Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

Implementation Of An Evidence-Based Toolkit To Improve Colorectal Cancer Screening In A Federally Qualified Health Center, Stephanie Mckithan

Doctoral Dissertations and Projects

The change in payor fee-for-service to value-based care is creating an opportunity for primary care clinics nationally to adjust their focus to meeting key clinical quality measures during patient encounters. Colorectal screening is one of such quality measures. Previous research has shown that early detection saves lives. The guidelines have lowered the recommended age of initial screening to 45 due to the incidence of colorectal cancer in younger patients. But with all the objectives that need to be met in the limited time of the visit, how can nurse practitioners improve their efficiency? This evidence-based project assessed the implementation of …

The Effectiveness Of Annual Mammograms Versus Triennial Mammograms In Women Under The Age Of 50, Jordyn A. Gowell, Dakota Grace Cochran, Ashley Cantwell, Sara Doughty, Allison Sgrosso

Non-Thesis Student Work

The current recommendation for mammography frequency is every 2 years after age 50. However, newer data shows that yearly mammograms are effective in early detection of breast cancer, even before age 50. These authors posed the question: In women under age 50, is a yearly mammogram more effective than a mammogram every 3 years in detecting breast cancer? A literature search was conducted on CINAHL, MEDLINE, Google Scholar and Cochrane Library using the following terms: mammography, mammogram, annual, yearly, every three years, triennial, and breast cancer. A total of 10 articles met the inclusion criteria. The results of the literature …

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …

Can Machine Learning Methods Be Used For Identification Of At-Risk Neonates In Low-Resource Settings? A Prospective Cohort Study, Babar S. Hasan, Zahra Hoodbhoy, Amna Khan, Mariana Nogueira, Bart Bijnens, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Timely identification of at-risk neonates (ARNs) in the community is essential to reduce mortality in low-resource settings. Tools such as American Academy of Pediatrics pulse oximetry (POx) and WHO Young Infants Clinical Signs (WHOS) have high specificity but low sensitivity to identify ARNs. Our aim was assessing the value of POx and WHOS independently, in combination and with machine learning (ML) from clinical features, to detect ARNs in a low/middle-income country.
Methods: This prospective cohort study was conducted in a periurban community in Pakistan. Eligible live births were screened using WHOS and POx along with clinical information regarding pregnancy …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Hepatitis C Virus Screening Strategies To Improve Early Identification And Treatment: ​ A Scoping Review​, Megan Elizabeth Lyons, Rn, Bsn, Ccrn, Thomas Tyler Bennett, Rn, Bsn, Ccrn, Felicia Ann Gray-Hamilton, Rn, Bsn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment.

Methods

This review began with a literature search using CINAHL and PubMed …

Building A Community-Academic Partnership To Improve Screening For Intimate Partner Violence: Integrating Advocates In Healthcare Clinic Settings, Erin C. Schubert, Colleen M. Galambos, Teresa Jerofke-Owen, Erica Arrington, Greer C. Jordan, Nilanjan Lodh, Heidi Paquette, Gisela Chelimsky, Linda B. Piacentine

College of Nursing Faculty Research and Publications

Aims

To develop an innovative community-academic partnership to advance, test and promote intimate partner violence screening and referral protocols by comparing the effect of integrating intimate partner violence advocates versus enhancing medical training in medical clinic settings serving women from vulnerable populations. Detecting intimate partner violence in healthcare settings allows for survivors to connect to safety and referral resources prior to violence escalating. Screening for intimate partner violence and connecting patients to referral resources requires creating a safe and trusting relationship between healthcare providers and patients. Developing screening and referral protocols responsive to survivors' needs requires involvement of clinic staff, …

Implementation Of Evidence-Based Multiple Focus Integrated Intensified Tb Screening To End Tb (Exit-Tb) Package In East Africa: A Qualitative Study, Kahabi Isangula, Doreen Philbert, Florence Ngari, Tigest Ajeme, Godfather Kimaro, Getnet Yimer, Nicholaus P. Mnyambwa, Winters Muttamba, Irene Najjingo, Aman Wilfred

School of Nursing & Midwifery, East Africa

Introduction Tuberculosis (TB) remains a major cause of morbidity and mortality, especially in sub-Saharan Africa. We qualitatively evaluated the implementation of an Evidence-Based Multiple Focus Integrated Intensified TB Screening package (EXIT-TB) in the East African region, aimed at increasing TB case detection and number of patients receiving care.

Objective We present the accounts of participants from Tanzania, Kenya, Uganda, and Ethiopia regarding the implementation of EXIT-TB, and suggestions for scaling up.

Methods A qualitative descriptive design was used to gather insights from purposefully selected healthcare workers, community health workers, and other stakeholders. A total of 27, 13, 14, and 19 …

A Toolkit To Adequately Screen Pregnant Women For Depression And Thus Increase Screening In An Outpatient Obstetrical Clinic, Katherine Doherty

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal depression is a common health complication during pregnancy. Untreated depression among perinatal women is associated with adverse health outcomes for infants and mothers. Screening during the perinatal time period is needed to identify and treat depression and to prevent adverse health outcomes.

Purpose: The purpose of this clinical project is to equip health care providers with the knowledge and tools needed to screen pregnant women for depression and thus increase the amount of screening done in an outpatient obstetrical clinic.

Methods: An evidenced- based educational tool kit was developed to increase provider knowledge of perinatal depression …

Diagnosis And Initial Management Of Acute Stress Disorder And Post-Traumatic Stress Disorder In The Primary Care Setting, Lindsay Leonard, Blaine Winters

Student Works

Purpose: The purpose of this paper is to equip nurse practitioners (NPs) with resources and tools that will help with the early recognition and treatment of Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) in patients following a traumatic accident.

Background: According to the Centers for Disease Control and Prevention (2019), trauma, or unintentional injury, is the leading cause of death for individuals under the age of 45 and the third leading cause of death for all ages of people in the United States. Patients involved in traumatic accidents often develop adverse psychological sequelae such as PTSD and ASD. …

Implementing Universal Depression Screening In A College Health Clinic, Marilyn J. Grabau

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: College students are at high risk for depression, and this carries a considerable burden. The American College Health Association supports depression screening on college campuses recognizing that early identification leads to better outcomes.

LOCAL PROBLEM: The project site is a public university located in New England. The college campus health center incorporates medical and counseling services. From August 2019 to December of 2019, 67% of students seen in the counseling center described depressed mood as the presenting concern. Currently there is no routine depression screening in place.

METHODS: This QI project implemented universal depression screening at the student health …

Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard

DNP Final Reports

Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …

Increasing Colorectal Cancer Screening Adherence: A Scoping Review, Megan E. Billingsley Bsn, Rn, Tiameria T. Ford Bsn, Rn, Mikayla E. Vican Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Rates have steadily increased in recent years due to high rates of obesity, smoking, and sedentary lifestyles. Screening for the disease can lead to early detection and reduced morbidity/mortality, yet screening rates remain low. Existing literature is extensive in discussing methods to increase CRCS adherence; therefore, a scoping review allows for increased understanding of barriers to CRCS and how to address those barriers to increase screening compliance.

Methods A literature search was completed from September 2020 to October 2021. Multiple databases were used, including …

Implementing Intimate Partner Violence Screening In The Primary Care Setting, Deirdre F. Howard

Doctor of Nursing Practice (DNP) Projects

Background. Intimate partner violence is a highly prevalent problem in the United States and leads to serious negative physical and psychological health outcomes, including death. There are screening tools that can detect IPV, yet screening rates in healthcare settings remain low, due to a variety of barriers, including lack of time, confidence, screening policies, and resources. Purpose. The purpose of this DNP project was to increase IPV screening rates within a primary care clinic.Methods. To accomplish the purpose of the project, an education intervention on IPV and available resources was provided to clinicians and staff. This was followed by …

Depression Symptoms And Covid-19, Kaylee Armendariz

The Eleanor Mann School of Nursing Student Works

The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …

Human Trafficking Awareness Among Psychiatric Hospital Nursing Staff, Donna J. Czech, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Human trafficking is a public health crisis on a global, state, and local level. Victims of human trafficking are a vulnerable population who pass-through healthcare systems unrecognized by nurses and other healthcare professionals due to a lack of awareness about identifiable signs, symptoms, and circumstances. Nurses are in a crucial position to assess trafficking victims for a referral. The purpose of this evidence-based practice (EBP) pilot project was to understand nurses’ knowledge and awareness on human trafficking and assess the perceived ability to identify trafficked individuals in a psychiatric care setting for screening and potential referral. Nurses received an online …

Implementation Of An Evidence-Based Screening Tool For Children For Detection Of Developmental, Behavioral And Family Issues, Lyndsay Goss

Doctor of Nursing Practice (DNP) Projects

Background: Children are a vulnerable population who are at risk for a variety of developmental, behavioral and family concerns. Early intervention leads to improved outcomes. By implementing the comprehensive evidence-based screening tool the Survey of Well-being for Young Children (SWYC), within a Federally Qualified Health Center (FQHC), outcomes for these children may be improved through early intervention.

Methods: The SWYC survey was provided to parents and guardians of children ages zero to five years at one pilot site at a FQHC in New England during well child visits (WCV) over a 6-week period. Implementation success was measured through review …

Evaluating The Impact Of An Educational Program On The Healthcare Providers Knowledge On Depression And Screening Among Adolescents And Young Adults, Albert Peprah

Doctor of Nursing Practice (DNP) Projects

No abstract provided.

Alcohol Screening In A Pain Clinic To Reduce The Risk Of Overdose And Improve Patient Care And Compliance With Prescription Opioids, Alicia Ellis

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The nationwide opioid crisis is having a significant impact on the U.S. population. Patients may turn to alcohol and opioids for pain relief, which can lead to cancer, alcoholic liver disease, and heart disease. Providers can improve outcomes by screening patients for alcohol use prior to getting an opioid prescription using the Audit-C screening tool.

Purpose: This DNP Project started formal screening for alcohol abuse in a small rural pain clinic with five hundred patients per month.

Methods: During the first visit, patients were triaged by the nurse and screened using the AUDIT-C tool and had a urine …

Early Screening Of Postpartum Depression, Mary Ramirez

MSN Capstone Projects

Postpartum depression (PPD) is the most common pregnancy-related complication affecting over half-million mothers each year in the United States and only 50% of these women seek treatment or even receive a mental health evaluation (American College of Obstetrics and Gynecology, 2015; Horowitz & Goodman, 2004). Failure to detect or diagnose PPD can have serious consequences for both mom and baby. Nurses play a key role in discharge teaching and education, which puts them in the perfect position to ensure that adequate referrals are coordinated and to stress the importance of follow-up care to new mothers (Logsdon et al., 2018). Current …

Recognizing Delirium In The Picu: An Evidence-Based Practice Improvement Project, Abigail Begovich, Tracy L. Brewer, Jennifer G. Tourville Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Introduction: Pediatric delirium is underrecognized in the pediatric population and can lead to increased length of stay, hospital costs, and post-traumatic stress disorder (PTSD). Using a standardized screening tool to assess for delirium is an easy way for bedside nurses to evaluate patients and intervene as necessary. This quality improvement project aimed to implement the Cornell Assessment of Pediatric Delirium (CAPD) and complete a delirium screening on applicable patients once a shift > 85% over four months.

Methods: Between January 2020 to May 2020, bedside nurses completed a delirium screening assessment on applicable patients, first on paper and then …

Promoting Recognition And Rescue: Human Trafficking Screening, Erin E. Pittman

MSN Capstone Projects

The exploitation of human beings is a serious public health concern (Centers for Disease Control [CDC] 2018). The United States Department of Justice (2018) defines human trafficking as an act of coercing a person’s labor services or commercial sex acts. Family Nurse Practitioners play a significant role in the identification of victims, especially those practicing in emergency departments. A majority of healthcare providers have yet to establish a standardized screening tool and there is little evidence regarding the impact these screening tools have in recognizing victims of human trafficking (Emergency Nurses Association, 2018). This alarming information brings about the clinical …

Start Stop-Bang, Valerie D. Reeve

MSN Capstone Projects

Currently standard of care in the perioperative unit is not conducive when caring for patients with obstructive sleep apnea (OSA). OSA is highly prevalent and often undiagnosed. Screening patients with a STOP-Bang questionnaire is quick, effective, and cost efficient. OSA is linked to poor postoperative outcomes. Patients at high risk for OSA often encounter complications such as: additional airway management, respiratory complications, cardiovascular complications, and increased length of stay. Screening creates awareness and identification of patients at risk for postoperative complications.

The Intersection Between Sexual Assault And Mental Illness: Psychiatric Nurse’S Role, Shylettera Davis, Leslie Miles, Julie Valentine, Linda Mabey

Student Works

The Intersection between Sexual Assault and Mental Illness: Psychiatric Nurse’s Role

Shylettera Davis

College of Nursing, BYU

Master of Science

Background: Mental illness (MI) affects one in five Americans. Individuals with severe MI are frequently victims of crime, which includes sexual assault (SA). It is well established that individuals with severe MI are more vulnerable for SA victimization. What is not recognized is if this vulnerability for SA extends to other less serious types of MI.

Aim: To identify and synthesize findings from the literature for any connections between having a MI and increased vulnerability for SA victimization, specific mental …

Implementation Of Standardized Hereditary Breast And Ovarian Cancer (Hboc) Risk Assessment And Genetic Referral, Melissa M. Hessock, Tracy L. Brewer, Sadie Hutson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: To increase identification and genetic referral rates for women at risk of Hereditary Breast and Ovarian Cancer (HBOC).

Design: Evidence-based practice improvement initiative

Setting/Local Problem: Private suburban OB/GYN practice in Tennessee with no standardized process for HBOC risk assessment or genetic referral.

Participants: Women age 18 or older, presenting for routine well-woman visits.

Intervention/Measurements: Using PDSA (plan-do-study-act) cycles, a familial risk assessment tool was selected, and a clinical decision-making algorithm for risk assessment and genetic referral was designed and implemented for use in well-woman encounters. Pre-implementation and post-implementation risk identification and referral rates were …