Medicine and Health Sciences Commons^™

Intrathecal And Epidural Dexmedetomidine For Obstetric Patients, Sarah Tobias, Addison Hohner

Doctor of Nursing Practice Projects

The use of dexmedetomidine in spinals and epidurals can be beneficial for obstetric patients. The combination of dexmedetomidine with local anesthetics for neuraxial anesthesia potentiates the effect of the blockade while eliminating the undesirable side effects associated with opioid administration. This project used a non-experimental, pre-test/post-test design to assess key stakeholders' current use and intended future use of dexmedetomidine in neuraxial anesthesia for obstetrical patients. The goal of this project was to review current evidence-based literature regarding the use of dexmedetomidine as a neuraxial adjunct for obstetric anesthesia. The aim of this project was to summarize the results of the …

Addressing Tobacco Use With Improved Utilization Of 5as Framework In Primary Care, Binta Bojang

Doctor of Nursing Practice Projects

Abstract

Identifying and treating tobacco use disorder through screening and evidence-based intervention is necessary to assist all tobacco users to quit and or to decrease typical tobacco-linked health risks. The findings from the literature review suggested that the implementation of the technology-enhanced 5As model (asking, advising, assessing, assisting and arranging for follow up) approach might serve as a reminder to clinicians to assess tobacco use, and improve patient outcomes in tobacco cessation care. The purpose of this DNP project was to improve the treatment of tobacco use disorder among adults in a primary care. The objective of this project was …

Bridging The Gap In Education For Patients On Oral Chemotherapy: A Qi Project, Lindsay Rodriguez

Doctor of Nursing Practice Projects

Abstract

Oral chemotherapy and intravenous (IV) chemotherapy share many of the same side effects. However, at community General Hospital Medical Center oral chemotherapy patients were not receiving equitable monitoring and education like their IV chemotherapy counterparts. To bridge the gap, a quality improvement (QI) initiative to improve education, documentation and follow-up between visits was proposed to increase compliance and understanding. The QI project consisted of patients taking oral chemotherapy within the first 12 weeks of starting treatment. Patients were contacted weekly via nurse lead follow up calls and the Oral Chemotherapy Template was discussed with the patient to identify concerns …

Complete Health Improvement Program To Implement Lifestyle Medicine, Robert Hobbs Jr

Doctor of Nursing Practice Projects

The health of many Americans continues to worsen. Over the past 20 years there has been a fifty percent increase in the incidence of Type 2 Diabetes Mellitus in the US. America has an increase in obesity rates, and lower mortality rates compared to other countries that spend less per capita. Currently the US healthcare system only contributes about 20% of the overall care of patients. Provider burned out is increasing and many remain uneducated regarding lifestyle medicine. Since up to 90% of chronic diseases are lifestyle related, a different approach to chronic disease care is needed. The Complete Health …

Decreasing Falls: Communicating Safety With Patient-Directed Visual Cues, Signs, And Symbols, Lizelle Hill

Doctor of Nursing Practice Projects

Patient falls during hospitalization are a major clinical problem that occurs frequently. It is estimated that between 700,000 and 1,000,000 patients fall in hospitals each year. Between 30% and 50% of patients who fall in hospitals are injured. Consequently, falls with serious injury are among the most frequent hospital-reported sentinel events. Hospitals also suffer from patient falls as the Centers for Medicare and Medicaid Services no longer reimburse for costs related to preventable falls or fall-related injuries. Given the significant negative impact of falls on patients and healthcare organizations, hospitals continue to look for interventions to decrease falls. Research strongly …

Online Support For Families Affected By Opioid Use Disorder, Sharonda Hill

Doctor of Nursing Practice Projects

Families who care for children with neonatal abstinence syndrome (NAS) face many challenges and may be lacking support. The purpose of this project was to provide evidence-based information to families caring for NAS children through an established online support group, To the Moon and Back. Nola Pender’s Health Promotion Model was the theoretical model used to guide this project. An intervention to deliver support and information was implemented through three sessions. During these sessions participants were educated on evidenced-based tools to help their children with behavioral self- regulation and communication with providers. Data was collected through pre and post assessments …

Use Of Academic Detailing To Improve Reporting Of Peri-Operative Events, Allyn Sara Miller-James

Doctor of Nursing Practice Projects

Problem: Four million people worldwide die within thirty days of surgery. The EPIC Corporation has created the opportunity to collect and analyze data on the peri-operative care of patients. Initially, implementation of the program has identified barriers to event reporting by anesthesia providers. Barriers identified in the literature and in semi-structured interviews are fear of liability and retribution by patients, employers, and governing bodies. Significance: Despite national efforts to increase the reporting of medical errors, they remain grossly under- reported. The integration of the National Anesthesia Clinical Outcomes Registry (NACOR) events data collection tool into the EHR for anesthesia providers …

Simulation To Improve Dementia-Related Care Of Veterans, Brandy Wardrip

Doctor of Nursing Practice Projects

Millions of Americans, including Veterans, are diagnosed with dementia. Healthcare staff may benefit from dementia-related training. This Doctorate in Nursing Practice (DNP) project evaluated the effectiveness of the Virtual Dementia Tour (VDT) as a learning tool to improve staff’s knowledge of dementia, enhance their empathy and attitudes when interacting with Veterans diagnosed with the disease, and increase awareness that behaviors commonly seen with dementia may be forms of communication. Interprofessional healthcare staff (N=33) at a Veterans hospital participated in the experiential simulation. A pre-and post-test design utilized the Dementia Knowledge Assessment Scale (DKAS) and the Dementia Attitude Scale …

Providing Mbsr Tools To First Year Adn Nursing Students: A Dnp Project, Katherin Brandt

Doctor of Nursing Practice Projects

Abstract

As part of the educational training provided to nursing students it is important to not only provide information regarding stress management, but also to give them tools that they can use to handle stressful situations more effectively. Literature supports the use of mindfulness techniques practiced regularly to decrease stress and anxiety. This DNP project developed, implemented, and evaluated the addition of Mindfulness-Based Stress Reduction (MBSR) techniques into the curriculum of the first-year Medical Surgical nursing course in a prelicensure Associate Degree Nursing program. The project was guided by Watson’s Theory of Human Caring and the Model for Improvement (PDSA …

Streamlining The Referral Process For A Mental Health Clinic: A Dnp Project, Ashley Barr

Doctor of Nursing Practice Projects

Abstract

Mental health providers are in short supply in the United States. Access to mental health is impacted by the process used to refer patients. To bridge this gap, this DNP Project sought to increase mental health referrals to the partnering organization through strategic outreach to primary care and an online social media presence. After IRB approval, outreach to twenty-one primary care providers across eleven clinics was completed, a social media campaign was conducted, and the intake form for the partnering organization was updated for tracking the source of the referral. Results of the interventions included high satisfaction on the …

A Self-Compassion Intervention For University Students: A Dnp Project, David Coffey

Doctor of Nursing Practice Projects

University students are reporting increased levels of anxiety, depression, and suicidal ideation. Trends for mental health distress among this population have been increasing over the past few years. The COVID-19 pandemic has worsened this trend. It is important to provide college-age students with the knowledge and skills for self-compassion necessary to navigate the difficult transition from high school to university. Self-compassion skills have been shown to positively affect mental health outcomes, specifically anxiety and depression. A brief, two-part intervention was developed focusing on the major components of self-compassion and offered to university students over a two-week period. Results of the …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Improving Parent/Guardian Awareness Of Kindergarten Entry Health Requirements, Paul Prince

Doctor of Nursing Practice Projects

Ensuring students meet health requirements to enter Kindergarten is a time-consuming process. By improving education to parents to help them discern differences between PreK and Kindergarten requirements, the health of students can be optimized and the time burden for administrators and school nurses can be reduced. There is evidence that parents/guardians better respond to non-written material delivered through push notification or email. A 5-minute video presentation was distributed to 24 parents/guardians of PreK students. Project impact was measured through a pre/post survey evaluating levels of confidence in child readiness for Kindergarten. Results identified that parent/guardian confidence was increased after education. …

Diabetic Self-Management Education Program Evaluation, Amanda Thomas

Doctor of Nursing Practice Projects

Diabetes is a metabolic disease characterized by hyperglycemia, caused by impaired insulin secretions resulting in high hemoglobin A1C levels. Education is beneficial in reducing these as an additive to lifestyle and drug therapy. This student project reflects a program evaluation for a patient diabetes self-management education (DSME) intervention in one small rural outpatient system. DSME classes address the comprehensive blend of clinical, educational, psychosocial, and behavioral aspects of care needed for the daily management of people living with type II diabetes. Three months after completing a DSME the person experiencing type II diabetes has a repeat Hemoglobin A1C level taken …

Decreasing Preoperative Anxiety In Cataract Patients, Virginia Baltz

Doctor of Nursing Practice Projects

Several studies show that patients present with anxiety before surgical procedures. Preoperative anxiety may cause unwanted sympathetic nervous system (SNS) responses which can result in nervousness, anger, or sadness. Hypertension and tachycardia are often present, along with unwanted postoperative complications including increased pain perception and decreased patient satisfaction. Understanding that anxiety is both an emotional and physiological response, emphasizes the need to alleviate anxiety preoperatively (Aust et al., 2016). This Quality Improvement project aims to manage patient surgical expectations with cataract surgery through positive preoperative education. Patients were given written education and the opportunity to discuss the information before cataract …

Does Urgent Care Depression Screening Lead To Increased Depression Diagnosis?, Eric Haertling

Doctor of Nursing Practice Projects

There is a knowledge gap in the administering of depression screening within the urgent care setting. The Patient Health Questionnaire (PHQ) depression screening can identify patients with depression, but evidence has been limited in identifying an increase in depression diagnosis with the implementation of depression screening. This project aims to determine if routine depression screening with the PHQ increases depression diagnosis in the urgent care setting. The translational science project was performed in a rural urgent care in north-central Arkansas between January 2022 to February 2022. A total of 2,135 records were included in the project, with eight ICD-10 codes …

Addressing Compassion Fatigue In Critical Care Nurses, Melissa Bowen

Doctor of Nursing Practice Projects

Compassion fatigue causes a ripple effect that impacts caregivers, patient outcomes, and the reliability of healthcare organizations. Jarrad et al. (2018) suggests the physical, emotional, spiritual, social, and organizational consequences of compassion fatigue are so extensive that they threaten the integrity of the nurse. Addressing compassion fatigue in critical care nurses is an indispensable part of maintaining the integrity and trust of the healthcare profession. It is imperative to care for the caregivers to warrant a solid foundation for optimal patient outcomes and engagement. Self-education and awareness, nursing leadership involvement, and self-care are integral to ensuring that compassion fatigue does …

Improving Care Of Women Experiencing A Pregnancy, Belinda T. Ferguson

Doctor of Nursing Practice Projects

The purpose of the Doctor of Nursing Practice (DNP) project was to provide evidence-based staff education at a pregnancy resource center to increase staff/patient engagement and communication by implementing a clinical practice change and use of a DNP student-developed discharge summary referral form (DRF) to assist with assessing patient’s needs, evaluating access to services and utilization of medical care and health promotion services. The overall aim of this project is to increase care with medical follow-up and seek to address improving engagement and communication with patients during their care and after discharge from the Pregnancy Resource Center (PRC). The major …

Obstructive Sleep Apnea Education To The Rural Community, Brandi Harris

Doctor of Nursing Practice Projects

This project was executed to provide obstructive sleep apnea education to the men and women of the rural community. Many residents of rural communities remain undereducated and unaware of diseases and disorders in which they are subjected to or have increased risks for. Obstructive sleep apnea affects approximately twenty-two billion Americans. Of those affected, nearly eighty percent remain undiagnosed and untreated (Nagappa et al., 2015). Victims of the sleep disorder fail to acknowledge signs and symptoms of obstructive sleep apnea, many oblivious to the etiology, risk factors, symptoms, and pathophysiology of the disorder. Presenting education to residents of the rural …

Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison

Doctor of Nursing Practice Projects

Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …

Implementing Obesity And Comorbidity Education In A Faith-Based Setting, Tammy Lynn

Doctor of Nursing Practice Projects

The aim of the study was to increase knowledge of the damaging consequences of obesity and related comorbidities. Obesity has reached epidemic proportions on a global scale and increases the potential health risk of many associated diseases. Faith-Based organizations have been found to be optimal resources for public health education. The shared beliefs and comradery are a source of support and encouragement for those who face many of life’s challenges, as well as life’s joys. The purpose of the project was to investigate the effectiveness of education delivered in a Baptist church on the topics of obesity and related comorbidities. …

Game-Based Learning Effects On Nclex-Rn Perception Of Preparedness And Pass Rates, Alexis Utley

Doctor of Nursing Practice Projects

Background: The National Council Licensure Examination for Registered Nurses (NCLEX-RN) has been used to measure the quality of a nursing program’s effectiveness in preparing nursing students to pass the exam since 1988. The combined average pass rate percentage for the Hunt School of Nursing (HSON) nursing programs for the year 2021 was 88%.

Method: Information on feelings of preparedness and time to test after graduation was collected via survey prior to the game-based learning (GBL) activity. This same information was collected post GBL and compared to the pre-survey results. NCLEX-RN pass rate data was collected 1 month after graduation.

Results: …

Sepsis Identification In The Long-Term Care Facility, Shonna Bible

Doctor of Nursing Practice Projects

BACKGROUND: Each year approximately 1.7 million people in the United States develop sepsis, and an estimated 270,000 Americans die from this disease (Center for Disease Control and Prevention [CDC], 2020). Early recognition, and identification is essential in decreasing potential for mortality in this population.

METHODS: During a two-week period six individual sessions via a one-hour presentation was provided on evidence based best practice of sepsis recognition. A pretest was utilized to determine prior knowledge of sepsis recognition. A post-test was provided to evaluate the effectiveness of the educational material. Finally, a survey was conducted to provide input for …

Benefits Of Ambulation In Older Adult Population, Kelsie E. Wilkes

Doctor of Nursing Practice Projects

Background: Loss of mobility is an outcome of aging. Decreased ambulation leads to a loss of mobility and ultimately a loss of independence. There are additional health risks associated with loss of mobility. There can be challenges to facilitating ambulation and mobility in an aging population.

Objective: A literature review of the benefits of ambulation/mobility and the risks of loss of mobility was conducted. The purpose was to promote ambulation/mobility in a community-based setting and educate those caring for the adult population about the importance of ambulation.

Methods: A presentation was provided to staff and participants of …

Changing The Ways Bedside Nursing Staff Think About ‘All Things Urinary Catheters, Angela Foard

Doctor of Nursing Practice Projects

The purpose of this project was to bring attention to the importance of the bedside nursing staff’s "back to the basics" approach to nurse-led interventions to help reduce the number of increasing hospital-acquired infections (HAI), specifically catheter-associated urinary tract infections (CAUTI). The motivation to address this problem was due to the bedside nursing staff under-utilizing best practice interventions to prevent insertions and re-insertions of urinary catheters. A high number of urinary catheter insertions and re-insertions increases the risk of a CAUTI. Evidence-based interventions should be reinforced and utilized by bedside nursing staff to prevent insertions and re-insertions. Evidence-based nurse-led practices …

Superwoman Schema: Fighting Back With Holistic Therapy, Chavonne Good

Doctor of Nursing Practice Projects

For decades, Black women have upheld the stereotype of being consistently strong, capable, tenacious, and unwavering throughout life’s many challenges. Unfortunately, while being resolute in their desire to succeed against all odds, many Black women have unknowingly embraced the characteristics of a phenomenon known as Superwoman Schema. Superwoman Schema consists of five characteristics that are not inherently negative. However, when Black women consistently embody these traits which include the determination to succeed and to be strong, and an obligation to help others; they may neglect their own self-care needs. Subsequently, while neglecting themselves, focusing on others, and continuously trying to …

Enhancing Knowledge And Confidence In A Retail Clinic Setting Of Practitioners In Treating Primary And Secondary Hypertension, Ravon Mckoy

Doctor of Nursing Practice Projects

Many adult and adolescent patients in primary care settings are diagnosed with primary hypertension, however the workup often does not include an evaluation of secondary causes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve the diagnosis and treatment of hypertension for patients seeking health care in a retail clinic setting. The PICOT question was, what is the effect of an educational offering on hypertension standards of care in enhancing knowledge and confidence for providers working in a retail health clinic setting? The sampling frame was 40 Nurse Practitioners and Physician Assistants employed at CVS Minute …

Improving Self-Care Awareness Among Undergraduate Nursing Students, D'Anna Helms

Doctor of Nursing Practice Projects

The purpose of this DNP project was to improve self-care (SC) awareness among undergraduate nursing students by educating on the use of constructive SC activities. Twenty-two senior level nursing students attended an educational seminar, completed the Mindful Self-Care Scale – Clinical (MSCS-C) pre- and post-survey, and reflective journaling. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p < .05). Thematical analysis revealed enhanced awareness and incorporation of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC, thus improving students’ overall success and further empowering students in their transition from graduate to licensed nurses.

"Healthy Skills 4 Life" Program: A Pilot Study And Program Evaluation, Wendy Hines

Doctor of Nursing Practice Projects

This project piloted and evaluated “The Healthy Skills 4 Life” (HS4L) program within a middle school population. HS4L is an innovative holistic health curriculum focusing on four key areas of healthy behavior: nutrition, physical activity, stress management, and sleep hygiene. A middle school physical education teacher was supplied with the HS4L instructional materials and support needed to independently implement the program. The HS4L program allowed the students to self-assess wellness behaviors and create an action plan for improvement focusing on healthy lifestyle concepts. The implementation was evaluated utilizing the "Healthy Skills 4 Life" Feedback survey. The total average …

Faith-Based Approach: Reaching The Rural Population To Increase Diabetes Awareness, Regina Ledford

Doctor of Nursing Practice Projects

With diabetes at an epidemic level in the United States, more awareness needs to be brought surrounding prediabetes and diabetes prevention. This DNP Project consists of implementing a faith-based educational informational event at a local rural church to increase diabetes awareness. Findings within this DNP project suggest that the rural population can increase knowledge of diabetes awareness through faith-based education. With a sample size of 21 participants, positive statistical significance was found on analysis of pre-test and post-test Likert style questions regarding diabetes prevention, risk factors, and diabetic resources.