Medicine and Health Sciences Commons^™

Screening For Social Determinants Of Health Screening In The Primary Care Setting: A Quality Improvement Project, Arifa Khan

DNP Projects

Significance and Background: Social determinants play a major role in the overall health of our nation. While screening for social determinants of health (SDOH) in the primary care setting is encouraged, there is no streamlined process in place. Studies have determined that improved SDOH screenings can result in better patient outcomes and a decrease in healthcare costs. A protocol to improve SDOH screenings was needed to guide patient outcomes at a Federally Qualified Health Center (FQHC) in Connecticut.

Purpose: Deliver education to providers and healthcare staff across the health system on significance of social determinants of health and PRAPARE screening …

Introducing An Evidence-Based Copd Care Bundle To Reduce Readmission Rates: A Quality Improvement Project, Michael Distasio

DNP Projects

Background

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating lung condition, and a leading cause of readmission following an acute exacerbation. The Centers for Medicare and Medicaid Services (CMS) Hospital Readmission Reduction Program (HRRP) determines reimbursement penalties to hospitals when patients admitted with acute exacerbation of COPD are readmitted for any reason within 30 days of discharge. A regional medical facility (MF) identified 30-day readmission rates for COPD patients as a key improvement metric. Several gaps in the standardized care of patients with COPD on a pulmonary-focused medical-surgical unit (MSU) identified by key unit stakeholders provided impetus for …

Implementing The Phq-9 Tool To As A Standard Of Practice In A Mental Health Setting: A Quality Improvement Project, Gabriella Laferriere

DNP Projects

The objective of this project was to implement the Patient Health Questionaire-9 (PHQ-9) tool as a standardized protocol for depression screening on patients being treated at an outpatient mental health facility in Central Connecticut, where there was no depression screening protocol in place. The clinical question being asked was, is there any correlation between use of the PHQ-9 tool and changes being made to a patient’s depression treatment plan?

Methods: A data collection form was completed by the psychiatric nurse practitioner on each patient who met the following criteria: Depression and/or anxiety was the patient’s primary diagnosis and patient was …

Enhancing Primary Care With Progressive Muscle Relaxation For Anxiety, Depression, And Acute Stress: A Quality Improvement Project, Andrew Dudley

DNP Projects

Introduction

Depression affects 1 in 5 individuals during their lifetime (Hidalgo et al., 2021), with 23 million Americans seeking mental health treatment annually (Parish et al., 2023). While guidelines from the AAFP and APA advocate comprehensive care approaches, medication prescriptions for anxiety and depression remain prevalent, particularly among children aged 6-18 (Lester et al., 2022). Direct observation identified a need to bridge gaps in adjunctive therapies between the primary care setting and counseling services for patients who presented with mild or mild to moderate anxiety or depression. Feedback analysis by staff in the setting identified a gap in knowledge and …

Dnp Project Proposal: Toolkit For Transition Of Young Adults With Autism Spectrum Disorder (Ya-Asd) To Primary Care, Dawn Boal

DNP Projects

Significance and Background: Young adults (YA) with autism spectrum disorder (ASD) transitioning from pediatric to adult care may have more difficulty finding a primary care clinician trained to address their unique medical and mental health needs. Transition resources need to be developed to help these patients and their caregivers while they are still being cared for by their pediatrician.

Purpose: To develop an ASD resource toolkit with resources designed to help YA-ASD and their caregivers with the transition from pediatric care to adult primary care.

Methods: The Model for Healthcare Improvement guided this evidence-based quality improvement project. An evidence …

Implementing A Skin Care Bundle On Hypoperfusion Skin: A Quality Improvement Project, Emily O'Connor

DNP Projects

Significance and Background: Pressure injury rates have increased within the critical care population. Pressure injuries are known to increase pain, infection risk, length of stay leading to decreased quality of life. Thermal imaging cameras highlight areas of hypoperfusion, allowing staff to target these areas as high likelihood to progress to a pressure injury. Foam dressings have been shown to help decrease pressure injury acquisition. Prevention methods should utilize evidence-based skin care bundles and focus on known information and target areas. Combining knowledge from thermal cameras, foam dressings, turning every two hours and accurate use of documentation scale (Braden Scale), a …

Implementing Continuous Glucose Monitoring: A Quality Improvement Project, Molly Suydam

DNP Projects

Significance and Background: Continuous glucose monitoring (CGM) devices are beneficial for assessing blood glucose measurements throughout the day by simply waving a smartphone over the sensor that’s attached to the back of a patient’s arm. Patients with T2DM who check blood glucose measurements via finger-sticks, have to undergo numerous daily finger-sticks. Over time, this action can grow very cumbersome while CGM offers real-time blood glucose measurements without having to pierce the skin repeatedly. CGM use in patients with T2DM may help to improve overall blood glucose measurements.

Purpose: To trial CGM in patients with T2DM and monitor blood glucose measurements …

Implementation Of A Risk Stratification Foot Screening Tool At A Free Outpatient Clinic: A Quality Improvement Project, Joni-Kay Johnson

DNP Projects

Background: Foot conditions and disorders are prevalent concerns for the medically underserved population, that can manifest through chronic illnesses like diabetes, peripheral vascular disease, and hypertension, especially if these conditions go undetected or unmanaged for periods of time. This population is faced with complex challenges and are at risk of illness due to inequities and disparities in access to health care services. They are known to suffer from poor health and can be reluctant to seek healthcare except in crisis. Walking is a common mode of transportation among underserved individuals and increased risks of physical injury, poor hygiene, and inadequate …

Implementing Teach Back Heart Failure Education To Improve Self-Care And Reduce Re-Hospitalization: A Quality Improvement Project, Sweata Patel

DNP Projects

Heart failure (HF) is a major health concern. External evidence supports the use of the teach-back method for patient education to promote self-care behaviors in patients with HF which may also reduce rehospitalizations. Patients with HF at one home health agency in New England participated in the quality improvement project which consisted of delivering 20 minute weekly standardized teach-back educational sessions covering topics of HF self-care over six weeks. The existing patient education materials and two new resources, Medication Tracker and Self-Check Plan for HF management, were reviewed. Three questions from the Self-Care of Heart Failure Index were asked during …

Improving Provider Ordered Annual Breast Cancer Screening In Primary Care, Alexis Manzella

DNP Projects

Significance and Background: Breast cancer is the most common cancer in women throughout the United States. Specifically, the state of Connecticut has one of the highest rates of breast cancer in the country. Multiple evidence-based organizations have developed specific guidelines for screening in clinical practice. These guidelines specify when a woman should be screened and how frequently. A project was put in place at a FQHC in Connecticut to increase the number of breast cancer screenings ordered, based on clinical guidelines. Evidence supported the use of provider education to increase the number of mammograms ordered (Marks,2022).

Purpose: Increase the number …