Medicine and Health Sciences Commons^™

Reducing The Incidence Of Hospital Acquired Pressure Injuries With An Interprofessional Collaboration Using Range Of Motion Exercises, Angela Johnson

Doctor of Nursing Practice Projects

Background: Hospital - Acquired Pressure Injuries (HAPIs) are an enormous problem for healthcare institutions and patients. HAPIs are painful, can lead to additional infections, increase the length of stay, and even cause death. Hospitals around the country are experiencing increases in the number of HAPIs. This project was implemented in a medical-surgical unit of a local urban hospital in the southeastern United States. The medical-surgical unit reported an increase in the number of HAPIs that exceeded the national average of 3%.

Purpose: The purpose of this quality improvement project was to apply an interprofessional approach to reduce HAPIs using a …

Improving Influenza Vaccination Rates In A Primary Care Clinic: A Quality Improvement Crusade, Janet Lowe

Doctor of Nursing Practice Projects

Background: Research consistently shows that influenza vaccines prevent medical appointments, treatments, and disabilities. In the United States (U.S.), 25-49 million individuals contracted influenza from October 2022 through January 2023. However, despite a greater community consciousness regarding viral contagions and the improved availability of vaccinations through primary care settings, ambulatory clinics, and local pharmacies, adults in the U.S. continue to miss the national influenza vaccination goals of 70%.

Purpose: This Doctor of Nursing Practice (DNP) project aimed to boost influenza immunization rates and comprehension of vaccination benefits among patients in a primary care setting during the influenza season. The DNP student …

Improving Door-To-Balloon Times In Adult Patients With St-Elevation Myocardial Infarction By Utilizing A Stemi-Rn, Amanda Hunter

Doctor of Nursing Practice Projects

Background: Heart disease is the leading cause of death in Alabama. The national estimated annual incidence of myocardial infarction (MI) is 605,000 new and 200,000 recurrent attacks, of which approximately 170,000 are silent (Tsao et al., 2022). Roughly every 40 seconds, an American will have an MI (Tsao et al., 2022). An ST-elevation myocardial infarction (STEMI) occurs when one or more of the coronary arteries supplying the heart with blood occlude, leading to myocardial injury (Akbar et al., 2021). Clinical practice guidelines for STEMI recommend Door to Balloon (D2B) intervention in 90 minutes or less (O'Gara et al., 2013), while …

Utilization Of A Simulation Electronic Documentation Model For Healthcare Providers To Reduce Documentation Errors In A Hospital Setting, Icy Moton-Hale

Doctor of Nursing Practice Projects

Background: Electronic health records (EHRs) are commonly used within healthcare systems across the United States. Although EHRs were developed to provide safe delivery of care, poor documentation quality remains a problem. Poor HER documentation can negatively affect many patients’ health outcomes.

Purpose: The purpose of the DNP project was to determine the degree to which using a simulated electronic documentation model to train nurses in an acute care unit would decrease documentation errors and missed care and decrease missed opportunities for patient education in EHRs.

Methods: The theoretical framework was underpinned by the Donabedian model, positing that factors associated with …

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …

Promoting Wellness With Medical-Surgical Nurses In An Urban Medical Center Through Mindfulness-Based Stress Reduction, Shemeka Leonard

Doctor of Nursing Practice Projects

Background: Due to their position on the forefront lines of the healthcare system, nurses are more likely to experience stress at work. Job-related stress can cause increased anxiety, emotional turmoil, depression, and other mental issues. Nurses commonly deal with elevated distress due to workload demands such as passing medication, checking for errors, ensuring patient safety, and charting—mindfulness-based stress reduction (MBSR) is a useful means of reducing psychological distress.

Purpose: The DNP project objectives were to reduce stress, encourage well-being, and show how effective an MBSR program works in a hospital setting. The aim is to reduce stress/improve wellness.

Methods …

Improving Early Sepsis Recognition And Treatment By Utilizing The Surviving Sepsis Campaign In Emergency Department Patients, Rebecca Smith

Doctor of Nursing Practice Projects

Background: Sepsis is a physical reaction to infection that can cause bodily injury, organ deterioration, and death (Sepsis Alliance, 2022). Early sepsis identification and intervention requires staff engagement in quick recognition and implementation of care (Jorgensen, 2019). Septic patients require prompt initiation of intravenous fluids, hemodynamic observation, and appropriate laboratory testing (Evans & Rhodes, 2021). Rapid detection of sepsis can prevent patients from progressing to severe sepsis and septic shock, increasing the risk of mortality (Jorgensen, 2019). As a result of the high mortality rates and complications associated with this health disparity, evidenced-based care bundles were developed to improve care …

Using The 2as And R Method To Encourage Referral To Smoking Cessation Counseling In An Urban Pulmonary Clinic, Jennifer Holloway

Doctor of Nursing Practice Projects

Background: Smoking is a habit of millions of Americans despite the associated preventable health issues and death that it produces. Smoking cessation programs, particularly those using pharmacotherapy, are effective in increasing smoking cessation rates. However, smoking cessation programs remain underutilized.

Purpose: The purpose of the DNP project is to educate providers on using the 2As and R (ask, advise, and refer) of smoking cessation to assess a patient’s readiness to quit and refer to smoking cessation counseling. For providers working in an urban pulmonary clinic, does education regarding the use of the 2As and R method as a standardized intervention …

Evaluation Of A Peer Support Group Implementation To Reduce Burnout In Nursing Staff On An Acute Inpatient Mental Health Unit, Marilyn Scott

Doctor of Nursing Practice Projects

Background: Burnout is feeling emotionally overwhelmed and exhausted due to stress in the workplace. Caring for acute psychiatric patients can impact the mental health of nursing staff and contribute to high-stress levels. Nursing burnout contributes to staffing shortages and increased risk for adverse patient safety events in an acute inpatient mental health unit.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) Quality Improvement (QI) project was to evaluate the impact of a peer support group on burnout reduction in the nursing staff working in an acute inpatient mental health unit.

Methods: A peer support group was implemented …

Stress Reduction In Correctional Healthcare Workers: A Survey Of Healthcare Staff Stress Levels In A Tennessee Correctional Facility Using The Perceived Stress Scale, Lashelle Melton

Doctor of Nursing Practice Projects

Background: Correctional nurses’ function in a high-stress environment due to the nature of their clients and the importance of environmental security. Job stress and satisfaction are theorized relational concepts that influence intent to stay, and turnover as described in the anticipated turnover model. Acute stress can occur in correctional nurses when faced with unexpected or intense situations, such as a medical emergency, a violent incident, or a suicide attempt. Several factors can contribute to acute stress in correctional nurses, leading to overwhelming feelings and making it difficult for nurses to provide quality care.

Purpose: The DNP project aims …

Physical Exercise As A Lifestyle Modification To Lower Blood Pressure In Hypertensive Females With A Body Mass Index Greater Than 25, Kacee Pee

Doctor of Nursing Practice Projects

Background: Hypertension affects many Americans nationwide and, if untreated, can cause heart attack, stroke, and chronic kidney disease. Hypertension (HTN) accounts for about 1 in 5 deaths of U.S. women and is a greater burden for women than men (Wenger et al., 2018). Women who are overweight increase their risk of developing hypertension. Lifestyle modifications, such as diet and exercise, are the first-line treatment for hypertension. Physical exercise is a crucial component of lifestyle therapy for the primary prevention and treatment of hypertension. Several studies consistently demonstrate the beneficial effects of exercise on hypertension, with reductions in both systolic and …

The Quality Improvement Program For Sepsis Fallouts: Utilizing Education And An Order Set To Improve Compliance With Sep-1, Ryleigh Tibbitt

Doctor of Nursing Practice Projects

Background: Sepsis is a multisystem disease that occurs when the human body reacts to a severe infection in the body. Sepsis is a life-threatening response that can lead to multisystem organ failure and even death. Sepsis is the number one cost of hospitalization and is estimated to be $62 billion annually (Sepsis Alliance, 2022). This disease affects at least 1.7 million adults yearly in the United States, and nearly 270,000 die from it (National Institute of General Medical Statistics [NIGMS], 2021).

Purpose: This Doctor of Nursing Practice (DNP) project aimed to improve the compliance rate of the sepsis bundle with …

Utilizing The Cdc T-Dap Educational Material To Increase Parental Consent Of T-Dap Vaccination Rates Among Children 11-14 Years, Anita Pates

Doctor of Nursing Practice Projects

Background:The T-dap vaccine is vital to combating vaccine-preventable diseases. "T-dap vaccine can prevent tetanus, diphtheria, and pertussis" (Centers for Disease Control and Prevention [CDC], 2021). Therefore, providers must identify and educate parents whose child is unvaccinated with the T-dap vaccine. "If an increase in unvaccinated children continues to rise, there is risk for a resurgence of vaccine-preventable diseases and potential increase in deaths related to these infectious diseases" (Bowling, 2018, p. 128).

Purpose: The purpose of this DNP project was to implement an educational session targeting parents of children aged 11-14 in a pediatric clinic in an urban area …

Overuse Of Broad-Spectrum Antibiotics In The Acute Care Setting, Adaline Morris

Doctor of Nursing Practice Projects

Background: The identified problem discussed for the DNP project is antimicrobial resistance in acute care settings associated with the overuse of broad-spectrum antibiotics. Antibiotics are often started before obtaining cultures, thus skewing the results. The overuse of antibiotics can lead to almost complete resistance. In a study reviewed by Olesen, et al., performed in 2011, 34% of people received an antibiotic, and 10% of people received 57% of all antibiotic prescriptions (Olesen, et al., 2018). According to the World Health Organization (WHO), for example, a 92% resistance rate prescribing Ciprofloxacin for urinary tract infections with an E.Coli bacteria. (World Health …

Incorporating A Depression Screening Tool With A Music Strategy For Depression In Adults Aged 50 And Older In An Ltc Facility, Margaret L. Hill

Doctor of Nursing Practice Projects

Background: Depression is not a normal part of life or the aging process. Unfortunately, older adults are at an increased risk of experiencing depressive symptoms. The global prevalence of major depression in older adults at 13.3%, and adults (70 and above) have a higher risk of depression compared to other age groups.

Purpose: The purpose of the DNP project was to improve patient outcomes through the implementation of depression screening and an adjunctive music strategy in older adults with depressive symptoms.

Methods: A pre, mid, and post-intervention was conducted in a long-term care facility. This author conducted a …

Reducing Falls And Enhancing Patient Safety: The Role Of Purposeful Hourly Rounding In Rehab Units, Jeffrey Hughes

Doctor of Nursing Practice Projects

Background: This Doctor of Nursing Practice (DNP) project aims to evaluate the impact of purposeful hourly rounding (PHR) on fall rates and patient outcomes over eight weeks. Fall rates for the rehabilitation unit were examined at the facility, showing 5.19 falls per 1,000 patient days, while the national average is around 3.0 falls per 1,000 patient days. Falls in the hospital are often preventable events. Ensuring the staff in the rehab unit were adequately trained on the use of purposeful hourly rounding (PHR) offers an approach that may reduce the number of these largely preventable events.

Purpose: Purposeful …

Implementing An Emergency Severity Index (Esi) Triage Refresher Training To Decrease The Under-Triage Rate In The Emergency Department (Ed), Monique Wallace

Doctor of Nursing Practice Projects

Background: The Emergency Severity Index (ESI) is a triage tool used in most emergency departments in the United States (U.S.) that assesses acuity and resource allocation for emergency care patients. Registered nurses (RNs) must assign the appropriate triage category to ensure patients are seen in a proper time frame, have ideal patient outcomes, and have efficient patient throughput.

Purpose: This quality improvement project aims to decrease the under-triage rate of patients in the emergency department (ED) by implementing an Emergency Severity Index (ESI) triage refresher training.

Methods: This project used an A3 methodology. The triage specialist completed retrospective chart reviews …

Functional Ability And Quality Of Life Of Adult Patients With Hearing Loss: A Cross-Sectional Study, Shalini Saligrama, Soumya Christabel Dr., Jomon C U

Manipal Journal of Nursing and Health Sciences

Background and aim: The loss of hearing becomes precious when it is lacking, which makes it valuable. Hearing loss commonly affects functional ability and quality of life (QoL). Assessing the QoL in individuals with hearing loss helps with interventions and modifications of life habits. Objectives: The purpose of this study was to assess the functional ability and QoL of adult patients with hearing loss and to find the correlation between functional ability and QoL. Materials and methods: Adult patients (132) aged between 19 and 70 were chosen, all experiencing sensorineural, conductive, or mixed hearing impairments ranging from moderate to …

Pregnancy In United States Immigration Detention: Listening To Migrant Women's Stories, Amanda Heffernan

Nursing ETDs

Over the last five years, dramatic shifts in immigration policy across three presidential administrations have impacted migrants arriving at the U.S.’ southern border, with unique impacts on pregnant migrants. The purpose of this study was to document, analyze and contextualize the experience of pregnancy in United States immigration detention. Specifically, the study aimed to: 1) understand the situation of pregnant migrants detained in United States immigration detention facilities between 2017-2022; 2) situate the experience of detained pregnant migrants within multiple contexts, including their own individual and family migration stories and the larger context of United States immigration policy; and 3) …

Initiating A Childhood Obesity Screening Process In An Urban Pediatric Office, Kesha Thomas

Doctor of Nursing Practice Projects

Background: The benefit of identifying a pediatric patient with obesity is to prevent many chronic health conditions that can occur from diabetes. Pediatric patients can be at risk for prediabetes, low self-esteem, and musculoskeletal issues. The patients that are at higher risk for childhood obesity are African American and Hispanics.

Purpose: The Doctor of Nursing Practice project aims to identify a pediatric patient that is obese to make sure that the patient is assessed appropriately and to discuss an appropriate intervention for the patient. To make sure all pediatrics have an accurate height, weight, and A1C during their well-child visit. …

The Implementation Of The Pressure Injury Prevention Protocol To Reduce The Incidence Of Hospital-Acquired Pressure Injuries In A Va Medical Surgical Unit, Nekia Whitlow

Doctor of Nursing Practice Projects

Background: The clinical gap in service addressed in the DNP project was hospital-acquired pressure injuries. A hospital-acquired pressure injury (HAPI) is a local injury to the skin and underlying tissue during an inpatient hospital stay. The injury is caused by pressure, shear, or both (The Joint Commission (TJC), 2022). The development of a HAPI can result from other factors, such as advanced age, immobility, perfusion issues, nutritional status, illness severity, and chronic conditions (Rondinelli, Zuniga, Kipnis, et al., 2018). Immobile or sedated patients in the intensive care units are the most at risk because they have medical conditions that prevent …

Barriers And Facilitators Of Diet, Physical Activity Levels, And Sleep Among Nursing Undergraduates And Early-Career Nurses: A Qualitative Descriptive Study, Michael D. Wirth, Jaclyn Meyer Phd, Rn, Faan, Angela Jessup, Robin M. Dawson Phd, Rn, Cpnp-Pc

Publications

Purpose: Mechanisms leading to burnout, associated with high turnover in nursing, may start as early as in nursing school. Given health habits (e.g., diet, physical activity, and sleep) can exacerbate or lessen the impact of burnout, this study examined current barriers and facilitators to healthy diet, physical activity levels, and sleep among nursing undergraduates (UGs) and early-career nurses (ECNs). Research Design: Qualitative descriptive study. Sample: 25 nursing UGs and 25 ECNs (within 3 years of graduation) from a Southeastern college of nursing. Data Collection and Analysis: After development of theory-informed interview guides, participants conducted interviews either in-person or by phone, …

The Impact Of A Colonoscopy Bowel Prep Educational Video On Bowel Prep Outcomes, Tula Jefferson, Lauren Williams-Bryant

School of Nursing Student Presentations

Faculty Chair: Dr. Tedra Smith
Clinical Mentor: Briana Golden
Presented: DNP Orientation UAB School of Nursing, July 2023

The Impact Of Self-Care Education And A Meal Voucher Incentive Program On No-Show Rates At The University Alabama At Birmingham Heart Failure Transitional Services For Adults Clinic, Lauren Lipton, Sara Monson, Jihe Park, Mary Faith Trammell

School of Nursing Student Presentations

Faculty Chair: Dr. Somali Nguyen
Clinical Mentor: Dr. Connie White-Williams
Presented: DNP Orientation UAB School of Nursing, July 2023

Implementation Of Rapid Postcode Debrief Tool To Reduce Postcode Stress In Micu Rns: A Quality Improvement Study, Julie Capuson, Elyse Falchek, Elizabeth Harper, Nicole Kotval

School of Nursing Student Presentations

Faculty Chair: Dr. Patricia Speck and Dr. Tami Long
Clinical Mentor: Geri Anne Warman
Presented: DNP Orientation UAB School of Nursing, July 2023

Decreasing Fall Rates On Unit 75 Medical-Surgical Using Revised Fall Prevention Program, Sierra M. Foster, Brooke L. Johnson, Shelby F. King, Courtney R. Morris, Cassandra A. Wheeler

School of Nursing Student Presentations

Faculty Chair: Dr. Lisa Pair
Clinical Mentor: Sapheria Pollard
Presented: DNP Orientation UAB School of Nursing, July 2023

Diabetic Training For Nurses Through An Evidence-Based Bundle, Shanteia Beavers Bsn, Rn, Alex Bristow Bsn, Rn, Amanda Houser Bsn, Rn

School of Nursing Student Presentations

Faculty Chair: Curry Bordelon
Clinical Mentor: Emily Guess
Presented: DNP Orientation UAB School of Nursing, July 2023

Why We Work: Exploring The Relationships Between Work Rewards, Burnout, And Intention To Leave For Professional Nurses, Jacqueline Christianson

Dissertations (1934 -)

Nurse burnout leads to attrition from hospital nursing positions and the nursing profession prior to typical retirement age. Yet some nurses choose to stay despite burnout. Previous research indicates that nurses stay due to the rewards they receive from work but the relationships between different types of work rewards, work-related burnout, and intention to leave are poorly described. The ability to implement or execute altruistic behaviors may also represent an under-recognized work reward. Thus, the purpose of this study is to investigate the relationships between work rewards, work-related burnout, and intention to leave nursing positions and the nursing profession and …

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Establishment Of Unit-Based Council Using A Shared Governance Toolkit For Surgical Clinics, Fica Etienne

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational framework that empowers healthcare professionals by granting them authority over their own professional practice. The absence of a unit-based council (UBC) has been identified as hindering collaborative decision-making and problem-solving approaches.

PICOT: In four surgical clinics requiring a Unit Based Counsel (UBC) structure (P), what is the impact of implementing a Shared Governance (SG) toolkit (I) compared to not implementing an SG toolkit (C) over eight weeks? (T)

Evidence: The existing literature strongly indicates that shared governance (SG) empowers nurses to collaborate as equal partners with nursing leaders within …