Nursing Commons^™

Preoperative Education In Lumbar Fusion Patients: Impact On Postoperative Disability Perception, Megan Curtis

Doctor of Nursing Practice Scholarly Projects

Background/Review of Literature: A lumbar fusion is a complex surgical intervention with many postoperative guidelines and restrictions. Preparing patients with surgery specific education has shown to decrease their sense of disability and postoperative pain in other surgical specialties, but a disparity exists in spinal surgery.
Purpose: To examine the effect of a preoperative education class for lumbar fusion patients on their perceived level of disability, the number of patient phone calls made to the neurosurgery office, the number of postoperative emergency room (ER) visits, and the number of hospital readmissions after surgery.
Methods: A quality improvement project utilizing a quantitative …

Standardizing Assessment And Management Of Ankyloglossia, Marcia Nicole Cowen

Doctor of Nursing Practice Scholarly Projects

Ankyloglossia, which is characterized by a short, tight or thick lingual frenulum, can negatively impact breastfeeding. It has been recognized as a problem for centuries. Frenotomies have traditionally been performed to remove the lingual frenulum when indicated. The use of frenotomies and a focus on ankyloglossia fell out of favor in the twentieth century with renewed attention in the past several decades. Limited high-quality studies have been undertaken on ankyloglossia. There remains no standardized diagnosis or management recommendations. In efforts to promote a standardized approach that is based on current knowledge, this study will involve an educational in-service on ankyloglossia, …

Improving End-Of-Life Care On Navajo Through Education, Johanna G. Bahe

Doctor of Nursing Practice Scholarly Projects

End-of-life care (EOLC) is an essential component of comprehensive healthcare and has been shown to improve the quality of life of patients and their families by preventing and relieving pain caused by physical, psychosocial, and spiritual complications. Many rural communities lack access to EOLC, specifically certified palliative and hospice services. The lack of this specialty in rural areas directly affects the experience of healthcare staff. The absence of education for rural healthcare staff and the importance of culturally sensitive care among indigenous people are key concepts in this study.

The purpose of this study was to measure the knowledge, confidence, …

Report: The Beat Stops Here: A Nurse-Driven Protocol To Manage Telemetry Orders, Holly Dripps, Kirk Hummer

Doctor of Nursing Practice Scholarly Projects

At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian' s quality improvement framework of strnch1re-process-outcomes was utilized as the theoretical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the …

Poster: The Beat Stops Here: A Nurse-Driven Protocol To Manage Telemetry Orders, Holly Dripps, Kirk Hummer

Doctor of Nursing Practice Scholarly Projects

At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian' s quality improvement framework of strnch1re-process-outcomes was utilized as the theorical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the …

Report: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Poster: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Poster: Impact Of Educational Modules On Knowledge Among Neuroscience Nurses Working In The Epilepsy Monitoring Unit (Emu), Shivani Bhatnagar, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Background: Little data exists about nursing care and knowledge on an epilepsy monitoring unit (EMU). This study evaluated the impact of an educational series (three modules) on nursing knowledge and confidence in providing care, using a pre-test/post-test design. Objectives: There were three objectives for this study. The first objective was to improve nursing knowledge and competence in educating patients and families. The second, to increase nursing confidence in providing care and decision-making for the specialized patient population on the EMU. The third, to evaluate the effectiveness of educational modules. Subjects: Thirty-eight nurses working in the neuroscience unit participated in the …

Report:Impact Of Educational Modules On Knowledge Among Neuroscience Nurses Working In The Epilepsy Monitoring Unit (Emu), Shivani Bhatnagar, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Background: Little data exists about nursing care and knowledge on an epilepsy monitoring unit (EMU). This study evaluated the impact of an educational series (three modules) on nursing knowledge and confidence in providing care, using a pre-test/post-test design. Objectives: There were three objectives for this study. The first objective was to improve nursing knowledge and competence in educating patients and families. The second, to increase nursing confidence in providing care and decision-making for the specialized patient population on the EMU. The third, to evaluate the effectiveness of educational modules. Subjects: Thirty-eight nurses working in the neuroscience unit participated in the …

Value-Based Purchasing: Does Educating Direct Care Nurses Result In Value-Based Care?, Ryan Levi

Doctor of Nursing Practice Scholarly Projects

The United States health care system is undergoing the greatest transformation in the country’s history. Health care is rapidly moving away from volume-based reimbursement towards value-based models. The Hospital Value-Based Purchasing (VBP), a Center for Medicare and Medicaid pay-for-performance program, makes Medicare reimbursement contingent on performance in four quality categories. Clinical care, person and community engagement, safety, and efficiency determine an organization’s total performance score (TPS), which is used to impose positive, negative, or neutral payment adjustments. Nursing, more than any other health care profession, impacts hospitals’ TPS and subsequently Medicare reimbursement under VBP. While the literature indicates nurses should …

Effectiveness Of An Aquatic Exercise Program For Reducing Weight, Body Fat And Chronic Low Back And Joint Pain, Terilyn Darley

Doctor of Nursing Practice Scholarly Projects

According to the World Health Organization (WHO), obesity has risen at an alarming rate and has reached epidemic proportions throughout the world (WHO, 2017). In the U. S., approximately 93.3 million U.S. adults are obese with an overall prevalence of 39.8 %. Chronic pain is another public health issue in the U.S, affecting almost 100 million people and is associated with significant annual healthcare costs and lost productivity (National Center for Complementary and Integrative Health [NCCIH], 2017). Exercise is considered one of the most effective prevention strategies for reducing obesity and has been documented to decrease chronic pain. The purpose …

Poster: Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase self-efficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Poster: The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

Poster: Self-Efficacy And Outcome Expectancy In The Nurse Resident, Amy L. Smith

Doctor of Nursing Practice Scholarly Projects

EBP training is effective in improving nurses’ knowledge of and attitudes toward EBP, however, it does not consistently result in behavior change (Jackson, 2016; Black, Balneaves, Garossino, Puyat & Qian, 2015). Previous studies support the role of self-efficacy in promotion of EBP implementation (Blackman & Giles, 2017; Ryan, 2016). The purpose of this project is to examine how EBP training provided to nurse residents affects their EBP self-efficacy and outcome expectancy. A convenience sample of nurse residents in two acute care hospital residency programs were surveyed using an instrument found to be valid and reliable by Chang and Crowe (2011) …

Evidence-Based Practice Self-Efficacy And Outcome Expectancy In The Nurse Resident, Amy L. Smith

Doctor of Nursing Practice Scholarly Projects

Evidence-based practice (EBP) implementation in healthcare has been associated with improved patient outcome, reduction of costs, and increases in nursing job satisfaction (Melnyk & Fineout-Overholt, 2015); however, a lack of implementation remains (Melynk, Fine-out Overholt, Gallaher-Ford & Kaplan, 2012). Although EBP training is effective in improving nurses’ knowledge of and attitudes toward EBP, such training does not consistently result in behavior change (Jackson, 2016; Black, Balneaves, Garossino, Puyat & Qian, 2015). The results of previous studies support the role of self-efficacy in the promotion of EBP implementation (Blackman & Giles, 2017; Ryan, 2016). The Institute of Medicine’s Initiative on the …

Toward Expert Consensus On Guidelines For The Use Of Yoga In The Treatment Of Anxiety In Children And Adolescents., Laura J. Abels

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Despite clinical evidence to support the use of yoga as a treatment option for children and adolescents with anxiety, clinical practice guidelines do not exist. Purpose: This project used the modified Delphi technique to determine if consensus exists on the need for clinical practice guidelines among experts in the fields of child and adolescent psychiatry, psychology, and yoga. Additionally, this project aimed to determine if consensus exists on what should be included in clinical practice guidelines for the use of yoga as a therapeutic intervention for anxiety in children and adolescents. Methods: Three rounds of questionnaires were used …

Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase selfefficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Poster: Malignant Hyperthermia Preparedness For Labor And Delivery Nurses, Patricia Rabinowitz

Doctor of Nursing Practice Scholarly Projects

Malignant Hyperthermia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia.

Operating room (OR) nurses receive extensive training in MH crisis management. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and most commonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the mother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, …

Malignant Hypothermia Preparedness For Labor And Delivery Nurses, Patricia Rabinowitz

Doctor of Nursing Practice Scholarly Projects

Malignant Hyperthe1mia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia. Operating roo1n (OR) nurses receive extensive training in MH crisis 1nanagement. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and 1nost co1nmonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the 1nother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, …

Transitioning From Experienced Nurse To Resident In Blended Cohort Transition-To-Specialty Nurse Residency Programs, Rachael Frija

Doctor of Nursing Practice Scholarly Projects

Recommendations from the Institute of Medicine promote nurse residency programs for experienced nurses (EN) transitioning to new areas of specialty. A large non-profit healthcare system in the Southwest implemented three Transition-to-Specialty (TtS) residency programs using a blended cohort approach consisting of graduate nurses (GNs) and ENs. Upon review of program outcomes, ENs reported to have higher attrition rates than their GN counterparts. Given the substantial pecuniary loss related to EN turnover, understanding the ENs’ perspectives to achieve successful role transition to a new area of specialty is critical to a successful program. This qualitative descriptive study sought to describe the …

Gastrostomy Tube Complications And Management, Deborah J. Garcia

Doctor of Nursing Practice Scholarly Projects

The avoidable complications of clogging and dislodgement of gastrostomy tubes (g-tubes) place a tremendous burden on patients, caregivers, healthcare providers, and the entire medical system. These complications are associated with $130 million in healthcare utilization each year. Insufficient education of patients and personal caregivers regarding the prevention of complications of clogging and dislodgement of g-tubes is identified as a major barrier. Preintervention and postintervention education program models were established, which include a preprocedure clinic visit with education as well as scheduled follow-up phone calls. A chart review and follow-up phone call was used to evaluate the effect of providing consistent …

The Impact Of A Poverty Simulation On Baccalaureate Nursing Students’ Attitudes, Kristen Smith

Doctor of Nursing Practice Scholarly Projects

Poverty is an ongoing issue in the United States, with major implications for the health of U.S. citizens. In order to provide compassionate care, nurses must understand their own attitudes towards those living in poverty. The purpose of this study was to evaluate for possible changes in attitudes towards poverty in junior level BSN students after a poverty simulation intervention. Participants were surveyed using the Yun and Weaver’s Short Form Attitudes towards Poverty (SFATP) tool, which looks three factors of poverty attitudes: personal deficiency, stigma, and structural perspective.

The Adult Learning Theory provided the theoretical framework for the study. This …

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski

Doctor of Nursing Practice Scholarly Projects

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if …

Implication Of Concussion Preventative Behavior Through Youth Education On Playground Safety, Bryan Harris

Doctor of Nursing Practice Scholarly Projects

The concern with concussions has taken our society by storm as it relates to the health consequences either: acute, chronic, and/or later in life as a result of experiencing a single or multiple concussions. Research is thriving on concussion diagnosis, management, and treatment and will continue to do so in the years to come. Preventative measures in a variety of forms is the cornerstone for dealing with concussions at this time; with evidence showing formal educational programs are effective. ThinkFirst: National Injury Prevention Foundation, provides educational programs for first through eighth grade students on prevention of brain, spinal cord, and …

The Impact Of A Poverty Simulation On Practical Nursing Students’ Attitudes Towards Poverty, Jaime Crabb

Doctor of Nursing Practice Scholarly Projects

Poverty is a multi-faceted global problem. Nurses and providers are front-line caregivers for this vulnerable population. In order to provide effective care, individuals must understand their own attitudes towards poverty. The purpose of this study was to evaluate for changes in Practical Nursing students’ attitudes towards poverty with the use of a poverty simulation based upon the Experiential Learning Theory. Participants were surveyed using the Short Form Attitudes towards Poverty (SFATP) tool. The ELT espouses that the best learning occurs when students actively engage in an experience, reflect upon it, and then apply that learning to future experiences. Statistical significance …

Moodle-Based Chlamydia Awareness Project To Increase Intention To Test In College Freshmen Males: A Dnp Scholarly Project, Adam Burri

Doctor of Nursing Practice Scholarly Projects

In 2016, there were over 1.5 million cases of chlamydia reported in the United States with prevalence rates highest in people under 25 years of age (Centers for Disease Control and Prevention, 2017). Researchers have suggested that college aged adults (age 18-25) should be targeted for chlamydia educational programs because these individuals are lacking in knowledge about chlamydia prevention, infection, symptoms, and screening methods (Goundry, Finlay, & Llewellyn, 2013; Rutledge, Siebert, Chonody, & Killian, 2011). This scholarly project utilized a quasi-experimental, single-group pretest-posttest design and used a modified version of the Sex, Drugs, and Rock’n’Roll Questionnaire designed by Lim et …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

Doctor of Nursing Practice Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

Implementation Of A Scripted Debriefing Tool In Simulation-Based Nursing, Mary Kidd

Doctor of Nursing Practice Scholarly Projects

In nursing education, simulation represents real patient scenarios that are designed to enable students to practice combining theoretical knowledge with clinical skills within a controlled environment (Bland, Topping, & Wood, 2011). Debriefing is a facilitated reflection of the simulation experience and is performed to uncover relationships among the events, actions, thought processes and outcomes with the intention of improving future practice (Cheng et al., 2014; Kolbe, Grande, & Spahn, 2015). Without proper debriefing, erroneous critical thinking, decision-making, and clinical judgement may go uncorrected, potentially negatively impacting patient care. There is an abundance of literature on debriefing methods; yet, empirical evidence …

Identify The Qualifications, Major Duties, Responsibilities And Expected Outcomes For The Chief Experience Officer Among Health Care Systems In The United States, Kathleen D. Davis

Doctor of Nursing Practice Scholarly Projects

The Chief Experience Officer (CXO) role has emerged in health care in the last five to ten years. There is an absence of role descriptions, qualifications, duties, expected outcomes and reporting structures available in the literature. Most of the available information are reports from private organizations like the Experience Innovation Network, The Beryl Institute (TBI), Catalyst Healthcare Research (CHR) and The Health Care Advisory Board (Boehm, 2015; Boehm & Petty, 2016; Lauing & Woods, 2015; Palmer & Prince, 2013; The State of the Patient Experience, 2015; Wolf, 2015; Wolf & Prince, 2014) who produce information for members and are not …