Nursing Commons^™

Shivering In Postpartum Women: Development Of A Perioperative Protocol For Women Undergoing Cesarean Section, Lindsay Dawson, Kara Peters

Doctor of Nursing Practice Projects

In obstetric patients undergoing a cesarean section, a spinal anesthetic is the most common form of anesthesia (Hannallah, 2016). An intrathecal (or spinal) block is not benign. Postpartum shivering is a potential risk with any neuraxial procedure, with an incidence of 40-80% specifically following a spinal anesthetic (Feng et al., 2021). Patients who experience shivering are at a greater risk for postoperative complications, impaired mother-newborn bonding, and decreased patient satisfaction. Both nonpharmacological and pharmacological treatment options exist for prevention and treatment of postpartum shivering. The objective of this project was to introduce a standardized, evidence-based protocol to decrease the incidence …

Anesthesia Management For The Preeclampsia Or Hypertensive Parturient, Britanie Sumpter

Doctor of Nursing Practice Projects

Preeclampsia is a placental disease characterized by abnormal maternoplacental blood vessels and placental dysfunction resulting in fetoplacental hypoperfusion and maternal multi-system organ dysfunction (Wang et al., 2019). Expectant management of a hypertensive or preeclamptic parturient includes antihypertensive medications, magnesium sulfate for seizure prophylaxis, and early delivery of the fetus (ACOG, 2020). Neuraxial anesthetic-induced sympathectomy combined with circulating antihypertensives, magnesium sulfate therapy, and intravascular volume depletion in preeclampsia is thought to contribute to exaggerated hypotension.

Persistent refractory hypotension after neuraxial anesthesia in parturients with preeclampsia or hypertension has been an ongoing issue affecting obstetric providers at the host facility. This project …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Integrating Psychotherapy In A Psychiatric Outpatient Clinic, Ayesha Baluch

Doctor of Nursing Practice Projects

Mental illness is common in the United States, affecting millions of people. Although there are effective medications for mental illness, psychotherapy in addition to pharmacotherapy provides the best outcomes. This project aimed to improve providers' psychotherapy screening and education of patients about psychotherapy utilization. A pre-implementation survey was conducted to evaluate psychotherapy screening and the barriers faced by providers to utilize psychotherapy screening. An education session was provided to the providers about the importance of psychotherapy screening and education. Data showed that the providers discussed psychotherapy with eight patients (40%) and educated four patients (20%) pre-implementation. Data showed that the …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Nurses' Experience Implementating Weighted Blankets In Inpatient Psychiatric Unit, Michael Ragen

Doctor of Nursing Practice Projects

The complexity of treating sleep difficulties in patients with concurrent psychiatric disorders continues to be a struggle for the medical community. The mechanism that causes psychiatric disorders can induce insomnia or hypersomnia (Khurshid, 2018). There is also a growing interest in disturbed sleep ability to induce psychiatric episodes (Verkhratsky et al., 2020). This classic “Chicken or Egg Scenario” meets the modern focus on creating the best outcome for patients with the least medication, spurring interest in the holistic management of sleep disorders. The literature has little information on the use of weighted modalities for sleep management and anxiety in an …

Lung Cancer Screening In A Primary Care Clinic For Coal Mine, Glenda Mills, Sarah Cobb

Doctor of Nursing Practice Projects

Lung cancer is the leading cause of mortality for both men and women in the United States. Guidelines are set by the American Cancer Society for annual screenings of at-risk patients. Early identification of lung cancer risk and screening with low-dose CT scans can increase detection and treatment thereby reducing risk of death or disability. Coal miners are exposed to numerous cancer-causing agents, such as toxic chemicals, dust pollution from coal, and diesel exhaust fumes. However, primary care clinics serving coal miners lack lung cancer screenings despite the increased risk miners face. Patients were screened using criteria set forth by …

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Improvement In Patient Compliance For Gynecological Care, Tracee Williams

Doctor of Nursing Practice Projects

This quality improvement project implemented the patient-initiated follow-up (PIFU) pathway in a gynecology clinic setting. PIFU has potential to lead to decreased no-show appointments and increased patient autonomy in outpatient healthcare practices. Barriers that influence compliance with plans of care include lower socioeconomic status, racial and ethnic minorities, and unmet social needs such as food insecurity, healthcare travel and cost, and child/adult care needs. In addition to higher rates of no-show appointments, individuals facing these barriers have increased comorbidities. Prior to implementing the PIFU model, patients between the ages of 18 and 42 completed a patient satisfaction survey to better …

Text-Based Reminders: Pathways To Improve Hemoglobin A1c And Fasting Blood Glucose Levels Of People With T2 Diabetes Mellitus, David Bamidele Alao

Doctor of Nursing Practice Projects

Background

Research studies have shown that self-monitoring blood glucose levels is a cornerstone in DM management. Various studies have shown that a text message intervention effectively reminds people with T2 Diabetes Mellitus (T2DM) to check their blood glucose levels at home. Text message reminders successfully encourage medication adherence, blood glucose self-monitoring, and lifestyle changes (Xiqian et al., 2019). Through the beneficial effects on HgbA1c and blood glucose, text-based reminders have been demonstrated to improve blood glucose self-monitoring, essential to managing diabetes.

Purpose

This project aims to evaluate the effects of the 12-week text-based reminder intervention on the patient's blood sugar …

Incorporating Simulation Experiences Into The Nurse Aide Curriculum To Improve Clinical Judgment, Tonya A. May

Doctor of Nursing Practice Projects

This DNP Project was designed to strengthen clinical judgment skills in nurse aide students. Incorporating simulation-based learning opportunities into the nurse aide curriculum supports the development of clinical judgment skills. Four simulation scenarios were designed to focus on the student's ability to respond within the nurse aide’s scope of practice. Pre-test and post-test surveys were developed with a 5-point Likert scale (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 – strongly disagree) to assess the student's perception of their ability to perform, notice, interpret, respond, and reflect on patient care. A …

Sleep Hygiene Education, Hope Colon

Doctor of Nursing Practice Projects

This DNP project was designed to increase awareness of insomnia and sleep hygiene in the target community by providing an in-person educational session on sleep hygiene. The educational session provided information on insomnia, sleep hygiene habits, statistics of those with sleep disorders, and medication use for sleep. The impact of the project implementation was measured using a pre-intervention survey and a post-intervention survey. All survey items had an increase in correct answers post-intervention. In conclusion, the results revealed there was an increase in awareness and knowledge base of insomnia and sleep hygiene after the education was provided.

Identifying Patients Suffering From Housing Instability In The Emergency Department, Jarvis D. Roberts

Doctor of Nursing Practice Projects

Homelessness is the most visible form of housing instability in the United States of America. Yet, millions of people across our nation live in unstable housing, which consists of temporary housing, shelters, outside encampments, and vehicles. Many citizens facing these types of insecurities live paycheck to paycheck and are one health crisis or emergency away from financial ruin. The COVID-19 pandemic, inflation, and slow hourly wage growth have exacerbated this situation. This project aimed to construct a screening tool to identify patients suffering from housing instability in the emergency department setting and provide them with community resources.

Mentorships For New Graduate Nurses, Taylor Leigh Bailey

Doctor of Nursing Practice Projects

New graduate registered nurses (NGRNs) represent a crucial segment of the nursing workforce, embodying the future of the profession. Thus, it is imperative that we utilize our resources, knowledge, and experiences to continuously strengthen and grow this generation of nurses. Mentorship is one key method that can be used to support NGRNs. This DNP project aimed to evaluate the effectiveness of mentorship for NGRNs within their first year of nursing practice and was implemented within an existing residency program at a Level I trauma facility. Experienced nurse volunteers received mentor education, and 40 NGRNs were individually paired with these volunteer …

A Review Of The Effects Of Different Types Of Stigmas On The Retention Rates Of Patients In Medication-Assisted Treatment And How To Combat The Problem, Pamela Cox

Doctor of Nursing Practice Projects

It is difficult to turn on the news without hearing about the opioid epidemic or a recent opioid overdose. There is hope because there is a treatment to help prevent this epidemic. That treatment is known as medication-assisted therapy (MAT), where patients can present and, if they meet the criteria, can be given a prescription for buprenorphine/naloxone combination medication. Treatment with buprenorphine/naloxone has been shown to be highly effective treatment for substance use disorder (SUD). Even though it has been proven that this combination works, less than 20% of patients diagnosed with SUD present for treatment. This study focused on …

The Use Of Diaphragmatic Breathing Techniques To Reduce Stress In Pre-Licensure Nursing Students, Amy Naugle

Doctor of Nursing Practice Projects

Research supports the idea that pre-licensure nursing students experience higher levels of stress than their general education-focused peers. This DNP project focused on stress related to nursing exams in the first semester of nursing school and promoted the adoption of diaphragmatic breathing techniques. The use of stress management techniques has been explored in those with intense job experiences and has proven to alleviate stress and promote improved coping. This cohort of pre-licensure nursing students was asked to identify stressors that affected them within the preceding 6 months while attending the first semester of a 2-year nursing program. The cohort was …

Introducing Mental Health Resources To Nurse Practitioner Residents, Tiffanie Bailey

Doctor of Nursing Practice Projects

This DNP Project identified the increased need for mental health resources after the COVID-19 pandemic. Studies showed the rate of anxiety, depression, and substance use has also been on the rise since the beginning of the pandemic. As the impact of the COVID-19 pandemic began to devastate the country mentally and physically, it became quickly apparent that additional resources to provide support for those suffering from mental illness were essential. This project aimed to introduce a Mental Health First Aid course within the Residency Program at the Center for Family Guidance. Participants were asked to complete a pre-test indicating their …

Community Educational Session On Identifying The Signs Of Depression And Resources Available, Desiree Young

Doctor of Nursing Practice Projects

The DNP Project was designed to educate the community on identifying the signs of depression and the community resources available to them. The intent of the project was to improve the community’s knowledge of depression symptoms and the community resources available that offer assistance to those dealing with these symptoms. There is a great need for education on depression signs, as many in various communities suffer from untreated depression, which often leads to negative outcomes. The impact of the project implementation was measured by using pre- and post-survey data evaluating the participants' overall knowledge of the signs of depression, stigma …

Er Staff & Burnout: Interventions For Stress Management, Sara Elizabeth Kerbow

Doctor of Nursing Practice Projects

Nursing is one of the most difficult professions, not only physically exhausting but the mental and emotional toll can create havoc for the person’s life (Scala & Drummond, 2016). This DNP project, “Reset”, was founded on the concept of nursing burnout, compassion fatigue, and secondary trauma causing overwhelming stress related to the emergency room nurse and staff. The purpose of this project was to show how a 15-minute mental health reset can play an essential role in stress reduction. By using complementary health modalities such as lavender essential oil with diffuser, visual imagery, and massage while listening to soft calming …

Medication Reconciliation: Preventing Harm To The Senior Living Population, Charles (Chuck) Jennings

Doctor of Nursing Practice Projects

This project was designed to address the risk of medication errors occurring when geriatric adults return to a senior living setting following an acute care stay. In addition to a primary care physician (PCP), the health care of geriatric adults is often managed by medical specialists and subspecialists. The engagement of multiple providers poses significant communication challenges, as these providers often work in separate offices and are limited in their information sharing. Consequently, following a hospital discharge, reconciling medication orders amongst all providers can be challenging. This challenge is further complicated, as PCPs oftentimes do not interface with the specialists …

Determining The Need For 23-Hour Observation Following Transforaminal Lumbar Interbody Fusions: A Patient Perspective On Recovery At Home, Lacey Irias

Doctor of Nursing Practice Projects

Minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (TLIF) is becoming more frequently performed in ambulatory surgery centers (ASCs). Subsequently, patients are scheduled for an option to undergo a 23-hour observation which requires staff preparation. The preparation increases costs and creates a shortage during a standard daytime shift which can reflect negatively on patient care. Most patients elect to be discharged the same day, on account of experiencing minimal pain and seeking the comfort of their own home. The goal of this DNP project was to assess the necessity of scheduling a patient 23 hours for observation following a …

Mental Health And The Black Church: Decreasing The Division In Divinity, Latonya Gray

Doctor of Nursing Practice Projects

Racial disparities in mental health care persist for Black Americans, with only one in three who need treatment receiving it. The care they do receive is often of a poorer quality than that of other groups. Faith communities serving Black members could help address this gap by partnering with mental health professionals to meet congregants' needs. With mental health now at the forefront of public discourse, considering the specific needs of the Black community is critical. Black Americans face disproportionate mental health burdens but are more likely to seek counsel from clergy due to cultural stigma. Educating clergy on mental …

Bridging The Gap: Strategies To Improve Hpv Vaccination Uptake, Stephanie Ramsey

Doctor of Nursing Practice Projects

The human papillomavirus (HPV) vaccination is approved by the United States (US) Food and Drug Administration (FDA) for individuals beginning at age 9. Evidence shows that HPV vaccination uptake is lower than other vaccinations offered in the early adolescent/adolescent age group. Healthy People 2030 set forth a goal that 80% of adolescents ages 13-15 will have HPV vaccine series completion by 2030. Research has shown that provider recommendation for the HPV vaccine is one of the reasons adolescents, or parents of adolescents, have chosen to initiate and complete the HPV vaccination. Studies have shown that providers who have been educated …

The Early Prevention Of Diabetic Foot Ulcers, Aruodo Ukpai

Doctor of Nursing Practice Projects

Frequent and proper foot exams and foot care are fundamental in decreasing the incidence and morbidity of diabetic foot ulcers, yet many patients are still not screened at appointments or educated on the importance of foot exams. This research planned to address the lack of foot care education and foot assessments amongst patients with Type 2 diabetes. Past research done on this focused on providing education to diabetic patients either at home or in a setting where patients can come and receive the education. To our knowledge, no research has been done on the use of video teaching to provide …

Substance Abuse Awareness Amongst Practicing Nurses, Marjenia Williams

Doctor of Nursing Practice Projects

Background: This paper discusses the problem and potential solutions of substance abuse amongst practicing nurses. Substance abuse is prevalent among 10% of the nursing population in the United States (Sofer, 2019). This problem is more significant than the public realizes. It is essential that new nurses and student nurses become aware of the risks and the causes of substance abuse within the culture prior to them practicing.

Methods: A 45-minute educational presentation based upon 10 peer-reviewed articles which include five articles regarding the problem and five discussing solutions was utilized to facilitate open discussion of the topic. The …

Benefits Of Patient-Centered Education For Type 2 Diabetes Mellitus, Paige Bortnick

Doctor of Nursing Practice Projects

Type 2 diabetes is a chronic, lifelong illness that affects millions of individuals in the United States. The rate of diabetes has doubled over the last 20 years in America and has climbed to be the seventh leading cause of death amongst Americans. The purpose of this project was to determine if participants in the target community demonstrated increased knowledge and awareness of diabetes after receiving education. A pre-intervention and post-intervention survey was given to determine if the education was effective. Data collected revealed an increased awareness and knowledge regarding the prevalence of type 2 diabetes, lifestyle, and diet modification.

Remodeling Breastfeeding Education, Rhonda Coffey

Doctor of Nursing Practice Projects

Mothers face important decisions regarding how to feed their infants, and successful breastfeeding requires commitment, support, and education. The numerous health benefits of breastfeeding for both mothers and infants are well-documented throughout the literature, and experts recommend exclusive breastfeeding for the first year of life. Healthcare teams play a crucial role in supporting breastfeeding success by providing education, guidance, and troubleshooting assistance when complications arise. Reassurance from healthcare providers can also influence mothers' overall experiences with breastfeeding. The facility where participants deliver assists most mothers in initiating breastfeeding within 1 to 2 hours after delivery, with approximately 75% meeting this …

Improving Epilepsy Monitoring Unit Training For Registered Nurses, Akaia Danae Abernathy Lail

Doctor of Nursing Practice Projects

This quality improvement project was developed to increase the baseline knowledge of a group of registered nurses who work within a highly specialized in-patient healthcare setting, an Epilepsy Monitoring Unit (EMU). The increase in knowledge was trajected to decrease event reporting which would show improvement in this high-risk patient population’s safety. The pre-education survey was dispersed to the participants, the registered nurses, to obtain a baseline knowledge level. There was then EMU-specific educational material made available for the participants. After the set time, the participants were then given a post-education survey to determine if their post-test scores could reflect a …

Cardiovascular Disease In Firefighters, Emily Jordan Baldwin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of increased cardiovascular events in firefighters in a county in the foothills of North Carolina. Nola Pender and Dorothy Orem’s theories were utilized for this project. The literature review exhibits the prevalence and significance of cardiovascular disease in firefighters. The literature review demonstrates the benefits healthy eating and exercise have on the heart and towards the prevention of cardiovascular disease. A pre- and post-test was utilized for this project and allowed for the collection of data appropriately. The results showed education on cardiovascular disease, exercise, and healthy eating increased the knowledge …