Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

A Patient Centered Quality Improvement Education Program Designed To Improve The Health Of Patients Living With Uncontrolled Hypertension In A Primary Care Setting, Alia Jamison-Dinowitz

Doctor of Nursing Practice Projects

Cardiovascular disease is the leading cause of death in the United States and it negatively contributes to poor health outcomes (Martinez-Garcia et al., 2018). Within the Antelope Valley in Lancaster California, 30.3 % of city residents have a hypertension diagnosis (Los Angeles County of Public Health, 2017). Much like the city at large, hypertension is a critical issue at AV Pediatrics and Family Medicine (AV Peds). This issue is driven by a variety of factors including a lack of understanding about hypertension and medication compliance, and a lack of understanding about healthy lifestyle choices. Providers at AV Peds have seen …

The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …

Barriers To Screening For Diabetic Retinopathy: A Scoping Review, Amy Cooper Rn, Bsn, Lajerica Bates Rn, Bsn, Julie Bridges Rn, Bsn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

More than 34 million people in the United States have diabetes. Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of vision loss. Risk factors for diabetic retinopathy include Type 1 and Type 2 Diabetes, hypertension, smoking, and being African American or Hispanic/Latino. This scoping review seeks to analyze the current research on ways to increase vision screenings, thus reducing cases of diabetic retinopathy in adults.

Methods

Between September 2020 and November 2021, a search was conducted using PubMed, EBSCOhost, Medline, and CINAHL to identify articles using keywords such as diabetic retinopathy and ophthalmology. This …

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 To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment Recommendations: A Scoping Review, Charles W. Stewart Cpnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: Pediatric health is significantly affected by social determinants of health. Screening for and addressing social determinants of health helps to decrease negative effect on health outcomes. The purpose of this project is to determine if there is an association between addressing or not addressing social determinants of health by the healthcare provider and parents’ adherence to treatment recommendations in children with urinary tract infections.

Methods: Between October 2020 and November 2021, a literature review was performed to obtain data from studies regarding urinary tract infections, social determinants of health and adherence to treatment recommendations. The University of Tennessee Health …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Cultivating Appropriate Prescribing In A Primary Care House Calls Practice: A Quality Improvement Project, Sarah J. Marzolf

Doctor of Nursing Practice Projects

Problem Description: Polypharmacy in the frail elderly can lead to suboptimal management of medical issues. Primary Care Providers (PCPs) often lack knowledge of best practices regarding deprescribing and lack a systematic process for assessing mediation appropriateness. A quality improvement project was developed and executed at Housecall Providers, a home-based primary care practice in Portland, Oregon to facilitate the incorporation of deprescribing into daily practice.

Interventions: Following a literature review, a curriculum was developed and utilized during an educational intervention for PCPs regarding deprescribing best practices. A system for introducing new PCPs to evidence-based deprescribing for the frail elderly. This information …

Evidence-Based Guidelines And Protocol Implementation In A Primary Care Clinic To Improve Chronic Asthma Care, Jo E. Cote

Doctor of Nursing Practice Projects

The aim of this project was to pilot the implementation of evidence-based guidelines and protocols for chronic asthma care in a rural primary care clinic system. Asthma is under-diagnosed and under-treated, resulting in significant burden of disease. Achieving asthma control requires collaborative care between the patient and healthcare clinicians. Education on evidence-based guidelines was provided to healthcare clinicians. Effectiveness of education and integration of altered workflow was measured. Integration of evidence-based guidelines and protocols was demonstrated by clinicians. The results support expanding the project to the remaining five clinics in the clinic system.

Implementation Of A Nurse Visit Model For Patients With Congestive Heart Failure In A Federally Qualified Health Center, Heather Brantley

Doctor of Nursing Practice Projects

Background: Chronic congestive heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs .Congestive heart failure (CHF) continues to be one of the most prevalent and expensive chronic illnesses to treat throughout the world in a time when cost-effectiveness, improved quality, and care based on outcomes is a requirement . Chronic heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs (Lambrinou, Kalogirou, Lamnisos, & Sourtzi, 2012). Traditional approaches …

Increasing Primary Care Hepatitis C Screening In The 1945-1965 Birth Cohort, Maria M. Shimizu

Doctor of Nursing Practice Projects

Background: Over 3.2 million American citizens have been infected with the Hepatitis C virus (HCV). It is estimated three fourths of this population are from the birth cohort born between 1945 and 1965, otherwise known as Baby Boomers. Despite the Centers for Disease Control and Prevention (CDC; 2014) recommendations to screen this population at least one-time regardless of risk factors, screening practices in the primary care setting have been suboptimal (American Association for the Study of Liver Diseases [AASLD], 2015).

Aim: The aim of this project was to identify barriers to HCV screening of the Baby Boomer population in the …

Educating Mothers Of Obese Hispanic Preschoolers To Create Lifelong Healthy Habits, Lynette Marshall

Doctor of Nursing Practice Projects

Problem and Background: Childhood obesity has doubled in children and quadrupled in adolescents in the past 3 decades, increasing from 5% to 17% in one generation. The highest rates of childhood obesity are among Mexican Americans. Obesity can increase health morbidities, and as obese children continue to grow, these health concerns progress to adulthood. In spite of enhanced education and communication between mothers of obese children and their primary care providers, minimal improvement has taken place in terms of outcomes and lifestyle changes.

Methods: Fourteen obese Hispanic 2- to 5-year-olds and their mothers participated in the study. The children’s BMIs …