Nursing Commons^™

Addressing Compassion Fatigue In Critical Care Nurses, Melissa Bowen

Doctor of Nursing Practice Projects

Compassion fatigue causes a ripple effect that impacts caregivers, patient outcomes, and the reliability of healthcare organizations. Jarrad et al. (2018) suggests the physical, emotional, spiritual, social, and organizational consequences of compassion fatigue are so extensive that they threaten the integrity of the nurse. Addressing compassion fatigue in critical care nurses is an indispensable part of maintaining the integrity and trust of the healthcare profession. It is imperative to care for the caregivers to warrant a solid foundation for optimal patient outcomes and engagement. Self-education and awareness, nursing leadership involvement, and self-care are integral to ensuring that compassion fatigue does …

Obstructive Sleep Apnea Education To The Rural Community, Brandi Harris

Doctor of Nursing Practice Projects

This project was executed to provide obstructive sleep apnea education to the men and women of the rural community. Many residents of rural communities remain undereducated and unaware of diseases and disorders in which they are subjected to or have increased risks for. Obstructive sleep apnea affects approximately twenty-two billion Americans. Of those affected, nearly eighty percent remain undiagnosed and untreated (Nagappa et al., 2015). Victims of the sleep disorder fail to acknowledge signs and symptoms of obstructive sleep apnea, many oblivious to the etiology, risk factors, symptoms, and pathophysiology of the disorder. Presenting education to residents of the rural …

Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison

Doctor of Nursing Practice Projects

Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …

Game-Based Learning Effects On Nclex-Rn Perception Of Preparedness And Pass Rates, Alexis Utley

Doctor of Nursing Practice Projects

Background: The National Council Licensure Examination for Registered Nurses (NCLEX-RN) has been used to measure the quality of a nursing program’s effectiveness in preparing nursing students to pass the exam since 1988. The combined average pass rate percentage for the Hunt School of Nursing (HSON) nursing programs for the year 2021 was 88%.

Method: Information on feelings of preparedness and time to test after graduation was collected via survey prior to the game-based learning (GBL) activity. This same information was collected post GBL and compared to the pre-survey results. NCLEX-RN pass rate data was collected 1 month after graduation.

Results: …

Using A Deterioration Index Score To Improve Patient Outcomes, Amanda Doub

Doctor of Nursing Practice Projects

Quick recognition and response to clinical deterioration have a significant impact on patient mortality and outcomes. Nurses’ confidence in their ability to recognize signs and symptoms of deterioration and activate rapid response teams (RRT) is vital in preventing code blues and transfers to a higher level of care. The objective of this project was to determine the effect of an educational intervention on nurse acknowledgment of the deterioration index score and nurse confidence in intervening to improve patient outcomes by alerting the Rapid Response Team (RRT) within two months for adult patients on a medical-surgical unit. Findings from the project …

A Self-Compassion Intervention For University Students: A Dnp Project, David Coffey

Doctor of Nursing Practice Projects

University students are reporting increased levels of anxiety, depression, and suicidal ideation. Trends for mental health distress among this population have been increasing over the past few years. The COVID-19 pandemic has worsened this trend. It is important to provide college-age students with the knowledge and skills for self-compassion necessary to navigate the difficult transition from high school to university. Self-compassion skills have been shown to positively affect mental health outcomes, specifically anxiety and depression. A brief, two-part intervention was developed focusing on the major components of self-compassion and offered to university students over a two-week period. Results of the …

The Impact Of Mindful Breathing On Stress Of Employees Working From Home, Lindsey Goldberg

Doctor of Nursing Practice Projects

This DNP project was designed to decrease stress among employees working from home (WFH) by educating them on mindful breathing practices. Through the implementation of a mindful breathing activity, the intended project outcome was to improve stress levels of employees working from their homes. Mindful breathing is an evidence-based strategy that has demonstrated decreased stress levels. Mindful breathing was implemented among two companies employing an estimate of 170 WFH employees to improve health and well-being with potential long-term positive impact on sustainability of organizations in the post-COVID, work from home environment. The participants were invited to perform 8-minutes of daily …

Faith-Based Approach: Reaching The Rural Population To Increase Diabetes Awareness, Regina Ledford

Doctor of Nursing Practice Projects

With diabetes at an epidemic level in the United States, more awareness needs to be brought surrounding prediabetes and diabetes prevention. This DNP Project consists of implementing a faith-based educational informational event at a local rural church to increase diabetes awareness. Findings within this DNP project suggest that the rural population can increase knowledge of diabetes awareness through faith-based education. With a sample size of 21 participants, positive statistical significance was found on analysis of pre-test and post-test Likert style questions regarding diabetes prevention, risk factors, and diabetic resources.

Improving Self-Care Awareness Among Undergraduate Nursing Students, D'Anna Helms

Doctor of Nursing Practice Projects

The purpose of this DNP project was to improve self-care (SC) awareness among undergraduate nursing students by educating on the use of constructive SC activities. Twenty-two senior level nursing students attended an educational seminar, completed the Mindful Self-Care Scale – Clinical (MSCS-C) pre- and post-survey, and reflective journaling. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p < .05). Thematical analysis revealed enhanced awareness and incorporation of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC, thus improving students’ overall success and further empowering students in their transition from graduate to licensed nurses.

Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington

Doctor of Nursing Practice Projects

A rural facility in the foothills of North Carolina found a need for process improvement regarding the emergency department and completion of the NIHSS. The DNP student and the Stroke Coordinator along with the Quality Improvement Coordinator agreed with the need for education of staff concerning accurate assessment and documentation of the NIHSS. The DNP project implemented additional training for the emergency department nurses and paramedics in the form of face-to-face classes with a PowerPoint. A pre-and post-survey was conducted to gauge the comfort level of staff with the NIHSS and stroke processes of the rural emergency department. The Stroke …

Superwoman Schema: Fighting Back With Holistic Therapy, Chavonne Good

Doctor of Nursing Practice Projects

For decades, Black women have upheld the stereotype of being consistently strong, capable, tenacious, and unwavering throughout life’s many challenges. Unfortunately, while being resolute in their desire to succeed against all odds, many Black women have unknowingly embraced the characteristics of a phenomenon known as Superwoman Schema. Superwoman Schema consists of five characteristics that are not inherently negative. However, when Black women consistently embody these traits which include the determination to succeed and to be strong, and an obligation to help others; they may neglect their own self-care needs. Subsequently, while neglecting themselves, focusing on others, and continuously trying to …

Enhancing Knowledge And Confidence In A Retail Clinic Setting Of Practitioners In Treating Primary And Secondary Hypertension, Ravon Mckoy

Doctor of Nursing Practice Projects

Many adult and adolescent patients in primary care settings are diagnosed with primary hypertension, however the workup often does not include an evaluation of secondary causes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve the diagnosis and treatment of hypertension for patients seeking health care in a retail clinic setting. The PICOT question was, what is the effect of an educational offering on hypertension standards of care in enhancing knowledge and confidence for providers working in a retail health clinic setting? The sampling frame was 40 Nurse Practitioners and Physician Assistants employed at CVS Minute …

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Benefits Of Ambulation In Older Adult Population, Kelsie E. Wilkes

Doctor of Nursing Practice Projects

Background: Loss of mobility is an outcome of aging. Decreased ambulation leads to a loss of mobility and ultimately a loss of independence. There are additional health risks associated with loss of mobility. There can be challenges to facilitating ambulation and mobility in an aging population.

Objective: A literature review of the benefits of ambulation/mobility and the risks of loss of mobility was conducted. The purpose was to promote ambulation/mobility in a community-based setting and educate those caring for the adult population about the importance of ambulation.

Methods: A presentation was provided to staff and participants of …

Implementation Of Lean Principles During Operating Room Turnovers, Makenzie Marshall

Doctor of Nursing Practice Projects

Background

Many operating rooms across the country face the daunting task of making their turnovers between surgical patients quicker and more efficient. Turnover time is defined as the time it takes to clean an operating room and set up the next sterile field between surgical patients. The time begins when the patient leaves the operating room suite and stops when the next patient enters the same suite. Running an operating room is a complex and costly endeavor, and even small shortfalls can have a snowball effect, leading to delays, wasteful spending, and substandard patient outcomes; therefore, it is imperative to …

Sepsis Identification In The Long-Term Care Facility, Shonna Bible

Doctor of Nursing Practice Projects

BACKGROUND: Each year approximately 1.7 million people in the United States develop sepsis, and an estimated 270,000 Americans die from this disease (Center for Disease Control and Prevention [CDC], 2020). Early recognition, and identification is essential in decreasing potential for mortality in this population.

METHODS: During a two-week period six individual sessions via a one-hour presentation was provided on evidence based best practice of sepsis recognition. A pretest was utilized to determine prior knowledge of sepsis recognition. A post-test was provided to evaluate the effectiveness of the educational material. Finally, a survey was conducted to provide input for …

Improving Parent/Guardian Awareness Of Kindergarten Entry Health Requirements, Paul Prince

Doctor of Nursing Practice Projects

Ensuring students meet health requirements to enter Kindergarten is a time-consuming process. By improving education to parents to help them discern differences between PreK and Kindergarten requirements, the health of students can be optimized and the time burden for administrators and school nurses can be reduced. There is evidence that parents/guardians better respond to non-written material delivered through push notification or email. A 5-minute video presentation was distributed to 24 parents/guardians of PreK students. Project impact was measured through a pre/post survey evaluating levels of confidence in child readiness for Kindergarten. Results identified that parent/guardian confidence was increased after education. …

Implementation Of New Teaching Strategies By Psychosocial Rehabilitation Center Staff To Increase Member Participation And Retention Of Newly Referred Members, Joseph Warren Ledesma Perez

Doctor of Nursing Practice Projects

Non-profit organizations like psychosocial rehabilitation centers operate largely on reimbursements and funding from government agencies and charitable organizations, respectively. Since reimbursements are based on units of service provided, the center’s operations rely heavily on the attendance and participation of its members in the provided sessions. Charitable institutions, also require fund recipients to provide a report of outcomes and the impact the funds have on the recipients or the community at large. Members’ participation at the chosen site was reported to be low, which led to a projected unsustainability of operations if the numbers did not improve. Equipping the staff facilitating …

Increasing Cancer Survivorship Knowledge Through Individualized Cancer Survivorship Packets, Ashley Atkins

Doctor of Nursing Practice Projects

This project was developed with the aim of formulating an individualized educational packet that would improve patients’ knowledge of their initial cancer diagnosis and provide additional information to facilitate a smooth transition from treatment to remission. Using a pretest and posttest, quantitative data was collected pertaining to 10 different types of patient education. The pretest survey collected eight questions that related to gathering information about their cancer diagnosis, resources, and knowledge level. The DNP Project Leader secured a Cancer Survivorship Guide through the American Society of Clinical Oncology that was added to the initial cancer survivorship education for all patients. …

Implementing Obesity And Comorbidity Education In A Faith-Based Setting, Tammy Lynn

Doctor of Nursing Practice Projects

The aim of the study was to increase knowledge of the damaging consequences of obesity and related comorbidities. Obesity has reached epidemic proportions on a global scale and increases the potential health risk of many associated diseases. Faith-Based organizations have been found to be optimal resources for public health education. The shared beliefs and comradery are a source of support and encouragement for those who face many of life’s challenges, as well as life’s joys. The purpose of the project was to investigate the effectiveness of education delivered in a Baptist church on the topics of obesity and related comorbidities. …

Changing The Ways Bedside Nursing Staff Think About ‘All Things Urinary Catheters, Angela Foard

Doctor of Nursing Practice Projects

The purpose of this project was to bring attention to the importance of the bedside nursing staff’s "back to the basics" approach to nurse-led interventions to help reduce the number of increasing hospital-acquired infections (HAI), specifically catheter-associated urinary tract infections (CAUTI). The motivation to address this problem was due to the bedside nursing staff under-utilizing best practice interventions to prevent insertions and re-insertions of urinary catheters. A high number of urinary catheter insertions and re-insertions increases the risk of a CAUTI. Evidence-based interventions should be reinforced and utilized by bedside nursing staff to prevent insertions and re-insertions. Evidence-based nurse-led practices …

Improving The Mental Health And Wellness Of Middle School Educators Post-Covid19, April Pearson

Doctor of Nursing Practice Projects

U.S. public school teachers of all educational levels were challenged during the COVID-19 pandemic to provide education to students in alternative ways; face-to-face, hybrid model, or remote learning. This resulted in teacher stress, dissatisfaction, and turnover. Locally, after the 2020-2021 school year at East Iredell Middle School, 9 out of 22 educators resigned or transferred due to the stress and fatigue of teaching students in a hybrid model during the COVID-19 pandemic. The purpose of this project was to promote the health and wellness of middle school educators. The PICOT statement is, what is the effect of an educational program …

Improving Care Of Women Experiencing A Pregnancy, Belinda T. Ferguson

Doctor of Nursing Practice Projects

The purpose of the Doctor of Nursing Practice (DNP) project was to provide evidence-based staff education at a pregnancy resource center to increase staff/patient engagement and communication by implementing a clinical practice change and use of a DNP student-developed discharge summary referral form (DRF) to assist with assessing patient’s needs, evaluating access to services and utilization of medical care and health promotion services. The overall aim of this project is to increase care with medical follow-up and seek to address improving engagement and communication with patients during their care and after discharge from the Pregnancy Resource Center (PRC). The major …

Incentive Spirometer Use In Trauma Patients 65 Years And Older With Rib Fractures/Chest Trauma, Sharon F. Ali

Doctor of Nursing Practice Projects

Geriatric patients 65 years old and older admitted to the medical surgical trauma unit with rib fractures had increased readmission rates to the trauma ICU, due to respiratory insufficiency within the last 12 months. This DNP project followed all patients admitted to the trauma service of a Level I trauma hospital with rib fractures/blunt chest trauma during the months of February 2-April 30, 2022. The focus was on the nurse-driven protocol, which included providing incentive spirometer education to the trauma patient for aggressive pulmonary hygiene and documenting patients’ achievements and goals into the medical record. Registered nurses (RN) were asked …

Dnp Project Active Anson, Melissa C. Griffin

Doctor of Nursing Practice Projects

Objectives: To implement and evaluate the effectiveness of using a mobile app to encourage hospital workers to increase their physical activity.

Methods: Project was open and advertised to all hospital employees in a small rural community hospital in the south-eastern United States through flyers, bulletin boards, emails, banners and in-person registration assistance. Registered participants completed a 30-day walking challenge and recorded their daily step counts. Participants received a gift bag with fitness items such as water bottles. The three highest step count participants were awarded prizes. Weekly prize drawings were conducted for participants with 10,000 steps per day. Post challenge …

Smartphrases: Optimizing Discharge Education In Limited English Proficiency (Lep) Spanish-Speaking Patient Encounters, Somer Knight

Doctor of Nursing Practice Projects

Health inequities due to communication barriers exist at a high rate for those who identify with limited English proficiency. This quality improvement project aimed to decrease these inequities by providing pre-translated discharge instructions (AVS) to patients who receive surgical services and recover in the pediatric post anesthesia care unit (PACU) of a state hospital. Specifically, this project examined if the availability of pre-translated instructions (SmartPhrases) increased nurse and interpreter satisfaction with the discharge process, and improved their perceived level of equitable care they are able to provide. Discharge instructions were gathered from the participating surgical and interventionist teams, and the …

Diabetic Self-Management Education Program Evaluation, Amanda Thomas

Doctor of Nursing Practice Projects

Diabetes is a metabolic disease characterized by hyperglycemia, caused by impaired insulin secretions resulting in high hemoglobin A1C levels. Education is beneficial in reducing these as an additive to lifestyle and drug therapy. This student project reflects a program evaluation for a patient diabetes self-management education (DSME) intervention in one small rural outpatient system. DSME classes address the comprehensive blend of clinical, educational, psychosocial, and behavioral aspects of care needed for the daily management of people living with type II diabetes. Three months after completing a DSME the person experiencing type II diabetes has a repeat Hemoglobin A1C level taken …