Nursing Commons^™

A Digitally Enhanced Virtual Cognitive Behavior Skill Building Intervention To Reduce Parent Stress And Family Obesogenic Behaviors, Sharlene Smith

Electronic Theses and Dissertations, 2020-2023

Parental stress is associated with increased obesogenic family lifestyle behaviors contributing to childhood obesity. Novel interventions are needed to reduce parental stress and improve healthy lifestyle behaviors for preschool-age children and families. The primary study aim was to analyze preliminary effects of a digitally enhanced evidence-based cognitive- behavior skill-building (CBSB) intervention on parental stress and healthy lifestyle behaviors (diet and physical activity) among parents of preschool-age children. A secondary aim was to evaluate feasibility/acceptability of this school-based virtual intervention during the COVID-19 pandemic. The 12-week intervention involved text messaging and three pre-recorded CBSB educational video presentations accessed by parents of …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …

The Impact Of Utilizing The Eat, Sleep, Console Model On Pharmacologic Interventions And Length Of Stay, Kareena Parks

Master's Projects

Purpose: This systematic review seeks to explore whether utilizing Eat, Sleep, Console (ESC) over the Finnegan Neonatal Abstinence Scale (FNASS) in the neonatal abstinence syndrome (NAS) population decreases length of stay or pharmacological interventions.
Method: Systematic literature review utilizing CINAHL, PubMed and Google Scholar databases.
Results: Utilizing Eat Sleep Console, over FNASS decreased length of stay and pharmacologic intervention.
Conclusions: There is compelling research suggesting a change in NAS treatment from FNASS to ESC with a decrease in length of stay and pharmacologic intervention. However, there is an opportunity for further studies providing higher levels of evidence as the current …

Exploring The Effects Of Different Types Of Diets On Preventing And Managing Diabetes Mellitus Type 2, Ma. Patricia Diorel Peig

Nursing | Senior Theses

Diabetes is a major health problem that is becoming an epidemic in major countries of the world. Diabetes can affect people of all ages and of all races. However, there is a higher risk of developing diabetes for certain groups of people. As of today, there is still no cure for diabetes. The treatment plan for patients diagnosed with diabetes is to control the level of blood glucose through different interventions. The progression of diabetes is influenced by food behaviors, and diet control is an important aspect of management of this disease. There are different types of diet recommended that …

Using Family Focused-Care Solutions To Improve Child’S Quality Of Life, Joshua M. Del Sol

Nursing | Senior Theses

Chronic illness in children impacts not only themselves but their families too. Everyone in the family supports each other and provides each other with pretty much all our physiological needs including our emotional needs. Parents/caregivers are the role models for their young children and really shape the person they become because basic values and their early relationships are formed. A family provides that consistent balance in our life that is the center of our life at a young age. When children are diagnosed with a chronic illness, parents may feel responsible, ashamed, guilty, or angry. Families may turn on each …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Student Research Posters

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

Chronic Atopic Dermatitis: Symptom Management Using Moisturizers Among Asian American Pediatrics, Ethan J. Brillantes

Nursing | Student Research Posters

Background: Atopic Dermatitis (AD), also commonly known as eczema, affects 31.6 million (10%) of the United States Population, with 13% being Asian American or Pacific Islander. A cure is not present for AD; however, the best way to treat AD is with symptom management. While there are many pharmacological treatments that aid with symptom management such as topical or oral corticosteroids, there are also non pharmacological treatments such as moisturizers that can aid with symptom relief of AD as well. Objective: The literature review explores moisturizer use and other non pharmacological methods for symptom management of AD and provides understanding …

Strengthening New Hampshire’S Primary Care Workforce Pipeline: Utilization Of Alternative Scheduling Models, Elizabeth Harrison

DNP Scholarly Projects

Abstract

BACKGROUND: Traditional clinical scheduling coupled with the current reimbursement system have created systematic barriers leading to decreased clinical education opportunities. Alternative scheduling models such as longitudinal integrated clerkships, one preceptor to two students and wave scheduling have the potential to eliminate these barriers and provide financial gains and increased access to care.

INTERVENTION: Interventions to meet this quality improvement project's objectives included (1) pre-intervention planning (2) focus groups, (3) video presentations and (4) a pilot program of alternative scheduling models in clinical practice.

RESULTS: A pilot program utilizing the alternative scheduling models increased the relative value units (RVU) of …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Implementation Of Point-Of-Care Tick-Borne Disease Powerplan™ And Algorithm For Early Detection And Treatment Of Tick-Borne Diseases, Ashley Pinkham

DNP Scholarly Projects

Abstract

Local Problem: The Concord Hospital system, serving 30+ communities, is situated in the heart of New Hampshire surrounded by densely wooded forests, lakes, and mountains and is a mecca for camping, vacationing, and sightseeing, doubling its population of 1.6 million residents during spring, summer, and fall months. Despite the serenity, there is a predator that lingers among the hiking trails and lake shorelines. From January 2021 through August 2022 there were a total of 41 hospitalizations from tick-borne diseases, some with life threatening symptoms. Unfortunately, nearly half (43%) of patients presented to their primary care provider first where the …

Cabg Vs. Pci: Greater Outcomes For Severe Coronary Artery Disease, Haejin Cho

Master's Projects

Coronary artery disease is the leading cause of mortality in the United States. The lifetime probability of developing coronary artery disease after 40 is 40% in men and 32% in women. Cardiac revascularization for patients with complex coronary artery disease is performed commonly. Two common procedures for cardiac revascularization are coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this systemic review is to compare long-term outcomes of CABG and PCI in patients with severe artery disease. This review concluded that PCI was associated with higher rate of repeat revascularization compared to CABG, but the incidence …

Efficacy Of Gabapentin Versus Benzodiazepines In The Management Of Alcohol Withdrawal Syndrome, Douglas R. Fredona

Master's Projects

Alcohol abuse, complicated by a dependency relationship, is the third leading modifiable cause of death in the United States. In patients with chronic alcohol use disorder who experience a sudden cessation or significant decrease in alcohol consumption, half will experience symptoms of alcohol withdrawal syndrome. Benzodiazepines are the typical first line treatment for alcohol withdrawal. However, benzodiazepines carry with them significant risks and side effects. As a result, ongoing research has taken place to find either an alternative treatment or a method of reducing total benzodiazepine dosage during treatment. Gabapentin is a medication that is primarily used for seizure control …

A Systematic Review: Relationship Between Medication Adherence And Hypertension, Monica Chan

Master's Projects

Chronic diseases are defined as conditions that are present for over one year and limit activities of daily living or require ongoing medical attention. Heart disease is the number one leading chronic disease in the United States, making up one third of all deaths. In turn it costs the health system $216 billion per year (Center for Disease Control and Prevention, 2023). Uncontrolled blood pressure is a key risk factor for heart disease and stroke. 1 in 2 adults will need to take prescription medication to control blood pressure and lower the risk of having a cardiovascular event. This systematic …

Efficacy Of Utilizing A Discharge Checklist At A Northern California Hospital, Becky Le

Master's Projects

Standardization of patient discharges by utilizing a discharge checklist would address discharge barriers, improve discharge times, enhance communication among the multidisciplinary team, and improve efficiency of care. A 5-week pilot, which was a quality improvement study, explored whether the utilization of a discharge checklist would improve discharge times and communication among the multidisciplinary team. This study was conducted in a northern California county hospital, on 2 medical- surgical units, with a participating physician team, case managers, and approximately 150 medical- surgical registered nurses. The study yielded results of improved discharge times by 1 hour, and improved efficiency of care by …

The Impact Of A Blood Pressure Reduction Program In Optimizing Control Of Hypertension Amongst Adult Females In An Outpatient Ambulatory Clinic, Brooke Englert

DNP Projects

Background: Hypertension (HTN) is a public health problem that, when well-controlled, can significantly reduce the risk of stroke, coronary heart disease, heart failure and death. Effective patient-provider communication strongly incentivizes an improvement in medical outcomes. Communication with patients can often be effectively delegated to other clinical staff, such as registered nurses (RNs) or clinical service technicians (CSTs) (Tavakoly Sany, Behzhad, Ferns & Peyman, 2020).

Purpose: Given the increased risk of all-cause and cardiovascular disease mortality of uncontrolled HTN, the purpose of this study was to implement and evaluate a standardized, evidence-based practice intervention via communication between APRN providers and patients …

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams

DNP Projects

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.

Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Impact Of Physical Activity Vital Sign Screening On Physical Activity Counseling And Referrals In Primary Care, Anna Selepina

DNP Projects

Background/Purpose: Physical Activity Guidelines for Americans recommend 150-300 minutes of moderate-intensity physical activity each week for adults; however, half of the adults do not meet this goal, which leads to increased chronic health conditions and poor health outcomes. The physical activity vital sign (PAVS) screening tool is an evidence-based assessment tool associated with increased physical activity counseling, which can lead to increased physical activity and improved patient outcomes.

Objective: The purpose of this study was to examine the impact of PAVS screening on physical activity counseling and referrals in primary care.

Methods: This prospective study took place in a small …

Evaluating The Effect Of Electronic Health Record Patient Portal Use On Medication Adherence In Adults With Chronic Conditions, Jennifer Averbeck

DNP Projects

Background Medication non-adherence is prevalent among fifty percent of the United States population. This behavior leads to increased morbidity and mortality as well as increased healthcare costs for both the patient and the healthcare system. More than two-thirds of nonadherence exists in those aged over 65 years old who are diagnosed with Multiple Chronic Conditions (MCC). Several studies have researched and trialed interventions to improve rates of adherence, limit poor health outcomes, and decrease overall cost of care. The patient portal is an interactive tool which encourages participation of the patient in their healthcare management. Implementation of this tool has …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Evaluating Providers’ Knowledge, Attitudes, And Intentions Toward Utilizing First Post-Discharge Visit Checklist In Primary Care To Reduce Readmissions In Heart Failure Patients, Binu Bashyal

DNP Projects

Background and Significance: Heart failure (HF) affects approximately 6.2 million adults in the United States and 40 million people globally. HF is one of the leading causes of emergency department (ED) visits and hospitalizations in adults. Twenty percent of patients admitted for HF are readmitted within thirty days, and up to fifty percent are readmitted by six months. A First Post-Discharge Visit checklist could help mitigate the problem of readmission.

Purpose: The purpose of this DNP project was to evaluate primary care providers’ knowledge, attitudes, and intentions towards utilizing the First Post-Discharge Visit checklist to reduce hospital readmissions among …

Knowledge & Attitudes Towards Pediatric Pain With Needle-Based Procedures In The Emergency Department Setting, Charlstyn Paige Brown

DNP Projects

PURPOSE: By the time a child enters kindergarten, they may have faced as many as thirty-three vaccine-related injections. Throughout these experiences, parents and patients associated pain and fear regarding the administration of multiple vaccines concurrently to a child has played a role in vaccine hesitancy and refusal. Parents and patients experience associated fear and pain regarding the administration of multiple concurrent scheduled vaccines, thus leading to vaccination hesitancy and refusal. In addition to scheduled immunizations, there is also the possibility of unexpected needle-based procedures taking place when emergencies arise. The purpose of the study is to explore the current …

Evaluation Of Patient And Clinical Staff Perceptions Of Screening For Social Needs In An Underserved Population, Alysha Greenwell

DNP Projects

Abstract

Background. Despite ample strong evidence linking social determinants of health (SDOH) and unmet social needs to higher healthcare costs and worse health outcomes across the lifespan, only 16% of healthcare practices screen their patients for social needs. Various barriers contribute to low screening rates, including uncertainty about best methods for screening, the amount of time it takes to screen, and lack of confidence in knowing what to do once needs have been identified. As movements toward value-based models of care change the healthcare landscape, healthcare systems must find practical and effective methods to effectively screen for social needs utilizing …

Descriptions Of Breast Self-Care From Inner-City African American And Hispanic Women Seeking Care In A Comprehensive Breast Care Center, Salamata Yoda

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: A plethora of inquiries has irrefutably revealed a decline in the death rates of breast cancer in some ethnic populations due to timely diagnoses, and enhancement in treatment measures. However, not all women have gained equal access to these innovations in healthcare. Certainly, as a repercussion of the noted disparity, the overall breast cancer prevalence among African American and Hispanic women has steadily escalated. Although no single test can detect all breast cancers early, practicing breast self-care consisting of breast self-awareness (BSA) in combination with other screening methods such as clinical breast exam (CBE), mammogram screening, and a suitable …

Pet Loss And Grieving Strategies: A Systematic Review Of Literature, Ruth E. Cervantes

Master's Projects

The impact that companion animals have on human lives has been explored in many aspects including therapy and emotional support. In some cases, these types of pets have been deemed necessary for pet owners with medical problems. However, pets are not only a medical necessity for some humans, but they are also companions, and most are included as family members. The loss of a pet often brings on intense grief that is not often acknowledged in the workforce. Bereavement leave for immediate family members is a benefit offered to employees, and as we will read in this literature review pet …

Registered Nurse-Led Annual Wellness Visits In Rural Health Clinics: A Program Evaluation Of A New Role, Tina Switzer

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

The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

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

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

Assessment Of Caregiver Burden In A Memory Loss Clinic, Andrea Perkins

Doctor of Nursing Practice Projects

Background: Over 131,000 people in Illinois identify themselves as caregivers of someone with memory loss. The family caregiver may provide care including, but not limited to, assistance with activities of daily living, financial responsibilities, behavior management, and scheduling, and transportation to medical appointments. The care provided by the caregivers may lead to caregiver burden symptoms of depression, anxiety, and perceived stress. Purpose: Health care providers at a central Illinois memory clinic are not currently completing formal assessments of caregiver burden. This quality improvement project was done to determine if the current memory loss program services provide enough support …

Increasing Colorectal Cancer Screening Rates In The Psychiatric Inpatient Unit, Diane R. Ventura

Master's Projects and Capstones

Increasing Colorectal Cancer Screening Rates in the Psychiatric Inpatient Unit

Abstract

Problem: Colorectal cancer is one of the leading cancer deaths in the United States. The Psychiatric Inpatient Unit has a colorectal cancer screening compliance rate of 40% compared to the statewide average of 80%.

Context: The Psychiatric Inpatient Unit is a 58-bed inpatient intermediate care facility mental health program in Northern California. Upon review of the EMR, most PIU nurses give verbal instructions and patient education on colorectal cancer screenings when due. Still, no printed handout was provided to the patients upon review of the EMR.

Intervention: Review of …