Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …

The Effects Of Scheduling Acetaminophen And Methocarbamol Administration On Postoperative Opioid Use And Related Side Effects Among Cardiac Surgery Patients, Whitney Jamison

DNP Projects

The Effects of Scheduled Acetaminophen and Methocarbamol Administration on Postoperative Opioid Use and Related Side Effects Among Cardiac Surgery Patients

ABSTRACT

Purpose

Opioid therapy is commonly prescribed to combat surgical pain in hospitals across the United States and is associated with many negative side effects including dependence and nausea. The purpose of this study was to retrospectively examine the effects of scheduling acetaminophen and methocarbamol administration postoperatively throughout the cardiac surgery patients’ hospital stay. Through retrospective chart reviews, the aims of postoperative opioid use, postoperative opioid use according to hospital length of stay, antiemetic use, and opioid prescription at discharge …

The Effects Of Mindfulness Practices On Nurse Leader Resiliency, Kimberly Blanton

DNP Projects

Background: The purpose of this study was to evaluate if brief Mindfulness Based Stress Reduction (MBSR) sessions can improve nurse leader resilience and overall mindfulness.

Conceptual Framework: Two different conceptual frameworks, Jean Watson’s theory of caring and Albert Bandura’s theory of self-efficacy, were used to guide this project. Watson’s theory of caring is defined as healing of the mind, body, and spirit. This theory supports caring for oneself while caring for others. Bandura’s theory focuses on the belief that individuals can influence their own lives.

Methodology: This study employed a descriptive, pretest-posttest single site comparative design. Sixty-six nursing leaders from …

Don't Just Check The Box: Check Your Athlete's Heart: Adding A 12-Lead Ecg To Pre-Participation Screening To Identify High Risk Of Sudden Cardiac Arrest In Male High School Athletes, Shannon King

DNP Projects

PURPOSE: Sudden cardiac arrest (SCA) continues to be the leading cause of death in male high school athletes participating in competitive sports. There is gap in the current preventative screening practice of history and physical alone. The purpose of this project is to evaluate adding a 12-lead electrocardiogram (ECG) to pre-participation screening captures cardiac abnormalities that identify male athletes at a higher risk for developing SCA. METHODS: A descriptive secondary analysis design to determine the incidence of cardiac abnormalities detected with the addition of a 12-lead ECG during pre-participation screenings (annual sports physical) of high school-aged male athletes. The study …

Improving Assessment, Documentation, And Ordering Of Diabetic Retinopathy Screenings In A Primary Care Clinic, Lauren N. Motto

DNP Projects

Abstract

BACKGROUND: Diabetes mellitus (DM) is the leading cause of new blindness in American adults. As the number of people with type 2 diabetes continues to increase, the total number of people affected by diabetic retinopathy (DR) will continue to rise. Improved access to screening for DR, followed by treatment, if necessary, can reduce the progression to vision loss. Despite national recommendations, less than half of Americans with DM complete annual diabetic retinopathy screenings (DRS).

PURPOSE: The purpose of this project was to improve assessment, education, documentation, and ordering of DRS for patients with a diagnosis of type 1 and/or …

The Effect Of A Virtual Child Passenger Safety Educational Intervention On Uk Pediatric Residents' Self-Reported Knowledge, Confidence, And Anticipatory Guidance Beliefs, Brooklyn Johnson

DNP Projects

Background: Motor vehicle crashes are the leading cause of death in children. Car safety seats (CSS), when used properly, have been proven to reduce injuries and deaths in children during motor vehicle accidents. The leading cause of car seat misuse is parental lack of knowledge about proper car seat use and best practice recommendations. Studies have shown that pediatric primary care providers have variable knowledge of the most updated car safety seat recommendations and are not consistently educating parents about child passenger safety during well child checks.

Objective: To evaluate UK pediatric residents' self-reported knowledge, confidence, and anticipatory guidance beliefs …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Contraception Utilization Among Women, Ages 18-45, Receiving Medication Assisted Therapy For Opioid Use Disorder In Middle Tennessee, Kerry J. Ternes

DNP Projects

The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey …

Responding To Opioid Use Disorder: Identifying The Therapeutic Commitment Of Maine Nurse Practitioners, Jordan S. Porter

DNP Projects

Background: Buprenorphine, an underutilized pharmacotherapy, can play a key role in closing the substantial opioid use disorder (OUD) treatment gap in the United States. Although 2016 US legislation authorized trained nurse practitioners (NPs) to obtain the Drug Enforcement Agency waiver to prescribe buprenorphine for OUD, many NPs do not have the waiver, and a large proportion of waivered NPs do not prescribe to capacity. Purpose: To identify the therapeutic commitment of Maine NPs to OUD as well as understand why Maine NPs do not adopt and utilize buprenorphine for the treatment of OUD. Review of Evidence: Commitment …

Religious Coping And Christ-Centered Recovery For Women With Substance Use Disorders, Mary Beth Bever

DNP Projects

Women have unique risk factors for the development of substance use disorder (SUD), barriers to SUD treatment, and risk factors for SUD relapse that require holistic care models and provide trauma-informed care approaches that address effective coping strategies. The use of religion and spirituality has been commonplace in many SUD programs to inspire the use of positive religious coping; however, negative religious coping may also be drawn on which poses a potential harm for women with SUD. The aim of this project was to assess for a correlation in positive and negative religious coping scores and program completion rates in …

Stress And Coping In Hospice Care, Elyse L. Collier

DNP Projects

Accommodating current hospice care needs and anticipated industry expansion requires protection and optimization of human resources serving as frontline care providers. Coping responses employed by individuals serve as important determinants of their overall personal and occupational well-being. There is limited research focusing on the coping responses of hospice professionals, specifically, how they perceive and manage their own work stress and work-related quality of life. The purpose of this study was to examine how coping responses are related to work-related quality of life among individual professionals working together on outpatient interdisciplinary hospice care teams. A cross-sectional survey-based design was utilized to …

Effects Of Adverse Childhood Experiences On Pain Interference And Anxiety In An Integrative Chronic Pain Clinic, Kerrin Doran Kunze

DNP Projects

One in four children in the United States will experience abuse or neglect before the age of 18-years-old. Adverse childhood experiences increase the risk for chronic pain disorders and maladaptive coping strategies that can intensify patients’ experience of pain and disrupt or prolong treatment. Current research encourages a biopsychosocial approach to understanding and treating chronic pain, one that acknowledges the influence of childhood trauma and works to restore health by treating pain of the body, mind, and spirit. This retrospective study examined self-reported measures in a convenience sample of 162 individuals seeking treatment for chronic pain at an integrative care …

Self-Care And Burnout Among Nurses In A Hospital Setting, Hannah Stirnaman

DNP Projects

Rates of burnout among healthcare professionals are well documented. The burnout of professional nurses is associated with a number of poor outcomes with costly consequences to both the healthcare system and public health. The American Nurses Association (ANA) has pushed for an initiative entitled Healthy Nurse Healthy Nation that encourages nurses to prioritize their health first and lists compelling statistics of nurse stress, mental health concerns, and workplace injuries. Burnout, a combination of emotional exhaustion, depersonalization, and decreased productivity, is one consequence of workplace stress and the demands placed on nurses; however, there is a lack of research on individualized …

Mortality Influenced By Sepsis Bundle Compliance And Initial Lactic Acid In Severe Sepsis And Septic Shock, Evelyn George

DNP Projects

Sepsis, a life-threatening infection killing 270,000 yearly, is a concern to health care providers, policy makers, and patients due to its high volume and increasing cost. Patients older than 64 years have a higher occurrence of sepsis and greater mortality risk. The Surviving Sepsis Guidelines (SSG) recommends the use of the three-hour bundle that standardizes care to decrease cost, morbidity, and mortality. The three-hour bundle includes two treatments, intravenous fluids and antibiotics, and two tests, blood cultures and lactic acid level. One bundle element, lactic acid level, is associated with higher mortality rates, although only a few studies exist. The …

Screening For Alcohol Use, Misuse, Or Abuse In The Primary Care Setting Using The Audit-C Tool: An Extension Study, Courtney Amanda Minnis

DNP Projects

Abstract

PURPOSE: The purpose of this study was to improve alcohol screening rates in one primary care setting by educating and supporting providers and office staff on the use of the Audit-C alcohol screening tool.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected utilizing a retrospective chart review from the electronic medical records of adults over age 18 years by visit type: New Patient Visit, Annual Visit, or Employee Wellness Exam. Data included: demographic data of patient age, race, gender, the Audit-C score, and whether or not an intervention was performed.

RESULTS: Five providers …

Trauma-Informed Care: Needs Assessment In A Pediatric Intensive Care Unit, Christine Young

DNP Projects

It is estimated that over 60 percent of children and adolescents in the United States have experienced one or more traumatic event (Saunders & Adams, 2014) resulting in increased psychosocial needs. Trauma-Informed Care (TIC) involves recognizing and validating the effects of trauma and promotes for effective treatment. The purpose of this Doctor of Nursing Practice (DNP) project was to describe the frequency of neglect and trauma, including abuse and accidental events, among patients admitted to a pediatric intensive care unit and identify types of interventions and referrals documented by providers in the medical record. This project was based on a …

A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons

DNP Projects

Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.

Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.

Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …

Evaluation Of Emergency Department Use By Adult Patients With Established Primary Care Provider, Sherry Tolentino

DNP Projects

BACKGROUND: Overutilization of the Emergency Department (ED) contributes to the unnecessary use of healthcare resources. One common cause is related to barriers to Primary Care access. Patients use the ED for conditions that can be managed in primary care due to the perception of urgency and convenience.

PURPOSE: The purpose of this project was to evaluate factors contributing to the use of the ED for adult patients with primary care providers (PCP). METHODS: A retrospective chart review was completed on 280 randomly selected patients over the age of 18 who presented to the ED between January and June 2018. Only …

The Effect Of A Behavioral Health Specialist Program On Providers’ Perceptions Of Mental Illness, Self-Efficacy And Satisfaction In The Inpatient Medical Unit., Trinity D. Thomas

DNP Projects

PURPOSE: The purpose of this DNP project was to assess the effect of a Behavioral Health Specialist (BHS) program on providers’ perceptions of mental illness, self-efficacy and satisfaction in the inpatient medical unit.

METHODS: This DNP project used a mixed-methods approach to obtain data, which included a pretest-posttest design, and key informant interviews. The survey data was obtained from provider responses to an email that was forwarded from managers of four targeted medical-surgical floors. A cover letter was included in the email which further provided information about key informant interviews and the contact information for the principle investigator to arrange …

A Comparison Of Post-Concussion Neurocognitive Test Results Of Recently Concussed High School Athletes To Their Neurocognitive Baseline Test Results Prior To Returning To Play, Karen Powers

DNP Projects

PURPOSE: In 2017, an estimated 2.5 million U.S. high school students reported having suffered at least one concussion while participating in sports or physical activity during the previous year. The purpose of this study is to evaluate the incidence of concussion among high school athletes and compare the athletes’ post-injury neurocognitive function to their baseline test results prior to returning to play.

METHODS: A retrospective records review of neurocognitive test scores of high school athletes during the June 2017 – June 2018 sport season was conducted. The records of 696 high school athletes were reviewed, including 30 post-injury test scores. …

Evaluation Of The Effectiveness Of A System Based Nurse Manager Collaborative Council On Work Engagement, Psychological Empowerment, And Value, Stacy Colligan

DNP Projects

BACKGROUND: Nurse Managers often do not receive direct acknowledgment for their accomplishments or have input into the facility wide decisions which directly impact them. Currently there are no known shared governance programs tailored to the nurse manager level.

PURPOSE: To determine the impact of a system shared governance model on nurse manager’s work engagement, psychological empowerment, and inclusion.

METHOD: A pretest and posttest design was utilized to determine the impact of shared governance participation for nurse managers. Spreitzer’s psychological empowerment scale and the Ultrech “Work and Well-being” instrument, in addition to some Likert scale and open-ended descriptive questions, were included …

Evaluation Of The Effect Of Milner-Fenwick Video-Based Education And Teach-Back On Knowledge Acquisition In Atrial Fibrillation Patients, Melissa Czarapata

DNP Projects

PURPOSE: The purpose of this study was to evaluate if video education impacts knowledge acquisition and health literacy in patients with atrial fibrillation. METHODS: This study employed a descriptive, pretest-posttest single site comparative design. Baseline health literacy was assessed before video education was completed using the Atrial Fibrillation Knowledge scale. Health literacy regarding atrial fibrillation was again assessed for the same participants immediately after video education was completed and again in 7 to 10 days through the use of the Atrial Fibrillation Knowledge scale and teach-back questions. RESULTS: There was no statistical significance found when comparing scores before and after …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

The Effect Of An Educational Workshop On Relational Aggression In An Acute Care Nursing Unit, Jennifer M. Dorsey

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of an educational intervention on relational aggression in an acute care unit using a pre and post questionnaire. The questionnaire was used to examine changes in Relational Aggression (RA) self-awareness before and after an educational video and to determine the effectiveness of an educational video compared to no educational materials on self-awareness of RA behaviors.

METHODS: This study was single site, quasi-experimental non-equivalent pretest posttest study at the University of Kentucky. Sample size for the pre-survey was 15 acute care nurses on the control and experimental units, completed between …

Evaluating Pre-Procedural Anxiety In Adults Undergoing Interventional Radiology Procedures, Rebecca Doll

DNP Projects

PURPOSE: The purpose of this study is to evaluate pre-procedural anxiety with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the adult population of the Interventional Radiology department at University of Kentucky Medical Center. The objective is to provide meaningful data to providers in this clinical area that could potentially facilitate better departmental workflow and also promote quality patient outcomes.

METHODS: A retrospective chart review, using a pre/post design, was used to evaluate the departmental implementation of APAIS. Case logs for the department were observed from January 2018 to June 2018 and then again, following APAIS implementation, from July …

Gun Violence Screening In The Adolescent Setting, Amy Burnett

DNP Projects

Objective: The purpose of this project was to implement a routine gun violence screening tool into practice in order to assess the need for this type of screening in the Adolescent Medicine Clinic at the University of Kentucky.

Methods: This study used a quasi-experimental one group posttest design to examine the impact of the implementation of a gun violence screening tool on the proportion of patients screened and the proportion of patients referred for intervention that screen positive.

Results: There were 44 adolescent patients that participated in this study (n=44). Twelve out of 44 participants screened positive, which means they …

The Effect Of A Provider-Based Educational Program On Knowledge, Attitudes, Self-Efficacy, And Order Rates Of Cologuard® In A Primary Care Clinic, Cassilly B. Besten

DNP Projects

BACKGROUND: Colorectal cancer is one of the most common and deadly cancers, particularly in persons greater than 50 years of age. Most colorectal malignancies are slow-growing, making regular screening increasingly important to decrease morbidity, mortality, and cost of treatment. Cologuard® serves as an effective and non-invasive colorectal cancer screening modality for average-risk adults.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy, and ordering rates of Cologuard® among primary care providers.

METHODS: This study was a single-center, pre/post implementation study of the effectiveness of a provider-based educational intervention …

Barriers To Screening For Intimate Partner Violence Among Aprns In Kentucky, Kathryn L. Strait

DNP Projects

Abstract

Purpose:Intimate partner violence (IPV) occurs in at least one in every four females and one in nine men across the United States (Smith et al., 2017). While the prevalence of IPV is considerably high, the screening rates for IPV in primary care specifically average less than 12% (United States Preventative Services Task Force, 2013). Methods: In order to identify how to overcome the barriers to screening including time, knowledge of IPV, access to community resources, gender identity/sexual orientation, accuracy and availability of screening tools, and reimbursement for advanced practice nurses in Kentucky, a survey was sent to …

The Effect Of A Child's Guardian's Health Literacy On Asthma Knowledge In Pediatric Patients, Sylvan Ryder

DNP Projects

PURPOSE: The purpose of this project is to determine if there is a correlation between a guardian’s health literacy and their knowledge of their child’s asthma management.

METHODS: This is a cross-sectional study conducted in the University of Kentucky Pediatric Pulmonology Clinic in Lexington, Kentucky. The analysis focused on how a parent’s health literacy level effected their asthma knowledge. The Rapid Estimation of Adult Literacy in Medicine-Short Form was used to measure health literacy. An asthma knowledge questionnaire with a Likert-scale design was used to measure asthma knowledge. The sample included eight parents of children with an asthma diagnosis collected …

The Effect Of A Focused Education Session On Continuous Renal Replacement Therapy (Crrt) Troubleshooting To Increase Knowledge And Self-Confidence In Icu Nurses., Lauren Nance

DNP Projects

PURPOSE: The purpose of this study was to determine if education focusing on continuous renal replacement therapy (CRRT) troubleshooting was effective at improving ICU nurses’ knowledge and self-confidence levels. It was hopeful that, following the educational intervention, ICU nurses would have an increase in knowledge and report higher self-confidence levels regarding troubleshooting CRRT.

METHODS: This study involved the use of a pre-post-test and questionnaire to evaluate the efficacy of an educational intervention on ICU nurses’ knowledge and self-confidence levels at Saint Joseph Hospital. The pre-post-test was used to evaluate knowledge levels, while the pre-post questionnaire was used to evaluate self-reported …