessary to work effectively and safely, with operating room (OR) nurses at high risk for inadequate sleep due to atypical work schedules.

Purpose: This project aims to establish the importance of sleep health for OR nurses at a community-based hospital and improve sleep health perception and sleep health through sleep health education with staff.

Methods: The IOWA model for evidence-based practice and quality improvement tools, Plan-Do-Study-Act, and the …

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 …

Increasing The Utilization Of A Cardiovascular Risk Assessment & Screening Tool Through Education In A Primary Care Setting: A Quality Improvement Project, Taylor A. Massey

DNP Projects

Background and Significance: The World Health Organization (WHO) (2021) reports that 55.4 million people died worldwide in 2019; cardiovascular diseases due to ischemic heart disease and stroke were the top two leading causes of these deaths. Experts predict that by the year 2030, more than 22.2 million people will die annually from cardiovascular disease (Ruan et al., 2018). Noninvasive cardiovascular screening tests, such as the "Pulse4Pulse" screening tool, are a way to help providers identify patients at high-risk for cardiovascular disease and initiate treatment to reduce future risk.

Purpose: To increase provider utilization of the "Pulse4Pulse" screening test in a …

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 …

Increasing Adherence Of Chg Bathing: An Evidence-Based Practice Quality Improvement Project, Melissa Benedetto

DNP Projects

Introduction

Patients admitted to hospitals are at risk for developing Healthcare-acquired Infections (HAIs). Evidence suggests that these infections, including Central Line Associated Infections (CLABSIs), increase the cost of patient care and have a negative impact on patient outcomes. Daily chlorhexidine (CHG) bathing has been identified to help decrease HAIs in the hospital for patients in the Intensive Care Unit (ICU), those with Multi-drug Resistant Organisms (MDROs), and/or patients with a Central Venous Catheter (CVC).

Purpose

The purpose of this project is to implement an intervention to assess and improve CHG bathing adherence for hospitalized patients. Patients targeted include those at …

Implementation Of 3-Minute Diabetic Foot Exam For At Risk Diabetic Patients In Urban Primary Care Setting, Suzana Alvarez

DNP Projects

Background: Healthcare providers manage chronic health concerns by reducing the risk of diabetic complications among their patient population. In 2017, diabetes was the seventh leading cause of death in the United States and Connecticut. In Connecticut, there are 19,500 newly diagnosed diabetics and four Connecticut cities have higher occurrence of diabetes: Waterbury, New Britain, Hartford, and Bridgeport. Bridgeport Primary Care (BPC) had no policy or procedure in place to require the providers to complete a routine diabetic foot exam. The aim of this project was to promote and implement a tool to assist the BPC providers in evaluating adult …

Increasing Awareness Of Hereditary Fructose Intolerance: An Evidence-Based Practice Implementation Project, Jacqueline M. Bridge

DNP Projects

Background: Hereditary Fructose Intolerance (HFI) is an inborn error of metabolism which results in the absence of an effective Aldolase B enzyme. Without this enzyme, ingestion of fructose and metabolic precursors leads to acute illness, multiorgan damage, and possible death. The increased presence of these sugars results in earlier onset of symptoms and more difficulty for those with HFI.

Purpose: The project’s aim is to increase awareness of HFI in healthcare providers using a learning module and assessments of knowledge at three different points in time.

Methods: The IOWA model for evidence-based practice projects was applied during the development and …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

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 …

Implementation Of A Zone Of Silence During Administration Of Breastmilk To Decrease Nurses’ Distractions In A Neonatal Intensive Care Unit: Quality Improvement Project, Lauren Crociata

DNP Projects

Introduction: In the NICU, breastmilk is handled and administered as safely and carefully as a medication. Administration errors occur when incorrect breastmilk is administered to the wrong patient. This can lead to the transmission of infectious disease and create the loss of trust between families and the healthcare team during a neonate’s NICU stay. Nurses are often faced with interruptions and distractions during administration, and evidence shows that interventions to reduce nurses’ distractions lead to reduction of administration errors in inpatient settings. This quality improvement project took place in a level III NICU. It implemented an evidence-based zone of silence …

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 …

Improving Healthcare Provider Knowledge Of Hospice And Palliative Medicine, Ashleigh T. Flora

DNP Projects

By addressing the diseases symptoms directly, palliative care improves patients feel and can participate in their life by providing indispensable holistic health management and support for patients and families. Hospice is the focused service of palliative care, provided by specially trained healthcare professionals. Evidence suggests that patients are poorly educated on chronic illnesses, providers are failing to have end of life discussions with patients, and providers are poorly educated as to services available to patients at end of life. This quality improvement project was designed to assess provider knowledge of hospice and palliative care utilization. Convenience sampling was used to …

Improving Health Care Provider Knowledge And Compliance Of Breast Cancer Screenings, Jalisha Brown

DNP Projects

Breast cancer is the leading cause of cancer death in women worldwide. Different tests are used to detect breast cancer including mammograms, breast ultrasound, and breast MRI. Using screening mammography for breast cancer continues to be the most effective way to detect breast cancer in its early stages for better treatment outcomes. This Doctor of Nursing Practice (DNP) project aimed to determine if healthcare providers find that education regarding evidence-based guidelines for breast cancer screenings, increased knowledge, and compliance, and prompt a self-reported practice change. Participants were emailed a description of the project along with a pretest. The educational session …

Improving Primary Care Providers’ Assessment Of Type 2 Diabetic Patients, Jasmine Granger

DNP Projects

Type 2 diabetes is the most common form of diabetes and affects millions of Americans. Type 2 diabetes leads to many chronic medical conditions if not properly managed. Often, primary care providers (PCPs) deliver care to type two diabetic patients; therefore, it is imperative that PCPs are knowledgeable of current American Diabetes Association (ADA) guidelines. The purpose of this Doctor of Nursing Practice (DNP) project was to determine if implementation of a type 2 diabetes’ assessment algorithm improved PCP’s knowledge and compliance of ADA assessment guidelines. Educational sessions were conducted at clinics within Mississippi and Tennessee. A pre-test was administered, …

Increasing Healthcare Provider Engagement With Adult Patients Regarding Organ Donation In The Primary Healthcare Setting, Evelyn Michelle Rainey

DNP Projects

Though 90% of the United States population supports organ donation, only 60% actually sign up as registered donors (Health Resources & Services Administration [HRSA], 2021). This 60% makes up approximately 169 million Americans, but the chances of actually becoming an organ donor are only 3 in 1,000 (Health Resources & Services Administration [HRSA], 2021). Simply put, the need for organs far outweighs the availability of those organs for transplant. Literature reviewed supports that a lack of knowledge regarding organ donation may contribute to the decreased number of registered organ donors and that Primary Care Providers (PCP) have been successful at …

Evaluating Provider Knowledge On The Impact Of Vitamin D Deficiency In Chronic Health Conditions, Shelly Alamry

DNP Projects

Vitamin D deficiency affects nearly one billion individuals globally. It is an essential vitamin to maintain bone health as well as the overall health of the body. Recent research reveals the significance of vitamin D deficiency in chronic health conditions like osteoporosis, depression, breast cancer, dementia, and viral infections like COVID-19. The Doctor of Nursing Practice (DNP) project aimed to evaluate if education regarding vitamin D deficiency was effective in improving provider knowledge, increases practice confidence levels, and results in self-reported practice changes. An educational session and two questionnaires were administered to healthcare providers in the state of Mississippi. Before …

Educating Healthcare Providers On The Impacts Electronic Device Overuse Has On Health, Lacy Estes

DNP Projects

Healthcare concerns develop from various external mechanisms that impact health. Overtime it has been witness that such mechanisms can include the food we consume, environmental hazards, lack of activity, chronic exposure to carcinogens, and even natural parts of the eco system such as bacteria or virus. Electronic devices have evolved over the past century and can be contaminates of health. They decrease physical activity times, limit face-to-face communication, and may interfere with mental health. As technology continues to evolve limitations and safe use should be well understood to decrease the negative impact electronic devices may have on health. Electronic device …

Effectiveness Of Provider Education Concerning Prediabetes Treatment In Mississippi, Marlana Mcfarland

DNP Projects

Prediabetes is defined by the American Diabetes Association (ADA) as having an A1C of 5.7-6.4% or a fasting plasma glucose of 100-125 mg/dl. Prediabetes greatly increases the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (ADA, 2019). The purpose of this Doctor of Nursing Practice (DNP) project was to determine if providing education to PCPs, practicing in MS, regarding the implementation of a prediabetes treatment algorithm improved their knowledge and implementation of the ADA guidelines. The intention was to bring increased awareness of ADA guidelines regarding the current treatment recommendations for patients with prediabetes to PCPs. A …

Decreasing Anxiety, Depression, And Suicidal Ideation Through The Implementation Of Education And Screening At Chandler Medical Center, Ashley Gillstrap

DNP Projects

PURPOSE: To provide education on high suicide rates within the healthcare community, screen providers for suicide risk factors, and disseminate mental health resources at the University of Kentucky Chandler Medical Center (UKCMC). The goal of this intervention is to increase awareness and provide resources to providers to essentially decrease these suicide rates.

METHODS: A randomized controlled trial was used with a non-equivalent group pretest-posttest survey design to examine the effect of an education module about suicide risk factors. Along with a rating of how COVID-19 affected mental health, a Patient Health Questionnaire 9 (PHQ-9) was implemented, and mental health resources …

Exploring Palliative Care Education Needs And Desires Of Advanced Practice Providers In The Critical Care Setting, Jill Marie Clemmons

DNP Projects

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received …

Caring For Ourselves Before We Care For Others: A Mindfulness-Based Intervention For Acute Care Nursing Staff, Kent Brouwer

DNP Projects

Background: Acute care nursing staff have recently faced increasing rates of anxiety, stress, emotional exhaustion, and burnout. Nursing burnout is directly linked to patient outcomes, nurse retention, and the resilience of our nurses. Therefore, it is in the best interest of hospital organizations to focus efforts on the well-being of the nursing workforce. A recent innovative technology to prevent burnout teaches mindfulness through the utilization of smartphone applications. There is limited evidence regarding the implementation and impact of brief mindfulness interventions on intra-professional acute care providers.

Methods: A pretest-posttest design with a midpoint evaluation was utilized in this pilot study. …

Evaluating Providers’ Knowledge, Attitudes And Intentions Toward Assessing Pregnancy Desires In Women Of Childbearing Age, Sydney Hahn

DNP Projects

Abstract

Background: Unintended pregnancies account for over half of all pregnancies in the United States. Unintended pregnancies can lead to abortion, socioeconomic difficulties, medical complications, psychological issues, and political issues. Unintended pregnancies are potentially harmful to both the mother and the baby. Healthy People 2030 listed reducing the number of unintended pregnancies as one of their family planning objectives.

Purpose: The purpose of this DNP project was to evaluate providers’ knowledge, attitudes, and intentions toward assessing pregnancy desires in women of childbearing age. Methods: The study was a one-group pre/post intervention design. The data was gathered via a convivence sample …

Patient Transitions Between Acute And Post-Acute Care Organizations: Can Nursing Communication Prevent Patient Readmission?, Penny Gilbert

DNP Projects

Preventing Patient Readmission

Background and Review of Literature: Communication is the foundation of patient safety. As patients move from the acute to post-acute care setting, risk for insufficient communication rises. Research demonstrates a vast array of communication hand-off tools currently exist for and between different care arenas. No one tool has been standardized for patients transitioning from acute to post-acute care settings. The Institute of Medicine (IOM) and The Joint Commission (TJC) have published multiple documents discussing communication plagues within health care resulting in readmission.

Purpose: The purpose of this project is multifaceted: 1) identifying current nursing communication practices between …

Huddle Implementation In The Perioperative Setting, Tina Thomas

DNP Projects

Background: Communication is essential for safe and effective patient care. In the perioperative setting, information sharing is critical to care coordination. Lack of communication between caregivers can lead to medical errors. Evidence shows that huddles lead to increased communication, satisfaction, and engagement between team members resulting in better patient outcomes. Huddles are short, less than 10-minute gatherings that focus on the daily schedule, identify potential obstacles, explain unique needs, and discuss preceding day issues.

Objectives: This project aimed to evaluate the effectiveness of huddles on employee satisfaction, engagement, and communication of healthcare workers while also determining if huddles were …