Nursing Commons^™

Nutritional Assessment Process Revision In Adult In-Patients., Amanda Hellmueller

Doctor of Nursing Practice Papers

Thorough and appropriate nutritional screening upon admission to the hospital can mitigate the negative consequences often associated with secondary malnutrition. At a suburban hospital in the southeastern United States, there was an 250% increase in consults to dieticians upon initiating use of the Malnutrition Screening Tool (MST) as the primary form of nutrition screening, which has been previously shown to have a high false positive rate. As a result, the workload of the dieticians increased. This time spent on analysis of false positive screenings takes away from time that could be spent on truly malnourished or at-risk patients. This quality …

Increasing The Confidence Of Primary Care Nurse Practitioner Students In Caring For Patients With Preexisting Opioid Use Disorder., Christopher T. Hannon

Doctor of Nursing Practice Papers

Background: In the United States, more people die from drug overdoses related to increased heroin and fentanyl use than homicides and car accidents combined (Sederer & Marino, 2018). Frustrations and negative perceptions (stigma) on behalf of primary healthcare providers may result in negative health outcomes for patients, poor therapeutic relationships and lack of opportunity to engage clients in substance use treatment (Khenti et al., 2017).

Purpose: The purpose of this project was to implement a contact-didactic education module to improve adult gerontology primary care (AGPCNP) and family nurse practitioner (FNP) students’ attitudes towards OUD patients, and to increase their therapeutic …

Prescribing Probiotics In Tandem With Antibiotics In A Pediatric Setting., Allyson Riggs

Doctor of Nursing Practice Papers

Gastrointestinal (GI) discomfort including antibiotic associated diarrhea (AAD) is a common side effect of antibiotic therapy. As antibiotic use continues to increase, more patients are affected by AAD. Significant evidence has been found on using probiotics for the treatment and prevention of GI distress and AAD. Provider education is needed in the clinical setting to share evidence and make recommendations on best practice. The goal of this intervention was to increase the rate at which providers prescribe probiotics in tandem with antibiotics, via increased provider education. A retrospective Electronic Health Record (EHR) review was conducted once before and once after …

Pathophysiology Of Ards, Brittney Nessle

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a progressive life-threatening disease process, having an occurrence of up to 200,000 cases annually in the United States (Schreiber, 2018). The definition of ARDS has changed throughout the years. In 2011, the European Society of Intensive Care Medicine officially proposed the now adopted Berlin ARDS definition. The components within the definition include timing, chest radiography, the origin of edema, and severity of hypoxemia (Modrykamien & Gupta, 2015). There are over 50 different conditions that result in injury to the alveolar-capillary membrane that can lead to ARDS and produce several severe complications, including death. The …

Helicobacter Pylori Pathophysiology, Alisha Smith

Nursing Student Class Projects (Formerly MSN)

Abstract

This poster provides current research evidence on Helicobacter Pylori pathophysiology, treatment guidelines, and the potential etiology of associated disorders. The purpose is to provide a detailed overview of the functional changes within the intestinal cells caused by the microorganism. Furthermore, explaining of the mechanism and clinical manifestations of symptoms. The research focuses on risk factors, transmission, diagnostic evaluation, and the implications for nursing care. The best-available evidence offers concrete data examining the detrimental effects of the immune and inflammatory response stimulated by H. pylori. A description of the functional structures of H. pylori and its’ ability to survive. …

Hypermobile Ehlers-Danlos Syndrome (Heds), Jocelyn Akers

Nursing Student Class Projects (Formerly MSN)

Ehlers-Danlos Syndrome is a genetic connective tissue disease with varying expressions and phenotypes. Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most prevalent subgroup within this disease category. It is estimated to make up about 80% of the total population of those with EDS (Tinkle et al., 2017). New and updated diagnostic criteria was established in 2017 for hEDS as a way to categorize the syndrome apart from other connective tissue diseases on the hypermobility spectrum of diseases. The disease expressive itself through a complex pathological process and in varying degrees and levels of severity for those who inherit it (Castori et …

Type Ii Diabetes Mellitus, Marie Bertke

Nursing Student Class Projects (Formerly MSN)

Type II Diabetes Mellitus (DMII) is a metabolic disorder that affects glucose metabolism. Characteristics of DMII include: hyperglycemia, insulin resistance, and impaired insulin secretion by the pancreas. Contributing risk factors in the development of DMII includes: familial history of diabetes, obesity, physical inactivity, hypertension, and other comorbid medical conditions. Signs and symptoms of DMII include: polyuria, polydipsia, fatigue, weight loss, blurry vision, as well as, other long-term complications. The complex pathophysiology of DMII will be discussed in this poster, as well as the diagnosis and treatment of DMII. Greater discussion and education is needed for healthcare providers with the increase …

Pathophysiology Of Colorectal Cancer, Jessica Okey

Nursing Student Class Projects (Formerly MSN)

Colorectal cancer (CRC) is a slow developing preventable cancer that occurs after colon or rectal polyps undergo abnormal cellular changes. CRC is a very common cancer but can be preventable if screenings are completed as recommended. This poster will be discussing the pathophysiology of colorectal cancer and nursing implications related to the disease

Myasthenia Gravis, Joel Griffith

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is an autoimmune disease that is caused primarily by antibody mediated degradation of the somatic nicotinic acetylcholine receptors or muscle specific tyrosine kinase enzymes in the neuromuscular junction causing muscle weakness (Yokoyama & Hattori, 2017). Treatment for MG utilizes acetylcholinesterase inhibitors, immunosuppression with steroids, plasmapheresis, and surgical thymectomy (Muckler, O'Brien, Matson & Rice, 2019: Okusanya et al., 2016). MG is of particular concern in the perioperative area due to the use of neuromuscular blocking agents in surgery and the potential to cause severe muscle weakness and even respiratory failure (Muckler et al., 2019).

Acute Flaccid Myelitis Awareness, Olivia Ballard

Nursing Student Class Projects (Formerly MSN)

Acute Flaccid Myelitis (AFM) awareness is expanding in pediatric intensive care units(PICU) around the world. The underlying etiology and protocols of management remain unclear to many medical professionals today. As of 2014, a correlation to the disease is associated with an enterovirus pathology. Unfortunately, its presentation can be easily missed and lead to detrimental outcomes. The mysterious polio-like disease leaves the patient in a state of paralysis, frequently requiring feeding and ventilatory support. With the lack of scientific knowledge and surveillance in the hospital, clinicians and nurses feel guilt in not knowing if AFM was missed. As new research continues …

Thyroid Storm, Emmanuel Mann

Nursing Student Class Projects (Formerly MSN)

Brief analysis of thyrotoxicosis and the nursing implications involved. Common systems and medications needed to treat thyrotoxicosis. And a case study of unsuccessful medical management needing a thyroidectomy.

An Intervention To Improve Emergency Room Nurses' Swallow Study Implementation And Documentation., Amanda B. Hicks

Doctor of Nursing Practice Papers

Stroke is the 5^th leading cause of death when isolated from other cardiovascular diseases in the United States (U.S.) (CDC, 2017). The Centers for Disease and Control (CDC) indicated that 795,000 people have a stroke each year with 65% suffering from some form of dysphagia, or difficulty swallowing. Implementing a simple screening by a trained nurse can detect dysphagia and prevent adverse outcomes, such as aspiration. In the emergency department (ED) of a suburban acute care facility, a pattern of inconsistent Toronto Bedside Swallow Screening Tool (TORBSST) was noted for 24 consecutive months. The purpose of this quality improvement …

Efficacy Of Care With Assertive Community Treatment In Severe Mental Illness., Rex Dewan

Doctor of Nursing Practice Papers

Background: Severe mental illness is a devastating and undertreated problem in our society. Assertive Community Treatment (ACT) services could help fill the void left from the deinstitutionalization movement providing the severely mentally ill the needed support while allowing them to remain in their communities.

Aim: This evidence-based scholarly (EBP) project addressed the following question; How does length of time in ACT affect the number or length of hospitalizations, and incarcerations in patients with severe mental illness.

Methods: This project is a program evaluation of an Assertive Community Treatment Team Program in a metropolitan city. The impact evaluation consists of data …

The Effects Of Fall Health Belief And Knowledge Of Fall On The Prevention Of Fall In The Elderly: Mediating And Moderating Effects Of Fall Fear, Insun Jang, Seungmi Park, Phoebe (Yeon) S. Kim

Nursing Faculty Publications

Purpose: This descriptive study investigated the mediating and moderating effects of fear of fall on the relationships between health belief on fall, fall-related knowledge and fall prevention behaviors among older adults Methods: We enrolled 229 older adults residing in a senior citizen hall and community welfare center, and investigated their health belief on fall, fall-related knowledge, fall prevention behavior, and fear of fall. Descriptive statistics, ANOVA and t-test were used to analyze differences in variables. Pearson correlation and multiple regression were used to investigate mediating and moderating effects of the fear of fall on the relationships between health belief on …

Feasibility Of Online Psychoeducation For Bipolar Disorder., Scott Alan Kristie

Doctor of Nursing Practice Papers

Problem Statement: Bipolar disorder (BD) is a chronic mental disorder that can negatively affect an individual’s quality of life (QoL). Psychoeducation (PE) programs are an evidence-based psychosocial adjunct, recommended by the National Institute for Health and Care Excellence (NICE) for the treatment of BD. However, the majority of individuals with BD are not given access to formal PE programs.

Purpose: An online PE program was implemented at three outpatient local mental health settings in order to increase access to PE for adults with BD. The World Health Organization Quality of Life brief (WHOQOL-BREF) scale was used to assess the intervention’s …

Human Trafficking Education For Pre-Licensure Nursing Students: A Quality Improvement Project., Mollie Elizabeth Flowers

Doctor of Nursing Practice Papers

Human trafficking is a form of modern slavery and a violation of human rights (Scanwell, Macdonald, Berger, & Boyer, 2018). An estimated 40.3 million individuals are being trafficked globally at any one time with 14,500 to 17,500 being trafficked within the United States annually (Polaris, 2018; Mason et al., 2016; Richards, 2014). An estimated 87% of human trafficking victims were seen by health care professionals during the time they were being trafficked and went unrecognized. (Lederer & Wetzel, 2014). This project utilized the Plan– Do- Check -Act model for quality improvement. (Agency for Healthcare Research and Quality, n.d.). This project …

Implementing An Updated Evidenced-Based Maintenance Central Line Bundle (Clb) Policy: Monitoring Adherence And Central Line Associated Blood Stream Infections (Clabsis) In A Medical Intensive Care Unit (Micu)., Kimi Hart

Doctor of Nursing Practice Papers

Purpose: The purpose of this project was to update the current policy of CLB maintenance of CVCs by incorporating the latest recommendations from the literature, providing education and disseminating the new policy. Outcomes were measured by evaluating the effect on policy adherence and incidence of CLABSIs in a medical intensive care unit (MICU). Policy adherence was defined by the completion of CLB maintenance components.

Methods: This study included a pre- and post-interventional design utilizing a retrospective chart review to evaluate adherence to CLB maintenance interventions and incidence of CLABSI rates pre and post-implementation of a new CLB maintenance policy that …

Development And Implementation Of A Diabetes Management Flow Sheet In A Primary Care Practice: A Quality Improvement Project., Lace N. Houston

Doctor of Nursing Practice Papers

Primary care practices that do not utilize electronic medical records (EMR) could pose difficulty in adhering to clinical guidelines for diabetic patients. Diabetes flow sheets are a one page document that includes current practice guideline recommendations for easy access of results to promote comprehensive care. The main objective of this project was to promote adherence to diabetes guidelines with the use of a diabetes flow sheet for providers that do not utilize an EMR.

Plan-Do-Study-Act was the design for this project. A total of 50 medical records were randomly selected at a primary care office. A pre and post-implementation of …

Implementation Of An Educational Workshop On The Use Of Evidence-Based Lifestyle Management Programs To Prevent Diabetes., Angela Leinenbach

Doctor of Nursing Practice Papers

Prediabetes does not have to lead to type 2 diabetes. Lifestyle management programs (LMPs) have been shown to reduce the risk of conversion to type 2 diabetes (Diabetes Prevention Research Group (DPRG), 2002), however, research suggests providers refer to LMPs less than 10% of the time (Shiffman et al., 2009). The purpose of this project was to improve prediabetes management by increasing primary care (PCP) referrals to a local Diabetes Prevention Program (DPP) through the use of an educational intervention to increase knowledge of DPP, prediabetes documentation, and steps for DPP referral. The ACE Star Model of Knowledge Transformation guided …

Effectiveness Of Girls Only! Prevention Education Program For Self-Esteem Enhancement In At-Risk Adolescent Girls., Kennetha A. Porter

Doctor of Nursing Practice Papers

Background: Low self-esteem in adolescent girls has been found to be associated with risky behaviors including illicit drug use, early sexual intercourse, and delinquent behaviors. In addition, mental health concerns such as anxiety, depression, and body dissatisfaction have also been found to be associated with low self-esteem. Group-based interventions for increasing self-esteem and general well-being have been found to decrease risky behaviors and the symptoms associated with varying mental health problems.

Aims: To implement Girls Only! group-based intervention to improve self-esteem in at-risk adolescent girls living in a residential home.

Methods: A pretest posttest design was used to implement Girls …

Pediatric Discharge G-Tube Toolkit., Kimberly Hall

Doctor of Nursing Practice Papers

Surgically placed gastrostomy tubes (G-tubes) are used in pediatric patients to provide proper nutrition and hydration when illness or trauma renders the child unable to consume adequate oral intake. Parents/caregivers are given education and training on their child’s G-tube, which varies from hospital to hospital. Parents/caregivers are responsible for all aspects of the G-tube once discharged from the hospital. Studies have shown that after discharge, ER visits and/or unscheduled clinic visits are necessary for G-tube complications, many of which could be dealt with at home given the proper education and resources. The aim of this project was to provide a …

Generalized Anxiety Disorder: Management Practices Among Primary Care Providers In Northern Mississippi, Jennifer Bolen, Grace Henson, Sabrina Mcclain, Al Rayburn, Benjamin Spencer

MSN Research Projects

The purpose of this research was twofold. First, the research revealed the practices among primary care providers in northern Mississippi for treating GAD whether psychotherapy, pharmacological, or a combination. The specific modalities of psychotherapy and pharmacotherapy were listed. Second, the research revealed that these management practices are consistent with contemporary evidence-based research.

Compliance Of Primary Care Providers With Knee Osteoarthritis Guidelines, Komalben Desai, Catherine Elridge, Ashley Barber, Melissa Floyd

MSN Research Projects

The purpose of this study was to determine the compliance of primary care providers with AAOS guidelines of knee osteoarthritis (OA) and identify the most commonly used management options chosen by primary care providers for knee osteoarthritis.

Childhood Lead Poisoning Prevention: Healthcare Provider Knowledge And Self-Reported Practice, Lydia Ruth Rice, Mari Caitlyne Minga, Laken Fulcher, Eric Yarborough

MSN Research Projects

The purpose of this research study is to determine if primary care providers are knowledgeable of the CDC recommendations for childhood lead poisoning prevention and to evaluate the self-reported practices of primary care providers regarding these recommendations.

Are Health Care Providers Educating 1 Heir Patients On Proper Storage And Disposal Of Electronic Nicotine Devices?, Larisa Bell, Shada Breeze Chunn, Kaitlyn Smith, Tammy Steele

MSN Research Projects

The purpose of our research is to determine if healthcare providers are educating patients on the proper storage and disposal of electronic nicotine devices and the associated liquids.

Recombinant Zoster Vaccine (Shingrix) Knowledge And Practices Of Primary Care Providers In Mississippi, Leigh Gault, Casie Brown, Mackinzie Lee, Kimberly Word

MSN Research Projects

The purpose of this study was to determine Mississippi primary care providers' (PCP) knowledge and practices of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations for administering the Shingrix vaccine to immunocompetent adults aged 50 years and older.

Knowledge Of Women Of Childbearing Age Regarding Preconception Counseling, Allison Britt, Shelby Jackson, Jessica Mcgee, Jenna Pugh

MSN Research Projects

The purpose of the current research study was to assess the knowledge of women of childbearing age regarding key components of preconception counseling and look at relationships between demographics and knowledge of preconception health care.

Implementation Of A Heart Failure Risk Screening Tool In A Primary Care Setting., Paige Abell

Doctor of Nursing Practice Papers

Introduction: Heart failure (HF) is a progressive disease that is difficult to identify in its early stages. The Health ABC HF screening tool allowed primary care providers to identify and target interventions at their highest risk patients.

Purpose: The purpose of this project was to introduce providers to the Health ABC HF screening tool and assess the feasibility of using this tool in a primary care setting.

Intervention: Six primary care providers used the Health ABC screening tool for 4 weeks on their patients over age 65 with a diagnosis of hypertension, diabetes mellitus, or atherosclerosis. Providers then completed …

Educating Primary Care Providers On Assessment Of Herbal Supplements Used By Latino Patients., Elizabeth Arnold

Doctor of Nursing Practice Papers

Background: Latino population health care practices are rich in heritage and deeply rooted in ideas and traditions (CDC, 2008). Complementary and alternative medicine (CAM), specifically herbal supplement use, is widely practiced among this population. Literature suggests that there is a significant gap in provider-patient communication regarding herbal supplement use (Malika et al., 2017).

Aims: The purpose of this project was to assess commonly used herbal supplements or vitamins and implement a population-specific education for providers in a primary care clinic predominantly serving Latino patients. The project aim was to increase provider assessment and documentation of herbal supplement and vitamin use …

Improving Caregiver Coping And Reducing Recidivism With A Pediatric Burn Discharge Education Toolkit., Lindsay Hack

Doctor of Nursing Practice Papers

In 2015, 4,506 children from 0-19 years of age were hospitalized with burn injuries in the United States (Center for Disease Control and Prevention, 2017). From 2013-2014, 325 out of 11,940 pediatric burn patients discharged from US facilities had unscheduled readmissions within 30 days (Wheeler et al., 2018). Adequate discharge education and quality of transitions from hospital to home will help prevent negative health outcomes and readmissions (Braet, Weltens, Bruyneel, & Sermeus, 2016). In this quality improvement project, caregivers of pediatric burn patients were assessed on their day of discharge with the Readiness for Hospital Discharge Scale (RHDS)- Parent Form …