Nursing Commons^™

Implementation Of Diabetic Foot Care Education Quality Improvement Project, Mitaliben R. Gor, Msn Aprn Fnp-C

Doctor of Nursing Practice Projects

Background: A diabetic foot ulcer is a major complication in diabetes mellitus that results in increased mortality, morbidity, costs, and reduced quality of life. In 2015, the prevalence of diabetic foot ulcers was estimated by the International Diabetes Federation to develop annually among 9.1 million to 26.1 million people with diabetes worldwide. Diabetic foot care has economic consequences due to the expenses related to the treatments that arise from prolonged and recurrent hospitalizations and social problems from employment losses.

Purpose: The purpose of this project was to implement diabetic foot care education among diabetes patients in the clinic as a …

Adoption Of Evidence-Based Practices In Stroke Transitions Of Care, Sabena Passarello, Rn, Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Stroke is a leading cause of mortality in the U.S. Individuals who suffer from stroke or transient ischemic attack are at risk for further cerebrovascular events. Prevention requires thorough diagnostic evaluation and care coordination, particularly from inpatient to outpatient settings. Transition of Care programs are effective methods for developing long-term treatment, establishing follow-up, and preventing further complications.

Aims/Objectives: The project purpose was to integrate evidence-based recommendations into a Transitions of Care program for patients with ischemic stroke or transient ischemic attack. The aims were to evaluate whether implementation of Stroke Transitions of Care improved outpatient follow-up and stroke readmission …

A Multi-Faceted Quality Improvement Project Amid A Global Pandemic: Improving Guideline-Consistent Cervical Cancer Screening Rates And Provider Knowledge Of Abnormal Cervical Cancer Screening Results During Reactivation Of A Metro Family Practice Clinic, Taylor Villwock, Agpcnp-Bc

Doctor of Nursing Practice Projects

Background: Despite the evidence-based value of cervical cancer screening, recent updates to guidelines, and general availability of the Papanicolaou (Pap) test, guideline-adherent screening rates remain low. The COVID-19 pandemic further impedes progress as preventive healthcare is delayed and patients are reluctant to enter healthcare facilities.

Objectives: The purpose of this project was to evaluate if provider education and patient reminder letters comprising written education and risk-mitigation efforts improved cervical cancer screening rates and increased providers’ knowledge of appropriate follow-up during reopening of a metro family practice clinic amid the COVID-19 pandemic.

Methods: A multi-faceted quality improvement project included a 3-month …

Increasing Mental Health Competency In School Nurses, Jennifer M. Walsh Msn, Cpnp, Cne

Doctor of Nursing Practice Projects

Background: Mental health concerns in the pediatric population have increased over recent years, even more so due to the COVID-19 pandemic. Time from onset of symptoms to treatment is over eight years, leaving less than 25% receiving care. Virginia ranks 47th for pediatric mental health care. School nurses spend a significant amount of workload on MH issues but often report being untrained to deal with these issues. Aims: Implement a quality improvement pilot program for school nurses designed to increase competency of identification, management, and referrals for students with mental health concerns. Outcomes measured domains of knowledge, attitude, and competency …

Prep Education Intervention, Kristina Jung Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The nation’s HIV infection rate is alarming, yet only a small percentage of eligible individuals are prescribed pre-exposure prophylaxis (PrEP). This sluggish PrEP uptake may be related to lack of knowledge among non-HIV specialist providers. Thus, interventions toexpand providers’ use of PrEP as an HIV prevention strategy are needed.

Objectives: The project aim was to develop an intervention to improve retail nurse practitioners’ (NP) knowledge for PrEP clinical practice, comfort screening for “at-risk HIV” patients, confidence prescribing PrEP, and likeliness to prescribe PrEP in the next six months.

Methodology: An online PrEP tutorial was implemented for retail clinic NPs. …

Improving Nurse Manager Job Satisfaction: An Urban Academic Quality Improvement Project, Patricia A. Winston, Ms, Rn, Nea-Bc, Fache

Doctor of Nursing Practice Projects

Background: It is important that the nurse managers are able to contribute to organizational vision, mission, and goals by influencing others, sharing the vision, and implementing it (Boyce, 2018). They are pivotal to the successful accomplishments of the hospital mission. The issue of recruiting, developing and retaining nurse managers is one that challenges many health care institutions, hospitals, hospitals, and health systems. The literature regarding this concern was reviewed and the paucity of useful science in this regard led to question of how to improve the job satisfaction and job retention of nurse managers at urban academic medical centers.

Objective: …

Quality Improvement Initiative: Implementing A Nurse Peer Mentorship Program, Vepuka E. Kauari

Doctor of Nursing Practice Projects

Introduction: Formal mentoring programs are valuable experiences for the mentor and the mentee. They provide nurses with the ability to develop professional networks while refining their competency. Nurses should be properly mentored in focusing skills in addition to addressing their emotional needs. The purpose of this quality improvement project was to promote and evaluate the effectiveness of an existing mentoring program on intent to stay, perceived competency, and job satisfaction.

Methods: Institutional Review Board approval was obtained. A convenience sample of new nurses with less than 2 years’ experience in an academic medical center was recruited to assess their intent …

The Effect Of Covid-19 On The Mental Health Of College Athletes, Molly Mcardle

Senior Theses

This research aimed to explore how the mental status of student athletes at the University of South Carolina has been affected by the unprecedented COVID-19 pandemic. A total of 61 student athletes between the ages of 17 and 24 participated in the study and completed a series of questions including the Depression-Anxiety-Stress Scale 21 (DASS-21) and the Group Environment Questionnaire (GEQ). Independent samples t-tests and descriptive analyses were used for comparisons between gender and age. The results showed that female athletes reported statistically significantly higher levels of anxiety and stress than male athletes (p = 0.049 and p = …

The Effects Of Sleep Deprivation On Work Performance Amongst Night Shift Nurses, Hannah Pham

Nursing | Student Research Posters

The aim of this study is to identify sleep hygiene and coping mechanisms utilized by night shift nurses and to determine its association in relieving sleep deprivation.

Health Disparities Associated With Pre-Existing Cardiovascular Disease And Telemedicine Interventions During Covid-19 Pandemic: Best Practice Review With Recommendations, Barbara Mae Madriaga

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based evidence brought forth by other researchers and scientists. The first goal was to determine current health care disparities associated with COVID-19 and pre-existing cardiovascular disease. The second goal was to determine current recommendations of COVID-19 and pre-existing cardiovascular disease. The third goal was to determine the use of telemedicine during this pandemic for cardiovascular interventions.

Background: In the United States, heart disease has been the leading cause of death for most racial and ethnic groups. The COVID-19 pandemic has revealed deeply rooted inequities …

The Evaluation Of The Brøset Violence Checklist (Bvc) And Interventions To Reduce Patient Violence Incidents Occurring In The Emergency Department, Grace D. Yoon, Dnp, Rn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Patient violence in healthcare is an issue across many departments, but many staff members in the emergency department (ED) are directly affected by violent incidents.

Objectives: Three primary purposes determined the success of this Quality Improvement (QI) project: 1) to evaluate the effectiveness of utilizing the Brøset Violence Checklist (BVC) and implementing appropriate interventions to reduce the number of physical assault occurrences against healthcare providers in the ED; 2) to assess if there was an increase in reporting patient violence incidents; and 3) to assess for any improvements in perceived safety in the ED among the nurses.

Methods: Adult …

Implementation Of Capnography Monitoring To Improve Outcomes Among Intensive Care Unit Patients On Patient-Controlled Analgesia Or Opioids, Leslie Smith, Msn, Bmtcn, Aocns, Aprn-Cns

Doctor of Nursing Practice Projects

Background: Patient-controlled analgesia (PCA) administration of opioids is associated with risk for respiratory depression. Capnography is a non-invasive way to identify early respiratory depression and prevent adverse patient events.

Purpose: This project evaluated the effectiveness of capnography versus standard monitoring in reducing adverse events among patients admitted to an intensive care unit (ICU) who were prescribed PCA opioids and evaluated patients at high-risk for respiratory depression according to age, gender, diagnosis, co-morbidities, and type of opioid prescribed.

Methods: This project used a pre- and post-intervention design to compare differences in the number of adverse events among 20 adult patients …

A Quality Improvement Initiative To Engage Older Adults In The Discharge Process Using The Ideal Discharge Protocol, Ava D. Williams, Msn, Crnp Fnp-Bc

Doctor of Nursing Practice Projects

Background: Readmissions are costly and adversely affect patient outcomes. Readmissions significantly impact older adults’ ability to manage post-discharge. Older adults are more likely to have challenges with understanding newly prescribed medications after discharge and therefore are less compliant with medications. Older adults are also less likely to follow-up with their primary care physician after discharge. Engaging patients and families in a collaborative discharge process is a key foundational element needed to improve patient outcomes and reduce avoidable readmission rates.

Purpose: This quality improvement initiative engaged patients and families in an evidence-based discharge protocol to reduce avoidable readmission over three months. …

Symptoms And Comorbidities Of Older Adult Lung Cancer Patients In The 2017 Medicare Claims Data, Noelle A. Herrier, Kathleen A. Griffith, Alice S. Ryan, Beth B. Hogans

GW Research Showcase 2021-2026

No abstract provided.

Design And Implementation Of A Nursing Peer Review Program In A Two-Hospital Setting, Joan L. Goss Ms, Rn, Acns-Bc

Doctor of Nursing Practice Projects

Background and Purpose: The Institute of Medicine’s (IOM) landmark publication To Err Is Human: Building a Safer Healthcare System measured the impact of medical error on the American public in both unnecessary human suffering and unsustainable financial cost to the US healthcare system. Nursing literature suggests that peer review of safety events can help mitigate the impact of medical errors by increasing nurse accountability for practice and empowerment for leading change.

Methods: Fourteen volunteers were selected from over 900 direct care nurses to participate in a four-month Nursing Peer Review Program (NPRP) pilot. Structure, process, and outcome measures of implementation, …

Effectiveness Of Community-Based Hemorrhage Control Education, Kristin Conti Dnp, Aprn, Fnp-C, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Rural residents are 14% more likely to die from an injury than their urban counterparts due to untimely and ineffective prehospital treatment, inequitable access to the most comprehensive trauma centers, and a lack of injury prevention programs. Although bystanders with bleeding control (BCon) knowledge and skills are vital to injury survival, only 0.5% of Idahoans have completed STOP THE BLEED®.

Purpose: Implement an evidence-based BCon course on how to identify and control life-threatening bleeding with pressure, packing, and tourniquets to increase willingness, confidence, and BCon knowledge, while decreasing concerns.

Methods: A pre-post same subject design was used. Participants were …

Heart Failure Management In A Skilled Nursing Facility, Leigh T. Simpkins

Doctor of Nursing Practice Projects

Background: Reducing heart failure hospital readmissions remains a priority for health systems and is a marker of quality for the Center for Medicare and Medicaid Services (CMS). Heart Failure is the most common cause of U.S. hospital admissions and an effective management program in the nursing home setting is crucial for quality and outcomes.

Purpose: The purpose of this project was to implement and evaluate a Nurse Practitioner/Physician supported heart failure management program in a skilled nursing facility that is able to be incorporated into facility staff workflow, enhances nursing staff knowledge of heart failure, improves identification of patients with …

A Dnp Quality Improvement Project Addressing Low Hiv Testing Rates Of College Students, Kimberly Griffin

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

Abstract

The overall HIV testing rate is very low in the United States. HIV is easily preventable with safe sexual practices, and early HIV screening is effective in identifying individuals affected and assuring linkage to care. The rate of HIV testing among college students reflects the low numbers of the national average. This quality improvement project evaluated attitudes towards HIV testing of undergraduate college students. The project aimed to determine attitudes of college students towards testing as well as relationships between demographic factors, frequency of HIV testing, and attitudes towards testing. A total of 99 undergraduate college students participated in …

Promoting Civility In The Workplace: Addressing Bullying In New Graduate Nurses Using Simulation And Cognitive Rehearsal, Sandy Phan

Doctoral Projects

Bullying continues to be a widespread, devastating problem in nursing. Research indicates that bullying has a negative, rippling impact on nurses, organizations, and patient care. This evidence-based practice project aimed to enhance new graduate nurses’ abilities to identify and respond to bullying behaviors. The intervention used a mixed educational methodology of didactic, simulation role-play, and cognitive rehearsal. The project was implemented at a large academic healthcare system in Northern California. Outcomes were evaluated using Kirkpatrick levels 1-4 and the Clark Workplace Civility Index (CWCI). Participants reported that the educational intervention met intended learning objectives, enabled them to apply learned behaviors …

The Effects Of Virtual Reality On Symptom Distress In Patients Undergoing Hematopoietic Stem Cell Transplant, Colleen Vega, Robin Whitney, Josef Hannah, Grant Smith

Doctoral Projects

The purpose of this QI project was to evaluate the effects of virtual reality (VR) on symptom distress experienced by individuals receiving an allogenic stem cell transplant. Allogenic transplants are associated with a moderate to high risk for distressing symptoms such as depression, anxiety, and pain. VR targets multiple sensory modalities, including auditory, visual or haptic experiences, by using computer-generated scenarios, which can interact with an individual and possibly diminish unpleasant symptoms. Twenty individuals aged 19 to 70 years (median age of 56.5 years) who were hospitalized in an academic setting received VR up to two sessions a week for …

Improving Handover Process For Stroke Patients Transferring From Emergency Department To Interventional Radiology: A Quality Improvement Project, Megan Buchman

Doctoral Projects

Background: A standardized handover process is needed for stroke patients transferring from the Emergency Department to Interventional Radiology.

Local Problem: Emergency Department and Interventional Radiology had different handover processes.

Methods: A quality improvement project was conducted in a large Magnet® designated midwestern health system. Participants included emergency department and interventional radiology nurses and stroke patients. Pre/post-quality and post implementation measures were obtained.

Interventions: The interventions included utilizing a standardized handover tool between departments, calling report prior to patient transfer, and turning in handover tool following stroke case to ensure compliance. Two cycles of the Plan-Do-Study-Act Cycle were completed.

Results: No …

“Warm Handoff” To Increase Enrollment In A Maternal Infant Health Program, Samantha Worthem

Doctoral Projects

Introduction: In a Midwest Health Department’s (HD) Maternal Infant Health Program (MIHP), infant death rate has been on a steady incline at 4.8 deaths per 1,000 in 2019 (Michigan Department of Community Health, 2020). Implementation of a “warm handoff” between the local HD and Michigan Department of Health and Human Services (MDHHS) was created to increase enrollment and visits. During warm handoffs, health care providers work together within the same setting to provide evaluation and care to patients and clients (Musselman et al., 2018).

Methods: This program evaluation reviewed data retrospectively from March 31 to September 30, for 2019 and …

Enteral Nutrition Protocol For Pediatric Burn Patients: A Quality Improvement Initiative, Margaret Tepe

Doctoral Projects

Objective: This quality improvement project was conducted to determine the efficacy of an enteral feeding protocol to improve nutrition supplementation in pediatric burn patients.

Methods: Non-ICU patients with >10% total burn surface area requiring enteral nutrition supplementation were fed within 12 hours of admission or with the first sedated dressing change, whichever took place first. Pre (n = 3) and post (n = 5) implementation of the enteral feeding protocol data were obtained. Data were collected via chart audit and survey.

Results: Patients and nurses had similar characteristics; and nurses had similar nutrition practices. Total intake of calories (93.8%) and …

Improving The Screening And Care Of Hospitalized Adults With Obstructive Sleep Apnea Through Standardized Workflow Processes, Elizabeth Henschel

Doctoral Projects

BACKGROUND: Adults can be screened for obstructive sleep apnea in acute care settings using the validated STOP-BANG questionnaire. Healthcare providers can treat patients with confirmed or suspected obstructive sleep apnea to reduce risk for complications during hospitalization or after surgery.

PURPOSE/ RELEVANCE TO HEALTHCARE QUALITY: To determine if the standardization of obstructive sleep apnea screening and patient care workflows improves process efficiency saving nursing time and healthcare expenses.

METHODS: Quality improvement project included an organizational assessment of healthcare system setting to define clinical problem; determined appropriate evidence-based interventions; and implemented strategies guided by quality improvement models.

INTERVENTION: Updated inpatient units …

A Budget Impact Analysis Of A Tobacco Control Program In A Community Mental Health Clinic, Thuy-Nhi Nguyen

Doctoral Projects

Objectives: This project evaluation aimed to determine if the tobacco cessation program, American Lung Association’s Freedom From Smoking (ALAFFS), within the designated community mental health organization (CMHO) is affordable and sustainable through a budget impact analysis.

Methods: The study modeled the impacts on the costs of facilitator training, staff salaries/time, program workbooks, program supplies, bus passes, and other supplies and materials. The Medicaid reimbursement rate used for tobacco cessation group therapy was included. The budget impact analysis projected financial consequences of the presence of training costs and number of smokers with severe mental illness who attended the program.

Results: The …

Improving Care Coordination For The Homeless Population Using Systematic Quality Improvement, Rutendo Nyasvisvo

Doctoral Projects

Background and Objectives: Care coordination for the homeless population is challenging due to the complexity of healthcare and the uncertain life circumstances of the homeless individual. Objectives were developed to guide care coordination for the homeless by utilization of the free clinic to create PCP referrals, appointments and tracking follow-up care to increase appointment attendance and improve health outcomes for the homeless individual.

Design: A quality improvement project.

Setting: A faith-based non-profit homeless shelter organization in the Midwestern United States.

Participants: Participants include 25 homeless guests, 5 staff members including a clinic coordinator, 3 registered nurses and 1 licensed practical …

Sickle Cell Disease: Development Of An Acute Pain Management Program In A Hematology/Oncology Practice, Elizabeth Pohl

Doctoral Projects

Background: Patients with sickle cell disease experience can experience acute episodes of severe pain that require prompt pain medication. Treating uncomplicated, acute sickle cell disease pain in the emergency department setting has been shown to be costly and lead to higher rates of hospitalization than similar care in a dedicated outpatient setting.

Objectives: The aim of this article is to outline the program development efforts undertaken to apply current literature findings and evidence-based practice guidelines to create a program development toolkit and business plan for a sickle cell disease acute pain management program in an outpatient hematology practice.

Methods: A …

Utilizing Educational Materials To Change Vaccine Compliance In Children Under 24 Months Of Age, Kelsey M. Arnold

Doctoral Projects

Background: Childhood vaccinations are critical to preventative care for the pediatric population. The goal for the clinic’s combination 10 insurance quality measure, which reflects the number of fully vaccinated children by 24 months of age, is to be greater than 68%.

Purpose: This quality improvement project sought to implement evidence-based interventions to improve childhood vaccine compliance by increasing the parent/caregiver’s knowledge about vaccines and increasing the communication with their healthcare provider.

Methods: A parent friendly vaccine schedule, information pamphlet, interactive video, and survey were given to parents/caregivers during well-child visits. A total of 117 parent/caregiver surveys were collected. Vaccine compliance …

Addressing Social Determinants Of Health In Community-Based Palliative Care, Mary D. Chenge

Doctoral Projects

Background and Objectives: Addressing social determinants of health (SDOH) in the medical community has recently started; however, there is yet to be a standardized format for addressing the social needs of patients. Consequently, a protocol was developed to address SDOH to increase screening rates, social work referrals, and capture depression reimbursement.

Methods: The quality improvement project was implemented using the Plan-Do-Study-Act framework at an urban Community-Based Palliative Care organization in the Midwestern United States. Participants included office staff and 140 patients (two separate sets of 70 randomly selected patients pre/post-implementation). A protocol was developed for screening 11 SDOH using an …

Laboratory Techniques In Public Health: Bi-520 Introduction To Public Health Lab Manual, Anuradha Srivastava

Open Educational Resources

This laboratory manual for a foundations course Public Health is unique in the sense that very rarely, a foundations course in the field has a lab component offered with the lecture. This lab manual provides basic laboratory exercises that could be useful to introduce undergraduate students to the basics of public health laboratory practices.