Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing Student Works

ntroduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

Screening For Social Determinants Of Health Screening In The Primary Care Setting: A Quality Improvement Project, Arifa Khan

DNP Projects

Significance and Background: Social determinants play a major role in the overall health of our nation. While screening for social determinants of health (SDOH) in the primary care setting is encouraged, there is no streamlined process in place. Studies have determined that improved SDOH screenings can result in better patient outcomes and a decrease in healthcare costs. A protocol to improve SDOH screenings was needed to guide patient outcomes at a Federally Qualified Health Center (FQHC) in Connecticut.

Purpose: Deliver education to providers and healthcare staff across the health system on significance of social determinants of health and PRAPARE screening …

Impact Of Fall Education To Oncology Staff On Oncology Patient Fall Rates, Danni Sloane

Articles, Abstracts, and Reports

Significance & Background

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals. Patient falls also affect reimbursement rates and can increase length of stay by about 6.3 days and increase undue patient harm. An increase of patients falls on the medical and surgical oncology acute care units have caused undue physical harm, increased moral distress, mental fatigue, and burnout in nurses; as well as placing financial burdens on the healthcare system. Implementing fall education and interventions aligns with national patient safety goals, is a top-priority project, is in alignment with the …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

Depression Screening In Type 2 Diabetes In Adolescent 12-18 Year Olds, Mykyla Coleman Bsn,Rn, Chelsea Conlee Bsn,Rn, Carol Gracia Msn, Aprn, Fnp-Bc, Emily Jennewine Msn, Aprn, Cpnp-Pc, Ibclc, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background

Although more commonly diagnosed in adults, type 2 diabetes is increasingly diagnosed in pediatric populations in the United States. Research suggests a correlation between depression and type 2 diabetes, however, a gap in research exists regarding depression and type 2 diabetes among pediatrics, specifically adolescents. This scoping review aims to address this gap by assessing the impact of depression screening on glycemic control in this specific population.

Purpose

The goal of the review is to contribute to the development of effective strategies for depressing screening in adolescents with type 2 diabetes, with the expectation this may positively impact glycemic …

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.

Medicinal Treatment Versus Dialysis In End Stage Renal Disease Patients With Perioperative Hyperkalemia: A Scoping Review, Haley Bishop, Bsn, Rn, Hannah White, Bsn, Rn, Matthew Wilhaucks, Bsn, Rn, Ashton Weaver, Bsn, Rn, Christin Simpson, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

No abstract provided.

Brain Matters: Cognitive-Behavioral Therapy And Antidepressants For Post-Stroke Depression, Lindsey Anne Smith

MSN Capstone Projects

Stroke is the leading cause of death and disability in the United States, and approximately one-third of these patients will develop post-stroke depression, which is associated with higher rates of morbidity and mortality (American Stroke Association, 2022). Even though post-stroke depression is prevalent, it often goes undertreated. The combination of antidepressants and cognitive-behavioral therapy has shown to be an effective method of treating post-stroke depression. There are cognitive-behavioral exercises that nurses can implement, such as group therapy, acceptance therapy, and cognitive retraining, a method of coaching the patient to replace negative thoughts with positive ones (Byun et al., 2021). With …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Best Practice: Implementation Of A Central Line Bundle To Reduce Central Line-Associated Bloodstream Infections, Alexis N. Montero

MSN Capstone Projects

Central line-associated bloodstream infections (CLABSIs) are among the most frequent health care-associated infections and are reported to be correlated with an increased number of inpatient days, higher cost, and attributable mortality rates (Devrim et al., 2016). For this reason, central line bundles (CLB) have been widely used in hospitals to aid in the decrease of CLABSIs. Through implementation of the prevention strategies included in CLBs, CLABSIs can be reduced by greater than fifty percent (Devrim et al., 2016). A decrease in CLABSIs is clinically significant with the avoidance of negative patient outcomes and a decrease in healthcare costs (Rinke et …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Nursing Care Of Individuals Engaging In Non-Suicidal Self-Injury: Impact Of Dialectical Behavior Therapy Skills Reinforcement, Lucas Bridgens

MSN Capstone Projects

As explained by Linehan et al. (2006b), the seriousness of borderline personality disorder can be highlighted by the manifestations of emotional dysregulation, such as impulsive and suicidal and non-suicidal self-injurious (NSSI) behaviors. As the mental health field grows, so too does the knowledge base from which practitioners derive therapeutic interventions with hopes of effectively and safely treating patients while maintaining a culture of dignity and respect. One such treatment modality that has proven to reduce NSSI and improve interpersonal functioning, specifically in patients with borderline personality disorder, is Dialectical Behavior Therapy (DBT) which is a form of cognitive-behavioral therapy developed …

Stepping Into Mindfulness: Enhancing Mental Health For Nursing Student Athletes, Amanda A. Marek

MSN Capstone Projects

This capstone project explores the impact of mindfulness practice on nursing student athletes, aiming to understand how mindfulness techniques can enhance their psychological well-being. The project investigates the intersection of mindfulness and addresses the unique challenges and stressors face by nursing student athletes. The project proposals a research study that focuses on how mindfulness can impact nursing student athletes. There is literature that shows how mindfulness can improve stress and mental disorders for nursing students and student athletes separately, but there is a lack of knowledge on how this may affect nursing students who are also student athletes. Mindfulness based …

Food Insecurity Screening Of Families In A Level Iii Neonatal Intensive Care Unit, Katelyn P. Vawter Rn, Bsn, Rnc-Nic, Megan Ortiz Rn, Bsn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Full Study Title: Food Insecurity Screening of Families in a Level III Neonatal Intensive Care Unit

Background: Early infancy food insecurity (FI) is linked to poor health later in life, and Neonatal Intensive Care Units (NICUs) are often overlooked. Routine FI screening can help identify and assist the families suffering from FI seen in the NICU before being discharged home.

Purpose: The aim was to identify if families were assessed for FI by social workers or if they were more likely to report FI in a brief survey.

Method: A randomized chart review of social work notes for 30 NICU …

Introducing An Evidence-Based Copd Care Bundle To Reduce Readmission Rates: A Quality Improvement Project, Michael Distasio

DNP Projects

Background

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating lung condition, and a leading cause of readmission following an acute exacerbation. The Centers for Medicare and Medicaid Services (CMS) Hospital Readmission Reduction Program (HRRP) determines reimbursement penalties to hospitals when patients admitted with acute exacerbation of COPD are readmitted for any reason within 30 days of discharge. A regional medical facility (MF) identified 30-day readmission rates for COPD patients as a key improvement metric. Several gaps in the standardized care of patients with COPD on a pulmonary-focused medical-surgical unit (MSU) identified by key unit stakeholders provided impetus for …

Impact Of Baby Friendly On Exclusive Breastfeeding: Befriending Baby Friendly, Constance Z. Townson

MSN Capstone Projects

Unless you have personally breastfed a newborn baby or tried to help a struggling breastfeeding mother, chances are you would think breastfeeding is not only natural but comes easily. Breastfeeding is indeed a natural progression following delivery; however, various things can play a role in the success of a mother and newborn baby trying to breastfeed. Issues such as feeding position, waking a sleepy newborn, mothers not recognizing newborn hunger cues, a full day of well-meaning visitors impeding skin-to-skin time with mom, or delayed feedings are just a handful. Sometimes, breastfeeding is so difficult that moms who want to breastfeed …

Increased Venous Access With Ultrasound Guided Ultralong Iv Placement, Daniel Purifoy

MSN Capstone Projects

Maintaining intravenous (IV) access is a vital part of providing care in critical care areas of nursing. It allows for continuous therapies, blood draws, complicated scans, and emergency treatment when needed. There are current procedures for obtaining IV access that are guaranteed to have a successful attempt and placement of a long catheter in a deeper vein. Patients that have been determined to have difficult venous access have proven to lose access quickly with an IV catheter of less than 3.18cm in length (Moy & Keeyapaj, 2017). These difficulties can cause monetary loss to the patients and hospitals, and damage …

Evaluating The Efficacy Of Universal Depression Screenings In The High School Setting, Telisha Anthony Msn, Fnp-Bc, Jennifer Thorsen Bsn, Rn, Jackie Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Depression in adolescents is rising each year. Early detection of depression has been shown to result in better health outcomes and success in school. This scoping review aims to evaluate the implementation of universal depression screenings in the high school setting and how this detection of depression and initiation of treatment.

Methods

From August 2022 to November 2023, we used the Medline, PubMed, Elsevier, Google Scholar, and PsycINFO databases, using specific keywords related to depression in adolescents. Of the 38 articles found, 10 were chosen after extensive article critique. The publication dates ranged from 2014-2023, were full-text, and from …

A Plan To Improve Sleep During Critical Care Hospital Stay, Andrea Nutting

MSN Capstone Projects

The purpose of this paper is to bring awareness and possible solutions to the ongoing issue of sleep deprivation in hospitalized patients, specifically patients in the intensive care unit. Sleep deprivation can lead to delay in healing, and therefore delay in discharge. There are also many other issues that coincide with sleep deprivation, such as risk for development of delirium and lack of motivation to participate in care. The ICU is a constant state of distress for not only the staff, but also the family members and ultimately the patient. The stressful environment can inhibit relaxation needed to sleep, which …

Implementation Of Telemedicine In A Level Iii Nicu To Reduce Transfer Of Infants, Jennifer L. Welch

MSN Capstone Projects

In July 2012, a hospital located in North Texas opened its 9 bed Level II Neonatal Intensive Care Unit (NICU). Level II NICU is limited to the admission of infants with a gestational age of 32 weeks and above. There has been tremendous growth and expansion of the NICU resulting in an expansion to 13 licensed beds and gaining Level III NICU designation in 2017. Level III designation enables the care of infants that are 23 weeks or greater and have more complex medical conditions to be cared for. In the current competitive market of health care services, it is …

The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson

The Eleanor Mann School of Nursing Student Works

Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.

Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.

Results: In a comparison …

The Reduction Of Pain Perception Through Music Therapy In Surgical Patients, David Collier

MSN Capstone Projects

The control of pain perceptions of surgical patients is an ongoing problem in trying to control the pain with enough narcotics while not giving too much to depress their respiratory status. Using narcotics increases the risks of several side effects which can negatively impact the patient’s recovery (Fu et. al., 2019). Perioperative music is a nonpharmacological method used to decrease the need for pain medication (Fu et. al, 2019; Kahloul et. al., 2016). The patient is in an anxiety state that causes a heightened state of arousal of the sympathetic system, which in turn releases catecholamines to act on the …

The Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment: A Scoping Review, Barrett S. Patel, Ms, Bsn, Rn, Emily A. Gentry, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Urinary tract infections (UTIs) are a common diagnosis among children. Patients must fully comply with treatment regimens to reduce the risk of recurring UTIs and prevent long-term complications. This scoping review aims to evaluate the literature and examine the association between screening for social determinants of health (SDH) and adherence to UTI treatment.

Methods

A thorough literature search via PubMed, Cochrane Library, Elsevier Clinical Key, CINAHL, and JAMA was conducted with the following keywords: Pediatric UTI, Adherence to Treatment Plans, Social Determinants of Health, Social Needs Screening, and others. Ten articles were appraised for their evidence and quality. The …

Patient Throughput In The Emergency Department, Daniel Alanis

MSN Capstone Projects

In response to ongoing overcrowding in emergency departments, it is imperative to explore effective strategies for mitigating the capacity crises. The purpose of this project is to investigate and implement throughput strategies for a large level 1 trauma emergency department in Houston’s Texas Medical Center. The proposal involves launching a process improvement project to identify opportunity potential for two main interventions: 1. Patient classification for split clinical pathways 2. Dedicated liaison role for throughput responsibilities. The review aims to answer the question: In emergency department patients, how does the implementation of a dedicated throughput liaison compared to a split flow …

The Impact Of Kangaroo Care On Exclusive Breastfeeding In Premature Infants, Colleen Larue

MSN Capstone Projects

This benchmark project emphasizes the crucial imperative of promoting exclusive breastfeeding among preterm and low birth weight infants in neonatal intensive care units (NICUs). Despite the well-documented benefits, exclusive breastfeeding rates remain disappointingly low. This evidence-based project focuses on early intervention through kangaroo care to bolster exclusive breastfeeding rates, with the overarching aim of enhancing infant outcomes and mitigating risks of mortality and morbidity. Engaging key stakeholders, including NICU leadership, nursing staff, lactation consultants, and families, is paramount for the successful implementation of the program. The project presents a detailed implementation plan encompassing various phases, from admission procedures to sustainability …

Evidence-Based Practice - Oral Mucositis Prevention In Chemotherapy Patients: A Benchmark Project, Carrie Davenport

MSN Capstone Projects

The purpose of this implementation project is to help decrease the rates of mucosal barrier injuries (MBI’s) and oral mucositis (OM) in patients receiving chemotherapy on the oncology unit. In 2022, it was reported that seven MBI’s occurred on an oncology unit in a large county hospital in an urban area. This secondary infection has the potential to increase morbidity, increase treatment costs, lengthen hospital stays, and can have a devastating impact on quality of life (Correa et al., 2019). There is currently no protocol in place at the proposed location for this intervention that will help reduce this potential …

Adding Ofirmev: The Effectiveness Of Multimodal Treatment, Kimberly R. Bilal-Williams

MSN Capstone Projects

This project is on enhancing pain management in total knee arthroplasty (TKA) clients via the intravenous (IV) administration of acetaminophen (Ofirmev) by multimodal regimen. The patient, intervention, comparison, outcome, and time (PICOT) question shaping this initiative looks at frequency and intensity of patients’ pain scores as well as practical outcome measures such as healing and physical therapy during the recovery period ending with discharge. After a thorough literature synopsis, it is evident that multimodal pain management strategies including IV acetaminophen provide a better prospectus in comparison to the ones that solely employ opioids. Research repeatedly demonstrates the use of IV …

Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia

MSN Capstone Projects

Mitigating and eradicating central line-associated bloodstream infections (CLABSI) is a vital patient safety priority. These healthcare-associated infections lead to patient fatalities and incur costly, preventable expenses. Therefore, it is imperative to assess central venous catheter (CVC) maintenance protocols to mitigate the likelihood of infection. Federal guidelines advocate using chlorhexidine (CHG) dressings to lower this risk (Centers for Disease Control and Prevention, 2017). A comprehensive central line maintenance bundle includes incorporating a CHG dressing as a critical measure in reducing the risk of CLABSI (Buetti et al., 2022). Consequently, the escalating infection rates underscore the necessity for implementing CHG dressings (Buetti …

The Case For Crisaborole, Chelsea Carnes

MSN Capstone Projects

To begin, topical corticosteroids (TCS) have been the standard first-line treatment medication for atopic dermatitis (AD) since the Federal Drug Administration (FDA) approved them in 1955 (Siegfried et al., 2016). Given that evidence-based practice (EBP) usually changes every few years for many other issues, that is a long period of time. This long-standing standard unfortunately leads many clinicians to the classic “we have always done it this way” conclusion. However, with scientific advancement, there are many more treatments available for AD today. One that is particularly promising is crisaborole, which is currently available under the brand name Eucrisa.

This medication …