The Impact Of Clinical Reasoning Seminars On Medical-Surgical Specialty Hesi Exam Scores, Stephanie Fugate

DNP Projects

Abstract

Background: Clinical reasoning and clinical judgement have been identified as essential skills for the delivery of quality patient care. Nursing education relies heavily on standardized exams like the HESI to predict success on the national licensure exam.

Purpose The purpose of this study was to determine the impact of clinical reasoning seminars (CRS) on medical-surgical specialty HESI exam scores of first semester junior BSN nursing students.

Methods: A retrospective correlational design was used for this study, which involved a review of medical-surgical HESI scores for 115 junior level baccalaureate nursing students who were identified as academically high-risk and who …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Evaluation Of Emergency Department Use By Adult Patients With Established Primary Care Provider, Sherry Tolentino

DNP Projects

BACKGROUND: Overutilization of the Emergency Department (ED) contributes to the unnecessary use of healthcare resources. One common cause is related to barriers to Primary Care access. Patients use the ED for conditions that can be managed in primary care due to the perception of urgency and convenience.

PURPOSE: The purpose of this project was to evaluate factors contributing to the use of the ED for adult patients with primary care providers (PCP). METHODS: A retrospective chart review was completed on 280 randomly selected patients over the age of 18 who presented to the ED between January and June 2018. Only …

Evaluation Of The Effect Of Milner-Fenwick Video-Based Education And Teach-Back On Knowledge Acquisition In Atrial Fibrillation Patients, Melissa Czarapata

DNP Projects

PURPOSE: The purpose of this study was to evaluate if video education impacts knowledge acquisition and health literacy in patients with atrial fibrillation. METHODS: This study employed a descriptive, pretest-posttest single site comparative design. Baseline health literacy was assessed before video education was completed using the Atrial Fibrillation Knowledge scale. Health literacy regarding atrial fibrillation was again assessed for the same participants immediately after video education was completed and again in 7 to 10 days through the use of the Atrial Fibrillation Knowledge scale and teach-back questions. RESULTS: There was no statistical significance found when comparing scores before and after …

The Effect Of An Educational Workshop On Relational Aggression In An Acute Care Nursing Unit, Jennifer M. Dorsey

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of an educational intervention on relational aggression in an acute care unit using a pre and post questionnaire. The questionnaire was used to examine changes in Relational Aggression (RA) self-awareness before and after an educational video and to determine the effectiveness of an educational video compared to no educational materials on self-awareness of RA behaviors.

METHODS: This study was single site, quasi-experimental non-equivalent pretest posttest study at the University of Kentucky. Sample size for the pre-survey was 15 acute care nurses on the control and experimental units, completed between …

Barriers To Screening For Intimate Partner Violence Among Aprns In Kentucky, Kathryn L. Strait

DNP Projects

Abstract

Purpose:Intimate partner violence (IPV) occurs in at least one in every four females and one in nine men across the United States (Smith et al., 2017). While the prevalence of IPV is considerably high, the screening rates for IPV in primary care specifically average less than 12% (United States Preventative Services Task Force, 2013). Methods: In order to identify how to overcome the barriers to screening including time, knowledge of IPV, access to community resources, gender identity/sexual orientation, accuracy and availability of screening tools, and reimbursement for advanced practice nurses in Kentucky, a survey was sent to …

Change In Falls And Sitter Cost Post Implementation Of Remote Centralized Video Monitoring In Hospitalized Adult Patients, April Nicole Dougherty

DNP Projects

PURPOSE: Falls are the leading cause of injury in hospitalized patients. Patient sitter programs are proven to be an effective way to reduce falls in hospitalized patients. Innovative technologies have been examined that provide a safe and cost-effective way to reduce sitter costs and prevent falls. An innovative technology option is a remote centralized video monitoring system containing one video monitoring technician watching and verbally redirecting multiple patients at one time using mobile cameras. The purpose of this project is to evaluate the implementation of a remote centralized video monitoring system for adult patients in the acute care hospital setting. …

The Effect Of An Education Plan On Nursing Intervention Compliance With Inpatient Post-Operative Colorectal Surgical Patients Using Enhanced Recovery After Surgery (Eras) Protocols, Jennifer Austin

DNP Projects

Abstract

BACKGROUND: Compliance with the enhanced recovery after surgery (ERAS) protocols for colorectal surgery patients in the post-operative inpatient setting is low, creating a gap in successful outcomes of the program.

OBJECTIVE: The purpose of this project is to evaluate the impact of an education plan on inpatient nursing staff. A second purpose of the study is to examine the relationship between ERAS and specific post-operative nursing interventions linked to length of stay (LOS).

METHODS: A prospective cohort study analyzing the effect of a knowledge to action (KTA) education plan on nursing compliance with ERAS protocols was conducted on bedside …

Staff Perception Of Workplace Violence In The Ed: Implementing Egress Education And Cue Recognition, Kelsey Jobe

DNP Projects

Purpose: The purpose of this DNP project was to examine staff perception of workplace violence before and after an educational intervention provided to bedside staff members in the ED of a Level-1 trauma center. The project focused on assessing the impact of an educational intervention on staff perception of WPV related to safety and overall awareness.

Methods: This project was a single site project designed to examine the impact of an educational intervention using egress education and cue recognition in the ED setting using a pre- and post-survey. The survey examined staff perception of safety related to WPV before and …

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

The Effects Of A Mentor Program On Burnout, Resilience, Work Engagement, And Turnover Intentions Of New Nurse Managers, Jennifer Thomas

DNP Projects

BACKGROUND: The nurse manager position is an instrumental, critical role in healthcare organizations. However, nurse managers often enter the role lacking necessary leadership skills. Mentoring may add additional support and guidance in navigating the nurse manager role.

PURPOSE: The purpose of this study was to evaluate the effect of a nurse manager mentor program including focused, developmental classes on nurse manager burnout, resilience, work engagement, and turnover intention.

METHODS: A quasi-experimental study, utilizing a pre-test/post-test design was completed to evaluate the impact of a mentor program on new nurse manager burnout, resilience, work engagement, and turnover intention.

RESULTS: Nurse manager …

The Impact Of The Nurse Practitioner In Pre-Admission Testing: A Comparative Review, Laurel A. Robinson

DNP Projects

Abstract

PURPOSE: The purpose of this study was to compare the efficiency of pre-admission testing (PAT) surgical clinic pre and post implementation of the APRN for patient assessment. Cancellation and delay occurrences for scheduled surgeries will be compared during two time periods on patients on the surgical schedule at Norton Women and Children’s Hospital (NWC).

METHODS: This study was a single-center, pre and post implementation retrospective comparative study of the impact of the NP led PAT unit at Norton Women and Children’s Hospital (NWC) in terms of delay and cancellation rates for day-of-surgery. The sample consisted of 411 patients for …

Medication Adherence After Post Percutaneous Coronary Intervention: An Educational Intervention, Rebecca Shelton Thomas

DNP Projects

Purpose: The purpose of this evidenced-based education project was (i) assess current barriers and determining factors associated with medication adherence and how this coincides with health outcomes, (ii) assess whether medication adherence and hospital re-admission rates were improved with a comprehensive medication discharge educational plan.

Setting: The project took place on a 35 bed post interventional care unit (4IC) located in a 433 bed community care hospital in Central Kentucky.

Population: The population for this study was a sample of 10 acute myocardial infarction patients post percutaneous coronary intervention. Thirty percent of participants were female and 60% were male. Mean …

Piloting An Intervention To Improve Continuity In Lung Cancer Patients, Stacy L. Richey

DNP Projects

Purpose: Kentuckians facing a lung cancer diagnosis are at greater risk for care fragmentation due to the complexities associated with the diagnosis, staging and treatment of the disease combined with multiple health disparities such as advanced age, multiple comorbid conditions, low socioeconomic status, geographic isolation, and low literacy levels. Transitioning from primary to specialist care can be especially difficult for these patients. The main purpose of this paper was to determine the feasibility and effect of a nurse-led, multidimensional intervention designed to improve relational (RC), informational (IC), and management continuity (MC) across the primary to secondary care interface, as well …

A Randomized Controlled Trial Of Anesthesia Guided By Bis Vs. Standard Care And Effects On Cognition, Zohn Centimole

Theses and Dissertations--Nursing

Postoperative cognitive dysfunction (POCD) occurs frequently in individuals undergoing major surgery with general anesthesia. POCD adversely affects morbidity and health-related quality of life. Derived electroencephalographic (EEG) monitoring is utilized to guide the anesthesia provider in titration of volatile anesthetics. POCD has been associated volatile anesthetic neurotoxicity. EEG monitors are known to reduce a patient’s total cumulative dose exposure to volatile anesthetics. There is currently little evidence to support utilization of EEG monitors as a guide to reduce the incidence of POCD.

The purpose of this dissertation was to develop and test a technique of general anesthesia, delivered by anesthesia providers …

Co-Morbid Symptoms Of Depression And Anxiety And Bio-Behavioral Response To Stress In Patients With Heart Failure, Abdullah S. Alhurani

Theses and Dissertations--Nursing

Heart failure (HF) is a major public health problem throughout the world. It accounts for one death certificate among nine in the United States. Heart failure and sudden death combined are responsible for the largest number of deaths in America. The total costs of HF in the United States are estimated to be $37 billion each year. Despite substantial medical and surgical advances related to treatment of HF, it remains a very costly condition with high mortality and morbidity rates. Although biological factors contribute to high morbidity and mortality in HF, there are many unexplored psychosocial factors that also likely …

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m²) seen by one surgical service over a two and …

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Implementing Sbar Training With Acute Care Nurses, Maureen Murray

DNP Projects

Background In 1999, the Institute of Medicine reported 98,000 deaths in US hospitals due to medical errors. The Joint Commission posits 70% of sentinel events are rooted in communication errors. The US military and aviation industry had developed structured communication tools to reduce communication error and shared this with healthcare in the form of the Situation Background Assessment Recommendation (SBAR) tool. The Joint Commission recommends use of the SBAR tool.

Objective Formal training on SBAR was not present at one acute care facility, constituting a gap between evidence and practice. This practice improvement project aimed to close this evidence-practice gap. …

Do Call-Backs Help Patients Post Stroke, Taylor E. Clark

DNP Projects

Aim and Objective: To determine if the implementation of a post-discharge call-back intervention for patients discharged home from the hospital after stroke was associated with a decrease in 30-day readmissions and improved patient satisfaction.

Background: Stroke is a leading cause of death and disability in the United States (American Stroke Association, 2015). Several studies have examined various post-discharge interventions, including a call to the patient and/or family after their return home, to determine the benefit to patients, if any (Zolfaghari, Mousavifar, Pedram & Haghani (2012). Understanding and anticipating patient needs and removing barriers post-stroke may decrease readmission rates …

Evaluation Of A Rheumatology Patient Prioritization Triage System, Katharine R. Layton

DNP Projects

The United States health care system is currently experiencing an increase in demand for services due to an aging population. Rheumatology, an Internal Medicine sub-specialty, treats those patients with arthritic conditions as well as other autoimmune and inflammatory conditions. A shortage of rheumatologists is projected by 2025, adding additional stress to an already burdened clinical area.This means patients can face substantial wait times when requesting consultation with a rheumatology provider.This capstone project will present three manuscripts that explore the referral process from primary to specialty care and strategies to reduce wait times. The first manuscript is a literature review that …

An Assessment Of Knowledge And Attitude Towards Stock Epinephrine Among Kentucky School Nurses, Brandi M. Duran

DNP Projects

This cross-sectional, pre-post intervention study was designed to gather information on Kentucky School Nurses attitude and knowledge toward non-prescribed epinephrine auto injectors in Kentucky Schools. All 500 members of the Kentucky Schools Nurses Association received a link to the pretest, educational intervention and posttest via email. Of those, 75 nurses responded and 72 were eligible to participate in the study. The data was analyzed through a paired t-test using SPSS. The results showed an increase in level of comfort with epinephrine, although it was not statistically significant. There was a statistical significance between the pretest and posttest when school nurses …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

The Utility Of The U.S. Diabetes Conversation Map As An Intervention To Promote Diabetes Self-Management Adherence, Lisa Gale Jones

Theses and Dissertations--Nursing

Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease.

Specific Aims:

1. describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …

Influence Of Coping Styles On Emotional State, Illness Perception, And Information Sources Of Men With Prostate Cancer, Gwendolyn M. Hooper

Theses and Dissertations--Nursing

Prostate cancer (PCa) has been the leading cause of cancer death in men since1930. While studies pertaining to PCa have primarily focused on the disease and the subsequent side effects of treatment, psychological distress in this group has yet to be adequately addressed. The purpose of this dissertation was to: 1) conceptualize health related quality of life (HRQL) and health seeking behavior of men by describing lifestyle, cultural and health risks associated with being male, 2) evaluate the psychometric properties of the SF-12 Health Survey (SF-12) combined with the urinary and sexual portions of the UCLA PCa Index (UCLA-PCI), 3) …

Military Tobacco Dependence Treatment: Implications Of Treatment Type On Abstinence And Weight Management Ability, Bradley A. Briscoe

DNP Projects

Military readiness, employer productivity and individual health are all significantly impacted by high rates of tobacco use. Current research, to date, suggests that use of brief, individually tailored behavioral modification strategies through group therapy may be most effective in smoking cessation. The objective of this Practice Inquiry Project was to explore aspects of tobacco use the U.S. military population and examine potential relationships between type of treatment, smoking abstinence, and maintenance of body weight (e.g. avoid weight gain) among those seeking tobacco use cessation. The findings of this project can provide guidance on enhancing current tobacco cessation efforts to enable …