Medicine and Health Sciences Commons^™

Implementing Feno Testing Protocol In A Pulmonary Clinic: A Dnp Project, Herbert "Allen" Nolan

Doctor of Nursing Practice Projects

Airway inflammation is a common condition seen in the pulmonary clinic and can be present in patients with chronic obstructive pulmonary disease, asthma, chronic cough and asthma chronic obstructive overlap syndrome. Utilization of fractional exhaled nitric oxide testing is a quick means of identifying airway inflammation in patients who visit the pulmonary clinic with the diagnoses listed above. Fractional Exhaled Nitric Oxide testing along with Asthma Control Testing were used in the pulmonary clinic to aid in the identification of airway inflammation along with traditional spirometry testing. The results reflected an increase in the identification of patients with airway inflammation …

The Impact Of Nursing Staff Responsiveness On Patient Satisfaction: A Pilot Project, Lisa Wallace

Doctor of Nursing Practice Projects

Timeliness of healthcare staff responsiveness to patient requests is multifactorial. Inadequate responsiveness to patient requests may lead to increased patient injury, increased cost, and patient dissatisfaction which may impact stakeholders and profit margin. Evidence supports that proactive, timely, staff responsiveness to patient requests and call lights may lead to improved patient safety, higher patient satisfaction, and better healthcare outcomes. Bundled staff responsiveness interventions may be implemented to improve patient safety, patient and staff satisfaction. Examples of interventions include engaging staff project buy-in with formation of a patient experience team, hardwiring hourly safety rounding, providing staff education on the importance of …

A Diabetes Crash Course In A Primary Care Setting To Improve Diabetes Self-Care: A Pilot Project, Michelle L. Macdonald

Doctor of Nursing Practice Projects

Diabetes (DM) is a deadly disease affecting millions. Lack of proper DM self-care management can lead to numerous complications and even death. The American Diabetes Association (ADA) recommends lifestyle change as a first-line treatment along with diabetes self-management education (DSME). However, according to the Centers for Disease Control and Prevention (CDC) only a fraction of those diagnosed attend. The purpose of this project was to improve DM self-management behaviors following a patient focused unique DMSE designed to meet community needs. A customized crash course style DM educational session was offered to all DM patients in a rural primary care clinic. …

Checklist Utilization To Reduce Cauti Rates: A Dnp Project, Christina Jah

Doctor of Nursing Practice Projects

Catheter-associated urinary tract infections (CAUTIs) are preventable events with significant ramifications for both patients and hospitals. Proper training on evidence-based practices for catheter management is a vital component of preventing and decreasing CAUTIs. Following a review of the literature, evidence supports that CAUTI education with the use of a standard urinary catheter checklist for registered nurses (RNs) has the potential to ensure that knowledge is applied, thus decrease CAUTIs. This doctoral project developed, implemented, and evaluated an educational program and checklist to reduce CAUTI among patients at a Veterans Administration (VA) hospital. This project utilized a mixed-method data collection with …

Implementation Of An Educational “Boot Camp” To Increase Nurses’ Confidence, Knowledge And Use Of Evidence-Based Practice In A Veterans Affairs Medical Center, Anita S. Dahl

Doctor of Nursing Practice Projects

Evidence-based practice (EBP) can be used to promote quality patient care, improve population health, decrease healthcare costs, improve work-life balance of health care professionals, increase job satisfaction, and decrease staff turnover. Barriers to implementing EBP include perceived lack of autonomy and authority to change patient care processes; and knowledge deficits related to EBP implementation. Limited access to research materials and inadequate leadership support also stifles implementation of EBP. The purpose of this project was to increase confidence, knowledge, and use of EBP by nurses through implementation of an intense, structured educational “Boot Camp”. A convenience sample of 27 nurses participated …

An Organizational Readiness Assessment And Patient Survey For Adoption Of An Opioid De-Escalation Protocol In Curative Oncology Patients, Adria Myers

Doctor of Nursing Practice Projects

Since 2012, statistics illustrate an explosion in the number of Americans admittedly misusing prescription opioids which increase the risk of long-term adverse effects. By 2016, individuals admitting to taking opioids for non medical reasons exceeded eleven million and 1.9 million of these individuals met the mental health guidelines for opioid abuse. Oncology patients represent a target population with an unmet met need for opioid reduction. Goals for de-escalation or tapering opioids for non-cancer pain have gained increasing attention across healthcare. Evidence-based opioid de-escalation guidelines specific for curative oncology patients are lacking in the literature. The aim of this DNP project …

Effectiveness Of De-Escalation Training To Medical-Surgical Nurses, Tammy L. Sullivan

Doctor of Nursing Practice Projects

Nurses are the most common victims of workplace violence and typically are not equipped deliver appropriate prevention interventions. Although most violent episodes occur in the emergency department and mental health units, violence towards nurses on the medicalsurgical units is on the rise. Patient perpetrated aggression and violence is positively correlated with poor patient outcomes and length of stay. In addition to the physical effects on the nurse, there are psychological effects that can impact their career and personal life. The direct and indirect cost for an organization includes decreased productivity, increased absenteeism, and turnover. In potentially violent situations, nurses must …

Simulation Based Learning To Increase Competency And Self-Confidence In Novice Nurses, Veronica Eubank

Doctor of Nursing Practice Projects

New nursing graduates lack competency and confidence in failure to rescue situations could result in failure to rescue (FTR). High-fidelity simulation (HFS) is a potential solution to ensure a controlled environment in which new graduates can practice safely and gain the knowledge they need to develop critical thinking skills. Utilizing simulation education to improve an individual’s ability to recognize deterioration early, communicate, prioritize, delegate, and provide role clarity can foster confidence and competence in new graduate nurses. The project evaluated the effectiveness of using HFS for novice nurses to increase knowledge, competency, and confidence when a patient status deteriorates. The …

Preparing For Obstetrical Emergencies In The Emergency Department, Tracy Littlehale

Doctor of Nursing Practice Projects

Emergency Department nurses must maintain the skills to manage OB emergencies in the ED, especially in hospitals with no OB unit. Limited contact with OB patients diminishes the self-confidence, knowledge and skill of ED nurses, which may minimize their ability to recognize OB problems in a timely manner. As increasing numbers of patients with OB emergencies are expected to seek care in rural EDs due to closure of rural OB units and rising OB risk factors, maintenance of OB skills by ED nurses is critical. Simulation has been identified in the literature as an effective strategy to help nurses advance …

Using Simulation To Improve Skills, Confidence, And Satisfaction Related To Diabetes Education, Greshin M. Markwell

Doctor of Nursing Practice Projects

Diabetes mellitus is the seventh leading cause of death in the U.S. and affects 30.3 million people (Centers for Disease Control and Prevention [CDC], 2019). Research suggests that patients often have a limited knowledge and insight into self-management of diabetes mellitus (DM). Acceptance of the disease, insufficient knowledge, and noncompliance are the examples of key factors that affect the progress of the disease. Nurses play a key role in the delivery of diabetes education which can improve compliance. Simulation can be used to improve the nursing skill sets for diabetes education. The purpose of this project was to implement evidence-based …

Minimizing Antipsychotic Medication Side Effects In Adults Diagnosed With Mental Illness Through Psychoeducation: An Evidence-Based Approach, Sarah A. Yao

Doctor of Nursing Practice Projects

Adherence to antipsychotic medication has demonstrated significant impact in decreasing symptom exacerbation among patients diagnosed with mental illness. Antipsychotic medications have several benefits including the management of psychotic and mood disorders; however, they could cause unwanted medication side effects with metabolic and cardiovascular risks. This issue is one of the commonly linked side effects resulting in nonadherence among mentally ill patients. The purpose of this project was to implement a psychoeducational intervention using the SIMPLE program to address metabolic and cardiovascular risks associated with antipsychotic medications among adult patients diagnosed with mental illness. A sample size of sixteen adult patients …

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 …

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 …

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, …

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 …

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 …

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 …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

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 …

Assessment Of Intensive Care Family Satisfaction, Jami Burnette

Doctor of Nursing Practice Projects

There continues to be an unknown factor in knowing true patient and family satisfaction within the intensive care unit (ICU) setting. Current literature reveals surveys used to measure patient satisfaction do not pertain to the ICU setting. Patients often do not remember the ICU stay due to critical illness and are unable to actively participate with care. Families act as surrogates, are included in patient care, and collaborate with nursing and medical teams to help make care decisions. Families are integral in the patient care process and are vital members of the health care team. Even though families are included …