Nursing Commons^™

Initial Refugee Health Assessment Educational Session, Yolondra Cochnan

Doctor of Nursing Practice Projects

The initial refugee health assessment presents an excellent opportunity to identify communicable diseases in newly arriving refugees. As the number of refugee arrivals increases, so will the need for nurses who possess the skills necessary to conduct the initial refugee health assessment. Prior to the pandemic, the United States was facing a nursing shortage. The impact of the pandemic devastated the nursing community, leaving them exhausted and burnt out, which led many nurses to retire and leave the field of nursing (National Council of State Boards of Nursing [NCSBN], 2023). Skilled nurses are needed to prevent the spread of communicable …

Improving Parental Communication With Adolescents About Sex, Amanda Blanton

Doctor of Nursing Practice Projects

In 2018, 68 million people in the United States were infected with a sexually transmitted infection. Of those 68 million, 26 million cases were newly diagnosed, and of that 26 million, half were youth aged 15-24 (Centers for Disease Control and Prevention [CDC], 2022a). The approaches to educating our youth about sexual health are inconsistent, leading to misconceptions about the dangers associated with risky sexual behavior. However, parents have the upper hand in discussing sexual health information with their children by being the child’s first contact and source of information. Teens who report talking with their parents about sex are …

Increasing Organ Donation In A University Setting, Zachary Hatton

Doctor of Nursing Practice Projects

The literature shows a strong correlation between education on organ donation and increased organ donation registration. Society has depicted a description of organ donation that is hostile and untrue. Increasing organ donation registration with knowledge sets the foundation of a grassroots movement to increase understanding and change society’s viewpoint(s) on organ donation. An education session on organ donation was developed and presented to the targeted population of 18–24-year-old students at a university in the foothills of the Appalachian Mountains. The focal point of the presentation was to dispel myths, educate on facts, and create a better understanding of organ donation …

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

Implementing A Strategic Reporting Model Among Public Health Nurse Consultants To Increase Communication, Heather Willis

Doctor of Nursing Practice Projects

Public health has seen a drastic amount of turnover post-pandemic. There was an estimated 44% turnover rate for public health registered nurses, with a vacancy rate that doubled from 12.7% in March 2020 to 23.2% in July 2022 (Skinner, 2022). With this high turnover rate, many nurses are new to North Carolina (NC) public health departments and health districts. Public Health Nurse Consultants (PHNCs) are expected to train and guide these new nursing staff members. With the turnovers continuing at the local health departments (LHDs), new nurses are not given the recommended training because of communication breakdowns. This project helped …

Bridging The Gap: Strategies To Enrich The Clinical Experience Of Undergraduate Nursing Students To Improve Clinical Judgment Skills, Gabrielle Hope

Doctor of Nursing Practice Projects

Introduction: The lack of competent clinical judgement among new graduate nurses contributes to poor patient outcomes, negatively impacting patient satisfaction scores, and subsequently raising the cost of healthcare for consumers. This project explores how reflective journaling and cooperative learning activities contribute to the development of critical thinking of nursing students during their Nursing Fundamentals clinical practicum.

Methods: Seventeen students enrolled in a private university nursing program were selected as the sample. The students were introduced to the recommended learning strategies and invited to anonymously participate in a pre-survey and post-survey. The surveys were identical in content and consisted …

Improving Sexually Transmitted Infections (Sti) Education And Access To Education For Healthcare Workers In A Rural Ambulatory Clinic, Savannah Elmore

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) are prevalent across the United States, with one in five people diagnosed in 2018, resulting in nearly $16 billion in medical costs. The prevention and treatment of STIs have been identified as a priority area for improvement, with healthcare providers playing a critical role in education, diagnosing, and treating STIs. The aim of this capstone project was to improve STI education and access to education for healthcare workers in a rural ambulatory clinic. Through a needs assessment and the development of objectives and a timeline, the project identified and addressed gaps in STI education and resources, …

Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton

Doctor of Nursing Practice Projects

Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.

Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.

Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …

Combating The Opioid Crisis: Opioid And Naloxone Training In A Rural School District, Phadra K. Murray

Doctor of Nursing Practice Projects

Background: The opioid epidemic is plaguing North Carolina and has crept its way into the academic setting of many elementary, middle, and high schools in the state, causing school nurses to scramble and search for ways to keep students safe. This DNP project was designed to educate school nurses in a rural county in eastern North Carolina about opioid education and naloxone administration. This project intended to increase the knowledge and confidence level of school nurses in case of an opioid overdose emergency within the school. As more and more children and adolescents experiment with opioids, there is an urgent …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Cardiovascular Disease Improvement Project, Deglan K. Mccrystal

Doctor of Nursing Practice Projects

Health prevention promotes positive healthcare outcomes by identifying risk factors associated with a disease process in its early stages to halt or slow its progression. Preventions, like routine screenings, facilitate the identification of risk factors or the initiation of treatment of a disease. Identifying risk factors, which often go unrecognized, helps to manage conditions like cardiovascular disease before it progresses in severity. Early treatment options or identifying risk factors that lead to cardiac disease positively impact healthcare costs by reducing the number of hospital visits, emergency services, and the need for costly long-term care. Prevention increases the quality of disease …

Addressing Nursing School Retention: The Necessity Of Orientation In Nursing Education, Kerstin A. Queen

Doctor of Nursing Practice Projects

Nursing schools have been challenged to impact attrition and retention by creating an environment that increases student success. This DNP project was created to impact the current nursing shortage by increasing the number of nursing students who were retained after the first semester of nursing school. The DNP Project Leader designed a structured orientation program consisting of a 2-day in-person orientation and an online repository of resources. The DNP project sought to increase retention and provide pre-licensure students with gained skills to progress in the nursing program after the first semester in nursing school. The in-person orientation program provided participants …

Student Academic Success System, Brandi Castle

Doctor of Nursing Practice Projects

This project aimed to enhance academic success and retention rates in a practical nursing program through the implementation of a Student Academic Success System (SASS), utilizing evidence-based teaching strategies. A quality improvement design using both the Iowa Model of Evidence-Based Practice and the Plan, Do, Study, Act (PDSA) framework was guided by Kolb’s Model. Nurse faculty saw a need for increased student retention among practical nursing students; the student then proposed a plan, translated evidence, created a pre- and post-survey, and carried out SASS with the use of trained nurse faculty coaches. The goal of the project was to reduce …

Microlearning In Asynchronous Online Rn To Bsn Program, Chandra Carter

Doctor of Nursing Practice Projects

This quality improvement project aimed to incorporate microlearning teaching methods, specifically short videos of less than 10 minutes, into the online setting of the Nursing Research course to improve student engagement and autonomy. Literature reviews revealed microlearning teaching methods improved students’ confidence, satisfaction, and engagement. Identifying teaching methodologies that allow students to learn the material and complete the work independently is essential for the student to be successful. The students completed a pre and post-survey measuring the students’ perception of microlearning teaching methods, satisfaction, and autonomy in completing work during weeks one and seven, and the analysis was completed using …

The Impact Of Improved Staff Education And Equipment Competency On Enhancing Hypertension Knowledge In Patients At A Rural Urgent Care Clinic, Mekeilah Johnson

Doctor of Nursing Practice Projects

Hypertension is a persistent medical condition characterized by its progressive nature, potentially leading to long-term complications if not managed appropriately. Accurate measurements of blood pressures play a pivotal role in determining the appropriate source of treatment in this chronic illness. High blood pressure is one of the most critical risk factors for ischemia, heart disease, stroke, chronic kidney and other internal organ damage, and dementia (Zhou et al., 2021). The absolute burden of hypertension has consistently increased from 87.0 million in 1999-2000 to 108.2 million in 2015-2016 (Journal of American Heart Association [JAHA], 2018). This quality improvement project aimed to …

Lncreasing Clinical Judgment And Critical Thinking Skills Using The Ncsbn Clinical Judgment Measurement Model In Licensed Nursing, Kathryn Roberts

Doctor of Nursing Practice Projects

Licensed nurses are having problems with critical thinking and using clinical judgment when caring for patients (Rogers & Franklin, 2023). There has been increased emphasis on critical thinking and clinical judgment in nursing school curriculum but not in hospital/orientation curriculum (Dickison et al., 2019). This quality improvement project aims to address the gaps in critical thinking and clinical judgment skills among licensed nurses by focusing on integrating the NCSBN-CJM, and cues into the prebriefing of the Respiratory Distress/Oversedation Scenario within the project hospital orientation program. The project utilized a quasi-experimental study design to investigate the cause-and-effect relationship by integrating the …

Impact Of An Education Program On Screening For Non-Alcoholic Fatty Liver Disease In Patients With Type 2 Diabetes, Lauren Rucker

Doctor of Nursing Practice Projects

Type 2 Diabetes Mellitus (T2DM) has the potential for multiple complications which include non-alcoholic fatty liver disease (NAFLD). The American Diabetes Association (ADA) updated its guidelines recommending screening of patients with T2DM for NAFLD (ADA, 2023). Screening is prompted by the increased incidence of NAFLD in patients with T2DM. Approximately 70% of people with T2DM suffer from NAFLD which can progress to hepatic steatosis or non-alcoholic steatohepatitis (NASH) (ADA, 2023). NALFD is a common diagnosis leading to the need for liver transplantation (Alkhouri et al., 2020). This project aims to determine if an education program for primary care providers and …

Improving Empathy With Simulation: A Quality Improvement Project, Jami Layne

Doctor of Nursing Practice Projects

This study examines the effectiveness of simulation-based training in enhancing empathy levels among undergraduate nursing students. A lack of empathy can negatively impact the healthcare outcomes of patients (Levett-Jones et al., 2019). Improving the empathy levels of nursing students can improve patient outcomes and impact student learning outcomes such as the student’s ability to think critically and improve communication and social skills (Chua et al., 2021; Ferri et al., 2017; Hakansson Eklund et al., 2019; Koukourikos et al., 2021). The purpose of the quality improvement project was to improve empathy levels in undergraduate associate degree nursing students and increase the …

Impact Of Self-Management Education On The Self-Efficacy Of People With Chronic Pain, Tanya Jones

Doctor of Nursing Practice Projects

Self-efficacy is a critical element in the self-management of chronic pain. Despite the traditional approaches to managing chronic pain, such as opioids, traditional methods have proven ineffective and often lead to addiction and misuse, contributing to the overwhelming and devastating opioid crisis. This quality improvement project aimed to reduce the knowledge gap among individuals between the ages of 18 and 75 who have chronic pain by producing data that illustrates that providing individuals with self-management education empowers them to understand and self-manage their pain. The concept of self-management education is grounded in Bandura's Social Cognitive Theory, which highlights the role …

The Effects Of Diet And Exercise On Menopause Symptoms And Symptom Severity, Nicole Crowder

Doctor of Nursing Practice Projects

Menopause is a phase of life that occurs between the ages of 45-50 years and can last from 7-10 years or longer. The purpose of this quality improvement project was to develop a clinical protocol of assessments not currently completed to decrease the common symptoms of menopause such as hot flashes by implementing dietary changes and exercise as a weekly routine to decrease menopause symptoms. Participation was solicited at a private primary care clinic to women aged 40 and older over a 6-week period. BMI was calculated, documented, and completed surveys were retuned at check-out, with no identifiers and deposited …

Sepsis Criteria On Triage (Scot): Sepsis Alert, Kristie Givens

Doctor of Nursing Practice Projects

Sepsis is a serious life-threatening condition that kills hundreds of thousands of patients every year and is a major leading cause of death. Sepsis is a medical emergency where early identification and prompt treatment are crucial for survival. Despite assessment tools for early recognition, a delay in antibiotic therapy remains. A sepsis alert (Code Sepsis) in the emergency department could improve sepsis care, spare countless lives, and save billions of dollars nationwide, annually. The implementation of a Code Sepsis will trigger a team to deliver immediate treatment and ensure one hour antibiotic administration times. The John Hopkins Nursing Evidence-Based Practice …

Conflict Resolution In Healthcare: The Vital Role Of Developing Conflict Management Skills Among Nurse Leaders, Kris Maddalena

Doctor of Nursing Practice Projects

Nurse leaders at the unit level play a vital and indispensable role in acute care settings. Their influence extends beyond administrative tasks, as they significantly impact crucial factors such as nurse retention rates, patient outcomes, and the overall work environment of the unit-level teams. Effective unit-level leadership has been consistently associated with improved outcomes, increased job satisfaction, and decreased turnover among nurses (Aiken et al., 2011). This DNP project is focused on enhancing conflict management skills among unit-level nurse leaders in an acute care setting. The project followed a quality improvement sequence, which included obtaining a needs assessment for unit-level …

Empowering New Ob Nurses To Combat Racial Disparities Through Education, Tabitha Poole

Doctor of Nursing Practice Projects

Minority patients are experiencing maternal morbidity and mortality at rates three to four times higher than white patients in America (Valerio et al., 2023). The project aims to measure the impact of anti-racism training on new OB nurses' understanding of racial disparities and their impact on maternal health outcomes. A three-hour educational course, in alignment with evidence-based practices, was provided to the participants. Utilizing a Likert Scale, pre- and post-intervention assessments were administered via Microsoft Forms to measure participants' perception of knowledge of implicit bias and structural racism. Gender, age range, and race/ethnicity were also collected to allow for further …

Analysis Of Phlebotomy Training Implementation To Reduce Lab Errors In The Clinical Setting, Sandy King

Doctor of Nursing Practice Projects

The primary responsibility of a laboratory technician is to obtain patient blood samples through venipuncture as well as collect, transport, and store other clinical specimens. Poor blood collection can lead to erroneous and misleading results for the provider in addition to the annoyance of repeat testing for the patient. The lack of formal phlebotomy training provided to nurses could be contributing to laboratory rejections. For patients receiving lab services, how effective is an implementation of formal phlebotomy training for nurses compared to non-formal phlebotomy-trained nurses, in reducing failed lab results? The purpose and aim of this quality improvement project are …

Medication Overrides In Emergency Departments Defy Safety Culture, Jennifer Holt

Doctor of Nursing Practice Projects

Medication errors are a growing problem in healthcare systems. Emergency Departments (ED) are especially susceptible to this. Automated dispensing cabinets (ADC) help promote patient safety, but ED nurses commonly override the safety steps built into that workflow. This quality improvement project aims to reduce the number of medication overrides in three rural emergency departments. Data was compiled for the six months before the education and then for the four-week time frame post-education. Education was developed concerning the effects of medication override and errors were presented to all ED nursing staff at the three facilities. Implementation occurred over four weeks and …

Medication-Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates: A Scoping Review, Whitney Nichole Trotter Ms, Bsn, Rdn/Ldn, Rn, Margaret Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background:

There is limited research aimed at addressing the reoccurrence of admission rates for first-episode psychosis. Research shows that early interventions for first-episode psychosis lead to remissions and prevention of relapses. Research also estimates that approximately one-half of first-episode clients have a history of cannabis abuse or dependence and one-third have a current cannabis use disorder (Wisdom et al., 2011). This study looks to determine whether Medication-assisted therapy (MAT) impacts readmission rates for patients who have substance use disorder and first-episode psychosis within six months of discharge.

Methods:

A comprehensive literature search was conducted using several electronic databases, including PubMed, …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

The Effects Of Postpartum Hemorrhage Simulation, Kera Olson

Doctor of Nursing Practice Projects

Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Evidence supports the importance and impact simulation has had on preparation for postpartum hemorrhage. Preparation with hands-on education is imperative for a safe outcome during a real-life hemorrhage situation. Lack of frequent education and simulation can equate to negative outcomes for all involved. The purpose of this project was to increase exposure to a safe environment to explore knowledge and skills during a postpartum hemorrhage event. This quality improvement project surveyed postpartum nurses pre and post-mock postpartum hemorrhage simulation. The setting allowed for mistakes, discussion, and open …

Implementation Of A Comprehensive Diabetic Foot Care Protocol In A Primary Care Clinic, Kakecha Taylor

Doctor of Nursing Practice Projects

Diabetes-related complications are significant in the diabetic patient population in the United States. Appropriate measures must be implemented to ensure that diabetic foot disease is prevented. One suggested approach to stopping the progression of complications is to ensure comprehensive diabetic foot exams and foot care education are performed and documented by providers, as recommended by the American Diabetes Association (ADA) annually. Diabetes poses a public health challenge requiring the implementation of evidence-based guidelines in primary care. This quality improvement project aimed to implement a comprehensive diabetic foot care protocol to impact providers' documentation and performance of foot exams in diabetic …