Nursing Commons^™

Improving Diabetes Self-Management (Dsm) Among Patients With Uncontrolled Type 2 Diabetes Mellitus (T2dm): A Patient-Centered Education Model, Maria Hannah Tiangha Mandecote

Doctor of Nursing Practice (DNP) Projects

Problem: Type 2 Diabetes Mellitus or T2DM is an epidemic of enormous proportions affecting many individuals globally. Considering the significant burden and adverse outcomes when uncontrolled diabetes and poor self-management remain unaddressed, it is critical to find ways in which clinicians or nurses can help motivate patients to participate in their care. The problem of patients with uncontrolled diabetes at the Davis Street Primary Care Clinic (DSPCC) has been ongoing; in fact, from the 2021 Uniform Data System (UDS) measure update, rates of patients with uncontrolled diabetes (measured by HbA1c values >7%) have gone up from 55% to 80%, which …

Development And Implementation Of A Standardized Protocol For Nurse Practitioners Working In An Aud Treatment Telehealth Program, Cj Dea

Doctor of Nursing Practice (DNP) Projects

Background

Alcohol Use Disorder (AUD) is a major public health concern in the United States. Ria Health is a growing telehealth provider delivering AUD treatment through pharmacotherapy combined with behavioral health counseling.

Local Problem

Ria Health employs six California licensed nurse practitioners, but two of them have not yet met all the California provisions to practice independently without protocols. Ria Health has not put any standardized protocols in place.

Methods

This DNP project involved the creation of an evidence-based standardized protocol for AUD. The Student Satisfaction and Self-Confidence in Learning questionnaire was disseminated to participating nurse practitioners to measure student …

Every Milliliter Matters: Quantitative Blood Loss In Postpartum, Iana Vatsenko

Master's Projects and Capstones

Postpartum hemorrhage remains a leading cause of maternal mortality in the United States. Postpartum hemorrhage occurs when mothers are bleeding excessively, have uterine atony, or the placenta has failed to come out completely. Research has shown that quantitative methods of blood loss estimation revealed a higher incidence of PPH than visual estimation. That is why using quantitative methods on time is essential for diagnosing PPH. Quantification of blood loss should be replaced by estimated blood loss since it is more accurate. The project's main focus was implementing quantification of blood loss and using the Triton Scale, a smart system to …

Addressing Nursing Burnout: Seeking The Need For Mental Health Interventions To Support The Nursing Workforce, Kayla Perry

Master's Projects and Capstones

Problem: Feelings of burnout are rampant in the nursing profession, and can have serious consequences for nurses’ mental health, patient safety, and healthcare facility costs. The COVID-19 pandemic has exacerbated burnout and made it difficult for nurses to cope with constant anxiety, fear, and grief.

Context: At an outpatient clinic in Santa Clara County, nurses on the COVID-19 testing and vaccination unit were observed and communicated feelings of burnout related to the pandemic and other stressors. Based on the mixed-methods data collection performed, a quasi-experimental study was carried out by implementing mental health interventions to support the staff.

Interventions: A …

Implementation Of Aidet And Commit To Sit In Pediatric Outpatient Setting, Shibani Dhir

Master's Projects and Capstones

Problem: This quality improvement project implements AIDET (Acknowledge, Introduce, Duration, Explain, and Thank You), Commit to Sit, and cultural-competent care to improve patient satisfaction and communication between multidisciplinary health care team members and patients in a microsystem of a pediatric outpatient setting. The National Research Company (NRC) scores from the microsystem are below the 85th percentile, and this microsystem strives for excellence in the care provided to patients. The detractors from the patient satisfaction scores include patients scoring low on staff needing to work together, care providers not taking enough time to explain and listen, wanting to trust providers with …

Increasing Patient Satisfaction In A Pediatric Perioperative Outpatient Setting, Ailen Revuelta

Master's Projects and Capstones

Problem: Effective and therapeutic communication in the healthcare setting is multidisciplinary, complex, and has its unique challenges for each microsystem. This quality improvement project implements two communication tools AIDET and Commit to Sit and incorporates cultural competency to improve communication and increase patient satisfaction in a pediatric outpatient perioperative microsystem. A microsystem assessment reflected some challenges that staff were facing when communicating with their patients and family members. A patient satisfaction assessment revealed that the microsystem is scoring below the target goal of the 85th percentile.

Context: The microsystem being addressed by this quality improvement project is an outpatient perioperative …

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused …

Every Milliliter Matters: A Quality Improvement Initiative For Postpartum Quantified Blood Loss, Amy O. Quinones

Master's Projects and Capstones

Problem: The microsystem for maternal-child healthcare in 2020 had 5.9% of deliveries progress to a postpartum hemorrhage. In 2021, the percentage of deliveries that progressed to a postpartum hemorrhage increased to 12.3%. The nearly two-fold increase in postpartum hemorrhage occurrence led to the creation of the Quality Improvement (QI) initiative to identify postpartum hemorrhage at an earlier stage. The QI initiative aims to extend the quantitative blood loss (QBL) measurement beyond labor and delivery, and support identification of postpartum hemorrhage in the postpartum period.

Context: The microsystem that this quality improvement project occurred on were three postpartum units in a …

Implementing Aidet And Commit To Sit To Increase Patient Satisfaction In The Pediatric Outpatient Setting, Tiffany Nguyen

Master's Projects and Capstones

Problem: This quality improvement initiative aims to implement AIDET, Commit to Sit, and culturally competent care in a pediatric outpatient surgery clinic to increase patient satisfaction. The microsystem falls beneath the 85th percentile of patient satisfaction scores on their unit. They have a pre-intervention Net Promoter Score (NPS) of 80.7, indicating about 80% of patients were "promoters" and would likely return to the clinic, and 20% of patients were "detractors" and unlikely to return (Appendix F). "Detractors" were found in areas including patients trusting providers with care, care providers listening, care providers explaining things, and patients recommending the facility to …

Using Group Interviews To Innovate The Selection Process For New Graduate Nurses, Karen T. Descent

DNP Qualifying Manuscripts

A pilot program in two hospitals using a group interview approach for new graduate nurse selection enabled multidisciplinary leadership participation. The interview process incorporated structured behavioral and scenario-based questions. The pilot shortened the traditional one-to-one interview process by 70% and improved retention one year from hire by 17.5%.

A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski

Evidence-Based Practice Project Reports

Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …

Deconstructing Tiktok Videos On Mental Health: Cross-Sectional, Descriptive Content Analysis, Corey H. Basch, Lorie Donelle Phd, Rn, Fcan, Joseph Fera, Christie Jaime

Publications

BACKGROUND: Social media platforms that are based on the creation of visual media, such as TikTok, are increasingly popular with adolescents. Online social media networks provide valuable opportunities to connect with each other to share experiences and strategies for health and wellness. OBJECTIVE: The aim of this study was to describe the content of the hashtag #mentalhealth on TikTok. METHODS: This cross-sectional, descriptive content analysis study included 100 videos with the hashtag #mentalhealth on TikTok. All videos that included the hashtag #mentalhealth were analyzed and coded for the presence of content categories. Additionally, the comments to each video were viewed …

Increasing Vaccination Rates In The Latin X Communities Through A Public Health Initiative For Increasing Education And Vaccination, Gabriela Carrico

Doctor of Nursing Practice (DNP) Projects

Background: The COVID-19 disease has been found to cause an estimated 570,003 deaths in the United States (Centers for Disease Control and Prevention [CDC], 2021). Statistics showed that the elderly, immunocompromised, and vulnerable populations are the most at risk for this disease. Vaccination is an important aspect of disease prevention in healthcare issues around the world. Vaccination against the COVID-19 prevents this communicable disease from the spread and serious adverse health outcomes.

Problem: The Latin X communities in the Tenderloin District in San Francisco city are confronted with multiple factors that affect their willingness to receive the COVID-19 vaccine. Factors …

Highly Efficient Loading Program For En Route (Helper) App, Melissa A. Wilson, Kaya N. Brown, Brittany L. Fouts

Nursing Faculty Publications

Various embodiments of the disclosed subject matter provide systems, methods, architectures, mechanisms, apparatus and/or computer implemented method configured for automatically managing En Route Care (ERC) transport patient and medical equipment loading

Implementation Of A Primary Care Toolkit To Improve Dementia Diagnosis And Management In A Rural Setting, Meredith George-Wieland

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: There are six million people with dementia living in the United States and this number is expected to rise exponentially due to the aging population. In the United States, it is estimated that only two thirds of dementia cases are recorded during primary care visits and an estimated, one third of cases have been either missed or disregarded.

LOCAL PROBLEM: In a remote primary care clinic on Kodiak Island, off the southeastern coast of Alaska, there is a lack of dementia and related cognitive diagnoses in the primary care setting due to patients’ and families lack access to the …

A Competence-Based Online Learning Video And In-Situ Simulation To Improve Perioperative Anesthesia Nurse Practitioner Self-Efficacy In Responding To Anesthesia Emergencies, Sara Durgerian

Doctor of Nursing Practice Scholarly Projects

Background: Nurse Practitioners (NPs) are broadly educated to the population-based role in which they practice. Further education in subspecialties is essential as more NPs are working autonomously in highly specialized care areas.

Problem: In the Department of Anesthesia at a large urban hospital, perioperative anesthesia NPs lack formal training in the subspecialty of anesthesia, which contributed to a lack of self-efficacy when responding to anesthesia emergencies.

Methods: An asynchronous multimodal brief instructional video accompanied by an in-situ simulation of an anesthesia emergency was developed to increase knowledge and confidence in perioperative anesthesia nurse practitioner response to anesthesia emergencies.

Results: A …

Mentorship In Retail Health - A Quality Improvement Project Initiative, Judith Thigpen

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Nurse practitioners (NPs) practicing in retail health face issues that complicate provision of care including isolation, lack of support staff, and non-clinical administrative and business duties. To address this, a national retail health company implemented a mentorship program for newly graduated, newly hired NPs. This quality improvement project will facilitate the implementation and evaluation of this mentorship program in one of the company’s regions in Georgia.

AVAILABLE KNOWLEDGE: Literature suggests that NPs believe that a mentor can help contribute to professional development, counter stress and anxiety, provide support, increase job satisfaction, and guide in critical decision making.

AIMS: 1. …

Revision And Deployment Of An Oral Anticancer Medication Adherence Toolkit, Kristine Lefebvre

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Oral anticancer medications offer state-of-the-art cancer treatment with the convenience and autonomy of self-care in the home. Professional organizations often provide expert guidance and resources to support the provision of high quality, safe, evidence-based care. LOCAL PROBLEM: Many institutions lack a formal oral anticancer medication program, including a process to assess and monitor adherence. Nurses and their colleagues look to the literature, training, collaboration with colleagues, and through practice tools and programs available through their specialty associations for support in their adherence work. The Oral Adherence Toolkit released in 2016 needed updating to reflect current best practices. METHODS: The …

Acute Kidney Injury: Evaluating Risk Factors In Hematopoietic Stem Cell Transplant Patients, Jennifer Tenley, Pamela Millin, Austyn Franklin

Nursing Masters Papers

Hematopoietic stem cell transplant (HSCT) patients are at risk to develop acute kidney injury during the transplant process. Acute kidney injury (AKI) can occur due to a multitude of insults related to nephrotoxic medications, hypoperfusion, and dehydration. Additionally, patients who present for HSCT may have risk factors that could pose an increased risk of developing AKI which include chronic kidney disease, hematologic disease, type of transplant, conditioning chemotherapy, and poor pretransplant renal testing. The purpose of this secondary analysis was to identify the contributing factors that may influence the development of AKI, understand the relationships between the variables, and identify …

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Assessing Provider Confidence Of Acute Otitis Media Diagnosis And Treatment With An Optical Coherence Tomography Device In The Urgent Care Setting, Meghan Weber, Susan Wolf

Doctor of Nursing Practice Projects

Acute otitis media (AOM) is one of the most common causes of pediatric infection worldwide at approximately 350 million visits per year, as well as one of the most challenging illnesses to diagnose for providers (Tong et al., 2018). This dilemma leads to antibiotics being inappropriately prescribed, at a rate of approximately 75% (Islam & Hassinger, 2018). This project sought to explore the impact of implementing an optical coherence tomography (OCT) device in an urgent care setting when assessing otalgia in patients 0 to 17 years of age. The three main objectives of the project were to increase provider confidence …

When Helping Becomes Hurting: Compassion Fatigue In Pediatric Nurses, Annabelle Nagy

Undergraduate Theses and Capstone Projects

Compassion fatigue is prevalent in all nursing settings; however, it is particularly important to consider in pediatric nursing because of the unique aspects of this nursing speciality. Compassion fatigue, comprised of burnout and secondary traumatic stress, is a risk to pediatric patients due to the nurse’s inability to care adequately secondary to the overwhelming feelings of physical and mental exhaustion contributing to nursing attrition and inadequate nurse-to-patient ratios. This thesis applies Jean Watson’s Theory of Human Caring to study the problem of compassion fatigue in pediatric nursing. Compassion fatigue must be recognized and managed, and the necessary interventions employed to …

Humanizing The Intensive Care Unit With Animal-Assisted Therapy, Amanda Pugh

Undergraduate Theses and Capstone Projects

This project serves as an exploration into the current research about animal-assisted therapy in the intensive care unit (ICU) population. Incorporating more holistic treatments into the healthcare field improves patient experiences and encourages patients to have an active role in their recovery journeys. Treating both the physical and emotional needs of patients is valuable to nurses because it helps them to better view patients with unique human dignity, improve the quality of care they perform, and make the healthcare system more centered around the patient as a whole. Patients in intensive care units are more susceptible to developing health complications …

Factors Influencing Vaccination Rates In Children Under Two In Southeast Kansas, Danielle Bennett

Doctor of Nursing Practice Scholarly Project

Introduction

A large Federally Qualified Health Center (FQHC) in Southeast Kansas has a 37% compliance of children completing the recommended combo 10 primary vaccination series before their second birthday. An additional 20% of children would be compliant if the flu vaccine was excluded, raising the compliance rate to 57%. This is still below the national average of 68-75%, leaving many children in Southeast Kansas and northeast Oklahoma unprotected from preventable childhood diseases.

Purpose

The purpose of this scholarly project was to identify barriers to vaccination, including vaccine hesitancy and socioeconomic barriers affecting completion of the primary vaccine series, or combo …

Improving Family Involvement Through Dementia Education Using A Video Sharing Service, Marissa Lynn Bernabe

Doctor of Nursing Practice Scholarly Project

Dementia is a growing issue among healthcare organizations within the United States (U.S.) with approximately 5.7 million individuals diagnosed. These numbers of affected individuals are expected to increase and reach approximately 152 million by 2050 globally. Dementia is a progressive disease of cognitive loss. Establishing goals or items the patient can perform can have a positive impact on patient care by allowing for a collaborative approach and initiating the family as necessary participants in the care of the dementia patient. Video sharing services such as YouTube have made learning easily accessible for a multitude of varied reasons.

A descriptive quality …

Genetics And Genomics In Nursing Practice: Assessing Barriers, Facilitators, And Tailoring Implementation Strategies, Jaanna Guillory

Doctor of Nursing Practice Scholarly Project

The Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were published in 2006. These guidelines define the minimal competency in genetics expected of all nurses regardless of role, specialty, or level of education. However, research indicates that nurses lack knowledge and confidence in their role in genetics/genomics.

This quality improvement project aimed to assess barriers and facilitators of genetics/genomics integration into nursing. This study followed a cross-sectional design emphasizing a representative subset of the nursing practicing community at the Veterans Healthcare System of the Ozarks. Participants were invited to complete the Genetics and Genomics in Nursing Practice Survey …

Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug

Doctor of Nursing Practice Scholarly Project

As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …

Provider Education On Physical Activity For Older Adults, Joseph Morris

Doctor of Nursing Practice Scholarly Project

PROVIDER EDUCATION ON PHYSICAL ACTIVITY FOR OLDER ADULTS

An Abstract of the Scholarly Project by

Joseph Morris

The purpose of this study was to educate nursing staff and providers on the importance of physical activity for older adults to prevent functional decline and maintain quality of life. The project was conducted online using Qualtrics survey software. Data was collected from October 25, 2021 to November 25, 2021. Nursing staff and healthcare providers (physicians, nurse practitioners and physician assistants) that are actively practicing medicine and have experience interacting with older adults participated by completing a two-part survey. The survey consisted of …

An Educational Project On Guidelines Of Treating Respiratory Syncytial Virus And Bronchiolitis In Rural Pediatric Patients, Mallory Revell

Doctor of Nursing Practice Scholarly Project

Bronchiolitis is the leading cause of hospital admission for infants. Eighty percent of bronchiolitis cases are caused by the respiratory syncytial virus (RSV). While guidelines on the treatment of RSV/bronchiolitis have been published since 2006, the literature reveals that they are not widely followed. After completing a literature review on the current evidence-based treatment guidelines of RSV/bronchiolitis, nurses from a rural hospital in southeast Kansas were educated on these guidelines to improve their knowledge regarding treatments for RSV/bronchiolitis pediatric patients. This study utilized a pretest-posttest design to determine the knowledge gained after the educational presentation. The nurses completed a survey …

Improving Venous Thromboembolism Prophylaxis Knowledge Among Registered Nurses On A Medical-Surgical Inpatient Unit In The Midwest, Theresa Umscheid

Doctor of Nursing Practice Scholarly Project

Venous thromboembolism (VTE) is the third most common vascular disease and includes approximately 900,000 cases annually in the United States. The purpose of this quality improvement project was to enhance education regarding VTE prophylaxis for registered nurses on a medical-surgical inpatient unit at a hospital in the Midwest. This study was initiated due to one nurse’s perception that staff on this unit lacked confidence and expertise on the importance of VTE prophylaxis interventions. Participants completed a VTE knowledge pretest, followed by an educational intervention on VTE prophylaxis utilizing Health Stream. After the intervention, participants completed a VTE knowledge post-test. The …