Medicine and Health Sciences Commons^™

Does Use Of A Mobile App And Telephone Support Promote Improved Self-Care Of Heart Failure?, April Christine Chew

Doctor of Nursing Practice Projects

Background

Heart failure is a complex disease and a growing global epidemic. Symptoms and multiple comorbidities contribute to the overwhelming burden of heart failure, and support people make an important contribution to self-care. Effective self-care maintenance behaviors along with confidence and support can help people living with heart failure to effectively self-manage the disease.

Purpose

This project aimed to determine if use of a mobile app with telephone support calls was an effective intervention to promote improved self-care of heart failure and caregiver contribution to self-care of heart failure compared to the standard of care where the intervention was not …

Effect Of An Educational Intervention On Coronary Artery Disease Knowledge In Men And Women At Risk For Coronary Artery Disease, Rochelle Anderson-Doyley

Doctor of Nursing Practice Projects

Background

Coronary artery disease (CAD) is the leading cause of death in the United States. The management of CAD, a preventable disease, has significant implications for health and wellness outcomes in the United States. Decades of research have examined the role and effectiveness of an educational intervention in promoting the patient's knowledge of and ability to manage risk factors for CAD. This project examined the effectiveness of an educational tool implemented in a primary care setting in improving patients' knowledge about CAD risk factors.

Method

The research design was a non-experimental one-group pre-test and post-test design. After receiving institutional review …

Implementing Feno Testing Protocol In A Pulmonary Clinic: A Dnp Project, Herbert "Allen" Nolan

Doctor of Nursing Practice Projects

Airway inflammation is a common condition seen in the pulmonary clinic and can be present in patients with chronic obstructive pulmonary disease, asthma, chronic cough and asthma chronic obstructive overlap syndrome. Utilization of fractional exhaled nitric oxide testing is a quick means of identifying airway inflammation in patients who visit the pulmonary clinic with the diagnoses listed above. Fractional Exhaled Nitric Oxide testing along with Asthma Control Testing were used in the pulmonary clinic to aid in the identification of airway inflammation along with traditional spirometry testing. The results reflected an increase in the identification of patients with airway inflammation …

The Impact Of Nursing Staff Responsiveness On Patient Satisfaction: A Pilot Project, Lisa Wallace

Doctor of Nursing Practice Projects

Timeliness of healthcare staff responsiveness to patient requests is multifactorial. Inadequate responsiveness to patient requests may lead to increased patient injury, increased cost, and patient dissatisfaction which may impact stakeholders and profit margin. Evidence supports that proactive, timely, staff responsiveness to patient requests and call lights may lead to improved patient safety, higher patient satisfaction, and better healthcare outcomes. Bundled staff responsiveness interventions may be implemented to improve patient safety, patient and staff satisfaction. Examples of interventions include engaging staff project buy-in with formation of a patient experience team, hardwiring hourly safety rounding, providing staff education on the importance of …

A Diabetes Crash Course In A Primary Care Setting To Improve Diabetes Self-Care: A Pilot Project, Michelle L. Macdonald

Doctor of Nursing Practice Projects

Diabetes (DM) is a deadly disease affecting millions. Lack of proper DM self-care management can lead to numerous complications and even death. The American Diabetes Association (ADA) recommends lifestyle change as a first-line treatment along with diabetes self-management education (DSME). However, according to the Centers for Disease Control and Prevention (CDC) only a fraction of those diagnosed attend. The purpose of this project was to improve DM self-management behaviors following a patient focused unique DMSE designed to meet community needs. A customized crash course style DM educational session was offered to all DM patients in a rural primary care clinic. …

Checklist Utilization To Reduce Cauti Rates: A Dnp Project, Christina Jah

Doctor of Nursing Practice Projects

Catheter-associated urinary tract infections (CAUTIs) are preventable events with significant ramifications for both patients and hospitals. Proper training on evidence-based practices for catheter management is a vital component of preventing and decreasing CAUTIs. Following a review of the literature, evidence supports that CAUTI education with the use of a standard urinary catheter checklist for registered nurses (RNs) has the potential to ensure that knowledge is applied, thus decrease CAUTIs. This doctoral project developed, implemented, and evaluated an educational program and checklist to reduce CAUTI among patients at a Veterans Administration (VA) hospital. This project utilized a mixed-method data collection with …

Implementation Of An Educational “Boot Camp” To Increase Nurses’ Confidence, Knowledge And Use Of Evidence-Based Practice In A Veterans Affairs Medical Center, Anita S. Dahl

Doctor of Nursing Practice Projects

Evidence-based practice (EBP) can be used to promote quality patient care, improve population health, decrease healthcare costs, improve work-life balance of health care professionals, increase job satisfaction, and decrease staff turnover. Barriers to implementing EBP include perceived lack of autonomy and authority to change patient care processes; and knowledge deficits related to EBP implementation. Limited access to research materials and inadequate leadership support also stifles implementation of EBP. The purpose of this project was to increase confidence, knowledge, and use of EBP by nurses through implementation of an intense, structured educational “Boot Camp”. A convenience sample of 27 nurses participated …

Using Simulation To Improve Skills, Confidence, And Satisfaction Related To Diabetes Education, Greshin M. Markwell

Doctor of Nursing Practice Projects

Diabetes mellitus is the seventh leading cause of death in the U.S. and affects 30.3 million people (Centers for Disease Control and Prevention [CDC], 2019). Research suggests that patients often have a limited knowledge and insight into self-management of diabetes mellitus (DM). Acceptance of the disease, insufficient knowledge, and noncompliance are the examples of key factors that affect the progress of the disease. Nurses play a key role in the delivery of diabetes education which can improve compliance. Simulation can be used to improve the nursing skill sets for diabetes education. The purpose of this project was to implement evidence-based …

An Organizational Readiness Assessment And Patient Survey For Adoption Of An Opioid De-Escalation Protocol In Curative Oncology Patients, Adria Myers

Doctor of Nursing Practice Projects

Since 2012, statistics illustrate an explosion in the number of Americans admittedly misusing prescription opioids which increase the risk of long-term adverse effects. By 2016, individuals admitting to taking opioids for non medical reasons exceeded eleven million and 1.9 million of these individuals met the mental health guidelines for opioid abuse. Oncology patients represent a target population with an unmet met need for opioid reduction. Goals for de-escalation or tapering opioids for non-cancer pain have gained increasing attention across healthcare. Evidence-based opioid de-escalation guidelines specific for curative oncology patients are lacking in the literature. The aim of this DNP project …

Effectiveness Of De-Escalation Training To Medical-Surgical Nurses, Tammy L. Sullivan

Doctor of Nursing Practice Projects

Nurses are the most common victims of workplace violence and typically are not equipped deliver appropriate prevention interventions. Although most violent episodes occur in the emergency department and mental health units, violence towards nurses on the medicalsurgical units is on the rise. Patient perpetrated aggression and violence is positively correlated with poor patient outcomes and length of stay. In addition to the physical effects on the nurse, there are psychological effects that can impact their career and personal life. The direct and indirect cost for an organization includes decreased productivity, increased absenteeism, and turnover. In potentially violent situations, nurses must …

Minimizing Antipsychotic Medication Side Effects In Adults Diagnosed With Mental Illness Through Psychoeducation: An Evidence-Based Approach, Sarah A. Yao

Doctor of Nursing Practice Projects

Adherence to antipsychotic medication has demonstrated significant impact in decreasing symptom exacerbation among patients diagnosed with mental illness. Antipsychotic medications have several benefits including the management of psychotic and mood disorders; however, they could cause unwanted medication side effects with metabolic and cardiovascular risks. This issue is one of the commonly linked side effects resulting in nonadherence among mentally ill patients. The purpose of this project was to implement a psychoeducational intervention using the SIMPLE program to address metabolic and cardiovascular risks associated with antipsychotic medications among adult patients diagnosed with mental illness. A sample size of sixteen adult patients …

Simulation Based Learning To Increase Competency And Self-Confidence In Novice Nurses, Veronica Eubank

Doctor of Nursing Practice Projects

New nursing graduates lack competency and confidence in failure to rescue situations could result in failure to rescue (FTR). High-fidelity simulation (HFS) is a potential solution to ensure a controlled environment in which new graduates can practice safely and gain the knowledge they need to develop critical thinking skills. Utilizing simulation education to improve an individual’s ability to recognize deterioration early, communicate, prioritize, delegate, and provide role clarity can foster confidence and competence in new graduate nurses. The project evaluated the effectiveness of using HFS for novice nurses to increase knowledge, competency, and confidence when a patient status deteriorates. The …

Preparing For Obstetrical Emergencies In The Emergency Department, Tracy Littlehale

Doctor of Nursing Practice Projects

Emergency Department nurses must maintain the skills to manage OB emergencies in the ED, especially in hospitals with no OB unit. Limited contact with OB patients diminishes the self-confidence, knowledge and skill of ED nurses, which may minimize their ability to recognize OB problems in a timely manner. As increasing numbers of patients with OB emergencies are expected to seek care in rural EDs due to closure of rural OB units and rising OB risk factors, maintenance of OB skills by ED nurses is critical. Simulation has been identified in the literature as an effective strategy to help nurses advance …

Improving Transgender Healthcare Experiences Using Photovoice, Amy Nelson

Doctor of Nursing Practice Projects

The transgender community is one of many marginalized populations. There are a variety of factors that influence the healthcare experiences and quality of care that members of the community receive. Some aspects of the difficulties experienced are widespread and not limited to transgender individuals while others are exclusively experienced by transgender patients related to their unique needs. Transgender patients agree that issues identified by providers, like access to insurance and lack of protocols and provider education, are indeed barriers. However, transgender patients have identified other issues, like stigma and discrimination, to be more significant barriers to their accessing healthcare. Additionally, …

Nursing Satisfaction With The Electronic Medical Record: Implementing Meaningful Change At Seattle Children's Hospital, Mary T. Field

Doctor of Nursing Practice Projects

Purpose: The purpose of this study is to describe nursing use, quality, and satisfaction with the electronic medical record before and during the course of the electronic medical record transition. In addition, this study examines the differences between nurse age, role, and area of work as these demographics relate to nursing use, quality, and satisfaction.

Background: Nurses spend a large part of their shift using technology, including the electronic medical record, however the use, quality, and satisfaction of this tool as it relates to the nursing profession has not been formally evaluated.

Methods: The design of this study is an …

Evaluating The Impact Of A Depression Care Management Program, Natalie Dreyfoos

Doctor of Nursing Practice Projects

Depression is a common mental health disorder that causes significant individual and societal burden. Depression care management programs use a collaborative approach to lessen these effects. Evaluating patient satisfaction and experience are essential to obtain a comprehensive view of program benefits. This program evaluation project evaluated the experiences of patients in a depression care management program provided by a healthcare system in Washington state. A mixed methods approach using opened ended question surveys, telephone interviews and PHQ-9 scores provided a deeper understanding of individual experiences. The analysis showed patients were highly satisfied with the program. Collectively, depression severity scores decreased …

Improving Provider Confidence And Partnership With Lgbt Patients Through Inclusivity And Education, Katherine Rowe

Doctor of Nursing Practice Projects

The focus of this project utilizes patient recommendations for LGBT-inclusive intake practices to increase provider confidence in communication with LGBT patients using pre-and post-survey data comparing provider confidence before and after a 20-minute video education session. LGBT-inclusive provider education has been shown to be deficient if not nonexistent in most educational settings, yet, LGBT individuals have increased risk of negative health disparities, violence, and discrimination. Research examining the ability for small changes in provider education to enable positive health outcomes for this vulnerable and marginalized population is imperative for the quality of life of these communities. A quasi-experimental design utilized …

Active Rehabilitation In Sports-Related Concussions: An Educational Intervention For Primary Care Providers, Lior Habinsky

Doctor of Nursing Practice Projects

Background and Review of Literature: Sports-related concussion (SRC) is a form of traumatic brain injury caused by a blow to the head and remains a prevalent issue across the 11-18-year-old age group within the United States. Historically, total physical and cognitive rest has been the preferred method to help individuals recover after suffering a concussion. However, recent data have shown that incorporating active rehabilitation or aerobic exercise therapy as part of acute post-concussion treatment is safe. Further investigation into these methods could provide valuable insight into prognosis as well as promote clinical recovery.

Purposes/Goal: This project involved delivering an educational …

Evaluating The Feasibility Of Practice Change: The Use Of The Phq-2 In The Urgent Care Setting, Helena Laubach

Doctor of Nursing Practice Projects

Adolescents in the United States may go unscreened for mental health disorders, such as depression, despite current recommendations. This population has an increased use of urgent care clinics (UCC) for their acute and primary care needs, where they might not be screened for depression at regular intervals. This project looked at determining the feasibility of implementing a two-question depression screener in the urgent care setting – the PHQ-2. Additional aims were to increase screening rates and to determine barriers to screening. Healthcare providers at a pediatric urgent care setting used the PHQ-2 to screen all adolescent patients over a two-week …

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

Enhancing Teamwork In Nursing Students, Heather Rawson

Doctor of Nursing Practice Projects

Abstract

The purpose of this project was to equip senior practical nursing students (n = 11) with the skills needed to increase their feelings of preparedness to join an intradisciplinary team in the workplace after graduation. This project utilized a pre-test/post-test design using TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) to determine if participation in TeamSTEPPS^® training and a simulation exercise enhanced perception of teamwork in senior practical nursing students. A paired t-test was performed to analyze the data collected from the questionnaires acquired before and after the TeamSTEPPS^® training. The results showed a t-value of 8.49, greater than …

Preparing Ambulatory Care Leaders For Service: Onboarding To Mentorship, Kara Simpson

Doctor of Nursing Practice Projects

At a large academic medical center in the Southeastern United States, a gap was identified in the process for onboarding and mentorship new leaders in the ambulatory care setting. Based on the evidence in the literature, a standardized onboarding and mentorship program can improve job satisfaction and retention of leaders. A program was developed to bridge this gap and provide educational support for new leaders. Participants completed surveys at the onset and conclusion of the program with a validated survey tool. While the quantitative results were not statistically significant, the feedback from the participants indicated the time spent in the …

Equipping Early Childhood Educators To Manage "Behaviors That Challenge" In The Early Childhood Years, Shanna Scott

Doctor of Nursing Practice Projects

This scholarly project pursues the development, implementation, and evaluation of techniques to help improve the health and well-being of children ages 1-5, who have difficulties with challenging behaviors, to effectively manage stress and boost resilience through the incorporation of music and educational techniques of the early childhood educator.

This paper will discuss the positive or negative outcomes on external factors affecting child health, such as economic, judicial, societal, cultural, cognitive development, parental separation, and mental health concerns of all members of the family. It will also discuss the positive effects educational strategies and music can have on young children experiencing …

Assessment Of Intensive Care Family Satisfaction, Jami Burnette

Doctor of Nursing Practice Projects

There continues to be an unknown factor in knowing true patient and family satisfaction within the intensive care unit (ICU) setting. Current literature reveals surveys used to measure patient satisfaction do not pertain to the ICU setting. Patients often do not remember the ICU stay due to critical illness and are unable to actively participate with care. Families act as surrogates, are included in patient care, and collaborate with nursing and medical teams to help make care decisions. Families are integral in the patient care process and are vital members of the health care team. Even though families are included …

Work Well: Promoting Health Behaviors And Self-Care Amongst Public School Faculty, Staff, & Administrators, Sherri Smith

Doctor of Nursing Practice Projects

Workplace wellness is a critical aspect within an organization. Failure to encourage and meet the wellness needs of staff can lead to increased absenteeism, decreased productivity, as well as increased stress levels. Improved workplace wellness in an academic setting has not only potential positive impact on employees but also the students they teach. Evidence shows that implementing wellness initiatives in academic settings has the potential to improve the overall wellbeing of teachers as well as students. Interventions include a Walkabout Challenge, a Caring Peer Group, and education. The interventions are an effort to improve self-care habits amongst faculty and staff …

Suicidal Risk Education In Hospice Care, Shannon Jones

Doctor of Nursing Practice Projects

It is well-documented that oncology patients experience greater rates of suicidality including suicidal ideation, actions, or completions, as compared to the general population. The small, rural county which was the setting for this project has a higher rate of lung and colon cancers as compared to regional, state, and national rates. A review of the literature revealed best practices for suicide screening including universal education and screening and targeted education and screening for at-risk populations. The rate for suicides in the county is also higher than the rates for the region, state, and nation. The purpose of this project was …

Civility Promotion: How It Affects Workplace Incivility, Shawanda Lang

Doctor of Nursing Practice Projects

Incivility is also known as uncivil behavior, horizontal violence, or bullying. These terms are often used to describe the conduct an individual may display toward another that are deemed undesirable in healthcare organizations. Uncivil behavior has been an increasing topic in healthcare and has consequently gained the attention of organizations such as the American Nurses Association and regulatory agencies such as The Joint Commission. Incivility has the opportunity to affect teamwork, individual well-being, and patient safety. The aim of this project was to promote civility by bringing knowledge and awareness of the participants through an educational series. Although the pre …

Improving Workplace Incivility By Educating Frontline Nurse Leaders: The Charge Nurse, Temika Ford

Doctor of Nursing Practice Projects

The term workplace incivility is often replaced interchangeably with workplace bullying, horizontal/lateral violence, psychosocial harassment, intimidating behavior, and/or aggression (micro/macro). Workplace incivility in nursing has lasting effects on the profession through worsening the nursing shortage, contributing to low morale, negative working environments, safety issues for staff and patients, stress-related health problems, absenteeism, and decreased quality of patient care. Incivility can be from a variety of sources including: Nurse managers, clinical team leads, unit coordinators, physicians, patients, and other healthcare professionals. Buy-in by nursing executive leadership and evidence-based education for nurses is mandatory to address organizational incivility.

The purpose of this …