Nursing Commons^™

Using Multi-Faceted Validated Tools To Evaluate The Functional Outcomes And Quality Of Life In Patients Undergoing Elective Spine Surgery And Associated Referral Patterns For Post-Hospital Rehabilitation: A Quality Improvement Project, Mercy Oigbokie, Msn, Agnp-C, Aprn

Doctor of Nursing Practice Projects

Background/Significance: A lack of validated multi-facet assessment tools to assess postoperative patients’ functional ability and quality of life may result in untimely or no referrals to rehabilitation.

Objective: The objective of the DNP project was to introduce the use of validated multi-facet questionnaires in assessing patient-reported outcomes and to assess effect on the time in generating prescriptive rehabilitation therapies and the type of therapies following elective spine surgery evaluated in the outpatient neurosurgery clinics.

Methods: This was a quality improvement (QI) project comprising of 100 patients (50 pre and 50 post the intervention). After the introduction of baseline data, the …

Implementation Of A Provider In Triage Program In A Level Iii Emergency Department, Rachel Parmer Mph, Msn, Fnp- Bc

Doctor of Nursing Practice Projects

Background: This project implemented a Provider in Triage (PIT) system in a small emergency department (ED) in Washington State. The employment of a PIT to decrease patient waiting time and improve ED flow was supported by a literature review. A needs assessment was conducted, which indicated potential benefit from a PIT system, particularly because several ED metrics are worse than national average.

Aims/Objectives: This project aimed to develop, implement, and evaluate a PIT system by employing ED Advanced Practice Clinicians (APCs). The objectives consist of evaluating the impact of a PIT system on the percentage of patients who leave without …

Multidisciplinary Team Approach To Prevent Hf Readmissions In Rural Areas, Naydu Lucas, Rn, Msn, Mba

Doctor of Nursing Practice Projects

Background: Despite the national efforts to decrease 30-days hospital readmissions, readmission remains a challenge for healthcare organizations across the continuum of care. The aim of this quality improve project was to develop and implement a multidisciplinary team approach to provide education to patients hospitalized with congestive heart failure (CHF) to improve 30-day hospital readmissions.

Method: This project was conducted in a critical access hospital in Northeast Washington. Using a pre-post design, we evaluated the 30-day readmission before and after implementing the multidisciplinary education program for patients hospitalized with CHF. The education focused on disease management, discharge education, pharmacy consult and …

Combating Pediatric Obesity With A Community-Based, Family-Centered Pediatric Obesity Prevention Program, Hillary Mayers, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Overweight and obesity among children contributes to significant adverse health outcomes that reduce quality of life. Because children are influenced by the behaviors of their parents, there is a need for multicomponent family-based interventions within the community to help overcome these issues.

Objectives: This quality improvement project provided parents and children aged four to six years old with an interactive nutrition and physical activity educational program to increase their knowledge related to healthy lifestyle patterns and alter BMI status.

Methods: A 10-week pre/posttest design was implemented to evaluate outcome measures including BMI percentile, physical activity and nutritional habits, and …

The Effects Of Non-Pharmacological Interventions Consisting Of Earplugs And Eye Masks, Reducing Environmental Factors To Improve Self-Reported Sleep Quality In Icu Patients, Stephen Risch Msn, Rn, Ccrn, Ccns

Doctor of Nursing Practice Projects

Background: Intensive Care Units (ICU) are noisy environments that hinder sleep. Sleep disruption may have negative affects in ICU patients’ recovery.

Aims/Objectives The aim was to determine the feasibility, patient’s comfort level, and the effects of ear plugs, eye masks, and limiting nursing interventions on self-reported sleep quality during ICU stay.

Methods: This quality improvement project was conducted in a community hospital using a quasi-experimental design. Patients in the intervention group wore earplugs and eye masks with limited nursing interventions during nighttime hours compared to patients in the control group who received routine care. Patients subjective sleep quality was measured …

A Systems Perspective For Integrating A Community-Based, Family-Centered Nutrition And Exercise Program Into A Preexisiting Physical Extracurricular Activity, Chayna Hardy-Taylor, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Childhood obesity continues to be a problem in urban areas despite an understanding of the causes and consequences. It is essential to develop ways to reduce childhood obesity from a systems perspective, addressing the multifaceted elements that contribute to it.

Objectives: This project aimed to implement and evaluate a community-based, family-centered nutrition and exercise program to improve health outcomes and long-term complications related to childhood obesity in a New Jersey city.

Methods: A 12-week nutrition and exercise program based on materials from Let’s Go 5210 was provided for children age 8-13 enrolled in a community organization dance class. Participants …

Increasing Adult Influenza Vaccination Rates In The Primary Care Setting, Leah Prescott Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Provision of vaccinations is one of the most basic interventions aimed at health promotion and disease prevention in the primary care setting. Despite increased public awareness and improved access to vaccinations through minute-clinic settings, health fairs, and employer-offered vaccination clinics, adults in the United States continue to fall short of national goals. Literature demonstrates vaccination rates among adults vary widely and may be affected by a multitude of factors, however vaccination rates may be greatly improved with increased provider engagement.

Objectives: The purpose of this project was to develop, implement, and evaluate a program to improve immunization rates in …

Alcohol Screening, Brief Intervention, And Referral To Treatment Protocol In The Emergency Department, Malvis Ndips Achonduh Tamon, Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The impact that results from inappropriate alcohol consumption poses challenges to public health. The rate of alcohol-related visits to the Emergency Department (ED) has increased, which has resulted in an increased annual cost of alcohol-related visits. ED serves as a common portal of entry into the healthcare system for many patients and offers a unique opportunity to impact drinking behaviors.

Objectives: To increase the number of alcohol screenings and brief interventions when indicated to adult patients who visit the ED and increase ED nurses' knowledge regarding alcohol misuse and indications for brief interventions.

Methods: An educational module was delivered …

The Effect Of Hypertension Education On Knowledge, Lifestyle Behaviors And Blood Pressure Management Among Parishioners In A Faith-Based Setting, Lynda N. Goodfriend, Msn, Rn

Doctor of Nursing Practice Projects

Background: Hypertension (HTN) is a major risk factor for life threatening events. Although evidence supports using faith-based settings to provide health education to better manage chronic conditions and prevent complications, HTN education is underutilized in this setting.

Aims/Objectives: This project aimed to assess the effectiveness of HTN education on knowledge, self-reported lifestyle behaviors and blood pressure (BP) management among parishioners in a suburban church.

Method: A pre-post educational intervention was used in this evidence-based project. BP screening identified 56 eligible adults and a convenience sample of 44 parishioners with HTN were enrolled. Participants received two 45-minutes educational sessions. Pre- and …

A Nurse Led Pre-Operative Patient Education Intervention And Its Effect On Anxiety Levels In General Surgical Patients, Elisabet C. Harms Ms, Rn, Cmsrn, Cnecl

Doctor of Nursing Practice Projects

Background: Substantial research has shown anxiety can negatively affect patients during the surgical period. Healthcare staff have limited time to educate.

Objectives: This study assessed the effect of pre-operative patient education on general surgical patients’ level of state anxiety. Also, compared the differences of pre and post intervention anxiety scores between patients undergoing different types of surgery and anticipating varied length of hospital stay.

Methods: A one-hour educational class, either in-person or online, provided information about surgery and recovery phase to 20 pre-operative patients. Participants’ anxiety levels before and after the class were measured using the State Anxiety Inventory questionnaire. …

Mitigating Delirium For The Elderly Post-Operatively Without Medication, Ann Lo Basso

Doctor of Nursing Practice Projects

Background: Often occurring after surgery, or hospitalization, the development of delirium in older adults, initiates a cascade of events culminating in loss of independence, increased morbidity and mortality, and high health care costs (Oh, et al., 2017).

Objective: The purpose of this quality improvement (QI) project was to adapt and implement best practices using HELP for managing older patients with postoperative delirium through the existing 1:1 observation structure and implementing cognitive care strategies. The 1:1 sitter roles and responsibilities were redesigned to include non-pharmacological, multicomponent interventions.

Methods: The QI project used a pre-test post-test intervention design comparing groups before and …

Time For Quiet Reducing Nighttime Interruptions In The Icu (Turn In-Icu): Evaluation And Implementation Of A Nonpharmacological Sleep Bundle To Improve Sleep Quality, Delirium, And Nighttime Sedation Requirements, Christina Junker, Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Undisturbed, restful sleep is essential for physiological as well as psychological well-being. For critically ill patients, sleep deprivation caused by frequent nighttime interruptions is associated with poor sleep quality and negative patient outcomes.

Objectives: The purpose of this Quality Improvement (QI) project was to promote uninterrupted sleep between the hours of 10 PM and 5 AM. Outcomes for evaluation consisted of the following three components: (1) sleep quality, (2) incidence of delirium, and (3) nighttime sedation requirements. Except for sleep quality, these variables were compared before and after the intervention.

Methods: A descriptive, before and after design for data …

Implementing The Ami Readmits Risk Assessment Score Within A Referral Protocol To Increase Referrals For Follow-Up Among Patients With Type I Myocardial Infarction, Nailya Muganlinskaya, M.S.N., M.P.H., Acnp-Bc, Dnp Graduate

Doctor of Nursing Practice Projects

Background: The hospital’s post- myocardial infarction (MI) referral protocol does not address patient risk characteristics. Referrals to a post- MI clinic have been lower than expected. Evidence suggests the AMI READMITS score can predict readmissions within 30 days after discharge among patients with acute MI.

Aim: This quality improvement study evaluated a referral protocol that integrated the AMI READMIT score to increase appropriate referrals after discharge.

Methods: Patient chart data was analyzed to assess changes in referrals and timely follow-up from pre-intervention to intervention. A survey assessed providers’ satisfaction with the new referral protocol.

Results: Among 57 patients (n=29 pre-intervention; …

The Development, Implementation And Evaluation Of An Evidence-Based Biohazard Training Program Within A Pediatric Ambulatory Practice, Lakeshia L. Evans Mba, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Communicable disease(s) such as Ebola or Coronavirus can cause a catastrophic health crisis within the United States healthcare system, especially among the pediatric and elderly population. Lack of knowledge, skills and confidence among health care professionals in the pediatric setting regarding these infectious organisms can affect early identification, proper isolation, early treatment, and increased risk of a possible pandemic and/or fatalities.

Aims/Objectives: The aim of this study was to develop, implement and evaluate an evidence-based biohazard training program-using the Identify, Isolate and Inform (3I) tool within a pediatric urgent care center to increase the staff’s knowledge, skills and confidence …

Implementing A Digital Imaging Platform Using Tissue Analytics In A Level 1 Trauma Center, Victoria Donaldson, Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: More than 2.5 million people develop pressure ulcers (PUs) annually. PUs cost the U.S. $9.1-11.6 billion per year and add about $43,180 to a hospital stay. The Centers for Medicare Medicaid Services (CMS) stopped reimbursement for hospital-acquired pressure ulcers (HAPUs). Documentation of PUs must indicate if they are present on admission (POA) and include accurate stages and treatment plan of PUs. Aims/Objectives: To use Digital Imaging platform using Tissue Analytics (TA) along with the standard care protocol. The objectives of this study were to (1) Improve identification of PUs, (2) Increase accuracy of PU staging and (3) Improve documentation …

Nurse’S Perception Of Safety Culture And Patient Safety Following Implementation Of A Handoff Communication Process Between Pre-Operative And Operating Room Nurses, Tracy Willett, Msn, Mba, Rn, Nea-Bc, Cnor

Doctor of Nursing Practice Projects

Background: In a hospital environment the care of the patient is transferred multiple times during his or her stay. Current needs assessment indicates that nurses’ perception of safety culture with handoff communication and patient safety is an area of focus for the practice site.

Objectives: This study aimed to improve the Pre-operative and Operating Room nurses’ perception of safety culture measured with four valid and reliable survey questions. The second study’s aim was to improve patient safety with the handoff process, measured by the number of adverse events reported by the practice site.

Methods: Pre-implementation data was collected. Nurses worked …

Improving Patient And Provider Engagement By Utilizing Ask Me 3®, Joseph G. Smith, Msn, Arnp, Fnp Bc

Doctor of Nursing Practice Projects

Background: Patient and provider engagement in healthcare has an impact on health outcomes.

Purpose: To study the implementation of the Ask Me 3 (AM3) tool, a tool that encourages patients to ask three questions about their health to their care provider. The aim of the project is to explore the level of patient and provider engagement by patients` reports of their perception of engagement with their provider and in understanding their diagnosis.

Methods: The setting was a small urban family practice in the Pacific Northwest. Every patient that checked in for their appointment, excluding pediatric and younger than 18 years …

Utilizing A Mentorship Approach To Address The Underrepresentation Of Ethnic Minorities In Senior Nursing Leadership, Kimberly Jean-Louis, Msn, Mpa, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Many healthcare institutions have acknowledged the benefits of and the need for a workforce that reflects the diverse patient populations they serve. However, few healthcare organizations have made progress in increasing the diversity of their leadership teams. The American Hospital Association’s Institute for Diversity in Healthcare Management (2016) found that while minorities represent 32% of hospital patient populations across the nation, they only account for 11% of executive leadership. The objective of this DNP project was to implement a 4-month mentorship program that empowered minority nurse leaders who desire career advancement to executive leadership roles and provide them with realistic …

Increasing Chlamydia Trachomatis And Neisseria Gonorrhea Screening Among Women 15 To 24 Years Old Using A Multifaceted Approach, Mackenzie Shireman

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC) (2017a) estimates that one-quarter of sexually active people are between 15 and 24 years old, but account for half of 20 million sexually transmitted diseases (STD) reported annually in the United States. Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) are the most common reportable STDs (CDC, 2018). The purpose of this project was to increase CT/NG screening rates among sexually active, nonpregnant women 15 to 24 years old within the primary care setting through colleague education, routine sexual history taking, and indicated testing. A 30-minute colleague in-service was provided to educate clinical …

Implementation Of A Heart Failure Discharge Guide And Its Effects On Patient Self-Care, Nickelow Carlton

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Heart failure (HF) is a chronic progressive disease that, if not managed adequately, may result in complications including rapid disease progression, frequent hospitalization, and early death. The prevalence of HF related deaths in Muscogee County, Georgia is the highest of all counties in Georgia. Additionally, Georgia is a state with one of the highest prevalence of heart- related diseases in the United States (Centers for Disease Control, 2016). The purpose of this translational project was to identify a standard HF discharge guide to implement on admission and determine if implementation increased self-care in HF patients after discharge. Self-care management …

Learning Lean To Lead, Krystle Irene Guenther

Doctoral Projects

This project sought to see if training frontline nurses and physicians together in Lean methodology improved collaboration between the two disciplines while giving them the tools they need to lead change at the bedside and in their practice. A quasi-experimental pre- and post-intervention methodology was used. The intervention was six, four-hour in-person modules on performance improvement (PI). Respondents completed two surveys, the performance improvement instrument and the Professional Practice Environment Assessment Scale (PPEAS). Surveys were paired for analysis. There was a statistically significant median increase in participants confidence for all questions on the PI instrument post-intervention. Results for the PPEAS …

The Mental Health Experience Among Parents Of Children With Autism, Thao Tran

Doctoral Projects

Parents of children diagnosed with autism spectrum disorder (ASD) face challenges, stress, and mental health issues than parents of children without autism. Mental health experience of parents in underserved communities are not adequately studied. This qualitative study used a phenomenological approach to understand the mental health experience of eight parent caregivers residing in San Joaquin Valley, California. All parents reported the journey was stressful but not all parents described the point when they received the diagnosis as being more stressful than before and after the ASD diagnosis. Parents’ responses to the semi-structured interview that assesses for the degree of ambiguous …

Evaluating The Experience Of Patient And Provider Satisfaction In Participation In A Hybrid Virtual Perinatal Care Model In A Private Practice Setting, Gretchen Ann Delong Nelson

Doctoral Projects

Improving access to health care in general and to appropriate prenatal care specifically are two leading health indicators (LHI) as designated by Healthy People 2020 (U.S Department of Health and Human Services, 2010). The California Department of Public Health (CDPH) also prioritizes minimizing health disparities that prevent women from entering into prenatal health care (CDPH, 2019). In Fresno county, transportation to specialty care such as perinatal care has been identified as a barrier (CDPH, 2017). The American College of Obstetricians and Gynecologists (ACOG) and The American Academy of Pediatricians (AAP) have identified a standard of fourteen to sixteen visits for …

Screening Of Acute Stress Disorder (Asd), Katie Bergan Adn, Rn, Eva Marte Adn, Rn, Ashley Young Adn, Rn

Patient Care Services / Nursing

No abstract provided.

Increasing Staff Compliance With Preterm Neonatal Standardized Prone Positioning Tool, Nicole Conover Bsn, Rn, Gabrielle Morena Bsn, Rn, Kelly Staub Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

My Safety Plan, Kadeshur Strickland Rn, Kristin Ballenger Rn, Emily Albinson Rn, Pamela Trimper Rn

Patient Care Services / Nursing

No abstract provided.

Compassion Fatigue, Richard Roller Rn, Erin Kellow Rn, Madeline Thurwanger Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Making Change In Medical Errors In The Emergency Department, Devon Green Bsn, Rn, Soo Jin Han Bsn, Rn, Kaitlyn Kilroy Bsn, Rn, Danielle Michlovsky Bsn, Rn, Amy Min Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Pressure Injury Prevention With Proper Wedge Use In The Emergency Department, Kristen Fitzsimons Bsn, Rn, Jacqueline Mee Bsn, Rn, Noelle Noble Rn, Jordan Taffel Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Is Bed Alarm Activated?, Roosevelt Totaye Rn, Doris Amo-Mensah Rn, Yan Yang Rn, Bonnie Emmett Rn

Patient Care Services / Nursing

No abstract provided.