Medicine and Health Sciences Commons^™

Reduction Of Seclusion And Restraint Among Children And Adolescents In An Inpatient Psychiatric Hospital: A Health Policy Analysis, Huma Moez

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Seclusion and restraint (SR) or restrictive intervention in inpatient/ acute psychiatric hospitals, emergency departments, crisis stabilization units, residentials, or group homes is a pressing and an immediate concern in mental health settings, particularly for children and adolescents, for whom SR rates are higher. The Joint Commission and other national organizations have made significant strides in prioritizing the reduction and elimination of SR among children and adolescents due to its negative physical and psychological consequences.

Objective: This DNP project will aim to provide the results of a policy analysis to present evidence-based techniques and a resulting re-envisioned policy recommendation to …

Advanced Practice Clinician Outcomes: Pre/Post Implementation Of An Advanced Practice Clinician Council, Jeannine M. Moss

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Improving access to quality, affordable, and timely healthcare is a national priority. Health systems across the United States are utilizing Advanced Practice Clinicians (APCs) to fill the void in healthcare delivery. As provider shortages continue and the demand for APCs increases, organizations must develop robust structures to support APC engagement, retention, job satisfaction, and professional growth. Currently, 44% of the provider workforce within a large urban health system are APCs, yet despite substantial APC provider labor pool representation, the organization had little infrastructure to support APC professional growth and no mechanism for organizational involvement. This quality improvement (QI) project aimed …

Reducing No-Shows In A Behavioral Health Setting: A Program Evaluation, Meagan Evans

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Mental healthcare in America faces many significant challenges; this is especially true in rural regions like Southwest Virginia. When patients miss their scheduled appointments, it represents a lost opportunity to deliver the critical mental health services that other individuals in need could have benefited from. A significant access issue presents itself when patients are not able to get the mental health support they need. The lack of outpatient access leads to patients utilizing emergency rooms inappropriately for what could have been routine care visits. A multitude of factors can contribute to patients failing to attend their scheduled appointments, including transportation …

Implementation Of An Advanced Practice Provider Into The Outpatient Neurology Clinic To Improve Access To Care And Medication Compliance, Sean O'Laughlin

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The American Association of Neurology (AAN) recommended that post-stroke and TIA patients receive follow-up care within 2–4 weeks of discharge to reduce complications, improve medication adherence, and decrease readmission rates (2023). However, in 2022, a Central Virginia neurology practice reported an average wait time of 98.66 days for outpatient follow-up appointments, significantly exceeding the AAN recommendation, while medication adherence was only 72.23%, compared to the national average of 80%. Research by the American Academy of Neurology Workforce Task Force (2013) and Woo et al. (2017) highlighted that incorporating advanced practice nurses into outpatient settings could enhance access to care and …

Naloxone Prescribing At Hospital Discharge: A Quality Improvement Initiative, Timothy Ford

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Opioid overdose deaths remain one of the largest public health challenges in the United States. Naloxone allocation is an important tool to help combat opioid overdose deaths. The literature supports that hospitalized patients are generally receptive to receiving naloxone and opioid education and interdisciplinary teams working together can help facilitate identification of high-risk patients for naloxone allocation. This quality improvement change, guided by the IHI Triple Aims and Model for Healthcare Improvement frameworks, sought to increase the rate of patients leaving the Hospital Medicine Service with naloxone. To accomplish this, during the target units’ daily interdisciplinary rounds, providers were prompted …

Implementation Of A Standardized Screening And Referral Process For Social Determinants Of Health For Families With Children Within Two Rural Health Clinics, Laura Britton Stace

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The American Academy of Pediatrics Bright Futures Guidelines recommends social determinants of health (SDOH) screening at well-child checks (WCCs). Social determinants of health are environmental factors, including food accessibility, mental health, and substance use, that can affect quality of life.

Rural health clinics (RHCs) in a county in Virginia did not routinely use a standardized screener to identify pediatric SDOH risks, nor did they have a standardized referral process for identifying SDOH risks. A hospital community needs assessment found that over 20% of the county households were below the federal poverty level. It is estimated that many children in …

Improving Immunization Rates In Children Under Two Years Of Age In Linn County, Kansas Through Nursing Education, Heather L. Webber

Doctor of Nursing Practice Scholarly Project

Immunizations are one of the most beneficial preventive health measures available to children under two years of age. Failing to receive these preventative immunizations during these crucial years could result in the child developing serious diseases that may lead to long term disability or even be fatal. By increasing immunization rates, children will be more protected against common childhood diseases which will allow them to grow and thrive. The purpose of this scholarly project was to identify ways to improve vaccination rates in children under two years of age at specific clinics in Linn County, Kansas, using healthcare professional education. …

Improving Nursing Deployment Readiness, George Mcenroe

Doctor of Nursing Practice (DNP) Projects

Improving Air Force Nursing Deployment Readiness

Abstract

Background. Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, mass casualty care, and military-specific skills.

Problem. Air Force nurses are required to maintain an annual Comprehensive Medical Readiness Program (CMRP) checklist, a list of clinical skills based on their nursing specialty. Assessing and maintaining deployment readiness is an ongoing challenge. The Air Force does not currently use any …

Evaluation Of Implementing Clinical Partnerships For Fourth Semester Bachelor Of Science In Nursing (Bsn) Students And Employers On Perception Of Readiness To Practice, Gwendolyn Kay Chrisenbery

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Gwendolyn K Chrisenbery MSN, APRN, FNP-C

Abstract

Today’s new graduate nurses are entering a complex and constantly evolving healthcare environment. Nursing education has not kept up with the changing environment, resulting in graduate nurses not being ready to practice at graduation. To better prepare graduate nurses for practice, education methods must evolve with the changing demands of healthcare (National Academies of Sciences, Engineering, and Medicine, 2021). Utilizing clinical partnerships between universities and healthcare facilities to provide clinical experience to Bachelor of Science in Nursing (BSN) students could provide opportunities for learning that better …

Understanding Anatomy & Physiology Students’ Knowledge And Perceptions Of Learning Sex And Pleasure, Yaileen Velazquez

Honors Capstones

Undergraduate anatomy & physiology (A&P) is an opportune place for future healthcare providers to learn a diversity of topics related to human health and function, including sexual health. However, the current undergraduate curriculum and instruction in A&P classes do not support students in achieving a high level of understanding of sexual health, including sexual anatomy and physiology. Previous studies have shown that college students obtain a mean score of lower than 65% in sexual knowledge tests, with the lowest mean scores on sections concerning sexual anatomy and sexually transmitted diseases (STDs) (Weinstein et al., 2008). Sexual pleasure is an important …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

¿Qué Futuro Les Espera A Los Trabajadores Latinos? El Calor Extremo, Las Promesas Vacías Y La Incertidumbre Política, Yunior Rivas Garcia

Capstones

Este artículo explora las condiciones mortales que enfrentan los trabajadores latinos en Estados Unidos debido al estrés por calor, un riesgo creciente en sectores esenciales como la construcción, la agricultura y el almacenamiento. A pesar de representar una proporción significativa de las muertes laborales, las protecciones contra el calor son insuficientes, y la falta de regulación federal agrava la vulnerabilidad de estos trabajadores, muchos de los cuales son indocumentados. A través de casos específicos, como la muerte de Esvin Cruz Mateo, y un análisis de las políticas laborales actuales, el texto examina las fallas estructurales que perpetúan la inseguridad laboral …

Stress Management Education Module For Nursing Students, Valentina Loreto-Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background. Stress refers to a state of mental tension caused by a difficult situation. Research indicates that stress negatively affects university students.

Problem. Researchers have found that 30% of undergraduate nursing students have symptoms of burnout resulting from an overaccumulation of stressors and 97.8% were at moderate risk for developing burnout.

Approach. An educational module consisting of a 15-minute YouTube videos was designed, developed, and implemented to increase awareness about stress, reduce feelings of anxiety, and identify integration potential of such a module in nursing education to promote student well-being. Participants completed an online survey before …

An Overview Of Japanese Kampo: An Integrative Approach To Medicine, Olivia Yaste

Honors College Theses

There is a growing interest in the use of traditional medicine for the treatment of disease and health conditions around the world. The traditional medicine system of Japan has been in place for thousands of years and the traditional herbal system, Kampo, has been fully integrated into the modern national healthcare system. The compilation of information on topics surrounding Kampo written in English is scattered, making it difficult to gain a broad understanding of the subject without immense time and effort. This paper aims to review the existing literature on a variety of topics surrounding Kampo in order to give …

Improving Compliance In Missed Visits Documentation, Ma Rosalie Felix

Master's Projects and Capstones

Problem: Within the South Bay Hospice Agency, documentation compliance for missed visits was 68% in the first quarter of 2024, when the national standard should be 100% according to the Centers for Medicare & Medicaid Services.

Context: Inadequate nurse documentation and communication between health professionals can lead to medical errors, poor team communication and suboptimal patient outcomes (Tasew et al., 2019). Therefore, the importance of documentation compliance is imperative. Hospice staff perform scheduled visits for terminally ill patients 1-2 times a week; however, a missed visit can occur when a patient declines it for a variety of reasons.

Interventions: The …

Interventions In Treating Ptsd As A Result Of Birth Trauma, Christine Marie Samatra-Montalvo

Master's Projects and Capstones

This paper explores the prevalence, causes, and consequences of PTSD resulting from childbirth, highlighting the need for effective intervention strategies. A systematic review of 25 studies encompassing cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), pharmacotherapy, and support groups was conducted to evaluate their effectiveness. Findings indicate that CBT and EMDR are the most promising treatments, with pharmacotherapy and support groups also providing substantial benefits. However, access to these interventions remains a challenge for certain populations. This paper underscores the importance of tailored, trauma-informed care and suggests that comprehensive maternal mental health programs can significantly improve outcomes for mothers …

Implementation Of A Daily Engagement System Board (Desb) To Improve Hospital Staff Communication, Catherine Villanueva

Master's Projects and Capstones

Implementation of a Quality Improvement (QI) project to help improve staff communication between shifts at an Inpatient Acute Psychiatric Unit was determined to be of immense need. This unit is part of a large acute medical hospital. Currently, the end of shift report consists of a verbal report along with a robust printed end of shift report consisting of shift related information. This printed end of shift report can have as many as seven to nine pages thus causing information overload and decreases prioritized patient information. Furthermore, missed information or too much information can be provided in the verbal shift …

Adolescent Suicide Prevention Techniques, Kaitlyn R. O’Malley

Honors Capstones

The purpose of this paper is to understand prevention techniques for adolescent suicide. Suicide is defined as death caused by injuring oneself with the intent to die. Suicide is the fourth leading cause of death among 15–29-year-olds (WHO). From 2021 to 2022, the number of suiciderelated deaths increased by 2.6%. 48,123 people died from suicide in 2021 alone. (CDC) From 2011-2021, 13% of high school girls tried to commit suicide, and 30% of them considered trying (Youth Risk Behavior Survey Data Summary and Trends Report: 2011–2021). Suicide is very preventable in society, which is why, with how many people try …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients, Alexandra Violeta Theodosopoulos

Master's Projects and Capstones

Objective: Cytotoxic chemotherapy places oncology patients at risk of complications such as mucosal barrier injuries (MBI) and aspiration pneumonia. Current literature supports the use of high-quality oral hygiene protocols to reduce the frequency and severity of these complications.

Aim: By end of fiscal year 2025, we will achieve a 0.2% reduction in incidences of aspiration pneumonia, from 1.5% to 1.3% of total patient discharges, among adult cancer patients in the oncology units. Methods: A survey was used to gather baseline oral hygiene compliance data on six acute care oncology units. Based on the results of the survey and discussions with …

Training Staff Members And Caregivers On Utilizing Allen Cognitive Levels To Aid Individuals Living With Alzheimer's And Dementia To Maintain Activities Of Daily Living, Kristy Boyd

Student Capstone Papers

This capstone is about training caregivers and staff members on utilizing the Allen Cognitive Levels to help individuals living with Alzheimer's and Dementia to maintain their ADLs.

Somethin' I'M Tryin' To Work On, Ian P. Summers

Capstones

A filmmaker tells the story of the night he nearly committed suicide. Traveling from his home in Brooklyn, Ian tells three of his closest friends, Drake, Alec and Matt, about how they unknowingly helped him through the most difficult time in his life.

https://www.youtube.com/watch?v=87iUM31s-Eg

Journey To Baby-Friendly: Standardizing Patient Breastfeeding Education In The Postpartum Microsystem, Emily Korwin

Master's Projects and Capstones

Problem Low breastfeeding rates remain a global challenge and a cause of adverse infant health outcomes despite the benefits of exclusive breastfeeding. In response, UNICEF and the WHO developed the Baby-Friendly Hospital Initiative (BFHI) to promote, protect, and support breastfeeding for infant growth and development. Context Hospital A is a mid-size hospital in Northern California. It has 24 labor, 13 antepartum, and 33 postpartum beds and serves a diverse population of patients. Intervention After a literature review, microsystem assessment, stakeholder survey, and root cause analysis, a standardized infant feeding nurse patient education checklist was developed and aligned with Baby-Friendly teaching …

Practicing Responses To Acute Clinical Troubles: Initiative Through Clinical Education (P.R.A.C.T.I.C.E.) To Improve Medical Emergency Response Increasing Nurse Confidence And Preparedness Through Low-Stakes Clinical Education, Lauren Castelblanco Rn, Viviana Lopez Rn, Nosa Odiase Rn, Everly Pompa Rn

Master's Projects and Capstones

A newly established pediatric outpatient infusion center in Los Angeles does not have immediate access to a Code Blue Team or a Rapid Response Team, and instead relies on the Staff Assist protocol to manage medical emergencies. Via direct interviews, registered nurses at the infusion center report feeling underprepared and lacking confidence to respond to medical emergencies that must be escalated to code blue. Microsystem assessment tools determined the root cause to be limited clinical exposure and limited opportunities for skills development. To address the nurses' concerns, Practicing Responses to Acute Clinical Troubles: Initiative through Clinical Education (P.R.A.C.T.I.C.E.) was implemented …

Journey To Baby-Friendly Designation: Standardizing Infant Feeding Education, Jasmine Geronimo Ibay

Master's Projects and Capstones

Problem The influence of formula companies in hospitals has caused a decrease in national breastfeeding rates, increasing risks of adverse health outcomes among infants. In response, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) in 1991 to support breastfeeding practices for infant development and eliminate commercial interests of formula companies from hospitals. Context The quality improvement (QI) project was conducted at Hospital A’s Birth Center, serving a diverse population of patients in the greater East Bay of Northern California. The microsystem has 24 labor beds, 13 antepartum beds, and 33 …

Chronic Disease Screening And Detection In Vulnerable Populations, Courtney J. Seman, Hussein Hadid, Tania Jaimes, Robert Walls

Master's Projects and Capstones

This quality improvement project aims to address gaps in chronic disease screening by implementing standardized protocols for diabetes, hypertension, vision impairment, and scoliosis within the University of San Francisco (USF) Nurse-Led Clinic in Orange County. Problem: The clinic identified a lack of screening practices, which limited early detection and intervention for two specific vulnerable populations. Context: The clinic serves two high-risk groups: older adults, including formerly homeless individuals, and children in two local grade schools. These populations face significant healthcare disparities, making early detection of chronic conditions critical. Interventions: Guided by Kotter’s Change Theory, the project developed and implemented evidence-based …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

Improving Performance And Documentation Of The Bedside Mobility Assessment Tool, Joseph P. Chellew

Master's Projects and Capstones

Objectives: Decreased patient mobility is associated with negative health outcomes including decreased functional capacity, pressure injuries, deep vein thrombosis, and bloodstream infections (Yasmeen et al., 2020). Early and increased mobilization mitigates these complications and is associated with positive outcomes (Wang et al., 2020). The Bedside Mobility Assessment Tool 2.0 (BMAT) is a mobility assessment that guides the selection of equipment to safely mobilize patients (Boynton et al., 2020). Aim: This quality improvement project aims to increase BMAT documentation compliance by 10% in three medical-surgical units at Hospital A where only 31.3% of patients were assessed per day using the BMAT. …

Increasing Access To Fresh Fruits And Vegetables At An Urban Clinic: A Quality Improvement Project, Jordan Michael Leahy

Master's Projects and Capstones

The microsystem setting for this quality improvement project is an adult health unit at one of five safety net clinics housed within a macrosystem in a large urban setting in Northern California serving a low-income, predominantly Hispanic population. Professionals involved in the delivery of the food security program include patient support services, medical assistants, case managers, health promoters, registered nurses, and providers. With enrollment in clinic’s food security program significantly lower than program goals, clinical site stakeholders sought to identify and address gaps in delivery. This quality improvement aimed to improve the screening process to increase the percentage of eligible …

Improving Mood Scores With Social Robot Dog ‘Pupper’ In Pediatric Cardiovascular Patients, Alyssa Lopez

Master's Projects and Capstones

Objective Pediatric hospitalization has been shown to increase the risk of developmental delays, social isolation, and mental health disorders. Consequently, decreased happiness also results from hospitalization, leading to reduced motivation and less engagement in their care. Aim The aim of this project is to improve the mood of pediatric patients aged 3-25 years by 50% from the patient’s baseline level within one month, from October 16, 2024 to November 13, 2024, on a pediatric cardiac step down unit by utilizing a social robot dog to motivate patients in engaging in their care. Methods Twelve participants between the ages 4-18 years …

Sleep To Heal: Creating A Quiet At Night Environment, Victor Marie V. Blardony

Master's Projects and Capstones

Problem: Noise in hospitals disrupts patient well-being, recovery, and satisfaction. A 120-bed community hospital in South San Francisco consistently scored below the national average for nighttime quietness (Medicare, 2023).

Context: Over six months, a multidisciplinary committee launched the Quiet at Night (QAN) Program, focusing on the high-acuity telemetry unit. The program utilized Kotter’s 8 Steps Model and the Institute for Healthcare Improvement Model for Improvement (MFI) to tackle nighttime noise issues.

Interventions: Quiet hours were established from 8:30 p.m. to 6:00 a.m. Patients were provided an “Enhanced Sleep Menu” that included a sleep sound machine and “sleep kits” (eye masks …