Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Oxygen Therapy Education To Improve Oxygen Safety In The Emergency Department: A Quality Improvement Project, Latania Wolfe

DNP Projects

Background and Significance: Oxygen is often administered in emergency departments (ED) in US without the nurses and other healthcare staff inputting orders for this medication. This gap in placing orders poses a risk to patient safety and poses a regulation issue.

Purpose: The goal of this quality improvement project is to increase the rate of orders placed for patients using oxygen in ED staff by 12% from March 1, 2023 to May 31, 2023.

Methods: The Model for Improvement guided this quality improvement project. Two PDSA cycles were completed.

Results: PDSA #1 Completed SWOT analysis and used information to …

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

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 …

Operating Room Nurses Sleep Health: An Evidence-Based Practice Sleep Health Education Project, Gabriella M. Castignoli

DNP Projects

Background: "Sleep Health" is a new Healthy People 2023 priority due to notable poor sleep health across the nation, with more than 25% of U.S. adults reporting insufficient sleep. Adequate sleep is necessary to work effectively and safely, with operating room (OR) nurses at high risk for inadequate sleep due to atypical work schedules.

Purpose: This project aims to establish the importance of sleep health for OR nurses at a community-based hospital and improve sleep health perception and sleep health through sleep health education with staff.

Methods: The IOWA model for evidence-based practice and quality improvement tools, Plan-Do-Study-Act, and the …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

The Effects Of Cultural Competency Training On Providers Knowledge, Skills And Attitudes Towards The Latino Population, Jennifer L. Peppiatt

DNP Projects

Background: Providers in the United States (U.S.) healthcare system need to understand the cultural values, beliefs, and traditions of the growing Latino population. As a result, academic institutions are incorporating cultural competency training in their curricula. However, a noticeable knowledge gap exists for those currently practicing in the healthcare arena, impacting patient and provider satisfaction and healthcare outcomes.

Purpose: The purpose of the study was to obtain a baseline assessment of the cultural competence of a select group of Advanced Practice Providers (APPs) caring for the Latino population at the University of Kentucky and provide a targeted educational intervention, followed …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this …

Effectiveness Of Provider Education Concerning Prediabetes Treatment In Mississippi, Marlana Mcfarland

DNP Projects

Prediabetes is defined by the American Diabetes Association (ADA) as having an A1C of 5.7-6.4% or a fasting plasma glucose of 100-125 mg/dl. Prediabetes greatly increases the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (ADA, 2019). The purpose of this Doctor of Nursing Practice (DNP) project was to determine if providing education to PCPs, practicing in MS, regarding the implementation of a prediabetes treatment algorithm improved their knowledge and implementation of the ADA guidelines. The intention was to bring increased awareness of ADA guidelines regarding the current treatment recommendations for patients with prediabetes to PCPs. A …

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Population Assessment To Determine The Eligibility For Birth Center Care At University Of Kentucky Midwife Clinic, Dolores Polito

DNP Projects

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Improving First Dose Administration Of The Hpv Vaccine For Adolescents In A Pediatric Primary Care Clinic, Scarlett Mikesell-Pierce

DNP Projects

BACKGROUND: Nationwide more than 90% of cervical cancer cases are caused by the human papilloma virus (HPV). Cervical cancer can be largely prevented by administration of the HPV vaccine for children before becoming sexually active. However, vaccination rates in the United States, remain low at 60%, and only 39.7% through series of completion, despite the strong evidence to support the effectiveness of the HPV vaccine. Research indicates a clinician’s recommendation, providing information and opportunity for discussion about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity. This study addresses the barriers to parent/caregiver intent to …

The Effect Of A Child's Guardian's Health Literacy On Asthma Knowledge In Pediatric Patients, Sylvan Ryder

DNP Projects

PURPOSE: The purpose of this project is to determine if there is a correlation between a guardian’s health literacy and their knowledge of their child’s asthma management.

METHODS: This is a cross-sectional study conducted in the University of Kentucky Pediatric Pulmonology Clinic in Lexington, Kentucky. The analysis focused on how a parent’s health literacy level effected their asthma knowledge. The Rapid Estimation of Adult Literacy in Medicine-Short Form was used to measure health literacy. An asthma knowledge questionnaire with a Likert-scale design was used to measure asthma knowledge. The sample included eight parents of children with an asthma diagnosis collected …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

Increasing Smoking History Documentation And Lung Cancer Screening Orders In A Primary Care Clinic, Tabitha M. Caudill

DNP Projects

BACKGROUND: In 2018, there were approximately 234,030 new lung cancer diagnoses and 154,500 lung cancer deaths in the United States. Kentucky leads the nation in new lung cancer cases each year. The USPSTF estimates that 10% to 12% of lung cancers detected by routine screening would not have been detected until the cancer advanced; therefore, the USPSTF recommends yearly lung cancer screenings using low dose CT (LDCT) scans of the chest for patients 55 to 80 years old who have a 30 pack-year smoking history and are currently smoking or have quit within the last 15 years.

PURPOSE: …

A Comparison Of Post-Concussion Neurocognitive Test Results Of Recently Concussed High School Athletes To Their Neurocognitive Baseline Test Results Prior To Returning To Play, Karen Powers

DNP Projects

PURPOSE: In 2017, an estimated 2.5 million U.S. high school students reported having suffered at least one concussion while participating in sports or physical activity during the previous year. The purpose of this study is to evaluate the incidence of concussion among high school athletes and compare the athletes’ post-injury neurocognitive function to their baseline test results prior to returning to play.

METHODS: A retrospective records review of neurocognitive test scores of high school athletes during the June 2017 – June 2018 sport season was conducted. The records of 696 high school athletes were reviewed, including 30 post-injury test scores. …

Improving Fall Risk Assessment And Documentation: A Qi Project, Ashley N. Kohari

DNP Projects

BACKGROUND: Unintentional falls commonly arise and can cause significant harm including fractures, head injuries, and death. Assessing each patient for falls and performing a fall risk assessment is recommended by the American Geriatrics Society and the Center for Disease Control and Prevention, and is mandated for institutional reimbursement. Fall risk assessment has been shown to decrease the rate of falls and healthcare costs.

PURPOSE: The purpose of this quality improvement project was to improve compliance for fall risk screening and documentation to meet MACRA requirements in a family medicine clinic.

OBJECTIVES: The objectives for this project were: 1. Conduct PDSA …

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli

DNP Projects

Problem: The CDC estimates one person every 20 minutes every day acquires an HPV-related cancer. Kentucky’s HPV associated cancer burden is among the highest in the nation. Adolescent HPV vaccination rates in Kentucky are far below HealthyPeople 2020 goals. Barriers are multifaceted and include provider, patient and system barriers. The AFIX model is an evidenced based quality improvement program that addresses key provider barriers. The USPSTF findings identify a gap in the literature related to AFIX methods to improve rates of adolescent vaccines.

Objectives: The purpose of this study was to evaluate the effects of an intervention using the AFIX …

A Secondary Analysis Of Survey Data Evaluating The Lifelines Suicide Prevention Program Among Middle School Students, Nicki Sullivan

DNP Projects

PURPOSE: The purpose of this study was to evaluate student feedback of the 2015 Lifelines Suicide Prevention Program at Jessie Clark Middle School. Student feedback was examined by assessing students’ knowledge of suicide, attitudes toward suicide, knowledge of when and from whom to seek help if feeling suicidal or told by a friend that they are suicidal, and impressions of the educational presentation following participation in the Lifelines Suicide Prevention Program.

METHODS: In this secondary analysis, anonymous student responses (N=269) from a 2015 middle school survey were examined by using a mixed method design with the quantitative study measures being …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …