Medicine and Health Sciences Commons^™

Nurse Champions For Medication Reconciliation: Making A Difference, Stacey Waters

Doctor of Nursing Practice Projects

Background: Medication reconciliation creates a significant safety risk when patients transition from one care environment to another. This is especially true for older adults who may have multiple medications, poor health literacy, or multiple providers. During care transitions, collecting accurate information about previous medication regimens can be a challenge. If providers are unskilled at eliciting the needed information, discrepancies can result, leading to medication errors, poorer outcomes, or patient harm. These discrepancies, if unresolved, can follow the patient throughout hospitalization and back into the outpatient setting, leaving patients unable to manage their care at home safely.

Purpose: The objective …

Increasing Long-Term Care Employee Influenza Compliance Through An Educational Approach, Shyandrea H. Brazil

Doctor of Nursing Practice Projects

Influenza (flu) is a highly contagious respiratory illness caused by several influenza viruses (Centers for Disease Control, 2019). The CDC estimates that there have been approximately 42.9 million flu incidents, 20.1 million flu medical visits, 647,000 flu related hospitalizations and 61,200 deaths from October 1, 2018 through May 4, 2019. Individuals who contract this illness may have symptoms varying from mild to severe. This project focused on the elderly population because these individuals fall into the high-risk category. Individuals 65 and older are more likely to experience flu-related complications, which could ultimately lead to hospitalizations and in some cases, death. …

Protecting The Integument: Changing Nursing Practice To Prevent Pressure Injuries, Latonya Lawery

Doctor of Nursing Practice Projects

The purpose of this project is to assess and improve nurses’ knowledge of pressure injuries and pressure injury preventions using evidence-based guidelines and a southeastern United States hospital’s skin integrity policy. My population of focus is direct care professional nurses caring for adults and geriatric patients in the acute care setting.

Design and Methods: The DNP student’s project is a quality improvement project using a Quasi-experimental design, which includes using a pre-test (Appendix A) and post-test (Appendex B). FADE (Appendix C) is the quality improvement method chosen for this project. FADE (Appendix C) is an acronym representing focus, analyze, develop, …

Improving The Accuracy Of Temporal Artery Thermometry In Pediatric Direct Care Providers: A Performance Improvement Project, Kimberly L. Bell

Doctor of Nursing Practice Projects

Purpose: The purpose of the project was to improve the accuracy of temporal artery thermometry (TAT) measurements compared to axillary, rectal, and oral thermometry readings on a Pulmonary Pediatric Care Unit.

Design and Methods: A pre-educational and post-educational competency tests and skill performance test of obtaining accurate TAT results with an Exergen 5000 Temporal Scanner were implemented after the pediatric nursing staff participated in a 60-minute educational program. Of the 32 participants, most were RNs (84%) followed by certified nursing assistants (9%) and LPNs. Most participants worked the 12-hour day shift 7a-7p (59%), followed by the 7a-3p shift (38%) and …

The Effect Of A Provider Education Program On Antibiotic Overuse In Acute Sinusitis, Shawna Berg

Doctor of Nursing Practice Projects

Background: Acute sinusitis is a typical patient diagnosis encountered in the outpatient setting. Inappropriate antibiotic prescribing is a well-documented concern. The overprescribing of antibiotics is associated with increased antibiotic resistance, cost, and adverse side effects. Despite the research, improper prescribing of antibiotics continues to be problematic.

Purpose: A provider education program was implemented at three separate urgent care centers for healthcare providers concerning antibiotic stewardship. The objective was to evaluate the effectiveness of a provider education program to examine changes in the immediate antibiotic prescribing habits.

Design Method: A pretest-posttest quasi-experimental design with provider educational intervention was implemented concerning antibiotic …

The Evolution Of Nursing Leadership: Novice To Expert, Yolanda Chandler

Doctor of Nursing Practice Projects

The nurse leader is critical in staff development, contentment, retention, patient safety, quality of care, and achievement of organizational goals. Nurse leaders in a managerial role must lead, oversee, delegate, guide, and support staff nurses. They are expected to demonstrate clinical competence, make decisions, communicate effectively, be visible and approachable, and empower others. Some skills learned as a charge nurse can help the new manager adapt to the role, but many healthcare organizations offer a novice nurse manager a limited orientation.

Purpose: Effective nursing leadership requires nurse managers to have clinical experience, think critically, motivate others, communicate and delegate constructively, …

A Multifocused Intervention To Reducing Antibiotic Prescribing In Uncomplicated Upper Respiratory Infections In The Urgent Care Setting, Chelsea Popp

Doctor of Nursing Practice Projects

Background: Upper respiratory infections (URIs) comprise a large amount of Urgent Care visits. Though certain patients with URIs may require antibiotic intervention, the majority of patients are considered uncomplicated. Inappropriate prescribing of antibiotics has a direct association to antibiotic resistant bacteria and increased patient mortality (Harris, et al., 2016). Antibiotics are prescribed for more than half of URI’s presenting to Urgent Care clinics.

Purpose: The purpose of this quality improvement project is to determine if proper education on current evidence-based practice guidelines for both the patient and provider will result in a reduction in the number of antibiotics prescribed for …

Improving Skin Tears Healing Time Is Demonstrated By The Staff Rn Who Performs Early Initiation Treatment Of The Skin Tear Protocol, Sharon Brazile

Doctor of Nursing Practice Projects

Skin tears create numerous challenges for managing skin integrity for our aging population. Skin tears result from trauma, such as a patient bumping into a doorknob or rubbing against the wheelchair; they also occur because the epidermis and dermis lose elasticity and rub against each other, causing a shearing process that separates the outer skin layers from their protective under layers. Skin tears not only look terrible but can be painful and lead to infection if treatment is not initiated early by the nurse.

Purpose: The Chief Nursing Officer chose to focus on skin tear treatment at a southeast urban …

Improving School Attendance Rates Utilizing A School-Based Clinic, Tameka Minter Hines

Doctor of Nursing Practice Projects

Student attendance and good health are two essential concepts that correlate with procuring students' academic success. Students can gain knowledge with the ability to be present in the class setting. Any disruption in the student's ability to attend class can have long-lasting negative consequences. Chronic health conditions are the primary obstacles in student attendance. Chronic health conditions such as asthma, sickle cell, childhood cancers, type 2 diabetes, and mental health issues or defects are significant barriers to school attendance. School administrators, parents, and community health partners are task with developing viable options for managing student healthcare along with access to …

Purposeful Hourly Rounding And Reduction Of Patient Falls, Iesha S. Bell

Doctor of Nursing Practice Projects

Falls are a pervasive and persistent problem in all healthcare settings, with adverse clinical, social, and economic outcomes for patients, staff, and institutions involved. The systematic process of purposeful rounding is an intentional act conducted with a clear purpose for the patient's benefit. Prevention of inpatient falls remains a challenge for nurses. Despite fall prevention efforts by nurses, the rate of patient falls in the acute care setting is a major safety concern. A Doctor of Nursing Practice project was crafted and implemented to educate nursing staff on purposeful hourly rounding and apply the 4 P's (pain, positioning, possessions, and …

Can We Talk? Bridging The Communication Gap Between Nurses And Providers, Jolie Wildinger

Doctor of Nursing Practice Projects

Background: Effective communication is the key to successful relationships and improving patient care. Effective and efficient communication is also essential in producing a healthy self-confidence and knowledge base, which is needed by nurses and physicians who are providing daily care to patients.

Purpose: The purpose of this performance improvement project is to increase the communication competence and self-awareness of staff nurses during intraprofessional interactions with the healthcare providers.

Methods: A quasi-experimental quality improvement process that included a pre and post-survey alongside an educational program to arm nurses with information and communication techniques needed to help build relationships to foster effective …

Improving Patient Follow-Up For Laboratory Testing Using Telephone Calls As An Intervention: A Quality Improvement Project, Jill Gray

Doctor of Nursing Practice Projects

Background: Today, in the United States, 74,273 individuals are actively waiting for an organ transplant. Of those, approximately 8,000 need a liver transplant. With the increased need for an organ transplant, the use of increased risk donors is on the rise. In these patients, it is imperative to monitor for the transmission of HCV, HBV, and HIV.

Purpose: Increase compliance for monitoring transplant recipients who receive organs from increased risk donors for HCV, HBV, and HIV.

Design method: In order to measure the outcomes of this project, the following instruments were used: parametric testing and paired t-test. Parametric …

Improving Hypoglycemia Protocol Compliance Through Nursing Education, Concepta Onyatta

Doctor of Nursing Practice Projects

Nurses hold a vital role in glucose management in order to ensure safety and quality outcome for hospitalized patients.

Background: Assessing serum and point of care glucose results and bringing abnormal results to the attention of the healthcare team can help maintain optimal management. Despite challenges to hypoglycemic protocol compliance, informed nurses can advocate effectively for their patients. Understanding insulin action and the effective use of evidence-based guidelines/protocols can help nurses promote optimal patient outcomes. Common barriers to glucose control and education of current best practices in the acute care setting were reviewed.

Purpose: To improve hypoglycemic protocol compliance …