Medicine and Health Sciences Commons^™

Implementing Home Blood Pressure Monitoring To Identify Essential Hypertension: A Quality Improvement Project, Julianne Peterson

DNP Projects

Background White coat hypertension (WCH) affects around 12-15% of the population and may lead to a misdiagnosis of hypertension (HTN) and unnecessary treatment. The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend home BP monitoring (HBPM) to aid in differentiating between WCH and HTN. A HBPM program was implemented in a primary care office.

Project Goals

1. Educate providers about the ACC/AHA guidelines promoting HBPM to assist in differentiating between WCH and HTN in patients with elevated office blood pressures (BP).

2. Implement a HBPM algorithm for patients presenting with a BP > 130/80 mmHg.

Methods The …

Implementing Breast Milk Expression Education Protocol: A Quality Improvement, Brenda Balarezo

DNP Projects

Significance and Background: Prematurity related complications (PRC) are the second leading cause of death for children under the age of five. Breast milk (BM) contains bio-actives that reduce PRC. However, delayed BM expression (BME) reduces BM availability. Adherence to Baby Friendly Hospital Initiative’s recommendation for BME within 6 hours in mothers of neonatal intensive care unit (NICU) infants remain poor without a standardized BME protocol.

Purpose: To increase the percentage of NICU mothers initiating BME within 6 hours of birth. To educate labor and delivery nursing staff on early BME.

Methods: The Institute for Healthcare Improvement’s Model for Improvement Plan-Do-Study-Act …

The Importance Of Feedback With An Asynchronous Online Training Program When Learning Debriefing For Meaningful Learning, Aimee A. Woda, Brandon Kyle Johnson, Jamie Hansen, Kristina Chen, Kristina Thomas Dreifuerst

College of Nursing Faculty Research and Publications

Background

Despite knowing the importance of debriefing, there is insufficient evidence to guide the best way to train and provide formative feedback to develop competent debriefers.

Method

This multi-site, experimental, repeated measures study was used to test the impact of different intervals of expert feedback on a debriefer's competence implementing debriefing after participating in an asynchronous, online, distributed modular training program.

Results

Training and early feedback facilitated rapid improvements in a debriefer's ability to implement a debriefing method correctly. Regular feedback improved competence over time.

Conclusion

A well-developed, asynchronous online training program is an effective way to train debriefers.

An Integrative Review Of The Use Of The Individual And Family Self-Management Theory In Research, Wendy S. Bauer, Rachel F. Schiffman, Julie L. Ellis, Jeanne M. Erickson, Michele Polfuss, Murad H. Taani, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

The extent of the application of the Individual and Family Self-Management Theory (IFSMT) in research has yet to be determined. The purpose of this analysis was to review the use of the IFSMT in published research and evaluate posited constructs and relationships. Dimensions and categories of the IFSMT and the interrelationships were generally supported in the 77 articles reviewed. A majority focused on self-management of chronic conditions in the adult population. More research on the strength, direction, and interaction of relationships is needed. Defining and exploring social constructs, including race, ethnicity, and gender, should be prioritized in future IFSMT research.

Strategies To Improve Nurse Documentation Compliance And Confidence In The Delivery Of Preprocedural Education, Danielle A. Burris

Doctor of Nursing Practice Final Project Abstract

Strategies to Improve Nurse Documentation Compliance and Confidence in the Delivery of Preprocedural Education:

Abstract

Introduction:This project aimed to implement tools to improve preprocedural education compliance between nurses and patients in an interventional radiology department. The secondary aim was increasing staff confidence in providing education, reducing the potential for avoidable harm and adverse procedural-related outcomes. The project was implemented within an interventional radiology department of a healthcare system in the Texas Medical Center, Houston, Texas.

Methodology: The project utilized the Model for Improvement and followed the steps of the Plan-Do-Study-Act cycle to implement change. Strategies included checklists, reminder tools, …

A Psychometric Validation Of The Neonatal Abstinence Syndrome: Exploring Neonatal Nurses' Attitudes, Knowledge, And Practice Tool, Megan A. Ventrello

Theses & Dissertations

Background:

The National Center for Drug Abuse Statistics estimates that as of 2020, 3.8% of American adults have abused opioids in their lifetime (Centers for Disease Control and Prevention, n.d.). In addition, around 7% of women self-reported that they were using opioid pain relievers during their pregnancy, and 1 in 5 of these women reported misusing these medications while pregnant (Centers for Disease Control and Prevention, 2022a; Ko, 2020). Women who use opioids throughout their pregnancy give birth to infants who are born with Neonatal Abstinence Syndrome. The symptoms can be marked by a signature high-pitched cry and inconsolability, making …

A Holistic Perspective On Pain Assessments, Focusing On The Multidimensional Measurement Of Comfort Levels: A Quantitative Analysis And Psychometric Evaluation Of The 13-Item Shortened General Comfort Questionnaire, Victoria A. Marner

Theses & Dissertations

Background: Pain is multidimensional. It is a physical, psychospiritual, environmental, and sociocultural experience (Ebrahimpour & Hoseini, 2018). Current measures of pain tend to be unidimensional, only focusing on the physical aspect of pain. The entire experience of pain may not be effectively communicated by patients or adequately controlled by interventions (e.g., analgesics, repositioning, physical therapy). Adults in pain may struggle to participate in daily activities and responsibilities. A scale encompassing all pain contexts and comfort levels could provide a more comprehensive view of the patient’s experience. Transitioning from measuring pain to measuring comfort holistically would provide patient satisfaction and improved …

Student Described Importance Of Nurse Educator Caring Actions In Various Class Settings, Jessica Leiberg

Dissertations (1934 -)

Caring pedagogy is a well-known and proven nurse educator instructional approach resulting in improved student attrition, enhanced attitude towards the students’ nursing program, and a caring approach extending into professional practice. Despite much research and development of nurse educator caring actions, the possible effect of different class settings on the student perception of these nurse educator caring actions is unknown. The purpose of this study aimed to identify how students’ rate and rank order the importance of nurse educator caring actions within the different class settings. A descriptive quantitative design was conducted to explore student perceptions of the importance of …

The Impact Of Electronic Health Record Training: How Students Utilize The Electronic Record To Inform Clinical Judgment, Sarah Marie Calonder

Dissertations (1934 -)

Nurses practice within a complex healthcare environment and must make well-informed judgments about their patients to provide safe, quality care. The electronic health record (EHR) is a piece of healthcare and informatics technology which houses important patient information that nurses utilize frequently while making clinical judgments surrounding patient care. The importance of entry-level nurse competency with the EHR and similar healthcare and informatics tools has been outlined by the American Association of Colleges of Nursing (AACN) Essentials and other nursing organizations concerned with the preparation of future nurses (AACN 2021; QSEN, 2020). Currently, there are limited established best practices for …

Confirming The Validity And Reliability Of The Placement Evaluation Tool To Evaluate Midwifery Practice Placements (Pet-Midwifery), Fiona Bogossian, Dianne Bloxsome, Angela Brown, Robyn Cant, Susan Hunter, Lauren Kearney, Lesley Kuliukas, Carolyn Ross, Simon Cooper

Research outputs 2022 to 2026

Problem: In Australia, program accreditation requirements include that education providers monitor and evaluate teaching and learning environments and provide evidence of outcomes being used to inform program quality improvement. Yet, closing this loop has proven challenging. Background: The Australian National Placement Evaluation Centre (NPEC) functions to measure the quality of placements through student evaluations. One measure the Placement Evaluation Tool (PET) had not been tested in midwifery student cohorts. Aim: To confirm the validity and reliability of the Placement Evaluation Tool (PET) for midwifery. Design: Survey instrument development. Methods: A three-phase, sequential study involving seven Australian universities and students enrolled …

Improving Medication Adherence For Post-Operative Pediatric Patients With Spanish-Speaking Caregivers Using A Written Medication Action Plan, Carissa Vicente

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aims to improve written discharge education, medication adherence for pediatric patients, and medication education retention for Spanish-speaking caregivers.

BACKGROUND

The project was implemented in a children’s hospital in the Pediatric Post-Anesthesia Care Unit. The discharge process for post-operative pediatric patients lacked appropriate written medication education for Spanish-speaking families, placing patients at an increased risk for improper medication use.

METHODOLOGY

A quality improvement method utilizing Plan-Do-Study-Act (PDSA) cycles was used for implementation, with three cycles completed. A written Spanish-translation medication action plan (MAP) was implemented during discharge for Spanish-speaking caregivers, including adaptions to an electronic health record version …

Medicaid Patient Experiences With Nurse Practitioners And Other Providers: A Big Data Analysis, Deanna Jan Emory, Thomas A. Kippenbrock

The Eleanor Mann School of Nursing Faculty Publications and Presentations

There is a current and ongoing shortage of primary care providers that is projected to increase through 2034. Over the last decade, this shortage has resulted in increased reliance on nurse practitioners and physician assistants to fill the gap. The pur-pose of this study was to investigate Medicaid recipients’ experiences with their respective primary care providers using responses from the Consumer Assessment of Healthcare Providers and Systems database with a focus on nurse practitioners compared to other provider types identified. Responses from 68,761 Medicaid recipients were analyzed. The results showed that Medicaid recipients’ scores for nurse practitioners were comparable to …

Integrating Mental Health And Substance Use Treatment Using The Integrated Care Model: Policy Analysis, Victoria Reis

Doctor of Nursing Practice Final Project Abstract

Purpose of Statement

Policy analysis evaluates the integration of mental health services into substance use treatment, particularly for co-occurring disorders. It identifies gaps in existing policies and offers recommendations to enhance access, coordination, and effectiveness of integrated care.

Background

Integrating mental health services is crucial due to the high prevalence of co-occurring disorders. However, the fragmented treatment landscape leads to poor patient outcomes and rising healthcare costs. Policies such as the 21st Century Cures Act and Texas House Bill 4 provide a framework for improvement, but significant gaps hinder effective integrated care.

Methodology

Using the Bardach Policy Analysis Framework, this …

The Prevalence Of Suicide And Suicidal Ideation In Adult Oncology Patients, Mutiat Bamiloshin

Doctor of Nursing Practice Final Project Abstract

Objective

The aim of this quality improvement initiative is to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) to enhance the early detection of suicide risk among adult oncology patients and to facilitate timely referrals for mental health support.

Background

Adult cancer patients experience substantial psychological distress due to the challenges related to their diagnoses and treatments, significantly increasing their suicide risk. The lack of routine suicide screenings in oncology settings impedes the early identification of at-risk patients, necessitating evidence-based approaches.

Methodology

The project involved 50 adult oncology patients and was conducted at a hospital in Texas over eight weeks. Weekly …

Food Allergies On The College Campus: Increasing Awareness, Kelly Wagner

DNP Projects

Project Title: Food Allergies on the College Campus: Increasing Awareness

Background and Rationale: The prevalence of food allergies in the United States is high and continues to increase, affecting approximately 32 million people (10.8% of the population). Food allergies are a chronic disease, and students transitioning to college are in the age group that experiences the highest rate of lethal anaphylactic reactions related to food allergies. Current best practice guidelines recommend that colleges should have a comprehensive, campus-wide approach to food allergy awareness, management, and emergency protocol. At a midsize southeastern university, there was no campus-wide approach to addressing the …

Impact Of Using A Shared Decision-Making Tool In Atrial Fibrillation, Shiloh Knoy

Doctor of Nursing Practice

Background
Atrial fibrillation (AF) is the most common cardiac arrythmia impacting nearly six million Americans. Symptoms associated with AF significantly impact quality of life and can have serious health consequences. Risk factor optimization through lifestyle modification is a crucial component in AF care plans though often deferred to primary care providers.

Purpose
This project assessed the impact of using a shared decision-making tool on patient knowledge regarding their AF care plan and assessed patient and provider perception of using the tool during routine AF visits.

Methods
Tools were distributed to patients during AF clinic visits then graded according to current …

Bluetooth-Enabled Self-Measured Blood Pressure To Control Hypertension, Lisa J. Parker

Doctor of Nursing Practice

Background
Hypertension is a major risk factor for cardiovascular disease, contributing to26% of annual U.S. deaths. Unreliable office-based blood pressure (BP) measurements have spurred the adoption of self-measured BP (SMBP). However, only half of adults aged fifty to eighty with hypertension regularly monitor their BP and share BP measurements with healthcare providers. Bluetooth-enabled SMBP (BT-SMBP) is a potential solution to promote at-home monitoring and information sharing.

Purpose
The purpose of this project was to evaluate the use of BT-SMBP on the frequency of home BP measurement recording, timeliness of clinic response, and effect on BP, compared to SMBP using handwritten …

Rural Access To Multidisciplinary Cancer Care Center For Patients With Pancreatic Ductal Adenocarcinoma, Irene Gielen

Doctor of Nursing Practice

Background
Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer and among the most aggressive malignancies. It is projected to be the second leading cause of cancer related mortality in the United States by 2030. Due to its nonspecific early symptoms, PDAC often remains undetected until advanced stages, limiting treatment options and reducing survival rates.

Purpose
This project evaluated the impact of geographic distance on diagnostic staging and treatment initiation for patients with PDAC referred to the Providence Cancer Institute of Oregon (PCIO) from 2018-2023.

Methods
A retrospective chart review assessed the relationship between geographic distance, demographics, …

Evaluating The Relocation Of A Rural Hospital’S Helipad, Jamie M. Hammer

Doctor of Nursing Practice

Background
Island Hospital, a 43-bed Level III Trauma and Stroke Center in rural northwest Washington, manages over 170 annual helicopter EMS landings from Airlift Northwest, Life Flight, and the U.S. Navy. Serving as a critical hub, it provides essential care for the San Juan Islands and surrounding Salish Sea communities.

Purpose
The purpose of this project was to evaluate the impact of relocating the helipad from the parking lot to the roof of the inpatient building on patient time to treat, safety, and staff workflow satisfaction. The previous helipad was located 360 feet opposite the ED entrance, while the new …

A Program Evaluation Of A Clinic’S Breast Cancer Screening Process, Monica Richardson

Doctor of Nursing Practice

Background
Breast cancer is the most common cancer across all ethnic groups with 270,000 women in the U.S. diagnosed yearly (Centers for Disease Control and Prevention [CDC], 2023). Breast cancer is the second causative factor of death in women with mortality estimates greater than 42,000 annually. Screening and early referral is essential. Mammography is the gold standard for detecting early, non-palpable, and preventable cancers. Primary care clinics can impact screening efforts by creating policies and utilizing electronic health records (EHR) to identify, track, and notify adult female patients who meet recommendations for breast cancer screening (BCS).

Purpose
The purpose of …

Preeclampsia: Implementation Of The American College Of Obstetricians And Gynecologists Standardized Protocol, Sheila Ann Harwell

Electronic Theses and Dissertations

Preeclampsia is a significant medical condition that affects the perinatal population, posing risks to both the mother and fetus. Complications associated with preeclampsia include stroke, seizure, placental abruption (premature separation of the placenta from the uterus), fetal growth restriction (impaired growth due to reduced blood flow through the placenta), premature birth, and low-birth-weight infants with associated developmental issues. Because there is no cure for preeclampsia, the current management involves the timely administration of intravenous antihypertensives to reduce the risk of stroke and seizure. The gap in practice identified was the obstetrical department’s lacking a standardized protocol, compared to adopting the …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Impact Of A Transplant Nurse Navigator In The Dialysis Setting, Judith D. Pozzerle

Electronic Theses and Dissertations

Patients with kidney disease have better patient outcomes and quality of life with a kidney transplant. However, the transplant process is complicated with inherent inequalities and biases and patients frequently fail to initiate a referral for transplant evaluation. The Centers for Medicare and Medicaid have now placed financial incentives to improve the number of patients transplanted. The only way to increase the number of patients transplanted is to start with a referral for evaluation. Studies have been done highlighting the barriers, but there is a lack of studies implementing strategies to improve these numbers. Utilizing Kotter’s change theory and describing …

Changing Intimate Partner Violence Screening And Intervention: Focus Group Perspectives, Colleen M. Galambos, Teresa Jerofke-Owen, Heidi Paquette, Linda B. Piacentine, Erin C. Schubert, Mychoua Vang, Erica Arrington, Nilanjan Lodh, Kimberly S. Gecsi

College of Nursing Faculty Research and Publications

Background: Many survivors of intimate partner violence (IPV) remain unconnected to professional help. Screenings in health settings may improve connections to support services.

Purpose: The purpose of this study was to gather data to help inform an IPV screening intervention in an obstetrics/gynecology health clinic.

Methods: A qualitative analysis was employed using a summative content analysis approach of the transcripts of 2 focus groups consisting of health care providers, advocates, and survivors of IPV.

Results: Four thematic categories and additional subcategories emerged from the analysis, including (1) current process (what is done); (2) need (what is not done); (3) concerns …

Factors Affecting Nurse Retention In A Private Healthcare System In Malaysia, Zarin Ikmal Zan Mohd Zain, Annamma Kunjukunju, Govethamma Subramaniam, Nur Izzana Tajuddin

Jurnal Keperawatan Indonesia

Nurse retention has become increasingly challenging in the post-pandemic era, particularly for private hospitals. This study aimed to identify the significant predictors of nurse retention in selected private hospitals in Malaysia. A quantitative, descriptive, cross-sectional design was employed. A pre-validated, self-administered questionnaire, distributed via Google Forms, was used for data collection. The respondents included 532 registered nurses employed at three private hospitals in Malaysia. Data analysis was conducted using descriptive statistics and correlation studies, including Spearman’s rho and multiple regression analysis. Among the participants, 54% reported good job satisfaction, 27.37% expressed organizational commitment, 25.97% were satisfied with human resource practices, …

Video Animation: Improving Older Adults Patients Knowledge And Motivation Related To Hypertension Diet, Gusti Ayu Kade Budiarti, Sri Susanty, Ruslan Madjid, Ramadhan Tosepu

Jurnal Keperawatan Indonesia

Hypertension is a dangerous medical condition that can increase the risk of heart, brain, and renal problems, among other issues. A balanced diet is an essential hypertension control intervention. This study seeks to examine the efficiency of employing animation media to explain the application of diets that prevent hypertension and boost the understanding and motivation of senior patients at Bahteramas Regional General Hospital. In both the control and intervention groups, a quantitative-quasi-experimental design was adopted, with pre-test and post-tests. Data was obtained via questionnaires from 92 respondents chosen using a purposive sampling approach, with 46 in the intervention group from …

Nurses' Performance In Operating Life-Saving Medical Devices At Pediatric Intensive Care Unit, Marwa G. Abouheiba, Magda A. Essawey

Nursing

Background: The life-saving medical devices can be define as are machines, apparatuses or technologist which used to ensure the optimal level of physiological functions. In case that the organ or organs failed to function well. Aim: The study aimed to assess nurses' performance in operating life-saving medical devices at Pediatric Intensive Care Unit Research Question: What is the level of nurses' performance in operating life-saving medical devices at Pediatric Intensive Care Unit? Operational Definition: Life-saving devices in this study refer to mechanical ventilator, cardiac monitor, and infusion and syringe pumps. Settings: The study was conducted at the Pediatric Intensive Care …

Workplace Stress For Licensed Practical Nurses And Registered Nurses In The Hospital Setting: A Quantitative Review, Dakota Zerman

Honors Projects

Nurses often work in stressful environments. These stressors can have many causes and may vary between specialties. Some examples of stressors are death and dying, conflict with others, and workload. One scale that analyzes these stressful factors is the Expanded Nursing Stress Scale (ENSS). This survey uses the ENSS to examine stressors experienced by Registered Nurses and Licensed Practical Nurses who work in a hospital setting and continues by asking nurses if these factors cause continued stress at home. A survey was distributed online through social media to nurses who reside within the United States. The survey used a Likert …

Assessment Of Nurses’ Knowledge Of Multiple Sclerosis In Morocco, Rachid Lotfi, Hind Bel Amgharia, Mourad Chikhaoui, Abdeslam El Kardoudi, Fatiha Chigr

Jurnal Keperawatan Indonesia

Nurses are essential in early detection, education, symptom management, treatment administration, and care coordination for patients with multiple sclerosis (MS). This role requires both theoretical and practical knowledge. This study evaluates the knowledge level among nurses regarding multiple sclerosis in Morocco. We conducted this cross- sectional study on 326 nurses in Morocco using a purposive sampling method, which involves selecting nursing specialties that have direct contact with patients with MS, aiming to target the most relevant professionals for the study. The data are collected using an anonymous questionnaire distributed individually to participants. We opted for multi- variable logistic regression models …