Nursing Commons^™

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

A Multimodal Approach To Decreasing Hesitancy Of The Influenza Vaccine In The Family Care Setting, Carley J. Ellenberger

Evidence-Based Practice Project Reports

The uptake of the influenza vaccine is the most effective and proactive action an individual can take to defend themselves against the influenza outbreak each season; therefore, it is recommended that everyone at least six months of age and older should receive the annual flu vaccine (CDC, 2022; WHO, 2023). Unfortunately, influenza vaccine hesitancy is demonstrated on a global level affecting the uptake compliance annually each influenza season despite the millions of people that experience influenza symptoms annually (CDC, 2022, WHO, n.d.; Healthy People 2030, n.d.). The PICOT question for this project was in adults, over the age of 18, …

Lovenox Prophylaxis: Improving Lovenox Nurse Education In A Postpartum Unit, Amy T. Nguyen

Master's Projects and Capstones

Problem: This quality improvement project aimed to increase nurse education about Lovenox

prophylaxis within the postpartum unit to reduce risks of pulmonary embolism among high-risk postpartum women in the postpartum unit. Context: A microsystem assessment was completed by Clinical Nurse Leader (CNL) students in the postpartum unit at Hospital X located in the southern Bay Area. This unit accommodates 25 beds and provides care for postpartum mothers after both cesarean section and vaginal births. Intervention: An anonymous pre-intervention survey was distributed to the registered nurses on the unit. Educational handouts were created and distributed to the nurses on the unit. …

Standardized Patient Education For Patients' Initial Chemotherapy Through An Integrated Telemedicine Platform, Karen D. Dougherty

Seton Hall University Dissertations and Theses (ETDs)

Telemedicine has demonstrated a high level of satisfaction in a variety of health settings as a safe and efficient method of delivering healthcare. The purpose of this project was to implement an Advanced Practice-led Quality Improvement (QI) initiative pilot to evaluate the standardization of chemotherapy education through an integrated telemedicine platform. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess and evaluate core concepts of knowledge, satisfaction, utilization, and program acceptance. This project aimed to utilize evidence-based processes to increase knowledge about the chemotherapy treatment routine, to raise awareness and develop skills to …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

A Prescription For Diabetes Self-Management Education: Best Practice For Persons With Type Ii Diabetes Mellitus, Ashley J. Milcarek

Evidence-Based Practice Project Reports

Diabetes self-management education and support (DSMES) programs have been shown to improve patient outcomes and lower hemoglobin A1c (Hgb A1c) levels in those who are diagnosed with type two diabetes mellitus (T2DM). However, these programs are often underutilized and have low referral rates, despite the known benefits (Powers et al., 2020). The purpose of this patient-centered EBP project was to evaluate the effectiveness of a patient-driven questionnaire, completed by patients with T2DM during routine office visits, in increasing the percentage of patients referred to DSMES by their provider. Specifically, this project addressed the following PICOT question: In adults who have …

The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen

Evidence-Based Practice Project Reports

Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …

Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly

Doctoral Projects

Kidney transplantation is the preferred treatment for patients suffering from kidney failure. It is a complex process that is intended to improve one’s quality of life by adhering to a lifelong treatment plan of immunosuppressant therapy. Therefore, it is essential for patients or their caregivers to have adequate knowledge to care for themselves following post-transplant, which can contribute to better patient outcomes. In a metropolitan Bay area hospital in Northern California, the current state of practice involves educating newly transplanted kidney recipients through face-to-face interactions with the patient and handing out a transplant booklet during their initial transplant hospital stay. …

Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei

Doctoral Projects

Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …

Health Literacy And The Feasibility Of Using Video-Based Education In The Emergency Department, Jenifer Carvell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The Department of Health and Human Services (HHS) defines health literacy as the degree to which an individual has the capacity to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. In the emergency department (ED), it is estimated that the prevalence of inadequate health literacy can reach as high as 88 percent. There is a need to implement literacy-sensitive interventions in the ED. Purpose: The purpose of this project was to engineer an intervention that explored the feasibility of the use of personal technology to deliver video-based education to adult …

A Nurse Led Heart Failure Education For Self-Care Symptom Monitoring And Management, Lynda Browning

Doctoral Projects

Title

Nurse-led education heart failure education for symptom monitoring and management

Abstract

Problem Statement: Over six million adults in the United States have heart failure (CDC.gov,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management …

Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey

Evidence-Based Practice Project Reports

Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …

Effectiveness Of Self-Care Education On The Perceived Quality Of Life In Adults With A Tracheostomy, Elizabeth A. Bonnet

DNP Projects

Background: A tracheostomy is an operative procedure performed to create a stable surgical airway for patients with respiratory compromise due to a variety of clinical reasons. Living with a tracheostomy has tremendous impact on the patient as they experience alterations in their ability to eat, speak, breathe normally, and care for themselves. There is also a potential negative impact to their quality of life. Under ideal circumstances, the tracheostomy is a planned event and education is given to the patient prior to the procedure in an effort to lessen the impact and prepare them to cope with the expected life …

Effectiveness Of Standardized Vs. Individualized Cancer Treatment Education, Jija Issac

Master's Projects

As the number of cancer diagnoses continues to increase and is expected to keep rising, it becomes imperative to explore avenues to optimize patient education. Research has consistently demonstrated that effective education plays a crucial role in improving patient outcomes. Through my previous experiences in various outpatient oncology infusion centers, I have observed significant variations in the methods employed for delivering patient education across different facilities. In this literature review, I explored the effects of standardized chemotherapy education and individualized chemotherapy education on patients in outpatient oncology clinics. The predominant themes across these studies encompass patient awareness of anticipated symptoms, …

Improving Access To Gender-Affirming Care: A Welcome Packet, Kelsey J. Rumley

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

BACKGROUND: Transgender and gender diverse (TGD) individuals face unique challenges in accessing healthcare such as stigma, bias, fear of rejection, limited access to providers, and lack of information on where to seek care. There is evidence that creating an inclusive clinic atmosphere improves access and leads to a more positive healthcare experience

AIMS: The global aim of this project is to improve access to gender-affirming care for students at a New England university. Specific aims were to assess stakeholder needs for content inclusion and develop a new patient welcome packet based on the needs assessment.

METHODS: The Plan Do Study …

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

Our Early Years Of Life's Effects On Our Future Health And Well-Being, Claudia Gagliano

Nursing | Senior Theses

Many poor health outcomes later into adulthood have been triggered by adverse life events that have occurred during childhood. Most of the general population has experienced some sort of adverse childhood event that has negatively impacted their future health. Adverse childhood events include any traumatic event that has occurred during childhood including maltreatment (sexual abuse, mental abuse, and physical abuse), neglect, parental loss, and peer victimization.

Raising awareness regarding the opportunities to intervene in a child’s life as a means to prevent behavioral, psychological, and substance abuse disorders before they would typically manifest on their own is the ultimate goal. …

The Components Of Vaccine Hesitancy And The Role Of Patient Education In Promotion Of Vaccinations In Newborns, Camille Joy Rayo

Nursing | Senior Theses

Background

Due to an array of reasons relating to vaccine hesitancy, many newborns are without their standardized and recommended vaccinations as a result of their parent’s beliefs. Parents hold the power to vaccinate their children. Nurses must provide reliable information, debunk myths, and pursue pro-vaccination ideas when educating a parent about newborn vaccinations. By doing so, vaccine hesitancy should decrease and vaccination rates should increase. Unvaccinated newborns are put at a greater risk of contracting serious illnesses that may spread to others or even lead to one’s own death.

Objective

To identify common factors regarding vaccine-hesitant parents of the newborn …

Implementing The 4ds (Diet, Drinks, Drugs, And Dialysis) To Lower Hyperphosphatemia Among Outpatient Hemodialysis Patients, Morgan Atchison

Doctor of Nursing Practice Projects

Background: Hyperphosphatemia, also known as excess phosphate in the blood, is a problem that continually causes health issues for the outpatient hemodialysis population. Hyperphosphatemia yields multiple health comorbidities and can increase mortality (Rastogi et al., 2021).

Purpose: Hyperphosphatemia is directly correlated with end-stage renal disease (ESRD) (Goyal & Jialal, 2020). This project aimed to decrease the incidence of hyperphosphatemia in the chronic outpatient hemodialysis setting. The primary objective of this project was to increase adherence levels to diet, drinks, drugs, and dialysis (4Ds) in those receiving chronic outpatient hemodialysis in the pursuance of achieving and maintaining blood serum phosphorus levels …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

A Multimodal Approach To Decreasing Hesitancy And Increasing Uptake Of The Covid-19 Vaccine In The Family Care Setting, Meghan Zwierzynski

Evidence-Based Practice Project Reports

Since December 2019, the coronavirus disease 2019 (COVID-19) has swept across the world, infecting and killing millions of people, making it one of the worst pandemics in history (WHO, 2021). However, the rates of confirmed cases and deaths have slowed since the discovery of the COVID-19 vaccine. The purpose of this evidence-based practice (EBP) project was to decrease vaccine hesitancy and increase uptake of the COVID-19 vaccine in the family care setting. The Iowa Model-Revised (Iowa Model Collaborative, 2017) is a practical, effective multi-step change process that acted as a guide for the EBP project. A review of literature showed …

The Efficacy Of Tailored Text Messages To Improve Medication Adherence And Lifestyle Changes For Patients With Type 2 Diabetes Mellitus, Vanessa B. Silverio

Evidence-Based Practice Project Reports

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by increased amounts of glucose in the blood, and is the seventh leading cause of death in the United States (United Health Foundation [UHF]), 2021). T2DM can be effectively treated with medication and behavioral lifestyle modifications. Even small improvements in glycemic control can reduce the risk for debilitating complications such as heart disease, stroke, kidney disease, sepsis, and retinopathy (Wang et al., 2021, Haider et al., 2019). The purpose of this evidence-based practice (EBP) project was to identify the most effective intervention for improving medication adherence, lifestyle changes, and hemoglobin …

Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis

Evidence-Based Practice Project Reports

Osteoporosis is caused by caused by low bone mass, microarchitecture disruption and increase in skeletal fragility (Rosen & Drezner, 2021). This disease presents as a silent disease without any clinical manifestations and increases risk for bone fracture. The purpose of this Evidence-Based Practice (EBP) project was to increase screening rates for osteoporosis in the female population by mailing a patient reminder letter to the home of qualifying patients in the primary care setting and to determine if mailing a patient reminder letter would increase screening rates. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare professionals (JHEBP) model was used …

Empower You: An Adult Type 2 Diabetes Mellitus Management Program With Utilization Of A Mobile Phone Application, Kelsey Jahn

Evidence-Based Practice Project Reports

In 2018, 34.2 million Americans had diabetes and there continues to be 1.5 million Americans diagnosed with diabetes every year (ADA, 2018). Due to this increasing prevalence, self-management of type 2 diabetes mellitus (T2DM) is essential to disease management. The PICOT question for this project was: In adults with T2DM with a hemoglobin A1C (HbA1C) greater than 8% in a diabetes specialty clinic (P), what is the effect of a multimodal smartphone application (I) compared to prior nonuse of the application (C) on average blood glucose readings (O) over an 8-week period (T)? The project was completed in a large, …

Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder

Evidence-Based Practice Project Reports

Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin …