Medicine and Health Sciences Commons^™

Use And Evaluation Of A New Nurse Practitioner Fellowship Program, Brandi Herman

Doctor of Nursing Practice Scholarly Projects

The project addresses fellowship programs for new graduate nurse practitioners. The goal is to determine if a nurse residency or fellowship program is beneficial in role transition as a new graduate nurse practitioner. Nurse practitioner residency or fellowship programs are typically 12 months in duration, have small cohort sizes of two to four trainees, and are composed of a combination of didactic educational content, clinical supervision, peer support and debriefing, and self-reflection The study utilizes a survey design to measure the impact of a nurse practitioner fellowship program versus a standard orientation period. The article concludes with barriers and recommendations …

Implementation Of Evidence Based Practices To Reduce Postoperative Sore Throat, Anthony Brusadin

Doctor of Nursing Practice Scholarly Projects

An estimated 15 million endotracheal tube (ETT) intubations occur annually in the United States. In addition to pain and nausea, one of the leading complaints by patients after intubation is a sore throat. Postoperative sore throat (POST) is caused by increased pressure on the trachea from the ETT during intubation and after the ETT cuff has been inflated. To prevent the occurrences of POST many options were explored, including cuff material, shape, filling media, and ETT tube size. Through research one of the ways to reduce POST is by monitoring the cuff pressure of the ETT against the tracheal. Typically, …

Implementation Of Evidence Based Practices To Reduce Postoperative Sore Throat, Anthony Brusadin

Doctor of Nursing Practice Scholarly Projects

An estimated 15 million endotracheal tube (ETT) intubations occur annually in the United States. In addition to pain and nausea, one of the leading complaints by patients after intubation is a sore throat. Postoperative sore throat (POST) is caused by increased pressure on the trachea from the ETT during intubation and after the ETT cuff has been inflated. To prevent the occurrences of POST many options were explored, including cuff material, shape, filling media, and ETT tube size. Through research one of the ways to reduce POST is by monitoring the cuff pressure of the ETT against the tracheal. Typically, …

Implementation Of A Diabetes Education Program In The Correctional Setting: A Project Proposal, Raymond Lengel

Doctor of Nursing Practice Scholarly Projects

Diabetes is a chronic disease requiring patient responsibility to ensure good control and reduced morbidity and mortality. Incarcerated diabetic adults suffer from poor control and complications associated with their disease partly due to their limited health literacy. Arming diabetics with knowledge related to diabetes improves disease control and healthcare outcomes. The proposed final scholarly project involves the implementation of a diabetic education initiative to assess the effects of diabetic-specific education on self-care activities. The proposed quality improvement project will be framed with the Plan-Do-Study-Act and Nola Pender's Health Promotion Model. The proposed final scholarly project involves obtaining a baseline assessment, …

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.

Evaluating Implementation Of Diabetes Screening In Family Practice, Makilah Furlan

Masters Theses/Capstone Projects

Poster presentation on implementing diabetes screening in family medicine practice.

Inadequacies In Nutritional Counseling In The Perinatal Population, Tiffany Fry

Doctor of Nursing Practice Scholarly Projects

Abstract

Obesity continues to increase at unprecedented levels and warrants immediate provider attention at the perinatal level to improve the health of the present and future generations. Reduction of this condition can reduce risk factors leading to morbidity and mortality. Guidelines exist for the prevention and management of obesity, yet little focus is placed on prevention in the perinatal population. Lack of consistent and healthy lifestyle in the perinatal population has the potential to not only place the mother at risk for obesity but also her unborn child. The overall purpose of the scholarly project is to identify any potential …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Hepatitis Screening, Kathryn Bland

Masters Theses/Capstone Projects

Project on hepatitis screening.

Increasing Awareness, Understanding, And Support For Healthcare Second Victims Through The Creation And Distribution Of An Infographic For Leaders And Executives, Theresa Reed

Doctor of Nursing Practice Scholarly Projects

Second victim syndrome describes the constellation of symptoms suffered by healthcare clinicians because of the stresses of caregiving, experiencing adverse patient outcomes, and the increasing pressures of the care environment. The occurrence of second victim syndrome (SVS) in nurses is well supported in literature, along with resultant effects on patient safety, organizational culture, and the organization's financial outcomes. The interconnectedness of nurses with patients is undeniable, and relational impacts can be both profound and enduring. Burnout and stress, manifested by mental, psychological, and physical effects, are possible and may affect the ability of the nurse to provide effective nursing care …

Standardized Handoffs For Anesthesia Students, Shawn Barkalow, Noah Prebish

Doctor of Nursing Practice Scholarly Projects

Communication between healthcare providers is an essential aspect of caring for patients. Effective communication is vital during the patient handoff process. The patient handoff process involves exchanging patient’s medical information between a provider currently caring for the patient and the provider assuming care of the patient. If the information exchanged during the handoff process is inaccurate or essential information is omitted, that could potentially lead to harmful consequences for the patient. Currently, no standardized handoff tool exists for student registered nurse anesthesia students (SRNAs) in clinical practicum at the local level one trauma center. The lack of a standardized handoff …

Analysis Of Current Practices In Prehospital Congestive Heart Failure Care And Protocol Development To Prevent Readmission., Ayushma Neupane

Doctor of Nursing Practice Scholarly Projects

Congestive Heart failure patients have the highest readmission rate within 30 days of discharge placing a significant burden on healthcare costs and quality of life for the patient and families. Community Emergency Medical Services are the first to respond to moderate to severe exacerbation of Congestive Heart Failure (CHF) patients’ calls. Involving Emergency Medical Services in a preventive approach rather than just responding to exacerbation calls has proven to be effective in pilot studies to prevent heart failure readmissions. The purpose of this Scholarly project was to develop evidence-based recommendations for community Emergency Medical Services’ involvement in the management of …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

Early Vs Late Referrals To Nephrology And Its Effect On Patient Outcomes In End-Stage Renal Disease (Esrd) Patients Who Are On Renal Replacement Therapy (Rrt) A Retrospective Chart Review, Tricia Brown

Doctor of Nursing Practice Scholarly Projects

End-stage renal disease may greatly affect a patient’s overall health and outcomes. This project aimed to look at early versus late nephrology referrals. A retrospective chart review of patient’s demographic and health outcome data was reviewed through a patient’s electronic health record. The patient data from the chart review, along with the evidence obtained from the review of the literature has been utilized to describe findings and develop evidence-based practice-guided recommendations for nephrology referrals in clinical practice. This project has been completed at a dialysis center in rural Ohio. The patient population included around 60 patients who had dialysis at …

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When …

Development And Implementation Of An Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Program For Student Registered Nurse Anesthetists, Nicholas Colangelo, Zachary Wise

Doctor of Nursing Practice Scholarly Projects

The American Association of Nurse Anesthetists (AANA) has defined the scope of nurse anesthesia practice to include services in acute, chronic, and interventional pain management, as well as the use of ultrasound (U/S) and other diagnostic technologies. However, there are no standard curriculum requirements in place that mandate graduate programs to educate student nurse anesthetists in U/S-related modalities. In addition to the AANA, the use of U/S in nurse anesthesia practice has recently been adopted by The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which characterizes U/S use by its clinical impact on the reduction in complications, increased …

Communication Assessment Tools For Emergency Department Nurses Who Interact With Individuals With Intellectual And Developmental Disabilities, Holly Hunt

Doctor of Nursing Practice Scholarly Projects

Abstract/Executive Summary

Problem Statement: Communication is an essential part of every nurse-patient interaction. During the best of times the patient and nurse can clearly understand each other and engage in successful interaction with positive patient outcomes. Individuals with intellectual and developmental disabilities (IDD) often use nontraditional ways of communicating that can complicate the ideal nurse-patient interaction. When a patient presents with a different method of communicating, the nurse must possess tools available to facilitate a successful interaction. Identifying such a tool or if one cannot be found building a sample tool is vital for positive patient outcomes for individuals with …

Activated Clotting Times And Rebleed Rates In Pediatric Patients Post Cardiac Catheterization: A Pilot Project Proposal, Stacey Carey

Doctor of Nursing Practice Scholarly Projects

Cardiac catheterization (CC) procedure is a minimally invasive procedure that requires arterial and/or venous access with the introduction of a small tube called a sheath that allows for the passage of wires and catheters into the heart. Heparin is a medication known as a ‘blood thinner’ that is administered throughout the procedure to prevent clots from forming. The activated clotting time (ACT) is a diagnostic point of care test used to measure how long it takes blood to clot. Post CC care requires patients to lie flat for several hours to ensure bleeding will not occur at the punctured vessel …

No-Show Rates In Community Mental Health Clinics, Teresa Jordan

Doctor of Nursing Practice Scholarly Projects

Now Show Rates in Community Mental Health Clinics

No-show rates in community mental health clinics are typically higher than in other areas of healthcare. No show rates have a negative impact upon patients, clinics, and communities.

Mental illness has reached an all-time high in the U.S. In his first State of the Union address, President Joe Biden stated that our country faces an “unprecedented mental health crisis among people of all ages.” Evidence well supports his statement. To extinguish this crisis, all barriers to mental health care must be evaluated and attacked from all possible angles. Increasing access to mental …

A Systematic Record Review Of A Local Quality Improvement Impacts On Anesthesia Provider Knowledge And Attitudes Following A Presentation Of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use In Total Joint Arthroplasty Surgical Patients, Kevin Mcclellan

Doctor of Nursing Practice Scholarly Projects

Abstract Patients undergoing spinal anesthesia for total joint arthroplasty (TJA) must urinate and ambulate within 1-hour before discharge from the post-anesthesia care unit to indicate a healthy return of lower body neuro-function after spinal administration. The most common spinal medication used is bupivacaine which has complications including postoperative urinary retention (POUR), altered proprioception, delayed ambulation, and prolonged motor block, resulting in increased cost and length of stay. One alternative solution is mepivacaine, an intermediate local anesthetic lasting 1.5 to 2.5 hours with comparative surgical blockade but a quicker motor and sensory function return. Research suggests mepivacaine is just as safe …

Examining The Need For Change By Describing The Attitudes And Perceptions Of Team Communications Related To Patient Care And Safety Among Ambulatory Clinic Healthcare Staff, Peter Seivers

Doctor of Nursing Practice Scholarly Projects

Medical errors account up to 250,000 patient deaths annually. Research suggests medical errors are attributable to poor healthcare team communications. The Institute of Medicine posits that communication and teamwork are essential components to safe and successful health care environments. According to the Joint Commission poor communication is considered the root cause of nearly 80% of all serious medical errors. Consequently, the Department of Defense and Agency for Healthcare Research and Research created a team-based training program, known as TeamSTEPPS®, which has shown to improve team communication, performance, effectiveness, patient safety, satisfaction, and health outcomes in healthcare settings. Despite evidence supporting …

Evidence-Based Guidelines For Prevention Of Inadvertent Hypothermia In Total Joint Arthroplasty, Courtney Morris

Doctor of Nursing Practice Scholarly Projects

Hypothermia is a core body temperature below 36 degrees Celsius. Hypothermia is a common occurrence for many surgical patients that presents with many complications. When patients experience hypothermia during the perioperative setting, it is defined as Inadvertent Perioperative Hypothermia (IPH). During surgery, the patient typically has large body areas exposed to perform surgery in a room that is kept cool leading to lower body temperature and under general anesthesia the body’s ability to regulate body temperature is impaired. Patients who are undergoing total joint arthroplasties (TJA), a hip or knee replacement, are a high-risk population for IPH, therefore, increasing their …

Evidence-Based Practice Guidelines For The Optimal Assessment Of The Airway In Predicting Difficult Intubation, Meredith Louden

Doctor of Nursing Practice Scholarly Projects

Adverse respiratory events are the most common injuries in anesthesia; difficult intubation and ventilation contribute to most cases. Injuries following inadequate airway management include cerebral hypoxia, aspiration, and cardiac arrest. Despite the risk and consequences following inadequate airway management, most medical facilities lack standardized airway assessments for anesthesia providers. Current evidence implicates that ultrasound measurement of the hyomental distance demonstrates the highest specificity and accuracy in predicting difficult intubation. The traditional approach to conducting airway assessments includes Mallampati classification, which shows high specificity for predicting difficult airways only when combined with other airway assessments. The purpose of this evidence-based project …

Small Intestinal Bacterial Overgrowth Testing Strategies, Carla Bonczak

Doctor of Nursing Practice Scholarly Projects

Small Intestinal Bacterial Overgrowth (SIBO) is an overgrowth of bacteria in the small intestine. Symptoms such as bloating, abdominal pain and discomfort, malabsorption, nausea, constipation, or diarrhea overlap with several common GI complaints. SIBO affects millions of people worldwide. Many providers are not aware of SIBO or the guidelines that standardize testing and diagnosing.

The Final Scholarly Project (FSP) was based on a literature review that discovered evidence-based literature on SIBO testing strategies such as gut aspirate and culture, clinical symptom presentation, breath testing, nutrient challenge test, and scintigraphy with either lactulose or hydrogen breath testing. To implement the project, …

Development Of Guidelines For Early Implementation Of Regional Anesthesia In United States Personnel With Peripheral Injuries, Matthew Baker

Doctor of Nursing Practice Scholarly Projects

Dating back to 3200 BC, military personnel routinely experience peripheral extremity wounds during combat. Traditionally, military anesthesia providers utilized general anesthesia and opioids to treat acute pain in the combat setting. Opioids can cause adverse effects such as respiratory depression, delirium, hemodynamic instability, nausea & vomiting, and addiction, which causes delays in care and requires more resources. Regional anesthesia is gaining favor during military operations due to its safety profile and effectiveness in controlling acute pain. Regional anesthesia is safer and more effective than opioids in the trauma/combat setting. Guidelines were provided based on current evidence in the literature and …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Guidelines For Performing Caudal Blocks In Pediatric Sub-Umbilical Surgeries, Rachael Allen

Doctor of Nursing Practice Scholarly Projects

Adequate pain control in pediatric patients undergoing sub-umbilical surgeries is critical because of the increased need for opioids and heart rate (HR) fluctuations that occur in the postoperative period. The traditional approach of providing anesthesia in sub-umbilical surgeries is general anesthesia(GA); however, this approach does provide prolonged pain relief. This project aims to establish evidence-based guidelines for implementing caudal blocks (CA) with GA in pediatric sub-umbilical surgeries. By implementing CA with GA, patients experience less pain, leading to a reduction of opioids and HR fluctuations in the postoperative period. The project follows the John Hopkins Evidence-Based Practice (JHEBP) model, a …

Acute Otitis Media, Allie Luther

Masters Theses/Capstone Projects

Learning about Acute Otitis Media

Nutritional Management: Head And Neck Cancer, Christina Eagle

Masters Theses/Capstone Projects

Nutritional management in head and neck cancer patients will help to promote treatment compliance and reduction of treatment-related co-morbidities.