Nursing Commons^™

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

Implementation Of A Multifactorial Fall Prevention Protocol, Laura Wilkerson

Evidence-Based Practice Project Reports

According to the Joint Commission Center for Transforming Healthcare (2016), moderate to severe injuries from falls on average add 6.3 days to a hospital stay and cost approximately $14,056 per patient hospitalization. The purpose of this evidence-based practice (EBP) project was to implement a multifactorial approach to identify patients at risk for falls on admission to the orthopedic/neurosurgical unit and provide individualized interventions necessary to prevent falls. The Iowa Model of Evidence-Based Practice and Orlando’s Nursing Process Discipline facilitated the implementation of this project. A total of 45 staff members on the unit were educated on the multifactorial fall protocol …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

The Peanut Allergic Patient: Diagnosis, Treatment, And Prevention, Daniel W. Hill, Jane Lassetter Phd, Rn, Craig Nuttall

Student Works

The prevalence of peanut allergies (PAs) continues to rise through recent decades, despite the best attempts to reverse that trend. PAs are unpredictable and can be life-threatening. Therefore, it is imperative that nurse practitioners (NPs) are fully aware of the most recent guidelines and evidence regarding diagnosis, treatment, and prevention of PAs. This article presents information on current research in diagnosis and treatment of PA, as well as the latest guidelines established to prevent PA development. NPs should understand this information, allowing them to provide the best care possible for their patients.

Nurse Burnout And The Effects Of Coping And Stress Management, Meghan Baranda

Capstone Research Projects

Aim: To investigate the relationship among nurses and decrease in nurse burnout followed by primary research to compare the relationship of certain coping mechanisms and burnout levels. Setting and Subjects: Southern Adventist University and BS, MSN, DNP students. Results: Showed that practicing stress management and coping mechanisms contributed to a decrease in burnout levels, especially coworker support, family support, positive attitude/optimism, exercise/physical activity, and spirituality/religion. Conclusions: Primary research supported the findings from the initial research study, which gives further evidence that coping and stress management is important and effective in minimizing burnout levels.

An Off-Season Brace-Free Neuromuscular Ankle Training Program Among Brace- Reliant And Nonbrace-Reliant Division Ii Female Athletes, Katelyn Koeninger, Jillian Markus, Linsey James, Kristen Thomas, Heidi Neitzke, Robert Topp, Joseph A. Brosky

School of Nursing and Health Science: Faculty Scholarship

Background: Neuromuscular training (NMT) has been shown to be effective in preventing recurrent ankle injuries. However, the NMT effect during the off-season in athletes who wear and those who do not wear an ankle brace during their sport season remains undetermined.

Purpose: The purpose of this study was to determine the effect of an off-season bracefree neuromuscular ankle training program on ankle functional ability among female athletes who wore and those who did not wear an ankle brace during the sport season.

Study Design: This study included a pre- and posttest 2-group cohort.

Methods: In this study, division II female …

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Caring For Patients With Delirium In The Intensive Care Unit, Susan Archer

Walden Dissertations and Doctoral Studies

Patients in hospital intensive care units are at increased risk to develop delirium, a condition which is characterized by a disturbance of consciousness and a change in cognition. Critical care nurses must have the knowledge to assess, recognize, and manage delirium. The purpose of this project was to develop an evidence-based policy for the assessment of delirium and a comprehensive nursing education plan which included an analysis and synthesis of the literature, a curriculum plan, and a pretest/posttest. The Johns Hopkins Evidence-Based Practice Model framed the project, which used a multidisciplinary team approach. Two nursing leaders, each with a doctor …

Patient Falls: Reducing Patient Falls With Injury, Frederick Comer

Master's Projects

The occurrence of patient falls is a very important health concern facing the healthcare industry. Many patients not only experience falls, but have falls with an injury. This is a patient safety concern that can have serious effects on patient outcomes, is a leading cause of patient injuries in hospitals, and are costly adverse events (Trepanier & Hilsenbeck, 2014). It is important that healthcare professionals determine ways to prevent what has been deemed a preventable event (Bemis-Dougherty & Delaune, 2008). In 2005 The Joint Commission (TJC) included patient falls with injury as part of their National Patient Safety Goals (Bemis-Dougherty …

Transitioning Care From Hospital To Home, Increasing Awareness Of Take-Home Pressure Injury Prevention Kits, Erika A. Yazdanbakhsh Mrs

Master's Projects and Capstones

With proper implementation of evidence-based interventions, most pressure injuries (PI) can be prevented. While prevention is considered standard of care while inpatient, there is a need to transition this care from hospital to home. This CNL project aimed to increased awareness of take home PI prevention kits made available to staff nurses at on medical surgical hospital unit with 15 staff nurses. An author-blinded, internal chart review and a comprehensive review of evidence-based literature were studied to provide background data and support for implementation using the staff huddle. Direct observation and staff interaction was incorporated with Lewin’s change theory to …

Effect Of An Educational Intervention For Prevention Of Std In Minority Women, Umparrys L. Witherspoon

Evidence-Based Practice Project Reports

Historically, African Americans and Hispanics in the United States have been disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), as compared with non-Hispanic whites. Females continue to outnumber males with these diagnoses. Women are generally at greater risk of acquiring HIV and other STDs than men because the female genital tract is more prone to injury and infection resulting from high-risk heterosexual contact (Crepaz et al., 2009). The purpose of the evidence based project was to implement and evaluate an educational intervention for the prevention of HIV and STDs. The Health Belief Model (HBM) was …

Vaccination For Prevention Of Postherpectic Neuralgia, Erik C. Burke

Nursing Capstones

No abstract provided.

Smoking Perceptions Among Adult Cameroonian Men Who Smoke Cigarettes, Elvis N. Ngyia

Nursing Dissertations - Archive

Background: Over five million people die annually from smoking related illnesses. As more people consider quitting smoking in industrialized nations, the rate of smoking has been rising in African countries, also referred to as low and middle-income countries. The projected population growth in Africa has led tobacco manufacturers to strategically target African teenagers who do not clearly understand the adverse effects of smoking cigarettes. In developed countries such as the United States, public education about the dangers of smoking and the availability of structured smoking cessation programs have been influential in helping smokers quit. Unfortunately in most developing countries in …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

The Use Of Supplemental Progesterone In Preventing Preterm Birth In High-Risk Women: A Critical Review Of The Literature, Leah Marie Schroeder

All Electronic Theses and Dissertations

Background: Twelve percent of births in the United States occur before 37 weeks of gestation and therefore are considered preterm births (Norwitz, 2015). While the ability to identify women at risk for preterm birth has improved dramatically over the past three decades, the application of primary and secondary interventions has failed to reduce the incidence of preterm delivery, which has actually been on the rise (Norwitz, 2015). Preterm birth is a phenomenon that needs to be reduced not only in the United States, but also across the world. Purpose: To determine to what extent the use of supplemental progesterone in …

Childhood Obesity And Nursing Interventions, Rebecca Oswald

Senior Honors Theses and Projects

This paper will examine obesity and the multitude of methods for a healthcare professional to help influence their patients using health promotion techniques for those who are at risk for obesity. This paper will discuss the pathophysiology of obesity as well as childhood obesity risk factors that pertain to this disease. This paper will investigate the nursing interventions being used today to combat childhood obesity within the following settings; school, in-patient, and clinic.

Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James

Walden Dissertations and Doctoral Studies

Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Early Prevention Of Pressure Ulcers In The Emergency Department, Marie Fagan

Seton Hall University DNP Final Projects

Purpose: Pressure ulcers characterize a major health problem in clinical practice, which in turn, can have an impact on quality of life and health care costs (Dugaret, Videau, Faure, Gabinski, Bourdel-Marchasson & Salles, 2012). Pressure ulcers can develop during treatment regardless of the setting. They develop in long term facilities, family homes and hospitals. The purpose of this DNP project was to ensure patient health and safety by educating the primary emergency room nurses to at-risk individuals presenting to the Emergency Department and to initiate early intervention strategies. Significance of the Project: Until recently, there has been very little literature …

Postoperative Delirium Prevention In The Older Adult: An Evidence-Based Process Improvement Project, Tracy Layne, Sheila A. Haas, Judy E. Davidson, Audrey Klopp

Nursing: School of Nursing Faculty Publications and Other Works

Postoperative delirium is a major complication in hospitalized older adults. Implementation of a screening tool and evidence-based delirium-prevention protocol on a surgical unit increased nurses’ knowledge regarding delirium, increased identification of delirium, and produced medical treatment alterations leading to positive patient outcomes.

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

Radon Potential, Geologic Formations, And Lung Cancer Risk, Ellen J. Hahn, Yevgeniya Gokun, William M. Andrews Jr., Bethany L. Overfield, Heather Robertson, Amanda T. Wiggins, Mary Kay Rayens

Nursing Faculty Publications

OBJECTIVE: Exposure to radon is associated with approximately 10% of U.S. lung cancer cases. Geologic rock units have varying concentrations of uranium, producing fluctuating amounts of radon. This exploratory study examined the spatial and statistical associations between radon values and geological formations to illustrate potential population-level lung cancer risk from radon exposure.

METHOD: This was a secondary data analysis of observed radon values collected in 1987 from homes (N = 309) in Kentucky and geologic rock formation data from the Kentucky Geological Survey. Radon value locations were plotted on digital geologic maps using ArcGIS and linked to specific geologic map …

A Retrospective Chart Review To Profile Appalachian Fall Risk, Hannah M. Warren

Undergraduate Honors Theses

This study was designed to create a high-risk fall profile for a specific Appalachian community. Data were obtained from 1,598 individuals with fall-related injuries who had been had been evaluated at a Level 1 Trauma center in Northeast Tennessee throughout 2011 and 2012, ages of individuals were 18 to 85 years. Data collected included: age, gender, county of fall, site of fall, type of fall, number of co-morbidities, season of fall, and time of day of fall. Results showed differences in criteria for categorizing individuals at high risk of falls, as well as data that had not appeared in the …

Coping Mechanisms Of Children With Atopic Dermatitis, Whitney A. St. Mary

Honors Theses

This was a qualitative study that explored the lived experience of parents who had children with atopic dermatitis, otherwise known as eczema. The study had seven volunteer participants and the objective of this study was to determine any coping mechanisms used to overcome the negative aspects of atopic dermatitis. Volunteers were obtained from the Oak Grove Family Clinic. Phone interviews were then conducted and the participants were asked a series of eight questions. After the interviews concluded the researcher then transcribed the interviews and determined common themes from parents’ responses. All of the parents discussed how using unscented lotion, preventing …

The Youth Health Summit, North Carolina: A University-Community Partnership To Promote Health Among Rural Youth, Janie Canty-Mitchell Ph.D., R.N., Musarrat Nahid M.Sc.

National Youth Advocacy & Resilience Conference

Learn how to build partnership with educators, researchers, and practitioners in order to develop educational programs, such as, the Youth Health Summit- a university initiated program undertaken in collaboration with schools and healthcare organizations to promote mental and physical health and create awareness about HIV/AIDS, substance abuse, teen pregnancy, and other hazards among rural middle school students in North Carolina.

Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe

Walden Dissertations and Doctoral Studies

Adequate medication management is a focus of effective care that is often overlooked in caring for adults with comorbid psychiatric and physical conditions, especially in patients who are treated by multiple care providers and have a variety of health issues at the same time. The purpose of this project was to develop evidence-based policies and practice guidelines to reduce polypharmacy in elderly patients in a rural outpatient psychiatric clinic. Bandura's self-efficacy theory was used to inform the project for its value in assessing motivation, capacity for self-regulation, and perceptions of individual ability. An interdisciplinary team of stakeholders explored best practices …

Ventilator-Associated Pneumonia Prevention Bundle, Patricia Cal

Walden Dissertations and Doctoral Studies

Ventilator-associated pneumonia (VAP) is a serious complication in critically ill patients; it can prolong intubation, increase intensive care unit and hospital length of stay, and increase mortality to twice the level of patients who do not develop VAP. The purpose of this project was to determine the effect of an evidence-based educational program to prevent VAP on ICU nurses' actual and documented practices for preventing VAP. The research questions addressed whether an educational program focused on VAP prevention will affect critical care nurses' compliance with a VAP prevention bundle, and whether the education will result in maintenance of a rate …

Outpatient Medication Error Improvement, Savannah M. Klinginsmith

Master's Projects and Capstones

Patient Safety Initiative -Improving Medication Administration (Outpatient Care)

SPECIFIC AIM: We aim to Improve the medication administration process and involve all staff within 6 months

In the microsystem consisting of 14 family practice and urgent care clinics, there is not a standard process based on evidence based practices for medication administration. With and estimated of 400-600 medications (immunizations included) being administered per day, without a standard of care protocol, the risk for medication errors is evident.

Objectives and changes anticipated based on implementation of the project is to engage staff in support for improving medication administration standard of care based …