Nursing Commons^™

The Impact Of A Poverty Simulation On Baccalaureate Nursing Students’ Attitudes, Kristen Smith

DNP Scholarly Projects

Poverty is an ongoing issue in the United States, with major implications for the health of U.S. citizens. In order to provide compassionate care, nurses must understand their own attitudes towards those living in poverty. The purpose of this study was to evaluate for possible changes in attitudes towards poverty in junior level BSN students after a poverty simulation intervention. Participants were surveyed using the Yun and Weaver’s Short Form Attitudes towards Poverty (SFATP) tool, which looks three factors of poverty attitudes: personal deficiency, stigma, and structural perspective.

The Adult Learning Theory provided the theoretical framework for the study. This …

Implication Of Concussion Preventative Behavior Through Youth Education On Playground Safety, Bryan Harris

DNP Scholarly Projects

The concern with concussions has taken our society by storm as it relates to the health consequences either: acute, chronic, and/or later in life as a result of experiencing a single or multiple concussions. Research is thriving on concussion diagnosis, management, and treatment and will continue to do so in the years to come. Preventative measures in a variety of forms is the cornerstone for dealing with concussions at this time; with evidence showing formal educational programs are effective. ThinkFirst: National Injury Prevention Foundation, provides educational programs for first through eighth grade students on prevention of brain, spinal cord, and …

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski

DNP Scholarly Projects

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if …

The Impact Of A Poverty Simulation On Practical Nursing Students’ Attitudes Towards Poverty, Jaime Crabb

DNP Scholarly Projects

Poverty is a multi-faceted global problem. Nurses and providers are front-line caregivers for this vulnerable population. In order to provide effective care, individuals must understand their own attitudes towards poverty. The purpose of this study was to evaluate for changes in Practical Nursing students’ attitudes towards poverty with the use of a poverty simulation based upon the Experiential Learning Theory. Participants were surveyed using the Short Form Attitudes towards Poverty (SFATP) tool. The ELT espouses that the best learning occurs when students actively engage in an experience, reflect upon it, and then apply that learning to future experiences. Statistical significance …

Moodle-Based Chlamydia Awareness Project To Increase Intention To Test In College Freshmen Males: A Dnp Scholarly Project, Adam Burri

DNP Scholarly Projects

In 2016, there were over 1.5 million cases of chlamydia reported in the United States with prevalence rates highest in people under 25 years of age (Centers for Disease Control and Prevention, 2017). Researchers have suggested that college aged adults (age 18-25) should be targeted for chlamydia educational programs because these individuals are lacking in knowledge about chlamydia prevention, infection, symptoms, and screening methods (Goundry, Finlay, & Llewellyn, 2013; Rutledge, Siebert, Chonody, & Killian, 2011). This scholarly project utilized a quasi-experimental, single-group pretest-posttest design and used a modified version of the Sex, Drugs, and Rock’n’Roll Questionnaire designed by Lim et …

Implementation Of A Scripted Debriefing Tool In Simulation-Based Nursing, Mary Kidd

DNP Scholarly Projects

In nursing education, simulation represents real patient scenarios that are designed to enable students to practice combining theoretical knowledge with clinical skills within a controlled environment (Bland, Topping, & Wood, 2011). Debriefing is a facilitated reflection of the simulation experience and is performed to uncover relationships among the events, actions, thought processes and outcomes with the intention of improving future practice (Cheng et al., 2014; Kolbe, Grande, & Spahn, 2015). Without proper debriefing, erroneous critical thinking, decision-making, and clinical judgement may go uncorrected, potentially negatively impacting patient care. There is an abundance of literature on debriefing methods; yet, empirical evidence …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

DNP Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

Preterm Labor Assessment Toolkit Implementation, Mandi Wilkins

DNP Scholarly Projects

ABSTRACT

PRETERM LABOR ASSESSMENT TOOLKIT IMPLEMENTATION

Mandi Mae Wilkins

Every year 10% of babies in the United States are born premature. Prematurity is the leading cause of infant mortality. Standardized preterm labor (PTL) assessment protocols reduced preterm birth rates, decreased costs, and resulted in more timely diagnoses and prevented the overtreatment of pregnant women who were not experiencing true preterm labor. At a Midwestern, Level II trauma hospital with regional neonatal intensive care unit and 700 annual deliveries, a Preterm Labor Assessment Toolkit (PLAT) was implemented and pre- and post-data garnered. The toolkit contained a provider algorithm and an order …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

DNP Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Advance Care Planning: Cardiopulmonary Resuscitation Education And The Veteran Population, Rhian Elizabeth Dalgord

DNP Scholarly Projects

Cardiopulmonary resuscitation educational tools are prevalent in the realm of advance care planning and shared decision making. However, tools developed specifically in the interest of veterans are lacking. This deficit impedes the advance care planning process. Easy-to-use advance care planning tools that meet specific population needs can result in a threefold higher rate of usage. The purpose of this DNP scholarly project was to evaluate the use of the Honoring Healthcare Choices CPR educational handout through administration of the iDECIDE CPR Decision Aid Acceptability questionnaire to veterans (N=70) residing in a veterans nursing home in the Midwest. The iDECIDE CPR …

Oral Health Literacy In Parents And Care Providers Of Young Children, Rachel Nye

DNP Scholarly Projects

Tooth decay ranks first as the most common chronic disease in childhood (U.S. Department of Health and Human Services [HHS], 2000). In addition to the morbidity directly related to cavities, there are a myriad of other systemic implications of this disease. The purpose of the study was to determine baseline oral health literacy levels for a sample of pediatric caregivers living in the Upper Peninsula and to determine the impact of a community based education program on these levels. The program was offered at three locations. A paired sample t-test of sixty-four complete data sets demonstrated a statistically significant increase …

An Analysis Of Factors Which Affect Self-Management In Language-Diverse Patients With Type 2 Diabetes, Sarah Hayden

DNP Scholarly Projects

Purpose: The purpose of this scholarly project was twofold: 1) To identify the impact that health literacy, diabetes knowledge, self-efficacy, and illness perception have on diabetes self-management behaviors and 2) To assess differences in project variables between English and Spanish-speaking participants. The Individual and Family Self-Management Theory was used as a guiding theoretical framework. Methods: Thirty-three English-speaking and twenty-eight Spanish-speaking adults with Type 2 diabetes (n=61) were recruited from a diabetes private-practice in the Southeastern United States. Patients completed a cross-sectional composite survey composed of demographic information, the Brief Health Literacy Screener, Diabetes Knowledge Questionnaire (DKQ-24), Diabetes Management Self-Efficacy Scale …

Fear-Avoidance Beliefs In Patients With Acute Low Back Pain, Kayla Heldman

DNP Scholarly Projects

Low back pain affects over 80% of the population impacting their quality of life and causing both disability and loss of work productivity. Acute low back pain is seen as a “favorable” prognosis yet many patients continue to suffer from chronic low back pain. Psychological barriers such as fear-avoidance beliefs have been shown to be a contributing factor in low back pain rehabilitation and chronicity. This project was designed to evaluate if fear-avoidance was a health determinant that affects how primary care providers create treatment plans and to explore the relationship between fear-avoidance beliefs with physical therapy outcomes. Specifically, the …

The Impact Of In-Home Lactation Support On Breastfeeding Self-Efficacy, Duration, And Exclusivity, Kristian Beach

DNP Scholarly Projects

While there is evidence to suggest that hospital lactation support impacts rates of breastfeeding initiation by new mothers, women may benefit from additional lactation support and intervention to meet Healthy People 2020 goals for breastfeeding duration and exclusivity. Breastfeeding self-efficacy can be targeted by lactation counselors to improve breastfeeding outcomes. The purpose of this study was to determine how in-home lactation support influences breastfeeding self-efficacy, duration, and exclusivity. A descriptive, cross-sectional, survey-based design with convenience sampling was used in the study, in which a one-time, voluntary, electronic survey with a retrospective pretest-posttest was emailed to postpartum women who received in-home …

Evidence-Driven Diagnosis And Treatment Of Acute Urinary Tract Infections In Long-Term Care, Morgan K. Clouse

DNP Scholarly Projects

Misdiagnosis of asymptomatic bacteriuria as a urinary tract infection continues to occur, leading to the overuse of antibiotics. Due to the growing elderly population in long-term care facilities (LTCFs), LTCFs can play a critical role in antimicrobial stewardship. Urinary tract infections are a starting point for moving toward antimicrobial stewardship, since urinary tract infections are common in LTCFs. A retrospective chart review of 156 cases with suspected urinary tract infections (UTIs) was completed in a LTCF. The purpose of the scholarly project was to assess diagnostic and treatment practices for UTIs and compare them to a diagnostic and treatment algorithm. …

Subclinical Atherosclerosis Vascular Evaluation (Save): Nurse Practitioner Barriers To And Facilitators Of Research Utilization Regarding Screening For Subclinical Atherosclerosis, Gina Pritchard

DNP Scholarly Projects

The project identified factors affecting implementation of evidence-based non-invasive screening tests to identify early stage cardiovascular disease (CVD). The use of coronary artery calcium scores and carotid intima media thickness testing improves accuracy of risk stratification over risk factor scoring systems alone. The purpose of this project was to identify NP’s perceived barriers to and facilitators of utilization of evidence-based non-invasive CVD screening tests and to make recommendations for improvements in implementation. The SAVE project consisted of a cross-sectional survey of 64 nurse practitioners, recruited using a multi-pronged strategy, using Funk’s barriers instrument plus two additional qualitative questions regarding intent …

Comparing The Effects Of Immersion Service Learning And Local Service Learning In Pre-Licensure Health Care Students’ Transcultural Self-Efficacy, Kimberly Johnson

DNP Scholarly Projects

Local and immersion service learning methods prepare pre-licensure health care professionals to deliver culturally competent care to diverse populations- an important need because of the rapid racial and ethnic diversity growth in the U.S. A mixed-methods approach compared the effect of local and immersion service learning methods on multiple disciplines of pre-licensure health care students’ confidence in delivering care to diverse populations. Guided by Jeffreys (2016) CCC Model, the Transcultural Self Efficacy Tool (TSET) was used to compare pre-licensure health care students’ (n=34) transcultural self-efficacy perceptions following local or immersion service learning experiences. Secondary source, qualitative data obtained from …

Evaluation Of Intimate Partner Violence Screening In A Metropolitan Public Health Department, Niani Conerly

DNP Scholarly Projects

Routine intimate partner violence (IPV) screening has been recommended for all health care settings to prevent subsequent short and long term health consequences of survivors. However, provider adherence remains low. The purpose of this quality improvement project is to evaluate current screening practices, identify the needs of, and provide resources to three family planning clinics within a metropolitan public health department. The project utilized Donabedian’s Structure, Process, and Outcomes Model to map current protocols within three family planning clinics to identify current practices. A chart review including 105 patient charts was done to identify documentation of IPV screening/discussion as well …

Simulation As A Clinical Remediation Strategy For Undergraduate Nursing Students, Sara Camp

DNP Scholarly Projects

Given the imperative of success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination, academic proficiency rather than clinical competence remains the primary focus of nursing education. It is imperative that nursing programs have an intentional remediation plan to provide resources designed to monitor, evaluate and improve clinical competence, distinct from those necessary for academic success. Simulation is an established nursing pedagogy in the development of clinical competency, as it facilitates and grounds the application and reinforcement of abstract and theoretical concepts. and may be useful as a formative strategy when students show faltering clinical proficiency. Clinical and …

Compassion Fatigue As It Relates To Nurse Turnover In Oncology Nurses At An Urban Hospital, Diana Wells-English

DNP Scholarly Projects

According to Stamm (2010), Compassion fatigue (CF) refers to the negative aspects of caring and compassion satisfaction (CS) refers to the positive aspects. Compassion fatigue is well documented in oncology nurses. It is a concept incorporating both burnout (BO) and secondary traumatic stress (STS). Nurses working with patients who have cancer are exposed to a multitude of stressors that may contribute to CF and ultimately high turnover rates. The purpose of this study is to explore the relationships between CS, STS, BO, and turnover intention in a sample of oncology nurses. The study is a correlational study utilizing survey methodology …

Foster Youth Transition To Adulthood: Effects Of Housing Stability And Social Support On Mental Health, Elizabeth Gray Kaiser

DNP Scholarly Projects

Foster care adolescents have a more difficult time transitioning to adulthood, compared to non-foster care peers, due to the maltreatment and uprooting they often experience prior to entering the foster care system. Although foster care protects children from harmful environments, literature supports that multiple placement changes and lack of stable family and social support contributes to higher likelihood of housing instability, such as homelessness, and mental health problems, including stress, anxiety, and depression, in adulthood. Independent living programs, such as YVLifeSet, facilitate more successful transitions to adulthood by offering support in the form of mentors, life-skills training, and counseling. These …

Exploring The Perceived Barriers To Long-Acting Reversible Contraception In Women Who Are In Treatment For Opioid Addiction, Carleigh Smith

DNP Scholarly Projects

The rise in rates of opioid addiction among women of childbearing age, alongside the consistent rates of unintended pregnancy, has changed the landscape for the public health risks and outcomes of unintended pregnancies in the United States. Concurrently, uptake of long-acting reversible contraception (LARC) remains low among all women, particularly those with substance use disorder. This project explores the perceived barriers to LARC among women enrolled in medication-assisted treatment (MAT) for opioid addiction. A mixed methods, cross-sectional survey design was used to capture how women in MAT access care, their reproductive planning and intention, contraceptive knowledge and behavior, and their …

The Impact Of Antibiotic Stewardship Education On Parental Care Satisfaction And Follow-Up, Paige Ferguson

DNP Scholarly Projects

Parental satisfaction with antibiotic stewardship has been investigated extensively in pediatric inpatient settings; however, there has been relatively little research in pediatric outpatient settings. In 2014 upper respiratory infections were the most common infections seen among the general population with children having an average of 3 to 8 viral respiratory illnesses per year and receiving 34.6% of all antibiotic prescriptions. Escalating antibiotic resistance and increased emphasis on patient/parental satisfaction necessitates the exploration of a method to improve antibiotic stewardship while maintaining parental satisfaction. The purpose of this project was to assess parental satisfaction with care and follow-up visits after antibiotic …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Using Clinical Supervision To Improve Interprofessional Collaboration, Melissa Copenhaver

DNP Scholarly Projects

USING CLINICAL SUPERVISION TO IMPROVE

INTERPROFESSIONAL COLLABORATION

By

Melissa Copenhaver

Interprofessional collaboration (IPC) is important to the future of the healthcare system in that IPC is part of the solution for promoting better healthcare outcomes (Gilbert, Yan, & Hoffman, 2010; Reeves, Perrier, Goldman, Freeth, & Zwarenstein, 2013). Marshall (2011) notes that “interprofessional collaborative practice promotes team identity, conserves energy by a unity in direction, and invites harmony of efforts” (p. 158). The skills needed to engage in IPC are cultivated through interprofessional education (IPE) (Reeves et al., 2013). Currently, at Northern Michigan University (NMU), there are limited opportunities included in …

Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen

DNP Scholarly Projects

Background

Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital.

Purpose

The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse …

An Inpatient Rehabilitation Interprofessional Care Pathway For Traumatic Hip Fracture: A Pilot Quality Improvement Project, Sarah Plante

DNP Scholarly Projects

Background: Each year over 300,000 older adults are hospitalized for hip fracture. The impact of the cost of hip fracture on the US health care system is estimated to be as high as $9 billion, with the typical cost of a hip fracture episode around $30,000. Formalized pathways have been developed and successfully utilized for many patient presentations, including hip fracture, in the acute setting. Although this research is important to the comprehensive care of the elderly hip fracture patient, very little research exists that outlines evidence-based best-practice for patients in the post-acute recovery period.

Purpose: The primary aim of …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …