Nursing Commons^™

Increasing The Utilization Of A Cardiovascular Risk Assessment & Screening Tool Through Education In A Primary Care Setting: A Quality Improvement Project, Taylor A. Massey

DNP Projects

Background and Significance: The World Health Organization (WHO) (2021) reports that 55.4 million people died worldwide in 2019; cardiovascular diseases due to ischemic heart disease and stroke were the top two leading causes of these deaths. Experts predict that by the year 2030, more than 22.2 million people will die annually from cardiovascular disease (Ruan et al., 2018). Noninvasive cardiovascular screening tests, such as the "Pulse4Pulse" screening tool, are a way to help providers identify patients at high-risk for cardiovascular disease and initiate treatment to reduce future risk.

Purpose: To increase provider utilization of the "Pulse4Pulse" screening test in a …

Implementation Of 3-Minute Diabetic Foot Exam For At Risk Diabetic Patients In Urban Primary Care Setting, Suzana Alvarez

DNP Projects

Background: Healthcare providers manage chronic health concerns by reducing the risk of diabetic complications among their patient population. In 2017, diabetes was the seventh leading cause of death in the United States and Connecticut. In Connecticut, there are 19,500 newly diagnosed diabetics and four Connecticut cities have higher occurrence of diabetes: Waterbury, New Britain, Hartford, and Bridgeport. Bridgeport Primary Care (BPC) had no policy or procedure in place to require the providers to complete a routine diabetic foot exam. The aim of this project was to promote and implement a tool to assist the BPC providers in evaluating adult …

Increasing Awareness Of Hereditary Fructose Intolerance: An Evidence-Based Practice Implementation Project, Jacqueline M. Bridge

DNP Projects

Background: Hereditary Fructose Intolerance (HFI) is an inborn error of metabolism which results in the absence of an effective Aldolase B enzyme. Without this enzyme, ingestion of fructose and metabolic precursors leads to acute illness, multiorgan damage, and possible death. The increased presence of these sugars results in earlier onset of symptoms and more difficulty for those with HFI.

Purpose: The project’s aim is to increase awareness of HFI in healthcare providers using a learning module and assessments of knowledge at three different points in time.

Methods: The IOWA model for evidence-based practice projects was applied during the development and …

How The Practice/Academic Partnership Model Helped One State During Covid-19, Mary E. Dietmann, Audrey M. Beauvais, Beth P. Beckman, Marianne Snyder, Cheryl-Ann Resha, Lisa Rebeschi, Pamela Forte

Nursing Faculty Publications

During the spring and summer of 2020, boards of nursing (BONs) throughout the U.S. were faced with requests from educational programs for ways to replace clinical hours due to the inability to access clinical sites caused by the COVID-19 pandemic. While many clinical sites have since reopened to nursing students, some barriers still remain, resulting in a backlog of clinical hours for many nursing students throughout the state of Connecticut. Reflecting on lessons learned over the past year, collaboration between the BON and nursing leaders throughout the state has proved essential to providing the practice hours and clinical learning experiences …

Identifying And Co-Managing The Hiv-Infected Adult: A Guidebook For Primary Care Clinicians, Jason Leider, Susan F. Lelacheur, Julie G. Stewart Dnp, Mph

Nursing Faculty Publications

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART).

Hiv: Make The Diagnosis And Take The Next Step, Julie G. Stewart, Amy R. Weinberg

Nursing Faculty Publications

With the CDC urging screening for all willing patients, providers will be testing and managing a growing number of HIV-positive individuals.

The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV-and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection …

Impact Of An Adherence Program On The Health And Outlook Of Hiv-Infected Patients Failing Antiretroviral Therapy, Michael F. Parry, Pamela Wright, Julie G. Stewart, Gavin Mcleod, James Tucker, Amy R. Weinberg

Nursing Faculty Publications

Background: We prospectively studied the impact of an adherence counselor on the outcome of patients failing antiretroviral therapy because of nonadherence. Methods: Forty-six patients, identified as chronically nonadherent were enrolled. Individual attention was provided using the information, motivation and behavioral methodology. HIV RNA (viral load, in copies/mL), CD4 count (in cells/[mm.sup.3]), and body weight before and after the adherence counselor were measured. Qualitative outcome and patient satisfaction were assessed by deidentified third-party interviews. Results: Over half completed at least 1 year; only 8 patients were lost to follow-up. Mean CD4 counts increased significantly (P < .05) for completers at 6 and 12 months. Viral loads decreased between baseline and 6 months. Most clients reported subjective benefit from working with the adherence counselor. Conclusion: Although few clients showed complete virologic suppression, the value of an adherence counselor was validated. Longer term adherence programs should be evaluated.

Collaborative Management Of Hiv Infection In The Community: An Effort To Improve The Quality Of Hiv Care, Michael F. Parry, Julie G. Stewart, P. Wright, Gavin X. Mcleod

Nursing Faculty Publications

Our hospital led a multidisciplinary community team to improve the quality of care delivered to HIV-infected clients utilizing a disease management approach in a US metropolitan community of 150,000 people. Community needs assessment and client and community surveys were used to define the problems. Patient care flowcharting and the creation of an electronic patient database facilitated patient tracking across the entire community. Clinical guidelines and a consultation and referral immunology clinic standardized care practices. Measurable improvements in the quality of care were noted in multiple areas. Flowchart completion rates rose from 44% to 100%; medication adherence assessment rose from 82% …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …