Medicine and Health Sciences Commons^™

Obesity Management Guideline For The Correctional Setting, Rumi Y. Sato

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obesity can cause multiple chronic conditions, including cancer and death. Los Angeles jail primary care clinics do not address obesity management despite health hazards, rising costs, and high obesity rates in correctional facilities. The Centers for Medicare and Medical Services (CMS) obesity-management guidelines are over ten years old and outdated. The aim of this Doctor of Nursing Practice (DNP) project was to update the CMS obesity-management guideline with the newest intense behavioral therapy (IBT) evidence to assist the correctional multidisciplinary healthcare team. This project took place in a Los Angeles correctional facility's primary care clinic. A detailed literature review gathered …

Guideline To Decrease Nursing Turnover In Intensive Care Units, Carol L. Mention

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Turnover rates of registered nurses working in intensive care units continue to increase significantly after the pandemic. Many nurses have left the profession due to the increased workload and stress during and after the COVID-19 pandemic. Having staffing challenges and turnover can affect the outcome of this patient population. Intensive care nurses experience workplace violence at an increasing volume. Also, robust nurse onboarding and training programs can help decrease turnover rates. The current national guideline does not address these concerns about nursing turnover. A guideline project was performed to identify needed recommendations based on evidence for stakeholders to …

Bundle For Left Ventricular Assist Device (Lvad) In The Ed, Tina Morris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff …

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Glutamate Optimization As A Treatment For Depression: A Clinical Guideline, Luisa Angeles Collins Villares

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Based on the use of drugs to treat hypertension and tuberculosis for depression, the monoamine hypothesis led to the development of antidepressants in 1952. Serotonin was recognized as a deficiency associated with depression in 1967. As a fine-tuning orchestration of neurotransmitters and neuromodulators, the glutamate system became known using Spravato in 2019 and Auvelity in 2022. In this pilot study, mental health experts rated the importance of 24 science-based recommendations to optimize glutamatergic therapy in depression for a proposed guideline on a Likert scale from zero to four. The results were analyzed using a non-parametric predictive modeling method called Chi-Square …

Intentions To Seek Mental Health Services Among Nursing Students In The United States: The Impact Of Adverse Childhood Experiences And Psychological Distress, Zainab Almogheer

Theses and Dissertations--Nursing

Supporting the mental health of university/college students is a crucial issue facing institutions of higher learning in the U.S. A web-based survey encompassing 196 campuses in the U.S. found that rates of diagnosed mental illness among college students has significantly increased in the last decade from 21.7% in 2007 to 35.5% in 2017 (Lipson et al., 2019). Despite the availability of mental health services within universities/colleges, students with mental health problems do not often utilize these services. Recognizing the significance of assessing the mental health of nursing students is paramount, as evident from a study where 35% of 170 participants …

Reducing Mortality Among African American Mothers Related To Postpartum Hemorrhage By Implementing Early Education And Risk Assessments, Don'ya Truesdale

Theses and Dissertations

African American women are at the highest risk for hemorrhaging during childbirth (Okunlola, 2022). A hemorrhage can occur among postpartum mothers for many reasons, with the main causes being uterine atony, tissue trauma, and clotting issues. However, risks for Black mothers differ. The comorbid and social factors within the Black community greatly influence the likelihood of Black mothers experiencing postpartum hemorrhage. Additionally, the lack of assessment and attention catered towards those risk factors lead to an increased mortality among African American (AA) mothers compared to Caucasian mothers and all other ethnicities. Nonetheless, as maternal risk assessments and education increase, mortality …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

The Impact Of Multidisciplinary Just-In-Time Training On Confidence In The Delivery Of Care In The Humanitarian And Disaster Response Environment, Jennifer Verstreken

DNP Scholarly Projects

Background: Team Rubicon International deploys emergency medical teams with little targeted training on the health and illness patterns common to the geographic region and the type of disasters to which they respond, such as cholera, malaria, and malnutrition. These high-risk, low-incidence illnesses are infrequently seen in Western medical practices. Medical, nursing, and paramedical training programs address these illness patterns in the curriculum. Still, a lack of consistent exposure to the care and treatment of patients with these illnesses can lead to a lack of knowledge and confidence in delivering appropriate care.

Purpose: This quality improvement project aimed to determine if …

Assessing Barriers And Facilitators To School Nurse Recommendations Of Human Papillomavirus Vaccination, Amy E. Dark

DNP Scholarly Projects

Background Vaccine hesitancy among students and caregivers is a pervasive challenge for educational leadership and school health staff, leaving the school community at risk for vaccine preventable disease. The human papillomavirus (HPV) vaccine is an underutilized primary prevention strategy against six HPV related cancers.

Purpose The purpose of this quality improvement (QI) project was to measure the effect of an evidence-based educational intervention and facilitated role play on the knowledge and confidence of school nurses (SNs) when discussing HPV vaccination.

Methods This QI project was performed using a brief educational presentation with facilitated role play and a pre/post survey design. …

Implementation Of An Electronic New Patient Intake Questionnaire (E-Npiq) In A Child Development Clinic: A Quality Improvement Project, Wilma Hyde

DNP Scholarly Projects

BACKGROUND: A rural academic medical center child development clinic in New Hampshire experienced high volumes and inefficient workflows, causing delays in care. With a referral rate at 5-fold capacity, the need to create an efficient intake process that allowed for triage and data collection was apparent.

PURPOSE: Institute an integrated electronic new patient intake questionnaire (e-NPIQ) to improve work efficiency.

METHODS: A literature review on barriers and enablers for patient uptake of electronic questionnaires guided best practices for workflow redesign. The project instituted an integrated e-NPIQ while simultaneously creating a standardized new patient intake process. A mixed methods approach analyzed …

Ob-Pdcds Chinese, Marianne E. Weiss, Lili Wei

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Pdcds-Adult German, Marianne E. Weiss, Matthias Marsall

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Pdcds-Adult Korean, Marianne E. Weiss, Kim Jeoung Hee

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Pdcds-Adult Bahasa Indonesian, Marianne E. Weiss, Azizah Khoiriyati

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Ped-Pdcds German, Marianne E. Weiss, Gaby Stoffel

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Management Of High Spinal, An Objective Structured Clinical Examination, Stephanie Williamson, Darienne Lowery

Doctoral Projects

Certified Registered Nurse Anesthesiologists (CRNAs) are responsible for administering safe anesthesia and prompt intervention throughout the continuum of surgical care. During the surgical experience, many potentially life-threatening complications will require timely treatment to prevent irreversible or even fatal consequences. CRNAs are held accountable for recognizing and addressing a wide range of these complications despite their infrequency in clinical practice. Strategic education and training tools must be employed to ensure student registered nurse anesthesiologists (SRNAs) are equipped with the knowledge and critical thinking skills necessary to mitigate crises in the clinical setting.

This DNP project created an Objective Structured Clinical Examination …

The Development, Implementation, And Evaluation Of An Online Program For Emergency Nurses Caring For Victims Of Interpersonal Violence: A Mixed Methods Study, Melanie Brown

Theses

Forensic nursing encompasses a range of skills that can be utilised across healthcare services and legal services. The delivery of forensic nursing care covers a vast number of roles and practice areas that can improve patient outcome, including the care of victims of interpersonal violence who often face multiple barriers in achieving a positive medicolegal outcome. A nurse’s ability to identify a potential victim and initiate forensic nursing care in an emergency care setting can positively influence the patient’s engagement with support services and the justice system. Despite this, a review of the Australian literature has identified inconsistencies in forensic …

The Effect Of A Neonatal Palliative Care Education Program In Increasing Knowledge And Communication Self-Efficacy Among Nicu Nurses, Shiou-Huei Joy Wang

Doctoral Projects

Background: Neonatal palliative care is crucial to providing comprehensive, high-quality care to neonates with life-limiting or life-threatening health conditions and their families. One significant barrier to the inconsistent provision of neonatal palliative care is the lack of education. This project aimed to deliver an education training program to increase neonatal palliative care knowledge and self-efficacy in NICU nurses. Method: A pre-post-test study design was used to examine the efficacy of an educational training program on NICU nurses’ knowledge and communication self-efficacy in neonatal palliative care. A post-test was administered immediately after the training and again four weeks later to evaluate …

Dental Students’ Psychological Stress: A Comprehensive Investigation Of Stress Inducing Factors At Mohammed Vi University Of Sciences And Health, Latifa El Mouden, Elmehdi Fettach

Health Sciences

Dental students are significantly confronted with mental health problems. We conducted a prospective recruitment of students at the Faculty of Dentistry of the Mohammed VI University of Sciences and Health to investigate the determinants of stress specific to this population in order to find solutions to improve their quality of life. In our study, 410 students responded to the survey, the average age of the students was 21.51 ± 2.102 years, 70% were female, 30% were in their 6th year, and 60% of the students were from Casablanca. The average MSP-25B score was 101.94 ± 33.035. In our study, there …

Improving Patient Engagement Post-Percutaneous Coronary Intervention Using The Systematic Introduction Of A Cardiac Rehabilitation Bundle In A Community Hospital: A Quality Improvement Project, Rebecca Vela

Doctor of Nursing Practice Final Project Abstract

PURPOSE This quality improvement project aimed to increase patient participation and program completion rates in cardiac rehabilitation (CR) following percutaneous coronary intervention (PCI) by 10% of the historical baseline within 3 months.

BACKGROUND Heart disease is the leading cause of death in the United States. PCI is a standard treatment for symptomatic heart disease. CR is a post-PCI secondary strategy proven to reduce mortality and improve quality of life. The project addressed below-average CR attendance at a community hospital in the greater Houston area.

METHODOLOGY An evidence-based, multidisciplinary bundle that included education, signage, defined quality metrics and dashboard, patient-centered care, …

Decreasing Compassion Fatigue In Inpatient Nurses Using Debriefing And Group Care Program, Hanh Nguyen

Doctor of Nursing Practice Final Project Abstract

Purpose: The quality improvement project's purpose was to use a group care program to decrease compassion fatigue (work-related stress) in nurses. The project aimed to reduce compassion fatigue in nurses by 25% and nurse turnover rates by 10% post-intervention.

Background: The project was implemented on two inpatient units in Texas. Decrease in compassion fatigue can help improve nurse well-being and nurse retention, promoting safe quality nursing care.

Methodology: The Professional Quality of Life Scale (ProQOL) survey measured compassion satisfaction and burnout pre-intervention. Twelve weekly program sessions were completed using strategies: debriefing, breathing exercise, and muscle relaxation. A …

Implementation Of Same Day Cervical Cancer And Chlamydia Screening In A University Clinic Setting, Amanda Rodriguez

Doctor of Nursing Practice Final Project Abstract

Implementation of same day cervical cancer and chlamydia screening in a university clinic setting

PURPOSE The purpose of this quality improvement project was to implement a screening questionnaire in a university student health center to increase the rates of up-to-date cervical cancer and chlamydia screening.

BACKGROUND The project was implemented at a university-based student health center with a student population of 31,559 with 60.3% of the population being female.

METHODOLOGY A screening questionnaire regarding pap smear results and last chlamydia testing was developed for all female students age 18-65 to complete at check in for their appointments. Medical staff were …

Impact Of A Nurse Manager Development Program On Manager Competency And Intent To Leave, Yashamika Short

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this Quality Improvement Project is to create an evidence-based onboarding and orientation process for novice and assistant nurse managers that positively impacts nurse manager competency and intent to leave.

BACKGROUND Many organizations don’t provide formal leadership training for their nurse managers. Nurse managers are typically selected for their positions based on clinical expertise rather than leadership and management competency.

METHODOLOGY American Organization for Nursing Leadership Manager Competency Assessment tool and Dr. Nora Warshawsky Nurse Manager Intent to Leave Survey were utilized pre/post training. The framework has 3 domains: the science (managing the business), the art (leading …

Enhancing Medication Safety Through Standardized Protocols And Skills Competency Checklist: A Quality Improvement Project In Group Homes For Individuals With Intellectual Disabilities, Mary Chilaka

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement (QI) project aimed to enhance medication safety in group homes for individuals with intellectual disabilities by implementing standardized protocols and a skills competency checklist for Unlicensed Assistive Personnel (UAPs).

BACKGROUND

Medication errors in group homes often result from inconsistent training and oversight among UAPs. This project addressed these gaps by introducing structured training, a competency checklist, and workflow improvements to enhance adherence to best practices.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) cycle, key interventions included bi-weekly training, hands-on shadowing, competency assessments, and "do not disturb" signage to minimize distractions. Data collection included pre- and post-training surveys, weekly …

Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson

Theses & Dissertations

Background:

Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.

Purpose:

The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity …

Increasing First-Attempt Endotracheal Intubation Success Rates In The Aeromedical Environment, Jared Copeland

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: In 2022, the first-attempt endotracheal intubation success rate of an aeromedical agency had steadily declined and was currently below the international average of 88.48%. This decreased success rate potentially placed patients at risk for adverse events that increase morbidity and mortality. Background: Patients who experience a failed first-attempt intubation are at greater risk of intubation related complications. These complications include hypoxemia episodes, severe arrhythmias, pulmonary aspiration, hypotension episodes, cardiac arrest, and death. Literature Review: Preoxygenation, patient positioning, maintenance of oxygenation, drug selection, and device utilization have been found to increase first-attempt endotracheal success rates. Project Aims: The project …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Establishing Guidelines For Implementing Electronic Hand Hygiene Monitoring Systems, Olaoti Opaleye

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Healthcare-associated infections (HAIs) in hospitals threaten patient safety and quality of care, which leads to increased healthcare costs. Despite national and state-level progress in hand hygiene compliance (HHC), the 2022 CDC annual report on HAIs highlighted ongoing concerns for standard infection ratios (SIRs) and called for improved HHC to reduce HAIs. Many hospitals use trained observers to collate HHC data; their audits are limited and often skewed by the Hawthorne Effect (HE) and observer bias, resulting in inaccurate HHC data. This project aimed to create guidelines for implementing electronic hand hygiene monitoring systems (EHHMSs) to help hospital inpatient units adopt …