Aiming For Accuracy In Primary Care Penicillin Allergy Identification, Elizabeth A. Thomason

Doctor of Nursing Practice Projects

Throughout scientific literature, there is overwhelming evidence penicillin-allergic diagnoses are often inaccurate and inappropriate. As this diagnosis can often have unwanted effects for both patients and the healthcare team, it is essential to aim for accuracy when considering penicillin allergies. The purpose of this project was to implement a more focused penicillin allergy screening tool aimed at accurate allergy identification. Evaluation methods included pre and post-intervention electronic medical record reviews. The project also evaluated the impact on total post-tool implementation visit time. Providers and staff received verbal instructions on how to use the tool and the project inclusion criteria. The …

Improving Medication Reconciliation Quality During Long-Term Acute Care Transitions Of Care, Teresa Clark

Doctor of Nursing Practice Projects

Literature reveals accurate medication reconciliation results in increased patient satisfaction, improved patient outcomes, higher patient safety, shorter length of stay, and cost-effectiveness. With every transition of care a patient experiences, their risk for medication discrepancies increases—the project aims to enhance the medication reconciliation process in one long-term acute care hospital in Arkansas. The project aims to evaluate the current process, educate staff, implement a medication reconciliation toolkit, and assess accuracy. Baseline information resulted from reviewing twenty medication reconciliations. Seventeen of the 20 (85%) records had some type of medication discrepancy: (13) lack of verification, (6) dosing errors, (5) missing stop …

Utilization Of A Statin Therapy Initiation Clinical Decision Aid In A Rural Health Clinic: Analysis And Implementation, Debra Schulte

Doctor of Nursing Practice Projects

Low-density lipoprotein (LDL) elevation is a primary risk factor for atherosclerotic cardiovascular problems such as heart disease and stroke. Heart disease is the leading cause of death in the United States and stroke is the fifth leading. Earlier LDL reduction improves morbidity and mortality. Literature indicates fewer women start statin medications compared to men. The purpose of this quality improvement project was to implement a policy change that integrated evidence-based clinical practice guidelines translated into a clinical decision tool. Our aim is to determine whether it would improve statin initiation for the local female population between the ages of 25 …

Improving The Utilization Of Cnas In Pressure Ulcer Prevention, Jaclyn N. Bitterman

Doctor of Nursing Practice Projects

An estimated 2.5 million Americans are affected by pressure ulcers annually with the largest majority impacted the geriatric population. In order to achieve prevention of facility acquired pressure ulcers, the nursing team must properly identify patients at risk to prevent the injury associated with pressure. CNAs play a key role in this effort. The purpose of this project was used to develop, implement, and evaluate a training program for CNA students to improve knowledge and promote engaged attitudes in the prevention of pressure ulcers. Results of the project showed improvement after the training, but overall was not statistically significant. Overall …

Discharge Planning Considerations For Congestive Heart Failure: A Dnp Project, Jainarine Ramlochan

Doctor of Nursing Practice Projects

Abstract

Clinicians are challenged to prevent readmission of patients with congestive heart failure (CHF). The purpose of this project was to: 1) prepare students to better understand the discharge process for patients with CHF; and 2) obtain the opinion of nurses that were involved in the discharge process in the presence of COVID-19 Pandemic. The Delta Care Program (DCP) was used to guide the project and may be a useful tool for discharge planning. An intervention on use of the DCP was delivered to students (N = 83). Findings indicated that student nurses felt confident in the application of …

Understanding Cyanide Toxicity In Victims Of Smoke Inhalation, Jessica L. Wyman

Doctor of Nursing Practice Projects

Every day in the United States forty-two people are killed or injured as a direct result of fire. Building construction materials and furnishings have evolved from natural textiles to synthetic plastic-based goods that release excessive lethal toxic gases when heated. Rapid release of gas results in critical levels of hydrogen cyanide and carbon monoxide leading to fatal toxic exposures. Nursing knowledge and confidence can improve victim survivability by improving rapid recognition and assessment of these complex patients. The purpose of this DNP project was to increase emergency department nursing knowledge, confidence and ability in assessing and appropriately triaging smoke inhalation …

Case Management Of Primary Care Patients, Bernadette Webster

Doctor of Nursing Practice Projects

Case management (CM) offered in primary care is a collaboration, guided by the registered nurse, working to coordinate all aspects of care for the patient and the family. The purpose of this quality improvement/assurance project was to provide nurses in primary care with the education and methods of CM to assist in more effectively managing care for a patient after testing positive for COVID-19. An intervention was delivered to registered nurses (RN) in the primary care setting designed to improve knowledge and skill with case management for patients with high care needs or recently diagnosed with COVID-19. A templated note …

Guideline Utilization To Promote De-Escalation Of Benzodiazepine Use In Adults With Generalized Anxiety Disorder, Magdalena A. Malloy

Doctor of Nursing Practice Projects

Benzodiazepines are commonly used as the first line treatment for adults diagnosed with Generalized Anxiety Disorder (GAD) despite clinical guidelines that recommend otherwise. This can lead to misuse, abuse, addiction, and dependence. To de-escalate use of benzodiazepines as first-line treatment, this DNP Project seeks to reinforce use of evidence-based practice via a reminder card. The guideline compliance program was assessed by chart review to determine impact on GAD-7 scores and benzodiazepine prescriptions. Total of 69 patients’ charts were audited by six prescribers, over the period of eight weeks, to determine if outcomes were met. When analyzed pre and post intervention …

Intervention Of Mindfulness With Students To Identify Mental Health Problems And Enhance Coping Strategies, Aileen M. Jones

Doctor of Nursing Practice Projects

When mental health care is delayed, a young person may have more difficulty in academia and social situations. Therefore, it is important to reach young people to provide them with the skills to deal with stressors and mental health issues. The purpose of this project is to use mindfulness techniques to increase mental health literacy (MHL) and strengthen coping skills which can possibly assist students in building resilience to cope with stressors. By utilizing available mental health resources and learning coping skills, there can be a drastic change in the trajectory of a young persons’ life who struggles with stressors …

Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz

Doctor of Nursing Practice Projects

Racism and racial discrimination occur in a variety of forms (Kendi, 2017). Both can contribute to poor mental health outcomes in the United States (Alvarez, Liang, & Neville, 2016; Comas-Diaz, Hall, & Neville, 2019; Levy, 2019; Malott & Schaefle, 2015; Williams, Lawrence, Davis, & Vu, 2019). These social conditions have been identified as chronic stressors that can illicit trauma symptoms, result in post-traumatic stress disorder (PTSD), and contribute to increased suicidality (French et al., 2020). Providers should understand the ramifications of the psychological trauma that can occur and endeavor to deliver evidence-based solutions. This doctoral project was designed to develop, …

A Protocol For Improving Early Recognition And Treatment Of Bipolar Disorder, Zelluyah Gaitho

Doctor of Nursing Practice Projects

In bipolar disorder, patients present to a clinician during depressive episodes often leading to a misdiagnosis. In turn, this could lead to inappropriate treatment. This failure to diagnose could be attributed to lack of use of validated screening tools and deviation from clinical guidelines. The purpose of this quality improvement project was to develop a protocol that will help improve early recognition and treatment of bipolar disorder by using the Mood Disorder Questionnaire. A training program was developed to increase knowledge on the proper use of the Mood Disorder Questionnaire (MDQ) and the Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). …

Enhanced Breastfeeding Support Using Video Education To Improve Exclusive Breastfeeding Rates In A Baby-Friendly Acute Care Facility, Carol Mayernik

Doctor of Nursing Practice Projects

Exclusive breastfeeding (EBF) provides health benefits and is recommended by professional health organizations including the American Academy of Pediatrics, The World Health Organization, and the Centers for Disease Control and Prevention. Healthcare facilities support families to achieve EBF by educating clinicians and patients about the benefits of exclusive breastfeeding, providing prenatal education and hospital support to patients, and by achieving Baby-Friendly Designation through the Baby-Friendly USA, as endorsed by the World Health Organization/UNICEF. Most pregnant patients desire to exclusively breastfeed yet multiple barriers exist to achieve this goal. Evidence supports the use of video learning as an effective way to …

Improving The Safety Knowledge Of Associate Degree Nursing Students, Melissa Jones

Doctor of Nursing Practice Projects

The purpose of this study was to implement the Quality and Safety Education for Nurses (QSEN) safety component using several teaching strategies during didactic experiences to improve the safety knowledge and competency of first-year students enrolled in an associate degree nursing program. As a metric assessment, aggregate scores of the QSEN safety areas on the Health Educational System, Inc © (HESI) exam were compared to the previous year’s aggregate scores on the same examination. The results indicated an improvement in scores in students who participated in the implemented intervention. Statistical analysis suggests the intervention improved the participant’s knowledge and acquisition …

Evaluating An Overall Experience Of Virtual Learning In Meeting The Continuing Education Needs Of Rural Nurses In North Carolina, Yuen Li (May) Cheung

Doctor of Nursing Practice Projects

Background. Rural nurses in North Carolina (NC) face several barriers to accessing face-to-face continuing education (CE) opportunities.

Objective. The purpose of the project is to connect to rural nurses in NC by designing accessible and flexible CE programming that includes virtual learning activities.

Methods. System Usability Scale (SUS) and the Usability Metric for User Experience short version (UMUX-Lite) tools were used. to predict whether participants will use or adopt a new technology following a North Carolina Area Heath Education Center (NC AHEC) hosted virtual conference.

Findings. Of the 103 participants who attended the CE conference, 93 …

Improving Senior Level Nursing Students’ Application Of Assessing And Managing Pain Through A Virtual Game Simulation, Miranda Yelverton

Doctor of Nursing Practice Projects

Senior nursing students in the last semester of a community college nursing program take the Health Education Systems Incorporated (HESI) Exit Exam to evaluate their ability to pass National Council Licensure Examination for Registered Nurses (NCLEX-RN). The objective of this project was to implement a virtual game simulation on pain assessment and management to improve scores related to the concepts of pain comparing two different cohorts. Senior nursing students were offered the virtual game simulation and could voluntarily report attempts and results through a Google ™ Form.

Improving Medication Adherence In Depressed Patients Via Mobile Applications, Melanie Ocampo

Doctor of Nursing Practice Projects

About 7% of US adults had experienced depression. Depression is characterized by the presence of feelings of sadness, emptiness, or irritability, accompanied by bodily and cognitive changes lasting at least two weeks that significantly affect the individual’s capacity to function. For successful treatment patients must adhere to taking the medication on its scheduled times. Evidence suggests apps reminding patients to take their medication is still a novel idea. The purpose of this project is to determine the impact of Medisafe™ app on medication adherence and overall compliance when used for six weeks.

Virtual Medication Reconciliation Simulation With Senior Nursing Students, Courtney B. Calhoun

Doctor of Nursing Practice Projects

Abstract not available

A Multi-Client Simulation To Improve Communication, Prioritization, And Clinical Judgment Among Nursing Students, Adam K. Combs

Doctor of Nursing Practice Projects

Background: Hospital administrators have noted a lack of clinical judgment in novice nurses, which can result in negative client outcomes. This paper describes the implementation of a multi-client simulation experience with the purpose of determining if the experience improved communication, prioritization, and clinical judgment.

Method: A descriptive, pretest postest study, using the National League for Nursing (NLN) Jeffries Simulation Theory, examined the perceived competence of 37 senior level Associate Degree Nursing students.

Intervention: The participants rated their perceived competence on the Perceived Competence Scale and were scored on the ISBAR Interprofessional Communication Rubric (IICR) and the Lasater Clinical Judgment Rubric …

Nursing Workplace Incivility And Mindfulness, Cassandra Graham Gibson

Doctor of Nursing Practice Projects

Nurse incivility is currently prevalent in the nursing workplace. Incivility is described in the form of disrespectful attitudes and behaviors. Ethnic values may be ignored by those committing uncivil behaviors. Victims of incivility may not report uncivil incidents. Organizations and other stakeholders may discover difficulty in responding or exploring causative incivility behavior. Workplace incivility may be displayed as unsafe actions, nurse management errors, and staff dissatisfaction. Nursing staff may decide on resigning positions because of workplace incivility. Healthy, civil, caring workplace environments are imperative to patient and staff well-being.

Workplace incivility intervention may introduce a solution to uncivil behavior, rebuild …

Aromatherapy As A Non-Pharmacological Complementary And Integrative Sleep Intervention For Veterans, Amy D. Stewart

Doctor of Nursing Practice Projects

Twenty-seven percent to 54% of military personnel and veterans experience insomnia, with apnea and insomnia being the most common disorders in this same population. Due to high incidences of sleep disorders in the veteran population, this project sought to identify and validate a non-pharmacological intervention, aromatherapy, as a viable option for veterans with sleep problems. Aromatherapy, essential oils, have proven to be a natural, safe, low-cost, and non-pharmacological option for improving patient health outcomes and patient satisfaction.

Prescription Labels: Get To Know Them, Karen Adams

Doctor of Nursing Practice Projects

Low health literacy is a problem for millions of Americans resulting in increased use of healthcare resources resulting in poor health outcomes. The older adult population is continuing to grow and is the largest user of healthcare. Use of pharmaceutical regimens to manage chronic illnesses is the most commonly used treatment modality. Unfortunately, people with low health literacy may have trouble understanding and following their providers instructions. It can be difficult to read directions on over the counter and prescription medication bottles. Community-based health educational programs benefit the maintenance of older adult health. The purpose of this project was to …

Satisfaction Of Telehealth For The 55+ Population, Cynthia Schweizer

Doctor of Nursing Practice Projects

There is a primary care need for the 55+-year-old population related to the increasing aging population, physician shortages, and, more recently, Coronavirus Disease 2019 (COVID-19) to implement Telehealth care. The Telehealth project will include the 55+ population to provide more participants for the project at an internal medicine clinic. Telehealth's contribution and interventions will affect causal factors such as moderating or mediating factors of health problems. Some of those factors include insufficient primary care coverage due to decreasing numbers of primary care providers (PCP), the increasing older population, complex health issues that come with aging, the need for frequent follow-up …

Human Trafficking: Empowering Healthcare Providers And Community Partners As Advocates For Victims, Marielle A. Combs

Doctor of Nursing Practice Projects

Human trafficking (HT) is a public health crisis and the need for education is dire. Healthcare providers lack confidence in victim recognition and aid provision all while encountering victims in their practice. The project leader aimed to empower healthcare providers in recognizing signs of HT and making appropriate referrals. Ten community volunteers, including registered nurses, who assist with a mobile medical unit and spiritual 12-step program, participated in a Human Trafficking 101 training. The application of holistic nursing core principles and Human Caring Science was integrated as vital in victim identification. A pretest posttest design was utilized to administer the …

Evaluating The Impact Of Resilience Training In The Group Home Care Provider Population, Gwangia O. Hudson

Doctor of Nursing Practice Projects

Stress, compassion fatigue (CF), and burnout are all potential problems faced by those who have adopted a career in caring for others. Poorly managed stresses are associated with strained work interactions, dysfunctional personal connections, poor health, and poor quality of work (Edwards & Burnard, 2003; Richardson et al., 2015; Zajac et al., 2017). Organizations do well to focus on preventing stress, CF, and burnout; and or at a minimum providing, employees with tools to build resilience (Edwards & Burnard, 2003; Gentry, 2018; Zajac et al., 2017).

Improving Delirium Assessment In Critical Care, Michelle Reed

Doctor of Nursing Practice Projects

The objective of this project was to identify barriers that impact nurses completing delirium assessments and to improve compliance rates with delirium assessments. The design was an observational, single group pretest-post-test. The preliminary results demonstrated an educational intervention, using the Knowledge-to-Action theory, improved nurses’ compliance with delirium assessments.

Self-Care Practice In Nursing, Leslie Rhom

Doctor of Nursing Practice Projects

Nurses encounter multiple stressors throughout each shift. If this is not managed well through self-care and coping strategies, it can negatively impact one 's health and the well-being and care delivered to patients. The purpose of this project is to bring awareness of current self-care strengths and limitations of nursing students, equipping students with evidence-based practices to enhance self-care. This effort can lead to improved patient care outcomes by decreasing job turnover, burnout, and compassion fatigue. The participants in this project were pre-licensure nursing students in the final semester of nursing school. Participants attended a didactic lecture, completed the Mindful …

Inspiring Nurse Leader Connectedness To Improve Patient Experience, Shauna Maxson

Doctor of Nursing Practice Projects

Objectives:

1. Interventions targeted at improved communication, retention, empowerment, and encouragement will be utilized to enhance the practice environment of incumbent and future nurses in the emergency department. Nurse connectedness will be improved 25% over baseline following implementation of interventions to positively augment practice environment.

2. Patient experience scores in the emergency department will be sustained at benchmark, or greater, following efforts to improve nurse connectedness.

Design: Prospective, single-center, non-randomized, pre- vs. post-

Data Sources: Scholarly, peer-reviewed journal articles and texts, results from pre- and post-intervention completion of Utrecht Work Engagement Scale, Press Ganey patient experience scores

Review Methods: Review …

Nursing Education Intervention On Using Video-Based Patient Education "Modifiable Stroke Risk Factors", Julie C. Webb

Doctor of Nursing Practice Projects

Objective: Nurses play a significant role in the discharge education and understanding of the disease state to stroke patients. This study aimed to educate nurses on implementing video-based stroke patient education, focusing on individualized patient modifiable risk factors.

Methods: This project included education sessions focused on training nurses to access and use available video-based stroke education. In addition, nurses participated in a needs and knowledge-based survey. These education sessions were provided during staff huddles on different shifts over one week.

Results: Education sessions focused on the proper use of the video-based stroke patient education tool positively influenced nursing opinions regarding …

Spiritual Dimensions Of Care: Need For Spiritual Care Interventions In Nursing Clinical Practice, Jillian Jack

Doctor of Nursing Practice Projects

Empirical research has identified emerging evidence concerning the value and importance of spirituality in the provision of nursing care. Spiritual well-being has important implications for a patient’s well-being and there is evidence that points to the association between spirituality, individual healthcare outcomes, and quality of life (QOL). Assisting patients in meeting their spiritual needs is also recognized internationally. Despite the fact that spiritual care is an essential part of nursing care, there remains a gap concerning spiritual care practices in the nursing clinical environment. The magnitude of the problem has to do with the lack of spiritual care education training. …

The Impact Of An Escape Room Simulation On Confidence And Competence In Nursing Student’S Identification Of Critical Changes In Patients: A Mixed-Method Approach, Kristy Schmaldinst

Doctor of Nursing Practice Projects

Background The novice nurse takes time to show competency and confidence when implementing the new skills learned throughout their time in nursing school. With the increasing complexities of the healthcare system in the United States, it is necessary to ensure graduates are adequately prepared to handle critical situations. However, the ability of novice nurses to recognize critical changes in patients continues to be a hurdle that nursing faculty are attempting to address.

Objectives The objectives of this project were to explore the impact of an escape room simulation on student’s confidence and competence in recognizing critical changes in patients.

Design …