Family Practice Nursing Commons^™

Reducing Unnecessary Antibiotics For The Treatment Of Urinary Tract Infections, Megan A. Carullo

West Chester University Doctoral Projects

Urinary tract infections (UTIs) are among the most common infections in women and are often a reason for prescribing antibiotics. Appropriately treating these infections is vital to prevent significant health concerns such as pyelonephritis or sepsis. Providers commonly prescribe antibiotics as a preventive measure, but incorrect usage can lead to unnecessary use of antibiotics. This is a large concern for the medical community, given the increased rates of antibiotic resistance. This quality improvement project aimed to answer the following research question: In women with recurrent UTIs (rUTIs), does presumptive treatment compared to standard treatment upon confirmed infection increase the number …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Prescription For Change: Tackling Inappropriate Antibiotic Use In Urgent Care Settings, Lachundra Mosley

Doctoral Projects

A pressing global health issue that significantly contributes to antibiotic resistance is the inappropriate antibiotic prescribing for Upper Respiratory Infections (URI’s) in urgent care settings (World Health Organization [WHO], 2022). The purpose of this doctoral project was to reduce inappropriate antibiotic prescriptions for URI at an urgent care in D’Iberville, Mississippi through the implementation of an educational pamphlet.

A pre-post intervention project was conducted, collecting data on antibiotic prescribing practices via retrospective chart reviews before and after the educational intervention. Data was collected using a researcher developed screening tool based on Evidence based guidelines to distinguish viral vs bacterial infections. …

Evaluating An Evidence-Based Quality Improvement Initiative For Food Insecurity Screening And Referral In Adults With Diabetes Initiating Continuous Glucose Monitor Therapy, Coni Dennis

Graduate Theses, Dissertations, and Capstones

Diabetes affects 37 million people annually in the United States, with direct medical costs exceeding $237 billion per year (American Diabetes Association, 2018; Xu et al., 2018). Complications account for up to 64% of diabetes-related expenses, emphasizing the importance of glycemic stability in preventing costly and debilitating outcomes (Dieleman et al., 2016). Diet and nutrition, essential for glycemic control, are often undermined by food insecurity—defined as inconsistent access to adequate, nutritious food—affecting 16% of adults with diabetes (Casagrande et al., 2022; Kirby et al., 2021). Food insecurity is linked to higher HbA1c levels, increased complications, and hospitalizations (Thomas et al., …

Mental Fatigue And Self-Care In Informal Oncology Caregivers: A Descriptive Mixed Methods Study, Megan Wayne

MUSC Theses and Dissertations

Purpose:

This dissertation study aimed to enhance understanding of informal caregiver wellbeing by exploring the presence of mental fatigue, the relationships among mental fatigue, self-care, and informal oncology caregiver quality of life (QOL), and determining whether differences exist in self-care engagement and QOL between caregivers who report high and low levels mental fatigue.

Problem:

Healthcare is becoming increasingly reliant on informal caregivers for the management and care of individuals with serious illnesses such as cancer. Previous research has shown that informal caregivers routinely experience many negative effects as a result of providing care including decreased mental health and …

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

Evaluation Of An Advanced Practice Clinician Onboarding Program, Sophia Robinson

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of a mentorship-based onboarding program versus a standard program without mentorship.

PICOT: The PICOT question that guided this project was (P), In newly hired APCs did the inclusion of mentorship in the onboarding process (I) lead to higher levels of general self-efficacy compared to standard orientation practices lacking mentorship (C), within an 8-week timeframe (T)?

Evidence: Nine articles were reviewed, revealing that standardized mentorship, structured orientation, and tailored support for professional development are critical strategies to boost confidence and retention among healthcare professionals.

Intervention: A standardized onboarding program that incorporated …

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 …

Utilization Of The Reproductive Justice Framework In Contraceptive Counseling With Black And African American Women: A Comparison Of Patient Satisfaction And Provider Knowledge, Simranjeet K. Tagore

Doctoral Projects

Current practice in contraceptive counseling is characterized by great variation in both content and implementation. The literature indicates that African American women desire contraceptive counseling based in respect, trust, and equity. Conducted over 8 weeks, this quality improvement project compared satisfaction in African American and Black patients receiving contraceptive counseling by a provider trained in the Reproductive Justice Framework (RJF) versus those receiving contraceptive counseling by a provider not trained in the Reproductive Justice Framework. This project also evaluated the effects of Reproductive Justice Framework training on clinician knowledge. Inclusion criteria for the patients included identifying as Black and/or African …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Cultural Education Interventions Impact On Cultural Competence, Kaylie V. Griffin Ms

ONU Student Research Colloquium

Problem: In the United States, there is a substantial increase in diversity. This increase in diversity poses multiple challenges for healthcare workers and healthcare systems. Because nurses care for patients with various cultural backgrounds, health beliefs and practices, and languages, cultural competency plays a pivotal role in providing patient-centered care. There is a need to enhance cultural education for healthcare workers to ensure that healthcare workers have the skills and knowledge to effectively engage with all patient populations. Implementing cultural education interventions seeks to increase healthcare workers' competency, communication, and patient outcomes. Purpose: The purpose of this research question is …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Senior Theses

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

What Are The Key Factors Influencing The Successful Integration Of Ai In Healthcare?, Gabe Herman

Graduate Research Projects

No abstract provided.

Cycle Synced Fitness: The Impact Of Menstrual Cycle Phases On Women's Exercise Performance And Health, Sabrina Galindo

Graduate Research Projects

No abstract provided.

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Evaluating The Effect Of Sleep Hygiene Education On Sleep Quality Among First-Year College Students, Caroline Lowe Cunningham

DNP Projects

Abstract

Background: The American Academy of Sleep Medicine recommends college students should get seven to nine hours of sleep each night. Only one-third currently meet this recommendation. Poor sleep negatively affects academic performance, mood, and interpersonal relationships. Sleep hygiene is recommended to improve sleep quality and quantity.

Purpose: The purpose of this DNP project was to determine the effect of implementing a sleep hygiene educational intervention in classes intended for first-year college students at the University of Kentucky.

Methods: This quasi-experimental project utilized the Pittsburg Sleep Quality Index to assess participants’ sleep before an in-person sleep hygiene education and after …

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Diabetes Health Coaching Program In An Eastern Virginia Health Center: A Retrospective Program Evaluation, Moniqueia Flint

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

The primary goal of diabetes management is to assist patients in controlling their diabetes and minimizing complications. Diabetic patients require continuous medical care that encompasses medication management, multifactorial risk-reduction strategies, and a multidisciplinary team. Health coaching is an emerging tool used to provide education and motivational techniques to individuals for better self-management of their chronic condition. Health coaching is a proven strategy with favorable effects on hemoglobinA1c (HgbA1c), blood pressure, weight, and health behaviors. A diabetes health coaching program (DHCP) was implemented at an eastern Virginia healthcare center (EVHC). The DHCP’s objective was to assist patients in meeting their individualized …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Lactation Benefits, Experiences, And Education In Bereaved Mothers: A Literature Review, Grace Davis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background: Parents who lose an infant through miscarriage, elective termination, or stillbirth experience perinatal bereavement (Centers for Disease Control and Prevention, 2022). A bereaved mother’s grief could be influenced by lactation as most will still experience lactation regardless of their loss. Generally, these women are solely taught to suppress their milk production, oftentimes resulting in discomfort, leakage, clogged ducts, and even mastitis (Carroll et al., 2020). To prevent adverse effects, bereaved mothers need a comprehensive list of options and education regarding lactation including donation, expression, and suppression. Bereaved mothers' lactation experiences, education, and benefits are vital areas to be …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

The Routine Use Of Tympanometry To Prevent Unnecessary Antibiotics In Patients With Otalgia: An Evidence-Based Practice, Quality Improvement Project, Leslie Leffler

Graduate Theses, Dissertations, and Capstones

Abstract

Background: The use of Tympanometry to diagnosis Otitis Media with Effusion (OME) in adults is not routine practice in primary care, although it is supported by evidence and clinical practice guidelines. The misdiagnosis of OME frequently leads to inappropriate antibiotic prescribing, contributing to the rise in drug resistant infections.

Purpose: This evidence-based practice, quality improvement project sought to determine if the use of tympanometry by Family Nurse Practitioners (FNPs), to assess adults visiting primary care clinics, improved the accuracy of otitis media diagnoses and decreased unnecessary antibiotic therapy. The project also evaluated whether experience using the tympanometer …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Burnout In Medical Assistants In Primary Care: Can Mindfulness Be A Solution?, Natalee D. Calais

Electronic Theses and Dissertations

Burnout is described as feelings associated with emotional exhaustion, depersonalization of patients, and a loss of sense of personal accomplishment and it is unique to healthcare workers. Current research highlights this condition among physicians, nurses, and mid-level providers; however, insufficient research exists regarding the effects of burnout on medical assistants. Research led to mindfulness as a possible solution defined as an intentional regulation of attention and awareness of the present moment. This project sought to see if mindfulness practices could be utilized to mitigate the effects of burnout in medical assistants. It was hypothesized that mindfulness could be a solution. …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …