Nursing Commons^™

Social Determinants Of Health And Health Confidence: A Cross-Sectional Study, Laura Truman, Patricia Calero, Caroline Etland, Razel Bacuetes Milo, Cynthia D. Connelly

School of Nursing and Health Science: Faculty Scholarship

No abstract provided.

Between-Visit Asthma Symptom Monitoring With A Scalable Digital Intervention: A Randomized Clinical Trial, Robert S. Rudin, Savanna Plombon, Jorge Sulca Flores, Jessica L. Sousa, Jorge Rodriguez, Dinah Foer, Stuart Lipsitz, Maria O. Edelen, David Bates, Adriana Arcia, Anuj K. Dalal

School of Nursing and Health Science: Faculty Scholarship

No abstract provided.

A Systematic Review Of The Non-English Versions Of The Perceived Stress Scale (Pss)-10 Psychometric Analysis, Razel Bacuetes Milo, Arlin Ramira, Sandra Peppard, Maria Luisa B. Ramira, Roxane Brown, Kathleen Soon, Maria Fontimayor, Jaden B. Milo, Patricia Calero

School of Nursing and Health Science: Faculty Scholarship

No abstract provided.

Translated Versions Of The English Satisfaction With Life Scale (Swls) Among Adult Participants: A Systematic Review, Razel Bacuetes Milo, Nicole Martinez, Theresa Asmus, Jennie Lee, Kathleen Soon, Jaden Milo, Patricia Calero

School of Nursing and Health Science: Faculty Scholarship

No abstract provided.

Postpartum Depression Screening In The Neonatal Intensive Care Unit At A Tertiary Pediatric Hospital, Abbie Bates

Doctor of Nursing Practice Final Manuscripts

POSTPARTUM DEPRESSION SCREENING IN THE NEONATAL INTENSIVE CARE UNIT AT A TERTIARY PEDICTRIC HOSPITAL

By

Abbie Kim Bates

Razel Bacuetes Milo, PH.D. DNP., FNP-C

Background: Postpartum depression (PPD) is a treatable mood disorder with an onset at 1-3 months after childbirth. In the United States, PPD occurs at a rate of 1 in 8 women and as high as 1 in 5 women in parts of the country. In unique populations such as the neonatal intensive care unit (NICU), PPD rates can be as high as 40%. The treatment rate for PPD is 50% with a sizable percentage of …

Reducing Maternal Morbidity From Peripartum Hemorrhage In Cesarean Delivery, Jennie Lee

Dissertations

Background/Purpose: Maternal hemorrhage is the second highest cause of direct maternal death and the leading cause of morbidity and mortality in the United States. This public health crisis is highlighted by the economic burden of over $30.8 million annually in the United States. The greatest tragedy in the review of maternal mortality is that 84% of pregnancy-related deaths were determined preventable. Identifying trends of factors that predispose women to hemorrhage can mitigate rates of severe maternal morbidity and mortality. This study describes relationships among demographic factors (maternal age, race, and ethnicity), clinical and physiologic factors, which include coexisting medical conditions …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Improving Obesity And Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence In Motivational Interviewing, Jodi Wilson

Doctor of Nursing Practice Final Manuscripts

Background: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Implementing An Abnormal Involuntary Movement Scale At An Outpatient Mental Health Clinic, Amanda Ghamsari

Doctor of Nursing Practice Final Manuscripts

Background: Movement disorders caused from psychotropic medications affect an estimated 500,000 people in the United States. These disorders bring an added cost for treatment to the patient, cause emotional distress, and may hinder daily life. Overall health and additional medication costs were increased for these patients by $25,879 per patient per year compared to patients without a movement disorder.

Purpose of Project: To address the issue, the team of mental health providers at an outpatient clinic assess their mental health patients at start of care and at follow up visits utilizing the Abnormal Involuntary Movement Scale. With the goal of …

Improving Adherence Rates To Postpartum Screening Of Diabetes In Women With Gestational Diabetes Mellitus: An Evidence-Based Project, Alicia Hernandez Punsalan

Doctor of Nursing Practice Final Manuscripts

Background: Women with a history of gestational diabetes mellitus are at increased risk of developing type 2 diabetes mellitus. Approximately 6%–10% of pregnancies in the United States are complicated by gestational diabetes mellitus, yet postpartum diabetes screening rates are low nationwide.

Purpose: This project focused on implementing a multi-modal reminder system to increase adherence to postpartum diabetes screening, or the 2-hour oral glucose tolerance test, for women with a history of gestational diabetes mellitus in the 4-12 weeks postpartum period.

Evidence-Based Practice Change: The multi-modal reminder system was comprised of an educational session for the staff reviewing current clinical guidelines …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Screening For Adverse Childhood Experiences In An Adult Intensive Outpatient Therapy Program: A Pilot Project, Kristen Curry

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to pilot the implementation of the Adverse Childhood Experiences (ACEs) Questionnaire for Adults during admission to an intensive outpatient program (IOP) to identify clients who have experienced ACEs and provide risk-reduction measures to mitigate risks of ACE-related long-term health consequences. The study site is a Southern California-based large healthcare organization that provides outpatient intensive therapy programs which employ a variety of clinicians, to provide mental health care to clients across the lifespan.

Background: Adverse Childhood Experiences (ACEs) are potentially traumatic events including neglect, abuse, and certain forms of …

Improving Hypertension Outcomes In A Rural Community With The Use Of Remote Patient Monitoring, Jessica Ruiz Cuen

Doctor of Nursing Practice Final Manuscripts

Hypertension (HTN) remains one of the leading causes of premature death. Uncontrolled HTN is known as the “silent killer,” affecting 1.28 billion adults worldwide. Management of this chronic disease requires early detection, intervention, and, most importantly, patient involvement. Recent advancements in Telehealth medicine have identified Remote Patient Monitoring (RPM) as an essential avenue in managing HTN. This project aimed to improve patient outcomes by reducing blood pressure readings and emergency room visits. This evidence-based project used the Iowa Model and examined the effects of daily remote blood pressure measurements using the transmission of biometric data using a Bluetooth-operated device linked …

Implementation Of Controlled Substance Agreements In An Adult Outpatient Psychiatric Clinic, Bryana Weimer

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.
Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most …

School Stock Albuterol, Trish Reyes

Doctor of Nursing Practice Final Manuscripts

SCHOOL STOCK BRONCHODILATOR INHALER POLICY FOR IMMMEDITE ACCESS IN SCHOOLS

Introduction: The purpose of this evidence- based practice DNP project was to do a systematic review, examine stock inhaler policies in school districts, and provide policy recommendations for school districts to implement the Stock Albuterol Access law. The Stock Albuterol law enacted in January 2024 would allow schools to provide an Albuterol inhaler on hand for a student experiencing respiratory distress. Albuterol inhalers provided by school personnel can be lifesaving, control asthma symptoms, have better health outcomes, increase the quality of life, and decrease Emergency and Urgent Care visits, and …

Implementing A Naloxone Training And Opioid Overdose Prevention Program At A Residential Addiction Treatment Center, Martha Plack

Doctor of Nursing Practice Final Manuscripts

Introduction: Amidst the escalating opioid overdose crisis in the United States, it is imperative to deploy effective harm-reduction strategies. This Doctor of Nursing Practice (DNP) project involved the development, implementation, and evaluation of a Naloxone Training and Opioid Overdose Prevention Program delivered to clients at a residential addiction treatment center. The primary objective of this project was to determine if the educational intervention led to an improvement in participants' knowledge and attitudes about opioid overdose and naloxone use.

Background: Overdose fatalities are a leading cause of injury-related death in the United States. The majority of fatal overdoses involve opioids. Unfortunately, …

Keep The Beat: Increase Sudden Cardiac Awareness And Improve Cardiac Arrest Bystander Intervention, Carley Garnica

Doctor of Nursing Practice Final Manuscripts

Background: Sudden cardiac arrest (SCA) is a rare but life-threatening condition where a person’s heart stops suddenly. It remains the leading cause of death on school campuses with chances of survival being less than 10%. Every minute without cardiopulmonary resuscitation (CPR) decreases survival by 10%. Poor outcomes are attributed to bystanders who are not prepared or are unwilling to take action in the event of a cardiac emergency. Therefore, bystanders play a crucial role in cardiac arrest.

Objectives: The purpose of this project was to educate high school students about SCA and Cardiac Chain of Survival, with the primary objective …

Impact Of Mindfulness Education And Resources On Stress In Parents Of Children With Autism Spectrum Disorder, Jacqueline James

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.

Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental …

Dm Education On Lifestyle Modification To Improve Dm Knowledge Retention And Self-Care Confidence, Jinyoung Sanchez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice project was to provide diabetes education to improve diabetes knowledge and self-care confidence for patients with type 2 diabetes admitted to a tertiary hospital in San Diego. First, this study was to assess their DM knowledge and self-confidence before the education was provided. Second, based on the initial assessment and the education on lifestyle modification, 3 months of follow up was assessed to see if the education had been effective. Third, the study was to determine if the education also improved the self-confidence in managing diabetes on their own.

Background: Uncontrolled diabetes …

There’S An App For That: Reducing Stress In Peri- And Post-Menopausal Women, Roxane M. Brown, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based Doctor of Nursing Practice project aimed to demonstrate the impact of Calm mobile application mindfulness activities on perceived stress levels in peri- and post-menopausal women ages 45 - 60 years old in a community setting.

Background: In 2020, 31.8 million women in the United States (U.S.) were between 45 and 60 years old. They are mothers, daughters, employees, and bosses, navigate intimate and social relationships, and are often caregivers. It can be a stressful stage of life. Meanwhile, these women experience menopausal changes, including hot flashes, mood changes, sleep disturbances, and cognitive difficulties. Peri- and post-menopausal women …

Keep Our Children Smiling: Fluoride Varnish Education In The Pediatric Primary Care Setting, Isabella Mortola

Doctor of Nursing Practice Final Manuscripts

Background: Dental caries is the most common chronic childhood disease. In early childhood, it is associated with many negative factors such as pain, loss of teeth, and impaired growth. Fluoride varnish (FV) is a protective resin coating treatment that is reimbursable by most insurances and is recommended by the American Academy of Pediatrics (AAP), United States Preventative Services Task Force (USPSTF), and the American Dental Association (ADA) due to its high efficacy in preventing dental caries. FV is a low-cost treatment that can be easily applied in 1-2 minutes during a well-child visit in the primary care setting, where children …

Personalized Text Message Reminders For Psychiatric Out Patients, Jusac Suryanata

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the use of personalized text message reminders to increase adherence to out-patient psychiatric visits and decrease the rate of no-show appointments. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians to provide mental health care to clients across the lifespan for a variety of patients throughout all socio-economic brackets.

Background: Approximately 23% of individuals who are scheduled with this provider result with a no-show appointment during the period of data mining. In general, psychiatric patients are most …

Fall Reduction In The Home Setting For Older Adults: An Evidenced Based Practice Project, Alison Birnie

Doctor of Nursing Practice Final Manuscripts

Falls in the elderly over the age of 65 are the highest mechanism of injury in a Level II TraumaCenter in the SanGabriel Valley. In reviewing the data from 2021-2022, there were 20,653 patients over the age of 65 that arrived in the EmergencyDepartment, 12.3% of those patients had falls. The Senior Care Network is a service line of Huntington Hospital whose mission is to support the health and well-being of older adults living in and around Pasadena and the San Gabriel Valley. To meet this mission, the Multipurpose Senior Services Program (MSSP) supports community members 65 and older covered …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Assessing The Influence Of Education And The Diet Readiness Test On Self-Efficacy, Motivation And Resilience In Overweight Women, Ijeoma Iwu

Doctor of Nursing Practice Final Manuscripts

Purpose

The purpose of this evidence-based project is to assess motivation for weight loss and resilience to make lasting changes with weight management. The Diet Readiness Test (DRT) Questionnaire is a behaviorally based assessment tool used to evaluate psychological status prior to or during a weight-loss management program based on patients’ attitudes toward diet and exercise. The goal of using this survey was to identify predictive factors of successful weight changes for practitioners to implement into their approach to tackling obesity.

Background

One of the rising crises both in the United States and globally has been the topic of obesity. …

Education Program To Increase Compliance With Advance Directive Completion In A Primary Care Setting Among Filipino Americans, Genalin Paglingayen

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This evidence-based practice project aimed to provide an education program to Filipino Americans in their preferred language (English or Tagalog) to improve compliance with Advance Directive (AD) completion in a primary care setting. Educating them about AD empowers patients with their decision-making about their health in situations where they are incapacitated and unable to make sound decisions. Moreover, it will eliminate the decision-making problem for family members.

Background: An advance directive is a document that empowers patients to convey their wishes to their healthcare provider when they can no longer decide for themselves. Evidence suggested that …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

Increasing Patient Access To Mental Health Providers: Improving Depression And Anxiety Outcomes For African American Women Aged 18 Years Old And Older, Twanna Davis-Arnold, Farnaz Trasandes

Doctor of Nursing Practice Final Manuscripts

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis …

Evaluating The Implementation Of Biplane Ultrasound Probes For Guided Peripheral Intravenous Access In The Emergency Department, Ian Troupe

Doctor of Nursing Practice Final Manuscripts

Background: Single plane ultrasound (US) probes are currently standardized for initiating US guided peripheral intravenous (USGPIV) access for difficult intravenous access (DIVA) patients in the emergency department (ED). Emerging literature reveals the increased efficacy of biplane US probes for USGPIV access with an improved success rate of up to 36.6%.

Purpose of Project: Implement best practice recommendations by integrating one biplane US probe for USGPIV access at a Level 1 Trauma Center ED in Southern California after training ten registered nurses (RN) on its use. The project aimed to improve patient outcomes, department flow, RN education, and utilization …