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Articles 1 - 25 of 25
Full-Text Articles in Nursing
Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint
Doctor of Nursing Practice Final Manuscripts
Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.
Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …
Educating And Improving Collegiate Athlete Sunscreen Use, Julia Pederson
Educating And Improving Collegiate Athlete Sunscreen Use, Julia Pederson
Doctor of Nursing Practice Final Manuscripts
Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to prospectively evaluate the ability to alter the behavior of young adults by providing sunscreen education and thereby reduce their risk of skin cancer from sun exposure. Twenty-three collegiate athletes ages 18 to 21 years old who were on the university softball team were enrolled. These student athletes were then educated about the impact of daily sun protection and risk factors. The goal was to observe an increase in sunscreen use and increase sun exposure awareness.
Background: Skin cancer is the most frequently diagnosed cancer in …
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher
Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher
Doctor of Nursing Practice Final Manuscripts
Pancreatic cancer remains one of the most complex and lethal diseases worldwide with surgical resection as a major treatment choice. Although surgery may be one of the only options for advanced pancreatic cancer, it is not without a lengthy hospital stay, a long list of possible postoperative complications, and an increased risk for readmission after discharge. Enhanced recovery after surgery (ERAS) programs have been implemented for years in other surgical services for cancer care. These programs have now been extended and researched to include patients undergoing surgery for pancreatic cancer. These programs are designed to assist patients and their families …
National Early Warning Score (News) For Covid-19 Infected Patients: A Clinical Guidance Tool, Robert Villegas
National Early Warning Score (News) For Covid-19 Infected Patients: A Clinical Guidance Tool, Robert Villegas
Doctor of Nursing Practice Final Manuscripts
Background: Coronavirus 2019 (COVID-19) presents with variable clinical manifestations from asymptomatic to life-threatening organ dysfunction. The National Early Warning Score, also known as NEWS, was initially developed to detect adult inpatient deterioration using existing physiological data and adverse clinical outcomes from 35,585 medical admissions. The NEWS guideline consists of six parameters: respiratory rate, pulse, oxygen saturation, temperature, systolic blood pressure, and level of consciousness.
Purpose: This project implemented NEWS guidelines to identify patients at high risk for deterioration with COVID-19.
Evidence-Based Interventions: The project included retrospective-prospective chart reviews for 100 patients diagnosed with COVID-19 from October 2020 to December 2020. …
Development Of A Nurse Practitioner Driven Program For Cardiology Providers To Increase Knowledge And Awareness Of Neurodevelopmental Assessment Needs In Children With Congenital Heart Defects, Michele Readman
Doctor of Nursing Practice Final Manuscripts
Children diagnosed with congenital heart defects are at increased risk for neurodevelopmental delays. Timely referral of patients to a neurodevelopmental clinic for initial evaluation and referrals to support services can improve learning outcomes, provide early intervention for neurodevelopmental disorders, and mediate factors affecting low quality of life. Nationally, a substantial proportion of pediatric cardiologists are not referring children for neurodevelopmental evaluation. A review of patient referrals to a Cardiac Neurodevelopmental Clinic within an urban children’s hospital demonstrated an opportunity to improve provider awareness and knowledge of referral recommendations. Using the Iowa Model of Evidence-Based Practice to Promote Quality Care, an …
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Doctor of Nursing Practice Final Manuscripts
Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …
The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer
The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer
Dissertations
The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women
Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.
Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.
Methods: A retrospective cohort study design. The Adult Treatment Panel …
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Doctor of Nursing Practice Final Manuscripts
Abstract
The literature is clear that the diagnosis, treatment, and plan of care for hypertension in adults should rely, at least in part, on ambulatory blood pressure. Using in-office blood pressures alone risks inaccurate measurements and can result in inappropriate treatments. Many clinics, however, do not adhere to this recommendation and will fall back on clinic readings which puts the patient at risk of mismanaged hypertension and polypharmacy. This project was formulated to identify the extent to which hypertensive patients were diagnosed and managed without the use of home blood pressure monitoring in a small local community clinic. This …
A Guide To Vaccine Policy Change At A National Level, Janelle Bird
A Guide To Vaccine Policy Change At A National Level, Janelle Bird
Doctor of Nursing Practice Final Manuscripts
Abstract
Health policy is in a near constant state of improvement. In order to solidify those improvements, health policy requires assistance from the upcoming generations of healthcare workers to push for those changes. Due to the outdated vaccination policy in the American Nurses Association (ANA), many states continued to issue exemptions based upon unsupported religious preferences. This helped to worsen the outbreak of measles in 2018-2019. The Previous ANA Policy on Vaccinations as of July 21, 2015 stated the ANA supports immunization exemptions only for the following reasons: Medical contraindications and Religious beliefs. Educate and train future health care professionals …
Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek
Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek
Doctor of Nursing Practice Final Manuscripts
Eczema, or atopic dermatitis, is a complex and chronic condition that affects approximately 10% of children throughout the United States (Brown et al., 2018). The American Academy of Allergy Asthma & Immunology (AAAAI) (2017) estimates the average cost of eczema management for each patient is approximately $3,302 per year. The complex nature of atopic dermatitis indicates a need for individualized treatment plans. Research has shown that standardized patient teaching, written education materials, and Eczema Action Plans (EAP) reinforce patient teaching, parental understanding, and improve quality of life. This evidence-based practice (EBP) project introduces the use of a written Eczema Action …
Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd
Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd
Doctor of Nursing Practice Final Manuscripts
Purpose of Project: The ultimate goal of this short-term pilot project is for
overweight or obese osteoarthritis patients to increase their knowledge on the benefits of
weight loss and physical activity. Research shows that for every kilogram of weight lost,
2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to
thirty to fifty percent and improve quality of life. Following education from the provider,
patients will understand the correlation of osteoarthritis symptom management with
weight loss.
EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based
Practice to Promote Quality Care. This addresses …
Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel
Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel
Doctor of Nursing Practice Final Manuscripts
Abstract
Background
Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.
Methods:
Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …
Improving Latent Tuberculosis Infection (Ltbi) Screening And Treatment In A School-Based Setting, Andrea Bell
Improving Latent Tuberculosis Infection (Ltbi) Screening And Treatment In A School-Based Setting, Andrea Bell
Doctor of Nursing Practice Final Manuscripts
Abstract
Background: San Diego County’s tuberculosis (TB) incidence rate is nearly double than the national rate. In 2019, there have been 5 cases of active TB in the county’s public high schools, which have demonstrated the need for prevention interventions in this setting.
Objectives: This evidence-based project is aimed to increase awareness, screening and treatment of latent TB infection (LTBI) in the school setting.
Methods: A TB risk assessment form and consent was sent in the registration packets. A one-time TB educational presentation was given to high school freshman students with a pretest and posttest. For students at-risk, a confidential …
Implementing A Basal-Bolus Insulin Regimen Via A Manual Insulin Pump Device, Helen Stearns
Implementing A Basal-Bolus Insulin Regimen Via A Manual Insulin Pump Device, Helen Stearns
Doctor of Nursing Practice Final Manuscripts
Abstract
Purpose:The purpose of this evidence-based practice project is to decrease glycated hemoglobin (HgbA1C) levelsby initiating use of a manual insulin pump in patients with Type II Diabetes Mellitus (T2DM) with poor glycemic control who are on multiple daily insulin injections (MDII).
Background: Uncontrolled hyperglycemia is associated with a myriad of complications and co-morbidities that are generally associated with vascular changes that include nephropathy, neuropathy, blindness, stroke, and heart disease (Winter et al., 2015). Coronary artery disease and cerebrovascular disease alone accounts for approximately 65% of the deaths in diabetic patients (Molinaro & Dauscher, 2017). Achieving and maintaining therapeutic …
Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard
Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard
Dissertations
Abstract Background: Delirium is associated with devastating outcomes, cognitive loss,
decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART- DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.
Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, …
The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell
The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell
Doctor of Nursing Practice Final Manuscripts
The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control
Abstract
Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.
Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to eat less …
Shingles Vaccine: Identifying High Risk Groups In The Ibd Clinic Setting, Crystal Barajas
Shingles Vaccine: Identifying High Risk Groups In The Ibd Clinic Setting, Crystal Barajas
Doctor of Nursing Practice Final Manuscripts
Title: Shingles Vaccine: Identifying high risk groups in the IBD clinic setting
Background: The Inflammatory Bowel Disease (IBD) population is an immunocompromised patient population who is at risk for Herpes Zoster (HZ) due to their medication regimen, which further compromises their immune system. It can be difficult for patients to receive appropriate preventative health maintenance measures due to patients’ fears, primary care providers’ lack of knowledge, and gastroenterologists not addressing what may be considered primary care topics. Furthermore, evidence demonstrates that IBD patients have low vaccination rates despite insurance coverage.
Purpose of Project: (a) To increase awareness of the …
Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph
Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph
Doctor of Nursing Practice Final Manuscripts
Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidenced-based project was to increase chlamydia pre- screening and screening in women under age 25 presenting with urinary symptoms. Interventions included chlamydia pre-screening alerts embedded into the electronic medical record. Three-month evaluation showed a chlamydia pre-screening rate of 100% and an increase in chlamydia screening by 9%.
A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson
A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson
Doctor of Nursing Practice Final Manuscripts
HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.
The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy behavior …
Health Care Transition Program For Adolescents With Spina Bifida, Teresa M. Scavone
Health Care Transition Program For Adolescents With Spina Bifida, Teresa M. Scavone
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidence-based project was to evaluate the feasibility of implementing an NP facilitated formal transition program for adolescents with Spina Bifida. There is an increased awareness of the need for health care transition for youth with special health care needs (YSHCN) due to the 2009-2010 Maternal Child Health Branch National Survey findings that only 40% of YSHCN receive adequate support for transition that meets the core outcome measures. Recent studies have investigated transition in youth with chronic disease specific conditions such as diabetes, cystic fibrosis, and congenital heart defects, and provide valuable insight into possible strategies for …
Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien
Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien
Doctor of Nursing Practice Final Manuscripts
Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.
Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …
Transition After Breast Cancer Treatment: Implementing Survivorship Care Plans, Susan Hope Klein
Transition After Breast Cancer Treatment: Implementing Survivorship Care Plans, Susan Hope Klein
Doctor of Nursing Practice Final Manuscripts
The success of cancer treatments have resulted in a rapid growth of survivors, providing the impetus for the oncology community to examine models of care supporting smooth transition from active treatment to survivorship care. While initially a recommendation of the Institute of Medicine, treatment summaries and survivorship care plans are now an accreditation requirement for many organizations. This article describes the implementation of an evidence based practice project designed to meet these standards while improving the knowledge and satisfaction of a population of breast cancer patients at a community-based oncology practice.
Heart Failure Patient Self-Care: An Evidence-Based Outpatient Management Program, Christine Marie Ensign, Shelley Hawkins, Barry Greenberg
Heart Failure Patient Self-Care: An Evidence-Based Outpatient Management Program, Christine Marie Ensign, Shelley Hawkins, Barry Greenberg
Doctor of Nursing Practice Final Manuscripts
Background: According to the American Heart Association, there are over 5 million people in the United States with heart failure (HF) and projections suggest the prevalence of HF will increase by 46% through 2030. HF is the most common cause of hospital admissions in the United States for patients age 65 years or older and despite improvement outcomes, national readmission rates remain high at 23%. Current guidelines recommend health professionals provide comprehensive HF education and counseling that is not only focused on knowledge, but also on skills of management and self-care behaviors. In order to achieve quality patient-centered care, …
Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np
Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np
School of Nursing and Health Science: Faculty Scholarship
Purpose
To describe and compare patient perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who receive flu vaccines and those who do not.
Data Sources
Data collection during 2003 included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight (108) patients participated in the study.
Conclusions
Top barriers included fear of side effects from vaccine (35%) and fear of contracting the flu (30%). Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Barriers, motivators and patient decisional conflict differed depending upon patient …