Medicine and Health Sciences Commons^™

Increasing Lung Cancer Screening Referrals In Patients With Tobacco Use Disorder, Emily Thornberry

Doctor of Nursing Practice Projects

Lung cancer in the United States is a substantial cause of mortality. According to the American College of Radiology’s Lung Cancer Screening Registry, only 1.9% of eligible patients were screened for lung cancer in 2016. The National Comprehensive Cancer Network and U.S. Preventative Services Task Force (USPSTF) guidelines recommend lung cancer screening (LCS) in high-risk patients. The USPSTF recommends screening current and former smokers aged 55-80 years who have smoked for 20 or more pack-years, and for former smokers, those that have quit within 15 years.

Unifying Vision: Strategies That Influence Nurse Self-Care Practices In Intensive Care Unit Nurses, Latoya Parks

Doctor of Nursing Practice Projects

Background: The notion of self-care should include more than physical health; the concept should also include emotional, mental, and spiritual self-care. Self-care behaviors are tailored to an individual's perceptions and values.

Purpose: The primary focus of this project aimed to improve nurse’s self-care practices. Through interviews with executive leadership at a large urban hospital, the project facilitator identified the need for easy access to self-care strategies for ICU nurses.

Design Method: The Plan-Do-Study-Act (PDSA) Model for Quality Improvement was used for this project. A systematic review of the literature was performed to ascertain the effectiveness of self-care strategies for …

The Evaluation Of Nurse Residency Program On New Graduate Nurse Retention, Trenisha Wilson

Doctor of Nursing Practice Projects

Healthcare settings are facing a major challenge in recruiting nurses in this demanding field. Nurse residency programs are designed to assist new graduate registered nurses with their transition to nursing practice. The nurse residency program assists new graduate nurses to develop their nursing skills, enhance their overall performance, and decrease turnover rate.

Purpose: The purpose of this project is to evaluate the effectiveness of the Veteran Affair Medical Center’s ability to retain new graduate nurses after attending a new graduate residency program.

Design Methods: This study is a retrospective pre-test and post-test design of the impact of the …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Decreasing The Impact Of Diabetes In The Adult And Older Adults Rural Health Population Utilizing Phone Calls As Part Of The Chronic Care Management Program, Adrienne Shambray

Doctor of Nursing Practice Projects

This quantitative study was developed in order to evaluate the impact of phone calls on patient outcomes using the Chronic Care Management program (CCM). In January 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the (CCM), with the goal of improving health and quality of care for high-risk patients. The administration and physicians at the clinic of focus for this project recognized a need for the facility to help improve and manage these patients’ care to prevent issues such as hospital readmission. This project aimed at following patients in the program with the chronic condition of diabetes mellitus …

Early Detection Of Sepsis In Direct Admit Hospitalized Patients: Implementing A New Sepsis Screening Checklist, Connie Lasley

Doctor of Nursing Practice Projects

Background: Early detection of sepsis in hospitalized patients in small rural hospitals can save lives. Subtle changes in patients can go undetected by nurses and doctors, leading to septic shock, increasing the length of stay in the hospital or death. In a small Alabama hospital, nurses were missing the early signs and symptoms of developing sepsis due to a lack of a monitoring system and proper education regarding sepsis.

Objective: The development of a sepsis screening checklist to place on each direct admitted patient’s chart to collect vital signs every four-hours each 12-hour shift to alert nurses of early signs …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Diabetes Education Empowerment Program (Deep): Evidence-Based Practice Measures For Self-Care Management, Nakeshia Rutledge

Doctor of Nursing Practice Projects

Background: Prediabetes and Type 2 diabetes (T2DM) are major health challenges among the patient population at a family medical clinic in northwest Alabama. Poorly managed T2DM can cause complications which could decrease individuals’ quality of life and lead to mortality.

Purpose: The purpose of this project was to assess the feasibility and efficacy of a self-management intervention aimed at empowering prediabetic and T2DM patients to achieve better diabetes management and glycemic control (hbA1c < 5.7 percent).

Design Methods: A mixed-methods design was utilized with pre/post-questionnaires for analysis of data collected before and after the implementation of an educational intervention on diabetes self-management …

Eras Protocol For Lower Extremity Orthopedic Procedures, Tyler Mcdonald, Joshua Vaughn

Doctor of Nursing Practice Projects

The demand for total knee arthroplasty (TKA) and total hip arthroplasty (THA) will continue to rise as life expectancy increases. Coupling increased age with the increased prevalence of both obesity and osteoarthritis, the need for total joint arthroplasties is likely to increase (Oseka & Pecka, 2018). The frequency of arthroplasty procedures and the associated recovery period lead to heavy economic demands felt by most healthcare systems (Stowers et al., 2016). To address this burden, enhanced recovery after surgery (ERAS) protocols have been implemented at institutions and are designed to improve patient outcomes while simultaneously limiting cost and reducing readmission rates …

Opioid Screening In The Primary Care Setting, Melissa Welge, Shelby Jones

Doctor of Nursing Practice Projects

Implementation of an Opioid Risk Assessment Tool in the Primary Care Setting.

Introduction Of Strong For Surgery Pre-Surgical Checklist For Elective Procedures​, Dylan Defauw

Doctor of Nursing Practice Projects

Nearly one-third of hospitalized patients experience preventable harm or adverse effects related to the care they received, often due to preventable surgical complications. Thorough preoperative assessment and management of risk factors can lessen this risk. The purpose of this quality improvement project was to increase knowledge and prepare staff for use of the preoperative tool Strong for Surgery (S4S) in a general surgery clinic in a rural hospital in southern Illinois. Support for each of the key components of the Strong for Surgery pre-surgical checklist was reviewed in the literature; these include nutrition, smoking cessation, glycemic control, medication management, safe …

Culturally Appropriate Health Education: Translation Of A Parturient Pain Relief Options Pamphlet Into French And Spanish, Francis Minor, Austin Cook

Doctor of Nursing Practice Projects

The rise of immigration worldwide introduces a diverse, multicultural population of patients seeking healthcare in the United States. Barriers to communication, both spoken language and culturally associated communication norms, limit immigrant women’s ability to seek, gain access, and follow through with perinatal care. In order to provide safe, effective, and culturally sensitive care, recognition of language and cultural differences of all individuals must be considered when providing patients with educational materials (Perera et al., 2012; Plumbaum et al., 2014). The aim of this project was to translate an existing pain relief options pamphlet into French and Spanish in order to …

Pediatric Concussion Clinic: A Needs Assessment, Carrie West

Doctor of Nursing Practice Projects

Abstract

Pediatric Concussion Clinic: A Needs Assessment

Concussions are a mild traumatic brain injury by a biomechanical force to the head. Concussion rates among youth are as high as 33 million per year worldwide. Most children recover within 4 weeks post injury; however, 30% of patients have delayed recovery. Recent studies have shown that evaluation by a concussion specialist within 1 week of injury results in quicker recovery. The purpose and goal of this project was to determine if there was a need for establishing a pediatric concussion clinic at Southern Illinois University Medicine. Study participants included pediatric providers from …

Developing A Peer Mentoring Program For Srnas, Morgan E. Fitterer, Miranda Portwine

Doctor of Nursing Practice Projects

Faculty of a nurse anesthesia program at a Midwestern University requested evidence of the impact a peer mentoring program could make in reducing stress levels for SRNAs. To better tailor a peer mentoring program, surveys were developed and distributed to the university’s SRNAs and to program directors of CRNA programs across the country.

Based on the literature, a survey was developed and distributed to 81 SRNAs at this university to evaluate their stress and their perceptions of the impact of peer mentoring on stress. Another survey was developed and distributed to 118 program directors to learn if they have a …

Increasing Patient Access To Medication-Assisted Treatment Programs For Opioid Use Disorder, Matthew J. Bednarchik

Doctor of Nursing Practice Projects

The project sought to explore the perceived need for Medication-Assisted Treatment (MAT) for opioid use disorder among primary care providers in a rural central Illinois county. This project’s primary goal was to measure the prevalence of OUD in the community and the likelihood of primary care providers referring to an outpatient MAT program. A secondary objective was to utilize the survey results as a tool for the development of a MAT program. A cohort of twenty-five primary care providers were invited to participate in a survey to assess the perceived prevalence of OUD as well as the need for increased …

Increasing Compliance And Patient Outcomes In Hypertensive Patients Using The Hill- Bone High Blood Pressure Compliance Scale, Lauren Huff, Allyson Barbee, Julie Milton

Doctor of Nursing Practice Projects

Hypertension has been globally rated the most common non-communicable disease as well as the most common cause of premature death (Johnson, et al., 2019). The identified problem of focus for this project was to increase medication compliance within hypertensive patients as well as increase provider knowledge of compliance issues with the utilization of the Hill-Bone High Blood Pressure Compliance Scale. We administered a case study via Qualtrics to Illinois nurse practitioners via the ISAPN email list-serve. We provided an anonymous pre-and post-survey to each participant regarding their current area of practice, patient history taking behaviors, and views on the ease …

Implementation Of A Standardized Care Pathway For Ureteral Stents Patients Across The Continuum Of The Acute And Ambulatory Setting: A Quality Improvement Project, Ibukunoluwa Afolabi

Doctor of Nursing Practice Projects

Ureteral stents are one of the most used urologic devices to create and preserve ureteral patency. Side effects after ureteral stent placement have a high prevalence, and stent related pain has been reported to affect over 80% of patients. This Quality Improvement Project aimed to develop a standardized care pathway through education and pharmacological management for patients after ureteral stent placement. Specific goals included reducing readmission rates to the emergency department (ED), reducing the patient’s phone calls to the urology clinic, and improve patient satisfaction. The protocol developed for the project included discharging patients with an alpha- blocker, an anti-cholinergic, …

Addressing Referral Discrepancies For Hyperglycemia Diagnosis Codes, Brooke Buffington, Aubrey Parnell, Abigail Brohammer

Doctor of Nursing Practice Projects

Diabetes mellitus and prediabetes affect 34 million and 88 million Americans, respectively. The early detection and management of elevated blood glucose levels is fundamental to preventing comorbid complications. While other countries have published referral guidelines, the United States is lacking in practice standards. At a central Illinois healthcare institution, the diagnosis code for elevated blood glucose (R73) was noted at a higher rate than endocrinology referrals. The purpose of this retrospective investigation was to explore the root causes of this disproportion through deidentified patient data. The average number of wait days for an endocrinology appointment was investigated and found to …

Care Of The Healthcare Provider, Kari Hullinger, Emily Moscardelli

Doctor of Nursing Practice Projects

Evidence has shown a strong correlation between a healthy provider and the positive care that the provider can promote to others. Many evidence-based health promotion programs have been implemented throughout many health systems. These programs have shown improvement of the providers’ overall health. And in return, these providers are able to better care for their patients. Detailed reports have shown many health consequences that healthcare providers have acquired due to long hours, intense training, lack of time, lack of sleep, and the concept of always putting their patients first. A health system in Springfield, Illinois was examined to determine if …

Improving Depression Awareness And Screening In A Community College, Shelly Baldwin

Doctor of Nursing Practice Projects

Depression is a serious and disabling mental health problem impacting nearly 265 million people worldwide. Approximately 17.3 million U.S. adults aged 18 or older suffered at least one major depressive episode in the last year. Of those afflicted, individuals 18-25 years of age had the highest prevalence of depression. Undiagnosed or untreated depression can lead to long-term disability or suicide which is the 2^nd leading cause of death for 10–34-year-old persons. Early recognition of depressive symptoms can improve long-term outcomes of individuals by enhanced connection to mental health services. The overall goal of this project was to improve depression …

Evaluation Of High Fidelity Simulation Debriefing Methods For Nurse Anesthesia Students, Zachary Standefer, Alex Davie

Doctor of Nursing Practice Projects

Simulation for Student Registered Nurse Anesthetists has become an educational tool that provides valuable learning experiences that integrate problem-solving, prioritization, and critical thinking skills. Debriefing is an essential aspect of the simulation learning process. The debriefing period allows the debriefer to direct the students’ self-reflection and provide individualized feedback. Faculty members delivering the simulation curriculum at a midwestern university, with over 75 nurse anesthesia students, sought education regarding the various simulation debriefing methods. After conducting a literature review for the best evidence supporting debriefing methods, faculty education was implemented in the form of an interactive computer-based learning (CBL) module. The …

Improving Patient Outcomes By Preventing Airway Injuries Associated With Video Laryngoscopes, Alexis Jones, Kay Williamson

Doctor of Nursing Practice Projects

Video laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH …

Lung-Protective Ventilation Across The Lifespan: Implementation Of An Intraoperative Protocol For Adults And Pediatrics, Megan Reynolds, Rachel Riddle

Doctor of Nursing Practice Projects

Traditional ventilation strategies have been shown to lead to the development of lung injury and postoperative pulmonary complications. Lung-protective ventilation (LPV) strategies for adults include low tidal volumes of 6-8 mL/kg based on ideal body weight, moderate levels of positive end-expiratory pressure (PEEP), incremental recruitment maneuvers routinely and as needed, and low fraction of inspired oxygen. Recommendations for pediatrics are similar, with some suggesting a more liberal limit for tidal volumes of less than 10 mL/kg based on predicted body weight. However, adoption of LPV strategies is not universal. Completed objectives of this practice project included thoroughly reviewing literature relating …

Implementing A Validated Developmental Screening Tool In A Rural Pediatric Primary Care Clinic To Enhance Early Diagnosis Of Developmental Delays From Birth To 36 Months, Melissa A. Armstead

Doctor of Nursing Practice Projects

Abstract

Evaluation of childhood development with a validated screening tool has been the gold standard for best practice recommended by the American Academy of Pediatrics (AAP) since 2006. A rural pediatric clinic was the setting for this quality improvement project. The goals of the project were to 1) increase the number of children identified with developmental delays, 2) identify children with delays earlier, and 3) maximize the number of children receiving early intervention (EI) services between the ages of birth to 36 months. The Ages and Stages Questionnaire (ASQ-3) was the selected screening tool adopted by the clinic in June …

Implementing An Evidence-Based Multifactorial, Multidisciplinary Fall Prevention Program In A Nursing And Rehabilitation Center To Reduce Fall Rates Among Patients, Tincy Poovathur

Doctor of Nursing Practice Projects

Falls are the leading cause of morbidity and mortality in the elderly in the United States. Patients in long-term care facilities are at increased risk for falls, accounting for 20 percent of fatal falls that require hospitalization. The economic and social burden of falls and fall-related injuries is significant. Fall-related injuries and their resulting expenditures are expected to increase substantially with the increasing aging population making this a problem of high priority. The literature recommends and supports incorporating evidence-based fall prevention initiatives into long-term care facility safety programs to address this problem. Based on the literature review and the facility's …

Presurgical Optimization Videos For Patients Undergoing Elective Spine Surgery, Megan Knetzer

Doctor of Nursing Practice Projects

Spine surgery is a growing healthcare trend with more than 199,000 lumbar fusions alone being performed in the United States in 2015 and annual costs of more than $10 billion. Spine surgery represents a major life-altering event for patients, with high complication rates and extensive recovery periods for which patients often feel unprepared. Presurgical optimization and education have the potential to decrease medical complications, improve outcomes, and reduce patient anxiety related to surgery. The purpose of this project was to implement presurgical education videos focused on modifiable risk factors for patients undergoing spinal surgery at an urban academic medical center. …

The Impact Of A Cultural Competence Assessment Tool On Teaching Strategies In The Dnp Curriculum At Southern Illinois University Of Edwardsville, Katarina Dobrosavljevic

Doctor of Nursing Practice Projects

Providing culturally competent and culturally congruent care to patients leads to better outcomes and reduction of poor outcomes due to health disparities. Providing care that is not culturally congruent can contribute to communication barriers, resulting in deficient diagnostic testing, miscommunication about etiologies, treatment plans that are not individualized, and discounting of patient's ideas. Individuals from diverse cultures face health disparities which contribute to inadequate care and poor outcomes. The purpose of this project was to survey former graduates of the Southern Illinois University of Edwardsville (SIUE) family nurse practitioner (FNP) program to assess their level of cultural competence and areas …

The Misuse Of Convenient Care And Importance Of Establishing A Primary Care Provider, Bailey M. Johnston, Amanda Lt Hawkins

Doctor of Nursing Practice Projects

Over the last decade, there has been substantial increase in the use of urgent care (UC) and convenient care (CC) clinics nationwide. While these clinics are valued and serve a purpose in our communities, more patients are utilizing their services exclusively in place of primary care (PC), resulting in millions of Americans not receiving essential preventative care and chronic disease management. An extensive literature review evaluated current and effective interventions used to decrease inappropriate use of CC clinics, while simultaneously exploring strategies in increasing patient compliance with routine comprehensive health management. Based on literature review findings, an education-based project was …

Implementation Of A Mental Health Screening In A Gastroenterology Office, Kayla Craig

Doctor of Nursing Practice Projects

The growing prevalence of depression in gastrointestinal patients is the reason why outpatient offices, gastrointestinal offices included, need to screen for mental health problems in their appointments. Many outpatient settings don't have a standard tool to screen for depression in patients, and therefore many patients are not being treated or diagnosed with depression in the process. The PHQ-9 has been shown to have strong validity and specificity in diagnosing depression in the outpatient setting.