Reducing Polypharmacy Amongst Home Based Older Adults Using Patient Centered Education, Evelyn Oluoha

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to identify and implement a patient education program on medication safety that can help reduce instances of polypharmacy among home-based elderly patients. This education program is pursued as an effective intervention in reducing polypharmacy in home-based older adults.

Background: Studies show that the majority of home-based older adults take at least one to five medications daily, increasing the risk of polypharmacy adverse medical outcomes. Effects of polypharmacy include medication non-adherence, increased risk of potentially inappropriate medication, drug-drug interactions, drug duplications, adverse drug reactions, and higher healthcare …

Talking With Horses: Equine Assisted Activities To Promote Social Engagement In Individuals With Autism Spectrum Disorder, Amy Ezhaya

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this evidenced-based project is to gather data on how therapeutic horseback riding (THR) facilitates social engagement in individuals with autism spectrum disorder (ASD). The project aims to provide alternative treatment options and disseminate information to providers on the importance of community partnerships.

Background: In 2020, it was estimated that 1 in 54 children had ASD, which is a 170% increase since 2000. Often, those diagnosed with ASD also experience co-occurring mental health diagnoses placing a large burden of care on our healthcare system. THR is a growing alternative treatment option and has been found …

The Impact Of The Family Nutrition And Physical Activity (Fnpa) Tool With Diet And Physical Education On Obesity Awareness And Body Mass Index (Bmi) Of Overweight Patients, Sheena Amos

Doctor of Nursing Practice Final Manuscripts

Purpose

This evidence-based practice project aims to apply the Family Nutrition and Physical Activity (FNPA) tool with diet and physical education to increase obesity awareness and decrease body mass index (BMI) among overweight parents in the community. The FNPA screening tool is a behaviorally based assessment designed to allow parents to evaluate obesogenic environments and practices that may predispose their children to become overweight. The first goal was to recruit parents in the community and utilize the FNPA tool to assess and better understand their diet and physical activity levels. The second goal was to increase obesity awareness among these …

A Comparison Of Suprathel Burn Dressing Vs Standard Care On Length Of Hospitalization, Pain Scores, Opioid Use, Treatments, And Outcomes., Rakiema T. Sellars-Pompey, Anthonia Okoh

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced-based practice Doctor of Nursing Practice (DNP) project was to determine the impact and efficacy of using Suprathel artificial wound and burn dressing on patients treated at a UC San Diego Health Regional Burn Center for second-degree burns. The primary goal of this project will be to evaluate the impact of using Suprathel on hospital length of stay; compare wound infection rates, pain score, and morphine equivalent use; and to identify the cost-effectiveness of the Suprathel artificial wound and burn dressing.

Background: Burns are a global health concern causing significant morbidity and mortality, …

Improving Nursing Student Retention: Early Identification Of Determinants Causing Attrition In Nursing Academic Programs, Tennille Gifford

Doctor of Nursing Practice Final Manuscripts

Introduction: Student success in higher education is a vital focus for the health of a community and the improvement of an individual’s life. It is equally detrimental if a student leaves an educational program without a degree. The purpose of this project was to improve the early identification of students at risk of attrition in a nursing program by using an electronic dashboard interfaced with a self-reporting student survey to identify determinants that are statistically significant factors for student attrition. Background: The current accreditation benchmark for nursing program completion is 70% for Bachelor of Science in Nursing degrees. Concordia St. …

Implementation Of A Follow-Up Procedure For Patients Treated With Transcranial Magnetic Stimulation At A Primary Care Clinic, Brooke Marino

Doctor of Nursing Practice Final Manuscripts

Background: Depression is one of the most common mental disorders in the United States. In 2020 alone, an estimated 21 million adults experienced at least one depressive episode, representing 8.4% of all U.S. adults. Transcranial magnetic stimulation (TMS) therapy is a cutting-edge option for treatment-resistant depression, and up to 70% of patients treated with TMS will achieve at least a 50% reduction in depression symptoms. For some, these results are long-lasting; for others, depression symptoms may return. For those who experience return of their depression symptoms, more TMS may be necessary. Currently, there is no standardized follow up procedure after …

Improving Nurse Call By Evaluating A New Technology, Ariel Norton

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to evaluate a new technology designed to improve the nurse call experience. The goal of the technology pilot was to improve communication and care coordination, enhance patient satisfaction, and improve overall response time.

Background: Today, modern integrated nurse call systems are found in all acute care hospitals in the United States, as mandated by the Joint Commission. These systems continue to become more digital, while the core function stays the same—notifying the care team that the patient needs their assistance. A meta synthesis of the literature …

Implementation Of A Shared-Decision Making (Sdm) Approach In A Community Based Outpatient Mental Health Clinic, Alexa Vuylsteke

Doctor of Nursing Practice Final Manuscripts

Purposes/Aims: The purpose of this Doctor of Nursing Practice (DNP) project is to implement an evidence-based SDM approach in a culturally diverse community mental health clinic in order to increase patient-provider collaboration and improve patient autonomy and engagement in decision making processes of care in a mental health setting.

Rationale/Background: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), shared decision-making (SDM) is a collaborative communication approach between patient and provider that aims to help people in treatment work together to have informed, meaningful discussions about their health care decisions. SDM is an evidence-based approach to encourage and …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Utilization Of Telemedicine For Follow Up Appointments In Radiation Oncology, Priya Patel

Doctor of Nursing Practice Final Manuscripts

Access to healthcare remains a problem for patients in the United States, especially those who live in remote areas, are immobile, immunocompromised, or are experiencing financial strain. These barriers can lead to missed appointments, putting financial strain on healthcare institutions, and contributing to productivity loss and underutilization of clinic resources. During the COVID-19 pandemic there was a rapid increase in the use telemedicine. Patients were surveyed on the quality of their telemedicine visit at the UCSD Health Moores Cancer Center Radiation Oncology department. The majority of patients would schedule telemedicine appointments in the future, which can reduce the burden on …

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

The Lived Experience Of Patients With Clostridioides Difficile, Andrea Scherschel

Dissertations

Background: Clostridioides difficile (C. difficile) is the most common healthcare-acquired gastrointestinal infection in the United States. While there is a plethora of information on the treatment and diagnosis of C. difficile infection (CDI) in the literature, there is a paucity of research findings describing the lived experience of a person with the disease.

Objective: This study described the lived experience of patients who have had one or more CDIs.

Lines of Inquiry: There were two lines of inquiry for this study: (1) Describe the lived experience of having a CDI, and (2) determine if photo-elicitation as a research modality enhanced …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Social Determinants Of Health And Health Confidence, Laura Truman

Dissertations

Purpose/Aims: The purpose of this study was to investigate the relationship among social determinants of health (SDOH), select sociodemographics, and health confidence level in adults receiving care at an urgent care center.

Background/Rationale: To improve overall health and reduce health inequities during a global pandemic and unprecedented rates of inflation, the relevancy and urgency of identifying how patient-level SDOH impact health confidence level are even greater. Extant research indicates a relationship between the number of unmet social needs and low health confidence. Low health confidence predicts poor involvement in self-care and is associated with an increased use of costly health …

Implementing Outpatient Screening Of Adult Patients At High Risk For Peripheral Artery Disease, Coral Roseberry

Doctor of Nursing Practice Final Manuscripts

Background: Peripheral artery disease (PAD) is a prevalent chronic vascular disease that remains often underdiagnosed and inadequately treated. The development of PAD increases both with age and with the presence of modifiable and non-modifiable risk factors. Risk factors for PAD include smoking, diabetes, hypertension, hyperlipidemia, and chronic kidney disease. Furthermore, PAD can be an indicator of systemic atherosclerosis which is associated with coronary artery disease, carotid stenosis, and cerebrovascular disease. Undiagnosed obstructive PAD contributes to damaging atherosclerotic sequelae such as claudication, ulcers, infections, peripheral neuropathy, and amputations. It is common for PAD to exist in the absence of symptoms; therefore, …

A Prescription For Exercise In Adolescents: A Pilot Project, Alexa Sikalis

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice project was to increase physical activity (PA) times in pediatric patients who were not meeting the recommended guidelines of 60 minutes per day of activity. The goal was to educate adolescents on the benefits of exercise in order to increase their overall PA, even if it did not meet the recommended 60 minutes per day. The implemented education was also intended to motivate patients to establish healthy habits and minimize risks of poor health outcomes.

Background: Adolescence is characterized by development of neuronal plasticity and establishment of behavioral patterns. PA …

Assessing Genomic Literacy In Advanced Practice Nursing Students Before And After An Intervention, Guiselle Palomera

Doctor of Nursing Practice Final Manuscripts

Introduction

The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to examine genetics and genomics literacy in advanced practice nursing students before and after an intervention.

Background

As genomics continue to play an emerging role in healthcare, and advancements are introduced into clinical practice, it is critical that nurses be competent in genetics and genomics concepts. There is a fundamental need to incorporate genomics education into nursing school curriculum. However, studies have shown that the majority of faculty across nursing schools in the United States are ill-equipped to teach genetics and genomics concepts. Furthermore, many interventions to …

A Team-Based Approach To Increase Initiation Of Self-Management Goals In Adult Patients Diagnosed With Hypertension With The Use Of A Self-Management Goal Toolkit, Kristel Danette Ramsay

Doctoral Dissertations and Projects

Due to the high risk of cardiovascular disease and other negative complications, it is imperative that patients in the primary care clinic diagnosed with hypertension control blood pressure levels. The purpose of this scholarly project was to increase the initiation of self-management goals (SMGs) among adult males and females age 30 to 60 diagnosed with hypertension. These patients were active duty military, reservists, and dependent beneficiaries who receive care at the Navy Medicine Readiness Training Unit–Memphis. The practice change took the onus of introduction and education about SMGs off the provider and added key responsibilities to support staff, who provided …

Diversity In Nurse Anesthesia Education: Understanding The Perspective Of Racial-Ethnic Minority Nurse Anesthesia Students, Lorette Osun, Jeannette Ineza

Doctor of Nursing Practice Projects

The idea that race is not an issue, everyone is treated fairly, and the denial of racial differences is an act to refute that racism still perpetuates nursing education. Racial-ethnic minority student registered nurse anesthetists (SRNA) face unique challenges in their didactic and clinical training, including microaggressions, discrimination, and bias, all of which white students do not have to face during their educational experiences (Carter & McMillian-Bohler, 2020). Our project sought to highlight the lived experiences of ethnic minority student registered nurse anesthetists in the United States to bring awareness and effectuate change in nurse anesthesia education. Our Qualtrics survey …

The Effects Of Therapeutic Activities On Depression In The Long-Term Care Population, Stephanie Nacole Knowles

Doctoral Dissertations and Projects

Therapeutic activities are activities that encourage social interaction and promote cognitive skills. When these activities are put on hold for an extended period of time it can be detrimental to the Long-Term Care population. Depression related to social isolation has plagued the LongTerm Care population since the onset of COVID, causing increased sickness and in some situations death. The purpose of this integrative review is to determine the effectiveness of therapeutic activities in decreasing depression in the Long-Term Care (LTC) population. Literature was collected from 2018 through 2023 from the CINAHL database and analyzed using the PRISMA model. A total …

Improved Education For Caregivers Of Hospice Heart Failure Patients To Reduce Hospital Admissions: An Integrative Review, Sierra Spain Sanford

Doctoral Dissertations and Projects

Heart disease is the second-leading cause of death in the United States, excluding the COVID-19 pandemic. Despite being the leading cause of death, heart failure only comprises 15% of hospice deaths and remains the most likely to be discharged from hospice services due to acute hospitalizations compared to all other hospice diagnoses. This leads to low patient and family satisfaction as well as high medical costs. This integrative review synthesizes current published evidence highlighting the need to improve caregiver education for symptom management of terminal heart failure patients in hospice. The literature supports that improved caregiver education can lead to …

Reducing Medication Errors In Inpatient Hospital Settings By Implementing The Barcode Medication Administration Technology: An Integrative Review, Kali A. Brown

Doctoral Dissertations and Projects

Medication administration errors adversely affect patient outcomes, satisfaction, safety, and quality of care. Barcode medication administration (BCMA) technology automates the verification process during medication administration by requiring that nurses scan the barcode on the medication and the patient identification wristband to confirm the five rights of medication administration. The BCMA thus helps to intercept medication errors that occur at the point of administration. A review of 32 articles published within the past six years was conducted to explore the impact of using BCMA technology on medication error rates in inpatient hospital settings. The review findings indicate that systemic and individual …

Kangaroo Care And Improved Physiological Status In Preterm Infants: An Integrative Review, Kira Juunia Harkonen

Doctoral Dissertations and Projects

Preterm births continue to cause long-term sequelae for infants worldwide. Interventions in the neonatal intensive care unit (NICU) that promote better outcomes can make an impact on preterm infants’ futures. The purpose of this review was to determine if kangaroo care has positive physiological effects on preterm infants in the NICU. Practice changes to enhance kangaroo care in the NICU include reducing barriers such as medical complexity and staff misconceptions as well as facilitating increased parental presence. The review of the literature found evidence to support the positive outcomes that kangaroo care has on neonates’ growth, vital signs, stress outcomes, …

Developmental Boxes, Karina Ryabinina, Lauren Kelly, Marissa Bankey, Kaila Medeiros, Sammy Schultz

Nursing Leadership in Community Engagement Projects

Developmental Boxes

The assigned facility is a resource center that operates to assist families in need. Services offered include housing placement, homelessness prevention, securement of affordable childcare, after-school programs, and health education. The center has served the Mount Baker community for nearly three years and intends to continue partnering with public services to end the cycle of poverty and create brighter futures for those who need it most (Mercy Housing, 2021).

Our team conducted a windshield survey of the community served by the facility and determined there to be limited access to childcare in the area as well as minimal …

How Exemplary Chief Nurse Executives Utilize The Six Domains Of Conflict Transformational Strategies To Establish Common Ground And Produce Breakthrough Results, Michael Thompson

Dissertations

Purpose: The purpose of this phenomenological method study was to identify and describe strategies that exemplary chief nurse executive leaders use to identify and establish common grounds to produce breakthrough results in healthcare by using the six domains of transformational conflict strategies: collaboration, communication, emotional intelligence, ethical behaviors, problem solving, and shared interest.

Methodology: As a part of the thematic phenomenological study, the research identified and described the lived experiences of eight exemplary chief nurse executive leaders in health care who used conflict transformational strategies to find common ground to produce breakthrough results. The target population for the study included …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

The Importance Of Suicide Screening Training For Healthcare Providers As Part Of Suicide Prevention, Jennifer Maina

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Suicide is a major public health concern and was the 12th leading cause of death for all ages in 2020 in the United States. Suicide impacts relationships, families, and communities for a long time. Research shows that suicides are preventable and training healthcare providers on suicide prevention is part of the solution.

Search methodology: A computer-based search using CINAHL Complete, PubMed, and Cochrane was conducted with the following keywords; suicide prevention, gatekeepers’ training, healthcare providers or nurses, or community health public workers. Ten articles were selected and appraised using the John Hopkins appraisal tools.

Integrated review of the …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …