Medicine and Health Sciences Commons^™

Bridging The Gap: Strategies To Enrich The Clinical Experience Of Undergraduate Nursing Students To Improve Clinical Judgment Skills, Gabrielle Hope

Doctor of Nursing Practice Projects

Introduction: The lack of competent clinical judgement among new graduate nurses contributes to poor patient outcomes, negatively impacting patient satisfaction scores, and subsequently raising the cost of healthcare for consumers. This project explores how reflective journaling and cooperative learning activities contribute to the development of critical thinking of nursing students during their Nursing Fundamentals clinical practicum.

Methods: Seventeen students enrolled in a private university nursing program were selected as the sample. The students were introduced to the recommended learning strategies and invited to anonymously participate in a pre-survey and post-survey. The surveys were identical in content and consisted …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Sleep Hygiene Education, Hope Colon

Doctor of Nursing Practice Projects

This DNP project was designed to increase awareness of insomnia and sleep hygiene in the target community by providing an in-person educational session on sleep hygiene. The educational session provided information on insomnia, sleep hygiene habits, statistics of those with sleep disorders, and medication use for sleep. The impact of the project implementation was measured using a pre-intervention survey and a post-intervention survey. All survey items had an increase in correct answers post-intervention. In conclusion, the results revealed there was an increase in awareness and knowledge base of insomnia and sleep hygiene after the education was provided.

Improving Sexually Transmitted Infections (Sti) Education And Access To Education For Healthcare Workers In A Rural Ambulatory Clinic, Savannah Elmore

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) are prevalent across the United States, with one in five people diagnosed in 2018, resulting in nearly $16 billion in medical costs. The prevention and treatment of STIs have been identified as a priority area for improvement, with healthcare providers playing a critical role in education, diagnosing, and treating STIs. The aim of this capstone project was to improve STI education and access to education for healthcare workers in a rural ambulatory clinic. Through a needs assessment and the development of objectives and a timeline, the project identified and addressed gaps in STI education and resources, …

Mentorships For New Graduate Nurses, Taylor Leigh Bailey

Doctor of Nursing Practice Projects

New graduate registered nurses (NGRNs) represent a crucial segment of the nursing workforce, embodying the future of the profession. Thus, it is imperative that we utilize our resources, knowledge, and experiences to continuously strengthen and grow this generation of nurses. Mentorship is one key method that can be used to support NGRNs. This DNP project aimed to evaluate the effectiveness of mentorship for NGRNs within their first year of nursing practice and was implemented within an existing residency program at a Level I trauma facility. Experienced nurse volunteers received mentor education, and 40 NGRNs were individually paired with these volunteer …

Addressing Nursing School Retention: The Necessity Of Orientation In Nursing Education, Kerstin A. Queen

Doctor of Nursing Practice Projects

Nursing schools have been challenged to impact attrition and retention by creating an environment that increases student success. This DNP project was created to impact the current nursing shortage by increasing the number of nursing students who were retained after the first semester of nursing school. The DNP Project Leader designed a structured orientation program consisting of a 2-day in-person orientation and an online repository of resources. The DNP project sought to increase retention and provide pre-licensure students with gained skills to progress in the nursing program after the first semester in nursing school. The in-person orientation program provided participants …

Bridging The Gap: Strategies To Improve Hpv Vaccination Uptake, Stephanie Ramsey

Doctor of Nursing Practice Projects

The human papillomavirus (HPV) vaccination is approved by the United States (US) Food and Drug Administration (FDA) for individuals beginning at age 9. Evidence shows that HPV vaccination uptake is lower than other vaccinations offered in the early adolescent/adolescent age group. Healthy People 2030 set forth a goal that 80% of adolescents ages 13-15 will have HPV vaccine series completion by 2030. Research has shown that provider recommendation for the HPV vaccine is one of the reasons adolescents, or parents of adolescents, have chosen to initiate and complete the HPV vaccination. Studies have shown that providers who have been educated …

Remodeling Breastfeeding Education, Rhonda Coffey

Doctor of Nursing Practice Projects

Mothers face important decisions regarding how to feed their infants, and successful breastfeeding requires commitment, support, and education. The numerous health benefits of breastfeeding for both mothers and infants are well-documented throughout the literature, and experts recommend exclusive breastfeeding for the first year of life. Healthcare teams play a crucial role in supporting breastfeeding success by providing education, guidance, and troubleshooting assistance when complications arise. Reassurance from healthcare providers can also influence mothers' overall experiences with breastfeeding. The facility where participants deliver assists most mothers in initiating breastfeeding within 1 to 2 hours after delivery, with approximately 75% meeting this …

The Early Prevention Of Diabetic Foot Ulcers, Aruodo Ukpai

Doctor of Nursing Practice Projects

Frequent and proper foot exams and foot care are fundamental in decreasing the incidence and morbidity of diabetic foot ulcers, yet many patients are still not screened at appointments or educated on the importance of foot exams. This research planned to address the lack of foot care education and foot assessments amongst patients with Type 2 diabetes. Past research done on this focused on providing education to diabetic patients either at home or in a setting where patients can come and receive the education. To our knowledge, no research has been done on the use of video teaching to provide …

Improving Epilepsy Monitoring Unit Training For Registered Nurses, Akaia Danae Abernathy Lail

Doctor of Nursing Practice Projects

This quality improvement project was developed to increase the baseline knowledge of a group of registered nurses who work within a highly specialized in-patient healthcare setting, an Epilepsy Monitoring Unit (EMU). The increase in knowledge was trajected to decrease event reporting which would show improvement in this high-risk patient population’s safety. The pre-education survey was dispersed to the participants, the registered nurses, to obtain a baseline knowledge level. There was then EMU-specific educational material made available for the participants. After the set time, the participants were then given a post-education survey to determine if their post-test scores could reflect a …

Benefits Of Patient-Centered Education For Type 2 Diabetes Mellitus, Paige Bortnick

Doctor of Nursing Practice Projects

Type 2 diabetes is a chronic, lifelong illness that affects millions of individuals in the United States. The rate of diabetes has doubled over the last 20 years in America and has climbed to be the seventh leading cause of death amongst Americans. The purpose of this project was to determine if participants in the target community demonstrated increased knowledge and awareness of diabetes after receiving education. A pre-intervention and post-intervention survey was given to determine if the education was effective. Data collected revealed an increased awareness and knowledge regarding the prevalence of type 2 diabetes, lifestyle, and diet modification.

Mental Health And The Black Church: Decreasing The Division In Divinity, Latonya Gray

Doctor of Nursing Practice Projects

Racial disparities in mental health care persist for Black Americans, with only one in three who need treatment receiving it. The care they do receive is often of a poorer quality than that of other groups. Faith communities serving Black members could help address this gap by partnering with mental health professionals to meet congregants' needs. With mental health now at the forefront of public discourse, considering the specific needs of the Black community is critical. Black Americans face disproportionate mental health burdens but are more likely to seek counsel from clergy due to cultural stigma. Educating clergy on mental …

Er Staff & Burnout: Interventions For Stress Management, Sara Elizabeth Kerbow

Doctor of Nursing Practice Projects

Nursing is one of the most difficult professions, not only physically exhausting but the mental and emotional toll can create havoc for the person’s life (Scala & Drummond, 2016). This DNP project, “Reset”, was founded on the concept of nursing burnout, compassion fatigue, and secondary trauma causing overwhelming stress related to the emergency room nurse and staff. The purpose of this project was to show how a 15-minute mental health reset can play an essential role in stress reduction. By using complementary health modalities such as lavender essential oil with diffuser, visual imagery, and massage while listening to soft calming …

Identifying Patients Suffering From Housing Instability In The Emergency Department, Jarvis D. Roberts

Doctor of Nursing Practice Projects

Homelessness is the most visible form of housing instability in the United States of America. Yet, millions of people across our nation live in unstable housing, which consists of temporary housing, shelters, outside encampments, and vehicles. Many citizens facing these types of insecurities live paycheck to paycheck and are one health crisis or emergency away from financial ruin. The COVID-19 pandemic, inflation, and slow hourly wage growth have exacerbated this situation. This project aimed to construct a screening tool to identify patients suffering from housing instability in the emergency department setting and provide them with community resources.

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton

Doctor of Nursing Practice Projects

Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.

Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.

Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …

A Review Of The Effects Of Different Types Of Stigmas On The Retention Rates Of Patients In Medication-Assisted Treatment And How To Combat The Problem, Pamela Cox

Doctor of Nursing Practice Projects

It is difficult to turn on the news without hearing about the opioid epidemic or a recent opioid overdose. There is hope because there is a treatment to help prevent this epidemic. That treatment is known as medication-assisted therapy (MAT), where patients can present and, if they meet the criteria, can be given a prescription for buprenorphine/naloxone combination medication. Treatment with buprenorphine/naloxone has been shown to be highly effective treatment for substance use disorder (SUD). Even though it has been proven that this combination works, less than 20% of patients diagnosed with SUD present for treatment. This study focused on …

Implementing A Strategic Reporting Model Among Public Health Nurse Consultants To Increase Communication, Heather Willis

Doctor of Nursing Practice Projects

Public health has seen a drastic amount of turnover post-pandemic. There was an estimated 44% turnover rate for public health registered nurses, with a vacancy rate that doubled from 12.7% in March 2020 to 23.2% in July 2022 (Skinner, 2022). With this high turnover rate, many nurses are new to North Carolina (NC) public health departments and health districts. Public Health Nurse Consultants (PHNCs) are expected to train and guide these new nursing staff members. With the turnovers continuing at the local health departments (LHDs), new nurses are not given the recommended training because of communication breakdowns. This project helped …

The Use Of Diaphragmatic Breathing Techniques To Reduce Stress In Pre-Licensure Nursing Students, Amy Naugle

Doctor of Nursing Practice Projects

Research supports the idea that pre-licensure nursing students experience higher levels of stress than their general education-focused peers. This DNP project focused on stress related to nursing exams in the first semester of nursing school and promoted the adoption of diaphragmatic breathing techniques. The use of stress management techniques has been explored in those with intense job experiences and has proven to alleviate stress and promote improved coping. This cohort of pre-licensure nursing students was asked to identify stressors that affected them within the preceding 6 months while attending the first semester of a 2-year nursing program. The cohort was …

Medication Reconciliation: Preventing Harm To The Senior Living Population, Charles (Chuck) Jennings

Doctor of Nursing Practice Projects

This project was designed to address the risk of medication errors occurring when geriatric adults return to a senior living setting following an acute care stay. In addition to a primary care physician (PCP), the health care of geriatric adults is often managed by medical specialists and subspecialists. The engagement of multiple providers poses significant communication challenges, as these providers often work in separate offices and are limited in their information sharing. Consequently, following a hospital discharge, reconciling medication orders amongst all providers can be challenging. This challenge is further complicated, as PCPs oftentimes do not interface with the specialists …

Initial Refugee Health Assessment Educational Session, Yolondra Cochnan

Doctor of Nursing Practice Projects

The initial refugee health assessment presents an excellent opportunity to identify communicable diseases in newly arriving refugees. As the number of refugee arrivals increases, so will the need for nurses who possess the skills necessary to conduct the initial refugee health assessment. Prior to the pandemic, the United States was facing a nursing shortage. The impact of the pandemic devastated the nursing community, leaving them exhausted and burnt out, which led many nurses to retire and leave the field of nursing (National Council of State Boards of Nursing [NCSBN], 2023). Skilled nurses are needed to prevent the spread of communicable …

Incorporating Simulation Experiences Into The Nurse Aide Curriculum To Improve Clinical Judgment, Tonya A. May

Doctor of Nursing Practice Projects

This DNP Project was designed to strengthen clinical judgment skills in nurse aide students. Incorporating simulation-based learning opportunities into the nurse aide curriculum supports the development of clinical judgment skills. Four simulation scenarios were designed to focus on the student's ability to respond within the nurse aide’s scope of practice. Pre-test and post-test surveys were developed with a 5-point Likert scale (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 – strongly disagree) to assess the student's perception of their ability to perform, notice, interpret, respond, and reflect on patient care. A …

Increasing Education And Staff Knowledge Of Delirium Care: An Evidence-Based Quality Improvement Project, Serena Martinath

Master's Theses and Capstones

Introduction At a small, community hospital in Massachusetts a gap analysis was conducted leading to a quality improvement project to increase staff education and knowledge regarding delirium and evidence-based best practices for delirium care. Delirium is a growing, often under recognized medical condition that occurs in hospitalized patients (Loftus & Wiesenfeld, 2017). Delirium is characterized by acute changes in congnition, level of consciousness, and attention (Loftus & Wiesenfeld, 2017). A better understanding of this condition is expected to result in improved patient care.

Methods The clinical microsystem studied in this gap analysis project was assessed by using the AHRQ Gap …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Improving Discharge Education Quality In Urgent Care Settings: A Quality Improvement Project, Brielle N. Patscheider

Master's Theses and Capstones

BACKGROUND:

Effective discharge education is vital for improving patient care by enhancing health outcomes and reducing hospital readmission. When patients receive thorough and personalized discharge instructions, they are better able to manage their health, follow treatment plans, and identify symptoms needing further attention. This not only boosts patient satisfaction and safety but also reduces the strain on healthcare systems by decreasing preventable readmissions.

LOCAL PROBLEM:

Urgent care facilities serve diverse populations with a range of common, non-emergency ailments. The rapid service and walk-in availability often lead to a high volume of patients with diverse and complex medical needs. To eliminate …

Enhancing Inpatient Sleep Quality In Patients On An Intermediate Care Unit Through Healthcare Staff Education: A Quality Improvement Project, Avery B. Drouin

Master's Theses and Capstones

Background

In the Intermediate Care Unit (IMCU), patients often suffer from poor sleep quality due to continuous overnight care and inherent hospital environment noise. Poor sleep can adversely affect recovery, especially for cardiac patients, who constitute a significant portion of the IMCU population. Improving sleep quality in these patients is essential for their recovery and overall well-being.

Local Problem

Despite the importance of adequate sleep, only 47% of patients in the hospital that houses the microsystem reported a quiet environment at night using the Hospital Compare online survey platform. Disruptions from alarms, phones, and care activities significantly impact sleep quality, …

Improving Postpartum Depression Education Within The Microsystem, Mackenzie A. Sturdevant

Master's Theses and Capstones

BACKGROUND: Postpartum depression (PPD) is a significant mental health issue affecting a substantial percentage of new mothers, ranging from "baby blues" to severe forms like postpartum psychosis. Maternity nurses play a crucial role in early detection and education due to the gap in postpartum care follow-up appointments, which can delay necessary interventions.

LOCAL PROBLEM: Despite the critical role of maternity nurses, there is variability in their preparedness to educate and support patients regarding PPD during the immediate postpartum period. This study aims to enhance maternity nurses' knowledge and confidence in providing PPD education through a quality improvement (QI) project within …

Improving Patient Handoff In The Emergency Department Microsystem, Alahna V. Kinney-Sandefur

Master's Theses and Capstones

Abstract

Background: Gaps in communication in the patient handoff process have been directly linked to patient safety errors and unwanted patient outcomes. The reviewed literature highlights multiple factors impacting the handoff process and unanimously conclude that a standardized handoff process is necessary in maintaining a high standard of patient safety and a minimization of safety errors.

Methods: This intervention took place in an 86-bed, acute care facility, a level III trauma center macrosystem with implementation of this project taking place in the emergency department and medical/surgical microsystems. Utilizing the Plan, Do, Study, Act framework over a total of eight weeks, …

Improving The Postpartum Depression Discharge Education To Increase Quality And Safety Of Care: A Quality Improvement Initiative, Amanda Lucia

Master's Theses and Capstones

Background: Postpartum depression (PPD) is the most prevalent psychological condition to affect mothers following childbirth which can have detrimental consequences on the physical and mental health of the mother, child, and spouse (Wang et al., 2021). Globally, postpartum depression affects 17.2% of the world population, and in the United States 1 in 8 women who recently gave birth reported symptoms of PPD, and 1 in 10 women reported experiencing a major depressive episode within a year following delivery (CDC, 2023). Patients’ spouses and family members are in a unique position to identify early manifestations of PPD which can lead to …