Medicine and Health Sciences Commons^™

Fascia Iliaca Compartment Block Protocol For Hip Fracture, M. Ray Nordyke

Doctor of Nursing Practice Projects

Fascia iliaca compartment block (FICB) is a volume based block used to treat pain associated with hip fractures. An anesthesia group at a central Illinois hospital expressed interest in the creation of an evidenced-based protocol for FICB. After an extensive literature search an evidence-based protocol was designed. The initial implementation of the protocol was a presentation of an informational PowerPoint which discussed the aspects of the protocol presented to the anesthesia staff and the registered nursing staff who assist the anesthesia providers. The protocol was then evaluated with a Likert scale survey completed by the staff. The results from the …

Sphenopalatine Ganglion Block For Post-Dural Puncture Headache Treatment, Wesley Gallagher

Doctor of Nursing Practice Projects

Post-dural puncture headache (PDPH) is defined as an orthostatic, fronto-occipital headache. The incidence of PDPH from neuraxial anesthesia techniques averages 1%. There are several treatments for PDPHs. The gold standard is the epidural blood patch (EBP). The EBP can be costly, requires experience, and is associated with rare, but serious complications. These factors present significant barriers to treating PDPHs. The sphenopalatine ganglion (SPG) block consists of using local anesthetics to block the parasympathetic signals, which flow through the SPG. Current theories suggest that increased parasympathetic outflow is the trigger for many forms of headaches, including PDPHs. Various literature associated with …

Effects Of A Multi-Tiered Approach To Impact Immunization Compliance Of Students Attending A Medium-Sized Public University, Emily Watson, Stephanie Muertz, Kate Traum

Doctor of Nursing Practice Projects

Background: College students in Illinois must comply with laws regarding proof of immunity for specific vaccines. These laws, however, do not guarantee compliance with immunizations. Unvaccinated persons living in highly-vaccinated communities, such as college campuses, are at risk for many preventable diseases. Objective: The primary aim of this project is to collaborate with Southern Illinois University Edwardsville (SIUE) Health Service to develop, implement, and evaluate the effects of multi-tiered interventions to increase immunization compliance rates of first-semester college students. Methods: A brief YouTube video was presented to freshmen students, an eye-catching educational flyer was distributed by advisors and throughout campus, …

Developing A Ketamine Infusion Protocol To Treat Complex Regional Pain Syndrome, Nikolas M. Kozul

Doctor of Nursing Practice Projects

Complex Regional Pain Syndrome (CRPS) has been studied under different names dating back to the American Civil War. Despite being studied for over 100 years, CRPS is still not a very well understood disease process and there is no consensus on the best way to treat it (O’Connell, Wand, McAuley, Marston, & Moseley, 2016). One treatment that has shown to be effective in reducing pain scores in patients with chronic CRPS is a multiple day infusion of ketamine (Sigtermans et al., 2009). The purpose of this doctor of nursing practice project was to develop a ketamine infusion protocol for anesthesia …

The Effectiveness Of Implementing A Diabetic Checklist To Improve Patient Care Documentation, Evans Mutua, Edwilyn Colwell

Doctor of Nursing Practice Projects

The Effectiveness of Implementing a Diabetic Checklist to Improve Patient Care Documentation of Treatment and Outcomes.

Diabetes mellitus is a major public health problem worldwide. In 2012, about 29.1 million Americans had diabetes with about 1.4 million Americans being diagnosed with diabetes yearly (CDC, 2017). Diabetes is the 7^th leading cause of death in the United states and in Illinois, the cost is $6,490 per person with a treated population of 774, 600 (CDC, 2017). Complication due to diabetes include; diabetic retinopathy, neuropathy, end stage renal disease, amputations and death.

The American Diabetes Association, provide evidence-based guidelines for the …

Lung Protective Ventilation During General Anesthesia: A Staff Education Project, Carrie L. Hasenstab

Doctor of Nursing Practice Projects

Lung protective ventilation has shown to be an effective strategy of ventilation in perioperative patients. However, anesthesia providers often still employ traditional modes of ventilation. To improve the knowledge and utilization of lung protective ventilation during general anesthesia a clinical practice tool was developed. A PowerPoint educational program was utilized as the initial implementation of the lung protection tool. The practice guide and educational program was presented to anesthesia providers and PACU staff at a Southern Illinois Hospital. A pre/post survey served as the method of evaluation. The pre/post survey assessed the participant’s knowledge and utilization of lung protective ventilation …

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …

The Effect Of Home Health Interventions On Hospital Readmission Rates In Patients With Congestive Heart Failure, Lindsay Reavis

Doctor of Nursing Practice Projects

Heart failure is a common diagnosis that affects millions of people worldwide. Unfortunately, heart failure is associated with a high risk of 30-day hospital readmission rates. Home health nurses have the potential to bridge the gap between discharge and hospital readmission by providing up-to-date patient education on a one-to-one basis. Research indicates home health nurses lack knowledge of the disease process, nurse management of the disease, and treatment. This project focused on an educational session about the pathophysiology of heart failure, fluid/weight monitoring, diet, medications, and exercise with a pre- and post-tests evaluating home health nurses understanding of heart failure. …

Sugammadex Protocol, Brenna M. Thomas

Doctor of Nursing Practice Projects

Sugammadex is a new medication used for the reversal of muscle relaxation induced by rocuronium, vecuronium, and pancuronium. Sugammadex is available for use at St. Anthony’s Memorial Hospital in Effingham, IL. However, they did not have a protocol regarding the use of this medication. A sugammadex protocol was written for the operating room (OR) staff after a thorough, evidence based literature review was completed. The OR staff included certified registered nurse anesthetists, anesthesiologists, registered nurses, and pharmacy. The protocol was implemented and evaluated with a pretest, an educational PowerPoint regarding sugammadex, and a posttest. A paired samples t test was …

Patient Care Advocacy Through Electronic Communication, Jared T. Holton, Scott A. Kahre

Doctor of Nursing Practice Projects

Patient advocacy is a primary role of the Certified Registered Nurse Anesthetist (CRNA). While engaged in the legislative process, CRNAs have failed to materialize significant gains in political potency on a national scale. This project involved the development of prototype software for mobile communication devices to augment the CRNA community’s ability to advocate for patients in the healthcare policy arenas. After a demonstration of the software to key leaders of the American Association of Nurse Anesthetists (AANA), an anonymous survey was distributed to the AANA executive administrators. All six executives in attendance for the demonstration of the software completed and …

Postoperative Delirium Education, Aaron Wede

Doctor of Nursing Practice Projects

Surgical patients, aged 65 and older, comprise the largest surgical population. Increased age correlates with an increased incidence of postoperative delirium. Postoperative delirium (POD) can drastically increase healthcare costs, length of hospital stay, and overall morbidity and mortality. A clinical reference tool was created to have available for perioperative staff members at a 200-bed community hospital in the Midwest. The tool describes risk factors, prevention methods, and treatment options for POD. The initial implementation of the project was achieved with a PowerPoint presentation which was created to summarize the information found in the literature review and to instruct perioperative staff …

Obstructive Sleep Apnea: A Staff Educational Program And Protocol, Aaron Michael Quach

Doctor of Nursing Practice Projects

Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Despite its prevalence, OSA often goes undiagnosed. This can result in negative sequelae. By educating healthcare providers about OSA, screening patients, and altering the plan of care, better outcomes will arise and complications can be minimized.

The purpose of this project was to develop an obstructive sleep apnea educational program and protocol based on available current literature for anesthesia providers at a community hospital. The educational project and protocol consisted of an informational PowerPoint, pretest and posttest surveys, an OSA screening tool and identification of a high risk OSA patient …

Protocol Development In The Or: Lessons Learned, Megan Sims

Doctor of Nursing Practice Projects

The management of pain in those undergoing a laparoscopic cholecystectomy is complex and challenging. There have been advances in the understanding of the physiology of pain and a wide variety of treatment options are now available. Establishing a preventative multi-modal protocol with different types of pain medications that work on a variety of receptors along the pain pathway is imperative. Through an exhaustive literature review, a preventative multi-modal approach was established and introduced at a small hospital in Central Illinois available for all laparoscopic cholecystectomy patients undergoing surgery over a 10 week implementation period. There was only one completed case …

Introduction Of Enhanced Recovery After Surgery For Colorectal Surgical Patients: A Quality Improvement Project, Amanda R. Mcvey

Doctor of Nursing Practice Projects

The purpose of this practice project was to develop and introduce an enhanced recovery after surgery (ERAS) protocol for colorectal surgical patients at a tertiary care center in southern Illinois. Project aims included reviewing available literature and study outcomes to develop an evidenced-based ERAS protocol for colorectal surgery and educating anesthesia providers about ERAS to introduce the evidenced-based ERAS protocol for colorectal surgery. An educational presentation and learning assessment tool were developed and subsequently presented to the anesthesia providers at the host facility. The first step toward implementing the protocol is education, as such, the results of the assessment questions …

Improving Acute Postoperative Pain Management For Opioid-Tolerant Patients: Development Of A Postoperative Ketamine Infusion Protocol, Jeri Dockins

Doctor of Nursing Practice Projects

Anesthesia providers are encountering a growing number of opioid-tolerant patients. To date, the treatment for acute pain has been the administration of opioids. The administration of opioids leads to postsurgical complications. This project’s purpose was to improve acute pain management for opioid-tolerant patients by creating a postoperative ketamine infusion protocol. Ketamine is a noncompetitive antagonist at N-methyl-D-aspartate receptor sites involved in nociceptive and inflammatory pain transmission (Radvansky et al., 2015; Vandivelu et al., 2016). Research has demonstrated ketamine administered as a bolus dose or a continuous low-dose infusion for 24 to 48 hours postoperatively often results in a decrease in …

Improving Perioperative Management Of Patients Experiencing Local Anesthetic Systemic Toxicity: An Assessment Of A Staff Educational Program, Sarah O'Leary

Doctor of Nursing Practice Projects

Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication occurring after administration of local anesthetics. With the increasingly widespread use of local anesthetics (LAs), healthcare providers must be educated on safe administration, as well as recognition and treatment of LAST. This project involved the development of a computer-based learning (CBL) module for staff at a tertiary care center in central Illinois with a focus on the definition, characteristics, prevention, symptoms, and treatment of LAST.

Knowles’ adult learning theory served as the primary foundation and theoretical framework for the development of the CBL. A comprehensive review of the literature …

The Implementation Of A Health Blog At A Community College, Colin M. Solomon, Roxanne Strohbeck

Doctor of Nursing Practice Projects

This projects details the implementation of a health blog at a Midwestern community college family health clinic. The literature review examines issues regarding benefits of college health clinics to students, health dangers college students face, social media usage for health education, how enhanced awareness of college health clinics can lead to increased usage, social media intervention design, and ethics of social media use for health promotion. A theoretical nursing framework is applied to the project of designing the blog. Clinical relevance for nurse practitioner practice is established with supporting literature review. Methods of project implementation are delineated including possible improvements, …

Impact Of Motivational Interviewing On Body Mass Index, Tajsier L. Thompson

Doctor of Nursing Practice Projects

Introduction

Being overweight and obese has become a common lifestyle. More than half of American adults are overweight and more than a quarter of overweight adults are obese. Despite this overwhelming statistic, weight-loss coaching by primary care providers is usually disregarded due to time constraints and lack of skills to motivate patients to reach weight-loss goals. Motivational interviewing (MI) focuses on helping people investigate and overcome ambivalence toward healthy lifestyle modifications by helping them to explore their weaknesses, strengths, and preferences in an effort to facilitate behavioral changes.

Objective

The primary objective of this project is to assess the effectiveness …

Training Plan For Anesthesia Information Management Systems (Aims), Omololu Kaffy Kafisanwo

Doctor of Nursing Practice Projects

The federal government has set a mandate for healthcare facilities to adopt electronic health records (EHR) or be penalized through reimbursement cut. A SIH has plans to install Epic in November 2017, a survey completed by anesthesia providers at SIH revealed staff resistance to the Epic transition. Since this resistance has the potential to disrupt patient care and anesthesia workflow, the chief anesthesiologist at SIH and the author devised a training plan to reduce resistance and facilitate smooth transition. The author utilized the results from the completed survey to coordinate with the chief anesthesiologist and IT training specialist to develop …

Effects Of A Formal Educational Class On The Quality Of Life In Patients Diagnosed With Hypothyroidism, Tahimina Popal, Dnp, Bsn, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypothyroidism is a chronic disease that requires self-care skills such as healthy diet, exercise, and a daily medication regimen where timing of food intake is essential. Adequate education is essential for patients with hypothyroidism to be able to manage their disease, and to live with the best quality of life possible. Many studies have been conducted to assess the perceived health status of patients with hypothyroidism, but few have examined the effects of a formal educational program on the quality of life.

Objectives: The purpose of this study is to determine if a formal hypothyroidism educational class will improve …

Improving Primary Care Utilization For Transgender Patients At An Fqhc, Timothie J. Rochon, Dnp, Rn, Cnm

Doctor of Nursing Practice Projects

Background: Transgender and Gender-Nonconforming (TGNC) populations comprise approximately 6% of the U.S. population. Socially and within the medical treatment system TGNC individuals face widespread stigmatization and discrimination which negatively impacts their mental, physical, and emotional health and contributes to health disparities. Real and perceived barriers to safe and effective healthcare are worsened by the scarcity of primary care providers knowledgeable in caring for these populations.

Objectives: The aim of this quality improvement project was to examine the impact of inclusive gender-affirming integration on the utilization of preventive and primary care services.

Methods: A one group pre- and post-intervention design was …

Associations Between Nurse Experience, Clinical Specialty Setting, And Level Of Nursing Education With Adherence To Clinical Practice Guidelines For Inpatient Influenza And Pneumococcal Vaccination Administration, Amy C. Alsante, Dnp, Ms, Rn, Ne-Bc, Chep

Doctor of Nursing Practice Projects

Background: This research project examines associations between years of nursing practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. Previous research demonstrates novice nurses are at higher risk for errors of omission and face challenges with critical thinking.

Objectives: 1) Identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration and 2) to identify associations among independent variables including levels of education, and specialty setting.

Methods: A retrospective chart review was conducted to identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. …

Evaluation Of The Carestarttm Glucose-6-Phosphate Dehydrogenase (G6pd) Rapid Diagnostic Test At Community And Health Center Level, Cambodia, Bertha Nyagaya-Wojnarski, Dnp, Fnp-Bc, Mph

Doctor of Nursing Practice Projects

Background: Primaquine (PQ) is the only FDA-approved drug for radical cure of Plasmodium vivax (P.v) malaria, but treatment can result in life-threatening hemolysis if given to a glucose-6- phosphate dehydrogenase deficient (G6PDd) patient. Therefore, the G6PD status of the patient with P.v must be known prior to prescribing PQ. However, patient G6PD status in rural malaria endemic settings is generally unknown, illuminating the need for reliable point of care G6PD diagnostic tests as a prerequisite to safely administer PQ. To increase community PQ access in Cambodia, performance of CareStartTM G6PD rapid diagnostic tests (RDTs) needs to be evaluated in healthcare …

Incorporating Just Culture Principles Into Clinical Learning Experiences, Paula Gendreau, Dnp, Msn, Rn, Cne

Doctor of Nursing Practice Projects

Background: Although nursing student’s confidence regarding patient safety is influenced by both clinical faculty and environments in which they learn, faculty seemed to have the most influence in shaping student’s attitudes surrounding a culture of safety. Objectives: To explore and support faculty culture of safety practices that promote meaningful learning experiences for students surrounding patient safety in clinical learning environments.

Methods: An embedded mixed method design was utilized for this pilot study. Quantitative data was collected both pre- and post-semester utilizing an adapted Health Professional Education in Patient Safety Survey, and post-semester qualitative data further expanded on faculty perceptions and …

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports generalizability. …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Cancer Screening Practices Among Sexual Orientation Groups, Scott Kilgore, Dnp, Msn, Bs, Rn

Doctor of Nursing Practice Projects

Background: Increasing cancer screening testing is a national health initiative to decrease the mortality rates of all Americans; however, cancer screening practices among sexual minorities have been understudied.

Objectives: To assess and compare breast, cervical, prostate, and colorectal cancer screening practices among straight, lesbian, gay, and bisexual individuals.

Methods: A descriptive-correlational study was conducted using data from the Center for Disease Control and Prevention 2014 Behavioral Risk Factor Surveillance System survey. Respondents who answered questions about their cancer screening practices and sexual orientation were included.

Results: This study identified disparities in breast cancer screening practices with bisexual women (81.9%) meeting …

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

The Effects Of A Structured Teaching Session On Perceived Self-Efficacy Among Mental Health Nursing Supervisors, Pamela Fess, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Specific factors that contribute to nursing supervisors perceived self-efficacy remains unclear. Although several studies have examined the relationship between self-efficacy and mental health nursing supervision most have focused on the impact of client care. To date, there is a dearth of studies to assess the impact of a leadership focused teaching session on the perceived self-efficacy of mental health nursing supervisors. Equipping nurses who are responsible for the supervision of others with the skills needed to fulfill their role responsibilities has the potential to improve their job performance, the work satisfaction, and well-being of staff nurses they supervise as …

Pilot Study Of Anxiety, Depression, And Quality Of Life In Patients With The Diagnosis Of Metastatic Uveal Melanoma, Regine Nshimiyimana, Dnp, Bpharm, Fnp-Bc, Agacnp-Bc, Ocn, Aocnp

Doctor of Nursing Practice Projects

Background: Awareness of a patient’s anxiety, depression, and quality of life (QOL) in those with metastatic uveal melanoma (MUM) can influence care that meets patients’ bio-psychosocial-spiritual needs.

Objectives: To measure the level of anxiety, depression, and QOL in patients with MUM and explore differences by gender, age range, time to metastatic disease, and duration of illness since metastasis.

Methods: We used a descriptive-comparative survey design. Over three months, a convenience sample of 70 patients with MUM aged ≥ 18 years, treated at a Mid-Atlantic hospital were invited to complete a combined survey of the Hospital Anxiety and Depression Scale and …