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Articles 1 - 30 of 64
Full-Text Articles in Nursing
Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo
Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo
Seton Hall University DNP Final Projects
The increased prevalence of opioid use in society has led to an increase in surgical patients with a history of such use. Patients who use or are addicted to opioids have different tolerances and responses to anesthesia than non-opioid users, and will require different care than non-users both pre- and post-operatively. The means to identify this population prior to a surgical procedure is needed as a way to organize, plan and manage patient care during the perioperative period. An Opioid Risk Assessment Tool (ORAT) was used as a way to streamline the process of identifying these patients. This paper addresses …
Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass
Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass
Master's Projects and Capstones
Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used …
A Quality Improvement Initiative To Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency, Barbara Chavez
A Quality Improvement Initiative To Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency, Barbara Chavez
Doctor of Nursing Practice
The purpose of this project was to improve hypertension (HTN) treatment adherence among limited English proficient Hispanic patients with uncontrolled HTN. Limited English Proficiency (LEP) significantly reduces HTN control among Hispanics by diminishing their understanding of HTN diagnosis, treatment adherence, and complications. A language sensitive education session focusing on antihypertensive medications, reduced sodium intake, and appointment keeping was implemented among LEP Hispanic patients 21 to 85 years of age, with uncontrolled HTN, receiving care at a federally funded south San Antonio clinic. The Hill-Bone Compliance to High Blood Pressure Therapy Scale was utilized to measure adherence in the following domains: …
Increasing Depression Screenings In Adults With Advanced Non-Surgical Heart Failure Using 2013 Accf/Aha Recommendations And Healthy People 2020 Target Goals, Valerie Valencia
Increasing Depression Screenings In Adults With Advanced Non-Surgical Heart Failure Using 2013 Accf/Aha Recommendations And Healthy People 2020 Target Goals, Valerie Valencia
Doctor of Nursing Practice
The purpose of this evidence-based practice project was to increase depression screenings in adults with non-surgical advanced heart failure using reliable and valid tools, 2013 American College of Cardiology Foundation/American Heart Association recommendations, and Healthy People 2020 Target Goals as a method to identify and facilitate appropriate mental health referral, patient education, and follow-up for depressive symptoms. Interventions took place June 5, 2017, through August 10, 2017. This intervention project involving 246 adults with advanced heart failure demonstrated that an evidence-based intervention for depression screenings increased the number of patients screened from 5% to 44%. At project completion, 65% of …
Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb
Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb
Doctor of Nursing Practice
The purpose of this evidenced-based quality improvement project is to implement processes to facilitate providers’ adherence to the American Diabetes Association (2017), American Association of Clinical Endocrinologist (2015), and American College of Endocrinology (2015) immunization guidelines for adults with type II diabetes. Presently, diabetes is the 7th leading cause of death in the United States contributing to serious complications throughout the body as a result of poor glucose control. Adults with diabetes are at increased susceptibility to infectious disease because of hyperglycemia, poor glucose control, and decreased immunity. A protocol was created using The Four Pillars Transformation Program ™ to …
Increasing Provider Awareness Of Patient Health Literacy Needs For Dental Screenings Among Patients With Diabetes In A Rural Health Clinic, Diana M. Solis
Increasing Provider Awareness Of Patient Health Literacy Needs For Dental Screenings Among Patients With Diabetes In A Rural Health Clinic, Diana M. Solis
Doctor of Nursing Practice
The purpose of this project was to increase provider awareness of health literacy needs for recommended dental screenings among patients with diabetes in a rural clinic setting. Over 35% of adults in the United States are considered to have low literacy levels (Agency for Healthcare Research and Quality, 2015). Low health literacy levels have an impact on patient outcomes due to decrease compliance with recommended treatment plans and preventive health screenings. Patients with diabetes have a trifold increase of developing oral infections such as periodontal disease, fungal infections, and xerostomia (Kudiyirickal & Pappachan, 2015). Healthcare providers acknowledging a patient’s health …
Interventions To Increase Diabetes Self-Management Education Referral And Attendance, Genevieve Talamantez
Interventions To Increase Diabetes Self-Management Education Referral And Attendance, Genevieve Talamantez
Doctor of Nursing Practice
Despite the proven benefits of diabetes self-management education (DSME), referral and attendance remains suboptimal. DSME has the ability to encourage self-care behavior, improve clinical outcomes, and improve quality of life in a cost-effective manner. The American Diabetes Association recommends that all people with diabetes receive DSME in order to facilitate the knowledge, skills, and ability necessary for diabetic self-care. The Office of Disease Prevention and Health Promotion, Healthy People 2020, set a national diabetic patient education attendance target goal of 62.5% for adults. The purpose of this quality improvement project is to increase referral and attendance to DSME in type-2 …
Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks
Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks
The Eleanor Mann School of Nursing Undergraduate Honors Theses
A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …
Improving Hpv Vaccination Series Initiation Rates And Compliance Among Indigent Women In South Texas, Ages 19-26, Through Provider Recommendation And Additional Clinic Funding: A Quality Improvement Project, Lacey Cudd
Doctor of Nursing Practice
The purpose of this quality improvement project was to increase human papillomavirus vaccination series initiation rates among indigent women, ages 19-26, at a clinic in South Texas. The human papillomavirus is a sexually transmitted infection that has been associated with multiple types of cancers. Each year, approximately 6.2 million cases of the human papillomavirus infection are diagnosed; as many as 75% of all new infections occur among females 18-26 years of age. The human papillomavirus vaccination has a high efficacy in regards to cancer prevention, preventing as many as 76% of cancers with only one dose. The project included educating …
Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson
Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson
Doctor of Nursing Practice
A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health …
Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie
Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie
Doctor of Nursing Practice
The use and misuse of opioid pain medication has reached epidemic proportions in the United States. More than 16,000 people die each year due to the misuse or abuse of prescription opioid medications, which is more than from heroin, cocaine, and benzodiazepines combined. The purpose of this evidence-based practice project is to establish processes enabling a primary care clinic to implement and adhere to the 2016 Centers for Disease Control’s guidelines for opioid prescription practices in the primary care setting. A retrospective chart review conducted prior to implementation of the guidelines demonstrated that four of six of the CDC’s recommendations …
A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker
A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker
Doctor of Nursing Practice
The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke, and vascular …
Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman
Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman
Electronic Theses and Dissertations
With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …
Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger
Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger
Seton Hall University Dissertations and Theses (ETDs)
There is a need to understand the roles coping strategies play in enhancing resilience in adolescents and young adults with type 1 diabetes between the ages of 18-30. The purpose of this study was to examine the relationships between and among positive, protective coping strategies (courageous coping), negative coping strategies (defensive coping), and resilience. The Resilience in Illness Model (Haase, Kinter, Monahan, & Robb, 2014) was the theoretical model which guided this research.
A convenience sample was recruited via diabetes organizations’ Facebook and Forum pages, a College Diabetes Network chapter meeting, and Juvenile Diabetes Research Foundations’ (JDRF) sponsored events. Data …
Newborn Kangaroo Care Immediately After Cesarean Birth, Sarah Abdolcader
Newborn Kangaroo Care Immediately After Cesarean Birth, Sarah Abdolcader
Master's Projects and Capstones
Newborn Kangaroo Care Immediately after Cesarean Birth
Sarah Abdolcader
Global Aim: Improve exclusive breastfeeding rates from 76% to 80% in the Perinatal Unit during the newborn’s hospital admission by February 2018.
Project Aim: Improve the percentage of mother/baby skin-to-skin (kangaroo holding) from a baseline of 55% to 65% by August 2017.
Setting: Perinatal Units
Participants: Newborns birthed via cesarean section
Evidence: According to the World Health Organization (2003), hospitals should have a goal of >80% exclusive breastfeeding rates for all newborns during their acute hospital stay and it begins with skin-to-skin contact (SSC), newborn’s bare chest placed on mom’s bare …
Lyme Disease, Sondra Mcfadden
Lyme Disease, Sondra Mcfadden
Nursing Student Class Projects (Formerly MSN)
Lyme disease is caused by the spirochete Borrelia burgdorferi and is a bacterial infectious disease that is spread by zoonotic transmission in which animals act as reservoir hosts and ticks are the primary vector or carrier and are considered arthropods. This poster presents Lyme disease, its pathophysiology, and nursing considerations for treating it.
Group A Strep (Gas), Kimberly Hyatt
Group A Strep (Gas), Kimberly Hyatt
Nursing Student Class Projects (Formerly MSN)
Abstract
Group A Streptococcal (GAS) bacteria is a common but potent pathogen. GAS is the most common cause of pharyngitis in the world and can be easily treated with the right antibiotic. Left untreated or undertreated, however, GAS is the ninth leading cause of infectious disease mortality, worldwide. Lethality from a GAS infection is 10-30%. The virulence factors of GAS are responsible for the short and long term havoc it wreaks on an individual, and the incredible disease burden of 18.1 million severe cases of GAS, annually, around the globe. In the U.S., each year, GAS pharyngitis, alone, costs $500 …
Asthma Chronic Obstructive Pulmonary Disease Overlap Syndrome, Kimberly A. Babich-Speck
Asthma Chronic Obstructive Pulmonary Disease Overlap Syndrome, Kimberly A. Babich-Speck
Nursing Student Class Projects (Formerly MSN)
Asthma and COPD often have symptoms that overlap. The area of overlap is known as asthma COPD overlap syndrome.
Angioedema: Ace-Inhibitors Adverse Reaction, Jesse Vandyne
Angioedema: Ace-Inhibitors Adverse Reaction, Jesse Vandyne
Nursing Student Class Projects (Formerly MSN)
This is a poster presentation about angioedema caused by Angiotensin-converting enzyme (ACEI or ACE Inhibitors). Angiotensin-converting enzyme inhibitor (ACEI) medications are one of the leading causes of angioedema in the United States, also known as ACEI-RA (Chan & Soliman, 2015, p. 207). ACE inhibitors are among the most commonly prescribed medications worldwide because they are indicated for the management of hypertension, congestive heart failure, myocardial infarction, diabetic nephropathy, and chronic kidney disease (Chan & Soliman, 2015, p. 207).
Primary Hypertension, Leslie Mcchesney
Primary Hypertension, Leslie Mcchesney
Nursing Student Class Projects (Formerly MSN)
The intent of this poster is to provide an understanding of the pathophysiology of primary hypertension and its impact on nursing. This is a disease affecting millions of Americans daily and with proper understanding of the disease process, diagnosis and management can be initiated early before life altering consequences impact the patient.
Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James
Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James
Doctor of Nursing Practice Final Manuscripts
Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.
Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …
Prevalence Of Binge Eating Disorder In An Insurance-Based Weight Management Center, Kimberly M. Kittleson Dnp, Fnp, Karen Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc
Prevalence Of Binge Eating Disorder In An Insurance-Based Weight Management Center, Kimberly M. Kittleson Dnp, Fnp, Karen Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc
Doctor of Nursing Practice Final Manuscripts
Purpose: This project was anticipated to demonstrate an increase in the number of those diagnosed with BED according to Diagnostic and Statistical Manual (DSM) 5 criteria, diagnosed with ICD-10 code F50.8 or R63.2 and treated according to best practice guidelines.
Background: Binge eating disorder (BED) is the most common eating disorder in the United States, more than both anorexia and bulimia combined. It affects 3.5 percent of women, 2 percent of men and 30 percent of those seeking weight management.
Design: This evidenced-based project consisted of a retrospective analysis of 150 patients seen in a weight management …
Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt
Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt
Doctor of Nursing Practice Final Manuscripts
The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam …
Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)
Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)
Doctor of Nursing Practice Final Manuscripts
Background
Veterans are disproportionately affected by chronic pain. Conventional pain management lacks emphasis on self-care and relies heavily on prescription opioids. Primary care providers (PCP) are able to educate veterans on self-care management; however, frequent follow-up is needed to improve overall pain and quality of life.
Objective
To implement a Nurse Practitioner (NP) telephone follow-up guided by the 5A’s framework among veterans with chronic pain in a primary care setting. This pilot evidence-based project (EBP) aimed to improve follow-up of self-care management in order to decrease pain, increase quality of life, and decrease pain medication use.
Materials & Methods
The …
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidenced-based project was to increase chlamydia pre- screening and screening in women under age 25 presenting with urinary symptoms. Interventions included chlamydia pre-screening alerts embedded into the electronic medical record. Three-month evaluation showed a chlamydia pre-screening rate of 100% and an increase in chlamydia screening by 9%.
Evaluating An Employee Health Tobacco Cessation Program For Enhanced Success, Leah Griffiths, Kathy S. James
Evaluating An Employee Health Tobacco Cessation Program For Enhanced Success, Leah Griffiths, Kathy S. James
Doctor of Nursing Practice Final Manuscripts
Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated …
Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano
Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano
Doctor of Nursing Practice (DNP) Projects
Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …
Promotion Of Advance Care Planning For Individuals Experiencing Homelessness, Sarah A. Hubbell
Promotion Of Advance Care Planning For Individuals Experiencing Homelessness, Sarah A. Hubbell
Doctor of Nursing Practice (DNP) Projects
Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice …
I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam
I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam
Master's Projects and Capstones
The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …
Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas
Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas
Master's Projects and Capstones
Bedside shift report is a complex process, which involves the transition of care from one clinician to another. The Agency for Healthcare Research and Quality (AHRQ) (2013) reported that approximately 70% of patient adverse events are attributed to communication failures between healthcare providers. Nurses remain inconsistent with information sharing during bedside shift report leading to communication gaps. The object of the clinical nurse leader (CNL) internship project is to provide true patient-centered by standardizing bedside shift report by implementing a nursing report sheet and addressing patient needs. The project was conducted in a level-one trauma center in San Diego, CA …