Nursing Commons^™

Culturally Appropriate Health Education: Translation Of A Parturient Pain Relief Options Pamphlet Into French And Spanish, Francis Minor, Austin Cook

Doctor of Nursing Practice Projects

The rise of immigration worldwide introduces a diverse, multicultural population of patients seeking healthcare in the United States. Barriers to communication, both spoken language and culturally associated communication norms, limit immigrant women’s ability to seek, gain access, and follow through with perinatal care. In order to provide safe, effective, and culturally sensitive care, recognition of language and cultural differences of all individuals must be considered when providing patients with educational materials (Perera et al., 2012; Plumbaum et al., 2014). The aim of this project was to translate an existing pain relief options pamphlet into French and Spanish in order to …

Pediatric Concussion Clinic: A Needs Assessment, Carrie West

Doctor of Nursing Practice Projects

Abstract

Pediatric Concussion Clinic: A Needs Assessment

Concussions are a mild traumatic brain injury by a biomechanical force to the head. Concussion rates among youth are as high as 33 million per year worldwide. Most children recover within 4 weeks post injury; however, 30% of patients have delayed recovery. Recent studies have shown that evaluation by a concussion specialist within 1 week of injury results in quicker recovery. The purpose and goal of this project was to determine if there was a need for establishing a pediatric concussion clinic at Southern Illinois University Medicine. Study participants included pediatric providers from …

Developing A Peer Mentoring Program For Srnas, Morgan E. Fitterer, Miranda Portwine

Doctor of Nursing Practice Projects

Faculty of a nurse anesthesia program at a Midwestern University requested evidence of the impact a peer mentoring program could make in reducing stress levels for SRNAs. To better tailor a peer mentoring program, surveys were developed and distributed to the university’s SRNAs and to program directors of CRNA programs across the country.

Based on the literature, a survey was developed and distributed to 81 SRNAs at this university to evaluate their stress and their perceptions of the impact of peer mentoring on stress. Another survey was developed and distributed to 118 program directors to learn if they have a …

Increasing Patient Access To Medication-Assisted Treatment Programs For Opioid Use Disorder, Matthew J. Bednarchik

Doctor of Nursing Practice Projects

The project sought to explore the perceived need for Medication-Assisted Treatment (MAT) for opioid use disorder among primary care providers in a rural central Illinois county. This project’s primary goal was to measure the prevalence of OUD in the community and the likelihood of primary care providers referring to an outpatient MAT program. A secondary objective was to utilize the survey results as a tool for the development of a MAT program. A cohort of twenty-five primary care providers were invited to participate in a survey to assess the perceived prevalence of OUD as well as the need for increased …

Increasing Compliance And Patient Outcomes In Hypertensive Patients Using The Hill- Bone High Blood Pressure Compliance Scale, Lauren Huff, Allyson Barbee, Julie Milton

Doctor of Nursing Practice Projects

Hypertension has been globally rated the most common non-communicable disease as well as the most common cause of premature death (Johnson, et al., 2019). The identified problem of focus for this project was to increase medication compliance within hypertensive patients as well as increase provider knowledge of compliance issues with the utilization of the Hill-Bone High Blood Pressure Compliance Scale. We administered a case study via Qualtrics to Illinois nurse practitioners via the ISAPN email list-serve. We provided an anonymous pre-and post-survey to each participant regarding their current area of practice, patient history taking behaviors, and views on the ease …

Implementation Of A Standardized Care Pathway For Ureteral Stents Patients Across The Continuum Of The Acute And Ambulatory Setting: A Quality Improvement Project, Ibukunoluwa Afolabi

Doctor of Nursing Practice Projects

Ureteral stents are one of the most used urologic devices to create and preserve ureteral patency. Side effects after ureteral stent placement have a high prevalence, and stent related pain has been reported to affect over 80% of patients. This Quality Improvement Project aimed to develop a standardized care pathway through education and pharmacological management for patients after ureteral stent placement. Specific goals included reducing readmission rates to the emergency department (ED), reducing the patient’s phone calls to the urology clinic, and improve patient satisfaction. The protocol developed for the project included discharging patients with an alpha- blocker, an anti-cholinergic, …

Addressing Referral Discrepancies For Hyperglycemia Diagnosis Codes, Brooke Buffington, Aubrey Parnell, Abigail Brohammer

Doctor of Nursing Practice Projects

Diabetes mellitus and prediabetes affect 34 million and 88 million Americans, respectively. The early detection and management of elevated blood glucose levels is fundamental to preventing comorbid complications. While other countries have published referral guidelines, the United States is lacking in practice standards. At a central Illinois healthcare institution, the diagnosis code for elevated blood glucose (R73) was noted at a higher rate than endocrinology referrals. The purpose of this retrospective investigation was to explore the root causes of this disproportion through deidentified patient data. The average number of wait days for an endocrinology appointment was investigated and found to …

Care Of The Healthcare Provider, Kari Hullinger, Emily Moscardelli

Doctor of Nursing Practice Projects

Evidence has shown a strong correlation between a healthy provider and the positive care that the provider can promote to others. Many evidence-based health promotion programs have been implemented throughout many health systems. These programs have shown improvement of the providers’ overall health. And in return, these providers are able to better care for their patients. Detailed reports have shown many health consequences that healthcare providers have acquired due to long hours, intense training, lack of time, lack of sleep, and the concept of always putting their patients first. A health system in Springfield, Illinois was examined to determine if …

Improving Depression Awareness And Screening In A Community College, Shelly Baldwin

Doctor of Nursing Practice Projects

Depression is a serious and disabling mental health problem impacting nearly 265 million people worldwide. Approximately 17.3 million U.S. adults aged 18 or older suffered at least one major depressive episode in the last year. Of those afflicted, individuals 18-25 years of age had the highest prevalence of depression. Undiagnosed or untreated depression can lead to long-term disability or suicide which is the 2^nd leading cause of death for 10–34-year-old persons. Early recognition of depressive symptoms can improve long-term outcomes of individuals by enhanced connection to mental health services. The overall goal of this project was to improve depression …

Evaluation Of High Fidelity Simulation Debriefing Methods For Nurse Anesthesia Students, Zachary Standefer, Alex Davie

Doctor of Nursing Practice Projects

Simulation for Student Registered Nurse Anesthetists has become an educational tool that provides valuable learning experiences that integrate problem-solving, prioritization, and critical thinking skills. Debriefing is an essential aspect of the simulation learning process. The debriefing period allows the debriefer to direct the students’ self-reflection and provide individualized feedback. Faculty members delivering the simulation curriculum at a midwestern university, with over 75 nurse anesthesia students, sought education regarding the various simulation debriefing methods. After conducting a literature review for the best evidence supporting debriefing methods, faculty education was implemented in the form of an interactive computer-based learning (CBL) module. The …

Improving Patient Outcomes By Preventing Airway Injuries Associated With Video Laryngoscopes, Alexis Jones, Kay Williamson

Doctor of Nursing Practice Projects

Video laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH …

Lung-Protective Ventilation Across The Lifespan: Implementation Of An Intraoperative Protocol For Adults And Pediatrics, Megan Reynolds, Rachel Riddle

Doctor of Nursing Practice Projects

Traditional ventilation strategies have been shown to lead to the development of lung injury and postoperative pulmonary complications. Lung-protective ventilation (LPV) strategies for adults include low tidal volumes of 6-8 mL/kg based on ideal body weight, moderate levels of positive end-expiratory pressure (PEEP), incremental recruitment maneuvers routinely and as needed, and low fraction of inspired oxygen. Recommendations for pediatrics are similar, with some suggesting a more liberal limit for tidal volumes of less than 10 mL/kg based on predicted body weight. However, adoption of LPV strategies is not universal. Completed objectives of this practice project included thoroughly reviewing literature relating …

Implementing A Validated Developmental Screening Tool In A Rural Pediatric Primary Care Clinic To Enhance Early Diagnosis Of Developmental Delays From Birth To 36 Months, Melissa A. Armstead

Doctor of Nursing Practice Projects

Abstract

Evaluation of childhood development with a validated screening tool has been the gold standard for best practice recommended by the American Academy of Pediatrics (AAP) since 2006. A rural pediatric clinic was the setting for this quality improvement project. The goals of the project were to 1) increase the number of children identified with developmental delays, 2) identify children with delays earlier, and 3) maximize the number of children receiving early intervention (EI) services between the ages of birth to 36 months. The Ages and Stages Questionnaire (ASQ-3) was the selected screening tool adopted by the clinic in June …

Implementing An Evidence-Based Multifactorial, Multidisciplinary Fall Prevention Program In A Nursing And Rehabilitation Center To Reduce Fall Rates Among Patients, Tincy Poovathur

Doctor of Nursing Practice Projects

Falls are the leading cause of morbidity and mortality in the elderly in the United States. Patients in long-term care facilities are at increased risk for falls, accounting for 20 percent of fatal falls that require hospitalization. The economic and social burden of falls and fall-related injuries is significant. Fall-related injuries and their resulting expenditures are expected to increase substantially with the increasing aging population making this a problem of high priority. The literature recommends and supports incorporating evidence-based fall prevention initiatives into long-term care facility safety programs to address this problem. Based on the literature review and the facility's …

Presurgical Optimization Videos For Patients Undergoing Elective Spine Surgery, Megan Knetzer

Doctor of Nursing Practice Projects

Spine surgery is a growing healthcare trend with more than 199,000 lumbar fusions alone being performed in the United States in 2015 and annual costs of more than $10 billion. Spine surgery represents a major life-altering event for patients, with high complication rates and extensive recovery periods for which patients often feel unprepared. Presurgical optimization and education have the potential to decrease medical complications, improve outcomes, and reduce patient anxiety related to surgery. The purpose of this project was to implement presurgical education videos focused on modifiable risk factors for patients undergoing spinal surgery at an urban academic medical center. …

The Impact Of A Cultural Competence Assessment Tool On Teaching Strategies In The Dnp Curriculum At Southern Illinois University Of Edwardsville, Katarina Dobrosavljevic

Doctor of Nursing Practice Projects

Providing culturally competent and culturally congruent care to patients leads to better outcomes and reduction of poor outcomes due to health disparities. Providing care that is not culturally congruent can contribute to communication barriers, resulting in deficient diagnostic testing, miscommunication about etiologies, treatment plans that are not individualized, and discounting of patient's ideas. Individuals from diverse cultures face health disparities which contribute to inadequate care and poor outcomes. The purpose of this project was to survey former graduates of the Southern Illinois University of Edwardsville (SIUE) family nurse practitioner (FNP) program to assess their level of cultural competence and areas …

The Misuse Of Convenient Care And Importance Of Establishing A Primary Care Provider, Bailey M. Johnston, Amanda Lt Hawkins

Doctor of Nursing Practice Projects

Over the last decade, there has been substantial increase in the use of urgent care (UC) and convenient care (CC) clinics nationwide. While these clinics are valued and serve a purpose in our communities, more patients are utilizing their services exclusively in place of primary care (PC), resulting in millions of Americans not receiving essential preventative care and chronic disease management. An extensive literature review evaluated current and effective interventions used to decrease inappropriate use of CC clinics, while simultaneously exploring strategies in increasing patient compliance with routine comprehensive health management. Based on literature review findings, an education-based project was …

Implementation Of A Mental Health Screening In A Gastroenterology Office, Kayla Craig

Doctor of Nursing Practice Projects

The growing prevalence of depression in gastrointestinal patients is the reason why outpatient offices, gastrointestinal offices included, need to screen for mental health problems in their appointments. Many outpatient settings don't have a standard tool to screen for depression in patients, and therefore many patients are not being treated or diagnosed with depression in the process. The PHQ-9 has been shown to have strong validity and specificity in diagnosing depression in the outpatient setting.

Media Use Management With Toddlers And Preschoolers: Introducing Screen Time Recommendations In Pediatric Primary Care, Kaitlyn Mcgough

Doctor of Nursing Practice Projects

As the field of technology has advanced, screens have become easier than ever to access both for adults and their children in the form of smartphones, tablets, laptops, televisions, and more. This advancement has brought on unforeseen challenges for families as they grapple with understanding and implementing healthy boundaries between their children and technology. By their second year of life, 50% of children will have interacted with some form of media, and research is beginning to reflect that there is a measurable effect of screen time on toddler development. The need for intervention has continued to grow, as children are …

Developing An Educational Pamphlet For Patients Undergoing Interscalene Blocks With Liposomal Bupivacaine Exparel, Steve Fankam

Doctor of Nursing Practice Projects

There are over one million shoulder arthroscopies and arthroplasties performed worldwide each year, with interscalene blocks (ISBs) the typical treatment choice for postoperative analgesia (Etkin & Springer, 2017). In 2018, Exparel® was FDA approved for use in ISBs and educational materials currently are scarce (Pacira Pharmaceuticals, 2019). The effectiveness of pamphlets in the clinical setting has been well established (Sustersic, Gauchet, Foote, & Bosson, 2017). Pamphlets improve health literacy by providing patients a tool to aid in recall and adherence to postoperative instructions (Sustersic et al., 2017). This project reviewed the available literature on Exparel® ISBs, health literacy, and pamphlet …

Improving Skin Cancer Screening In Primary Care, Jaclyn Barnhouse, Rebecca Baietto

Doctor of Nursing Practice Projects

Skin cancer is one of the most common forms of cancer in the United States, with melanoma having the highest rate of mortality of all forms of skin cancer (CDC, 2019). However, there is hesitancy among primary care providers to perform skin cancer screenings (Oliveria et al., 2011). Prevention and early detection of melanoma is key. Melanoma has been known to be highly curable when found early. This makes early detection even more important in order to prevent metastasis and potential mortality (Bruce et al, 2017). The use of targeted screening tools can potentially save lives when utilized in primary …

Interventional Techniques For Chronic Low Back Pain And Migraine Headaches: Development Of Educational Pamphlets​, Muhidin Abukar, Mathew Schilling

Doctor of Nursing Practice Projects

Keywords

Chronic low back pain, migraine headaches, radiofrequency ablation, greater occipital nerve blocks, sphenopalatine blocks, botox injections.

Abstract 

Chronic low back pain and migraine headaches affect millions of adults in the United States. Traditionally, opioid and non-opioid pain medications were the mainstay pharmacological treatment of choice. However, due to the highly addictive nature of opioids, practitioners are seeking alternatives for pain management.  Radiofrequency ablation (RFA), a minimally invasive technique has been shown to alleviate chronic back pain while botox injections and other non-invasive opioid sparing techniques, such as greater occipital nerve blocks and sphenopalatine blocks have been found to be …

Physical Well-Being And Healthy Lifestyle Options, Michael Perkins

Doctor of Nursing Practice Projects

Background

The AANA has identified stress management or wellness as a priority for all CRNA programs. The Health and Wellness Initiative put in place by the AANA in 2004 is a model designed for all SRNA programs and intended to address students’ participation in wellness events in order to combat stressors.

The primary purpose of this project was to gain information about the stress faced by SRNAs enrolled at a Midwestern University and to evaluate strategies that could help students properly deal with stress.

Methods and Evaluation

Fifty-five students participated in the survey, data were compared by year in the …

Voyage: A Passage Through Orientation, Patricia Eppel

Doctor of Nursing Practice Projects

Dedication

This DNP project is dedicated to my husband, Jim who carried my school bags to and from the car on every hockey trip, dance competition trip, camping trip, and every other trip, just so I could say I had my homework in case I found time to study. Thank you for making dinners, doing dishes, vacuuming, and providing unwavering support for me through these past years. I also dedicate this project to my children Jacob and Sophia, who always seemed to migrate their way into the dining room late at night for talks when I was up studying. No …

Continuing Education Preferences Amongst Crnas, Jamie Nichting

Doctor of Nursing Practice Projects

The Illinois Association of Nurse Anesthetists (IANA) is a professional organization representing Certified Registered Nurse Anesthetists (CRNAs). To ensure compliance with high standards of care in the profession, CRNAs are required to obtain continuing education units (CEUs) for each 4-year certification period. The IANA offers conferences in both fall and spring, however, a loss in attendance and revenue at state meetings concerns the board members as to how state members are complying with the educational requirements to remain certified. It was imperative that the IANA needed to implement new educational opportunities that actively engaged CRNAs resulting in an increase in …

Virtual Cadaver Dissection Prior To Clinical Experiences In Nurse Anesthesia, Hannah Ruholl, Kyle Smith

Doctor of Nursing Practice Projects

Anatomy and physiology (A&P) courses are the foundation of anesthesia training. Student registered nurse anesthetists (SRNAs) must be A&P experts as they perform clinical skills for the first time. Traditionally, cadaver dissection has been used to enhance comprehension of A&P. However, not all facilities can allocate the time, space, or financial resources for cadaver dissection within their programs of study, especially at institutions that lie outside of major medical centers. Despite the presence of a virtual cadaver at a nurse anesthesia program in the Midwest, its introduction to SRNAs as a resource had not been fully employed. The goals of …

Identifying Barriers To Keeping Appointments In Mental Health, Shontel Ray

Doctor of Nursing Practice Projects

Abstract

Accessing healthcare for mental illness is important but has been challenging to resolve. Due to barriers, individuals are missing appointments leading to long-term negative effects of poor patient outcomes, such as homelessness and suicide. Understanding why individuals cancel or do not show up to their appointments is crucial to resolve this nationwide problem. Further investigation is needed to identify what barriers cause individuals to miss appointments so interventions can be created to resolve it and improve patient care. For this study, those who did not attend their first or second appointments were called and given an eight-question survey. The …

Standardizing Evaluation Methods For Simulation, Jessica Antisdel, Leslie Artinger

Doctor of Nursing Practice Projects

Background: Evidence suggests that student registered nurse anesthetists (SRNAs) benefit from simulation in the educational curriculum (Turcato, Roberson, & Covert, 2008). When simulation is implemented into coursework, it is important to evaluate student learning and perceptions (Adamson & Kardong-Edgren, 2012), however, there are few standardized instruments available (Adamson et al., 2012; Doolan et al., 2016).

Objectives: The goal of this project was to provide the foundation for standardizing simulation evaluation tools within a midwestern university’s school of nurse anesthesia.

Methods: A presentation on the Value Analysis Model was developed through extensive use of the literature and collaboration with a content …

Compassion Fatigue And Burnout During The Covid-19 Pandemic, Gabrielle Giamanco, Tyler Tanzyus

Doctor of Nursing Practice Projects

Abstract

The COVID-19 pandemic has pushed nurses to exhaustion while leaving them with compassion fatigue (CF) and burnout (BO). Compassion fatigue is secondary to traumatic stress and exposure, while burnout is the state of exhaustion of one’s ability to manage with their work and personal everyday stressors. This study aimed to determine whether a daily use of a meditation app could change quality of life indicators amongst front-line nurses affected by COVID-19. With the help of the ProQol assessment tool, along with a pre and post intervention surveys, participants’ awareness and personal experiences were evaluated. The study consisted of nurses …

Evaluating Unexpected Outcomes With A Change In Practice, Justin Trexler

Doctor of Nursing Practice Projects

Abstract

Quality improvement projects improve processes for delivering safe and effective care to patients. Most protocols can be implemented successfully, but what factors lead to an unexpected outcome? This project sought feedback from anesthesia providers after a protocol for administering intranasal midazolam instead of intravenous midazolam in older adults during cataract removal had unfavorable results. Using the concepts developed by Proctor et al. (2010) to analyze the feedback from the anesthesia providers, this project sought to understand why this change in practice elicited these unfavorable results.

The goal of the change in practice was to improve turnover times and reduce …