Medicine and Health Sciences Commons^™

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

Increasing Nurse Knowledge Using A Formal Lung Transplant Education Program, Amy M. Stoddard, Donna Lynch-Smith, Kate Carlson Wrammert, Bobby Bellflower

Doctor of Nursing Practice Projects

This quality improvement project was completed to show that a formal lung transplant education course for nurses caring for lung transplant patients increased their knowledge. An eight-hour education course was developed by experts in the field of lung transplantation. A pretest was administered before the education course. A posttest was administered to determine if knowledge was improved. A three-month follow-up test was administered to determine knowledge retention. Based on the data analysis, nurse knowledge improved after formal education. Item analysis determined what areas of educational content need to be the focus of quarterly education. The education course was adopted as …

A Quality Improvement Pilot To Reduce Caregiver Burden In Caregivers Of Hematopoietic Stem Cell Transplant (Hsct) Patients In A Hsct Program In The Northwest, Jody Acheson

Doctor of Nursing Practice Projects

Background: Hematopoietic stem cell transplant (HSCT) is an intensive and complex treatment for certain blood cancers. Caregivers are required for patients receiving this treatment. Caregivers frequently experience caregiver burden. Providing an intervention to alleviate caregiver burden can positively impact patient and caregiver health outcomes.

Project Design: The following was the project design: 1) review the literature to understand the best practices to prevent caregiver burden for caregivers of patients undergoing HSCT, 2) development a pilot quality improvement program based on the evidence, 3) implementation of the pilot, and 4) obtaining feedback from facilitators and participants to optimize intervention for ongoing …

Implementing A Health Promotion Physical Activity Program For Middle School Youth In A Rural, Faith-Based Organization, Karmin Maher-Hasse

Doctor of Nursing Practice Projects

Problem: Childhood obesity is more prevalent in rural areas, and these areas have fewer resources to address it. Geographic distance to available resources, health care provider shortages, parental obesity, and poverty contribute to higher prevalence of obesity in rural children compared to urban children.

Rationale: Obesity prevention and treatment often requires long-term healthy lifestyle behavior changes including nutrition counseling and physical activity (PA). It is likely an obese pre-adolescent will have obesity as an adult, and the likelihood increases if obesity continues into adolescence. Pre-adolescence provides a window of opportunity to influence healthier PA habits to prevent overweight (OW) and …

A Faith-Based Quality Improvement Project To Increase Awareness, Prevention, And Management Of Coronary Heart Disease In African Immigrants, Temitope S. Okpebho

Doctor of Nursing Practice Projects

Problem Description: Coronary heart disease (CHD) affects people globally, and it is the leading cause of death in the United States. Despite increased CHD awareness, evidence shows the increased prevalence and low CHD awareness among African Immigrants. According to Boateng et al. (2017), African immigrants are more likely to have CHD risk factors and be unaware. This may be due to changes in eating habits, lack of physical activity, increased stress level, and the adaptation of the Western diet.

Rationale: This project included implementing a culture care theory in a faith-based organization to increase awareness, management, and prevention of CHD …

Implementation Of Peer Support And Shared Decision-Making Aids For The Transcatheter Aortic Valve Replacement Population, Kimberlee Einfeld

Doctor of Nursing Practice Projects

Background: Patients at a community hospital verbalized fear, stress and anxiety about transcatheter aortic valve replacement (TAVR). Patients with aortic stenosis eligible for TAVR may experience low self-efficacy and anxiety while considering valve replacement which may lead to poor quality of life, interfere with understanding information from medical providers, and other health complications.

Methods: All patients eligible for TAVR between June and August of 2019 were invited to participate in a pilot project using peer support and use of shared decision-making (SDM) aids. Former TAVR patients were trained to be Mended Hearts TAVR peer volunteers. Participants were connected by telephone …

Reducing Pressure Injuries In The Intensive Care Setting: Nursing Knowledge And Best Practices Approach, Michelle Harvey

Doctor of Nursing Practice Projects

Background: For many health care organizations, pressure injury (PI) prevention strategies have become a priority focus to improve patient outcomes and associated costs.

Problem: A rural community hospital located in the Eastern U.S. experienced an increase in hospital acquired pressure injuries (HAPIs), predominantly in the intensive care unit (ICU). In 2018, 17.4% of HAPIs occurred in the ICU.

Approach: Implementation of a Quality Improvement project in an adult ICU, providing education and on-going learning activities to nursing staff, and applying a standardized plan of care “bundle” for prevention interventions.

Outcomes: The approach resulted in improved documentation of flotation of heels, …

Cultivating Appropriate Prescribing In A Primary Care House Calls Practice: A Quality Improvement Project, Sarah J. Marzolf

Doctor of Nursing Practice Projects

Problem Description: Polypharmacy in the frail elderly can lead to suboptimal management of medical issues. Primary Care Providers (PCPs) often lack knowledge of best practices regarding deprescribing and lack a systematic process for assessing mediation appropriateness. A quality improvement project was developed and executed at Housecall Providers, a home-based primary care practice in Portland, Oregon to facilitate the incorporation of deprescribing into daily practice.

Interventions: Following a literature review, a curriculum was developed and utilized during an educational intervention for PCPs regarding deprescribing best practices. A system for introducing new PCPs to evidence-based deprescribing for the frail elderly. This information …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …