Nursing Commons^™

Women’S Shelter Health Needs Assessment, Asmait Woldu, Kelly Dona, Anna Frediani, Andrea Herrejon-Duran

Nursing Leadership in Community Engagement Projects

Women’s Shelter Health Needs Assessment

Introduction

Homelessness is currently one of the biggest societal issues in the United States and evidence indicates it is increasing, particularly for women (McGeough et al., 2020). A group of nursing students from Seattle Pacific University teamed up with a women’s homeless shelter in a Metropolitan city. The agency provides shelter and warm meals as well as laundry, toiletries, bus tickets and more. But even with the resources that they do provide, the residents have other needs that are not fully met, particularly with regard to their health. This is due in large to a …

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …

Amniotic Fluid Embolism Diagnosis & Treatment Pathway, Jeremy May

Doctor of Nursing Practice Projects

Access to care in rural areas can prove difficult for any patient, but especially for the expecting mother. Healthcare providers in these rural settings often lack the staffing and experience to effectively recognize and treat rare obstetric emergencies. Amniotic fluid embolism (AFE) is a rare medical emergency that requires healthcare providers to rapidly diagnose, monitor, and treat the sequela of resulting symptoms in the obstetric patient. After a literature review, a teaching session was developed and implemented as part of the annual training for 20 nursing staff at a small 50-bed rural hospital in central California. An 8-question pre-test was …

Group-Based Interventions Using A Low-Fat Diabetes Diet To Improve Self-Efficacy And Hba1c Levels In African American Type 2 Diabetics, Linda Baker-Bynum

Doctor of Nursing Practice Projects

Background and Problem

Type two diabetes mellitus (T2DM) is a chronic medical condition of impaired glucose metabolism that has significantly impacted the health of Americans. According to Centers for Disease Control and Prevention (CDC), T2DM is the seventh leading cause of death making up over 270,000 deaths in 2017 (CDC, 2020a). There are noted disparities among African Americans who are disproportionately affected by T2DM more than Caucasians. African Americans account for 13% of the population in the United States of which 11.7% are diagnosed with T2DM as compared to Caucasians who make up 76.3% of the population of which 7.5% …

Self Management Programs And Its Effects On Blood Pressure, Thao Vo

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Resources To Promote Senior Independence, Amanda Anderson, Sheree Mae Cacal, Sophia Gallego, Madyson Grant, Lola Wallace

Nursing Leadership in Community Engagement Projects

Resources to Promote Senior Independence

Introduction

Our group of five students from Seattle Pacific University's Lydia Green nursing program assessed the community of an independent senior apartment complex that provides affordable housing for adults aged 65+ in the Seattle area run under Sustainable Housing for Ageless Generations (SHAG). This assignment is for our leadership project and occurred over an 8-week period. During this time, we applied the nursing process to assess, diagnose, plan, and implement an intervention specific to a population's needs. The community faced issues of resource access, exacerbated by the population's low income and age. Our focus was …

Supportive Resources For Unhoused Individuals & Families, Grace Felder, Jordyn Henson, Kial Neang, Nasha Phansangiam, Taylee Thain

Nursing Leadership in Community Engagement Projects

Introduction

Since 2016 King County’s unsheltered homeless individuals have increased by 24% and families experiencing homelessness have increased by 26% (National Alliance to End Homelessness, 2021). In the past 5 years, homelessness has risen by 10% in King County alone (NAEH, 2021). Our agency was an emergency family shelter located in King County that “ensures that no child sleeps outside by centering equity and opportunity for women and families” (Mary’s Place Seattle, n.d.-a). This facility has 5 other family center facilities that provide shelter and resources. Since 1999, our agency with its 6 facilities have aided thousands of women and …

Death Cafés As A Strategy To Foster Compassionate Communities: Contributions For Death And Grief Literacy

The International Journal of Ecopsychology (IJE)

The death-positive movement, the most recent manifestation of the death awareness movement, contends that modern society is suffering from a “death taboo” and that people should talk more openly about death. This movement is striving to shift the dialogue about (and place of) death and dying into community spaces. Death literacy is defined as a set of skills and knowledge enabling people to learn about, understand, and act on end-of-life and death-care options. People and groups with a high level of death literacy have a context-specific comprehension of the death system and can more easily adapt to it, becoming better …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

Measuring The Effectiveness Of Antidepressant Treatment By Implementing Beck's Depression Inventory (Bdi), Azeem Anjum

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project integrates a structured periodic depression evaluation follow-up protocol for patients diagnosed with Major Depressive Disorder who have been prescribed antidepressant(s) at an outpatient mental health clinic. The purpose of this DNP project is to standardize the method of treatment progression monitoring to improve the timeliness of change detection and subsequent treatment adjustments using the Beck Depression Inventory (BDI) Scale.

Background: According to the World Health Organization (WHO), MDD is one of the most common mental health conditions affecting approximately 280 million people globally and 17.5 million adults in the United States. (WHO, 2021). The economic …

Church-Based Hypertension Education: An Alternative Solution To Hypertension Management In The African American Community, Nicole Tofi Rice

Doctor of Nursing Practice Final Manuscripts

Purpose: The objective of this evidence-based project is to explore a church-based hypertension education program as an alternative solution to providing hypertension education to the African American community. The desired goals of this project are: (a) to assess the current levels of adherence to antihypertensive therapy among members of a local African American church, using the Hill-Bone Compliance to High Blood Pressure Therapy Scale, and (b) to conduct a literature review exploring policy options encouraging the implementation of a church-based hypertension education program.

Background: Despite medical advances aimed towards prevention and effective treatment, the African American community remains disproportionately affected …

Are You In Control Of Your Diabetes? Providing 1:1 Diabetic Self-Management Education To Adults With Type Ii Diabetes Mellitus In An Outpatient Clinic In An Underserved Community, Joe Gonzales

Doctor of Nursing Practice Final Manuscripts

Non-insulin-dependent diabetes mellitus (DM) is a complicated multisystem disease that accounts for over 20% of health care spending in the United States (Hildebrand et al., 2019). Uncontrolled DM can lead to heart disease, stroke, blindness, amputations, and peripheral artery disease. The literature supports the use of practice guidelines to improve patient outcomes with diabetes self-management education (DSME) and pharmacological interventions.

The purpose of this evidence-based project was to improve hemoglobin A1c (HgbA1c) levels by introducing the 2021 American Diabetes Association (ADA) Standards of Care guideline to improve diabetes self-management in a largely underserved adult Latino community. The intervention included a …

Improving Patient Self-Efficacy, Readiness, And Completion Of Advance Care Planning Documents Using Prepare Documents And Advance Care Planning Group Referral, Marie Vassiliadis

Doctor of Nursing Practice Final Manuscripts

Advance Care Planning (ACP) is an ongoing discussion about medical decision making between a provider, patient, and support person. ACP can also include legal documentation in the form of an advance directive (AD). Nationally, only 36.7% of adults complete any form of AD for end-of-life care. Recently, ACP has become an important quality metric that many organizations are prioritizing. The purpose of this evidence-based project is to improve ACP readiness, self-efficacy, and documentation among patients at an internal medicine clinic using the PREPARE program and referral to an ACP group meeting. PREPARE for Your Care is an online program aimed …

Managing Menopausal Symptoms Through Exercise And Dietary Changes, Ae Rah Kang

Doctor of Nursing Practice Final Manuscripts

Background: The most critical aging stage for women is the menopausal transition period, which causes various symptoms such as hot flashes, night sweats, sleeping disturbance, and mood swings that lower women's quality of life. Menopausal symptoms that are not managed can exacerbate severe medical conditions such as cardiovascular disease, bone illnesses, neurological diseases, and psychosocial problems. As the first non-pharmacological treatment for menopausal syndrome, several studies have shown that regular exercise and diet control can potentially improve menopausal symptoms and the quality of life.

Purpose: This project aimed to examine the effect of improving the quality of life by reducing …

Implementation Of An Evidenced Based Peripheral Artery Disease Screening Protocol In An Outpatient Internal Medicine Clinic, Sarah Lee Bolanos

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced based project was to implement an evidenced based peripheral artery disease screening protocol in an outpatient internal medicine clinic serving adult patients with multiple co-morbidities. This clinic inconsistently screened patients for PAD using the ankle-brachial index (ABI).

Methods: During a three-month period, 50 patients were screened using current American Heart Association and American College of Cardiology (AHA/ACC) screening guidelines for PAD using the Ankle-Brachial Index (ABI) and the Edinburgh Claudication Questionnaire (ECQ).

Results: Out of the 50 patients screened for PAD, only one patient (2%) had a normal ABI score (1.0-1.4) and was categorized …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …

Evaluation Of Depression Screening Frequency In The Geriatric Population: A Pilot Project, Neha Bhagat

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to emphasize the importance and address the frequency of depression screenings for patients 65 years and older who reside at a nursing home. The first goal was to conduct a retrospective chart review of 18 patients residing at an assisted living facility (ALF) to determine whether a depression screening was completed two-four weeks after admission. The second goal was to educate ALF staff on evidenced-based practice of the importance and frequency of depression screenings for the elderly. The third goal was to increase ALF staff knowledge …

Improving Access To Colorectal Cancer Screening In Latino Communities In California: Eliminating Transition To Practice Hours For Nurse Practitioner Full Practice Authority, June Spilburg

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice Doctor of Nursing Practice (DNP) project was to investigate barriers to colorectal cancer screening in young Latinos living in California. The goals of this project included examining current trends in colorectal cancer in young Latinos, factors which affect access to care, and the current and future state of the California primary health care provider workforce. The aim of this project was to make recommendations regarding strategies to improve access to colorectal cancer screening among Latinos in California.

Background: Early onset colorectal cancer (EO-CRC) is increasing in Latino communities, with colorectal screening rates …

Increasing Utilization Of Ivc Pocus For Patients With Sepsis, Alexis Arreola

Doctor of Nursing Practice Final Manuscripts

Background: Sepsis is the cause of death of half of all admissions in the United States (Rhee, 2019). Medicare has adopted guidelines from the surviving sepsis campaign and labeled them the “The Severe Sepsis and Septic Shock Management Bundle (SEP-1) guideline to address the care required to try to reduce mortality involving septic patients. This bundle has an all or none feature that suggests every patient presenting with septic shock receives 30 ml/kg of normal saline as a bolus. (Medicare, 2021). One must document medical reason for not providing this bolus. Inferior vena cava point of care ultrasound (IVC POCUS) …

Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint

Doctor of Nursing Practice Final Manuscripts

Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.

Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …

Implementation Of The American Diabetes Association Pharmacological Approach For Adults With Type 2 Diabetes Mellitus With Cardiovascular Disease, Jose Cedillo

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice project is to improve the utilization of the 2022 ADA pharmacological approach for individuals with Type 2 Diabetic Mellitus (T2DM). The project implementation site was an outpatient clinic in Southern California with a large T2DM Hispanic population. The new ADA guidelines recommend selecting a glucagon-like peptide 1(GLP-1RA) and/or sodium-glucose cotransporter two inhibitors (SGLT-2) when clinically appropriate to reduce the risk of major cardiovascular events in T2DM patients.

Background: According to the American Diabetes Association, ASCVD is the leading cause of morbidity and mortality for adult individuals with T2DM. The use of …

Be Kind To Your Mind: The Use Of Mobile Based Applications To Reduce Stress And Improve Health Outcomes, Akira Hanson Finn

Doctor of Nursing Practice Final Manuscripts

Now more than ever mental health is in the spotlight on a global scale. Professionals from a variety of different disciplines are being encouraged to evaluate several different coping techniques in order combat the magnitude of societal crisis being discovered post-pandemic. At the top the list is Mindfulness-based interventions. The concept of mindfulness practices is nothing new. Evidence suggests it has existed for thousands of years; however, it is getting more notoriety in the past decade due to increasing expansion of mobile-based applications. These types of technology driven applications offer an easily accessible, convenient, and trackable way for individuals to …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

The Future Of Cognitive Dysfunction In Elderly Patients: A Clinical Perspective With Recommendations, Laura Taylor

Doctor of Nursing Practice Final Manuscripts

Background: The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. The geriatric patient population will likely require the use of surgical services at a higher rate than ever before. To best care for the elderly undergoing procedures with anesthesia, it is imperative to follow the most up to date evidence to avoid post-operative complications, and more specifically post-operative cognitive dysfunction.

Purpose: The purpose of this DNP evidence-based practice project is to identify patients that are at high risk for post-operative cognitive dysfunction prior to undergoing anesthesia. Post-operative …

Improve Hypertensive Patients’ Compliance Postgraduation From The Virtual Care Team Program, Marcie Santillan

Doctor of Nursing Practice Final Manuscripts

Background: Virtual Care Team (VCT) began their program approximately 15 months ago to assist their most vulnerable patients with chronic and uncontrolled conditions such as hypertension, diabetes mellitus, and nicotine use disorder. The program follows the patients for a year to help them manage their chronic conditions and comply with chronic management. When the Virtual Care Team followed up a few months after the graduation with some recent graduates, it was found that a small number of patients returned to their pre-Virtual Care Team habits.

EBP Purpose: The purpose of the project is to follow up on those …

Reducing Polypharmacy Amongst Home Based Older Adults Using Patient Centered Education, Evelyn Oluoha

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to identify and implement a patient education program on medication safety that can help reduce instances of polypharmacy among home-based elderly patients. This education program is pursued as an effective intervention in reducing polypharmacy in home-based older adults.

Background: Studies show that the majority of home-based older adults take at least one to five medications daily, increasing the risk of polypharmacy adverse medical outcomes. Effects of polypharmacy include medication non-adherence, increased risk of potentially inappropriate medication, drug-drug interactions, drug duplications, adverse drug reactions, and higher healthcare …

Talking With Horses: Equine Assisted Activities To Promote Social Engagement In Individuals With Autism Spectrum Disorder, Amy Ezhaya

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this evidenced-based project is to gather data on how therapeutic horseback riding (THR) facilitates social engagement in individuals with autism spectrum disorder (ASD). The project aims to provide alternative treatment options and disseminate information to providers on the importance of community partnerships.

Background: In 2020, it was estimated that 1 in 54 children had ASD, which is a 170% increase since 2000. Often, those diagnosed with ASD also experience co-occurring mental health diagnoses placing a large burden of care on our healthcare system. THR is a growing alternative treatment option and has been found …

The Impact Of The Family Nutrition And Physical Activity (Fnpa) Tool With Diet And Physical Education On Obesity Awareness And Body Mass Index (Bmi) Of Overweight Patients, Sheena Amos

Doctor of Nursing Practice Final Manuscripts

Purpose

This evidence-based practice project aims to apply the Family Nutrition and Physical Activity (FNPA) tool with diet and physical education to increase obesity awareness and decrease body mass index (BMI) among overweight parents in the community. The FNPA screening tool is a behaviorally based assessment designed to allow parents to evaluate obesogenic environments and practices that may predispose their children to become overweight. The first goal was to recruit parents in the community and utilize the FNPA tool to assess and better understand their diet and physical activity levels. The second goal was to increase obesity awareness among these …

A Comparison Of Suprathel Burn Dressing Vs Standard Care On Length Of Hospitalization, Pain Scores, Opioid Use, Treatments, And Outcomes., Rakiema T. Sellars-Pompey, Anthonia Okoh

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced-based practice Doctor of Nursing Practice (DNP) project was to determine the impact and efficacy of using Suprathel artificial wound and burn dressing on patients treated at a UC San Diego Health Regional Burn Center for second-degree burns. The primary goal of this project will be to evaluate the impact of using Suprathel on hospital length of stay; compare wound infection rates, pain score, and morphine equivalent use; and to identify the cost-effectiveness of the Suprathel artificial wound and burn dressing.

Background: Burns are a global health concern causing significant morbidity and mortality, …