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, …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Implementation Of A Comprehensive Diabetic Foot Care Program In Primary Care, Peguy Sylvain

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Diabetes Mellitus is a growing health problem in America. Uncontrolled diabetes can result in vascularcomplications. One of the most common complications of diabetes is diabetic peripheral neuropathy. Early foot carescreening can help prevent Diabetic peripheral neuropathy and other complications such as skin injuries, burns, falls,infection, lower- extremity amputations, and peripheral arterial disease. Interventions that have been shown to improve theidentification of diabetes foot complications include staff education, screening and assessment, use of monofilament,tuning fork for diabetic foot assessment, patient education/ self-care, standardization, and use of electronic medical records(EMR)/electronic reminders.

METHODS: The Plan Do Study Act method of quality improvement …

Examining The Need For Change By Describing The Attitudes And Perceptions Of Team Communications Related To Patient Care And Safety Among Ambulatory Clinic Healthcare Staff, Peter Seivers

Doctor of Nursing Practice Scholarly Projects

Medical errors account up to 250,000 patient deaths annually. Research suggests medical errors are attributable to poor healthcare team communications. The Institute of Medicine posits that communication and teamwork are essential components to safe and successful health care environments. According to the Joint Commission poor communication is considered the root cause of nearly 80% of all serious medical errors. Consequently, the Department of Defense and Agency for Healthcare Research and Research created a team-based training program, known as TeamSTEPPS®, which has shown to improve team communication, performance, effectiveness, patient safety, satisfaction, and health outcomes in healthcare settings. Despite evidence supporting …

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 …

Does Nurses Confidence Improve After Attending A Training For Teaching Home Infusion Patients?, Carol Menorah Young Dnp

Doctor of Nursing Practice Scholarly Projects

Discharge can be a difficult step for patients and their families and a challenging task for nurses. Poor instructions have a negative impact on the patient population. In addition, improper and incomplete discharge information negatively affects the posthospital recovery period and may cause the patient to return to the hospital for the same episode of care. Returning to the hospital emergency room or readmission for the same episode of care will increase the dangers to the patient’s health and recovery plan and increase the cost of individual healthcare. The patient population ranks the quality of discharge information via their responses …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Hepatitis C Screening, Confirmation, And Referral Improvement Project, Maria E. Mcmahon

Doctor of Nursing Practice Scholarly Projects

Hepatitis C is an illness caused by the blood-borne Hepatitis C virus (HCV), and usually becomes a chronic condition. Left untreated, HCV can lead to severe liver disease and liver failure. Newer treatments are effective and well tolerated, but most people with chronic HCV are not accessing treatment due to several factors that will be discussed. The primary objectives of this quality improvement project were to improve the treatment cascade, provide education to providers and patients, and facilitate screening, virus confirmation, and referral to treatment, in a Federally Qualified Health Center.

Evaluating The Impact Of A Team-Based Model Of Primary Care On Provider Burnout And Patient Experience, Kimberly A. Moreland

Doctor of Nursing Practice Scholarly Projects

Background: To assure high quality, safe, affordable, and accessible health care, organizations are embarking on quality improvement initiatives to work toward the triple aim of patient satisfaction, improving the health of populations, and reducing the cost of care.

Description of the Problem: Primary care is the backbone of the health care system, but it is a challenging environment with high rates of clinician burnout. Clinician burnout undermines the ability of organizations to meet the triple aim. Innovative new care delivery models are needed that can meet the triple aim while also mitigating burnout.

Available Knowledge: A PRISMA review of the …

Limiting Potentially Inappropriate Medications In Long-Term Care, Clare M. Ironside

Doctor of Nursing Practice Scholarly Projects

Aim: This project aimed to assess the effectiveness of the STOPP/START tool in identifying and reducing potentially inappropriate medications among multi-morbid, older, long-term care residents in a metropolitan area of a Southwestern state.

Design: In this quality improvement project, seven prescribers working within four long-term care facilities were trained to assess for potentially inappropriate medications using the STOPP/START tool. The medication lists for long-term care residents (n =45) over age 65 were collected at baseline and again at three months post-intervention and assessed for overall medication use, psychotropics, and proton pump inhibitors. The project also assessed prescribers’ comfort and …

Eastern European Orthodox Christian Immigrant Women: A Pilot Study And Needs Assessment, Kimberly A. Babich-Speck

Doctor of Nursing Practice Scholarly Projects

The healthcare perceptions of the Eastern European Orthodox Christian immigrant women (EEOCIW) to the United States (U.S.) are under-represented in the literature. Although they appear similar to Americans, their cultural and religious traditions are outside the mainstream American culture. This pilot study and health needs assessment examines the women’s healthcare perceptions of 14 EEOCIW and identifies similarities and differences with 25 U.S. born Orthodox Christian women (USOCW). Between September and November 2020, interviews were conducted with Orthodox Christian immigrant women from Eastern Europe and Orthodox Christian women born in the U.S. Questions covered the perceptions of women’s healthcare, factors influencing …

Evaluating Va Nurse Acceptance Of Virtual Healthcare Technology During The Coronavirus Outbreak, Francesca Bryan-Couch

Doctor of Nursing Practice Scholarly Projects

At a regional Veterans Administration (VA) hospital, nurses performing case management were unable to perform face-to-face visits with patients due to coronavirus. Care coordination and discharge planning efforts occurred through telephonic case management to preserve personal protective equipment and reduce transmission rates through social distancing. Trust and rapport between patients and nurses were reduced without personal contact. Peplau’s theory of interpersonal relations described six nurse roles and three phases of relationship development required to create therapeutic nurse-patient relationships. Connectedness was a key concept considered to be the path to a successful meaningful therapeutic nurse-patient relationship (Hrabe, 2005).

To evaluate current …

Identification Of Variables For Hemoglobin A1c Prediction, Erica A. Richards

Doctor of Nursing Practice Scholarly Projects

An evolution in healthcare is taking place throughout our country. Healthcare providers are required to achieve an ever-growing number of regulatory and metric-driven standards. This transformation aims to improve both the quality and cost of healthcare in the United States. Diabetes mellitus (DM) is one of the most costly chronic diseases in the United States. Since DM has high mortality, high morbidity, and low quality of life rates, it is no wonder that DM is one of the focuses of the National Committee for Quality Assurance performance improvement tools known as the Healthcare Effectiveness Data and Information Set (HEDIS). In …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Assessment Of Air Force Providers’ Adherence To Overweight And Obesity Guidelines, Dale Harrell

Doctor of Nursing Practice Scholarly Projects

Despite the existence of obesity treatment guidelines, Air Force healthcare providers may offer suboptimal weight management. The purpose of this quality improvement project is to assess adherence by healthcare practitioners with adult overweight and obesity guidelines before and after an educational session on the optimal management of the overweight or obese patient. Overweight or obese adults treated in Military Treatment Facilities (MTF) may not be properly identified and controlled, as providers may not be adhering to the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for the management of obesity.

Improving Vaccination Compliance Among Amish Children In Knox County, Ohio, Laura J. Segraves

Doctor of Nursing Practice Scholarly Projects

Abstract

Children living in Amish communities in Ohio are under-immunized and under-immunized communities are reservoirs for preventable childhood diseases. A recent measles outbreak in central Ohio involved 9 counties and 377 cases of this vaccine-preventable disease. There were 5 hospitalizations related to this measles outbreak in Knox County. Vaccine-preventable illnesses contribute to pediatric morbidity and mortality and are cost prohibitive to individuals and society.

The purpose of this study was to identify real and perceived barriers to immunizations among Amish parents in Knox County, Ohio. The information obtained in this study will be disseminated to the Knox County Health Department …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Development Of A Personalized Education Program Based On An Assessment Of Knowledge Of Coronary Heart Disease And Risk Factors In A Filipino-American Community In New York City, Mervin David

Doctor of Nursing Practice Scholarly Projects

Abstract

Filipino-Americans (FAs) are considered the fastest growing Asian immigrant population in the United States. There are about 2.6 million Filipino-Americans living in the United States (U.S. Census, 2010). Coronary Heart Disease (CHD) is the leading cause of death among FAs in the United States (National Vital Statistics, 2009). Research studies on CHD and CHD risk factors among FAs are limited. The purpose of the study was to explore FAs’ knowledge of CHD, risk factors for CHD and to provide a personalized educational intervention in raising awareness and changing attitudes about CHD among FAs aged 35-75 in a community setting …