Nursing Commons^™

Effects Of Preoperative Chlorhexidine Gluconate (Chg) Cloths Educational Intervention For Preoperative Staff On Chg Knowledge And Surgical Site Infection Rates: A Quality Improvement Initiative., Deven Leffler

Doctor of Nursing Practice Papers

Abstract

Background: Surgical site infections (SSIs) are the most common cause of a surgical complication and account for 38% of all hospital acquired infections (HAI). The cost of caring for SSIs in the United States can range from $3.5-$10 billion annually.

Purpose: The purpose of this DNP Quality Improvement (QI) initiative was to improve preoperative staff’s knowledge and application of the Food and Drug Administration (FDA) approved 3-minute application scrub time for the 2% CHG cloths and reduce SSIs for an acute care hospital located in Louisville, Kentucky.

Methods: Quality improvement was initiated using the Plan, Do, Study, Act (PDSA) …

Lung Cancer Screening Implementation, Jessica Lee Digiorgio

Doctoral Dissertations and Projects

The Lung Cancer Research Foundation has stated that lung cancer is one of the leading causes of death worldwide. In 2022, 236,740 individuals were diagnosed with lung cancer, and 130,190 American lives are lost annually from lung cancer. Smoking is the number one risk factor for lung cancer and is responsible for approximately 80% of deaths related to lung cancer. Because of the high mortality rates from lung cancer, the American Cancer Society recommends the use of the U.S. Preventive Services Task Force (USPSTF) screening tool. Individuals who meet the criteria defined by the USPSTF qualify for yearly low-dose computed …

Initiating A Childhood Obesity Screening Process In An Urban Pediatric Office, Kesha Thomas

Doctor of Nursing Practice Projects

Background: The benefit of identifying a pediatric patient with obesity is to prevent many chronic health conditions that can occur from diabetes. Pediatric patients can be at risk for prediabetes, low self-esteem, and musculoskeletal issues. The patients that are at higher risk for childhood obesity are African American and Hispanics.

Purpose: The Doctor of Nursing Practice project aims to identify a pediatric patient that is obese to make sure that the patient is assessed appropriately and to discuss an appropriate intervention for the patient. To make sure all pediatrics have an accurate height, weight, and A1C during their well-child visit. …

The Implementation Of The Pressure Injury Prevention Protocol To Reduce The Incidence Of Hospital-Acquired Pressure Injuries In A Va Medical Surgical Unit, Nekia Whitlow

Doctor of Nursing Practice Projects

Background: The clinical gap in service addressed in the DNP project was hospital-acquired pressure injuries. A hospital-acquired pressure injury (HAPI) is a local injury to the skin and underlying tissue during an inpatient hospital stay. The injury is caused by pressure, shear, or both (The Joint Commission (TJC), 2022). The development of a HAPI can result from other factors, such as advanced age, immobility, perfusion issues, nutritional status, illness severity, and chronic conditions (Rondinelli, Zuniga, Kipnis, et al., 2018). Immobile or sedated patients in the intensive care units are the most at risk because they have medical conditions that prevent …

Unlocking Population-Specific Treatments To Render Equitable Approaches And Management In Cardiovascular Disease (Upstream Cvd): African American Emerging Adults, Shannon Bright Smith

Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death in America. African American people have disparate CVD outcomes, and African American emerging adults (AAEAs) aged 18-25 have CVD risk factors. This study aimed to examine the state of CVD risk factors in AAEAs, assess upstream and population factors in AAEAs attending a southeastern historically black college/university (HBCU), compare their perceived and objective CVD risk, explore their level of CVD knowledge, and examine responses when they learn their objective CVD risk.

Chapter 1 presents background literature on CVD in AAEAs and the research plan. Chapter 2 presents a newly synthesized situation-specific …

Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio

Nursing Leadership in Community Engagement Projects

Introduction

The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Masters Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, An Evidence-Based Intervention, Kara M. Roman, Aaron Mestemaker

Masters Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Adult Post-Cardiac Surgery Deep Sternal Wound Infections, Samantha Porcher, Cole Gatzke

Nursing DNP Projects

ABSTRACT

Purpose and rationale: Deep Sternal Wound Infections (DSWI) are associated with morbidity rates and mortality rates as high as 10% -15% as well as significantly increased hospital costs. The purpose of this project is to decrease current rates of DSWIs in adults undergoing cardiac surgery at a large medical institution.

Synthesis of evidence: The literature shows a strong relationship between elevated HbA1C and DSWI. All articles reviewed for this proposal which implement a sternal vest intervention support its use to prevent DSWI.

Practice change and implementation strategies: The strategy used to implement these evidence-based practice interventions includes …

Pediatric Obesity In Primary Care, Lynne C. Liggins

Electronic Theses and Dissertations

The purpose of this evidence-based quantitative quasi-experimental research was to compare if providing the parents with information on the health risk associated with childhood obesity would cause the parents to make healthier food choices and encourage their children to be involved in a full hour of physical activity a day. Participants included parents and pediatric and adolescent children 5 to 18 years of age at a solo practice primary care office in a large city in Southern, California, which specializes in treating pediatric and adolescent patients. A pre- and postquantitative intervention design were used and analyzed using the paired t …

Access To And Utilization Of Primary Care: A Synthesis, Klaire M. Johnson

Kentucky Journal of Undergraduate Scholarship

Barriers to access and utilization of primary care affect nearly 9% of the nation’s population (USDHHS, n.d.a). These barriers are important to evaluate for members of the aging population due to increased need for health care as a result of chronic conditions and falls. Research indicates that access for the aging population is affected by a variety of factors, including: transportation, non-financial barriers, and internal factors. Issues surrounding current delivery of care, such as a workforce shortage of primary care physicians, have compounded the problem even further. While this issue has begun to be addressed through the Affordable Care Act, …

Instrumental Fracture In Endodontics: A Short Review, Fatima Zohra Rouggani, Ayoub Belkamel

Health Sciences

Oneofthemostfrequentaccidentsthattakeplaceduringstandardendodontictreatment is instrument fracture. The fractured instrument such as a metallic obstruction inthe root canal system, hinders cleaning and shaping operations, and affects the effectivenessofendodontictherapy.Themanagementofinstrumentfracture,factorsthataffe ctinstrumentfracture,andprecautionsforinstrumentfracturearethethreeheadingsusedtoel aborateonthistopicin thisreview.

Women’S Views On Obstetric Fistula Risk Factors And Prevention In North-Central Nigeria: An Interpretive Descriptive Study, Lydia Babatunde Bulndi, Deborah Ireson, Esther Adama, Sara Bayes

Research outputs 2022 to 2026

Objective: Obstetric fistula, also known as vesicovaginal fistula or rectovaginal fistula, is an abnormal opening between the vagina and rectum caused by prolonged obstructed labour that causes substantial long-term harm to women. It is most prevalent in low resource settings and although preventative measures have been proposed, they have not, to date, taken women’s own views into account. The objective of this study was to explore the views of North Nigerian women on obstetric fistula risk factors and prevention.

Design: This study was conducted using Interpretive Description methodology, which is a qualitative approach underpinned by Symbolic Interactionism. A semistructured questionnaire …

Reducing Risk Factors Of Diabetes Mellitus Type Ii Development In Veterans Post Military Discharge Through The Patient Aligned Care Team Model And The Utilization Of Preventive Programs Involving Lifestyle Changes., Jeni Grundy

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already …

Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee

Master's Projects and Capstones

Hospital acquired pneumonia’s (HAPs) are unfortunate and preventable events quality improvement efforts should focus on. At a Northern California Hospital, there was an unmet HAP rate goal of 2.3 (20 out of 8795 patients) against a target goal of 2. This increase in HAP rates, both non-ventilated and ventilated was a call to action to reduce HAP to the target goal. The quality improvement project specifically aimed to reduce HAP rates on medical-surgical units through an ultra-brief refresher on the hospital validated and endorsed ROUTE bundle. The education focused on oral care completed by the patient care technicians (PCT’s). The …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Chronic Obstructive Pulmonary Disease (Copd), Joseph Earich

Nursing Student Class Projects (Formerly MSN)

Background: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible, preventable respiratory disease characterized by airflow limitation and obstruction that is usually progressive. COPD affects millions of people globally and over $7 billion dollars is spent on COPD related hospitalizations in the U.S. annually. This poster includes information focused on COPD, the underlying pathophysiology, clinical manifestations, diagnosis, nursing care implications, and treatment.

Methods: Research articles within the last five years were obtained using keywords such as COPD, pathophysiology, treatment, prevention, emphysema, and chronic bronchitis from databases EBSCO and PubMed. The data and quality of these articles were assessed and information compiled …

Acute Kidney Injury, Chelsey Benner

Nursing Student Class Projects (Formerly MSN)

Acute kidney injury (AKI) is a common complication of surgical procedures and can lead to increased morbidity and mortality. AKI can be described by a sudden decline in kidney function, evidenced by elevation of serum creatinine, elevated blood urea nitrogen levels, and a decreased glomerular filtration rate (McCance & Huether, 2018, p. 1360). Optimal perioperative management and recognition of patients at high risk for AKI is important in preventing the development of acute kidney injury.

Reducing Catheter-Associated Urinary Tract Infections In The Pediatric Intensive Care Unit, Maria Smith

Dissertations

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC).

Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything …

Improving Colorectal Cancer Screening In Primary Care, Bushra Iqbal

Doctor of Nursing Practice (DNP) Projects

Colorectal Cancer (CRC) is the second leading cause of cancer related deaths in the U.S., although it is preventable with adequate routine screening. Medically underserved minorities and immigrants require screening program awareness in their respective communities. The incidence of CRC remains markedly high despite the screening modalities among various populations. In the United States (U.S.), there were approximately 147,950 reported CRC diagnoses, 53,200 deaths, and over 35.2 cases per 100,000 in California alone reported in 2020 (Siegel et al., 2020). Healthcare providers can prevent colorectal cancer (CRC) through adequate routine screening. Various screening practices are widely implemented in primary cases …

Safe Traffic Behaviors In Adolescents: A Cross-Sectional Study Based On The Theory Of Planned Behavior, Alireza Shahab Jahanlou, Laleh Hassani, Vahid Ranaei, Ghodratollah Roshanaei, Sonja Forward, Kristin Haglund, Forouzan Rezapur Shahkolaei

College of Nursing Faculty Research and Publications

Adolescents do not have adequate safe traffic behaviors. This cross-sectional study investigated safe traffic behaviors of 414 male high school students of Hamadan, Iran, randomly selected using the multistage sampling method in 2020. This study used a researcher-made questionnaire based on the theory of planned behavior about safe traffic behaviors with Cronbach’s alpha coefficient of 0.95, content validity ratio of 0.70, and content validity index of 0.85. There was a strong positive correlation between safe traffic behaviors with perceived behavioral control and intention. Adolescents can be influenced to internalize behavioral safety precursors that can lead to a sustained increase in …

Lifestyle Modification Interventions On Hemoglobin A1c Level In Patients With Type Ii Diabetes Mellitus In An Underserved Community: A Pilot Project, Anniesatu Newland

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) is a pandemic of great concern among the nutrition-related non-communicable diseases. Its prevalence is mounting worldwide, particularly in underserved communities and minority groups. In 2019, 463 million people were diagnosed with T2DM, a number expected to increase to 578 million by 2030 globally. The prevalence of T2DM is increasing the mortality rate from cardiovascular complications. The social and health costs of treating this disease is currently 11% of the global health budget. This project aims to utilize an evidence-based approach to assess lifestyle interventions' effectiveness at decreasing the Hemoglobin A1c levels in T2DM individuals after …

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

Implementation Of An Evidence-Based Bundle To Reduce Hospital Acquired Pressure Injury Harm Rates In The Intensive Care Unit: A Quality Improvement Project, Jessica Tripp

Doctor of Nursing Practice Scholarly Projects

A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based …

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …