An Undergraduate Baccalaureate Simulation On Weight Bias And Caring For A Patient With Obesity, Kathy Andrews

DNP Scholarly Projects

Background: There is considerable evidence showing the correlation between weight related bias among healthcare professionals, and poor health outcomes for patients with obesity. Educating healthcare professionals on both safe and effective care practices and compassionate patient-centered care techniques can reduce the negative health impact of weight bias on this patient population. Purpose: This scholarly project adjusted the existing curriculum to address existing weight bias among a cohort of undergraduate baccalaureate nursing students and to inspire improvement in their care of patients with obesity. Methods: Using Kolb’s ELT a sequence of learning activities were adapted and implemented as a …

Student Veterans’ Transition To Nursing Education: Barriers And Facilitators, Bruce P. Hunter, Steven Busby Dr., Jeannie Giese Dr., David Phillippi Dr.

DNP Scholarly Projects

Student Veterans’ Transition to Nursing Education: Barriers and Facilitators

Abstract

The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that …

Promoting Mental Health And Well-Being Among Undergraduate Nursing Students: A Practice Guideline, Armen Mailyan

DNP Scholarly Projects

Poor mental health and well-being among undergraduate nursing students negatively affects social dynamics, communication, decision making, and stress management, thus compromising the quality of healthcare delivery and patient care outcomes. It is imperative that nursing programs support students to develop positive self-care, resilience, and mental health skills while in school to foster their well-being, enhance their academic success, and to promote high-quality, patient-centered care in their future practice. The purpose of this Doctor of Nurse Practice (DNP) project was to develop a mental health and well-being practice guideline with a comprehensive set of evidence-based interventions for academic nursing programs to …

"Salir Adelante": Improving The Quality Of School Entrance Physicals For Immigrant Minors, Jennifer Sternberg, Elizabeth Morse

DNP Scholarly Projects

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record …

Advancing Health Equity On Campus A Minority Health Promotion Quality Improvement Initiative, Natasha Wilson

DNP Scholarly Projects

Abstract Background: Minority students at predominantly white institutions face unique stressors due to their minority status, impacting their health. Initiatives promoting community engagement, diversity, equity, and inclusion can help reduce minority stress and foster health equity and success in higher education Method: This project employed a Community-Based Participatory Research (CBPR) framework to enhance minority student involvement in sexual and mental health services both on campus and in the wider community. It involved forming partnerships between minority student organizations, faculty, and community partners to organize wellness events focusing on sexual and mental health during the fall semester of 2023. The events …

Increasing Faculty Knowledge Of Competency-Based Education: A Quality Improvement Project, Lindsay O'Sullivan

DNP Scholarly Projects

Background: The nursing academic-to-practice knowledge gap creates systems-based and patient outcomes issues. The changing demands of healthcare require the advancement of the discipline of nursing through the improvement of nursing education. The American Association of Colleges of Nursing (AACN) requires all nursing programs to implement Competency-Based Education (CBE) evaluations and assessments into existing nursing curricula to respond to changing healthcare demands. The aim of this project was to improve the knowledge of nursing educators regarding the use of CBE at a mid-sized university in the southeast.

Methods: The Diffusion of Innovation Theory was used as a framework for this project. …

The Impact Of An Educational Video On Physician Confidence And Comfort Level In Discussing Autopsies, Joy N. Owings, Laura Gray, David Phillippi

DNP Scholarly Projects

Background: Autopsy rates have declined since the 1970s despite the procedure's benefit to families and medical science. Two well-documented reasons for the declining autopsy rate are physicians’ lack of knowledge about autopsies and lack of confidence in offering them. Objective: The primary aim of this study was to evaluate the impact of a brief educational video on physicians' comfort level, confidence, and knowledge regarding autopsy discussions. The objective was to address the declining autopsy rates by enhancing physicians' confidence and comfort level in offering autopsies to families. In addition, this study aimed to investigate physicians’ practices of consenting for an …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

The Effect Of Skin Tone Inclusive Dermatology Education On Diagnostic Accuracy And Self-Confidence In Graduate Nursing Students, Kaylyn Bourne, Laura Gray

DNP Scholarly Projects

Abstract

BACKGROUND: People with skin of color face worse health outcomes than their light-skinned peers. According to the literature, graduate nursing programs lack skin tone inclusive curricular content (Shue-McGuffin & Powers, 2022). This contributes to disproportionate racial and ethnic health disparities. Skin tone inclusive online dermatology modules have been shown to improve diagnostic accuracy and self-confidence among medical students and residents in primary care specialties (Trinh et al., 2021; Salava & Salmela, 2022; Wang et al., 2020). Similar models may be an effective approach for graduate nursing students as they prepare to evaluate skin disease across the skin tone …

Screening For Unhealthy Alcohol Use: Implementation Of Screening And Brief Intervention (Sbi) In Primary Care Using The Audit-C, Sarah Bell

DNP Scholarly Projects

Background: In 2021, the NIAAA reported that alcohol use disorder affected 29.5 million Americans. Alcohol Screening and Brief Intervention (SBI) is an evidence-based prevention strategy, recommended by the USPSTF, to reduce alcohol consumption. Unfortunately, less than 50% of patients receive advice from their provider about the harms of excessive alcohol use. This study aimed to implement an effective SBI process in a rural primary care setting utilizing the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) tool while addressing known barriers to proper implementation.

Methods: Donabedian's Structure-Process-Outcome (SPO) framework for Quality Assessment guided this quality improvement design. Intervention planning included considerations …

Defining Success In Patient Care Technician Development, Ferrol A. Thomas

DNP Scholarly Projects

The national nursing shortage has created a need for unique staffing models in healthcare organizations that incorporate unlicensed assistive personnel such as, patient care technicians (PCT). As part of the healthcare team, PCTs provide support to registered nurses contributing to positive patient outcomes. Recruitment and training for PCTs is successful in workforce development programs through employer academic partnership programs. The Success Case Method (SCM) was used to evaluate a local workforce development program for PCT at Nashville State Community College. Participants were evaluated to gain demographic data (n=25) and qualitative interviews (n=6) to provide insight about what made the program …

Implementation Of A Rounding Tool To Promote Compliance With Central Line Dressing Changes In An Adult Intensive Care Unit, Fabiola Demuth

DNP Scholarly Projects

Abstract

Evidence supports implementing central line (CL) maintenance bundles and nurse-led rounding interventions to prevent central line-associated bloodstream infections (CLABSIs). In a Tennessee intensive care unit (ICU), increased CLABSI rates were associated with inconsistent CL dressing maintenance and documentation. This Doctor of Nursing Practice scholarly project was implemented to improve ICU CLABSI rates and reinforce nursing standard practices for CL dressing care. This quality improvement project used the Institute for Healthcare Improvement (IHI) model for improvement, which used the plan, do, study, act (PDSA) cycles as part of the framework to implement a daily nurse-led rounding tool in the ICU, …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Scholarly Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Learn, Reflect, Practice, Discuss: A Professional Development Pilot For Clinical Nurse Educators, Jessica Savage, Linda Wofford Dr., David Phillippi Dr.

DNP Scholarly Projects

Abstract

AIM: The aim of this project was to assess the effect of a professional development pilot on the self-efficacy among clinical nurse educators toward evaluation and assessment of students in the clinical setting.

BACKGROUND: Nursing schools employ clinical nurse faculty with varied levels of experience and formal education in teaching. Positive student outcomes are dependent on the competency of their nursing faculty, yet best practices to train and support the professional growth of clinical faculty have not yet been identified.

METHOD: A multi-modal professional development pilot including online-learning modules, self-reflection, practice-learning, and peer-mentoring components was designed and implemented with …

Women's Stories Of Reaching A Diagnosis Of Endometriosis: A Qualitative Study, Susan C. Debolt

DNP Scholarly Projects

Endometriosis is a chronic gynecological condition affecting 10% of reproductive-aged women worldwide. Women with endometriosis often experience a decreased quality of life compared to women without endometriosis. The average time to diagnosis is greater than six years for adult women and greater than 11 years for adolescents. Yet, there is little research investigating the pre-diagnostic experiences of women with endometriosis. This study aims to inform healthcare providers of patients' pre-diagnostic experiences of endometriosis in an effort to improve patient care. Using one-on-one, semi-structured online interviews and a qualitative design, this study explored six women's pre-diagnostic experiences of endometriosis. The main …

Culturally Sensitive Emergency Care For Sexual And Gender Minority Youth, Kaysi Goodall

DNP Scholarly Projects

There is substantial evidence of disparities in access to healthcare and health outcomes affecting sexual and gender minority youth (SGMY). However, evidence of SGMY cultural sensitivity training for pediatric emergency health professionals is limited. This quality improvement research project in an urban pediatric emergency department (PED) used a cross-sectional, pre-test post-test design to improve health professionals’ knowledge, attitudinal awareness, and clinical preparedness in caring for this population. It was informed by the Institute for Healthcare Improvement’s Model for Improvement and completed in four Plan-Do-Study-Act (PDSA) cycles. Evidence-based pedagogical strategies were utilized for a 60-minute staff training session, including introducing foundational …

Exploring Factors Influencing Nursing Engagement In 4ms Initiatives On An Inpatient Older Adult Unit, Sarah Nelson

DNP Scholarly Projects

Background: The older adult population is growing, and these individuals often have health challenges that require complex nursing care. On an older adult unit in Tennessee, a 4Ms (What Matters, Medication, Mentation, and Mobility) Age-Friendly care initiative was implemented to improve care and outcomes. Early data showed inconsistent nursing engagement with 4Ms initiatives and qualitative data on engagement factors was needed to increase nursing support and improve patient outcomes. Purpose: Therefore, this scholarly project explored factors influencing nursing staff engagement with the 4Ms initiative on an older adult unit. Methods: Nurses and …

Early Progressive Mobility In The Micu: A Qi Project, Kenneth Johnson

DNP Scholarly Projects

Abstract

Background: Immobility causes grave harm to ICU patients. There is not a body system that bedrest does not affect negatively. The MICU has an early mobility protocol; however, patients are often left in bed, PT/OT is underutilized, and nurses are unfamiliar with the current early mobility protocol.

Methods: The Plan Do Study Act quality improvement method was used for this project which ran from September 1 to November 30, 2022, and involved the MICU RN staff. This QI project evaluated the current early mobility protocol, assessed barriers, determined the nurse’s perceptions, and offered recommendations for sustainability.

Intervention: The project …

Impact Of Teamstepps On Team Performance In An Oral And Maxillofacial Surgery Practice, Katherine E. Lee

DNP Scholarly Projects

Effective communication and teamwork skills among oral and maxillofacial surgery (OMS) teams are essential for quality and safe patient care. As some in the profession assert that the team model for delivering anesthesia care is integral to their history of safety, the model continues to be scrutinized by professional groups whose members seek to limit oral surgeons’ ability to provide anesthesia services in the office setting. This quality improvement project assessed how introducing the TeamSTEPPS Office-Based Care (OBC) program in an OMS clinic impacted team dynamics. The impact of TeamSTEPPS OBC training on attitudes and perceptions of teamwork was evaluated …

Exploring Hapi Incidence In Patients Admitted Through The Ed: A Quality Improvement Initiative, Alexa L. Tietgens

DNP Scholarly Projects

Each year in the U.S., pressure injuries, or PIs, are responsible for more than 60,000 patient deaths and billions of dollars’ worth of treatment costs. Research shows that roughly 95% of all PIs are preventable by following evidence-based practice guidelines which include early identification of patients at risk, frequent skin assessments, and implementation of prevention strategies. However, the ED environment creates unique risks for PI development due to the routine use of hard surfaces (i.e., stretchers, backboards, exam tables) and frequent hospital overcrowding. Although nurses play a pivotal role in PI prevention, frequent staffing shortages, high patient acuity levels, and …

Perceptions Of Preparedness Among New Graduate Nurses: Traditional Curriculum Versus Concept-Based Curriculum, Ashley A. Wheeler, Steven Busby, David Phillippi, Tammy Legge

DNP Scholarly Projects

Concept-based curriculum (CBC) is a newer trend in nursing education curriculum aimed at preparing new graduates to enter the workforce as generalist nurses better suited to care for a more medically complex population. Using CBC, students are introduced to concepts in order to build conceptual understandings as they engage in knowledge and skill learning, as opposed to a traditional nursing curriculum that is taught in sections grouped by patient population and medical complexity. At a nursing school housed within a private university in the southeast, the traditional nursing curriculum was replaced with CBC in 2016. To better understand the preparedness …

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Scholarly Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

Psychological Safety In Pre-Licensure Nursing Simulation, Lauren Rickman

DNP Scholarly Projects

Background

Simulation-based experiences (SBEs) allow learners to use clinical decision-making, clinical judgment, and hands-on skills to analyze and respond to realistic clinical situations in a controlled, interactive environment. Psychological safety (PS) is essential for increasing a learner's engagement in an SBE. Psychologically safe learning environments allow students to feel valued and comfortable speaking up and taking risks without consequences to themselves or others, promoting learning and innovation. Measuring PS may help simulation faculty improve their learning environment by supporting learning-oriented behavior and boosting students' clinical competency.

Purpose

The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to …

Compassion Satisfaction, Burnout, And Secondary Traumatic Stress Among Heart Transplant Nurses In A Hospital Setting, Marissa Potts

DNP Scholarly Projects

Abstract

Purpose: The purpose of this study was to assess whether or not, and the degree to which compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) are present among inpatient acute-care heart transplant nurses. Perceived presence of other contributing factors that contributed to CS, BO, and STS was also assessed.

Design: A cross-sectional survey-based mixed methods study with an explanatory sequential design was used to assess baseline levels of CS, BO, and STS and identify any other factors at work or home that may impact these constructs.

Methods: A Qualtrics survey was sent to potential participants. A convenience …

Adverse Childhood Experiences Screening In Adulthood: Knowledge, Attitudes, And Self-Efficacy Among Tennessee Nurse Practitioners, Megan M. Wanca

DNP Scholarly Projects

Despite the prevalence of adverse childhood events (ACEs) and the relationship with negative health outcomes in adults, research shows clinical use of ACE screening is low among healthcare providers including nurse practitioners (NPs). The scholarly project’s purpose was to examine how Tennessee NP knowledge, attitudes, and self-efficacy influence intentions to screen for ACEs related to childhood trauma or abuse in adult patients. Using the Information-Motivation-Behavioral Skills Model as the theoretical framework, a cross-sectional and exploratory design assessed the association of NPs’ ACE screening knowledge, attitudes, and self-efficacy on the NPs’ intention to screen for ACEs in adult patients. A reliable …

A Quality Improvement Project To Examine The Impact Of The Use Of Structured Diabetes Educational Materials For Medical Personnel, Alina Jaffer

DNP Scholarly Projects

With the immigrant population increasing in the United States, the demand for healthcare providers who can provide culturally appropriate care and intracultural communication has increased. Compared to individuals born in the United States, immigrants with diabetes are less likely to meet the standardized targets for diabetes management, resulting in disparities in diabetes-related complications. The problem is the lack of evidence-based patient education for all people, including immigrants who do not speak English as a first language. The purpose of this project was to assess whether or not language-specific structured diabetes educational material for healthcare personnel use would increase the efficacy …

Examining Nurse Engagement In Antimicrobial Stewardship At Long-Term Care Facilities, Mosam S. Patel, Kathryn L. Dambrino, Olivia Bahemuka, David Phillippi

DNP Scholarly Projects

Background: The World Health Organization stated that antimicrobial resistance is one of the top 10 threats to global health. To combat antimicrobial resistance, antimicrobial stewardship (AMS) programs were developed. Efforts to engage nurses in stewardship efforts have been limited. Bedside nurses are in an optimal position to help decrease antimicrobial use, which is especially relevant in long-term care facilities where up to 75% of antibiotic use is deemed unnecessary or inappropriate. The purpose of this Doctor of Nursing Practice scholarly project was to examine factors that influence nurse engagement in AMS at long-term care facilities in Tennessee. Methods: A …

Interprofessional Socialization Of Nursing Students After Participating In Interdisciplinary Rounds In An Intensive Care Unit, Ashlyn S. Upshaw

DNP Scholarly Projects

Background: Nursing engagement in interprofessional collaboration leads to safe and quality healthcare for patients. In order to effectively engage in interprofessional collaboration, nursing students must socialize among healthcare providers from various disciplines. Purpose: The purpose of this project was to examine pre-licensure nursing students’ beliefs and attitudes towards interprofessional socialization and collaboration following their participation in interdisciplinary rounds in an intensive care unit (ICU) setting. Methods: A mixed-methods, cross-sectional design was used to collect data from undergraduate nursing students at a private university. Following an ICU clinical rotation, participants completed the Interprofessional Socialization and Valuing Survey-21 (ISVS-21) …