Medicine and Health Sciences Commons^™

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

Implementation Of Trauma Informed Care In A Primary Care Setting Using The Adverse Childhood Experience As A Screening Tool, Adedoyin Adepoju

Doctor of Nursing Practice (DNP) Projects

Background: The prevalence of trauma is widely unacknowledged in the primary care setting. Unfortunately, the injury that individuals sustained as children may continue to adversely affect their health as adults in various ways, including having risky health behaviors, early death, chronic health conditions, and low life potential. Prevention of trauma is crucial and can is achieved with consistent public health education. There are available treatments for childhood trauma, and the inclusion of primary care for screening is vital for quality care.

Purpose: The Adverse Childhood Experience (ACEs) is a screening tool that can be utilized to survey adult patients …

Reducing Restraints Through Patient Involvement In Care Plans, Matt Thompson

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Restraint use has been demonstrated to pose a risk of psychological and physical injury to both clients and staff in health care facilities and programs. Evidence from the literature suggests that including patients in the planning of their care has been demonstrated to reduce problem behaviors, violent outbursts, instances of self-harm, and the need for restraint.

Purpose: The aim of this quality improvement project was to promote collaborative care through the attainment of provider knowledge of best practices to prevent and reduce restraint use at three group homes in St. Petersburg, Florida.

Methods: The intervention involved presenting …

Implementation Of An Online Mindfulness-Based Intervention For Reducing Stress Amongst Undergraduate Nursing Students, Joy Garmaise-Yee

Doctor of Nursing Practice (DNP) Projects

Background & Purpose: Nurses and nursing students have notoriously high levels of stress, which can lead to burnout, depersonalization, deterioration of mental or physical health or exiting the profession. A pilot educational mindfulness-based intervention was implemented online amongst undergraduate nursing students to decrease stress and increase mindfulness. Mindfulness is an evidence-based self-care skill that has proven effective in reducing stress in student populations and amongst nurses.

Methods: Students in an online nursing theory course engaged in the mindfulness-based intervention online. Stress and mindfulness were measured pre-, immediately post-, and 4 weeks post-intervention and were analyzed using linear regression. Students were …

Enhancing Cultural Humility For Sexual And Gender Minorities Within An Inpatient Mental Health Hospital: A Quality Improvement Project, Kathleen Dalton

Doctor of Nursing Practice (DNP) Projects

Background: Sexual and gender minorities (SGM) are a population that experiences health disparities. Cultural competence among healthcare providers is one way to help reduce health disparities that is shown to be improved by educational interventions.

Purpose: The purpose was to enhance cultural humility among healthcare professionals in a mental health hospital to promote inclusivity especially as it pertains to SGM. The purpose was to shift a training model focused on cultural competence to one that incorporates concepts related to cultural humility by implementing a classroom-based training with a pre and posttest.

Methods: The design was non-experimental, using a convenience sample …

Educating Nurse Practitioners On The Cdc Guidelines For Prescribing Opioids For Chronic Pain In The Practice Setting, Amber Whitehill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Prescription opioids have become a problem in the current opioid crisis, being inappropriately used by those who do not require them. The purpose of this DNP project was to increase the awareness, knowledge, and comfort level of nurse practitioners in relation to the CDC Guidelines for Prescribing Opioids for Chronic Pain.

Methods: An educational program was used to inform Nurse Practitioners who were members of the Massachusetts Coalition of Nurse Practitioners of the CDC Guidelines for Prescribing Opioids for Chronic Pain. A prescribing survey was initially given to determine their awareness, knowledge, and comfort level using the CDC …

Considering Premenstrual Dysphoric Disorder As A Differential Diagnosis In The Psychiatric Population An Educational Intervention Project, Sarah Mcnulty

Doctor of Nursing Practice (DNP) Projects

Background:The assessment and treatment of Premenstrual Dysphoric Disorder (PMDD) in the female population is an important issue to be examined. Upward to thirty percent of all females’ report symptoms of moderate to severe PMDD. Proper assessment, identification and treatment of PMDD as a differential diagnosis by healthcare providers is essential for the effective treatment PMDD.

Purpose:To provide evidenced based education to mental health professionals for the assessment and treatment of PMDD in order to help improve the quality of life for patient’s living with this disorder.

Methods: The PMDD education intervention took place at a inpatient …

Educating Health Care Providers On The Benefits Of Screening For Adverse Childhood Experiences In Children And Adolescents, Kristen Hickey

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are associated with the development of chronic health problems as well as increased risk for negative mental health outcomes. Research supports the need for health care providers (HCP) to change current practice by adding one of the many types of screening tools for ACEs, such as the ACEs Q, to well-child visits. The information obtained from the assessment leads to early identification of children who are at risk for negative mental health outcomes, allowing HCPs to initiate early interventions potentially decreasing the negative outcomes.

Purpose: The purpose of this quality improvement project was to provide …

Implementation Of Pressure Injury Prevention Intervention In A Long-Term Care Facility, Alfred Owusu-Ansah

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Pressure injuries (PIs), formerly known as pressure ulcers, affect approximately 2.5 million people in the United States and cost the American healthcare system more than $11.6 billion annually. The goal of this project was to reduce the pressure injury incidence rate at the project site by 50% within a period of six months.

Methods: The purpose of this project was to evaluate the impact of implementation of PI prevention measures in a medium-sized long-term care facility in central Massachusetts. The project utilized parts of the MISSCARE survey and AHRQ checklists as a pre-test. Collection of data from nurses …

Discharge Education For Pediatric Post-Operative Pain After Spinal Surgery, Elise Buckley

Doctor of Nursing Practice (DNP) Projects

Background: Many pediatric orthopedic surgeries require legitimate opioid prescriptions for pain control, however caregivers report they do not have adequate discharge teaching. Integrating videos into discharge processes shows promise in increasing patient and caregiver comprehension and satisfaction of discharge education.

Purpose: The purpose of this quality improvement project was to standardize discharge teaching by developing an educational video for caregivers on how to manage their child’s post-operative pain after spinal surgery.

Methods: An educational video was created and viewed by caregivers at the DNP project site. Outcomes were measured through brief questions asked to caregivers after viewing the video …

Improving Osteoporosis Screening Rates In A Primary Care Practice, Heidi Doreau

Doctor of Nursing Practice (DNP) Projects

Background: Osteoporosis is a prevalent condition that is often overlooked until a fragility fracture occurs. Screening for bone loss with dual-energy X-ray absorptiometry (DXA) scans is underutilized in the primary care setting. Direct communication with at-risk patients, offering self-referral for DXA screening, has been demonstrated to be the most effective intervention in increasing DXA screening rates.

Purpose: The goal of this DNP project was to improve bone density screening rates in a primary care practice by inviting patients at greatest risk of osteoporosis to schedule a DXA without a provider order.

Methods: After a review of the electronic medical record, …

Cultural Communication For New Nurse Residents: K.I.N.D Communication Toolkit, Jennifer Caraballo

Doctor of Nursing Practice (DNP) Projects

Background: Microaggressions can create a hostile work environment and decrease rapport and functioning in clinical and personal relationships. Exposure to micro aggression and implicit bias results in micro trauma and possible compassion fatigue by medical staff. Symptoms can include headaches, poor sleep, depressions, and anxiety, similar to compassion fatigue.

Purpose: To develop a toolkit for healthcare staff to use as educational material to facilitate for cultural communication and cultural humility.

Methods: Nurses that were enrolled in a nurse residency program at a level 1 trauma center participated in the education of a communication toolkit related to K.I.N.D …

School-Based Telemental Health And Family Psychoeducation: A Program Evaluation, Ainat Koren

Doctor of Nursing Practice (DNP) Projects

Background: Telemental Health has been established as an effective model of care in the adult population. There are few studies that addressed the effects of providing child and parent telehealth services in underserved communities where mental health services are sparse. Families who attend face to face mental health support report high levels of satisfaction, show increased knowledge about mental illness/treatment, and youth have a lower risk of relapse.

Purpose: The purpose of this DNP project was to evaluate an innovative Telemental Health model offering timely social/behavioral health support for children/families’ mental health services in rural Massachusetts.

Methods: Process …

An Evaluation Of “Diabetes Day” Using Implementation Science To Improve Support For Families Of Children With Type 1 Diabetes Mellitus, Georgianna R. Shea

Doctor of Nursing Practice (DNP) Projects

Background: Type 1 diabetes (T1D) is one of the most common life-long endocrine disorders in children and adolescents. Attending to the psychosocial and emotional needs of children with T1D and their families is fundamental in attaining optimal clinical health outcomes. Diabetes Day is a collaborative effort that is offered at a pediatric endocrinology clinic in Western Massachusetts. The Diabetes Day team spends multiple hours planning, recruiting and implementing Diabetes Day as a way to provide this requested support; however, participation rates of families continues to decrease.Purpose: The purpose of this DNP project was to evaluate the process of planning, …

Routine Alcohol Screening And Brief Intervention In The College-Aged Population: A Quality Improvement Project For University Health Services Staff, Rebecca Chevalier

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Alcohol abuse is a significant concern in the college-aged population (18 to 24 years old) in the United States. Evidence supports the use of the alcohol screening and brief intervention (SBI) and the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) for this population in reducing negative consequences associated with high-risk alcohol use.

Purpose: The purpose of this quality improvement (QI) project was to engage University Health Services (UHS) staff to use a routine SBI protocol with the AUDIT-C on all students that entered UHS and based on risk profile, if necessary, staff performed a brief educational intervention. …

Nurse-Delivered Standardized Chemotherapy Education Intervention To Reduce Distress Among Older Adults In An Outpatient Setting, Michelle Viveiros

Doctor of Nursing Practice (DNP) Projects

Background/Review of Literature: A new cancer diagnosis is overwhelming and stressful. A multitude of information will be shared, and treatment initiated quickly. To prepare patients for chemotherapy, a comprehensive and systematic education program should be utilized. Combining written instructions and supportive material with nurse-led teaching sessions have been found to be most beneficial. Well prepared patients have been shown to have less anxiety, more confidence to handle adverse effects at home, and improved quality of life. Purpose: The quality improvement (QI) project purpose was to explore the effect of a nurse-delivered, enhanced education intervention on distress among older adults receiving …

School-Based Suicide Awareness And Prevention Education For Licensed School Personnel, Alexandra Moylan

Doctor of Nursing Practice (DNP) Projects

Background: The numbers of youth at risk for attempting, contemplating, or completing suicide is a significant concern in the Commonwealth of Massachusetts. The Commonwealth has recognized the vital role that school personnel have in suicide prevention, yet training is not mandated due to a lack of funding. Though limited, evidence from the literature written to date has demonstrated improved outcome measures when suicide awareness and prevention training is implemented.

Purpose: This DNP project aimed to reduce the gap in practice by providing in-person suicide awareness and prevention education to nurses of a western Massachusetts school district.

Methods: A …

Serious Mental Illness And The Continuum Of Cancer Care, Beriline Akwe

Doctor of Nursing Practice (DNP) Projects

Background and Review of Literature: Cancer has been associated with up to a 30 percent higher case fatality rate among adults living with serious mental illness (SMI) although their incidence is similar to that of the general population. This disparity has been attributed to healthcare system, health care provider, community/policy, family caregiver and individual patient factors.

Purpose: To provide community mental health care clinicians with knowledge and skills to effectively function in the key role as care coordinators in the clinical-community relationship in efforts to assist persons with serious mental illness access effective, efficient, safe, timely, equitable and person-centered care …

Improving Intimate Partner Violence Screening Practices Among Postpartum Nurses, Robin Mills-Humphreys

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of the Literature: Intimate partner violence (IPV) during pregnancy is a global public health issue that has negative outcomes on both an individual and a societal level. Health care providers play a pivotal role in providing services to women experiencing violence during pregnancy. Regardless of the setting, barriers to IPV screening exist among healthcare providers. Review of the literature examined the existing IPV screening practices and screening barriers among healthcare providers to better understand the relationship between barriers and frequency of screening for IPV. Purpose: The purpose of this DNP project was to enhance …

Epidural Education For Parturients Using A Video Teaching Tool, Matthew Moore

Doctor of Nursing Practice (DNP) Projects

Introduction: The use of epidural analgesia for labor pain is becoming more common across the United States. Laboring mothers report feeling under informed about epidural side effects and dissatisfaction with the timing of the information.Background: Providing appropriate and adequate education and informed consent for epidural analgesia can prove challenging, especially during labor. Nevertheless, it is important for women to understand the potential risks in order to make a fully informed decision. Purpose: The purpose of this Quality improvement project was to show evidence of the benefits for the use of an obstetric anesthesia video during the education process and …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

Improving Cultural Competency Among Healthcare Providers Working With Refugee Patients, Tena Chau

Doctor of Nursing Practice (DNP) Projects

Background: Increased diversity of the United States population has resulted in the presence of greater disparities in healthcare. One way to address factors contributing to health disparities has been to increase cultural competency in healthcare. Evidence from a review of the literature supports the idea that understanding aspects of cultural competency that are lacking among specific healthcare organizations are helpful to develop programs to address the areas of need. Purpose: The purpose was to complete a quality improvement project to evaluate if an educational intervention based on a specific model would lead to increased level of cultural competence among healthcare …

Improving Alcohol Screening And Brief Intervention In Community Health Settings: Training And Evaluation, Abdonne Mbouadeu

Doctor of Nursing Practice (DNP) Projects

Background: Excessive alcohol use is responsible for 88,000 deaths in the United States each year. Alcohol Screening and Brief Intervention (ASBI) is highly effective for the prevention and treatment of harmful alcohol use in community healthcare settings; however, this intervention is not widely used by healthcare professionals. A structured search of bibliographic databases was conducted to locate evidence-based articles pertaining to barriers to ASBI. Evidence suggests that the lack of knowledge and confidence is responsible for the underutilization of ASBI. Purpose: To assess the impact of ASBI training on nursing staff knowledge, attitude, and confidence and to make ASBI a …

In Beers We Trust: Using Deprescribing Tools To Reduce Inappropriate Polypharmacy In Adults Age ≥ 65, Angelica Ferrazzi

Doctor of Nursing Practice (DNP) Projects

Background: Adverse drug events (ADEs) are a significant cause of morbidity and mortality in older adults (age ≥ 65). Polypharmacy and potentially inappropriate medications (PIMs) are especially prevalent in this population and are a notable contributing risk factor for ADEs. Research demonstrates that comprehensive medication reconciliation that includes evaluation of both the risks and benefits of medications, in conjunction with deprescribing practices, can reduce PIMs; therefore, reducing ADEs.

Purpose: The aim of this quality improvement project was to empower clinicians to deprescribe current medications that are inappropriate, as well as reduce the rate of newly prescribed PIMs among patients age …

Heart Failure: Effective Collaboration And Education To Reduce Preventable Hospitalizations And Readmissions, Iwona Prabucka-Davis

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of Literature: Worldwide heart failure (HF) prevalence rates are steadily increasing at a high magnitude. With rates of mortality and morbidity high for those diagnosed with HF, patients are often faced with a poor prognosis. Management of the disease that is in accordance with the most recent recommended guidelines has been shown to reduce exacerbations that require hospitalizations and thereby preserving patient quality of life and life expectancy.

Purpose: The purpose of this project was to decrease hospital readmissions for HF exacerbations in the primary care setting through improving practitioner and patient adherence to the current …

Contraceptive Education Module Intervention, Rachel Cox

Doctor of Nursing Practice (DNP) Projects

Background and Review of Literature: Unplanned pregnancy is associated with poor mother and child outcomes physiologically and psychologically. Since contraception is an integral piece of family planning, ensuring that patients have quality information to make an informed decision about their birth control choices is important. Purpose. This intervention sought to increase women’s contraceptive knowledge, correct use of their chosen birth control methods, and the number of women using birth control through the evidence-based interactive computer-based education. Methods: 20 participants were administered a pretest to assess their utilization, correct usage, and knowledge of contraception. Then, participants watched an …

A Resource To Guide Clinicians For Patients With Severe Mental Illness And Anosognosia: Anosognosia Mental Illness Screening And Intervention Strategies (Amiss) Toolkit ©, Jessica Bardina

Doctor of Nursing Practice (DNP) Projects

Background: An alarming percentage of individuals with severe mental illness lack insight or awareness of their disorders, a symptom known as anosognosia. Due to the obscurity of the symptom of anosognosia, clinicians may misinterpret patients’ thoughts about their diagnosis as being in denial rather than an extension of their disorder, a lack of insight. Misidentifying or inappropriately addressing this key symptom can lead to poor mental health and psychosocial outcomes.

Purpose: The aim of this Integrative Review (IR) was to garner the best evidence to develop a Toolkit and a presentation to educate clinicians about anosognosia in mental illness, …

Peer Support To Reduce Vicarious Trauma In Mental Health Providers, Alina Kendrick

Doctor of Nursing Practice (DNP) Projects

Mental health providers working with individuals with trauma and stress are at increased risk for vicarious trauma (VT) and compassion fatigue.

A quality improvement project was implemented with six mental health providers engaged in weekly peer support group sessions lead by the DNP student over a six week timeframe. Topics discussed included education on vicarious trauma, client case vignettes, and mindfulness around the treatment of vicarious trauma. Professional quality of life (ProQOL) and secondary traumatic stress (STSS) assessments were completed prior to the start of the peer group and at the completion of the sixth group.

Analysis of post group …

Evaluation Of The Impact Of A Nurse Practitioner (Np) Residency Program On A Selected New Np Graduate In An Outpatient Clinic In Massachusetts, Ian Penn

Doctor of Nursing Practice (DNP) Projects

Background: As the role of nurse practitioners (NPs) evolves and educational approaches to training NPs are modified to accommodate these changes, a gap in adequate training for many newly graduated nurse practitioners exists. Additional post-graduate supervised training is needed to ensure confidence and competence of new providers. Such programs are not currently available at small, outpatient settings in the United States. Purpose: The purpose of this Quality Improvement (QI) DNP project was to evaluate the impact of a newlylaunched primary care nurse practitioner residency program on a selected new NP graduate (hereafter called the ‘resident’) at an independent, outpatient, …

Clinical Assessment Of Pediatric Bipolar Disorder In The Prepubescent Population, Rachel Weitz

Doctor of Nursing Practice (DNP) Projects

Abstract

Purpose: Diagnosis of serious mental illness (SMI) in the prepubertal pediatric population is exceedingly challenging. There is ongoing controversy associated with the diagnosis of pediatric bipolar disorder (PBD), largely due to poor clinical consensus surrounding criteria particularly in the youngest cohort. Specificity of symptom identification is invaluable as it relates to available empirical evidence, and wider classification characteristics appear to detract from this precision. The aim of this project is to present the current evidence around the diagnosis of PBD before adolescent onset and to summarize best practice guidelines from an ethical and theoretical perspective (Bronfenbrenner’s Bioecological Theory of …