Nursing Commons^™

Increasing Nurses' Comfortability Using The Defibrillator, Mandy Whitaker

Doctor of Nursing Practice Projects

The educational needs of nurses vary depending on the practice setting in which he or she is employed. Some competencies are taught yearly or bi-yearly. The current process for registered nurses to learn how to use the defibrillator is through the advanced cardiovascular life support (ACLS) training they are required to take every 2 years. Although a certification proves a nurse is competent in a certain area, skills tend to be forgotten over time. It is often noted “if you don’t use your skills, you lose them.” Nelson and Aguirri (2020) reported even though there are many facets to the …

Advanced Practice Registered Nurses And Healthcare Disparities: Understanding The Impact Of Implicit Bias, Marla Lepley-Starr

Doctor of Nursing Practice Projects

Introduction: Disparities in healthcare have long been a challenge for physicians, advanced practice providers, nurses, and other interdisciplinary team members. More recently, population health-focused efforts have been implemented to manage everincreasing rates of diabetes, hypertension, and obesity, as well as lack of transportation, limited access to care, and poverty (North Carolina Department of Health and Human Services [NCDHHS], 2019). Racism, sexism, ageism, sizeism, etc., are present in the healthcare setting and manifests in implicit bias during care delivery. This can manifest as beliefs, behaviors/practices, and emotions of the provider (Paradies et al., 2014). Research is limited related to the …

Connecting Simulation-Based Learning And Quality Improvement Among Student Nurses To Prevent Catheter-Associated Urinary Tract Infections, Jason Defreitas

Doctor of Nursing Practice Projects

Hospital Acquired Infections (HAIs) are a form of infection a patient acquired during hospitalization. Whether through the application or implementation of medical devices, performing bedside procedures, or non-adherence to following aseptic techniques, healthcare providers are responsible to ensure patients remain safe throughout the course of their inpatient treatment. Over the past 2 years, the Centers for Disease Control and Prevention (CDC), has reported HAIs, specifically catheter-associated urinary tract infections (CAUTI) have increased above pre-pandemic reported cases (CDC, 2021). These types of infections can lead to many factors that affect the patient and their family such as, “increased length of stay …

The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve acute care nurses’ knowledge of evidence-based palliative care interventions utilizing the framework from the End-of-Life Nursing Education Consortium (ELNEC) training modules. Increasing the knowledge, comfort, and competence of acute care nurses has the potential to improve end-of-life care delivery in the acute care setting. A lack of access to specialized inpatient palliative care service teams was identified in a rural county in the Southeastern United States. This county is served by a small, criticalaccess hospital. The frontline nursing staff of this facility regularly provides end-of-life …

Improving Osteoporosis Awareness By Implementing Bone Mineral Density (Bmd) Testing Algorithm, Mark A. Roark

Doctor of Nursing Practice Projects

One of the leading concerns in the United States healthcare system is the aging population and age-related health concerns such as osteoporosis. Estimates suggest that 50 percent of women and 20 percent of men over 50 are at increased risk of fractures from osteoporosis. However, the diagnosis and treatment of osteoporosis are on a downward trend. If no changes are made by 2040, it is estimated that there will be an annual expense of $95 billion and over 3.2 million fractures per year in the United States alone. The National Osteoporosis Foundation (NOF), along with Healthy People 2030, recommends goals …

Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry

Doctor of Nursing Practice Projects

Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …

Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook

Doctor of Nursing Practice Projects

There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case …

Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford

Doctor of Nursing Practice Projects

Hospitals strive to become Magnet-accredited facilities. Having Magnet status indicates an institution has high standards regarding nurse work environments and positive patient outcomes. The American Nurses Credentialing Center (ANCC) created the Magnet program criteria in 1994 (Dierkes et al., 2021). Obtaining Magnet accreditation is a coveted goal for hospitals. The target organization is currently not a Magnet-accredited hospital, nor does it have a nurse manager succession planning program. In preparation to achieve this accreditation, the target organization needed to implement a succession plan for nurse leaders. Institutions with successful succession planning programs pay careful attention when selecting participants for succession …

Getting The Most From M.O.S.T.: Promoting Most Education For Palliative Care Providers, Shelby Mood

Doctor of Nursing Practice Projects

Physician Orders for Life-Sustaining Treatment (POLST) forms are relatively new in medicine. These forms help patients and providers navigate some of the difficult decisions that can occur near the end of life and in palliative care. Each state has its own version of POLST forms. In the state this DNP project was implemented, this form is called Medical Orders for Scope of Treatment, or MOST form. Given the complexities of medical decisions, patients may not always understand the options covered in the MOST form or the implied tasks with each choice. To further patient understanding of the MOST form, this …

Heart Smart Holidays: Coping With Stress, Staying Active, And Healthy Cooking Strategies For Seniors In Cleveland County, Lauren Ridgeway

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice Project assessed whether attending community group meetings focusing on stress, staying active, and healthy eating during the holidays, could influence cardiovascular disease awareness, mental health awareness, and quality of life of senior citizens in Cleveland County. A convenience sample of 6 participants attended the Coping with Stress and Staying Active event while 10 participants attended the Healthy Cooking Strategies event. The objectives were measured using a pretest posttest design before and after the presentations. There was strong evidence (t(9) = -13.597, p < .05) that the group seminar on managing stress and staying active during the holiday season improved the mental health awareness of participants. Data also showed a significant increase in Cardiovascular Disease Awareness from pretest to posttest (t(5) = 3.246, p < .05) after the seminar on healthy cooking strategies. The project raised community awareness to the importance of managing stress, staying active, and making small nutritional changes to positively impact the cardiovascular health of Seniors.

Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb

Doctor of Nursing Practice Projects

Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between …

Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash

Doctor of Nursing Practice Projects

Providing effective discharge education to patients who are treated in the emergency department setting remains a very important component of a patient’s visit to an emergency department. Literature confirms although there are various governmental regulatory agencies that set forth regulations and guidelines, there remains a need to continually evaluate and critique the discharge education process to best meet the evolving needs of the patients, stakeholders, and community. Universally understood standards include appropriate reading levels and usability of the discharge education being provided. Discharge education can be very simple to complex creating higher demands on nursing staff to ensure they understand …

Why Doesn't She Just Leave? Improving Identification And Response To Victims Of Intimate Partner Violence In The Emergency Room, Elizabeth Berry

Doctor of Nursing Practice Projects

The purpose of this project was to improve identification and response to victims of intimate partner violence (IPV) presenting to the emergency department. Project participants completed a pre-education questionnaire prior to the project leader providing intimate partner violence educational materials and a presentation entitled Recognizing and Responding to Victims of Intimate Partner Violence in the Emergency Room. The project participants then completed a mirrored post-education questionnaire. Evaluation of the project included a comparison of the participant's responses to the mirrored questionnaires. Project participants reported an increase in the:

• recognition of the prevalence of intimate partner violence among their patients, …

Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder

Doctor of Nursing Practice Projects

Background: The crisis in the competency of newly licensed graduate nurses continues to grow despite the efforts of nursing academia. Transition to practice programs has improved new graduate attrition and narrowed the gap of practice readiness, but much of the responsibility to train graduate nurses falls on nurse preceptors. Many of these preceptors have minimal nursing experience and little to no training in fostering clinical judgment. Furthermore, nurse preceptors must balance providing care for their clients while also guiding novice nurses. They often do not have the time to provide the emotional support, real-time reflection, and timely feedback required to …

Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley

Doctor of Nursing Practice Projects

Nursing programs are intended to prepare nursing students to become competent nurses, that can make decisions to promote positive patient outcomes. However, studies suggest that as students transition into clinical practice, they are still lacking decision-making skills. Emotional Intelligence (EI) has been suggested to improve communication skills, problem-solving, and resilience. The purpose of this project was to enhance the emotional intelligence of Baccalaureate prelicensure nursing students. The PICOT statement was: Can formal EI training combined with interactive EI training, influence EI awareness, knowledge, and skills of baccalaureate nursing students as evidenced by scoring 77% or higher on an EI posttest …

How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey

Doctor of Nursing Practice Projects

This project set out to see if stress and anxiety (leading to burnout) could be combatted with the use of essential oils (EOs). Burnout is a common concern amongst the medical community and healthcare providers are leaving their jobs and field at unprecedented rates. While EOs have been used for patients, they are rarely used for the healthcare providers’ benefit. Because of that, this project wanted to focus on the employee for a change, which in turn would benefit the patient by having a mentally-present provider and the company by having less turnover. The project consisted of a pre-survey prior …

Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts

Doctor of Nursing Practice Projects

A rural North Carolina community is experiencing an increase in inactivity, obesity, and comorbidities. The project leader collaborated with the local health department and recreation department to implement community walking events. The events aimed to promote physical activity while providing education to the residents as to why physical activity is important. The project leader used optional pre-walking event and post-walking event surveys to assess activity change and increased knowledge. Out of the 90 attendees, 68% completed the pre-event survey and 14% responded to the post-event survey. This created limited data available for follow-up. All participants who completed the follow-up plan …

Combating Compassion Fatigue In The Emergency Department, Pam Packard

Doctor of Nursing Practice Projects

Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?

Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander

Doctor of Nursing Practice Projects

The DNP project was designed to improve future healthcare providers’ knowledge on the complexity of endometriosis by providing students with a lunch and learn session on endometriosis. The intent of the project implementation was to improve students’ knowledge on endometriosis to facilitate early diagnosis for patients. Improving provider knowledge of evidence-based endometriosis guidelines is imperative to achieve early diagnosis. The educational session provided students with information regarding symptoms, impact of delayed diagnosis, discerning differential diagnoses, associating timing of symptoms, and identifying endometriosis lesions. The impact of the project implementation was measured using pre/post-survey data evaluating overall knowledge, symptoms awareness, “best …

Evaluating Hpv Vaccination Adherence Amongst Teenagers Ages 12-18, Jade Vo, Myah Mukes, Kenya Nelson, Joye' Thomas, Laura Reed, Sharon Little

Doctor of Nursing Practice Projects

Human papillomavirus (HPV) is a sexually transmitted infection that can cause genital warts and different cancers. According to the CDC, 85% of people will get an HPV infection in their lifetime. HPV infections have decreased significantly since the implementation of the HPV vaccine. Data has shown 90% of cancers caused by HPV can be prevented with administration of HPV vaccination. Current guidelines recommend vaccination administration as early as 9 years of age. This quality improvement project will evaluate HPV vaccination rates amongst teenagers ages 12-18.

Screening For Social Determinants Of Health In Children With Attention-Deficit/Hyperactivity Disorder, Sarah L. Carter Msn, Aprn, Cpnp-Pc, Ronald Espinal Md, Toni Whitaker Md, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Increased social determinants of health (SDoH) are associated with poorer health outcomes and decreased treatment compliance. Addressing SDoH can be associated with increased treatment compliance, although currently there is no standard for completing SDoH screening. The WE CARE screening tool is a validated screen that asks about 6 SDoH and whether the family is interested in assistance if the screen is positive. The purpose of this project was to implement the use of the WE CARE screening tool for patients with attention deficit hyperactivity disorder (ADHD) at follow-up visits.

Methods

From October 17, 2022 through November 22, 2022, charts …

Increasing Clergy Members Awareness, Sensitivity, And Knowledge (Ask) Of The Lgbtqia+ Community Improves Health Outcomes, Claudette Green

Doctor of Nursing Practice Projects

Introduction: Individuals who identify as belonging to the LGBTQIA+ community in the context of religion and faith often experience spiritual discrimination and are made to feel like an outcast (Cole & Harris, 2017). Often, spiritual leaders lack the training, knowledge, and skills necessary to understand and communicate in a way that offers solace and comfort to their LGBTQIA+ congregants (Yarhouse & Sadusky, 2020). Moreover, the church has been at the forefront of leading the discrimination and condemnation of LGBTQIA+ members. This discrimination has led many to leave the church and become involved in self-harming behavior, ongoing mental health struggles, …

Decreasing Nursing Burnout Post Covid-19 Pandemic Through Complementary Therapies, Linda Martiin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of nursing burnout post COVID-19 pandemic through complementary therapies. Nursing burnout can be mental, emotional, or physical exhaustion which an excessive amount of prolonged stress can cause. Nursing burnout has affected nursing staff worldwide, directly impacting the care provided to patients and the patient's satisfaction. The Nursing Worklife Model was utilized as the theoretical framework for this project (Appendix A). The literature review exhibits the prevalence of nursing burnout in nursing staff. A quantitative study was utilized for this project. The Oldenburg Burnout Inventory was utilized to establish the participant's level …

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

Increasing Cpr Awareness In School Staff, Savanna Parker

Doctor of Nursing Practice Projects

There are a limited number of staff members in Stokes County Schools that are CPR certified. A CPR workshop was conducted to provide an opportunity to allow more staff members to become certified, to gain knowledge and gain confidence in Cardiopulmonary Resuscitation, and to reduce delays in administering aid. Participants were asked to complete the Perceived Competence Scale (PCS) before and after participation in the CPR Workshop. The PCS is a 4-item questionnaire, based on a 7-point Likert scale. Answer choices range from Not True to Very True. Each question provides a lead-in statement, allowing for the concept being studied …

The Effectiveness Of A Ventilator Care Bundle Protocol In Decreasing Incidence Of Ventilator-Acquired Pneumonia: A Scoping Review, Katherine I. Garrett Bsn, Rn, Erin Houston Myatt Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Ventilator-acquired pneumonia (VAP) is a preventable hospital-acquired infection with a high mortality rate. Ventilator care bundles (VCB) are implemented to decrease the risk of infection while patients are mechanically ventilated. The aim of this scoping review was to assess how adult patients in the intensive care unit (ICU) requiring mechanical ventilation and the incidence of VAP are affected by staff’s compliance to a VCB.

Methods

From August of 2022 to November 2022, literature research was done among databases such as PubMed, MEDLINE, and CINAHL. The systematic search in PubMed yielded 55 results with the headings of “(ventilator) AND (care …

The Effects Of Diet And Lifestyle On Wound Healing, Chinwe Orabuchi

Doctor of Nursing Practice Projects

A current policy for wound care and teaching is present at Reskin Clinic. However, nurse practitioners identified delays in wound healing. A retrospective review of approximately 50 patient charts compared wound healing of patients who have stated they adhere to a healthy diet and lifestyle compared to those who do not. This information was compared to the patient's chart and determined what type of education on wound care, diet, and lifestyle changes were documented in the patient chart. Inclusion criteria includes patients ages 50+ with acute or chronic wounds. The results of this retrospective review demonstrated a lack of nutritional …

Evaluating A Rapid Response Team Performance To Implement Best Practice In Rapid Response Team Protocol, Pansy Samuel

Doctor of Nursing Practice Projects

Background

Rapid Response Teams (RRT) provide clinical resources to improve patient safety outcomes at healthcare institutions. This team promptly responds to deteriorating patient conditions to prevent further deterioration and reduce mortality rates. Rapid response teams do not always perform optimally. Reasons for this performance failure include breakdowns in communication, team dynamics, or other variables that can often be adjusted when the team members understand the role these variables play in undermining the performance of the RRT. An understanding of the perceptions of the RRT members regarding their roles and potential areas of improvement did provide valuable data that was utilized …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Increasing Hpv Vaccination In Adolescents, Emily Martin, Emily Hartmann

Doctor of Nursing Practice Projects

Human papillomavirus virus (HPV) is a sexually transmitted disease that can negatively affect both males and females by leading to cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancer. Vaccinating against HPV using the Gardasil vaccine is an effective method to prevent HPV, however, vaccination rates are still unacceptably low in adolescents ages 11 to 14. Pediatric providers should encourage and strongly recommend HPV vaccines to all adolescents. Addressing and easing parental hesitancy is a key component to improving vaccine acceptance. The setting for the project was a rural pediatric office in southern Illinois where HPV vaccination rates are lower than …