Treatment Of Bipolar Disorder With Lithium, Emily Ongaga

Nursing Capstones

No abstract provided.

Suicide Induced By Depression, Josephine Ball

Nursing Capstones

No abstract provided.

The Expansion And Evaluation Of Medication Assisted Treatment Services For An Underserved Rural Northern California Community, Carolyn Perrotti

DNP Qualifying Manuscripts

Problem: Widespread opioid misuse has led to the opioid epidemic that claims 130 deaths per day due to an opioid overdose (CDC, 2018). The opioid epidemic has plagued the United States for three decades and has been considered a public health emergency since 2017 (HHS, 2017). Rural communities are disproportionately affected by this problem and in 2014, the rate of opioid overdose deaths was 45% higher in rural communities (SAMHSA, 2018).

Context: Medication-assisted treatment (MAT) is considered the most effective treatment for opioid dependence because it incorporates medication management and biopsychosocial supports (Jones et al., 2018). Retention in a MAT …

Recruiting And Retaining Np Preceptors, Angelica Renteria

DNP Qualifying Manuscripts

It is estimated that by 2020, the shortage of primary care providers will reach over 20,000. This has led to a surge of nurse practitioner (NP) programs across the nation. Recruiting and retaining preceptors is of paramount importance. Barriers and incentives to precepting must be identified in order to maximize teaching capacity. More effective ways of training NP students (NPs) need to be explored to capitalize on the time preceptors invest with students. The adoption of the OMP teaching model may facilitate training for the preceptor and improve the learning of NPs due to its simplicity and efficiency.

Reducing The Second Victim Phenomenon: Promoting Healing With Caritas Coaching, Shanda N. Whittle

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The second victim phenomenon is one in which healthcare providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol to cope with serious mistakes in the absence of a healthier means for healing (Wu, 2000). This phenomenon can be caused by adverse events or other personal/professional crises and can lead to healthcare professional absenteeism, leaving the job or leaving the profession altogether (Burlison et al., 2018; Hirschinger et al., 2015).

Context: The second victim phenomenon was identified as a problem within this DNP student’s organization and support was obtained for conducting the project. A …

Wound Care Education For Primary Care Providers At A Regional Medical Center, Zaira Torres

Doctor of Nursing Practice (DNP) Projects

Problem. Due to the aging population and the high prevalence of chronic diseases such as diabetes and cardiovascular disease, in the US, millions of people suffer from chronic wounds secondary to these chronic conditions. Wound care treatment is very expensive, costing the US health care system approximately $10 billion annually. San Mateo Medical Center treats many patients with wounds. However, the treatment is suboptimal as most primary care providers (PCPs) are not trained to perform wound care according to best practice. This creates several problems such as a large number of referrals to the Vascular Clinic, visits to the emergency …

Evidence-Based Suicide Assessment And Prevention Training For Licensed Nursing Staff, Rose Waithira Zhang Dnp(C), Msn-Fnp-Bc, Bsn, Rn

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: Suicide is a major public health concern that kills over 45,000 people in the U.S every year. At a psychiatric hospital in Northern California, several suicide attempts occur every year.

Context: The aim of this DNP project was to train licensed nursing staff at a large safety net psychiatric hospital in Northern California on interventions and best practices in suicide prevention to improve suicide screening, assessment, and detection for an at-risk population.

Intervention: Interventions consisted of training on the appropriate use of (a) the organization’s Evidence-based Suicide Screening and Prevention Protocol and (b) an evidence-based suicide …

Reducing Frustration With Wait Times Utilizing Technology And Education: A Patient Satisfaction Improvement Model, Tiffany Brown

Doctor of Nursing Practice (DNP) Projects

Problem: Patients spend considerable amounts of valuable time waiting to be seen by physicians in outpatient clinical settings. Many consider waiting as wasted time, inactive time, or as a lost opportunity which can cause frustration. Research suggests that long clinic wait times have a major impact on patients with cancer causing a significant amount emotional distress. Context: At the hospital and thoracic oncology clinic implementation site which is located in northern California, the target time for a New Patient Visit (NPV) is less than or equal to 90 minutes, and less than or equal to 60 minutes for a Return …

Initiating Prep In Primary Care: Addressing The Adolescent And Young Adult High Risk Populations, Igor G. Mocorro

Doctor of Nursing Practice (DNP) Projects

Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers.

Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult …

Dnp Final Project: Implementing Teamstepps Training: Using Evidence To Impact Teamwork In An Acute Care Hospital, Nana Baah Adjei

DNP Final Reports

Background: Medical errors are the third leading cause of death in the United States. Patient morbidity and mortality will decrease when institutional efforts result in the implementation of action plans which reduce medical errors. Teamwork, education, and training through structured initiatives are the most effective mechanism to improve patient safety. Purpose: The project aims to impact the perception of communication among newly hired medical surgical nursing and support staff. The acute care hospital is a 200-bed tertiary care hospital. Intervention: The intervention consists of the registered nurses and support staff participating in an innovative, six-hour, interactive TeamSTEPPS fundamentals course. Results: …

Dnp Final Report: Sedation Protocol Compliance For Improved Outcomes In Intensive Care, Sonya M. Grigsby

DNP Final Reports

Background: Current evidence-based practice guidelines show that lighter sedation reduces mechanical ventilator days (MVD) and intensive care (ICU) length of stay (LOS). Guidelines (2018) for the management of pain, agitation, delirium, immobility, and sleep were released to direct appropriate high-quality care to achieve positive outcomes. However, studies demonstrated there were barriers to compliance of these guidelines.

Objective: To improve compliance with an existing evidence-based sedation protocol in an intensive care, and, thereby, improve patient outcomes (MVD and ICU LOS).

Methods: The three-month quality improvement (QI) project evaluated processes leading to compliance with the guideline. First, nurses were surveyed to determine …

Implemented Nurse Education To Improve The Effective Use Of The Sapphire Pca Pump: Achievement Of Quality Pain Control, Fanta Keita Zable

Master's Projects and Capstones

The Sapphire ™ Infusion System Patient-Controlled-Analgesia (PCA) pump is a device that is used to administer high pain medication to manage a patient’s pain level after an invasive procedure such as surgery. In order to achieve this goal, nurses must be able to use the sapphire equipment efficiently to prevent medication overdose and underdose, as well as to preserve safety for both the patients and the nurses themselves. In addition, nurses must be able to document accurately on EPIC. The purpose of this project, led by the team of Clinical Nurse Leader (CNL) students from the University of San Francisco, …

Sprotte Into The Future, Amanda French

Cohort VIII

Post-dural puncture headache (PDPH) is a frequent complication that affects up to 35% of all patients who undergo lumbar puncture. Lumbar puncture with intrathecal chemotherapy administration is a required procedure that is outlined in the treatment plan for pediatric oncology patients who have been diagnosed with leukemia. During my ten-day reflective practice, 66% of patients developed a PDPH. After conducting a literature review, a variety of interventions for decreasing the incidence of PDPH (i.e. hydration, bed rest, controlled analgesics during procedure, and needle design) were found. After comparison of all the interventions, a consensus was reached in which the needle …

Utilizing Phq-9 To Standardize Healthcare Assessments, Angela M. Wooley

Cohort VIII

Depression is a serious condition that if left untreated can lead to life threatening situations. Healthcare providers are responsible for recognizing and assessing those individuals dealing with depression. Screening tools have been shown to be beneficial in assisting healthcare providers to identify those individuals meeting the depression criterion. The PHQ-9 is a self-administered screening tool that has shown to be reliable and valid in screening individuals for depression in most healthcare settings. The PHQ-9 was utilized in this project and, as shown by evidence-based practice, can assist clinicians in assessing for depression and provide valuable information regarding the severity of …

Competency-Based Practicum Evaluation Tools For Family Nurse Practitioner Programs, Angelica Renteria

Doctor of Nursing Practice (DNP) Projects

Problem: Training family nurse practitioners (FNPs) was identified as a concern within a university MSN FNP program. A major gap identified was that student practicum evaluation tools needed to be competency-based.

Context: The paradigm shift from content-focused curriculum to competency-based curriculum has led to a refinement in program accreditation and increased national certification requirements.

Interventions: Revision (aligned with NONPF core competencies and AACN Master’s essentials), adoption, implementation, and evaluation of competency-based FNP practicum evaluation tools and training of faculty and preceptors to use the revised tools and one-minute preceptor model were the interventions in this project.

Measures: …

Dnp Final Report: The Flipped Classroom: An Evidence-Based, Course Redesign To Increase Retention Rates In A Vocational Nursing Program, Jennifer P. Hauger

DNP Final Reports

Over the past three decades, Vocational Nursing has been taught using a conventional didactic method that is content heavy and lecture focused. Despite having a group of highly qualified professors and an excellent student pass rates on the National board examinations, student retention in a Vocational Nursing Program in central Texas remains below the National benchmark. With a unique student demographic that is identified as non-traditional (over 21, full-time working adults, English Second Language and single parents), we embarked upon the redesign of a Medical-Surgical Nursing course using the flipped pedagogical framework to increase retention rates. Therefore, in 2019 we …

Unaddressed Challenges For The “Most Honest And Ethical Profession:” A Pilot Study Of Web-Based Learning Strategies To Prevent Moral Distress, Kelly Straight

Doctor of Nursing Practice (DNP) Projects

Background: Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and because of widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Even with codified ethical standards, unresolved and/or ongoing ethical questions and dilemmas pose further issues such as the development of moral distress. This pilot project was designed to help NPs and other healthcare workers …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts

Evidence-Based Practice Project Reports

Substance use disorders are a worldwide problem, according to the Center for Disease Control (CDC) there were 70,237 drug overdose deaths that occurred in the United States in 2017, of which 47,600 were opioid related. Illinois had a 14.3% increase of opioid deaths from 2016-2017 (CDC, 2017). Numerous interventions exist to address this health concern, yet evidence shows that Motivational Interviewing (MI) was the most efficient and effective way to promote behavioral change. The purpose of this EBP project was to provide evidence that MI increased referrals and promoted compliance with appointments to treatment programs. The sample for this project …

Pain Management: Genetic Basis For Racial Disparities?, Brittany Taylor

Publications and Research

No abstract provided.

Evaluation Of Obstructive Sleep Apnea In Veterans With Coexisting Psychiatric Symptoms, Zenith Perpignani

Doctor of Nursing Practice Projects

Abstract

There is a growing body of evidence that suggests a correlation between post-traumatic stress disorder (PTSD), nightmares with broken sleep, obstructive sleep apnea (OSA), and worsening of symptoms by OSA, Veterans who received treatment at a Midwest Veteran Affairs (VA) Center for Behavioral Health were often subject to variable wait times between scheduling of behavioral health and primary care providers (PCP). The purpose of the doctoral project was to reduce a Veteran's wait time for evaluation by a PCP after having been identified as at risk for OSA during routine psychiatric evaluation. The project examined Veteran's reports and measures …

Understanding Nursing Students' Attitudes And Knowledge In Caring For People With Disabilities, Cassidy Kaczor, Ashley Mcdanald

Undergraduate Research and Scholarship Symposium

This study focused on exploring the knowledge, attitudes, and comfort level of undergraduate nursing students in caring for people with disabilities (PWD). Inclusion of disability content in nursing curricula is limited. Smeltzer and colleagues (2010) discovered an absence of disability-related content in pre-licensure nursing textbooks. PWDs have indicated four areas of concern regarding their care by nursing staff: poor communication, lack of competence, negative attitudes, and quality of care received. We hypothesized, if education on the health care of PWD and standardized patient experiences are implemented into nursing school curriculum then nursing students will have an increase in knowledge and …

Healthy Jacksonville, Erica Hunt, Alison Fornoff

Doctor of Nursing Practice Projects

Abstract

According to the Morgan County Community Needs Assessment, a significant opportunity for improvement exists in healthcare access among individuals in the northeast region of Jacksonville, Illinois. Tools to screen clients, interventions to identify the healthcare needs, and access to appropriate resources can promote improved health of individuals and the community. The Healthy Jacksonville Initiative was created to improve access to healthcare and community resources for the underserved people of Jacksonville, Illinois. The goal of this project was to implement a community resource registry and individualized needs assessment for community health care workers to use in order to better serve …

Developing Training To Address Neonatal Nurse Knowledge, Practice, And Perceived Attitude For Neonatal Abstinence Syndrome, Rebekah Draper

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

Background: Neonatal abstinence syndrome (NAS) is increasing in the United States as a result of increased opioid-use disorder among women of childbearing age. NAS affects three out of four babies who are exposed to chronic use of opioids during the mother’s pregnancy. Caring for infants with NAS is challenging. Researchers have identified a deficit of knowledge and skills, and have discovered judgmental attitude of nurses caring for babies with NAS. Globally, nurses caring for infants with NAS need education on current evidence-based practice to improve quality of care. The purpose of this project was to create an educational …

Evaluation Of A New Nurse Mentor Program, Corinne Romano, Diane Whitehead

Walden Faculty and Staff Publications

Novice nurses in a 160-bed inpatient rehabilitation hospital had a turnover rate of 32% in 2017 and 2018, despite participation in a novice nurse residency program. This quality improvement project was a 3-month process evaluation of a 1-year mentor program designed for novice nurses. The purpose of the process evaluation was to explore whether the organization had (a) successfully implemented the program as identified, (b) successfully recruited and retained participants to date, (c) maintained projected timelines, and (d) provided all participants the opportunity to provide feedback at the 3-month mark of the program. The process evaluation provided an opportunity for …

Steep Trendelenburg Associated Postoperative Vision Loss Prevention Education, Mitchell Coval

Doctor of Nursing Practice Projects

Postoperative vision loss (POVL) is a rare, but devastating complication that has been reported following robot-assisted laparoscopic surgeries that require prolonged steep Trendelenburg positioning. A central Illinois hospital had recently established a robot-assisted surgical program but lacked active interventions to reduce POVL risk due to a knowledge gap of the anesthesia providers. Following a comprehensive literature review, a PowerPoint educational program was provided at an anesthesia staff meeting. An evidence-based cognitive aid to provide a quick reference of POVL risk reduction strategies was created by the author in collaboration with the stakeholder. Once approved, the cognitive aid was attached to …

Patient Assessment And Provider Education Regarding Antibiotic Use In The Treatment Of Viral Uris In The Urgent Care Setting, Ashlee Schoby, Candra D. Hulskotter

Doctor of Nursing Practice Projects

Improving Antibiotic Stewardship Through the Use of Patient Assessment and Provider Education Regarding Treatment of Viral URIs in the Urgent Care Setting

Candra Kronewitter and Ashlee Schoby

Date of Award

Spring 5-2020

Document Type

DNP Project

Project Team Faculty Member

Mary Zerlan, CRNA, DNP, APN

Project Team Faculty Member

Kay Gaehle, PhD

Keywords

Antibiotics, Antibiotic stewardship, URIs, Upper respiratory infections, Urgent care, ABUSE screening tool

Abstract

Antibiotic-resistant bacteria is a growing problem in the United States. The misuse or overuse of antibiotics is being considered the leading cause. Nearly 2-million individuals are infected with resistant bacteria yearly, and antibiotics prescribed …

A Pilot Of Prenatal Transitional Care Services In The Urgent Care Setting, Alexandra Huddleston, Gloria Pryzgoda, Tiffany Hazel

Doctor of Nursing Practice Projects

Established prenatal care leads to better outcomes and reduced healthcare expenditures. Inadequate prenatal care is associated with numerous risks. Many women face a variety of barriers that contribute to inadequate prenatal care. The purpose of this project was to create and pilot a new transitional care protocol to improve the referral rate of pregnant patients to establish prenatal care at a midwestern physician services (MPS) women’s health care clinic after a MPS express care visit. An extensive literature review was conducted, and a streamlined referral process linking pregnant patients to obstetric care was created to address identified barriers. The referral …

Implementing Quality Into Practice: Nurse Driven Protocol To Reduce Unnecessary Telemetry Use, Richard Clapp

Doctor of Nursing Practice Projects

Abstract

Background: As part of the American Board of Internal Medicine's Choosing Wisely initiative, the Society of Hospital Medicine issued the recommendation to reduce unnecessary use of continuous telemetry monitoring in the inpatient setting. Outside of its primary purpose continuous telemetry monitoring rarely positively impacts clinical decision making and overuse can lead to unnecessary and costly diagnostic work-ups, cause alarm fatigue, lead to emergency department congestion, and increase institutional financial burden.

Objective: Pilot an evidenced based nurse driven protocol for discontinuation of continuous telemetry monitoring to reduce unnecessary telemetry use among adult patients hospitalized outside of the intensive …

Evaluation Of An Interdisciplinary Ketogenic Diet Clinic For The Treatment Of Pediatric Refractory Epilepsy, Britt Schloemer

Graduate Theses, Dissertations, and Capstones

Pediatric refractory epilepsy affects approximately 30% of all children diagnosed with epilepsy. Childhood refractory epilepsy patients pose a challenge for traditional approaches to epilepsy management due to their complex and unique needs. Refractory epilepsy negatively impacts a patient’s ability to attend school or hold a job, and patients have a generally poor health status related to seizures as well as pharmaceutical side effects (Conway et al., 2016). The ketogenic diet (KD) is an alternative option for the treatment of pediatric refractory epilepsy due to established efficacy, manageable side effects, and reduced health care-associated costs due to reduced emergency department (ED) …