Medicine and Health Sciences Commons^™

Naloxone Education To Improve Distribution In Primary Care: A Quality Improvement Project, Joanna Boback

DNP Projects

Significance and Background: Opioid overdose is a major public health problem in the United States. The Centers for Disease Control and Prevention (CDC) developed guidelines for prescribing opioids which have not been widely integrated into practice. These guidelines specify co-prescribing naloxone with opioids as a form of harm reduction. A policy to reflect these recommendations was needed to guide prescribing at a Federally Qualified Health Center (FQHC) in Connecticut to increase low naloxone prescribing rates. Evidence supported the use of provider education to increase prescribing rates.

Purpose: Deliver education to providers across the health system on best practices related to …

Implementation Of The Stop-Bang Screening Tool In The Primary Care Setting: A Quality Improvement Project, Thriciana Powell

DNP Projects

Significance and Background. There are approximately 25 million adults in the United States with obstructive sleep apnea (OSA). OSA is a sleeping disorder that is caused by periodic airflow blockage during sleep. It has been linked to numerous health problems and within the primary care setting OSA is not routinely screened for at visits. This leads to delayed diagnosis of a serious health issue and the potential for poor health outcomes. The STOP-BANG questionnaire (SBQ) is a simple eight-question tool that is used to screen patients for OSA. The STOP section focuses on snoring, tiredness, observed apnea, and high blood …

Reducing Urinary Catheter Usage In The Intensive Care Unit Setting And Education Related To Preventing Cautis: A Qi Project, Kristina Diurno

DNP Projects

Significance and Background: Catheter-associated urinary tract infections (CAUTIs) are common but preventable hospital-associated infections. The inappropriate and prolonged use of indwelling urinary catheters can pose a significant risk for patients and healthcare organizations. The Centers for Disease Control and Prevention identified that the most important factor related to an increased risk of CAUTI is the length of time an indwelling catheter remains in place. This DNP (Doctor of Nursing Practice) project assessed the barriers to removing indwelling catheters in the intensive care unit (ICU) while providing encouragement of prompt removal.

Purpose: Three aims were developed for this quality improvement project: …

Use Of An Alarm Bundle To Reduce Alarm Fatigue In The Icu: A Quality Improvement Project, Blerina Petitti

DNP Projects

Significance and Background: In the critical care setting, frequent false alarms can lead to sensory overload and delayed reactions to alarms (aka, alarm fatigue). Patients are at risk because overtime staff may ignore or become desensitized to all alarm sounds, even true ones.

Purpose: The purpose of this QI project is to establish alarm management protocol in a 14-bed ICU. The goals were to reduce alarm fatigue and create a safe environment for patients and clinical staff.

Methods: The Model of Improvement (IHI, 2023) with cycles of the Plan-Do-Study-Act (PDSA) was used to implement an alarm bundle checklist that …

Implementation Of A Standardized Universal Protocol Process At A Large Academic Medical Center, Lisa Ann Heard

Doctor of Nursing Practice Scholarly Projects

Background: Decreasing the risk of wrong site, wrong procedure and wrong patient surgery is an essential healthcare safety initiative. The Joint Commission’s Universal Protocol along with the World Health Organization (WHO) Safe Surgery Checklist were designed to aid in this patient safety effort and have been implemented in hospitals worldwide.

Local Problem: Perioperative and procedural areas at the project hospital areas have adopted the Universal Protocol and Safe Surgery Checklist. Despite agreement in their importance, there is a lack of uniform application of all components. This leads to variation in practice which may impact team compliance with the protocol and …

Implementing An Augmented Perioperative Obstructive Sleep Apnea Pathway For Improvement Of Perioperative Management In Patients Undergoing Elective Orthopedic Surgery, Michelle Dwyer

Doctor of Nursing Practice Scholarly Projects

Background: Obstructive sleep apnea (OSA) in the perioperative period is a frequently encountered complex clinical challenge that increases the risk for post-operative complications. Patients undergoing elective orthopedic surgery may be untreated for OSA or unaware of an increased risk for OSA at the time of scheduling an elective surgical procedure. Appropriate intervention for these patients is needed to decrease the risk of postoperative complications and increased morbidity and mortality.

Methods: The objective of this improvement project was to improve the care across the perioperative experience for patients with obstructive sleep apnea or at a high risk for obstructive sleep apnea …

Implementation Of A Peer Mentoring-Network Initiative In Outpatient Psychiatry To Improve Psychiatric Advanced Practice Nurses' Job Satisfaction, Maria Romanoff Rand

Doctor of Nursing Practice Scholarly Projects

Background: Post-pandemic rates of mental illness have increased, resulting in a rise in demand for psychiatric services. At the same time, a growing shortage of psychiatric providers is occurring. This combination has given rise to an expanding mental health crisis where strengthening and stabilizing the psychiatric workforce is paramount. Psychiatric Advanced Practice Nurses are uniquely qualified to staff this shortage. Therefore, positive job satisfaction for Psychiatric Advanced Practice Nurses is vital to increase and retain psychiatric healthcare providers available to address this critical need for mental health services.

Methods: At the project site, the shift to telehealth, changing leadership, and …

Integration Into Professional Practice: Emergency Medical Services, Eva Finkelstein

Senior Honors Projects

No abstract provided.

Erac (Enhanced Recovery After Cesarean): A Safer And More Efficient Recovery Protocol, Allison Deluca

Senior Honors Projects

No abstract provided.

Pilot Study: The Effect Of Individual Versus Group Animal-Assisted Therapy On Undergraduate Student Anxiety, Jessica Hanson, Hannah Tucker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Purpose: The purpose of this study was to evaluate the relationship of Animal-Assisted Therapy (AAT) on undergraduate student test anxiety; comparing an individual AAT session to a group AAT session. AAT may be a solution for decreasing anxiety for undergraduate students. The study adds empirical knowledge to the field of AAT and student anxiety coping methods. The study question was: What is the effect of one-on-one and group Animal-Assisted Therapy sessions on undergraduate student anxiety?

Methods: This study used a convenience sample randomly assigned to either a group of 3 to 5 students (n=9) or an individual AAT session (n=10) …

Introduction Of Probiotics To Improve Eczema Symptoms In Children In One Pediatric Primary Care Practice: A Quality Improvement Project, Christie Potter

Doctor of Nursing Practice Scholarly Projects

Background: There is emerging interest in alternative approaches to treating children with eczema because there is currently no allopathic cure. Non-pharmacological approaches are regarded as generally safe, well tolerated, and cost effective. Eczema is a chronic, relapsing inflammatory, itchy skin condition that adversely affects quality of life in many individuals, including children. Eczema interferes with sleep, leads to secondary skin infections, and causes intractable itching. Topical steroids are the current standard of practice in treating patients but, evidence suggests that they can cause unwanted side effects and can lead to serious systemic reactions. The purpose of this quality improvement project …

Evaluating The Impact Of A No-Show Policy: A Quality Improvement Project, Adrianne S. Harding

DNP Projects

Significance and Background: No- shows are a global problem that creates a significant challenge for the healthcare system. When a patient misses an appointment, it decreases health care staff productivity, creates a waste of resources and it negatively impacts revenue (Lance et. al, 2021). Current evidence supports interventions that incorporate voluminous data and artificial intelligence with strategies such as overbooking, appointment notification systems and financial incentives to reduce outpatient no-shows (Oikonomidi et al., 2022). This project will evaluate the impact of a no-show policy and provide insights to improve primary care attendance and inform decisions.

Purpose: To evaluate an outpatient …

Baby-Friendly Hospital Initiative’S Benefits, Effectiveness, And Relevance To Internship At A Women’S Hospital, Katherine Locke

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: This review was conducted to analyze the benefits and effectiveness of the Baby-Friendly Hospital Initiative and compare it to my internship at a Baby-Friendly designated women’s hospital.

Purpose: The purpose of this review was to compile and compare existing research on Baby-Friendly Hospital Initiative to determine its benefits, effectiveness, and relevance to my internship.

Method: Two databases, CINAHL Complete and MEDLINE, were used to find a total of 18 peer-reviewed journal articles on Baby-Friendly Hospital Initiative benefits and effectiveness. Key words consisted of “baby friendly,” “hospital,” and “benefits or advantages.”

Results: The Baby-Friendly Hospital Initiative …

Adolescent Depression Management: An Inner City Federally Qualified Health Center Program Evaluation, Aurora Wernette

Masters Projects

Background: Within the state, approximately 119,000 adolescents aged 12-17 have depression, and it is estimated that 57.8% do not receive any mental health care (National Alliance on Mental Illness [NAMI], 2021).

Objectives: The purpose of this program evaluation is to evaluate the management of adolescent depression. This evaluation focused on adolescent depression screening rates, medication prescribing and adherence, counseling referrals and initiation, barriers to treatment, follow-up visits, and parent feedback about the care received.

Methods: All adolescents who did not have previously diagnosed depression or developmental delay were included in this program evaluation., A weekly manual chart review was used …

Preoperative Pain Management Education And Narcotic Use: A Quality Improvement Project, Sarah Scheller

DNP Projects

Introduction: Comprehensive preoperative education is an important aspect of pain management and helps empower patients prior to their surgery. Evidence supports the use of a combination of the teach-back method, videos, and pamphlets to educate patients prior to their surgery. A quality improvement project was initiated for patients having total shoulder arthroplasty surgery with an orthopedic surgeon in Connecticut.

Methods: An educational video and handout were created, and preoperative education sessions using the teach-back methods were performed. Postoperative phone calls were placed at 24 and 72 hours to assess the patient’s use of narcotic pain medication, alternative pain management medication …

Personal Health Questionnaire-9 And Interventions In Adults, Grace Alford

Masters Theses/Capstone Projects

This is an evaluation of the PHQ-9 depression screening and interventions in adults within an urban setting.

Patient Compliance With Colorectal Cancer Screening: A Scoping Review, Peyton Jackson Bsn, Rn, Brandon Crocker Bsn, Rn, Ne-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance.

Methods

Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of …

Tiny Tusk Internship: Barriers To Effective Breastfeeding Within Low Socioeconomic Populations, Catherine Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusk Breastfeeding and Infant Support is a program created to facilitate safe and quiet places for mothers to breastfeed at various events at the University of Arkansas. It serves as a platform to spread important and essential information about breastfeeding to mothers and reach various women all from different backgrounds and populations. The purpose of this review of literature is to identify barriers that women within low socioeconomic populations face that influence their decision to breastfeed. These barriers included lack of social support from family, friends, and healthcare providers; latch difficulty; and concerns of milk supply. Altogether, low-income women …

The Lived Experience Of The Dnp-To-Phd Nursing Graduate: Examining The Journey, Bonni S. Cohen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The traditional route of obtaining a Doctor of Philosophy (PhD) in nursing is vertical: a Master of Science in Nursing (MSN), followed by PhD in nursing. An ongoing shortage of PhD- prepared nurses—nurse educators and nurse researchers, in particular, has spurred the creation of more pathways to obtaining a PhD in Nursing. In recent years, there has been a drive to increase the number of nurse scientists with doctoral degrees through innovative pathways. A newer terminal nursing degree, the Doctor of Nursing Practice (DNP), has taken root over the past decade to produce nurse leaders who are experts at translating …

Evaluating Risk-Appropriate Perinatal Care In Nevada, Janice Enriquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States, (U.S.) technological advancement and increased accessibility to health care resources have not deterred the increasing maternal morbidity and mortality rates (CDC, 2022). In 2019, 754 maternal deaths were reported; in 2020, 861 deaths were reported. In a span of one year, the maternal mortality rate increased by 14% (CDC,2022). American Indian/Alaska Native and Black birthing people are 2 to 3 times more likely to die from a pregnancy-related cause than White birthing people (CDC, 2019). 80% percent of all pregnancy related deaths can be prevented (CDC, 2022). Risk-appropriate care is a strategy used to improve perinatal …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

The Covid-19 Pandemic And On-Time Vaccine Completion In The Childhood Population: A Strategic Plan, Chris Elaine Mariano

UNLV Theses, Dissertations, Professional Papers, and Capstones

In March 2020, the entire world was placed into lockdown due to the COVID-19 virus, which impacted everyday life, including healthcare. People were scared to leave their homes and obtain preventative services, including vaccinations from birth to adulthood. There was a significant decrease in childhood vaccinations due to the COVID-19 pandemic. A strategy mix is defined as an intervention utilized for vaccination improvement. Strategy mixes were implemented to improve vaccination administration, and ultimately, vaccination rates. However, due to the COVID-19 pandemic, these strategy mixes or interventions were placed on hold causing immunization administration to decrease which could cause vaccine-preventable diseases …

No Scrubs: Nursing Applicant Trajectories After Rejection, Jennifer Torgerson

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is a nursing shortage in the United States which has become even more apparent during the COVID-19 pandemic. Despite qualified applicants, thousands of students are turned away from educational programs each year as programs reach capacity limits. The rejection may have social, psychological, and economic consequences for the student. Students faced with rejection need to make decisions whether to continue their pursuit of nursing or go a different direction. This exploratory quantitative study aims to understand the trajectories of students that are not admitted into a capacity restricted nursing program at a community college in the Southwestern United States. …

Fear Of Recurrence As A Mediator Of Illness Perception And Perceived Stress In Acute Myocardial Infarction Survivors, Sarah E. Zvonar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The primary objective of this study is to evaluate fear of recurrence as a mediator of illness perception and perceived stress. This research will determine how illness perceptions and fear of recurrence affect perceived stress in the acute myocardial infarction (AMI) population. Other aims will observe how demographics predict patients who may experience increased fear of recurrence and stress in the AMI population, how the variables of fear of recurrence change over time, and if fear of recurrence is still a significant mediator after controlling for depression and anxiety.Rational/ Conceptual Basis/ Background: Acute myocardial infarctions (AMIs) are often accompanied …

Decreasing Hospital Readmission Rates Of Heart Failure Patients: An Evidence-Based Quality Improvement Project, Elizabeth Rodriguez

DNP Projects

BACKGROUND: Teach back is an evidence-based health literacy intervention that encourages patient engagement in own treatment, adherence to treatment, medications, and quality of care. Implementation of teach back method could positively impact readmissions to the hospital in patients experiencing heart failure and any other chronic diseases and it could improve patient’s outcomes.

OBJECTIVE: The objective of this project was to implement teach back method in a home care agency in the Hartford area in patients with HF to prevent readmission to the hospital.

METHODS: The IOWA model was used and PSDA as tools to support EBP project.

RESULTS: Pre and …

Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto

Doctoral Projects

For patients with advanced heart failure (HF) ineligible for or awaiting heart transplantation, left ventricular assist device (LVAD) implantation can be considered. LVADs have helped to improve recipients’ survival rates and quality of life. However, LVAD patients are at risk for complications such as stroke, bleeding, infection, and right ventricular failure. Moreover, events such as end-stage malignancy or progression of a neurodegenerative disorder may occur. Such complications and repeated hospitalizations can pose questions about the acceptability of LVAD therapy. As such, both the Centers for Medicare and Medicaid Services and The Joint Commission require that palliative care (PC) be part …

Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor

Doctoral Projects

Background: One of the leading causes of death in the college age population is suicide. While colleges provide opportunities in the acquisition of knowledge and skills for future careers; those same opportunities can also bring about challenges that put students at risk for suicide such as: dealing with their mental health issues, finding and maintaining support system, financial costs, and the pressure from ensuring academic success. One of the ways to help student at risk for suicide is by early intervention by connecting them with mental health support system such as crisis counselors. Question, Persuade, and Refer (QPR) is a …

Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo

Doctoral Projects

Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …

Does The Enhanced Recovery Pathway Decrease Length Of Stay And Readmission Rates In Patients Undergoing Gynecologic Surgery?, Trinh T. Nguyen

Doctoral Projects

The Enhanced Recovery After Surgery (ERAS) pathway promotes an early recovery after surgery using an evidence-based multidisciplinary approach. The ERAS protocol is aimed at standardizing care to improve patient outcomes. There is consistent evidence that ERAS pathways reduce hospital length of stay (LOS) and readmission rates, decrease healthcare costs, and improve patient satisfaction and outcomes. By attenuating the surgical stress response and supporting the return of physiological function, the ERAS pathway achieves its effectiveness. This scholarly project aimed to evaluate how ERAS improves patient outcomes in gynecology patients at a county hospital. A standardized method for improving patient recovery was …