Medicine and Health Sciences Commons^™

Application Of Preceptorship Bundle To Enhance New Graduate Rn Success, Joann R. Nardoni

Doctor of Nursing Practice Projects

New graduate Registered Nurses (RN) are experiencing a difficult transition to practice. In turn it causes increased stress and job dissatisfaction. The quality improvement project focused on a bundled intervention to bridge this gap. It involved a preceptorship enhancement bundle to improve training with an emphasis on intentional pairing of preceptor/preceptee and use of the One-Minute Preceptor Model. People of like temperament were paired using the Ntrinsx personality profile to enhance the learning relationship. The One-Minute Preceptor Model was used to train preceptors how to engage critical thinking and clinical reasoning in the new RN. The actions of intentionally pairing …

Improving Self-Management Of Diabetes With Culturally Sensitive Interventions, Janet O. Makori

Doctor of Nursing Practice Projects

Abstract

Adult Latino patients with diabetes may require education and skills that are culturally appropriate to achieve optimum results. The purpose of this DNP project was to improve diabetes self-management among Latino and other at-risk adults. The project used an intervention bundle to streamline screening, education, and improve patients’ self- confidence. Adult patients were screened during triage to obtain vital signs and blood glucose levels per the routine at the clinic and via phone to discuss management of diabetes. Implementation of the project included provision of culturally sensitive diabetes education material, culturally sensitive “traffic light” food guide in English and …

Implementation Of A Psychiatric Mental Health Nurse Practitioner Transition To Practice Survival Kit Series: A Dnp Project, Dera Harvey

Doctor of Nursing Practice Projects

It is imperative that new graduate PMHNPs successfully traverse the gap from student to prescriber of care to meet these needs. Currently, a transition to practice gap exists for PMHNPs who are often left alone to navigate the beginnings of their new career. Additionally, the transition has not been analyzed extensively in literature (Barnes, 2015). The purpose of this DNP project is to implement a transition to practice survival kit series. The proposed DNP project is a mixed methods design focused on program evaluation. The project will assess the effect of a 6-session transition to practice survival kit series on …

Therapeutic/Expressive Writing And Resilience Promotion For Nurses To Reduce Burnout Syndrome, William D. Wagner Mr.

Doctor of Nursing Practice Projects

COVID-19 accelerated the rate in which nurses were unable to maintain resilience and reduce burnout. This evidence-based DNP project obtained data from a therapeutic/expressive writing intervention and group resilience discussion with Women’s Care Center (WCC) nurses to improve resilience acuity and reduce symptoms associated with burnout syndrome. A review of previous studies indicated therapeutic/expressive writing and group resilience discussions have been beneficial in improving resilience and reducing burnout. A demographic and two preintervention surveys were completed by WCC nurses in the hospital relaxation room or skills lab. The Connor-Davidson RISC-25© was used to determine resilience scores for morning and evening …

Improving Self-Management Of Diabetes With Culturally Sensitive Interventions, Janet O. Makori

Doctor of Nursing Practice Projects

Abstract

Adult Latino patients with diabetes may require education and skills that are culturally appropriate to achieve optimum results. The purpose of this DNP project was to improve diabetes self-management among Latino and other at-risk adults. The project used an intervention bundle to streamline screening, education, and improve patients’ self- confidence. Adult patients were screened during triage to obtain vital signs and blood glucose levels per the routine at the clinic and via phone to discuss management of diabetes. Implementation of the project included provision of culturally sensitive diabetes education material, culturally sensitive “traffic light” food guide in English and …

Improving Early Utilization Of Palliative Care Services To Impact Quality Of Life, April Mcdonald

Doctor of Nursing Practice Projects

Despite studies indicating the benefits of palliative care, many barriers remain that prevent individuals from accessing this specialty service. Palliative care needs improved utilization. The purpose of this quality improvement project was to improve the utilization of palliative services and increase general knowledge and confidence among nursing staff within one nursing home facility. In the intervention bundle, training was provided on the use of a Palliative Referral Flowchart and the Palliative Performance Scale (PPS) along with evidence-based materials made available to residents and families. Data was collected pre and post intervention. Knowledge was improved by 26 %. Confidence was improved …

Improving Hepatitis C Virus Screening Through Bundle Interventions, Jennifer West

Doctor of Nursing Practice Projects

Abstract

Hepatitis C (HCV) is estimated to impact 57,500 people in the US and is a leading infectious disease worldwide. The purpose of this DNP Project is to increase provider confidence in screening, early detection rates and ultimately timely treatment for patients at risk for HCV served within a rural Federal Qualified Health center (FQHC).

Interventions for this project included bundle steps consisting of provider and staff training of Hepatitis C guidelines for screening, use of an Electronic Medical Records (EMR) HCV flowsheet and lab template, revision of preventative health form, and self-efficacy survey to evaluate provider and nursing confidence …

Advanced Practice Registered Nurses And Healthcare Disparities: Understanding The Impact Of Implicit Bias, Marla Lepley-Starr

Doctor of Nursing Practice Projects

Introduction: Disparities in healthcare have long been a challenge for physicians, advanced practice providers, nurses, and other interdisciplinary team members. More recently, population health-focused efforts have been implemented to manage everincreasing rates of diabetes, hypertension, and obesity, as well as lack of transportation, limited access to care, and poverty (North Carolina Department of Health and Human Services [NCDHHS], 2019). Racism, sexism, ageism, sizeism, etc., are present in the healthcare setting and manifests in implicit bias during care delivery. This can manifest as beliefs, behaviors/practices, and emotions of the provider (Paradies et al., 2014). Research is limited related to the …

Improving Osteoporosis Awareness By Implementing Bone Mineral Density (Bmd) Testing Algorithm, Mark A. Roark

Doctor of Nursing Practice Projects

One of the leading concerns in the United States healthcare system is the aging population and age-related health concerns such as osteoporosis. Estimates suggest that 50 percent of women and 20 percent of men over 50 are at increased risk of fractures from osteoporosis. However, the diagnosis and treatment of osteoporosis are on a downward trend. If no changes are made by 2040, it is estimated that there will be an annual expense of $95 billion and over 3.2 million fractures per year in the United States alone. The National Osteoporosis Foundation (NOF), along with Healthy People 2030, recommends goals …

Evaluating Hpv Vaccination Adherence Amongst Teenagers Ages 12-18, Jade Vo, Myah Mukes, Kenya Nelson, Joye' Thomas, Laura Reed, Sharon Little

Doctor of Nursing Practice Projects

Human papillomavirus (HPV) is a sexually transmitted infection that can cause genital warts and different cancers. According to the CDC, 85% of people will get an HPV infection in their lifetime. HPV infections have decreased significantly since the implementation of the HPV vaccine. Data has shown 90% of cancers caused by HPV can be prevented with administration of HPV vaccination. Current guidelines recommend vaccination administration as early as 9 years of age. This quality improvement project will evaluate HPV vaccination rates amongst teenagers ages 12-18.

Screening For Social Determinants Of Health In Children With Attention-Deficit/Hyperactivity Disorder, Sarah L. Carter Msn, Aprn, Cpnp-Pc, Ronald Espinal Md, Toni Whitaker Md, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Increased social determinants of health (SDoH) are associated with poorer health outcomes and decreased treatment compliance. Addressing SDoH can be associated with increased treatment compliance, although currently there is no standard for completing SDoH screening. The WE CARE screening tool is a validated screen that asks about 6 SDoH and whether the family is interested in assistance if the screen is positive. The purpose of this project was to implement the use of the WE CARE screening tool for patients with attention deficit hyperactivity disorder (ADHD) at follow-up visits.

Methods

From October 17, 2022 through November 22, 2022, charts …

The Effectiveness Of A Ventilator Care Bundle Protocol In Decreasing Incidence Of Ventilator-Acquired Pneumonia: A Scoping Review, Katherine I. Garrett Bsn, Rn, Erin Houston Myatt Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Ventilator-acquired pneumonia (VAP) is a preventable hospital-acquired infection with a high mortality rate. Ventilator care bundles (VCB) are implemented to decrease the risk of infection while patients are mechanically ventilated. The aim of this scoping review was to assess how adult patients in the intensive care unit (ICU) requiring mechanical ventilation and the incidence of VAP are affected by staff’s compliance to a VCB.

Methods

From August of 2022 to November 2022, literature research was done among databases such as PubMed, MEDLINE, and CINAHL. The systematic search in PubMed yielded 55 results with the headings of “(ventilator) AND (care …

The Effects Of Diet And Lifestyle On Wound Healing, Chinwe Orabuchi

Doctor of Nursing Practice Projects

A current policy for wound care and teaching is present at Reskin Clinic. However, nurse practitioners identified delays in wound healing. A retrospective review of approximately 50 patient charts compared wound healing of patients who have stated they adhere to a healthy diet and lifestyle compared to those who do not. This information was compared to the patient's chart and determined what type of education on wound care, diet, and lifestyle changes were documented in the patient chart. Inclusion criteria includes patients ages 50+ with acute or chronic wounds. The results of this retrospective review demonstrated a lack of nutritional …

Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry

Doctor of Nursing Practice Projects

Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …

Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook

Doctor of Nursing Practice Projects

There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case …

Decreasing Nursing Burnout Post Covid-19 Pandemic Through Complementary Therapies, Linda Martiin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of nursing burnout post COVID-19 pandemic through complementary therapies. Nursing burnout can be mental, emotional, or physical exhaustion which an excessive amount of prolonged stress can cause. Nursing burnout has affected nursing staff worldwide, directly impacting the care provided to patients and the patient's satisfaction. The Nursing Worklife Model was utilized as the theoretical framework for this project (Appendix A). The literature review exhibits the prevalence of nursing burnout in nursing staff. A quantitative study was utilized for this project. The Oldenburg Burnout Inventory was utilized to establish the participant's level …

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander

Doctor of Nursing Practice Projects

The DNP project was designed to improve future healthcare providers’ knowledge on the complexity of endometriosis by providing students with a lunch and learn session on endometriosis. The intent of the project implementation was to improve students’ knowledge on endometriosis to facilitate early diagnosis for patients. Improving provider knowledge of evidence-based endometriosis guidelines is imperative to achieve early diagnosis. The educational session provided students with information regarding symptoms, impact of delayed diagnosis, discerning differential diagnoses, associating timing of symptoms, and identifying endometriosis lesions. The impact of the project implementation was measured using pre/post-survey data evaluating overall knowledge, symptoms awareness, “best …

The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve acute care nurses’ knowledge of evidence-based palliative care interventions utilizing the framework from the End-of-Life Nursing Education Consortium (ELNEC) training modules. Increasing the knowledge, comfort, and competence of acute care nurses has the potential to improve end-of-life care delivery in the acute care setting. A lack of access to specialized inpatient palliative care service teams was identified in a rural county in the Southeastern United States. This county is served by a small, criticalaccess hospital. The frontline nursing staff of this facility regularly provides end-of-life …

Why Doesn't She Just Leave? Improving Identification And Response To Victims Of Intimate Partner Violence In The Emergency Room, Elizabeth Berry

Doctor of Nursing Practice Projects

The purpose of this project was to improve identification and response to victims of intimate partner violence (IPV) presenting to the emergency department. Project participants completed a pre-education questionnaire prior to the project leader providing intimate partner violence educational materials and a presentation entitled Recognizing and Responding to Victims of Intimate Partner Violence in the Emergency Room. The project participants then completed a mirrored post-education questionnaire. Evaluation of the project included a comparison of the participant's responses to the mirrored questionnaires. Project participants reported an increase in the:

• recognition of the prevalence of intimate partner violence among their patients, …

Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash

Doctor of Nursing Practice Projects

Providing effective discharge education to patients who are treated in the emergency department setting remains a very important component of a patient’s visit to an emergency department. Literature confirms although there are various governmental regulatory agencies that set forth regulations and guidelines, there remains a need to continually evaluate and critique the discharge education process to best meet the evolving needs of the patients, stakeholders, and community. Universally understood standards include appropriate reading levels and usability of the discharge education being provided. Discharge education can be very simple to complex creating higher demands on nursing staff to ensure they understand …

Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb

Doctor of Nursing Practice Projects

Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between …

Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley

Doctor of Nursing Practice Projects

Nursing programs are intended to prepare nursing students to become competent nurses, that can make decisions to promote positive patient outcomes. However, studies suggest that as students transition into clinical practice, they are still lacking decision-making skills. Emotional Intelligence (EI) has been suggested to improve communication skills, problem-solving, and resilience. The purpose of this project was to enhance the emotional intelligence of Baccalaureate prelicensure nursing students. The PICOT statement was: Can formal EI training combined with interactive EI training, influence EI awareness, knowledge, and skills of baccalaureate nursing students as evidenced by scoring 77% or higher on an EI posttest …

Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder

Doctor of Nursing Practice Projects

Background: The crisis in the competency of newly licensed graduate nurses continues to grow despite the efforts of nursing academia. Transition to practice programs has improved new graduate attrition and narrowed the gap of practice readiness, but much of the responsibility to train graduate nurses falls on nurse preceptors. Many of these preceptors have minimal nursing experience and little to no training in fostering clinical judgment. Furthermore, nurse preceptors must balance providing care for their clients while also guiding novice nurses. They often do not have the time to provide the emotional support, real-time reflection, and timely feedback required to …

Increasing Clergy Members Awareness, Sensitivity, And Knowledge (Ask) Of The Lgbtqia+ Community Improves Health Outcomes, Claudette Green

Doctor of Nursing Practice Projects

Introduction: Individuals who identify as belonging to the LGBTQIA+ community in the context of religion and faith often experience spiritual discrimination and are made to feel like an outcast (Cole & Harris, 2017). Often, spiritual leaders lack the training, knowledge, and skills necessary to understand and communicate in a way that offers solace and comfort to their LGBTQIA+ congregants (Yarhouse & Sadusky, 2020). Moreover, the church has been at the forefront of leading the discrimination and condemnation of LGBTQIA+ members. This discrimination has led many to leave the church and become involved in self-harming behavior, ongoing mental health struggles, …

How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey

Doctor of Nursing Practice Projects

This project set out to see if stress and anxiety (leading to burnout) could be combatted with the use of essential oils (EOs). Burnout is a common concern amongst the medical community and healthcare providers are leaving their jobs and field at unprecedented rates. While EOs have been used for patients, they are rarely used for the healthcare providers’ benefit. Because of that, this project wanted to focus on the employee for a change, which in turn would benefit the patient by having a mentally-present provider and the company by having less turnover. The project consisted of a pre-survey prior …

Combating Compassion Fatigue In The Emergency Department, Pam Packard

Doctor of Nursing Practice Projects

Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?

Heart Smart Holidays: Coping With Stress, Staying Active, And Healthy Cooking Strategies For Seniors In Cleveland County, Lauren Ridgeway

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice Project assessed whether attending community group meetings focusing on stress, staying active, and healthy eating during the holidays, could influence cardiovascular disease awareness, mental health awareness, and quality of life of senior citizens in Cleveland County. A convenience sample of 6 participants attended the Coping with Stress and Staying Active event while 10 participants attended the Healthy Cooking Strategies event. The objectives were measured using a pretest posttest design before and after the presentations. There was strong evidence (t(9) = -13.597, p < .05) that the group seminar on managing stress and staying active during the holiday season improved the mental health awareness of participants. Data also showed a significant increase in Cardiovascular Disease Awareness from pretest to posttest (t(5) = 3.246, p < .05) after the seminar on healthy cooking strategies. The project raised community awareness to the importance of managing stress, staying active, and making small nutritional changes to positively impact the cardiovascular health of Seniors.

Increasing Nurses' Comfortability Using The Defibrillator, Mandy Whitaker

Doctor of Nursing Practice Projects

The educational needs of nurses vary depending on the practice setting in which he or she is employed. Some competencies are taught yearly or bi-yearly. The current process for registered nurses to learn how to use the defibrillator is through the advanced cardiovascular life support (ACLS) training they are required to take every 2 years. Although a certification proves a nurse is competent in a certain area, skills tend to be forgotten over time. It is often noted “if you don’t use your skills, you lose them.” Nelson and Aguirri (2020) reported even though there are many facets to the …

Getting The Most From M.O.S.T.: Promoting Most Education For Palliative Care Providers, Shelby Mood

Doctor of Nursing Practice Projects

Physician Orders for Life-Sustaining Treatment (POLST) forms are relatively new in medicine. These forms help patients and providers navigate some of the difficult decisions that can occur near the end of life and in palliative care. Each state has its own version of POLST forms. In the state this DNP project was implemented, this form is called Medical Orders for Scope of Treatment, or MOST form. Given the complexities of medical decisions, patients may not always understand the options covered in the MOST form or the implied tasks with each choice. To further patient understanding of the MOST form, this …