Nursing Commons^™

Screening For Adverse Childhood Experiences In An Adult Intensive Outpatient Therapy Program: A Pilot Project, Kristen Curry

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to pilot the implementation of the Adverse Childhood Experiences (ACEs) Questionnaire for Adults during admission to an intensive outpatient program (IOP) to identify clients who have experienced ACEs and provide risk-reduction measures to mitigate risks of ACE-related long-term health consequences. The study site is a Southern California-based large healthcare organization that provides outpatient intensive therapy programs which employ a variety of clinicians, to provide mental health care to clients across the lifespan.

Background: Adverse Childhood Experiences (ACEs) are potentially traumatic events including neglect, abuse, and certain forms of …

Improving Hypertension Outcomes In A Rural Community With The Use Of Remote Patient Monitoring, Jessica Ruiz Cuen

Doctor of Nursing Practice Final Manuscripts

Hypertension (HTN) remains one of the leading causes of premature death. Uncontrolled HTN is known as the “silent killer,” affecting 1.28 billion adults worldwide. Management of this chronic disease requires early detection, intervention, and, most importantly, patient involvement. Recent advancements in Telehealth medicine have identified Remote Patient Monitoring (RPM) as an essential avenue in managing HTN. This project aimed to improve patient outcomes by reducing blood pressure readings and emergency room visits. This evidence-based project used the Iowa Model and examined the effects of daily remote blood pressure measurements using the transmission of biometric data using a Bluetooth-operated device linked …

Implementation Of Controlled Substance Agreements In An Adult Outpatient Psychiatric Clinic, Bryana Weimer

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.
Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most …

School Stock Albuterol, Trish Reyes

Doctor of Nursing Practice Final Manuscripts

SCHOOL STOCK BRONCHODILATOR INHALER POLICY FOR IMMMEDITE ACCESS IN SCHOOLS

Introduction: The purpose of this evidence- based practice DNP project was to do a systematic review, examine stock inhaler policies in school districts, and provide policy recommendations for school districts to implement the Stock Albuterol Access law. The Stock Albuterol law enacted in January 2024 would allow schools to provide an Albuterol inhaler on hand for a student experiencing respiratory distress. Albuterol inhalers provided by school personnel can be lifesaving, control asthma symptoms, have better health outcomes, increase the quality of life, and decrease Emergency and Urgent Care visits, and …

Implementing A Naloxone Training And Opioid Overdose Prevention Program At A Residential Addiction Treatment Center, Martha Plack

Doctor of Nursing Practice Final Manuscripts

Introduction: Amidst the escalating opioid overdose crisis in the United States, it is imperative to deploy effective harm-reduction strategies. This Doctor of Nursing Practice (DNP) project involved the development, implementation, and evaluation of a Naloxone Training and Opioid Overdose Prevention Program delivered to clients at a residential addiction treatment center. The primary objective of this project was to determine if the educational intervention led to an improvement in participants' knowledge and attitudes about opioid overdose and naloxone use.

Background: Overdose fatalities are a leading cause of injury-related death in the United States. The majority of fatal overdoses involve opioids. Unfortunately, …

Keep The Beat: Increase Sudden Cardiac Awareness And Improve Cardiac Arrest Bystander Intervention, Carley Garnica

Doctor of Nursing Practice Final Manuscripts

Background: Sudden cardiac arrest (SCA) is a rare but life-threatening condition where a person’s heart stops suddenly. It remains the leading cause of death on school campuses with chances of survival being less than 10%. Every minute without cardiopulmonary resuscitation (CPR) decreases survival by 10%. Poor outcomes are attributed to bystanders who are not prepared or are unwilling to take action in the event of a cardiac emergency. Therefore, bystanders play a crucial role in cardiac arrest.

Objectives: The purpose of this project was to educate high school students about SCA and Cardiac Chain of Survival, with the primary objective …

Impact Of Mindfulness Education And Resources On Stress In Parents Of Children With Autism Spectrum Disorder, Jacqueline James

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.

Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental …

Dm Education On Lifestyle Modification To Improve Dm Knowledge Retention And Self-Care Confidence, Jinyoung Sanchez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice project was to provide diabetes education to improve diabetes knowledge and self-care confidence for patients with type 2 diabetes admitted to a tertiary hospital in San Diego. First, this study was to assess their DM knowledge and self-confidence before the education was provided. Second, based on the initial assessment and the education on lifestyle modification, 3 months of follow up was assessed to see if the education had been effective. Third, the study was to determine if the education also improved the self-confidence in managing diabetes on their own.

Background: Uncontrolled diabetes …

There’S An App For That: Reducing Stress In Peri- And Post-Menopausal Women, Roxane M. Brown, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based Doctor of Nursing Practice project aimed to demonstrate the impact of Calm mobile application mindfulness activities on perceived stress levels in peri- and post-menopausal women ages 45 - 60 years old in a community setting.

Background: In 2020, 31.8 million women in the United States (U.S.) were between 45 and 60 years old. They are mothers, daughters, employees, and bosses, navigate intimate and social relationships, and are often caregivers. It can be a stressful stage of life. Meanwhile, these women experience menopausal changes, including hot flashes, mood changes, sleep disturbances, and cognitive difficulties. Peri- and post-menopausal women …

Keep Our Children Smiling: Fluoride Varnish Education In The Pediatric Primary Care Setting, Isabella Mortola

Doctor of Nursing Practice Final Manuscripts

Background: Dental caries is the most common chronic childhood disease. In early childhood, it is associated with many negative factors such as pain, loss of teeth, and impaired growth. Fluoride varnish (FV) is a protective resin coating treatment that is reimbursable by most insurances and is recommended by the American Academy of Pediatrics (AAP), United States Preventative Services Task Force (USPSTF), and the American Dental Association (ADA) due to its high efficacy in preventing dental caries. FV is a low-cost treatment that can be easily applied in 1-2 minutes during a well-child visit in the primary care setting, where children …

Personalized Text Message Reminders For Psychiatric Out Patients, Jusac Suryanata

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the use of personalized text message reminders to increase adherence to out-patient psychiatric visits and decrease the rate of no-show appointments. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians to provide mental health care to clients across the lifespan for a variety of patients throughout all socio-economic brackets.

Background: Approximately 23% of individuals who are scheduled with this provider result with a no-show appointment during the period of data mining. In general, psychiatric patients are most …

Clinical Nurse Manager Fatigue And Its Personal And Professional Impacts, Carlene Galanopulo

Walden Dissertations and Doctoral Studies

Workplace fatigue has been empirically linked with errors, injuries, and chronic health issues that negatively impact the healthcare worker, patients, and staff with whom that person comes in contact, as well as the organization for which that person works. The experience of fatigue in clinical nurse managers (CNMs) has been understudied. The purpose of this study was to understand the individual experience of fatigue and its professional and personal impacts as more fully described by CNMs. The research question that guided this study involved the professional and personal impact of fatigue as described by CNMs. The occupational fatigue in nursing …

Fall Reduction In The Home Setting For Older Adults: An Evidenced Based Practice Project, Alison Birnie

Doctor of Nursing Practice Final Manuscripts

Falls in the elderly over the age of 65 are the highest mechanism of injury in a Level II TraumaCenter in the SanGabriel Valley. In reviewing the data from 2021-2022, there were 20,653 patients over the age of 65 that arrived in the EmergencyDepartment, 12.3% of those patients had falls. The Senior Care Network is a service line of Huntington Hospital whose mission is to support the health and well-being of older adults living in and around Pasadena and the San Gabriel Valley. To meet this mission, the Multipurpose Senior Services Program (MSSP) supports community members 65 and older covered …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Assessing The Influence Of Education And The Diet Readiness Test On Self-Efficacy, Motivation And Resilience In Overweight Women, Ijeoma Iwu

Doctor of Nursing Practice Final Manuscripts

Purpose

The purpose of this evidence-based project is to assess motivation for weight loss and resilience to make lasting changes with weight management. The Diet Readiness Test (DRT) Questionnaire is a behaviorally based assessment tool used to evaluate psychological status prior to or during a weight-loss management program based on patients’ attitudes toward diet and exercise. The goal of using this survey was to identify predictive factors of successful weight changes for practitioners to implement into their approach to tackling obesity.

Background

One of the rising crises both in the United States and globally has been the topic of obesity. …

Education Program To Increase Compliance With Advance Directive Completion In A Primary Care Setting Among Filipino Americans, Genalin Paglingayen

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This evidence-based practice project aimed to provide an education program to Filipino Americans in their preferred language (English or Tagalog) to improve compliance with Advance Directive (AD) completion in a primary care setting. Educating them about AD empowers patients with their decision-making about their health in situations where they are incapacitated and unable to make sound decisions. Moreover, it will eliminate the decision-making problem for family members.

Background: An advance directive is a document that empowers patients to convey their wishes to their healthcare provider when they can no longer decide for themselves. Evidence suggested that …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

Increasing Patient Access To Mental Health Providers: Improving Depression And Anxiety Outcomes For African American Women Aged 18 Years Old And Older, Twanna Davis-Arnold, Farnaz Trasandes

Doctor of Nursing Practice Final Manuscripts

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis …

Lived Experiences Of Quality Of Life Among Makonde Immigrants In Kenya During And After The Covid-19 Pandemic, Shem Migosi Kenyanya

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic affected Makonde immigrants’ health and quality of life around the world more than any other previous event. This descriptive qualitative study aimed to contribute knowledge and understanding of the lived experiences of Makonde immigrants and their health and quality of life during and after the COVID-19 pandemic. Shye’s systematic quality of life model served as the theoretical basis for the study, along with Wilson and Cleary’s conceptual model of health quality of life. Semi-structured interviews were conducted with ten participants recruited through social media and flyers posted in Kilifi and Kwale counties. Subjects were interviewed face-to-face and …

Challenges And Opportunities In The Uptake Of Simulation In Healthcare Education In The Developing World: A Scoping Review, Faisal Wasim Ismail, Khairulnissa Ajani, Syed Mujtaba Baqir, Ahmed Nadeem, Rayyan Qureshi, Pammla Petrucka

Centre for Innovation in Medical Education

Background: Simulation is increasingly being adopted by healthcare educators throughout the developed world as it offers a safe environment to practice skills. While there is literature on learning via simulation in healthcare in the developed world, more studies are required to investigate the factors influencing this approach in the developing world.
Objective: This scoping review highlights the key factors that act as deterrents as well as encouragement to the uptake of simulation as a teaching methodology in healthcare education in developing countries.
Design: The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and …

Short- And Long-Term Predicted And Witnessed Consequences Of Digital Surveillance During The Covid-19 Pandemic: Scoping Review, Leigha Comer, Lorie Donelle Phd, Rn, Fcan, Bradley Hiebert, Maxwell J. Smith, Anita Kothari, Saverio Stranges, Jason Gilliland, Jed Long, Jacquelyn Burkell, Jacob J. Shelley, Jodi Hall, James Shelley, Tommy Cooke, Marionette Ngole Dione, Danica Facca

Publications

BACKGROUND: The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). OBJECTIVE: We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. METHODS: Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Enhancing Community Engagement: Perspectives From Researchers, Community Members, And Service Providers, Anne-Marie O'Brien, Elyssa Wood

Virginia Journal of Public Health

Purpose: Compare and contrast perspectives from Research Team Members (RT), Community Members (CM) and Service Providers/Others (SP/O) about barriers and facilitators to community engagement and participation in health research.

Methods: A cross-sectional, descriptive survey study with a convenience sample of adults who lived and/or worked in the Commonwealth of Virginia was conducted between May and July 2022. Descriptive statistics and chi-square analyses were conducted to identify similarities and differences across the three stakeholder groups.

Results: A total of 303 participants were involved in this study. In general RTs, CMs and SP/Os were similar in their responses to perceived barriers and …

Evaluating The Implementation Of Biplane Ultrasound Probes For Guided Peripheral Intravenous Access In The Emergency Department, Ian Troupe

Doctor of Nursing Practice Final Manuscripts

Background: Single plane ultrasound (US) probes are currently standardized for initiating US guided peripheral intravenous (USGPIV) access for difficult intravenous access (DIVA) patients in the emergency department (ED). Emerging literature reveals the increased efficacy of biplane US probes for USGPIV access with an improved success rate of up to 36.6%.

Purpose of Project: Implement best practice recommendations by integrating one biplane US probe for USGPIV access at a Level 1 Trauma Center ED in Southern California after training ten registered nurses (RN) on its use. The project aimed to improve patient outcomes, department flow, RN education, and utilization …

Implementation Of Post-Operative Discharge Instructions To Outpatients In A Pre-Procedural Endoscopy Suite Prior To Sedation, Kalaya Valdez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project is to improve overall patient satisfaction scores, patient safety and education retention postoperatively. The aim is to provide patients with the opportunity to review their discharge instructions and seek clarification prior to their procedure.

Background: Roughly 75 million endoscopies are conducted annually in the United States. The majority, 68%, are gastrointestinal endoscopies. Routine endoscopy procedures such as a colonoscopy or esophagogastroduodenoscopy utilize moderate sedation which is often a combination of midazolam and fentanyl. This combination reduces anxiety and discomfort during the procedure. The amnesic effects …

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Faculty, Staff and Student Publications

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

Improving The Utilization Of Lunch Breaks For Nursing Staff, Norma Dawson, Kelsey Robinson, Bridget Miller, Deborah Monck, Beth Kessler

Operations Transformation

The Med-Surg Unit at LincolnHealth has a high number of nursing staff missing lunch breaks, despite encouragement and existing efforts to promote taking breaks. In addition, there are many instances where staff are not accounting for the breaks they have taken on their time sheets.

Facilitator Ethnicity And Clinical Judgement Among Senior Minority Students Using Unfolding Case Studies, Rachael King

Doctoral Dissertations and Projects

Unfolding case studies are a technique used in advancing critical thinking in order for nursing students to enhance their clinical judgement. The format at which they are delivered can influence the degree of learning, understanding, applying, analyzing, and evaluating for students, especially senior minority nursing students. This quasi-experimental posttest survey between-groups study involved implementing unfolding case studies with a randomly selected minority or non-minority facilitator video recording for senior minority nursing students. After completing the case study, all participants were given a posttest survey, the Clinical Decision Making in Nursing Scale (Jenkins, 1983). The survey evaluates students’ self-perceived clinical judgement. …

Adapting To Change: Adn Faculty Perspectives About The Future Of Adn Education: A Qualitative Case Study, Linda D. John

Doctoral Dissertations and Projects

The purpose of this qualitative, single case study was to offer more insight into how the adoption of the BSN as the entry-level for nursing practice affects the future ADN education and what the change means for ADN faculty at multiple programs throughout regions of the United States. Eleven ADN faculty were sampled to acquire their perspective about this phenomenon. Semi-structured, open-ended interviews enabled data collection. Rogers’ diffusion of innovation theory (DIT) facilitated an understanding about how ADN faculty are responding and adapting to the anticipated educational change. The central research question asked, “What is the perspective of ADN faculty …