Medicine and Health Sciences Commons^™

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Experiences Of Undergraduate Nursing Faculty Adapting To The Changes Of The Next Generation Nclex, Marlene Kilpack Whiteside

Walden Dissertations and Doctoral Studies

Undergraduate nursing faculty are responsible for preparing nursing students for patient care in a dynamic health care setting and are challenged with meeting the National Council Licensure Examination (NCLEX) change to the Next Generation NCLEX (NGN). The National Council of State Boards of Nursing recommended the incorporation of the Clinical Judgment Measurement Model (CJMM) and competency-based curriculum in preparation for NGN testing that began in 2023. Understanding how faculty experienced and adapted to changes in curriculum, patient-centered instruction, and NGN testing may help future nurse faculty in adapting. The purpose of this basic exploratory, qualitative study guided by the achievement …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Cervical Cancer Education & Prevention For Women In The Philippines, Kate Isabel Juanillo

Nursing | Senior Theses

Although cervical cancer is preventable, it continues to pose a significant health concern in the Philippines as evidenced by high cervical cancer diagnosis rates. The purpose of this quantitative study is to investigate low cervical cancer screening rates and the effectiveness of educational interventions in increasing awareness and screening rates. A literature review will examine topics such as low cervical cancer screening rates, cervical cancer screening methods, and barriers. This research proposal involves a quasi-experimental study that investigates education as an intervention for increasing cervical cancer awareness and cervical cancer screening rates. Fifty Filipino women will be randomly assigned to …

Enhancing Athletic Participation: Continuous Glucose Monitoring For Pediatric Type 1 Diabetes Athletes, Danielle Santiago

Nursing | Senior Theses

The difficulties that children and teenagers with Type 1 Diabetes Mellitus (T1DM) encounter are discussed in this thesis, with a focus on how fear of hypoglycemia (FOH) and actual hypoglycemia associated with this chronic illness affects their ability to engage in physical activities, especially organized sports. A common challenge for children diagnosed with T1DM is meeting the daily recommendation of 60 minutes of daily moderate to vigorous physical activity. The purpose of the proposed study is to evaluate if participation in structured exercise (physical education classes and after-school sports) increases among school-aged children who wear continuous glucose monitors (CGM) when …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Improving Preeclampsia Education And Assessment Frequency Among Nurses And Patients With Non-Severe Features In A Postpartum Unit, Monica Heredia

Master's Projects and Capstones

Problem: This Quality Improvement project aimed to improve preeclampsia education among Registered Nurses (RNs) and simplify the preeclampsia assessment frequency for patients with non-severe features in the Mother-Baby Postpartum Unit at Hospital Y.

Context: The Quality Improvement project occurred in a 25-bed Mother-Baby Postpartum unit at Hospital Y. The nurse educators at Hospital Y requested that University of San Francisco (USF) nursing students focus on increasing preeclampsia education among nurses and reducing the nursing assessment frequency.

Interventions: Collect quantitative data through observation and hand anonymous questionnaires to the registered nurses and clinical nurse leaders (CNLs) to determine …

Implementing An African American Cultural Awareness Program For Skilled Nursing Facility Staff, Adekemi T. Adedipe

Doctor of Nursing Practice (DNP) Projects

Background: Patient care is most effective when patients and providers establish a therapeutic connection in a cultural context. Nurses’ lack of awareness of a cultural context for patient care impairs establishing a therapeutic provider/patient relationship, with care of lesser quality and poorer health outcomes as consequences.

Local Problem: Staff at a Northern Californian skilled nursing facility (SNF) caring for African American patients with mental illness lacked self-awareness of the cultural context of care. Staff did not consider cultural constructs of care in treating patients and developing care plans.

Methods: Educational intervention to increase the cultural competence of a skilled …

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Improving Education On Preeclampsia With Non-Severe Features And Frequency Of Assessment Among Nurses In The Maternal-Child Postpartum Unit, Alyssa J. Willsher

Master's Projects and Capstones

Problem: This Quality Improvement (QI) project aims to improve preeclampsia education among nurses and reduce the frequency of preeclampsia assessments among patients(without severe features) (SF) in the Mother-Baby postpartum unit at Hospital A. Nurses often stated that patients are unable to have uninterrupted rest periods with frequent assessments, which research shows is necessary for reducing patient blood pressure.

Context: The QI project is implemented in a 25-bed postpartum unit that cares for women and their newborns in the postpartum period. The unit’s nurse educator and nurse manager requested that the visiting University of San Francisco research group focus on simplifying …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado

Doctor of Nursing Practice (DNP) Projects

Background: Globally, adverse health effects, including deaths and disabilities, occur from living or working in unhealthy domains where exposure to environmental and occupational hazards exists. A multitude of these hazards are present in clinical settings in the healthcare environment where nurses care for patients and risk ongoing exposures to toxic substances.

Problem: Environmental and occupational health education is rarely included in the standard undergraduate nursing curriculum, contributing to a deficit among nurses in environmental health awareness and knowledge.

Methods: The study design was a pre/post evaluation of a single cohort (n=32) of undergraduate nursing students to assess environmental and occupational …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Standardizing Congestive Heart Failure Education To Decrease Readmissions, Cyntia Boter

Master's Projects and Capstones

Background: The setting of this project took place in a small 100-bed community hospital that is a part of a larger healthcare organization in Northern California. The focus of the project was the implementation of standardized education for patients with congestive heart failure (CHF) to lead to an outcome of decreased readmissions. Readmissions to hospitals are costly and effective discharge planning can impact and decrease readmissions.

Problem: The facility in which this project took place has 35 readmissions a year for CHF. It is the third highest DRG and reason for readmissions in 2022. Although there is work in place …

Improving Prediabetes Screening, Diagnosis, And Referral To A Diabetes Prevention Program In The Primary Care Setting., Brittany Morguelan

Doctor of Nursing Practice Papers

Improving Prediabetes Screening, Diagnosis, and Referral to a Diabetes Prevention Program in the Primary Care Setting

Table of Contents

Abstract……………………………………………………………………………………………4

Background………………………………………………………………………………………..5

Purpose…………………………………………………………………………………………...10

Literature Review……………………………………………………………………………...…10

Conceptual Framework…………………………………………………………………………..15

Setting………………………………………………………………………………………...….17

Context…………………………………………………………………………………………..18

Procedures/Intervention…….……………………………………………………………………19

Ethical Considerations…..……………………………………………………………………….20

Measures…………………………………………………………………………………………20

Data Analysis……………………………………………...……………………………………..22

Results……………………………………………………………………………………………23

Discussion……………………………………………………………………………...………...26

References……………………………………………………………………………………….33

Appendix A: Implementation Timeline…………………………………………………………40

Appendix B: IROC Quality Improvement Leadership Approval Letter………………………...41

Appendix C: PCP Referral Process and Diabetes Prevention Program Referral Order………...42

Figure 1: Monthly Number of N-DPP EHR Referrals by PCPs…………………………………….43

Figure 2: Monthly Total PCP Screening HbA1c/FBG Orders vs. Monthly Results HbA1cs……44

Figure 3: Demographic Analysis: Patients with a Documented Prediabetes ICD-10 (R73.03/R73.0)………………………………………………………………………………………….45

Abstract

Background: Prediabetes is a …

Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko

Nursing (graduate) Student Scholarship

Background: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.

Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.

Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs …

Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley

Doctor of Nursing Practice Projects

Background: Formal education for type 2 diabetes mellitus (T2DM) patients is essential, especially in rural areas where diabetes is approximately 17% higher than in urban areas (Bolin & Ferdinand, 2018). In 2019, diabetes was listed as the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before 70 years (American Diabetes Association, 2021). According to the American Diabetes Association (2021), approximately 550,149 people in Alabama, or 14.1% of adults, have been diagnosed with diabetes. An additional 119,000 people in Alabama have diabetes but are unaware, significantly increasing their risk of complications (American Diabetes Association, …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

A Pilot Project For Tuberculosis Education In College Students, Sarah Williams

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).

Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.

Participants: Twenty Community College Students in San Diego participated in the project.

Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.

Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …