Nursing Commons^™

Medication Reconciliation: Preventing Harm To The Senior Living Population, Charles (Chuck) Jennings

Doctor of Nursing Practice Projects

This project was designed to address the risk of medication errors occurring when geriatric adults return to a senior living setting following an acute care stay. In addition to a primary care physician (PCP), the health care of geriatric adults is often managed by medical specialists and subspecialists. The engagement of multiple providers poses significant communication challenges, as these providers often work in separate offices and are limited in their information sharing. Consequently, following a hospital discharge, reconciling medication orders amongst all providers can be challenging. This challenge is further complicated, as PCPs oftentimes do not interface with the specialists …

Determining The Need For 23-Hour Observation Following Transforaminal Lumbar Interbody Fusions: A Patient Perspective On Recovery At Home, Lacey Irias

Doctor of Nursing Practice Projects

Minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (TLIF) is becoming more frequently performed in ambulatory surgery centers (ASCs). Subsequently, patients are scheduled for an option to undergo a 23-hour observation which requires staff preparation. The preparation increases costs and creates a shortage during a standard daytime shift which can reflect negatively on patient care. Most patients elect to be discharged the same day, on account of experiencing minimal pain and seeking the comfort of their own home. The goal of this DNP project was to assess the necessity of scheduling a patient 23 hours for observation following a …

Mental Health And The Black Church: Decreasing The Division In Divinity, Latonya Gray

Doctor of Nursing Practice Projects

Racial disparities in mental health care persist for Black Americans, with only one in three who need treatment receiving it. The care they do receive is often of a poorer quality than that of other groups. Faith communities serving Black members could help address this gap by partnering with mental health professionals to meet congregants' needs. With mental health now at the forefront of public discourse, considering the specific needs of the Black community is critical. Black Americans face disproportionate mental health burdens but are more likely to seek counsel from clergy due to cultural stigma. Educating clergy on mental …

Bridging The Gap: Strategies To Improve Hpv Vaccination Uptake, Stephanie Ramsey

Doctor of Nursing Practice Projects

The human papillomavirus (HPV) vaccination is approved by the United States (US) Food and Drug Administration (FDA) for individuals beginning at age 9. Evidence shows that HPV vaccination uptake is lower than other vaccinations offered in the early adolescent/adolescent age group. Healthy People 2030 set forth a goal that 80% of adolescents ages 13-15 will have HPV vaccine series completion by 2030. Research has shown that provider recommendation for the HPV vaccine is one of the reasons adolescents, or parents of adolescents, have chosen to initiate and complete the HPV vaccination. Studies have shown that providers who have been educated …

The Early Prevention Of Diabetic Foot Ulcers, Aruodo Ukpai

Doctor of Nursing Practice Projects

Frequent and proper foot exams and foot care are fundamental in decreasing the incidence and morbidity of diabetic foot ulcers, yet many patients are still not screened at appointments or educated on the importance of foot exams. This research planned to address the lack of foot care education and foot assessments amongst patients with Type 2 diabetes. Past research done on this focused on providing education to diabetic patients either at home or in a setting where patients can come and receive the education. To our knowledge, no research has been done on the use of video teaching to provide …

Substance Abuse Awareness Amongst Practicing Nurses, Marjenia Williams

Doctor of Nursing Practice Projects

Background: This paper discusses the problem and potential solutions of substance abuse amongst practicing nurses. Substance abuse is prevalent among 10% of the nursing population in the United States (Sofer, 2019). This problem is more significant than the public realizes. It is essential that new nurses and student nurses become aware of the risks and the causes of substance abuse within the culture prior to them practicing.

Methods: A 45-minute educational presentation based upon 10 peer-reviewed articles which include five articles regarding the problem and five discussing solutions was utilized to facilitate open discussion of the topic. The …

Benefits Of Patient-Centered Education For Type 2 Diabetes Mellitus, Paige Bortnick

Doctor of Nursing Practice Projects

Type 2 diabetes is a chronic, lifelong illness that affects millions of individuals in the United States. The rate of diabetes has doubled over the last 20 years in America and has climbed to be the seventh leading cause of death amongst Americans. The purpose of this project was to determine if participants in the target community demonstrated increased knowledge and awareness of diabetes after receiving education. A pre-intervention and post-intervention survey was given to determine if the education was effective. Data collected revealed an increased awareness and knowledge regarding the prevalence of type 2 diabetes, lifestyle, and diet modification.

Remodeling Breastfeeding Education, Rhonda Coffey

Doctor of Nursing Practice Projects

Mothers face important decisions regarding how to feed their infants, and successful breastfeeding requires commitment, support, and education. The numerous health benefits of breastfeeding for both mothers and infants are well-documented throughout the literature, and experts recommend exclusive breastfeeding for the first year of life. Healthcare teams play a crucial role in supporting breastfeeding success by providing education, guidance, and troubleshooting assistance when complications arise. Reassurance from healthcare providers can also influence mothers' overall experiences with breastfeeding. The facility where participants deliver assists most mothers in initiating breastfeeding within 1 to 2 hours after delivery, with approximately 75% meeting this …

Improving Epilepsy Monitoring Unit Training For Registered Nurses, Akaia Danae Abernathy Lail

Doctor of Nursing Practice Projects

This quality improvement project was developed to increase the baseline knowledge of a group of registered nurses who work within a highly specialized in-patient healthcare setting, an Epilepsy Monitoring Unit (EMU). The increase in knowledge was trajected to decrease event reporting which would show improvement in this high-risk patient population’s safety. The pre-education survey was dispersed to the participants, the registered nurses, to obtain a baseline knowledge level. There was then EMU-specific educational material made available for the participants. After the set time, the participants were then given a post-education survey to determine if their post-test scores could reflect a …

Cardiovascular Disease In Firefighters, Emily Jordan Baldwin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of increased cardiovascular events in firefighters in a county in the foothills of North Carolina. Nola Pender and Dorothy Orem’s theories were utilized for this project. The literature review exhibits the prevalence and significance of cardiovascular disease in firefighters. The literature review demonstrates the benefits healthy eating and exercise have on the heart and towards the prevention of cardiovascular disease. A pre- and post-test was utilized for this project and allowed for the collection of data appropriately. The results showed education on cardiovascular disease, exercise, and healthy eating increased the knowledge …

Initial Refugee Health Assessment Educational Session, Yolondra Cochnan

Doctor of Nursing Practice Projects

The initial refugee health assessment presents an excellent opportunity to identify communicable diseases in newly arriving refugees. As the number of refugee arrivals increases, so will the need for nurses who possess the skills necessary to conduct the initial refugee health assessment. Prior to the pandemic, the United States was facing a nursing shortage. The impact of the pandemic devastated the nursing community, leaving them exhausted and burnt out, which led many nurses to retire and leave the field of nursing (National Council of State Boards of Nursing [NCSBN], 2023). Skilled nurses are needed to prevent the spread of communicable …

Improving Parental Communication With Adolescents About Sex, Amanda Blanton

Doctor of Nursing Practice Projects

In 2018, 68 million people in the United States were infected with a sexually transmitted infection. Of those 68 million, 26 million cases were newly diagnosed, and of that 26 million, half were youth aged 15-24 (Centers for Disease Control and Prevention [CDC], 2022a). The approaches to educating our youth about sexual health are inconsistent, leading to misconceptions about the dangers associated with risky sexual behavior. However, parents have the upper hand in discussing sexual health information with their children by being the child’s first contact and source of information. Teens who report talking with their parents about sex are …

Increasing Organ Donation In A University Setting, Zachary Hatton

Doctor of Nursing Practice Projects

The literature shows a strong correlation between education on organ donation and increased organ donation registration. Society has depicted a description of organ donation that is hostile and untrue. Increasing organ donation registration with knowledge sets the foundation of a grassroots movement to increase understanding and change society’s viewpoint(s) on organ donation. An education session on organ donation was developed and presented to the targeted population of 18–24-year-old students at a university in the foothills of the Appalachian Mountains. The focal point of the presentation was to dispel myths, educate on facts, and create a better understanding of organ donation …

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

Implementing A Strategic Reporting Model Among Public Health Nurse Consultants To Increase Communication, Heather Willis

Doctor of Nursing Practice Projects

Public health has seen a drastic amount of turnover post-pandemic. There was an estimated 44% turnover rate for public health registered nurses, with a vacancy rate that doubled from 12.7% in March 2020 to 23.2% in July 2022 (Skinner, 2022). With this high turnover rate, many nurses are new to North Carolina (NC) public health departments and health districts. Public Health Nurse Consultants (PHNCs) are expected to train and guide these new nursing staff members. With the turnovers continuing at the local health departments (LHDs), new nurses are not given the recommended training because of communication breakdowns. This project helped …

Bridging The Gap: Strategies To Enrich The Clinical Experience Of Undergraduate Nursing Students To Improve Clinical Judgment Skills, Gabrielle Hope

Doctor of Nursing Practice Projects

Introduction: The lack of competent clinical judgement among new graduate nurses contributes to poor patient outcomes, negatively impacting patient satisfaction scores, and subsequently raising the cost of healthcare for consumers. This project explores how reflective journaling and cooperative learning activities contribute to the development of critical thinking of nursing students during their Nursing Fundamentals clinical practicum.

Methods: Seventeen students enrolled in a private university nursing program were selected as the sample. The students were introduced to the recommended learning strategies and invited to anonymously participate in a pre-survey and post-survey. The surveys were identical in content and consisted …

Improving Sexually Transmitted Infections (Sti) Education And Access To Education For Healthcare Workers In A Rural Ambulatory Clinic, Savannah Elmore

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) are prevalent across the United States, with one in five people diagnosed in 2018, resulting in nearly $16 billion in medical costs. The prevention and treatment of STIs have been identified as a priority area for improvement, with healthcare providers playing a critical role in education, diagnosing, and treating STIs. The aim of this capstone project was to improve STI education and access to education for healthcare workers in a rural ambulatory clinic. Through a needs assessment and the development of objectives and a timeline, the project identified and addressed gaps in STI education and resources, …

Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton

Doctor of Nursing Practice Projects

Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.

Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.

Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …

Combating The Opioid Crisis: Opioid And Naloxone Training In A Rural School District, Phadra K. Murray

Doctor of Nursing Practice Projects

Background: The opioid epidemic is plaguing North Carolina and has crept its way into the academic setting of many elementary, middle, and high schools in the state, causing school nurses to scramble and search for ways to keep students safe. This DNP project was designed to educate school nurses in a rural county in eastern North Carolina about opioid education and naloxone administration. This project intended to increase the knowledge and confidence level of school nurses in case of an opioid overdose emergency within the school. As more and more children and adolescents experiment with opioids, there is an urgent …

Dying Is The Easiest Part: Implications Of Palliative Care In America, Sophia Jordan

Undergraduate Honors Theses

The purpose of this paper is to uncover why Americans fear death. What are the foundational principles that cause most individuals of the American society to prolong the dying process? The topics discussed will include physician bias, disease mongering by pharmaceutical companies, consequences of aggressive treatment, the barriers to palliative care and the specific effects of pediatric palliative care. There is a small amount of research on this specific topic, therefore, this paper also seeks to bring awareness to the benefits of palliative care. It is the overall aim of this paper for society to shift their beliefs towards the …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Cardiovascular Disease Improvement Project, Deglan K. Mccrystal

Doctor of Nursing Practice Projects

Health prevention promotes positive healthcare outcomes by identifying risk factors associated with a disease process in its early stages to halt or slow its progression. Preventions, like routine screenings, facilitate the identification of risk factors or the initiation of treatment of a disease. Identifying risk factors, which often go unrecognized, helps to manage conditions like cardiovascular disease before it progresses in severity. Early treatment options or identifying risk factors that lead to cardiac disease positively impact healthcare costs by reducing the number of hospital visits, emergency services, and the need for costly long-term care. Prevention increases the quality of disease …

Addressing Nursing School Retention: The Necessity Of Orientation In Nursing Education, Kerstin A. Queen

Doctor of Nursing Practice Projects

Nursing schools have been challenged to impact attrition and retention by creating an environment that increases student success. This DNP project was created to impact the current nursing shortage by increasing the number of nursing students who were retained after the first semester of nursing school. The DNP Project Leader designed a structured orientation program consisting of a 2-day in-person orientation and an online repository of resources. The DNP project sought to increase retention and provide pre-licensure students with gained skills to progress in the nursing program after the first semester in nursing school. The in-person orientation program provided participants …

Nursing Care During Natural Disasters, War Zones, And Mass Casualty Incidents: Implications For An Educational And Professional Overhaul, Erin N. White

Undergraduate Honors Theses

Emergency situations around the world are inevitable. Any nurse who practices for any period of time is sure to encounter situations like these. Their hospital may be flooded with traumatic and severely life-threatening patient cases where supplies can become scarce. In these situations, a nurse and all other healthcare personnel are expected to act effectively, efficiently and in a highly organized way. Despite this need, many hospitals fail to implement effective disaster preparedness programs and plans. This leaves healthcare workers at a loss for how to treat patients, communicate within and outside of the hospital, coordinate transport, and all the …

Effects Of Nurse-Led Hemodialysis Education Intervention On Hospital Readmission Rates, Kristi L. Keller

Master of Science in Nursing Theses and Projects

Patients on maintenance hemodialysis have high rates of 30-day hospital readmissions. This causes a high burden on the Medicare budget as well as a high burden on hospitals, and the number of hemodialysis patients is only expected to increase. The readmission rate for maintenance hemodialysis patients in the project facility is higher than the United States average. Current education in the project facility is for patients to receive some printed booklets, pamphlets, and internet materials to read after discharge from the hospital. The proposed change to practice is to receive one-on-one education designed by hemodialysis nurses and to develop an …

Operating Room Efficiency: Time Is Money, Hannah Leonard

Master of Science in Nursing Theses and Projects

Healthcare costs, including the costs of surgery, are very expensive for patients. The operating room is a huge source of income and expenses for hospitals. In the operating room, there is room for improvement to improve efficiency as well as decrease the costs for patients and healthcare systems without harming patient care. By decreasing turnover time, increasing first case on-time starts, and better preparing for the daily flow in the operating room, there is a proposed cost saving. This project proposal will address methods to decrease turnover time between surgical cases. It will also target improvement in first case start …

Increasing Nurses' Comfortability Using The Defibrillator, Mandy Whitaker

Doctor of Nursing Practice Projects

The educational needs of nurses vary depending on the practice setting in which he or she is employed. Some competencies are taught yearly or bi-yearly. The current process for registered nurses to learn how to use the defibrillator is through the advanced cardiovascular life support (ACLS) training they are required to take every 2 years. Although a certification proves a nurse is competent in a certain area, skills tend to be forgotten over time. It is often noted “if you don’t use your skills, you lose them.” Nelson and Aguirri (2020) reported even though there are many facets to the …

Advanced Practice Registered Nurses And Healthcare Disparities: Understanding The Impact Of Implicit Bias, Marla Lepley-Starr

Doctor of Nursing Practice Projects

Introduction: Disparities in healthcare have long been a challenge for physicians, advanced practice providers, nurses, and other interdisciplinary team members. More recently, population health-focused efforts have been implemented to manage everincreasing rates of diabetes, hypertension, and obesity, as well as lack of transportation, limited access to care, and poverty (North Carolina Department of Health and Human Services [NCDHHS], 2019). Racism, sexism, ageism, sizeism, etc., are present in the healthcare setting and manifests in implicit bias during care delivery. This can manifest as beliefs, behaviors/practices, and emotions of the provider (Paradies et al., 2014). Research is limited related to the …

Connecting Simulation-Based Learning And Quality Improvement Among Student Nurses To Prevent Catheter-Associated Urinary Tract Infections, Jason Defreitas

Doctor of Nursing Practice Projects

Hospital Acquired Infections (HAIs) are a form of infection a patient acquired during hospitalization. Whether through the application or implementation of medical devices, performing bedside procedures, or non-adherence to following aseptic techniques, healthcare providers are responsible to ensure patients remain safe throughout the course of their inpatient treatment. Over the past 2 years, the Centers for Disease Control and Prevention (CDC), has reported HAIs, specifically catheter-associated urinary tract infections (CAUTI) have increased above pre-pandemic reported cases (CDC, 2021). These types of infections can lead to many factors that affect the patient and their family such as, “increased length of stay …