Medicine and Health Sciences Commons^™

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Enhancing Teamwork In Nursing Students, Heather Rawson

Doctor of Nursing Practice Projects

Abstract

The purpose of this project was to equip senior practical nursing students (n = 11) with the skills needed to increase their feelings of preparedness to join an intradisciplinary team in the workplace after graduation. This project utilized a pre-test/post-test design using TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) to determine if participation in TeamSTEPPS^® training and a simulation exercise enhanced perception of teamwork in senior practical nursing students. A paired t-test was performed to analyze the data collected from the questionnaires acquired before and after the TeamSTEPPS^® training. The results showed a t-value of 8.49, greater than …

Civility Promotion: How It Affects Workplace Incivility, Shawanda Lang

Doctor of Nursing Practice Projects

Incivility is also known as uncivil behavior, horizontal violence, or bullying. These terms are often used to describe the conduct an individual may display toward another that are deemed undesirable in healthcare organizations. Uncivil behavior has been an increasing topic in healthcare and has consequently gained the attention of organizations such as the American Nurses Association and regulatory agencies such as The Joint Commission. Incivility has the opportunity to affect teamwork, individual well-being, and patient safety. The aim of this project was to promote civility by bringing knowledge and awareness of the participants through an educational series. Although the pre …

Equipping Early Childhood Educators To Manage "Behaviors That Challenge" In The Early Childhood Years, Shanna Scott

Doctor of Nursing Practice Projects

This scholarly project pursues the development, implementation, and evaluation of techniques to help improve the health and well-being of children ages 1-5, who have difficulties with challenging behaviors, to effectively manage stress and boost resilience through the incorporation of music and educational techniques of the early childhood educator.

This paper will discuss the positive or negative outcomes on external factors affecting child health, such as economic, judicial, societal, cultural, cognitive development, parental separation, and mental health concerns of all members of the family. It will also discuss the positive effects educational strategies and music can have on young children experiencing …

A Policy Analysis Of The 2017 Fasting Guidelines Among Gi Surgical Patients, Toney Banks

Doctor of Nursing Practice Projects

The objective of the fasting guidelines is to improve the quality and efficacy of anesthesia care. It is based on two main researched principles: The ingested material must be clear without particulates, and it must not be within two hours of the procedure. The purpose of this project is to equip the medical community with the latest guidelines on NPO (fasting), ensuring that patients are seen on time without delays or cancellations of surgery and with improved patient comfort. A retrospective chart review of 500 randomly chosen charts from patients seen at an Endoscopy Center. Pearson’s Chi-square value and the …

Comparative And Cost Benefit Analysis: Vancomycin Versus Ancef In Total Knee Arthroplasties, Zelda Epperson

Doctor of Nursing Practice Projects

Total knee arthroplasty (TKA) is the definitive treatment for degenerative joint disease of the knee. Total joint infections, although low, are a complication that can be a massive expenditure on health care systems and patients. Economic costs have the potential of being high for this procedure. It is estimated to treat these TKA infections, primarily methicillin-resistant Staphylococcus aureus (MRSA) to be between $68,000 and $107,000. The purpose of this retrospective study is to determine whether vancomycin has greater cost benefits and efficacy in reducing post-operative infection rate of total knee arthroplasties than does cefazolin.

Comparison Of Novice Versus Expert Certified Registered Nurse Anesthetists Self-Perceived Competency Levels, Toni Brice

Doctor of Nursing Practice Projects

The purpose of the study is to describe the correlation of self-perceived competency levels between novice and expert Certified Registered Nurse Anesthetists (CRNAs) in the perioperative setting. Self-reflection on competence enables CRNAs to know their most reliable and weakest performance characteristics; thus, they can improve the efficiency of their work performance across surgical settings. The proficiency of the anesthetist is important in surgical settings when the anesthesia provider is often performing independently. Psychometric instruments such as surveys can aid in evaluating perioperative performance, yet psychometric tools for explicitly assessing nurse anesthesia competence are limited. The methodology for this study is …

Opioid Reduction Or Elimination With The Utilization Of Transversus Abdominis Plane Blocks In Gynecological Surgeries, Chris Ivy

Doctor of Nursing Practice Projects

The purpose of this retrospective study was to evaluate the efficacy of Tansversus Abdominis Plane blocks in women undergoing gynecologic surgery and the decreased or eliminated opioid need. The opioid crisis has sparked interest in alternatives to traditional pain therapies in the surgical patient. Regional blocks are being added to the surgical patient's plan of care. In gynecologic surgeries, the Transversus Abdominis Plane block (TAP), has been increasing in popularity due to ease of learning and effectiveness. This project evaluates the efficacy of the TAP block and the elimination or decreased usage of opioids. A retrospective chart review was conducted …

Substance Use Disorder Policy For Certified Registered Nurse Anesthetists: A Policy Analysis, Justin D. Mcadoo

Doctor of Nursing Practice Projects

Substance use disorders (SUDs) negatively impact society and communities while causing substantial harm to families and friends. The leading occupational hazard for Certified Registered Nurse Anesthetists (CRNAs) is SUDs. It is estimated that 15% of actively practicing CRNAs in the United States will have a SUD during their career. In order to address SUDs related to CRNAs in the workplace, anesthesia groups and healthcare facilities must develop, implement, and evaluate policies and procedures based on the translation of evidence-based research into the practice of anesthesia. This Doctor of Nursing Practice (DNP) project analyzed LifeLinc Anesthesia’s SUD policy for CRNAs, compared …

Hpv Immunization Intervention Application In Rural Arkansas, Randi M. Wright

Doctor of Nursing Practice Projects

HPV (Human Papillomavirus) is the most common sexually transmitted infection (STI) contracted with over 33,000 cases of cancer attributable to the virus in the United States. The socioeconomical impact of HPV can be combatted with the HPV vaccine which is almost 100 percent successful in preventing infection. A strong provider recommendation is the most effective way to increase HPV vaccination. A private clinic in Arkansas with a total of 13 employees were provided HPV vaccination education. A survey was provided to evaluate knowledge on the topic prior to the presentation. An intervention bundle including 9 changes to vaccination procedures was …

Screening For And Management Of Adult Obesity, Lisa Schafer

Doctor of Nursing Practice Projects

Purpose: To examine the interest of obese adults in participating in a weight management program based on Intensive Behavioral Therapy as recommended by the United States Preventive Services Task Force (USPSTF). Methods: During a three-week period, a non-probability consecutive sample of 73 patients with scheduled healthcare appointments at a primary care setting in eastern Arkansas were recruited to complete a 15-item Obesity questionnaire. Eligible participants included non-pregnant, mentally competent adults between the ages of 18 to 65 years with a body mass index (BMI) of 30 or greater. Results: Typical demographic characteristics reflected middle-aged (47 years of age), African American …

Dnp Translation Project: Knowledge, Attitudes, And Practice Of Nicotine Use Among Youth, Amber Clements-Fore

Doctor of Nursing Practice Projects

Vaping among youth is becoming a rapidly growing and dangerous habit leading to respiratory illness, developmental delays, as well as the potential gateway to smoking even substance abuse. Ongoing studies from the Centers for Disease Control (CDC) and state health departments continue to investigate dangers associated with vaping, but all agree vaping is marketed to and potentially deadly among youth. A pilot study was completed indicating that 92% of middle school age parents would like to know more information about vaping among youth and determined there is a need for further education regarding vaping. The strengths, weaknesses, opportunities, and threats …

Mentoring In Nurse Anesthesia: Positively Influencing Job Satisfaction, Patricia J. Tharp

Doctor of Nursing Practice Projects

Mentored nurse anesthetists reported greater job satisfaction in a pilot study (N=19), preceding this study. The purpose of this study was to examine mentoring in nurse anesthesia as it relates to job satisfaction, based on Patricia Benner’s theory “Novice to Expert.” The study was a non-experimental and measured job satisfaction. Twelve nurse anesthetists employed at a gastroenterology center were given paper surveys, after signing an informed consent. Surveys used in this study included a demographic questionnaire, a survey on mentoring, and the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS). The surveys were returned in a sealed envelope. Subjects were asked …

Evaluating The Impact Of A Depression Care Management Program, Natalie Dreyfoos

Doctor of Nursing Practice Projects

Depression is a common mental health disorder that causes significant individual and societal burden. Depression care management programs use a collaborative approach to lessen these effects. Evaluating patient satisfaction and experience are essential to obtain a comprehensive view of program benefits. This program evaluation project evaluated the experiences of patients in a depression care management program provided by a healthcare system in Washington state. A mixed methods approach using opened ended question surveys, telephone interviews and PHQ-9 scores provided a deeper understanding of individual experiences. The analysis showed patients were highly satisfied with the program. Collectively, depression severity scores decreased …

Nursing Satisfaction With The Electronic Medical Record: Implementing Meaningful Change At Seattle Children's Hospital, Mary T. Field

Doctor of Nursing Practice Projects

Purpose: The purpose of this study is to describe nursing use, quality, and satisfaction with the electronic medical record before and during the course of the electronic medical record transition. In addition, this study examines the differences between nurse age, role, and area of work as these demographics relate to nursing use, quality, and satisfaction.

Background: Nurses spend a large part of their shift using technology, including the electronic medical record, however the use, quality, and satisfaction of this tool as it relates to the nursing profession has not been formally evaluated.

Methods: The design of this study is an …

Improving Transgender Healthcare Experiences Using Photovoice, Amy Nelson

Doctor of Nursing Practice Projects

The transgender community is one of many marginalized populations. There are a variety of factors that influence the healthcare experiences and quality of care that members of the community receive. Some aspects of the difficulties experienced are widespread and not limited to transgender individuals while others are exclusively experienced by transgender patients related to their unique needs. Transgender patients agree that issues identified by providers, like access to insurance and lack of protocols and provider education, are indeed barriers. However, transgender patients have identified other issues, like stigma and discrimination, to be more significant barriers to their accessing healthcare. Additionally, …

Effect Of An Educational Intervention On Coronary Artery Disease Knowledge In Men And Women At Risk For Coronary Artery Disease, Rochelle Anderson-Doyley

Doctor of Nursing Practice Projects

Background

Coronary artery disease (CAD) is the leading cause of death in the United States. The management of CAD, a preventable disease, has significant implications for health and wellness outcomes in the United States. Decades of research have examined the role and effectiveness of an educational intervention in promoting the patient's knowledge of and ability to manage risk factors for CAD. This project examined the effectiveness of an educational tool implemented in a primary care setting in improving patients' knowledge about CAD risk factors.

Method

The research design was a non-experimental one-group pre-test and post-test design. After receiving institutional review …

Active Rehabilitation In Sports-Related Concussions: An Educational Intervention For Primary Care Providers, Lior Habinsky

Doctor of Nursing Practice Projects

Background and Review of Literature: Sports-related concussion (SRC) is a form of traumatic brain injury caused by a blow to the head and remains a prevalent issue across the 11-18-year-old age group within the United States. Historically, total physical and cognitive rest has been the preferred method to help individuals recover after suffering a concussion. However, recent data have shown that incorporating active rehabilitation or aerobic exercise therapy as part of acute post-concussion treatment is safe. Further investigation into these methods could provide valuable insight into prognosis as well as promote clinical recovery.

Purposes/Goal: This project involved delivering an educational …

Improving Provider Confidence And Partnership With Lgbt Patients Through Inclusivity And Education, Katherine Rowe

Doctor of Nursing Practice Projects

The focus of this project utilizes patient recommendations for LGBT-inclusive intake practices to increase provider confidence in communication with LGBT patients using pre-and post-survey data comparing provider confidence before and after a 20-minute video education session. LGBT-inclusive provider education has been shown to be deficient if not nonexistent in most educational settings, yet, LGBT individuals have increased risk of negative health disparities, violence, and discrimination. Research examining the ability for small changes in provider education to enable positive health outcomes for this vulnerable and marginalized population is imperative for the quality of life of these communities. A quasi-experimental design utilized …

Evaluating The Feasibility Of Practice Change: The Use Of The Phq-2 In The Urgent Care Setting, Helena Laubach

Doctor of Nursing Practice Projects

Adolescents in the United States may go unscreened for mental health disorders, such as depression, despite current recommendations. This population has an increased use of urgent care clinics (UCC) for their acute and primary care needs, where they might not be screened for depression at regular intervals. This project looked at determining the feasibility of implementing a two-question depression screener in the urgent care setting – the PHQ-2. Additional aims were to increase screening rates and to determine barriers to screening. Healthcare providers at a pediatric urgent care setting used the PHQ-2 to screen all adolescent patients over a two-week …

Why Won't This Heal?: Actinomyces And Wounds, Christina Wagener

Doctor of Nursing Practice Projects

Why Won’t This heal? Actinomyces and Wounds

Christina Wagener, MSN, Steve Kalish, MD, Mary Lee Barron, PhD, APRN, FNP-BC, FAANP

An incidental finding of Actinomyces europaeus in a refractory healing abscess presents an opportunity to close a knowledge and treatment gap. After finding Actinomyces species in multiple patients within a twenty-month period in an independent hospital in Chicago, IL, the probability exists that Actinomyces is becoming more prevalent in subcutaneous wounds. Chronic, non-healing wounds cause multiple negative consequences including financial, psychological and physical losses and possibly death.

Actinomyces is a Gram-positive, filamentous, non-acid-fast and anaerobic-to-microaerophilic bacteria first identified in 1997 …

Mindfulness-Based Stress Reduction Activities Via Smartphone In Advanced Practice Providers: A Pilot Quality Improvement Project To Reduce Perceived Stress, Burnout, And Intent To Leave, Cynthia L. Larsen-Bednarchik

Doctor of Nursing Practice Projects

Abstract

Burnout, attrition, and decreased work engagement among Advanced Practice Providers (APPs) are growing concerns and can have a negative influence on health care provider wellbeing. Chronic workplace stress is linked to various physical health problems, such as fatigue, insomnia, heart disease, depression, anxiety, and obesity. Chronic provider burnout is costly and extends to organizations and hospitals due to higher attrition, increased absenteeism, and decreased work engagement. Mindfulness-based stress reduction (MBSR) programs focus on the intent of practicing mindfulness to cultivate a state of being that is nonjudgmental, openhearted, friendly, curious, accepting, and compassionate. MBSR programs afford clinicians a way …

Physical Activity Group On An Inpatient Behavioral Health Unit, Patricia Brown

Doctor of Nursing Practice Projects

Physical activity is beneficial for the wellness of both the body and mind. Preventable physical diseases are the cause of the majority of deaths in individuals with severe mental illness (SMI) (Vancampfort et al., 2017). Motivation can be a barrier to regular physical activity. Learning by observation can facilitate maintaining behavior change. Thus, physical activity groups on an inpatient behavioral health unit were facilitated by exercise physiologists to improve mental health and physical health (Kaur et al., 2013; WHO, 2015). Lack of physical activity on inpatient behavioral health units is a common practice. The primary aim of this project was …

Implementation Of Provider Education For A Subanesthetic Ketamine Infusion For Acute Analgesia In Opioid Tolerant Postpartum Patients, Leah Baecht

Doctor of Nursing Practice Projects

The current opioid epidemic demands the development of new management policies and staff education to increase awareness of issues and improve care of patients with Opioid Use Disorder (OUD). A recent dramatic increase in OUD during pregnancy has paralleled the epidemic observed in the general population. The combination of OUD and cesarean delivery, place both the mother with OUD and neonate at risk for increased postoperative complications. The purpose of this project was to evaluate and increase staff knowledge regarding OUD in obstetrics. An analysis of staff knowledge was performed via surveys both pre and post dissemination of evidence. The …

Effectiveness Of Educational Intervention On Diabetic Knowledge & Hba1c Levels On Kenyan Adults With T2dm, Sabina Jeruto Bett

Doctor of Nursing Practice Projects

Background

Type II diabetes mellitus (T2DM) is a common chronic metabolic disease affecting millions of people globally, which causes many long-term complications such as high blood pressure, chronic kidney disease, improper wound healing and loss of sight. Literature supports that most people, in general and diabetic patients specifically, in Africa, including Kenya are currently not taught about the importance of proper management of their disease. Therefore, many have difficulty following treatment plans, resulting in improper eating, poor glucose control, and diabetic complications. The limited knowledge concerning T2DM contributes to the negative impact this serious disease has on those who live …

Impact Of Telehealth Education Versus Standard Care On Increasing Self-Efficacy Scores And Diabetes Knowledge In Adult Diabetics, Glenda A. Tisdale Msn Rn

Doctor of Nursing Practice Projects

Background: Evidence supports the use of telehealth as an effective method to support the increase in self-efficacy and knowledge among patients with Diabetes Mellitus.

Objectives: This study was to determine whether using telehealth education in conjunction with standard care compared to standard care only, could increase self-efficacy scores and knowledge for adults with diabetes.

Methodology: A randomized, pre-posttest design is used. A convenient sample of 58 adults with self-reported type 2 diabetes were recruited from a faith-based environment. The control group received two 45-minutes standard education sessions about diabetes and diabetes care. The intervention group received weekly smart-phone messaging for …

Change Agent Impact On Pain Management Experience Through Lavender Aromatherapy: Evidence-Based Practice Project, Karen Mack Ms, Mba, Aprn, Rn-Bc, Ccns, Acnpc

Doctor of Nursing Practice Projects

Inadequately controlled acute pain is a problem for hospitalized patients. Non-pharmacological pain management interventions (NPPMIs) are recommended but underutilized. Nurse-directed lavender aromatherapy is a feasible and effective NPPMI. Patients at a community hospital, including its surgical-orthopedic unit, reported lower patient pain management experience scores than the average score of Magnet Recognition status hospitals. The community hospital planned to improve pain management by implementing nurse-directed lavender aromatherapy. The purpose of this evidence-based practice project was to fortify the hospital’s nurse-directed lavender aromatherapy implementation with change agents. A logic model guided implementation. Project aims were to increase the surgical-orthopedic unit’s pain management …

Evidence-Based Practice Initiative For Staff Training To Reduce Adult Psychiatric Inpatient Restraints & Injuries, Mary Leveillee Phd, Rn, Pmhcns-Bc

Doctor of Nursing Practice Projects

Background: Violence against healthcare professionals is a growing phenomenon, and mental health care has the highest risk (Phillips, 2016). The experience of workplace violence is demoralizing, resulting in low job satisfaction, decrease productivity, physical injury, and potential Post-Traumatic Stress Disorder (Phillips, 2016; Howerton & Mentes, 2010). The Joint Commission and The Centers for Medicare and Medicaid identify patient perpetrated violence as a significant workplace risk, and they endorse education and training for risk reduction and safe intervention (The Joint Commission, 2018, 2019).

Objective: The purpose of this evidence-based practice initiative was to evaluate the impact of staff training with the …

Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree

Doctor of Nursing Practice Projects

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific …

Pre-Discharge Bnp: A Policy Change To Reduce Hospital Readmission, Melissa Duckett

Doctor of Nursing Practice Projects

Heart Failure (HF) is the leading cause of hospital readmission for patients 65 years of age and older. A pre-discharge B-type natriuretic peptide is a strong predictor of hospital readmission and mortality. The annual cost for admission of patients with HF is greater than $17 billion. Diagnosed heart failure patients continue to be discharged without the physician knowing their current BNP levels. The Affordable Care Act established the Hospital Readmissions Reduction Program (HRRP) requiring the Center for Medicare and Medicaid Services (CMS) to reduce reimbursement to hospitals with high readmission rates. A change in policy should be initiated to include …