Nursing Commons^™

Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren

Evidence-Based Practice Project Reports

The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free

Evidence-Based Practice Project Reports

Patient’s with a diagnosis of diabetes require significant lifestyle modification and education. The need for patient education has led to the development of diabetes self-management education (DSME) classes. Unfortunately, utilization of DSME classes is only 5% among Medicare beneficiaries and 6.8% among privately insured patients (Centers for Disease Control [CDC], 2018). The purpose of this evidence-based practice (EBP) project was to implement DSME via telehealth and assist with goal formation to help patients with uncontrolled diabetes achieve glycemic control by increasing access to crucial education. The intervention consisted of bi-weekly calls for a period of 3 months. Participant data were …

The Use Of Automated Text Messaging As An Intervention For Smoking Cessation, Oluwasayo Sinkaiye

Evidence-Based Practice Project Reports

Tobacco smoking is a widespread problem that affects the adult population in the United States (U.S.). In 2018, about 14 of every 100 adults in the USA aged 18 years or older were cigarette smokers (Centers for Disease Control and Prevention [CDC], 2020). Tobacco smoking is associated with chronic disease conditions that have serious health implications including cancer, heart disease, diabetes, and chronic obstructive pulmonary disease (COPD) (CDC, 2020). The purpose of this evidence-based practice project (EBP) was to determine the effectiveness of an automated text messaging application (SmokefreeTXT) for smoking cessation in a primary care setting for adult cigarette …

Use Of Probiotic In Preventing Antibiotic-Associated Diarrhea, Chanda Amatya

MSN Capstone Projects

Antibiotic-associated diarrhea (AAD) including Clostridium difficile associated diarrhea (CDAD) has been a challenging topic for the healthcare industry. AAD is caused by the disruption of normal microbial balance along with the gastrointestinal (GI) tract due to the use of an antibiotic. AAD not only increases healthcare cost burden but also increases morbidity and mortality among vulnerable populations such as the elderly. Death from CDAD for a patient over 65 years is about 90% (Mallina et al., 2018). Antibiotic use is very common among the elderly and it is the responsibility of healthcare providers to take appropriate measures in preventing complications …

Pediatric Obesity: Prevention, Assessment And Treatment In Primary Care, Susan Johnson

Theses and Graduate Projects

People of all ages deserve care for the disease of obesity. Pediatric obesity affects one in three children in the United States, and the number of obese children has tripled since the 1970s (Centers for Disease Control and Prevention (CDC), 2018a). High blood pressure, high cholesterol, type 2 diabetes, and sleep apnea are complications that pediatric patients now face, and these diseases are well known to worsen quality of, and potentially shorten life. This scholarly project addresses the question: How can family nurse practitioners effectively address pediatric obesity in the primary care setting? Interventions early in life, perhaps even pre-conception, …

Type 2 Diabetes - A Change For A Better Life, Hilary Greene

MSN Capstone Projects

Cardiovascular disease has been known to be the leading cause of mortality in patients with type 2 diabetes. With diabetes on the rise in the United States, it is important to assess changes in these patients to decrease the risk of developing cardiovascular disease or a major cardiovascular event such as a myocardial infarction, stroke, or death. If able to address healthy alternatives to patients to reduce the risks of major cardiovascular events such as a myocardial infarction or stroke, it could potentially save many lives. As a nurse educator, it is important to provide patients with the education they …

Treatment Of Acute Bronchitis In Active Duty Military Members Benchmark Project, Nicole Williams

MSN Capstone Projects

Antibiotic resistant infections are a growing problem in the United States and the world. The main cause of this is antibiotic prescriptions, which can not only cause antibiotic resistance but adverse events. Decreasing the amount of antibiotics prescribed for inappropriate conditions can help to decrease the rates of antibiotic resistant infections and the problems these infections can cause. One illness that is treated frequently with antibiotics, against recommendations, is acute bronchitis. Acute bronchitis is a self-limiting viral infection, characterized by cough. By decreasing the number of providers who are prescribing antibiotics for acute bronchitis, the clinic can help to prevent …

Triage Process In Primary Care Clinics, Ashley Vasilik

DNP Projects

Skillfully applied triage techniques can make the difference between rapid, appropriate, cost effective care and poor outcomes at increased cost. While triage has been well documented in emergency departments, military, and natural disasters, it is far less well-understood in the primary care setting. Appropriate, accurate triage and disposition in primary care can improve patient outcomes and reduce unnecessary emergency department visits. This may have an impact on emergency department over-crowding. This exploratory, qualitative, descriptive study examines the triage process of six primary care clinics in Tennessee and Alabama. Interviews with participants were conducted between September and November 2020. Donabedian’s SPO …

Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula

Evidence-Based Practice Project Reports

Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …

Identification Of Variables For Hemoglobin A1c Prediction, Erica A. Richards

Doctor of Nursing Practice Scholarly Projects

An evolution in healthcare is taking place throughout our country. Healthcare providers are required to achieve an ever-growing number of regulatory and metric-driven standards. This transformation aims to improve both the quality and cost of healthcare in the United States. Diabetes mellitus (DM) is one of the most costly chronic diseases in the United States. Since DM has high mortality, high morbidity, and low quality of life rates, it is no wonder that DM is one of the focuses of the National Committee for Quality Assurance performance improvement tools known as the Healthcare Effectiveness Data and Information Set (HEDIS). In …

Exploring The Lived Experience Of Adolescent Caregivers, Abbigale Laurentius

Honors Theses

In today’s society, the population is aging, and any member of the family could find themselves in the role as an informal caregiver. Adolescents between the ages of 12 and 18 years old may have these caregiving responsibilities, and it is imperative that healthcare professionals recognize and support this change of roles. A literature review revealed a general lack of research from within the last five years regarding adolescent caregivers. Those studies that were analyzed in the review presented themes of depression, anxiety, lack of education, and insufficient social supports for the adolescent. An unfolding case study was then designed …

Improving Antibiotic Prescribing For Acute Respiratory Illnesses, Laurinia Hunter

Student Scholarly Projects

Practice Problem: Unwarranted antibiotic prescribing practices when treating acute respiratory illnesses contribute to the national health threat of antibiotic resistance.

PICOT: In a pediatric outpatient setting for patients ages 6-25 who have no documented uncontrolled comorbidities, presenting with an acute respiratory illness (P), does provider utilization of clinical guidelines, and patient and (caregivers) utilization of educational pamphlets, to collectively develop a plan of care (I), compared to providers and patients who do not utilize such strategies(C) result in a reduction in antibiotics prescribed for acute respiratory illnesses (O) in a 6-week timeframe (T)?

Evidence: The evidence reviewed reported the utilization …

Resilience 101: A Resilience Education Intervention For College Freshmen, Angie Childre

Graduate Research Showcase

This evidence-based project sought to evaluate resilience in freshmen college students enrolled in a Bridge scholar program (BSP) in a liberal arts university in the southeastern United States. The American College Health Association (ACHA) found that stress and anxiety were the top two indicators for impacting academics in 2019 and had been at the top since 2009 at the university of study (ACHA, 2019). The study used a pretest and posttest design method with the implementation of a five-week resilience education intervention. The research questions (Q1-5) were: Q1: What effect did the intervention have on BSP student's resilience? Q2: What …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Assisting Nursing Students In Their Development Of Empathy: A Guide To Fostering Requisite Skills For The Art Of Empathetic Communication, Susan Mee

Open Educational Resources

This 7-week lesson plan is designed for use in clinical nursing courses. It is designed specifically for use by Nursing faculty teaching in the absence of state required patient facing clinical opportunity due to COVID restrictions. The lesson plan describes pedagogical techniques and provides video and education OER resources designed to help support the development of empathetic communication skills over 7 weeks. Refection and video debriefing techniques will be employed. Role play will culminate in the group presentation project of a brief video modeling effective therapeutic empathetic communication.

Development And Implementation Of Computer-Based Learning Modules On Alternative Communication For Pediatric Nurses And Nursing Students, Amanda Kaye Simmons

Theses and Dissertations (ETD)

Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The …

Preventing Insulin Storage And Administration Errors, Makena Reddick

Scholars Week

■The research problem was discovered when nurses were observed storing and administering insulin improperly. The objectives of this project were to find the correct policies for these procedures, obtain research that backed these policies, and present this information to nurses to create a safer habit. In researching, it was found that reducing the physical distance between a person completing work and the materials required to do so increased compliance (Gibbs & McLernon, 2017). In a second study, the delivery of safe, effective and high-quality care for patients with diabetes in the community is dependent upon (district) nurses having appropriate knowledge …

Exploring Parent Perception Of Adverse Childhood Experiences Screening In Pediatric Primary Care: A Clinical Inquiry Project, Kathryn Stevens

The Eleanor Mann School of Nursing DNP Capstone Projects

This manuscript explores the incidence and implications of Adverse Childhood Experiences (ACEs) and outlines a project assessing parental perception of their own ACEs screening during their child’s wellness visit. ACEs are adversarial events occurring during childhood, which may be chronic or singular. Abuse, neglect, and household dysfunction result in negative outcomes, including compromised neurological development and cognitive behaviors, developmental delays, poor lifestyle choices, and reduced mental and physical health. Additionally, a growing body of literature supports the impaired parenting skills in those with a history of ACEs. This can perpetuate intergenerational trauma, deprived opportunities, and poor familial health. Despite the …

Knowledge About Continuous Positive Airway Pressure Machine Usage Among Nurses At A Tertiary Hospital In Tanzania, Wilson Paulo Lomnyack, Tumbwene Mwansisya, Stewart Mbelwa, Kahabi Isangula, Zephania Saitabau Abraham

School of Nursing & Midwifery, East Africa

Introduction: Continuous Positive Airway Pressure (CPAP) provides an air pressure that maintains the patency of the airway in patients with a variety of breathing problems. Nurses provide the hour to hour management of patients who require CPAP. The aim of this study was to assess the knowledge of nurses about CPAP machine usage at the tertiary hospital in Tanzania which serves the largest number of patients who require CPAP.

Method: A hospital-based descriptive cross-sectional study was carried out from March to June 2019 at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac Institute (JKCI) where 149 nurses who consented …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Integration Of Kansas City Cardiomyopathy Questionnaire-12 In Clinical Practice, Norman Njihi

Dissertations

Abstract

Problem: Congestive heart failure (CHF) is a high symptom disease in which patients tend to decompensate frequently, most often leading to hospitalization and poor quality of life.

Methods: This project involved educating nurses about using patient reported outcome(PRO) tools with an emphasis on the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12). Pre and post surveys using a Likert scale tool designed by the author were used to determine if a change in knowledge occurred. Satisfaction of the providers was assessed using a survey, also designed by the author. A retrospective review of 13 patients was done to establish patients’ baseline KCCQ-12. …

A Watched Pot Never Boils: Attentive Care Needs No Timer, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the premise that length of patient consultation time is less important than what patients perceive happened during that time. Regardless of the time allotted to a clinical visit, health care providers should make efforts to address the emotional and psychosocial needs of their patients. As always, taking a little time to express empathy can make a big difference in patient satisfaction.

Implementing Tele-Coaching Diabetes Education To Improve Self-Care And Clinical Outcomes For Patients With Type 2 Diabetes, Sori Jung

DNP Research Projects

Abstract

Background: Type 2 diabetes (T2DM) requires initial and continuous patient education for lifelong management due to the complexity of the disease. However, diabetes education is not very well-supported in the office setting due to the providers’ limited time per patient. However, with the aid of technology-based intervention, patients can be more supported and educated, leading to better T2DM control.

Aims: The purpose of this scholarly project was to evaluate the effectiveness of diabetes education through tele-coaching in patients with T2DM for improved self-care and clinical outcomes, including hemoglobin A1c (A1c) and body mass index (BMI).

Method: A mixed-method, single …

Hypercoagulable State Of Covid-19, Amanda Martin

Nursing Student Class Projects (Formerly MSN)

From the data that has been collected and compiled on SARS-CoV-2, or Coronavirus disease 2019 (COVID-19), it has shown that there are unique qualities of the novel virus that leads to a hypercoagulable state in those diagnosed. To effectively treat those afflicted with this specific symptom of COVID-19, an understanding of the pathophysiology of the virus must be established to effectively treat and potentially prevent coagulopathy and the thrombotic events that can ensue. Gaining more insight into this will allow for standardized plan of care that includes appropriate predicative labs and effective prophylactic medications to be utilized in outpatient or …

Nursing Student’S Expectancy-Value Regarding Sudden Infant Death Syndrome Knowledge Retention, Raquel Suba

Nursing | Student Research Posters

Sudden Infant Death Syndrome (SIDS) is a sudden and unexpected death within the first year of life, which is attributable to unexplained causes after autopsies and full case investigations are unable to resolve the reason for death. Annually in the United States, approximately 3,600 infants die unexpectedly and suddenly of Sudden Unexpected Infant Death (SUID) and in 2018, there were 1,300 infant deaths due to SIDS (CDC, 2018). Despite American Academy of Pediatrics (AAP) recommendations promoting the endorsement and modelling of SIDS risk-recommendations from birth, studies reveal that both nursing students and registered nurses have deficient knowledge in adequate SIDS …

Providing Hispanic Immigrant And Migrant Health Care In America: Could Nps Be The Answer?, Hamabwe Kabwe

All Graduate Theses, Dissertations, and Other Capstone Projects

In recent years, the United States (U.S.) has seen an influx of Hispanic/Latino migrants/ immigrants fleeing their homes in South America, seeking opportunities for a better life in the U.S. Immigrants and their families often present to the U.S. with unique, unmet health care needs that ultimately impact the U.S. healthcare system and migrant health outcomes. Migration is a significant burden for the U.S. health care delivery system today and further magnifies known problems including inability to provide care to all because of lack of insurance for all, racial disparities in care outcomes, and unequal distribution of providers. There is …

Don't Miss These Patients! The Experience Of Working Full Time While Also Being A Caregiver, Debbie Conner, Alyncia Bowen

All Faculty and Staff Scholarship

The project sought to understand the experiences of working professionals who are also the caregiver for others with a health care issue. A caregiver in this research study is an individual who provides personal, financial, social, physical, and or psychological support from individuals other than themselves. It has believed that a significant number of professionals serve as a caregiver for individuals such as, but not limited to, a parent, partner, significant other, spouse or child.

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

The Evaluation Of An Amino Acid- Oral Re-Hydration Solution (Enterade®) To Improve Quality Of Life In Solid Tumor Cancer Patients By Reduction Of Chemotherapy Related Diarrhea, Holly Chitwood

DNP Projects

Background: Chemotherapy related diarrhea (CRD) is a common adverse effect of many chemotherapy agents used to treat cancer. CRD negatively affects quality of life (QOL) for cancer patients and often results in treatment delays, hold, dose reductions, and hospitalizations affecting morbidity and mortality. Proper management of CRD with novel therapeutics is needed to improve the quality of life and patient outcomes for this population.

Purpose: The purpose of this study was to evaluate the use of a proprietary amino acid-oral rehydration solution (AA-ORS) known as Enterade® to reduce the severity of CRD, to improve patient reported QOL among patients over …