Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

The Effectiveness Of Annual Mammograms Versus Triennial Mammograms In Women Under The Age Of 50, Jordyn A. Gowell, Dakota Grace Cochran, Ashley Cantwell, Sara Doughty, Allison Sgrosso

Non-Thesis Student Work

The current recommendation for mammography frequency is every 2 years after age 50. However, newer data shows that yearly mammograms are effective in early detection of breast cancer, even before age 50. These authors posed the question: In women under age 50, is a yearly mammogram more effective than a mammogram every 3 years in detecting breast cancer? A literature search was conducted on CINAHL, MEDLINE, Google Scholar and Cochrane Library using the following terms: mammography, mammogram, annual, yearly, every three years, triennial, and breast cancer. A total of 10 articles met the inclusion criteria. The results of the literature …

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …

Hepatitis C Virus Screening Strategies To Improve Early Identification And Treatment: ​ A Scoping Review​, Megan Elizabeth Lyons, Rn, Bsn, Ccrn, Thomas Tyler Bennett, Rn, Bsn, Ccrn, Felicia Ann Gray-Hamilton, Rn, Bsn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment.

Methods

This review began with a literature search using CINAHL and PubMed …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Improving Hepatitis C Virus Screening Through Bundle Interventions, Jennifer West

Doctor of Nursing Practice Projects

Abstract

Hepatitis C (HCV) is estimated to impact 57,500 people in the US and is a leading infectious disease worldwide. The purpose of this DNP Project is to increase provider confidence in screening, early detection rates and ultimately timely treatment for patients at risk for HCV served within a rural Federal Qualified Health center (FQHC).

Interventions for this project included bundle steps consisting of provider and staff training of Hepatitis C guidelines for screening, use of an Electronic Medical Records (EMR) HCV flowsheet and lab template, revision of preventative health form, and self-efficacy survey to evaluate provider and nursing confidence …

Addressing Perceived Barriers To Screening For Adverse Childhood Experiences In Primary Care, Trenton Conway

Dissertations

Problem: Inconsistent screening for Adverse Childhood Experiences (ACEs) in primary care settings leads to fewer appropriate behavioral health (BH) referrals and may increase risk for and incidence of chronic health conditions.

Methods: This quality improvement (QI) project used a descriptive observational design with prospective and retrospective data collection. The CDC’s ACE screening tool was administered to patients 18 years and older presenting to primary care. Data collection included number of ACE screenings completed and the number of BH referrals made following the screening. In additional, information was collected from medical assistants (MAs) and providers about the ACE screening process.

Results: …

Keeping Primary Care Providers Informed About Detecting Skin Cancer In Young Adults, Riley J. Spears

Evidence-Based Practice Project Reports

Skin cancer is a common, life-threatening disease that affects anyone, regardless of age or skin color (American Cancer Society [ACS], 2020). The incidence of melanoma is on the rise for young adults, with an estimated 2,400 new cases for individuals aged 15 to 29 (ACS, 2020). Although skin cancer is highly preventable, clinical guidelines are inconsistent regarding skin cancer screening. The purpose of this evidence-based practice (EBP) project was to determine if the implementation of the INternet curriculum FOR Melanoma Early Detection (INFORMED) program would improve primary care providers’ (PCPs’) confidence about skin cancer and the number of completed and …

Routine Screening For Binge Eating Disorder In Primary Care, Chantel B. Tousignant, Rn, Dnpc, Jennifer Laurent, Ph.D., Aprn

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Estimated prevalence of Binge Eating Disorder (BED) in the United States is 2- 3%, and 5% in the primary care setting. BED is associated with multiple comorbidities and is therefore a public health concern. Effective strategies to improve screening, diagnosis and management exist, but are underutilized. This project aimed to enhance BED screening and diagnosis while optimizing disease management. Methods: Routine screening for BED was completed using the 7-Item Binge Eating Disorder Screener. Patients were screened regardless of visit type and follow-up was offered to those screening positive. BED prevalence was assessed pre and post-implementation. Surveys were used to …

Promoting Recognition And Rescue: Human Trafficking Screening, Erin E. Pittman

MSN Capstone Projects

The exploitation of human beings is a serious public health concern (Centers for Disease Control [CDC] 2018). The United States Department of Justice (2018) defines human trafficking as an act of coercing a person’s labor services or commercial sex acts. Family Nurse Practitioners play a significant role in the identification of victims, especially those practicing in emergency departments. A majority of healthcare providers have yet to establish a standardized screening tool and there is little evidence regarding the impact these screening tools have in recognizing victims of human trafficking (Emergency Nurses Association, 2018). This alarming information brings about the clinical …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Increasing Staff Knowledge And Screening Practices For Adverse Childhood Experiences In Primary Care, Angela Mcgraw

Doctor of Nursing Practice (DNP) Projects

Adverse childhood experiences (ACE) are important to future health outcomes. Many health care providers lack the knowledge or training to assess for ACE. Purpose. The purpose of this quality improvement project is to increase the identification of ACE among adult clients in a primary care clinic in Saint John New Brunswick Canada, through the delivery of an education session for the health care team members and patient screening for ACE. Methods. Staff at one clinic attended an educational program about ACE. Staff completed a pre and post education survey questionnaire (N = 8). Additionally, clinic patients (N= 32) were screened …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

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

DNP Projects

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