Family Practice Nursing Commons^™

Implementation And Evaluation Of Diet And Physical Activity Screening Tools For Adults With Type 2 Diabetes Mellitus In Primary Care, Ashley O. Dalton

DNP Projects

Background: Only half of individuals with type 2 diabetes mellitus (T2DM) have a hemoglobin A1C (HbA1c) of less than 7%, indicating poor glycemic control and contributing to a global diabetes epidemic. Diabetes is considered a diet-sensitive disease and an individual’s diabetes-related nutrition knowledge is one of the most challenging aspects of the treatment plan. Empirical evidence supports that a combination of dietary and physical activity interventions is more effective than nutrition education alone. Performing a dietary evaluation is fundamental to establishing nutrition goals. The use of the Starting the Conversation (STC) tool, which assesses an individual’s dietary practices, and Physical …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Nursing Care Regarding Social Determinants Of Health For Breastfeeding In Mothers And Infants, Natalie Jefson

Senior Honors Theses

Breastfeeding is incredibly important to the health and well-being of the mother-infant dyad. Because of this, there are both world-wide and national recommendations and guidelines for breastfeeding in the United States. Although many women choose to initiate breastfeeding, the percentage of women who continue breastfeeding for the recommended duration does not meet the Healthy People goal for the United States. Many factors influence this early breastfeeding cessation, including physical and socioeconomic barriers. Certain populations face increased barriers to reaching these goals related to social determinants of health which can and should be addressed by nurses through preventive measures and education.

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice

DNP Projects

Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams

DNP Projects

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.

Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Provider Awareness Associated With Lifestyle Interventions And Adult Obesity, Reilly Tackett

Doctor of Nursing Practice Scholarly Project

The obesity epidemic cannot be solved through a single solution. A complex problem like obesity requires an intricately designed approach, comprised of both behavioral and environmental changes (Centers for Disease Control, 2015). Obese adults who attempt to alter their lifestyles often experience barriers to success. One such barrier is a provider who may be unfamiliar with evidence-based lifestyle interventions. Research suggests large variances both in provider knowledge levels and practice recommendations associated with adult obesity. This study’s purpose was; to determine if provider recommendations reflected clinical practice guidelines (CPG) associated with adult obesity, to measure current levels of provider knowledge, …

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

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 …

The Benefits Of Breastfeeding, Avery Kordus

Senior Honors Theses

Breastfeeding research is plentiful, and the majority of the literature shows that breast milk is the superior form of infant nutrition except in the rare circumstances of infant metabolic disorders, maternal drug use, or positive HIV status. In comparison to formula, breast milk provides improved cognition, development, behavior, bonding, nutrition, digestion, immunity, and long-term health with fewer diseases and conditions in infants. Mothers are benefited by breastfeeding through bonding, faster weight loss, and reduction in certain cancers and conditions. Breast milk contains the proper amount of carbohydrates, fats, proteins, vitamins, and minerals, and is also specialized for each infant and …