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Articles 1 - 18 of 18
Full-Text Articles in Medicine and Health Sciences
Primary Stroke Prevention: 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A (Hmg-Coa) Reductase Inhibitor (Statin) Use In The Diabetic Patient, Amy L. Hatcher
Primary Stroke Prevention: 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A (Hmg-Coa) Reductase Inhibitor (Statin) Use In The Diabetic Patient, Amy L. Hatcher
DNP Projects
Purpose: The primary objective for this retrospective chart review was to evaluate provider adherence to the 2011 AHA/ASA Primary Stroke Prevention guideline of prescribing a statin to all diabetic patients for primary prevention of stroke, regardless of dyslipidemia. A second aim of this study is to identify provider facilitators and barriers to prescribing a statin therapy for primary prevention.
Methods: Using a retrospective study design, a random sample of 100 medical records of diabetic patients presenting to a university women’s health clinic within the previous year were reviewed for statin use and rationale.
Results: Of the 100 diabetic patients sampled, …
Assessing Pediatric Nurses' Knowledge And Comfort Level With Recognition And Reporting Of Child Abuse, Andrea Sebastian
Assessing Pediatric Nurses' Knowledge And Comfort Level With Recognition And Reporting Of Child Abuse, Andrea Sebastian
DNP Projects
Child abuse is a serious, yet preventable problem in the United States. Child abuse is defined in The Child Abuse Prevention and Treatment Act as “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or an act or failure to act, which presents an imminent risk of serious harm” (United States Department of Health and Human Services [USDHHS], Children’s Bureau, Child Maltreatment 2009, 2010).
In 2010, there were an estimated 3.3 million referrals to Child Protective Services for the suspected abuse …
Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald
Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald
DNP Projects
Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …
Role Of The "Tobacco Free Teens" Mobile Application In Adolescent Smoking, Juawanna L. Schuller
Role Of The "Tobacco Free Teens" Mobile Application In Adolescent Smoking, Juawanna L. Schuller
DNP Projects
Adolescent tobacco use rates have plateaued. Tobacco use education is not mandatory in all states, yet schools remain a good opportunity to reach this population. School nurses should be able to identify components of effective tobacco use prevention education programs and learn to overcome barriers to implementation of these programs. The "Tobacco Free Teens" mobile application is a novel tool that may decrease adolescent tobacco use rates. A pilot study found that the Tobacco Free Teens mobile application was satisfactory to most participants but appealed to girls more than boys. Further research is needed to determine the effectiveness of this …
Emergency Nurses' Knowledge Of Pediatric Complaints, Kari J. Blackburn
Emergency Nurses' Knowledge Of Pediatric Complaints, Kari J. Blackburn
DNP Projects
Each year there are more than 25 million pediatric emergency department (ED) visits, with 37-60% of the complaints being non-urgent (Brosseau, Hoffman, Nattinger, Flores, Zhang and Gorelick, 2007). Injury is the number one reason children present to the ED and is strongly associated with a complaint of pain (AHRQ, 2013). While pain is a high volume reason for visiting the ED, there are other presentation causes that may pose a high risk to pediatric patients. Nausea and vomiting is not typically viewed as a high risk complaint, yet there are some high risk etiologies resulting in nausea and vomiting that …
Final Dnp Capstone Report: Improving Adolescent Hpv Vaccination Rates, Jessica L. Murray
Final Dnp Capstone Report: Improving Adolescent Hpv Vaccination Rates, Jessica L. Murray
DNP Projects
Background: Human papillomavirus (HPV) vaccines have been shown to be effective against HPV types that are linked to cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. Despite Advisory Committee on Immunization Practices (ACIP) recommendations that all 11-12 year old males and females in the U.S. should be vaccinated with the three-dose HPV vaccine series, vaccination rates remain low. In 2012, only 34.9% of adolescent females and 6.8% of adolescent males completed the series. Efforts to increase vaccination rates are needed, and healthcare providers have been shown to be an important part of the solution.
Purpose: This investigation was conducted to …
Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement
Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement
DNP Projects
Background: Pediatric obesity has reached epidemic levels in the United States and the burden of early identification and prevention lies with Primary Care Providers. With this burden comes the responsibility of increased documentation in order for patients to obtain the appropriate counseling, treatment, and referrals.
Objective: The objective of this study is to identify missed opportunities to identify pediatric patients that meet the criteria for overweight or obesity during well-child visits within a primary care practice.
Method: A retrospective chart review of 100 randomly selected patients born between 9/1/2001 and 9/1/2010 that have received a well-child visit between 1/1/2010 and …
Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis
Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis
DNP Projects
Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.
Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …
Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani
Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani
DNP Projects
Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.
Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.
Results: All surveyed providers were aware and …
Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser
Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser
DNP Projects
CAPSTONE INTRODUCTION
Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.
Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …
Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman
Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman
DNP Projects
This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …
Evidence-Based Blood Conservation Education For Icu Nurses: A Pre And Post-Test Evaluation Of Nursing Knowledge, Stefanie M. Bull
Evidence-Based Blood Conservation Education For Icu Nurses: A Pre And Post-Test Evaluation Of Nursing Knowledge, Stefanie M. Bull
DNP Projects
Purpose: The purpose of this evidence-based education project was (i) to evaluate baseline nursing knowledge of anemia, blood conservation and transfusion medicine, (ii) to identify current blood conservation practice and the nurse’s prior exposure to blood conservation education (iii) to determine the potential impact of evidence-based education on nursing knowledge, and (iv) to determine the impact of education on the nurse’s attitudes towards future implementation of blood conservation practices based on the nurse’s self report.
Setting: The project was implemented in the Cardiovascular and Thoracic ICU (CVICU) at an 875-bed level-1 Trauma and Multi-Organ Transplant Center located in central Kentucky. …
Tobacco Treatment In College Students, Teresa H. Huber
Tobacco Treatment In College Students, Teresa H. Huber
DNP Projects
This study was conducted in a southeastern University to determine tobacco use status in a population of university students, student intention to quit, treatment options, use of student health service, and student’s degree of support of a tobacco-free policy. A major implication for practice is the need for college health providers to screen all students utilizing the USPHS Guidelines, as even light smokers may be vulnerable to nicotine addiction. However, the study found that a high proportion of the smokers were nondaily smokers who do not consider themselves as smokers and the vast majority of those were undergraduates. Thus, college …
Post-Laminectomy Back Pain: Understanding The Progress From Acute To Chronic Pain State, James Derek Calhoun
Post-Laminectomy Back Pain: Understanding The Progress From Acute To Chronic Pain State, James Derek Calhoun
DNP Projects
In the United States, 74.6% of patients who have lumbar laminectomy surgery have residual low back pain (Hussain & Erdek, 2014) and overall costs of low back pain may reach up to $200 billion per year (Carey & Frebuger 2013). To further address this problem, a study was conducted to determine if treatment in a chronic pain clinic could result in a reduction in the development of a chronic pain state for adult patients who have had lumbar laminectomy surgeries. A convenience sample of 50 patients was selected from the Interventional Pain Associates clinic at the University of Kentucky. Records …
Assessing Provider Knowledge And Attitude Towards Animal-Assisted Therapy As A Complementary Treatment For Children, Shannon Leigh Million
Assessing Provider Knowledge And Attitude Towards Animal-Assisted Therapy As A Complementary Treatment For Children, Shannon Leigh Million
DNP Projects
Objective: The purpose of this project was to determine knowledge and attitudes of pediatric primary care providers working in a university outpatient clinic settings towards the use of animal-assisted therapy as a complementary treatment for children. This report also includes an integrative review of animal-assisted therapy in pediatric populations and a clinical practice guideline analysis regarding the use of equine facilitated learning with high risk children and adolescents in residential psychiatric treatment.
Methods: A survey tool was administered to the Department of Pediatrics at UK Healthcare.
Results: There were 41 respondents to the survey, 36 of which …
Trauma Resuscitation Team Program Evaluation, Lisa J. Fryman
Trauma Resuscitation Team Program Evaluation, Lisa J. Fryman
DNP Projects
To evaluate the effectiveness of a newly implemented charge nurse-led trauma resuscitation team approach in the Trauma Intensive Care Unit (TICU). The approach was developed to improve patient throughput efficiency at a Level 1 Trauma Center. Measures of effectiveness include patient throughput efficiency, patient clinical outcomes, and financial impact. The implementation of the charge nurse-led trauma resuscitation team showed an improvement in efficiency of patient throughput without adversely affecting patient outcomes, and opening up critical resources for the next patient that arrives.
Screening For Sepsis: A Key Strategy For Early Identification And Management Of Septic Patients, Amy P. Fisher
Screening For Sepsis: A Key Strategy For Early Identification And Management Of Septic Patients, Amy P. Fisher
DNP Projects
Background: Sepsis, defined as a systemic inflammatory response to infection, is a life-threatening medical condition that rapidly progresses from severe sepsis (characterized by signs of organ dysfunction) to septic shock with fluid-refractory hypotension. Adherence to the Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock have been associated with improved delivery of care and reduced mortality. Delays in recognition of sepsis has been identified as a barrier to achieving early goal-directed therapy targets.
Purpose: To determine if a sepsis screening protocol could facilitate earlier identification of patients with sepsis
Methods: A retrospective medical record review was …
Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus
DNP Projects
Abstract
Objectives:
- Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
- Determine which HF population characteristics are significantly associated with readmissions to the hospital.
- Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.
Design: Retrospective chart review.
Setting: Regional acute care facility in Central Kentucky.
Participants: All patients (n = 175) with a diagnosis or history …