Medicine and Health Sciences Commons^™

Maintaining The Vision In The Intensive Care Unit, Camille Leadingham

Doctor of Nursing Practice Program Projects

Background: Intensive care patients receiving mechanical ventilation have an increased chance for eye complications due to the inability to operate their own protective mechanisms resulting in dry eye.

Purpose: Develop and test an eye care protocol utilizing the evidence to prevent dry eye.

Method: In phase 1 retrospective data was collected on sedated and mechanically ventilated patients in the ICU (n=30) to determine baseline eye care practices and outcomes. Then the DEPP was developed based on the evidence. Finally data were collected prospectively (n=30) in the same patient population.

Results: From Phase 1 to Phase 2, eye crust cases diminished …

Nurses Perceptions Of Shared Governance Two Years Post Implementation Of A Councilor Shared Governance Model, Kathleen L. Wilson

Doctor of Nursing Practice Program Projects

Participation in shared governance councils can provide nurses with an opportunity for input into organizational policies that influence quality health care outcomes. Nurse leaders are diligently seeking a practice model that has a foundation of engagement of staff in decision making, quality outcomes, competency, evidence-based practice, shared power and job satisfaction. With the Patient Protection and Affordable Care Act (PPACA) of 2010, health care systems can expect an influx of some 30 million more patients (Pfeifer, 2013). In addition, mandated purchase of health care insurance will replace the fee for service model with one that ties payment to outcomes and …

Self-Care Of Heart Failure In A House Call Program, Becky Bryant

Doctor of Nursing Practice Program Projects

The incidence and prevalence of persons living with heart failure (HF) is growing in the United States. Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care of heart failure (SCHF) has been reported to decrease HF hospital admission rates. Elderly patients who are homebound do not have access to typical HF education and follow-up care. The purpose of this evidence-based practice (EBP) project was to implement a SCHF program intervention by nurse practitioners (NPs) with homebound elderly HF patients receiving home visits in a house call program. There were 18 sample …

Implementation Of A Total Knee Arthroplasty Evidence Based Practice Guideline Quality Improvement Project In A Va Orthopedic Surgical Setting To Reduce Surgical Infections, Paula A. Kimpton

Doctor of Nursing Practice Program Projects

The prevention of surgical site infections, specifically orthopedic surgery cases, has been cited as the most preventable source for morbidity and mortality for patients undergoing total knee arthroplasties (TKA). In the most recent Veteran Affairs (VA) National Surgery Office Quarterly Report (July 1, 2012 through June 30, 2013), a problem with surgical site infections was identified in patients with TKA surgery at Dayton Veterans Affairs Medical Center (VAMC). The Dayton VAMC had a 5.3% TKA surgical infection rate versus 1.3% nationally.

The purpose of this quality improvement project was to decrease post-operative TKA infection rates with utilization of evidence based …

The Impact Of Implementation Of An Evidence-Based Practice Model In A Long Term Acute Care Hospital, Michele L. Marshall

Doctor of Nursing Practice Program Projects

Inadequate and delayed implementation of current evidence into practice has contributed to medical errors, safety issues and patient deaths. The Institute of Medicine (IOM) has challenged the healthcare profession to achieve 90% of integration of current evidence into practice by 2020. The purpose of this doctoral project was to implement an evidence-based practice (EBP) model in a long-term acute care hospital as they began their journey in pursuit of Magnet recognition. Implementation of an EBP model, the Advancing Research and Clinical practice through close Collaboration (ARCC) model, involved conducting an initial organizational assessment of staff to understand the staff’s beliefs, …

Larckit: A Toolkit To Increase Prescribing Of Long Acting Contraceptives To Adolescent And Young Women In A Public Health Setting, Eva M. Fried

Doctor of Nursing Practice Program Projects

In an urban, publicly funded women’s health and family planning clinic, 56% of pregnancies were reported to be unintended. The clinic director decided to address this problem by focusing on providers’ contraceptive prescribing habits; especially contraceptive prescribing for women aged 15-25. The purpose of the evidence-based practice improvement (EBPI) project was to increase provider disclosure about longer-acting reversible contraception (intrauterine and implantable methods known as “LARC” methods). The goal of the EBPI project was to increase the percentage of contraceptive prescriptions that are LARC methods for women aged 15-25 years. The clinical question guiding the EBPI project was “Among healthcare …

Improvement Of Standardized Documentation Of Patients With Copd In An Acute Care Setting, Kimberly Biery

Doctor of Nursing Practice Program Projects

The purpose of this project was to improve patient clinical outcomes of average length of stay, mortality rate, and readmission within 30 days by increasing health care provider order set usage and documentation as it relates to patients with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Epic ™ computer based clinical documentation by healthcare providers at The Christ Hospital (TCH) was inconsistent. The PICOT question developed was: in the COPD population of an acute care hospital, how does standardized electronic COPD process measure documentation and order set usage compared to no COPD process measure documentation and order set …

The Effect Of An Early Mobility Protocol In Critically Ill Mechanically Ventilated Patients On Incidence And Duration Of Delirium And Length Of Stay, Melody R. Campbell

Doctor of Nursing Practice Program Projects

Delirium in mechanically ventilated patients is a significant problem. At Good Samaritan Hospital, the incidence of delirium in mechanically ventilated patients was found to be 78%, which is similar to results found by other researchers. Delirium is associated with longer lengths of stay on the mechanical ventilator, in the ICU, and hospital, as well as higher ICU mortality and healthcare costs.

The use of an early mobility protocol has demonstrated effectiveness in decreasing delirium and ventilator stay with minimal risk or harm to patients. The objective of the project was to answer a population-intervention-comparison-outcome-time question (PICOT): In (P) critically ill, …

An Evaluation Of The Chronic Disease Self-Management Program, Joan Sevy Majers

Doctor of Nursing Practice Program Projects

The prevalence and costs of chronic disease continue to escalate with the aging of the population and continued advancements in medical care. Self-management of chronic disease may be an alternative approach to care that could assist in moving away from a disease-oriented model to health-oriented one. Outcomes from chronic disease self-management programs are promising but inconsistent across disease entities and populations. Among the Veteran population, chronic disease self-management programs have been implemented in a number of Veteran Affairs facilities. The purpose of this project was to evaluate specific outcomes from the chronic disease self-management program conducted in the five medical …