Nursing Commons^™

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …

Community Healthcare Workers (Chw) High-Risk Stabilization Study: Does The Ability Of Chws At Mobile Covid Clinics To Link Patients With Uncontrolled Diabetes To A Physician Improve Short Term Outcomes?, Mo Hadaya, Venkateswar Venkataraman, Jaimy D. Jabon, Kenneth W. Stagliano, Richard T. Jermyn

Rowan-Virtua Research Day

Uncontrolled diabetes may cause preventable but significant effects. One major preventative measure is early screening; there are hopes that community healthcare workers can increase awareness and screening availability, especially in underserved populations. We hosted and recorded logs of patients at mobile COVID health clinics, educating those with uncontrolled diabetes and connecting them to healthcare. We then looked to see if any patients had improvements in blood glucose to non-diabetic levels. 378 patients were logged, but only 138 were in events that had a significant amount of repeat visits. Twenty-five of them had blood sugar indicative of uncontrolled diabetes. Out of …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross

Doctor of Nursing Practice Projects: College of Nursing

Background: Hospital-acquired pressure injuries (HAPIs) have been a longstanding problem in hospitals nationwide. HAPIs cause significant financial strain to a healthcare system and complications can be devastating to the patient.

Purpose: The purpose of this project was to implement the Standard Pressure Injury Prevention Protocol (SPIPP) 2.0 Checklist for patients in the Intensive Care Unit (ICU). The primary aim of this study was to determine if implementing the checklist would reduce the number of HAPIs.

Methods: This project took place over a four-week period at a Midwest hospital in the ICU. Data were collected via patient chart …

A Contextual Analysis Of Life Stories From Older Adults Participating In A Telephone Reminiscence Program, Eliana Likorama

Honors Scholar Theses

Life satisfaction, loneliness, and mental health & well-being are important factors to consider when working with the older adult population. This population is predisposed to many risk factors for mental health problems such as coping with a serious illness, losing a loved one, living alone, cognitive deficits, and more. Reminiscence is one simple, flexible, and cost-effective intervention that can be utilized to promote the mental health and well-being of older adults. Reminiscence is defined as the cognitive process of recalling the past. Numerous studies have shown beneficial effects of reminiscence in older adults: increased self-esteem, enhanced quality of life, increased …

Psychological Experiences Of Medical-Surgical Nurses Who Cared For Covid-19 Patients., Cecilia Dapilah

Walden Dissertations and Doctoral Studies

: The outbreak of COVID-19 caused unparalleled pressure that brought healthcare facilities and healthcare staff to their knees across the globe, causing multiple deaths and economic despondency. Several studies have documented the effects of COVID-19 on healthcare workers and facilities, but none have addressed the problem from the psychological perspectives of medical-surgical nurses, especially in developing countries. This study explored the psychological experiences of medical-surgical nurses who cared for COVID-19 patients in developing countries. The theoretical foundation that informed this study was the Schachter-Singer’s theory of emotions. A descriptive qualitative design used purposeful sampling to interview 10 medical-surgical nurses. Their …

Using A Novel Approach To Explore Women's Caesarean Birth Experience, Linda J. Deys, Valerie Wilson, Sara Bayes, Shahla Meedya

Research outputs 2022 to 2026

How a woman experiences birth is influenced by how she is treated, and who has power and control in the birthing environment. Focus on 'delivery' of an infant disregards the transformative event for the woman, with poorer physical and psychological outcomes. New evidence is needed to understand how to prevent trauma and improve maternal wellbeing.This paper presents a feminist methodology to view the lived experience of caesarean birth. Feminist birthing theories integrated with a phenomenological perspective provide insight for those working in maternity care and create a novel framework for researchers considering the position of women in a medicalised healthcare …

Improving Initial Management Of Acute Musculoskeletal Pain In The Emergency Department, Cynthia Y. Norris

Cohort XII

Background/Problem Statement: Acute musculoskeletal pain is one of the major chief complaints amongst Emergency Department (ED) visits each year. In the United States, approximately 41.9 million annual ED visits are musculoskeletal pain related (Fontánez, et al., 2021). Yet, data statistics demonstrate at least 40% of patients reported their pain remained unchanged during their presentation to an ED (Bussey et al., 2020).

Aims/Methods: At University Medical Center, site of the quality improvement project, a total of 91,455 ED annual visits were reported in the latest data reports (El Paso County Hospital District 2022 Annual Report, 2022). This paper chronicles the implementation …

Using Simulation To Enhance Undergraduate Nursing Education, Lori Prewitt Moore, Candice N. Selwyn

CoTL 2024 Posters

This poster presentation will discuss the implementation of simulation-based education in the undergraduate nursing curriculum to increase preparedness in caring for adolescent patients with symptoms of depression and suicidal ideation. This topic aligns with the conference’s theme by identifying the importance of introducing nursing students to urgent and life-threatening simulated healthcare events prior to graduation. The plan for this presentation is to impart information to others regarding the use of the International Nursing Association for Clinical Simulation and Learning’s standards of best practice when implementing innovative, simulation-based education for nursing students. The outcome and objectives for this presentation is to …

Second Victim Syndrome: Nurses Suffering In Silence, Matthew Riehm

Dissertations

Medication errors are inherent in health care due to human fallibility and inherent systemic complexities. Nurses are often unjustly blamed after committing a medication error despite the multitude of contributing factors. Formal education and healthcare organizations focus on preventing medication errors, but little has been done to support nurses involved in these tragic incidents. Recent cases, including RaDonda Vaught and Kimberly Hiatt, demonstrated the victimization of nurses after committing medication errors that plague the healthcare system potentially causing profound psychological trauma, often known as Second Victim Syndrome, SVS. There is limited research on the phenomenon of SVS in nursing due …

Impact Of Social Determinants Of Health On Skill Of Involvement: Differences In First Year Adn And Bsn Nursing Students In Rural Oklahoma, Cynthia Brown

Dissertations

The impact of Social Determinants of Health (SDOH) on Skill of Involvement (SOI) has not been adequately studied in nursing education. The skill of involvement is defined by Benner (2022) as necessary to expert-level nursing and it brings humanity, meaningfulness, acute situational awareness, and rapid thinking required for strong clinical decision-making in crisis management of the deteriorating patient. It is important for nurse educators to understand how SDOH impacts SOI on nursing students in order to transform the delivery of nursing education. The purpose of this study was to determine the impact of SDOH on SOIs in first-year nursing students …

The Association Between Emotional Intelligence, Empathy, And Social Determinants Of Health Among Accelerated Bachelor Of Science In Nursing Students: A Multi-State Cross-Sectional Descriptive Study, Kwanza Thomas

Dissertations

This study investigated the association between emotional intelligence (managing and understanding), empathy, and social determinants of health (SDOH) among accelerated Bachelor of Science in Nursing (ABSN) students. Despite the exponential increase in ABSN programs in the United States, little is known about the association between these variables among this nursing student population. A cross-sectional, correlational descriptive design was used to survey 104 students completing ABSN programs in Georgia, Mississippi, Philadelphia, and Texas. Participants self-reported their socioeconomic and programmatic characteristics using a researcher-developed questionnaire. Emotional intelligence (managing and understanding) was measured using two instruments, including the Situational Test of Emotional Management …

Using Motivational Interviewing To Increase Cpap Compliance, Karen Padilla Sanchez

Cohort XII

Background: Obstructive sleep apnea (OSA) affects one billion adults worldwide. Untreated OSA increases the risk of cardiovascular morbidity and mortality (Watach et al.,2021). OSA cost the United States approximately $149 billion dollars per year, with more than half of patients requiring continuous use of a positive airway pressure machine (CPAP) for treatment (Watach et al.,2021). Individuals’ beliefs and perceptions regarding OSA impact CPAP compliance. Motivational Interviewing is an evidenced-based approach to change behaviors and improve patient outcomes (Crosby et al.,2022). A 10-day practice assessment log at Sonno Sleep Center identified (n= 51 of 105) patients lacked adherence of 70% in …

Restorative Yoga To Increase Mindfulness And Reduce Anxiety And Burnout Of Inpatient Mental Health Workers: A Quality Improvement Project, Rachaele Warden

Doctor of Nursing Practice Papers

Background/Significance: Burnout syndrome negatively impacts healthcare systems via quality reduction of patient care and communication, increased medical errors, hospital-acquired infections, staffing shortages, and costly malpractice suits (De Hert, 2020). The characteristic exhaustion, cynicism, job detachment, feelings of inadequacy and incompetence that emerge from burnout further hinder individual mental health and wellbeing.

Purpose: The purpose of the restorative yoga intervention strives to reduce employee anxiety, burnout and enhance mindfulness-based practice strategies within a local inpatient mental health hospital.

Methods: Quality improvement project with evidence-based interventions.

Interventions: The project intends to hold one instructor-guided and one video-guided 25-minute restorative yoga weekly session …

Increasing Human Papillomavirus Vaccine Uptake In Primary Care Using The 4 Pillars Program: A Quality Improvement Project, Hannah Lyons

The Eleanor Mann School of Nursing DNP Capstone Projects

Aim: To explore the effectiveness of the 4 Pillars Program on increasing human papillomavirus vaccination use in patients ages 9-18 years.

Design: A retrospective quasi-experimental research design comparing pre- and post-implementation human papillomavirus vaccination rates.

Keywords: human papillomavirus, vaccination, pillars, program, communication, tool, quasi-experimental, retrospective

Methods: A retrospective chart review identified the rate of encounters per provider where the human papillomavirus vaccine was administered to patients ages 9-18 years. Interventions including increasing access to the vaccine, standardizing provider recommendation of the vaccine, enhancing utilization of the electronic health record, and introducing a vaccine champion, known as …

A Nursing Point Of View: Investigating The Causes Of Medical Errors And Strategies For Prevention, Lauren Shillo

University Honors College

Bedside nursing is more of an art then what is seen or heard of from news articles or stories depicting a day in the life of a healthcare worker. “250,000 people die every year from medical errors, making it the third leading cause of death in the United States” (James, 2013). While there is no definitive answer or clear-cut solution to avoiding medical errors within nursing practice, indefinitely, there are possible ways to greatly reduce the effects and harm that accidental human errors have within the world of medicine. Through time, thousands of new policies and protocols have evolved from …

Looking Beyond The Fracture: Initiating An Osteoporotic Fracture Liaison Service, Gabriela A. Hildenbrand

Cohort XII

Background/Problem Statement: Osteoporosis, known as the “silent disease,” has been estimated to cause 9 million fragility fractures worldwide, resulting in an osteoporosis fracture every 3 seconds (Pennestrì et al., 2019). Fragility fractures are projected to exceed $25.3 billion US dollars by 2025 (Barton et al., 2021).

Aims/Methods: This paper describes the implementation of an evidence-based practice DNP project using the Plan-Do-Study-Act (PDSA) method at the Texas Tech University Health Sciences Center El Paso Orthopedic Surgery and Rehabilitation Department. The aim of this project is to implement a fracture liaison service (FLS) to help close the post-fracture treatment gap.

Results/Interventions: This …

Tailoring Treatment Approaches With Supplemental Screening: Homeostatic Model Assessment Of Insulin Resistance (Homa-Ir) In An Obese Population, Christine Ruvaclaba

Cohort XII

Background: This quality improvement project, conducted in the Texas-Mexico border region with high obesity rates, aimed to explore the utility of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as a screening tool for insulin resistance (IR) among overweight and obese individuals. The study focused on patients with a Body Mass Index (BMI) greater than 25 who exhibited normal blood sugar levels or Hemoglobin A1c (HbA1c) levels less than 5.7%.

Aim/Methods: The aim is to identify early intervention strategies for metabolic disorders, particularly in obese populations. Obesity is often the precursor to comorbid conditions such as diabetes and cardiovascular disease. …

The Effects Of Mediterranean Diet On The Epileptic Population With Depression, Celina Navarro

Cohort XII

Background: People with epilepsy often develop depression during the course of their disease progression. This condition is multifactorial, often related to the unpredictability of their disease, the lack of control on their symptoms, and the medications they use to treat their seizures. Mental health services continue to be insufficient for our growing border region, and patients with epilepsy, often will lack the proper mental health management due to mental health provider shortage. Multiple medications can be used to successfully treat depression in the general population, however people with epilepsy often will struggle as anti-seizure drugs can interact with antidepressants. Also, …

Initiating Early Review Of Paxlovid Criteria With Suspected Covid + Patients To Reduce Disqualification Of Anti-Viral Therapy, Emily Robinson

Cohort XII

Introduction: Nearly 742 million cases of COVID have been detected since the beginning of the COVID-19 pandemic and over 6 million people have lost their lives due to COVID or a COVID related illness. While Arizona’s COVID-19 emergency declaration ended on March 30, 2022, there are still nearly 100,000 new cases each week as of September 2023. Nirmatrelvir-ritonavir (Paxlovid) is an outpatient antiviral medication recommended for adults with mild-to-moderate COVID-19 who have elevated risk of severe illness.

Aim/Methods: Regardless of vaccination status, taking Paxlovid within 5 days of diagnosis reduces the hospitalization rate by 51%. The majority of COVID positive …

What A Pain In The Back!!!, Sylvia De La Rosa

Cohort XII

Background: After reviewing my 10-day Practice Assessment Log (PAL) and documenting a clinical needs assessment of my practice, I documented, reviewed, and reflected upon my findings. In my current practice we address low back pain with Gabapentin 300mg TID and Methocarbamol 500mg BID. The present outcome is that most patients do not experience much in relief.

Aims/Methods: My Practice Improvement Project (PIP), validated via research, points to adding Celebrex 100mg BID, an anti-inflammatory, to patient’s regimen. I carried out this project for 30 days with a 2-week follow-up. The Translational Framework Knowledge-to-Action model was used to help me prepare the …

Following National Guidelines And Treatment To Eradicate Streptococcus Pharyngitis In Pediatrics, Rosa I. Montenegro

Cohort XII

Introduction: Sore throat (acute pharyngitis) is considered a prevalent disease worldwide among children and adults that requires healthcare. It is important to know that the etiology of sore throat in 70%-95% of cases is viral. Streptococcus pyogenes (group A streptococcus) is detected in approximately 15%-30% of all cases with sore throat, 5%-15% in adults, while 20%-30% in children. For the diagnosis of GAS infection, a throat swab is the gold standard procedure. Most guidelines are based on the seriousness of GAS infection to support the decision on the use of antibiotic treatment. All guidelines on sore throat give recommendations on …

Improving Bipolar Diagnosis With The Rapid Mood Screener, Leslie Richard

Cohort XII

Background: Bipolar disorder is a chronic, debilitating mental illness that affects individuals globally. It is characterized by significant challenges in diagnosis, often leading to delays in receiving appropriate treatment. This condition can mirror the symptoms of unipolar depression, leading to frequent misdiagnoses and hindering timely intervention that could improve functional outcomes and quality of life.

Aims/Methods: This project aims to enhance the accuracy of bipolar disorder diagnoses in clinical settings, specifically bipolar disorder type 1 (BPT1), at the earliest possible stage of the illness. By doing so, it seeks to improve symptom management, reduce the duration of episodes, and enhance …

Reaching Gold: Diagnosing And Individualizing Care Using Gold Abe Guidelines, Martha Flores

Cohort XII

Background: Chronic obstructive pulmonary disease (COPD) remains the fifth leading cause of disease-related deaths worldwide, resulting in an annual cost of $3.5 billion in the United States due to COPD exacerbations. COPD treatment necessitates a multifaceted approach that includes collecting complex, subjective, and objective patient information. A ten-day patient assessment log was completed in an outpatient pulmonary clinic to evaluate any shortcomings in the current practice, revealing that the current evaluation of breathlessness involved gathering subjective reporting with binary yes/no responses, leading to variability in diagnosis and treatment.

Methods/Aims: The binary evaluation fell short of the recommendations of the Global …

Hypertension And Treatment Modalities: What Does The Current Evidence Say?, Luis R. Tellez

Cohort XII

Background/Problem Statement: The significantly elevated rates of cardiovascular (CV) disease observed among individuals with mental health conditions might stem from suboptimal handling of cardiovascular risk factors. In this project, I sought to address one aspect of cardiovascular risk: hypertension in patients 18-74 years of age, marked with a blood pressure >140/90 mmHg in a psychiatric inpatient setting. A tenday review of patient care revealed that hypertension management provided to patients under our service was inadequate and might be improved by adopting and implementing more consistent and systematic protocols for medication administration.

Aims/Methods: At the onset of my project, I undertook …

On Solid Ground: A Quality Improvement For Fall Prevention, Jessica Vergara

Cohort XII

Background/Problem Statement: Falls among older adults are a significant concern, affecting up to 30% of individuals aged 65 and older annually. Multiple risk factors contribute to falls, including age, comorbidities, medications, and environmental hazards. Despite the common belief that falls are inevitable with aging, this project emphasizes the preventability of falls through multidisciplinary management and proactive engagement in fall prevention programs.

Aims/Methods: The initiative focuses on implementing the Matter of Balance (MoB) program within an institutional setting. MoB has shown favorable effects on fall-related concerns. The study employs a comprehensive outreach strategy targeting older adults at risk of falling, those …

Incorporating Aac Training In Nursing Education Programs To Enhance Understanding Of Caring For Patients With Complex Communication Needs, Tessa Bradley

Honors College Theses

As healthcare professionals, nurses must be able to effectively communicate with their patients to ensure their health, safety, and comfort. However, this can be particularly challenging when it comes to patients with complex communication needs (CCN), where communication breakdowns can lead to sentinel events. Alternative and augmentative communication (AAC) can help those with CCN improve communication across various settings, including in healthcare. Unfortunately, there is a severe lack of training for nurses when it comes to communicating with patients with CCN and the use of AAC. Webb et al. (2024) investigated the effectiveness of a combined synchronous and asynchronous training …

Uab School Of Nursing Ai Taskforce: Transforming Nursing Education At Uab, Matthew Jennings Med, Chris Hickman Msis, Tonya Judson Dnp, Rn, Ni-Bc, Cne, Benjamin J. Galatzan Phd, Rn, Tedra S. Smith Dnp, Cpnp-Pc, Cne, Chse, Carrie Beth Littleton Dnp, Rn, Cnecl, Chse, Penni Watts Phd, Rn, Chse-A, Fssh, Faan

School of Nursing Professional Posters

Invited poster presentation

Bean 5 Turn Team: Improves Turing Interventions & Reduces Hapi Rates, Paige Thompson Rn, Johnna Grant Rn

Nurse Residency

Does implementing a turn team on hospital units aid in preventing pressure-related injuries as compared to standard of care, without a turning team?