Nursing Commons^™

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Bridging The Gap Between Primary Care And Mental Health: A Quality Improvement Project, Coreyann Fluker

Doctor of Nursing Practice (DNP) Manuscripts

Establishing a robust connection between primary care and mental health services is crucial for fostering a patient-centered healthcare model. This quality improvement project addresses the pressing issue of limited access to mental health services in rural areas of the United States, leading to unmet mental health needs for patients. These challenges were identified within a Federally Qualified Health Center (FQHC) in Southwestern Pennsylvania. Implementing a collaborative care approach seeks to enhance triage practices by facilitating warm handoffs from primary care to mental health providers while integrating an informative triage tool, the SAD PERSONS Scale.

This collaborative approach enhances patient outcomes …

Integrating Health-Related Quality Of Life And Evidence-Based Polycystic Ovarian Syndrome Management: A Quality Improvement Initiative, Kami Beveridge Wast

Doctor of Nursing Practice (DNP) Manuscripts

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age, characterized by symptoms such as irregular menstrual cycles, infertility, and metabolic issues (Fatemeh et al., 2021). Despite its prevalence, the management of PCOS remains challenging due to its manifestations and impact on quality of life. Current treatment paradigms often fail to adequately address the comprehensive needs of this patient population, highlighting a substantial gap in care.

Utilizing the Plan-Do-Study-Act (PDSA) methodology, this quality improvement (QI) project aimed to enhance the management of PCOS and improve the quality of life for patients in a …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Improving Patient Care For Individuals With Autism Through An Evidence-Based Education Video: A Pilot Feasibility Project, Emily Santillan, Katreena Collette-Merrill, Terisa P. Gabrielsen, Petr Ruda

Student Works

Autism Spectrum Disorder (ASD) affects approximately 1 in 36 children in the United States, presenting challenges in healthcare provision due to varied severity and frequent comorbidities. Despite increased healthcare utilization by individuals with ASD, they often encounter barriers to receiving adequate care, including communication difficulties and untrained healthcare providers. Consequently, there is a pressing need for autism-friendly healthcare environments.

This study aimed to assess the feasibility of improving healthcare provider self-efficacy in caring for patients with ASD through an evidence-based online educational video. Following Bandura's Self-Efficacy Theory, the project developed a video outlining simple accommodations for ASD patients in ambulatory …

Instructor Characteristics That Increase Self-Efficacy In Nursing Students, Kaycee Jodean Jacobson

Walden Dissertations and Doctoral Studies

With the current nursing shortage, finding ways to increase nursing retention in graduate nurses can help ease the shortage. Self-efficacy is a factor that contributes to an individual’s well-being and can affect their professional accomplishments. The purpose of this study, guided by Bandura’s theory of self-efficacy, was to identify instructor characteristics that may impact student perceived self-efficacy in the clinical setting. Bandura identified self-efficacy as a factor that contributes to an individual’s well-being as a whole and can affect their professional accomplishments. A sample of 19 nursing students who were enrolled in a clinical course were recruited and completed the …

Enhanced Bariatric Surgery Preoperative Support To Improve Postoperative Surgical Outcomes, Jeffrey Eavey

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

Bariatric surgery is a procedure known to eradicate disease and improve the quality of life for patients suffering from obesity. The pathway to bariatric surgery is a comprehensive and lengthy process; therefore, patients require additional support from the multidisciplinary healthcare team and their support system. The accrediting body of an academic medical center bariatric surgery program (BSP) requires the program to limit and reduce 30-day all cause postoperative emergency department (ED) visits and 30-day all cause postoperative readmissions. A telemedicine visit within two weeks prior to surgery was added with the intent to assess patients for knowledge deficits and …

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

A Clinical Practice Guideline On Dyslipidemia Screening In Children, Nadine Touayem Mbou

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Nadine Mbou has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Deborah Lewis, Committee Chairperson, Nursing Faculty Dr. Elizabeth Diener, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2024 The burden of dyslipidemia among children has increased substantially, affecting approximately 7% of adolescents in the United States. Although pediatric dyslipidemia screening can promote early identification, a standardized clinical practice guideline (CPG) …

Cultural Responsiveness And Inclusion Tool For Health-Related Simulation, Beth F. Hallmark, Taryn Mccoy

Faculty Scholarship Symposium

The Cultural Responsiveness and Inclusion Evaluation Tool for Health-Related Simulation is a comprehensive instrument our team designed to evaluate effectiveness of culturally responsive teaching within simulation scenarios. This tool seeks to evaluate how the inclusion of diverse patient scenarios and culturally congruent information enhances the learner experience in health-related simulations. This tool was developed in conjunction with faculty from Bangalore Baptist Hospital Rebekah Ann Naylor Institute of Nursing, a leading nursing school in India and key partner of Belmont University. Through co-creation and co-development of this tool, we were able to create common definitions related to cultural congruence, psychological safety, …

Improving Outcomes In Patients With Major Depressive Disorder Through The Utilization Of The Patient Health Questionnaire-9 Screening Tool In A Mental Health Setting., Murielle Nankeu

Doctor of Nursing Practice Final Project Abstract

Improving Outcomes in Patients with Major Depressive Disorder Through The Utilization of The Patient Health Questionnaire-9 Screening Tool in a Mental Health Setting.

PURPOSE This scholarly project focused on the implementation and adherence of the PHQ-9 screening tool by nurses and healthcare staff in patients diagnosed with MDD, aiming to improve patient outcomes and reduce readmission rates.

BACKGROUND There is a lack of a standardized validated screening tool. Utilizing depression screening is crucial in preventing poor outcomes. Q.I. was initiated in a 23-bed inpatient psychiatry geriatric unit in a large city in Texas.

METHODOLOGY The methodology utilizes a standard analytical …

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Improving Early Identification And Management Of Depression Symptomology Through Implementation Of Universal Depression Screening In A University Student Health Center, Jessica M. Monjaras

Evidence-Based Practice Project Reports

Depression is the leading cause of disability in the United States for individuals aged 15 to 44 (Anxiety and Depression Association of America, 2023). The purpose of this evidence-based practice (EBP) project was to increase early identification of depression through implementation of universal depression screening, and to implement management strategies to decrease symptoms of depression. A two-tiered approach to universal depression screening was utilized through use of the PHQ-2 and PHQ-9 screening tools. Ten young adult patients, between the ages of 18 to 25, from a university student health center clinic in Northwest Indiana participated in this project. Participants underwent …

Parents And Health Care Teams Perceptions Of Communication In Neonatal Intensive Care Unit, Marjan Mardani, Haydeh Heidari

The Qualitative Report

Parents experience a lot of stress in the neonatal intensive care unit (NICU). Then effective communication between parents and members of the care team is an essential component of improving the quality of care. The present study was conducted by qualitative exploratory research method for explaining parents and health care teams' perceptions of communication in NICU. We selected 39 participants by purposive sampling. We collected data through in-depth semi-structured, face-to-face interviews. The transcripts were analysed using the conventional content analysis approach. Three themes were obtained by analyzing the data included, the nature of communication, the theme of factors affecting successful …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Implementing An Insomnia Assessment And Management Algorithm In A Rural Pirmary Care Clinic, Rebekah Gaffin

Doctor of Nursing Practice Projects

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

Impact Of Sepsis Education For Emergency Department Staff: A Quality Improvement Project, Shayna E. Thoene, Shannon Mills

Doctor of Nursing Practice Projects: College of Nursing

Background: Sepsis continues to be a critical issue worldwide. New sepsis guidelines instituted by the Centers of Medicare and Medicaid Services (CMS) list evidence-based standards to comply with regarding care for sepsis patients. To help a new acute care facility meet compliance, a sepsis educational program has been developed to assess staff knowledge and confidence in caring for these patients.

Methods: This quality improvement (QI) project was developed using a pre-post study design to assess the impact of implementing a sepsis educational program for emergency department staff at this new acute care institution. A sepsis educational program was derived from …

Implementation Of An Algorithm To Reduce Wait Times For College-Aged Women Presenting With Uti Symptoms, Mallory Beck, Miranda Neu

Doctor of Nursing Practice Projects: College of Nursing

Urinary tract infections, UTIs, are among the most common reasons college-aged women seek medical care. The selected University clinic has a difficult time triaging walk-in UTI patients promptly. Long patient wait times have a negative effect on patient and employee satisfaction scores. An algorithm was created to assist the University clinic in triaging walk-in UTI patients using guidelines from the American Academy of Family Physicians updated with the most current clinical practice recommendations. The algorithm includes the utilization of a point-of-care urine analyzer which provides urinalysis results in 120 seconds. With the algorithm and point-of-care urine analyzer, the student health …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Heart failure is the leading cause of hospital admissions among adults over 65 years old and lack of patient knowledge regarding the self-management of heart failure is a key factor in rising readmission rates. This project enhances inpatient heart failure education using a laminated heart failure zone tool handout to guide heart failure education. The intent was to increase patients’ confidence regarding heart failure self-management and positively impact patients’ knowledge regarding the management of heart failure.

Materials and Methods

The process included identifying hospitalized patients who had been flagged as a heart failure core measure or had been identified …

Home Based Primary Care Program Evaluation Of Loneliness, Depression, And Multimorbid Conditions Of Older Midwest Veterans, Renee R. Sullivan

Doctor of Nursing Practice Projects: College of Nursing

Objectives: This program evaluation of Veteran Administration’s (VA) Home-Based Primary Care Program (HBPC) measured the differences in loneliness, diagnoses of Major Depressive Disorder (MDD), Post Traumatic Stress Disorder (PTSD), Anxiety, and Traumatic Brain Injury (TBI) and multimorbid conditions in rural and urban older adult veterans compared with older adult community-dwelling veterans. The correlations of loneliness using the 11- Item Revised University of California Los Angeles (R-UCLA) Loneliness Scale will describe the relationship of loneliness to mental health diagnoses, multimorbid conditions, demographic data, caregiver presences and the number in-person and phone contacts with the HBPC providers of a Midwestern Veterans Administration …

Experiences Of Registered Nurses Returning To Practice After A Career Break, Jill V. Scott

Theses & Dissertations

This dissertation explores the complex experiences of Registered Nurses (RNs) returning to practice, with a particular focus on the impacts of self-efficacy, recruitment strategies, and regulatory barriers. The first article, a literature review, examines the self-efficacy of RNs returning to practice, emphasizing the importance of refresher programs and support to facilitate this transition. This review also evaluated the preparedness of RNs re-entering the workforce, and evaluated the role of self-efficacy in successful reintegration into clinical practice. The second manuscript delves into the challenges of reaching and recruiting health professionals who have left the profession, identifying community partnerships, social media, and …

Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer

Doctor of Nursing Practice Projects: College of Nursing

Purpose

The purpose of this study was to evaluate the knowledge and attitudes of nursing students participating in a high-fidelity transgender patient simulation. The aims were to increase student knowledge and confidence to improve communication and provide more inclusive and equitable care.

Healthcare providers are not adequately prepared to manage the unique health needs of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Nurses are ideally positioned to address gaps in LGBTQ healthcare by providing culturally competent care. Yet, LGBTQ health education is lacking in most undergraduate nursing school curriculums.

Methods

62 undergraduate nursing students participated in a post-surgical …

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …

Using Readiness To Change For Dietary Modification In A Rural Primary Care Setting, Rebecca Johnson Beller

Theses & Dissertations

Cardiovascular disease is a prevalent noncommunicable disease. Modifying lifestyle behavior can decrease cardiovascular disease morbidity and mortality outcomes. This dissertation's purpose was to explore behavioral change interventions with dietary strategies to reduce cardiovascular disease rates. The integrative review explored aspects of dietary strategies in the primary care setting. Despite the importance of diverse studies, comparing all the components results in limited generalizability. In the following chapter, a cross-sectional study elicited healthcare professionals’ perceptions of the usefulness of a readiness for lifestyle change tool in clinical practice. Currently, a common, widespread adoption of a readiness for lifestyle change tool is not …

Improving Collection Of Second Blood Pressure For Patients In Primary Care Who Present With An Elevated Reading, Jordan Sieh, Elizabeth Sundberg, Tania Arreguin

Doctor of Nursing Practice Projects: College of Nursing

Purpose: Early diagnosis of hypertension is critical to prevent complications such as renal and cardiovascular diseases. Many healthcare facilities do not have a blood pressure training program educating appropriate staff on importance of accurate blood pressure readings and techniques. The purpose of this project is to improve the number of patients with elevated blood pressure reading at the OneWorld Quick Sick Clinic.

Methods: Health aides/Health Assistants/Medical assistants at OneWorld Quick Sick will receive blood pressure training to review proper techniques. During this training they will also be educated on appropriate follow-up blood pressure readings and a new technique to document …