Family Practice Nursing Commons^™

Implementing The Steadi Fall Risk Screening Initiative Within A Primary Care Setting To Improve Patient Safety, Haleigh Marie Brown

Doctoral Projects

Falls among older adults are a significant public health issue and the leading cause of injury-related illness and death in people aged 65 and older. While evidence-based guidelines exist and awareness of fall risks has increased, many primary care settings do not use standardized fall risk screening protocols. This gap results in missed opportunities for early identification and prevention. To address this need, the Centers for Disease Control and Prevention (CDC, 2019) created the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Toolkit, which offers healthcare providers a structured approach to assess, manage, and reduce fall risk.

This doctoral project aims …

Evaluating The Impact Of Evidence-Based Guidelines On Corticosteroid Prescribing For Acute Upper Respiratory Infections In Outpatient Primary Care, Cody Allen Boyd Hyatt

Doctoral Projects

Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.

The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders …

The Ethical Justification Of Application Of Long-Acting Reversible Contraception In Patients With Intellectual Disabilities, Kelly Savitri

Journal of Health Ethics

This paper explores the ethical justification for the use of Long-Acting Reversible Contraception (LARC) in patients with intellectual disabilities, particularly in scenarios where patients cannot provide informed consent. The tension between respecting autonomy and ensuring beneficence presents a complex challenge for healthcare providers. Drawing on historical context, current reproductive justice issues, and evolving societal attitudes towards individuals with intellectual disabilities, this essay argues for a semi-discrete model that recognizes the need to prioritize patient health and safety while valuing their autonomy. By examining the implications of both past and present practices, this study highlights the necessity for healthcare providers to …

Relationship Of Stress, Family, And Social Support, And Job Satisfaction To Burnout Among Family Nurse Practitioners Employed In Primary Care Clinics In Mississippi, Laura-Jean Scott Brooks

Dissertations

In the realm of healthcare, burnout is the invisible monster that has infiltrated every facet of the industry with grossly visible results. From provider turnover to patient errors, burnout has lifelong effects on the healthcare provider and patient care. This researcher seeks to study variables and the relationship to burnout among Family Nurse Practitioners who practice in primary care in Mississippi. The Review of the Literature demonstrated a lack of findings in burnout among family nurse practitioners. Most of the literature reviewed focused on burnout among registered nurses. The guiding hypothesis of the research study was that social and family …

Reducing Congestive Heart Failure Readmissions Through Discharge Planning And Education, Coewonda Burse

Doctoral Projects

Chronic heart failure (CHF) is a widespread problem among individuals, which, at the same time, consumes a considerable share of global healthcare demand. CHF management poses a persistent issue mainly due to the short interval of hospital readmissions four weeks after discharge, which indicates deficiencies in care transitions and patient education. This doctoral project addresses this topic and evaluates whether implementing patient-specific education and discharge planning programs can decrease CHF-associated hospital readmissions. To investigate the phenomenon, the DNP student completed a retrospective chart review, found an intervention, implemented said intervention, and then evaluated the intervention's effectiveness versus interventions already in …

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. …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Preventing Diabetes Through Prediabetes Screening And Treatment In Primary Care, Dewona Beal

Doctoral Projects

Diabetes is an epidemic in the United States. There are three types of diabetes: type 1, 2, and gestational diabetes. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. This type of diabetes can be prevented or delayed. In persons with T2DM, the body cannot use insulin well to keep blood glucose within normal limits. Several factors, including genetics, lifestyle such as poor diet and physical inactivity, obesity, insulin resistance, hormones, and certain medications, can cause it. A precursor to T2DM is prediabetes. Prediabetes is when blood sugar levels are elevated but not elevated enough to be …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

Full Practice Authority: Determining Readiness Among Nurse Practitioner Students In Mississippi, Betty Hoffman

Doctoral Projects

Full practice authority has been granted to nurse practitioners by many states. These practitioners are educated and trained as full primary providers of health care. Full practice authority for nurse practitioners is not granted in Mississippi, which currently ranks in the lowest positions for health care in the United States. The low ranking can be attributed to a lack of providers and access to services.

This project seeks to explore attitudes and understanding of nurse practitioner students in the State of Mississippi regarding full practice authority. A survey will be electronically distributed to determine what is already known and understood …

Increasing Knowledge Of Fibromyalgia Diagnostic Criteria Using A Screening Tool In Primary Care, Diane Morris

Doctoral Projects

ABSTRACT

Fibromyalgia (FM) is a chronic pain condition that is second only to osteoarthritis. Fibromyalgia dramatically impacts the quality of life, with its many symptoms requiring a multidisciplinary approach to treatment. The recommendation is that patients with fibromyalgia are treated in primary care, as are other chronic diagnoses such as hypertension and diabetes, with referrals to other disciplines as needed. However, some primary care providers may not recognize fibromyalgia as a valid diagnosis, have received inadequate formal training in fibromyalgia, and have limited awareness of diagnostic criteria.

According to the research, as many as 3 out of 4 people with …

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Implementation Of A Self-Care And Wellness Educational Program Addressing Job Stress Among Child Protective Service Workers, Natonya Murray

Doctoral Projects

Job stress attributed to secondary exposure to trauma and the high work demands put child protective service workers at high risk of developing physical and psychological health problems. The purpose of the project was to develop and implement a self-care and wellness educational program addressing job stress among child protective service workers (CPS) guided by Substance Abuse and Mental Health Science Administration’s (SAMSHA, n.d.b) educational toolkit, Promoting Staff Wellness and Preventing Vicarious Trauma and other Work Force Concerns, the Centers for Disease Control and Prevention’s (CDC, 2019c) section on Adverse Childhood Experiences, and the National Council for Community Behavioral …

Actualizing Best Care Practices At A Psychiatric Treatment Center To Validate The Asset Of An On-Site Electrocardiogram, Pamela Metts

Doctoral Projects

Considerations to be contemplated in daily health delivery systems are complex and require varied approaches to deliver best-care processes that produce optimal patient outcomes. Specialty practice sites not only require the capability but also necessitate proficiency and dedication in meeting and exceeding essential healthcare competencies. A psychiatric treatment center specialty practice was the setting for this DNP project. The focus of this project included: (1) care resourcefulness, (2) safety initiatives, (3) increased privacy and confidentiality compliance, and (4) cost-efficiency measures.

Technology use beyond the security of the safety available within the treatment complex is a current policy at the psychiatric …

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 …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

Does Theory Translate In The Trenches Of Short Term Mission Work?, Rhonda D. Hensley

Journal of Health Ethics

Despite numerous criticisms in the literature on the ethics and sustainable outcomes of short term international mission trips, there can be positive outcomes for volunteers and for recipients of short term mission care efforts. Utilizing a theoretical framework that addresses efforts to promote sustainability can lead to a structured, productive, and satisfying experience. With effective host country partnerships and an organized model of care delivery, international mission volunteers can provide highly effective health care services that are specific to the health and cultural needs of the host community.

Evidence-Based Strategies To Minimize Risk For Opioid Pain Medication Misuse Among Patients With Chronic Pain In A Primary Care Setting, Carolyn Diane Coleman

Doctoral Projects

Background: Prescription opioid pain medication misuse has become a nationwide epidemic. Many states have implemented prescription drug monitoring programs (PDMP) to assist in combating the problem of prescription opioid pain medication misuse. Evidence-based clinical practice guidelines as well as the PMDP should be utilized by healthcare providers to guide treatment of chronic pain with opioid pain medications. Purpose: The purpose of this doctoral capstone project was to determine if providers are accessing the Prescription Drug Monitoring Program (PDMP) and utilizing evidence-based guidelines to minimize opioid pain medications misuse among patients with chronic pain in a primary care setting. …

Transitioning Traditional Acute-Episodic Primary Care Visits To Group Visits: An Evidence-Based Approach To Diabetes Care, Bridget Michelle Smith

Doctoral Projects

Diabetes is a national problem that has extended epidemic magnitudes. Its management difficulty impends to overwhelm acute-episodic healthcare systems and challenges the resources of current and future individual primary care providers. According to the Centers for Disease Control and Prevention (CDC) (2012), there are 25.8 million people in the United States or 8.3% of the population who have diabetes. Mississippi ranks second in the nation in the prevalence of diabetes and has the highest percentage of overweight and obese adults in the nation (CDC, 2012). In an effort to bridge the gap with delivery of quality care to patients with …

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

An Evaluation Of The Effectiveness Of Providing Foot Care Education In A Rural Clinic Setting, Gloria Green-Morris

Doctoral Projects

Diabetes is one of the most frequently diagnosed metabolic disorders and is currently at pandemic magnitude. Approximately 1.4 million adults are diagnosed with diabetes each year. According to the American Diabetes Association (2011), the numbers of diagnoses will more than double by 2030. Because of the high prevalence of diabetes, the perceptions of risk factors and healthy behaviors are important. A good understanding of written and verbal healthcare instructions, healthcare accessibility, and socio-economic status have a direct effect on patient health outcomes and the overall health of the population (Jovic-Vranes, Bjegovic-Marinkovic & Marinkovic, 2009).

Diabetic foot complications are common concerns …

The Development Of A Comprehensive Adhd Program For Elementary School Educators, Angie Lee Echoles

Doctoral Projects

On average, teachers will teach at least one student with Attention Deficit Hyperactivity Disorder (ADHD) in any given school year without receiving any instructions at all on ADHD. ADHD affects 3% to 7% of school-age students and one in every twenty children (Centers for Disease Control and Prevention (CDC), 2010). It is classified as one of the most common mental health disorders affecting school-age students. The American Psychiatric Association (APA, 2013) defines ADHD as a hereditary, non-curable, common childhood disorder. A triad of symptoms is associated with this disorder: inattention, hyperactivity, and impulsivity, which all have a major impact on …

Perceptions Of A Dedicated Education Unit In The Mississippi Delta, Jacquelyn Felecia Brownlow

Doctoral Projects

The highest health care disparities in the country plague the Mississippi Delta. A weakened economy, minimal access to healthcare and an outdated traditional clinical learning environment place enormous strains on nursing education in this area to provide more nurses. The office of Nursing Workforce reported a 14% to 16% nursing turnover in the Delta compared to the national average of 13.5%. As a result, the health care organization has encountered high nurse turnover, increased staffing shortages, and a decrease in nursing quality indicators. As an effort to improve clinical education and bridge gaps between education and practice, several schools in …