Nursing Commons^™

An Undergraduate Baccalaureate Simulation On Weight Bias And Caring For A Patient With Obesity, Kathy Andrews

DNP Scholarly Projects

Background: There is considerable evidence showing the correlation between weight related bias among healthcare professionals, and poor health outcomes for patients with obesity. Educating healthcare professionals on both safe and effective care practices and compassionate patient-centered care techniques can reduce the negative health impact of weight bias on this patient population. Purpose: This scholarly project adjusted the existing curriculum to address existing weight bias among a cohort of undergraduate baccalaureate nursing students and to inspire improvement in their care of patients with obesity. Methods: Using Kolb’s ELT a sequence of learning activities were adapted and implemented as a …

Student Veterans’ Transition To Nursing Education: Barriers And Facilitators, Bruce P. Hunter, Steven Busby Dr., Jeannie Giese Dr., David Phillippi Dr.

DNP Scholarly Projects

Student Veterans’ Transition to Nursing Education: Barriers and Facilitators

Abstract

The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that …

Promoting Mental Health And Well-Being Among Undergraduate Nursing Students: A Practice Guideline, Armen Mailyan

DNP Scholarly Projects

Poor mental health and well-being among undergraduate nursing students negatively affects social dynamics, communication, decision making, and stress management, thus compromising the quality of healthcare delivery and patient care outcomes. It is imperative that nursing programs support students to develop positive self-care, resilience, and mental health skills while in school to foster their well-being, enhance their academic success, and to promote high-quality, patient-centered care in their future practice. The purpose of this Doctor of Nurse Practice (DNP) project was to develop a mental health and well-being practice guideline with a comprehensive set of evidence-based interventions for academic nursing programs to …

"Salir Adelante": Improving The Quality Of School Entrance Physicals For Immigrant Minors, Jennifer Sternberg, Elizabeth Morse

DNP Scholarly Projects

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record …

Advancing Health Equity On Campus A Minority Health Promotion Quality Improvement Initiative, Natasha Wilson

DNP Scholarly Projects

Abstract Background: Minority students at predominantly white institutions face unique stressors due to their minority status, impacting their health. Initiatives promoting community engagement, diversity, equity, and inclusion can help reduce minority stress and foster health equity and success in higher education Method: This project employed a Community-Based Participatory Research (CBPR) framework to enhance minority student involvement in sexual and mental health services both on campus and in the wider community. It involved forming partnerships between minority student organizations, faculty, and community partners to organize wellness events focusing on sexual and mental health during the fall semester of 2023. The events …

Increasing Faculty Knowledge Of Competency-Based Education: A Quality Improvement Project, Lindsay O'Sullivan

DNP Scholarly Projects

Background: The nursing academic-to-practice knowledge gap creates systems-based and patient outcomes issues. The changing demands of healthcare require the advancement of the discipline of nursing through the improvement of nursing education. The American Association of Colleges of Nursing (AACN) requires all nursing programs to implement Competency-Based Education (CBE) evaluations and assessments into existing nursing curricula to respond to changing healthcare demands. The aim of this project was to improve the knowledge of nursing educators regarding the use of CBE at a mid-sized university in the southeast.

Methods: The Diffusion of Innovation Theory was used as a framework for this project. …

The Impact Of An Educational Video On Physician Confidence And Comfort Level In Discussing Autopsies, Joy N. Owings, Laura Gray, David Phillippi

DNP Scholarly Projects

Background: Autopsy rates have declined since the 1970s despite the procedure's benefit to families and medical science. Two well-documented reasons for the declining autopsy rate are physicians’ lack of knowledge about autopsies and lack of confidence in offering them. Objective: The primary aim of this study was to evaluate the impact of a brief educational video on physicians' comfort level, confidence, and knowledge regarding autopsy discussions. The objective was to address the declining autopsy rates by enhancing physicians' confidence and comfort level in offering autopsies to families. In addition, this study aimed to investigate physicians’ practices of consenting for an …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

The Effect Of Skin Tone Inclusive Dermatology Education On Diagnostic Accuracy And Self-Confidence In Graduate Nursing Students, Kaylyn Bourne, Laura Gray

DNP Scholarly Projects

Abstract

BACKGROUND: People with skin of color face worse health outcomes than their light-skinned peers. According to the literature, graduate nursing programs lack skin tone inclusive curricular content (Shue-McGuffin & Powers, 2022). This contributes to disproportionate racial and ethnic health disparities. Skin tone inclusive online dermatology modules have been shown to improve diagnostic accuracy and self-confidence among medical students and residents in primary care specialties (Trinh et al., 2021; Salava & Salmela, 2022; Wang et al., 2020). Similar models may be an effective approach for graduate nursing students as they prepare to evaluate skin disease across the skin tone …

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …

Evaluating The Impact Of Simulation On Perceived Knowledge And Confidence Of New Graduate Nurses (Ngns) In Maternal-Newborn Care, Disa Seymour

DNP Scholarly Projects

Abstract

Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Screening For Unhealthy Alcohol Use: Implementation Of Screening And Brief Intervention (Sbi) In Primary Care Using The Audit-C, Sarah Bell

DNP Scholarly Projects

Background: In 2021, the NIAAA reported that alcohol use disorder affected 29.5 million Americans. Alcohol Screening and Brief Intervention (SBI) is an evidence-based prevention strategy, recommended by the USPSTF, to reduce alcohol consumption. Unfortunately, less than 50% of patients receive advice from their provider about the harms of excessive alcohol use. This study aimed to implement an effective SBI process in a rural primary care setting utilizing the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) tool while addressing known barriers to proper implementation.

Methods: Donabedian's Structure-Process-Outcome (SPO) framework for Quality Assessment guided this quality improvement design. Intervention planning included considerations …

Optimizing The Assisted Living Experience: Integration Of Value-Based Care To Foster Augmented Resident-Centered Quality, Jennette Pietrzak

DNP Scholarly Projects

Background: Fee-for-Service models are quantity-focused reactive approaches and have historically been at the forefront of healthcare. Value-based models focus on proactive, resident-centered care that is aimed at quality care over quantity. Implementation of ValueBased Care models can positively impact healthcare and fiscal outcomes

Purpose: The quality improvement project aimed to develop, integrate, and implement a valuebased model in Memory Care as an alternative to traditional Fee-for-Service models. The project aimed to improve key performance indicators by reducing hospitalizations, emergency room visits, and falls following the implementation of Value-Based Care (VBC) models.

Method: Data metrics for hospitalizations, emergency room visits, and …

Empowering Nurse Leaders To Achieve Harmony: Fostering Work-Life Balance, Gilberto Gamba

DNP Scholarly Projects

BACKGROUND: Balancing professional and personal life demands has become a focal point in today’s healthcare organizational culture. Despite the technological advances in providing better and faster healthcare, team members often struggle to achieve work-life harmony while meeting the demands of a growing population of healthcare clients. The evidence highlights nurse leaders as one group for which the identification and implementation of work-life balance interventions is crucial.

METHODS: An original tool based on available evidence was developed and used with a group of nurse leaders participating in an educational activity to engage them in behaviors supporting work-life harmony. A post-educational survey …

Mortality And Length Of Stay In Patients With Covid-19 On Ecmo: A Retrospective Before And After Quality Improvement Study, Chantal Branco

DNP Scholarly Projects

The use of extracorporeal membrane oxygenation as a supportive modality for patients with COVID-19 pneumonia emerged as the gold standard of care for those who do not respond to traditional therapies. The primary aim of this 10-month, quantitative, retrospective, quality improvement project was to identify if V-V ECMO treatment guidelines, implemented in the treatment of COVID-19 pneumonia, led to decreased mortality rates and lengths of stay. A total of 27 patients met inclusion criteria during queried time frames (n = 14 in Wave 1 and n = 13 in Wave 2). Data collected demonstrated no significant difference (p = .385) …

Development Of A Resilience Program To Combat Burnout In Nursing Practice, Maggie Lynch

DNP Scholarly Projects

Burnout has been identified as a national health crisis, with implications for the retention and health of critical healthcare workers. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the United States. Understanding resilience and how to foster it in nurses will contribute to burnout prevention and consequently improve the quality of health care provided Americans. Resilience training has been identified as a valuable approach to retention of the workforce. This scholarly project developed a resilience training program for newly licensed registered …

Evaluating Advanced Nurse Clinicians’ Readiness To Use Augmented Reality For Delivery Of Simulated Teaching Sessions, Kelly Carbone

DNP Scholarly Projects

Background

Since the start of the COVID-19 pandemic, nurses have adapted numerous new processes and procedures. Keeping patients safe is dependent on the education and experience of providers caring for them. By utilizing the capabilities of augmented reality (AR), clinical nurse educators (CNEs)/advanced nurse clinicians (ANCs) can provide real-time learning while providing feedback to nurses during simulated instructional experiences. AR instructional methods hold promise for educators due to staff shortages, time constraints, and inadequate facility space for in-person teaching sessions.

Purpose

The purpose of this doctoral project was to evaluate the ANCs readiness to adopt new AR technology, the Microsoft …

Effectiveness Of An Instructional Program On Decreasing Fall Incidents In Geriatric Patients With Psychiatric Disorders, Maurice Washington

DNP Scholarly Projects

Falls occur in 25% of older adults, resulting in over 8 million fatal and nonfatal injuries. In addition to the human suffering, associated medical and legal costs amount to over 50 billion dollars a year. This study examines the impact on fall rates of an evidence-based fall prevention program provided to a multidisciplinary staff on a psycho geriatric unit in Philadelphia, Pennsylvania. Staff knowledge of effective fall prevention interventions was measured before and after their participation in an evidence-based instructional workshop provided by the Project Director using the Falls Prevention Knowledge Test by Dykes et al. (2019). While there were …

Effect Of A Community Hospital’S Sustainable And Enhanced Fall Prevention Quality Improvement Program On Inpatient Falls And Falls With Injury: A Before And After Study, Anne Catino

DNP Scholarly Projects

The frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 …

An Evidence-Based Teaching Plan For Preventing Wrong-Site Block Placement During Regional Anesthesia, Mark A. Michetti, Kristen E. Newbrough

DNP Scholarly Projects

Wrong-site regional anesthetic block placement is a threat to patient safety and quality perioperative care. The adverse outcomes for patients, providers, and institutions demonstrate safety risks that are linked to inconsistent use of comprehensive guidelines in clinical practice. The purpose of this Doctor of Nursing Practice Project is to create a comprehensive evidence-based Teaching Plan for preventing wrong-site block (WSB) placement during regional anesthetic induction and for use in institutions by anesthesia providers to prevent wrong-site anesthetic block placement. The teaching plan focuses on four main constructs to prevent WSBs, which include the incidence of WSBs, the consequences of WSBs, …

Cognitive Aid For Anesthesia Providers Caring For Lactating Mothers, Danielle Pantella, Dana Lawrence

DNP Scholarly Projects

Evidence on the transfer of medications into breastmilk during the administration of anesthesia and sedation medications may not be well known by anesthesia providers. As they teach lactating mothers, anesthesia clinicians may not be comfortable explaining details about breastfeeding, such as the effects of anesthesia on breast milk and when mothers can safely resume breastfeeding. Lack of provider knowledge may be a safety threat that can be decreased by an evidence-based cognitive aid. The purpose of this patient safety project is to develop a cognitive aid that includes anesthetic agents and knowledge components to structure the provision of care to …

An Evidence-Based Teaching Plan For Anesthesia Providers On Intraoperative Blood Glucose Monitoring In Diabetic Patients Undergoing Noncardiac Surgery, Brian Sabec, Christopher Mcmichael

DNP Scholarly Projects

As the incidence of diabetes continues to rise both locally and nationally, anesthesia providers must be prepared to manage diabetic patients intraoperatively during the administration of anesthesia. Literature suggests that blood glucose levels are not adequately monitored in the operating room, potentially contributing to many postoperative complications. Therefore, this doctoral project aims to develop an evidence-based teaching plan for monitoring intraoperative glucose levels in the diabetic patient population to enhance anesthesia provider knowledge.

Evidence-Based Interprofessional Education For The Labor And Delivery Team On Nitrous Oxide Anesthesia For Laboring Mothers, Amanda Rota, Jessica Stoffey

DNP Scholarly Projects

Pain management in the laboring patient continues to arise with challenges of safety, efficacy and comfort. Nitrous oxide is an option for managing laboring women’s pain. However, the lack of education for perinatal teams across the United States regarding nitrous oxide administration in the labor patients omits a successful pain management option. The purpose of this Doctor of Nursing Practice project is to create an evidence-and theoretically-based education module for the labor and delivery team, incorporating an instructional video to build knowledge on the use of nitrous oxide in the laboring mother.

Performance Improvement Project Implementing Rapid Cycle Deliberate Practice Simulation To Improve Team Performance During Administration Of Moderate Sedation By Non-Anesthesia Providers In The Interventional Platform, John Kost, Matthew Snyder

DNP Scholarly Projects

A steady increase in procedures in interventional platforms has required the administration of moderate sedation and analgesia by non-anesthesia providers. Of concern is managing the delicate balance between different levels of sedation on a continuum to ensure safe and effective care. Moderate sedation achieves suppression of consciousness while maintaining a patent airway and intrinsic respiratory drive compared to deep sedation where airway patency and respiratory function can be compromised. Administration of moderate sedation by non-anesthesia providers in interventional platforms leads to a higher rate of procedural complications. Rapid Cycle Deliberate Practice (RCDP) simulation will be utilized to educate non-anesthesia providers …

An Evidence-Based Teaching Plan For Anesthesia Providers On The Patient Safety Aspects And Pharmacoeconomic Advantages Associated With Sugammadex Use, Amanda Cruz, Courtney Keil

DNP Scholarly Projects

Anesthesia providers are often required to administer neuromuscular blockade during surgical procedures to optimize both surgical conditions and allow for mechanical ventilation. Reversal of neuromuscular blockade at the conclusion of surgery assists anesthesia providers in preventing adverse events and optimizing patient safety. Current literature supports the use of sugammadex as the safest neuromuscular blockade reversal agent in many cases, but also shows a lack of provider education regarding its use. The hesitancy of anesthesia providers and medical institutions to utilize sugammadex as a standard of care despite evidence-based literature supporting its regular use implies that there is either a knowledge …

An Evidence-Based Teaching Plan For An Anesthesia Crisis Resource Management Simulation Targeting Malignant Hyperthermia, Jacqueline Dowe, Michael Reynaltti

DNP Scholarly Projects

Most medical errors in health care are preventable and result from lack of communication and teamwork among health care workers. Despite health care providers’ training on preventing medical errors and managing medical crises, patient care services may be compromised and result in patient harm when teamwork and communication decrease among clinicians. Anesthesia Crisis Resource Management (ACRM) was designed to help anesthesia providers effectively manage crises by working in multidisciplinary teams to improve and develop both teamwork and technical skills. The purpose of the Doctor of Nursing Practice project is to design an evidence-based teaching plan for a ACRM simulation targeting …

Differences In Anxiety In New-To-Practice Traditional And Non-Traditional Registered Nurses In Clinical Practice, Sharon Mingo

DNP Scholarly Projects

New-to-practice RNs experience anxiety during licensure preparation and orientation. Such anxiety is anticipated to linger for approximately 6 months as the RN transitions to practice and adapts to professional nursing. Many new-to-practice RNs report feelings of anxiety. Their anxiety can negatively affect the quality and safety of nursing care and increase nurse turnover. Unfortunately, the literature on anxiety in traditional post-licensure in new-to-practice RNs in clinical practice lacks information on non-traditional post-licensure new-to-practice RNs' experiences when starting professional practice roles in health care settings. This descriptive comparative study compares differences in anxiety in new-to-practice RNs of traditional and non-traditional Bachelor …