Family Practice Nursing Commons^™

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 …

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic

Electronic Thesis and Dissertation Repository

Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Health Care Initiative To Evaluate The Impact Of A Nurse Practitioner Led Community Wound Care Service On Emergency Department Utilization, Sherry Morrell

Electronic Thesis and Dissertation Repository

Nurse Practitioners (NP) diagnose and treat wounds and wound-related conditions based on their advanced scope of practice. An NP with graduate-level wound care education (NP(W)) gains additional knowledge and clinical experience to provide comprehensive wound care.

This research aimed to explore community patients’ access to wound care in Southwestern Ontario (Canada). A quality improvement project was initiated utilizing stakeholder feedback to develop and implement a 12-week pilot NP(W)-Led community-based wound care service; the NP(W) wound care practices, clinical outcomes, and adverse events were described. One hundred twelve participants attended the service over 117 visits. The NP(W) services included prescribing and …

Providing Hispanic Immigrant And Migrant Health Care In America: Could Nps Be The Answer?, Hamabwe Kabwe

All Graduate Theses, Dissertations, and Other Capstone Projects

In recent years, the United States (U.S.) has seen an influx of Hispanic/Latino migrants/ immigrants fleeing their homes in South America, seeking opportunities for a better life in the U.S. Immigrants and their families often present to the U.S. with unique, unmet health care needs that ultimately impact the U.S. healthcare system and migrant health outcomes. Migration is a significant burden for the U.S. health care delivery system today and further magnifies known problems including inability to provide care to all because of lack of insurance for all, racial disparities in care outcomes, and unequal distribution of providers. There is …

A Nurse Practitioner-Led Group Advance Care Planning Program In An Independent And Assisted Living Community, Alexander Bustos

DNP Qualifying Manuscripts

It has been well documented that the majority of people want to spend their last days in the comfort of their own homes, free of pain, and off any dependent machine. , However, the majority of people have not documented these wishes or talked with their family or provider about end of life care (Hamel, Wu, & Brodie, 2017). The Patient Self Determination Act (PSDA), which took effect on December 1, 1991, was enacted to raise awareness and promote discussions between patients and providers about end of life (EOL) healthcare decisions. The primary care nurse practitioner is in a prime …

Identifying Perceived Barriers To Primary Health Care Access In Rural, Medically Underserved Areas, Suzanne Hewitt

Doctoral Projects

Persons living in rural areas designated as having primary care provider shortages often lack access to timely and appropriate levels of care, frequently forcing them to forego care, delay treatment, or seek care in an emergency department for non-urgent complaints. This qualitative study reviewed evidence-based research and data generated from two focus groups sessions to generate a body of distinctive knowledge of the barriers to primary healthcare access as perceived by members of this rural, medically-underserved area of northern California. The theme that was identified, through conventional qualitative content analysis, as most prevalent among subjects was the inability to schedule …

The Role Of An Advanced Practice Provider (App) And Its Relation To Physician Shortages And Rural Healthcare Survival: A State-By-State Analysis, Allen Anderson

Dissertations, Theses, and Projects

The extent that Advanced Practice Providers (APPs) are able to practice independently with a full scope of practice varies state-by-state. The purpose of this paper was to review how APPs could help in a number of different areas of healthcare. This analysis examines the state of rural healthcare and reviews physician shortage statistics and hospital closures by state. In the examination, it also evaluates which states have full scope, reduced scope, and restricted scope of practice laws and cross-references that with states that have experienced a hospital closure. Through case studies, this research finds that APPs can be an alternative …

Nurse Practitioner Students: Providing Wellness Screenings To Underserved Older Adults, Rexanna Tatlock

Purdue Journal of Service-Learning and International Engagement

Rexanna Tatlock (BSN, RN, CCRN) received a BSN from Saint Francis College in 2003. As a registered nurse, she specialized in critical care nursing and eventually enrolled in the Adult Gerontology Nurse Practitioner master’s program in Purdue University’s School of Nursing in 2016. Upon graduation in May 2018, Rexanna has planned to focus on primary health care. The service-learning project provided primary care clinical experience, while meeting the needs of an underserved older adult population. This article will discuss the community partnership, a needs assessment, and a wellness screening offered to Fairington Apartments (FA) residents.

Benefits Of Interprofessional Education Between Advanced Practice Nurse Practitioner And Dentistry Students, Oksana Prodan

DNP Qualifying Manuscripts

Background: Interprofessional Education (IPE) is mandated for accreditation in health professional schools. IPE between Advanced Practice Registered Nurse (APRN) and dentistry students have been developed to improve health oral systemic health outcomes and improve inter-professional practice competencies.

Method: Literature on APRN dental IPE was searched was searched via CINAHL Complete from 2007-2018, looking for scholarly journals, English language. The search was narrowed from 55 to three relevant, data-based studies.

Results: Review of literature produced one study demonstrating benefits of IPE for both APRN and dentistry students, one study only focused on benefits for APRN students, and another IPE article was …

Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan

Doctor of Nursing Practice (DNP) Projects

Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …

Changing Health Care Policy By Utilizing Kingdon's Policy Stream Theory, Brittney Welch

Graduate Theses, Dissertations, and Capstones

The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care …

Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)

Doctor of Nursing Practice Final Manuscripts

Background
Veterans are disproportionately affected by chronic pain. Conventional pain management lacks emphasis on self-care and relies heavily on prescription opioids. Primary care providers (PCP) are able to educate veterans on self-care management; however, frequent follow-up is needed to improve overall pain and quality of life.

Objective
To implement a Nurse Practitioner (NP) telephone follow-up guided by the 5A’s framework among veterans with chronic pain in a primary care setting. This pilot evidence-based project (EBP) aimed to improve follow-up of self-care management in order to decrease pain, increase quality of life, and decrease pain medication use.

Materials & Methods
The …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Feasibility Study For Rural Health Clinic, Cynthia A. Noble

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Cindy Noble

The purpose of this study was to determine the feasibility of a rural health clinic in the Adair, Oklahoma area. A mixed-mode survey was sent to 2,890 households within a certain zip code for the Adair community and surrounding area. A link for the survey was also included so the survey could be accessed on line. The total number of surveys returned was 88. The respondents of the survey did show a willingness to use healthcare clinic if one were available in Adair, Oklahoma. The surveying also showed that the majority …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Fnp Led Mobile Health Services For The Homeless Population, Tenzin D. Lama

Doctor of Nursing Practice (DNP) Projects

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing …

Primary Care At Home: Nurse Practitioners' Perceptions And Practices, Tonya Bragg-Underwood

Doctor of Nursing Practice Technical Reports

Background: Primary care at home is not a new idea, but rather a reinvention of an old and almost forgotten practice. Today, only 1% of primary care visits are provided in a home setting; despite the increasing aging homebound population in the United States. Current primary care at home research relates improved patient outcomes with primary care at home visits. Primary care at home is reemerging in the United States, but currently is not generating many positive reviews. There is a gap in the current primary care at home literature regarding nurse practitioner home visit practices and perceptions. Methods: A …

Nurse Practitioner Supply And Demand And Development Of A Family Nurse Practitioner Program, Cassaundra Hefner

Nursing Theses and Capstone Projects

The development of a nurse practitioner program in a rural community to meet the supply and demand of Nurse Practitioners (NP) in North Carolina was the focus of this project. With the recent enactment of the Patient Protection and Affordable Care Act (PPACA) (H.R. 3890), the United States (U.S.) is faced with a predicted primary care provider shortage of 45,400-65,800. According to Miller (2011) The New England Journal of Medicine ranked North Carolina as # 7 in the U.S. as having the biggest challenge of producing enough primary care providers to meet the needs of the newly insured. A detailed …