Medicine and Health Sciences Commons^™

Implementation Of Safe Patient Toileting To Decrease Patient Falls On Medical-Surgical Unit, Kimberly A. Goldsborough

DNP Scholarly Projects

BACKGROUND: Patient falls are a serious safety concern in the hospital setting throughout the country. Falls are one of the most challenging patient safety events to prevent, as there are many contributing factors with toileting activities producing the highest incidence. Fall prevention bundles are used to minimize and reduce these such events although multifaceted. The project was conducted with an academic medical center on an acute inpatient medical-surgical unit primarily housing burn wound patients. Nursing leaders and front-line nursing staff participated.

METHODS: Literature review to determine the gap in knowledge of interventions to prevent acute inpatient falls was completed. Concepts …

Bill To Restrict Indoor Tanning For Minors In The State Of Maine, Jamie M. Lowery

DNP Scholarly Projects

Background: Melanoma is the deadliest and the most common type of cancer in individuals age 15 to 29. Evidence has shown that ultraviolet radiation overexposure at younger ages significantly increases the risk of developing non-melanoma and melanoma skin cancer in later years. Despite these concerns, approximately 1.6 million minors under the age of 18 participate in the use of indoor tanning devices annually. The high prevalence of skin cancer in the United States continues to be a public health issue that warrants continued preventative and regulatory action. In spite of the health risks associated with indoor tanning, the state of …

Electronic Reminders To Improve Medication Adherence In Diabetes: A Quality Improvement Project, Lisa Wilson

DNP Scholarly Projects

BACKGROUND: Diabetes often contributes to many co-morbid conditions and their complications. Non-adherence to medications is common in patients with chronic disease. The project aimed to improve medication adherence through the implementation of electronic messaging. The project was set in a private medical practice within a critical access hospital. Participants were patients of the practice with diabetes.

METHODS: Baseline assessment included review and documentation of HgBA1cs, prescription requests, and past medical history. The development of an intervention to improve medication adherence utilizing electronic reminders was based on Bandura’s (1989) Social Cognitive Theory and Ajzen’s (1991) Theory of Planned Behavior.

INTERVENTION: The …

Health Risks Of Firearm Ownership: A Patient Screening And Education Intervention, Aaron Kahn

DNP Scholarly Projects

BACKGROUND

There is significant health risk associated with firearm ownership. To address this risk a primary care-based intervention was designed and implemented to screen for firearm ownership, educate patients on the risks of gun ownership, and provide patients with resources for reducing associated health risks.

METHODS

A mixed methods study design was employed. Four primary care providers (PCP) practicing in family health volunteered to participate in this intervention. Focus groups with participating PCPs were conducted prior to the intervention to solicit recommendations for intervention protocol and assess participating PCPs current understanding of the health risks of firearm ownership, and after …

Utilizing Telecommunication To Provide Patient Centered Care For Adults Newly Diagnosed With Gi Cancer: A Quality Improvement Project, Laurie Miller

DNP Scholarly Projects

INTRODUCTION: A confirmed diagnosis of GI Cancer causes anxiety and stress as patients become overwhelmed with questions, worries and fears. At diagnosis, patients are not yet formally connected to the support services available to those actively receiving chemotherapy, creating a “gap period”. To help reduce anxiety, as well as, foster therapeutic relationships and improve overall patient experiences, a structured telephone communication by the gastrointestinal cancer oncology nurse practitioner (GI NP) was proposed.

AVAILABLE KNOWLEDGE: Reduction of anxiety has been shown to enhance the quality of life, increase compliance with a prescribed treatment plan and foster the ability to sign informed …

Quality Improvement On The Long-Term Care Ventilator Unit: Interventions To Increase Patient Safety And Prevent Patient Harm, Billie Anderson, Joanne Samuels

DNP Scholarly Projects

BACKGROUND: Tracheostomy patients are susceptible to life-threatening emergencies when their airways are compromised. Epidemiologic data suggests that 3.2% to 30% of tracheostomy patents have a complication. The long-term care ventilator unit (LTCVU) is a 25-bed unit in a nursing home. It has noted that 40% of patients have a complication. A group of hospitals demonstrated a 90% reduction in complications through five interventions.

METHODS: The Johns Hopkins Nursing Evidence-Based Practice model was utilized to take the Global Tracheostomy Collaborative interventions and apply them to the LTCVU with the aim of reducing the number of airway complications on the unit by …

Improving Emergency Department Nurses' Self-Perceived Self-Efficacy In Early Recognition Of Patients In A Mental Health Crisis, Mary Kay Silverman

DNP Scholarly Projects

Abstract

The two largest counties within Southwest Florida (SWFL) are Lee and Collier where mental health evaluations for children under the state’s Baker Act have more than doubled between 2011 and 2017 (Gluck & Zeitlin, 2019, p. 4). Given the marked increase in mental health evaluations, early recognition, assessment with initiation of treatment by nurses in the pediatric emergency department (ED) who present with behavioral health complaints must be a priority for emergency department leaders. Purpose: This quality improvement (QI) project proposed to improve a nurses’ self-efficacy through expanding knowledge in the recognition and identification of the signs and symptoms …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

How College Students Discuss Their Relationships, John R. Domenico

Honors Theses and Capstones

It is a statistically significant fact that individuals who identify as homosexual are more likely to experience intimate partner violence (IPV.) Despite this, statistically, it is less likely for those who identify as homosexual to report IPV to healthcare clinicians or to law enforcement. “How College Students Discuss their Relationships” examines the implications of intimate partner violence in college students who identify as homosexual and the repercussions IPV may have on discussions with healthcare clinicians. By performing semi-structured interviews with individuals who identify as homosexual on the UNH campus, mental health outcomes of emotional intimate partner violence in …

Mentoring Nursing Leaders To Foster Frontline Accountability And Engagement In Continuous Performance/Process Improvement Through The Utilization Of Team Huddles And A Huddle Board, Brandon L. Buckingham

DNP Scholarly Projects

BACKGROUND: Establishing a connection for staff between the work being done and the associated implications and outcomes on patient safety and quality care delivery is not often a simple task for any nursing leader. Team huddles and huddle boards aim to establish and foster frontline accountability and engagement for continuous process and performance improvement. The setting of the project was a 17-bed acute care inpatient unit specializing in neurosciences within an academic medical center. Participants included nursing leaders and staff of the unit.

METHODS: Consultation and mentorship in conjunction with standard work were utilized for this project. The intervention was …

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Three-Dimensional Echocardiographic Analysis Of The Equine Aortic Valve, Amber Mcelhinney

Honors Theses and Capstones

This research focused on 3D echocardiography of the aortic valve (AV) in horses. Aortic regurgitation (AR) can be a common finding in older horses, and in severe cases can result in decreased performance and even sudden cardiac death. Standard AR diagnosis includes 2D echocardiography from the right side of the horse. Three-dimensional echocardiography (3DE) records a pyramid of tissue, showing structures in the heart difficult to visualize in 2D methods, and can be more accurate as it does not rely as heavily on placement of the transducer. Nine images of normal AV’s were assessed, and still frames of anatomical structures …

A Developmental Study Of Apoptotic Markers And Histamine In Cephalopod Statocysts, Samantha Nicole Leef

Honors Theses and Capstones

Cephalopods can participate in complex navigation using landmarks that show context due to their statocysts. Statocysts are analogous to the vertebrate vestibular and auditory system encased in cartilage rather than bone making them more easily accessible. Age and anatomical dysfunctions are the reasons for many human vestibular malfunctions. Two of these sources are endolymph hydrops and aging. In the past, endolymph pressure changes were attributed to the ineffectual ion transport. Recent studies have illuminated the possibility of histamine receptors in the semicircular canal could be responsible for patients’ endolymph pressure changes rather than the previous belief that the pressure changes …