Nursing Commons^™

The Effect Of An Educational Intervention On Knowledge And Intent To Participate In Cervical Cancer Screening, Ann Marie Trapp

Evidence-Based Practice Project Reports

Globally, cervical cancer ranks third among cancers affecting women (Arbyn et al., 2013). In the United States, approximately 12,000 women are diagnosed with cervical cancer and approximately 4,000 women die yearly (Centers for Disease Control and Prevention, 2014). Papanicolaou (Pap) screening is an effective means of detecting precancerous cell changes of the cervix with early cervical cancer diagnosis carrying a 91% five-year survival rate (Gonzalez et al., 2012). The purpose of this evidence-based practice project was to identify interventions that increase adherence to cervical cancer screening and to implement best practices to reduce unnecessary deaths related to late diagnoses of …

Commercial Sexual Exploitation: The Role Of The Advanced Practice Nurse In Screening Patient At-Risk, Sheri Rickman Patrick

Doctoral Projects

Problem: Human trafficking or commercial sexual exploitation (CSE) is a global problem effecting every country including the United States. The impact of human trafficking while it is devastating to individuals, the impact goes well beyond individual victims and undermines the health, safety and security of all nations (U.S. Department of State Publication, 2007, p. 5).This research is an attempt to assess the knowledge of advance practice nurses or nurse practitioners (NP) in the subject of commercial sexual exploitation and their willingness to screen their patients who may be at-risk.

Methods: The design was web-based with advanced practice nurses who are …

Practice Matters: Screening And Caring For Those With Hypertension, Dawn M. Garrett Wright, Maria E. Main, Mary L. Branstetter

International Journal of Faith Community Nursing

The purpose of this article is to review best practices for screening and monitoring hypertension for Faith Community Nurses (FCNs). Epidemiological data regarding hypertension will be presented, along with current guidelines for blood pressure monitoring. Information on lifestyle modification and patient education resources is included to assist the FCN to improve service to patients at risk for and with current hypertension.

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford

DNP Projects

Depression affects many people worldwide and is a leading cause of disability. National guidelines and recommendations have been created that support screening for depression in the primary care setting, however due to many barriers depression screening is often not performed or documented. This capstone project consists of three manuscripts, which evaluate the lack of depression screening in the primary care setting. The first manuscript is an integrative review of the literature to support depression screening in primary care and to address barriers to depression screening. The second manuscript is a guideline analysis of a national guideline published by the Institute …

Adolescent Risk Behaviors, Screening, And Referral At An Adolescent Health Clinic: A Retrospective Review, Cheryl Marrs

DNP Projects

Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to …

Conducting A Needs Assessment At Outpatient Medical Clinic, Fidelia Ijeuru Ukah

Walden Dissertations and Doctoral Studies

Colorectal cancer is one of the most common cancers in the United States and confronting its challenges has remained a problem to the United States health sector, especially among outpatient clinics. Guided by health belief model, the purpose of this needs assessment was to identify patients age 50 and older in outpatient clinic located in a large metropolitan city in Texas who should receive information on the need for colorectal cancer screening based on their risk for developing colorectal cancer as outlined by American Cancer Society. A sample of 70 charts of patients age 50-75 years was randomly selected and …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

Screening Asymptomatic Women For Cardiovascular Risk, Kathryn Nelson-Murphy

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) has long been recognized as a significant health problem in the U.S., and is the leading cause of preventable death in women, collectively causing about one death per minute (Caboral, 2013). A myriad of modifiable risk factors including dyslipidemia, hypertension, smoking, obesity, and type II diabetes are associated with 80-90% of CVD morbidity and mortality. Despite sobering statistics, valid risk prediction screening tools, and national preventive guidelines, adequate screening in clinical practice settings is sadly deficient. An evidence-based practice project was designed and implemented at a large OB/GYN practice in southern Ohio to address this identified gap …

Routine Versus Ad Hoc Screening For Acute Stress Following Injury: Who Would Benefit And What Are The Opportunities For Prevention, Nathaniel Bell, Boris Sobolev, Stephen Anderson, Robert Hewko, Richard K. Simons

Faculty Publications

BACKGROUND:

Screening for acute stress is not part of routine trauma care owing in part to high variability of acute stress symptoms in identifying later onset of posttraumatic stress disorder (PTSD). The objective of this pilot study was to assess the sensitivity, specificity, and power to predict onset of PTSD symptoms at 1 and 4 months using a routine screening program in comparison to current ad hoc referral practice.

METHODS:

Prospective cross-sectional observational study of a sample of hospitalized trauma patients over a four-month period from a level-I hospital in Canada. Baseline assessments of acute stress (ASD) and subsyndromal ASD …

The Development Of The Barriers, Elizabeth Hagelsieb-Escalera

Open Access Theses & Dissertations

Estimates of undiagnosed diabetics are as high as 50%. Early intervention and management can reduce the complications of diabetes; however, this is possible only after the disease has been diagnosed. A review of diabetes screening literature revealed a dearth of information regarding the diabetes screening behavior of individuals. Unlike barriers to cancer screening, little is known about barriers and facilitators to diabetes screening. The theory of planned behavior (TPB) is a logical theoretical framework to apply for the examination of screening intentions because it allows inference of behavioral predictors via survey item responses. Using the TPB framework, the Barriers and …

Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser

DNP Projects

CAPSTONE INTRODUCTION

Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.

Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …

Screening For Sepsis: A Key Strategy For Early Identification And Management Of Septic Patients, Amy P. Fisher

DNP Projects

Background: Sepsis, defined as a systemic inflammatory response to infection, is a life-threatening medical condition that rapidly progresses from severe sepsis (characterized by signs of organ dysfunction) to septic shock with fluid-refractory hypotension. Adherence to the Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock have been associated with improved delivery of care and reduced mortality. Delays in recognition of sepsis has been identified as a barrier to achieving early goal-directed therapy targets.

Purpose: To determine if a sepsis screening protocol could facilitate earlier identification of patients with sepsis

Methods: A retrospective medical record review was …

Depression Screening Of Young Adult Freshmen Students, Marlee R. Steele

Evidence-Based Practice Project Reports

Depression is a mental health issue that requires prompt identification and treatment. According to the CDC, it is estimated that in the U.S .one in 10 adults suffer from depression (CDC, 2011) with 4.7% of young adults, 18-39 years, suffer from depression (CDC, 2006). Many young adults report that college life is often more stressful than anticipated and the demands placed not only academically, but also socially, adversely affect their psychological and physical health (Dyson & Renk, 2006). The purpose of this EBP project was to answer the PICOT question: How does a depression screening tool in combination with a …

Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the overwhelming evidence that sudden cardiac death is the most frequent cause of firefighter fatalities, many fire departments do not have a program to measure or maintain basic firefighter fitness and health. This project evaluated and compared medical screening outcomes of four industrial fire brigades within a multinational oil and gas corporation and introduced a quality improvement plan. The goal of this project was to apply the evidence and measure outcomes to determine the most effective way to ensure that firefighters in a corporate setting are healthy. This was accomplished by utilizing established guidelines in developing an educational program …

Postpartum Depression In Immigrant Hispanic Women: A Comparative Community Sample, Laura Mae Shellman

Theses and Dissertations

Purpose: This study was initiated to verify whether a remarkably high rate of postpartum depression (PPD), previously found in immigrant Hispanic women receiving health care at a community clinic, would also be found in a community sample with a similar demographic.

Data Sources: Sixty immigrant Hispanic women who had recently given birth were recruited from local community settings. The Beck Postpartum Depression Screening Scale-Spanish version (PPDS-S) and the General Acculturation Index (GAI) were used to screen for PPD symptoms and to collect demographic data. These data were then compared with previously published data from the community clinic sample.

Conclusions: Sixty …

Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Health Care : Can Obesity In Combination With Other High-Risk Diagnoses Be Used For Screening Purposes?, Clelia Lima

Electronic Theses and Dissertations

Obstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia, arrhythmia, and coronary artery disease) can be used to help PCPs identify adult patients at risk for OSA. Unlike other screening tools, these diagnoses are easy to identify in a …

Delirium Screening: From Research To Point Of Care, Beth Ann Swan, Phd, Crnp, Faan, Sheena Ahlawat, Mph, Christopher N. Sciamanna, Md, Phd

College of Nursing Faculty Papers & Presentations

Delirium is a serious public health problem among older adults and is one of the most common cognitive disorders affecting postoperative older adults. Delirium is a treatable illness that disproportionately places postoperative older adults at increased risk for functional and cognitive decline, as well as increased morbidity and mortality. More than 50 percent of postoperative patients develop delirium during hospitalization. Epidemiologic and clinical studies over the past two decades have provided ample evidence that delirium in hospitalized older adults is under-recognized by nurses and physicians, often leading to untoward events that the safety and well-being of hospitalized older adults.

Assessing Facilitating Factors And Barriers To Body Mass Index Screening Among School Nurses, Ann M. Stalter

Nursing Faculty Publications

Child obesity among school age children is epidemic in the United States (U.S.). A critical review of literature was completed that concluded that Body Mass Index (BMI) screening for early identification and growth surveillance is needed for successful school-based obesity prevention intervention programs. This study used total survey design methods to identify the BMI screening practices of school nurses (SNs) and to identify the facilitating factors and barriers to BMI screening in public elementary schools among school age populations. Focus groups were used to identify current BMI screening practice in terms of facilitating factors and barriers. Survey methods were used …

Screening And Intervention Practices Of Family Nurse Practitioners For Smoking Tobacco Usage, Joseph H. Maness

MSN Research Projects

Smoking tobacco usage and it’s related health problems are a significant problem addressing the health care industry. Clients depend on primary health care provides to help identify potential health problems and to assist them in improving their health. The family nurse practitioner is in an ideal position to screen for smoking, and to intervene with those clients found to be at risk, to promote wellness within their client populations. Erikson, Tomlin and Swain’s theory o f Modeling, Role-Modeling served as the theoretical fi-amework for this research. This descriptive study explored the screening and intervention practices utilized by family nurse practitioners …

Screening Practices Of Primary Care Nurse Practitioners For Domestic Violence, Amy Branyon

MSN Research Projects

Domestic violence is prevalent in our society, affecting 2 million women each year (Butler, 1995). This creates a significant health problem for women, yet research has shown that few health care providers routinely screen for domestic violence. The purpose of this descriptive study was to identify the number of nurse practitioners screening for domestic violence among their clients, identify the methodology used for screening, and identify barriers to screening. The theoretical framework was based on the Health Promotion Model (Pender, 1997). The research questions for this study were as follows: What are the screening practices for domestic violence of nurse …

Nurse Practitioners’ Developmental Screening And Referral Practices For Children With Developmental Delays, Terri Chisolm Smith

MSN Research Projects

Children with developmental delays benefit from participation in early intervention programs. Yet many children are not screened for developmental delays, and many children with developmental delays are not referred to early intervention programs. Families depend on their primary health care providers for the detection of developmental delays and information about services available for their children with developmental delays. The primary care nurse practitioner is in an ideal position to screen for delays, provide necessary referrals for services, and assist the families in maximizing their self- care potentials. Orem's self-care deficit theory of nursing served as the theoretical framework for the …

Analysis Of Cholesterol Screening Practices, Jane Mattina

MSN Research Projects

Cardiovascular disease, which consists of hypertension, coronary heart disease, and cerebrovascular accidents, affects over 82 million American adults and is currently the leading cause of death in the United States. The Center for Disease Control and Prevention (CDC) identifies high-blood cholesterol as one of the main risk factors in the development of these diseases. Furthermore, 71 million Americans report having a high-blood cholesterol level, yet only about one third of those people have it under control (CDC, 2014c). The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines recommend that adults 20 years or older be screened …

A Descriptive Study Comparing The Results Of Hearing, Vision, And Developmental Screening Of Children At Preschool And School-Age Levels, Linda Sullivan

MSN Research Projects

This study was descriptive in nature, designed to compare the results of vision, hearing, and developmental screening of the same group of children at 2, 3, or 4 years of age and subsequently at 5, 6, or 7 years of age. The researcher hypothesized that there would be no significant difference in the result of screening at the two intervals. The audiometer was used to test hearing, the tele­ binoculars with the Peek-A-Boo series tested vision and the Denver Developmental Screening Test (DDST) tested develop­ mental levels. Nineteen subjects were located and rescreened, and the results compared to the first …