Evaluation Of Dyad Effectiveness In A Psychiatric Healthcare Facility, Elizabeth Smith

DNP Projects

Background: Inadequate communication can lead to poor quality of care and patient outcomes. Physician-nurse dyad partnerships have been shown to increase effective communication but there is a lack of data to show the impact these dyads have on dyad members’ perceptions about patient safety, work engagement and quality patient outcome measures.

Purpose: This purpose of this project was to determine if a physician-nurse dyad structure in an inpatient psychiatric hospital would lead to improved participant perception about patient safety, work engagement, and patient quality outcomes.

Methods: A quasi-experimental pretest-posttest design was used. Participant perceptions related to patient safety, work engagement, …

The Effect Of An Educational Intervention On Clinical Rn Knowledge And Attitudes Toward Shared Governance Program At Eastern State Hospital, Tanna Mckinney

DNP Projects

Background: Shared governance programs are a popular way to improve Registered Nurse (RN) engagement and retention. These programs are notoriously difficult to garner and maintain participation. However, successful shared governance can improve patient outcomes, patient satisfaction and RN engagement.

Conceptual Framework: The theory of planned behavior was used as the conceptual framework for this study. This theory posits that attitudes, subjective norms, perceived behavioral control and intentions towards a behavior can predict behavioral achievement.

Methodology: Eighty clinical registered nurses were invited to voluntarily complete a survey to determine current attitudes about shared governance and intent to participate in shared governance …

Implementation Of Education And Use Of A Screening Tool To Assess Palliative Care Needs In The Critical Care Setting, Megan Stoeckinger

DNP Projects

Purpose: The purpose of this study was to measure palliative care knowledge, attitudes, perceived empowerment, and familiarity of the Supportive Palliative Care Indicators Tool (SPICT) among critical care nurses and advanced practice providers (APPs) before and after viewing a web-based educational video on an adult medicine intensive care unit (MICU).

Methods: This study was a one group pre- and post- implementation assessment using a web-based educational video and electronic surveys. The population included critical care nurses and advanced practice providers (APPs). This study spanned the timeframe between January 2022 and March 2022.

Results: Paired t-tests comparing pre-intervention …

Evaluation Of A Process Change On Mammography Screening Rates In A Family And Community Medicine Clinic, Christina Rademaker

DNP Projects

Abstract

Background and Significance: Breast cancer is the 2^nd leading cause of cancer death among women worldwide. Mammography is a screening approach used in the detection of breast cancer and proven to help reduce mortality. Only 72.8% of eligible American women have been screened for breast cancer within the past 2 years. One urban family and community medicine clinic (FCM) fell below the national average with a rate of 60.9%; as a result, they implemented an evidence-based strategy to improve mammography rates within the clinic.

Purpose: The purpose of this study was to evaluate the implementation of a telephone …

Improving Pediatric Providers’ Intent For Safe Sleep Anticipatory Guidance With An Electronic Educational Intervention, Lindsay Hamilton

DNP Projects

Background: Sudden Infant Death Syndrome or SIDS is the fourth leading cause of infant mortality in the United States. There is no definitive cause of death pertaining to SIDS, but certain risk factors have been identified that increase the risk of SIDS in an infant. While safe-sleep education during the prenatal time of parenthood is important, it is also essential to continue this education comprehensively in the primary care setting and in any other exposure the family has to healthcare.

Objective: The objective of this study is to evaluate the self-reported knowledge of University of Kentucky Children’s Hospital Pediatric Residents’, …

Improving Smoking History Screening And Documentation To Increase Lung Cancer Screenings In Primary Care Clinics, Destinee R. Rein

DNP Projects

BACKGROUND: In the United States, lung cancer has the highest mortality rate of all other cancers among men and women. Kentucky is ranked 50th among all states, leading the nation in new lung cancer cases each year. Lung cancer screening using Low dose Computed Tomography (LDCT) can reduce lung cancer-related morbidity and mortality. Lack of smoking history documentation to identify eligible patients is a major contributing factor to low national screening rates. Obtaining complete smoking history remains the most important technique in identifying candidates for lung cancer screening.

PURPOSE: The purpose of this quality improvement project was to evaluate …

The Impact Of Icu Telemedicine On Patient Outcomes In The Surgical Critical Care Setting: An Observational Study, Megan Steely

DNP Projects

Abstract

Background: In April 2020, the University of Kentucky (UK) implemented a division entitled the Enhanced Care through Advanced Technology Intensive Care Unit (eCAT ICU) to provide tele-critical care (TCC) services in all critical care areas at UK Healthcare. The eCAT ICU at UK HealthCare was the first TCC delivery system of its kind in the state of Kentucky. Use of TCC has been associated with improved patient outcomes and decreased costs.

Purpose: The purpose of this study was to analyze targeted outcomes in the surgical critical care population pre- and post-implementation of TCC at UK HealthCare. Specifically, the aims …

Effects Of An Educational Module On Perceived Knowledge, Perceived Barriers, And Attitudes Related To Sleep-Promoting Practices Among Bedside Nursing Staff Within A Medical Intensive Care Unit, Arden Gross

DNP Projects

Background: Adult patients in the critical care setting are at risk for experiencing sleep disruption due to critical illness and environmental factors. The effects of disruption to the sleep/wake cycle has been associated with dysregulation of biological processes such as healing and immune system functioning. Current literature includes the use of sleep-promoting protocols that aim to reduce environmental disruptors of sleep in the critical care setting. However, there is a disconnect between the perceived importance of sleep and clinical practice. Additionally, there is a gap in literature exploring the effects of educational-modalities on nursing staff knowledge, perceptions, and attitudes related …

The Effect Of A Web-Based Training On Suicide Knowledge, Attitudes, And Health Access Behaviors Of Behavioral Health Nurses Regarding Suicide Prevention, Marc Woods

DNP Projects

Background: Nurses, critical to the health care delivery system, experience a variety of psychological stressors that predispose them to suicide risk. Recent studies have verified elevated suicide risks in nurses when compared to the general population. There is limited understanding regarding the effectiveness of various strategies to reduce risk factors and increase protective factors for suicide among nurses.

Purpose: The purpose of this study was to evaluate if a web-based education module can improve the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in behavioral health nurses.

Conceptual Framework: Ajzen’s theory of …

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

DNP Projects

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

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

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

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

DNP Projects

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

Purpose: The purpose of this …

Using The Samscore Questionnaire To Increase Skin Cancer Risk Screenings At Adult Patient Annual Exams, Taylor Abner

DNP Projects

Background: Malignant melanoma has become an increasingly prevalent problem in the United States. The earlier a skin cancer is identified, the better the outcome. There are conflicting recommendations about screening for skin cancer but in general identifying high risk patients is important and it is not being achieved in primary care.

Purpose: The purpose of this study is to evaluate use of the SAMScore Questionnaire to determine high risk patients at adult annual visits.

Methods: This was a multi-phased study with a quasi-experimental design that took take place at a family and community primary care clinic in central Kentucky. Baseline …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …

The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold

DNP Projects

Background: Substance use disorder (SUD) is a disparity affecting nearly 24 million individuals in the U.S., nearly 10% of the total population. Oftentimes, the emergency department (ED) is the only medical care this population receives. There is often a lack of screening for SUD in ED’s, therefore referred care may be limited for these individuals. The National Institute on Drug Abuse Modified Assist (NMASSIST) is an evidence-based tool developed to educate and screen for SUD. This tool can be completed in a timely manner and aid in the recommended referral of care for this select population.

Purpose: The purpose of …

A Multifaceted Approach To Improving Sedation Practices In The Cardiovascular Intensive Care Unit, Casey Mingua

DNP Projects

Purpose: Sedation protocols have been positively correlated with improved patient outcomes in the intensive care unit (ICU). Therefore, healthcare leaders should direct efforts to improving protocol compliance through evidence-based strategies. The purpose of this study was to evaluate the impact of a multifaceted intervention, consisting of educational outreach, point of care (POC) reminders, and audit and feedback (A&F), on nurse compliance with an ICU sedation protocol. A secondary data analysis was performed to evaluate the impact of the intervention on patient outcomes.

Methods: This was a before/after comparative analysis. A Research Electronic Data Capture (REDCap) pre-survey (n=58) was distributed to …

The Measurement Of The Impact Of Well-Being Resources On Moral Distress And Burnout Following The Covid-19 Pandemic In Front-Line Nurse Leaders, Benjamin Hughes

DNP Projects

Background: Due to the COVID-19 pandemic, there is significant burnout among front-line nursing staff. Little literature has been published about the measurement of burnout among front-line nursing leaders, such as nurse managers and directors, nor the interventions used to help with this ever-growing issue among this group. Since the pandemic began, there have been many resources identified to help front-line staff members with burnout, but none specifically looking at what has worked or been utilized by front-line nursing leaders.

Purpose: The purpose of this project was to describe what well-being resources were identified as being effective in decreasing moral distress …

Increasing Medicare Wellness Visit Participation In A Primary Care Clinic, Katherine Rodriguez-Guerrant

DNP Projects

Background: Medicare Wellness Visits (MWV) came into use in 2011 to provide Medicare patients and their providers a chance to create a 5 to 10 year plan to prevent illness, disease, and disability. These visits are often underutilized due to various barriers on both the provider and patient side.

Purpose: The purpose of this study is to assess provider barriers to conducting MWVs and provide an educational tool that will assist providers in increasing the number of MWVs conducted within this system.

Design: This is a descriptive, quasi-experimental study to assess provider barriers combined with a Quality improvement project that …

The Effect Of Relational Aggression Training On New Emergency Department Nurses, Mary Wethington

DNP Projects

BACKGROUND: Relational aggression (RA) in nursing is widespread. One group often at risk for exposure to RA is the newly licensed nurse. RA can lead to a negative work environment which can cause poor patient outcomes and high nurse turnover.

PURPOSE: The purpose of this study was to evaluate the effects of an educational program on RA in the emergency department with newly licensed registered nurses. This was conducted using one pre and two post surveys. The surveys evaluated the nurses’ knowledge of RA self-awareness before and six weeks after an educational session.

METHODS: This was a single-site, single-unit pretest …

Tobacco Use Screening And Cessation Counseling In Primary Care, Jacob A. Heil

DNP Projects

Abstract

BACKGROUND: Primary care providers (PCPs) are poised across healthcare settings to reduce the leading cause of preventable morbidity and mortality, cigarette smoking. However, their patients may not be screened for tobacco use and miss cessation counseling, thus increasing tobacco-related diseases, and incurring costs to healthcare payers.

PURPOSE: This project seeks to identify the documentation process in a new electronic health record (EHR), communicate efficacy barriers, administer an educational intervention regarding the new process for PCPs, and measure its impact on performance of tobacco use screening and cessation counseling.

METHODS: This project was a quasi-experimental, single center, pre- and post-interventional …

Activating The Patient: A Nurse Led Coaching Intervention To Engage Health Information Seeking Behaviors Using The Ideal Discharge Framework And Get Well Network, Korinne Callihan

DNP Projects

Background: Cardiovascular (CV) patients are often overwhelmed by the unexpected emergence of the health condition, volume of knowledge for self-care mastery and acceptance of the responsibility for self-care upon care transition to the home setting. Low health literacy levels have been linked to poor outcomes in CV patients, requiring investigation into appropriate methods for patient education. The Get Well Network (GWN), an interactive digital patient education care plan at UK HealthCare (UKHC), is underutilized in this patient population.

Purpose: the purpose of this study is to assess the effect of a nurse-to-patient coaching intervention using the IDEAL discharge framework from …

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

DNP Projects

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

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

Countering Moral Distress In Ecmo Nurses With Case-Review Debriefings, Sherry D. Griggs

DNP Projects

Abstract

Background: Moral Distress occurs when nurses know the ethically correct action to take, but they are restrained from taking it. It is especially prevalent in nurses caring for critically ill patients, such as those on extra-corporeal membrane oxygenation (ECMO). Effectively addressing moral distress is crucial to the growth and health of the nursing profession, which is the cornerstone of quality and safety in healthcare.

Purpose: The purpose of this project was to evaluate the effectiveness of case-review debriefings on moral distress of ECMO nurses.

Conceptual Framework: Analysis of Moral Distress Process was utilized. This framework addresses moral distress …

Increasing Adherence To Protocolized Diuresis For De-Resuscitation Of Icu Patients By Increasing Nursing Knowledge And Confidence, Jenna Haupert

DNP Projects

Background: Fluid overload in patients requiring intensive care leads to increased costs for hospitals and patients, increased length of intensive care unit (ICU) and total hospital stay, ventilator days, acute kidney injuries, and mortality rates. Multiple studies have indicated that aggressive de-resuscitation with diuretics can decrease length of stay, ventilator days, organ injury, and mortality rates. A nurse-driven diuresis protocol utilizing intravenous (IV) push furosemide was introduced to the University of Kentucky Medicine ICU, but patients are still commonly still over-resuscitated with no plan to diurese until organ damage has occurred. By educating bedside nurses, improving their knowledge and confidence …

Nurses' Knowledge Of Delirium In The Icu, Sara Hancock

DNP Projects

Abstract

Background: Delirium costs the healthcare system $38 to $152 billion dollars annually. Nurses have a unique opportunity as healthcare providers to assess for and identify delirium, but often fail to recognize delirium.

Purpose: The purpose of this DNP project was to determine the effect of implementing an educational intervention regarding delirium risk factors, symptoms, prevention strategies, and treatments, on the knowledge of nurses working in an intensive care unit.

Methods: This DNP project used a quasi-experimental pre-test post-test design. Participants completed a pre-test (Appendix A), an educational intervention (Appendix C & D), and a post-test (Appendix B). Pre-test …

Examining The Impact Of Patient De-Escalation Techniques Training On Nurses' Feeling Of Safety, Raymond O. Young

DNP Projects

Abstract

Purpose: To evaluate the effects of patient behavioral verbal de-escalation techniques training on bedside nurses’ feeling of safety in the presence of an aggressive patient, and nurses’ confidence level in their ability to successfully de-escalate aggressive patient behavior prior to the patient becoming violent. Objectives of this study were to demonstrate increased feelings of safety and security in the workplace among nurses receiving patient de-escalation training once the training was completed; to improve the overall perception of mental health status of nurses; to improve the job satisfaction and likelihood to stay in their current position; and to assess the …

Effect Of Anticipatory Guidance On Parental Knowledge And Anxiety Prior To Discharge Of Infant From The Neonatal Intensive Care Unit To Home, Stephanie Kelty

DNP Projects

Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.

Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions. …

Increasing Confidence Of Nurses In Giving And Receiving Constructive Performance Feedback, Savanna Carroll

DNP Projects

Background: Nursing peer review is a process of reviewing standard nursing practice in an organization and comparing a nurse’s own practice to that standard. Nursing peer review contributes to the professional practice environment by assuring standard practice and competence, maintaining a culture of accountability, and maintaining psychological safety.

Purpose: The purpose of this project was to design and implement an educational intervention and simulation activity to prepare nurses to have constructive conversations with peers regarding work performance. Evaluation of the intervention would yield increased confidence and competence of nursing staff in giving constructive performance peer feedback.

Conceptual Framework: Bandura’s Social …

Opioid Overdose Prevention And Naloxone Training Among College Students, Mackenzie Thode

DNP Projects

Background: Opioid abuse is a serious national crisis affecting both public health and economic welfare across the United States. In Tennessee, more than 1,800 overdose deaths were reported in 2018, with nearly 20% of those deaths occurring in Davidson County alone. The number of overdose deaths in Nashville has steadily risen amidst the COVID-19 pandemic by approximately 32% since 2019 to a total of 619 fatal overdoses in 2020, making it the city’s deadliest year on record. Review of evidence: Research shows that intranasal (IN) naloxone training is an effective approach to combating the opioid overdose crisis and can be …

Integrating The Concept Of Trauma Into An Undergraduate Nursing Curriculum, Jacey Walker

DNP Projects

Adverse childhood experiences, or ACEs, are early childhood traumas such as abuse, neglect or household dysfunction that can cause chronic physical and mental health problems across the lifespan. Approximately 61% of the adults in the United States have experienced ACEs. The prevalence of ACEs among nurses is at least comparable to population prevalence, and rates may be higher in subpopulations of individuals who work in helping professions. The stressful and highly interpersonal nature of nursing work may exacerbate and compound the health impacts of a nurse’s underlying ACEs, affecting not only the nurse’s health, but also his or her work …

Impact Of A Telephone-Based Care Management Program On Health Outcomes For Patients With Type 2 Diabetes And Hypertension, Abbegail Miller

DNP Projects

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) were the 7th leading cause of death in the United States, accounting for over 160,000 deaths annually. Complications related to T2DM and HTN are preventable with lifestyle modifications and medications. However, research has shown that lack of patient self-management, poor medication adherence, and physician time restraints limit disease improvement. A telephone-based care management program (CMP) provides a solution to meeting patient needs. Purpose: The purpose of this scholarly project was to evaluate individual biomarkers for glycemic and HTN control, as well as self-monitoring of blood glucose (SMBG) over one year of …