Public Health and Community Nursing Commons^™

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Scholarly Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Effects Of Education On Correcting Misconceptions And Acceptance Of The Influenza Vaccination Among A College Campus, Travis E. Fairbanks

DNP Scholarly Projects

Educating patients on the influenza vaccination is an important goal for health care providers. It fosters a working relationship between provider and patient and allows patients to make an informed decision on their health care needs. The percentage of individuals who receive the influenza vaccine in the United States has been consistently below goals set by the committee for Healthy People 2020. This DNP scholarly project aimed to determine whether the introduction of education was effective at increasing individuals’ choice to vaccinate against the influenza virus among college campus students. The study was a non-experimental, non-randomized control trial that utilized …

Implementing Faculty Development Modules To Increase Readiness For Addressing Social Determinants Of Health, Implicit Bias And Equity In Course Content, Claudia Ngafeeson

DNP Scholarly Projects

Implicit bias is viewed as an unconscious and involuntary attitude that lies below the surface of consciousness but can influence behavior, and cognitive processes (Maina et al., 2018). Social determinants of health are considered to be the conditions in which people are born, grow, live, work, and age; these circumstances are usually shaped by the distribution of money, power, and resources at global, national, and local levels, which in turns determines the distribution of the value of medical care. Existing literature on implicit bias has been fragmented in different fields such as; cognitive psychology, business ethics, and higher education, but …

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Scholarly Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

A Peer-Led Evidence-Based Contraceptive Counseling Initiative, Megan K. Tenbarge

DNP Scholarly Projects

The experience of sexual health and wellness varies for newly independent college freshman. For reproductive-age women, gaps in knowledge and self-efficacy overlap with barriers accessing contraception and reproductive health care contributing to high-risk behavior and poor sexual health outcomes. Community-based participatory research was used to develop and implement a peer-education program targeting sorority women on a college campus in the Southeastern United States in the fall semester of 2021. Two senior nursing majors completed continuing education to be empowered as peer-educators using The University of California San Francisco Beyond the Pill framework. They engaged directly with nursing faculty stakeholders and …

Nurses' Implicit Attitudes Regarding The Lgbtq Population, Carolyn Howard

DNP Scholarly Projects

Health inequities such as chronic medical conditions, mental health disorders, substance abuse, and suicide are prevalent in the LGBTQ population, resulting in part from minority stress, stigma, discrimination, and isolation. Studies showed mixed results regarding nurses’ and other healthcare professionals’ attitudes toward these individuals. Relatively little research has focused specifically on nurses, and most studies have centered on healthcare professionals’ explicit attitudes. Given the lack of studies on nurses and implicit bias, more research is needed on nurses’ implicit attitudes regarding LGBTQ patients. Using a retrospective design with secondary data from Project Implicit, the study compared United States (US) nurses’ …

Belmont University Covid Surveillance And Containment: An Evaluation Of Program Effectiveness, Morgan A. Lambrecht

DNP Scholarly Projects

In the early days of the Coronavirus (COVID) pandemic, members of university communities faced elevated risk of contracting COVID because they live and work in congregate settings, with shared living and dining arrangements. By the Fall 2020 semester, with limited information regarding the transmission of COVID, a quick, but comprehensive strategy was needed to allow students to return to university campuses, while maintaining a safe environment for students, faculty, and staff. The purpose of this project was to determine the effectiveness of the COVID surveillance and containment measures implemented in the 2020/2021 academic year for the residential campus community at …

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Scholarly Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

The Impact Of Early Goal Directed Sepsis Bundle Sets In The Emergency Department And The Impact Of Sep-1 Compliance Rates, Christie L. Ferrari

DNP Scholarly Projects

Sepsis is a medical emergency that is prevalent throughout hospitals everywhere. Due to the growing crisis, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Surviving Sepsis Campaign (SSC) adopted core measures for sepsis (SEP-1) which aim at improving overall compliance of evidence-based treatment standards for sepsis. The purpose of this Doctor of Nursing Practice (DNP) project was to determine if incorporating early goal directed sepsis bundles in a rural Midwestern ED was effective in increasing compliance with SEP-1 rates. The secondary purpose evaluated how nursing knowledge, awareness, and compliance with sepsis bundles affects SEP-1 compliance rates. …

Addressing Barriers To Colorectal Cancer Screening In A Federally Qualified Health Center: A Quality Improvement Project, Tania Centra

DNP Scholarly Projects

Abstract

Background: Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of several high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (non-insured), younger age, racial or ethnic minority, recent immigration to the U.S. (non-English speaking), fear or distrust of the healthcare system and rural residence. Addressing health equity within underserved populations requires improved access to CRC screenings per evidence-based guidelines.

Local Problem: The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) …

Opioid Overdose Prevention And Naloxone Training Among College Students, Mackenzie Thode

DNP Scholarly Projects

Background: Opioid abuse is a serious national crisis affecting both public health and economic welfare across the United States. In Tennessee, more than 1,800 overdose deaths were reported in 2018, with nearly 20% of those deaths occurring in Davidson County alone. The number of overdose deaths in Nashville has steadily risen amidst the COVID-19 pandemic by approximately 32% since 2019 to a total of 619 fatal overdoses in 2020, making it the city’s deadliest year on record. Review of evidence: Research shows that intranasal (IN) naloxone training is an effective approach to combating the opioid overdose crisis and can be …

Improving Emr Usability And Clinical Efficiency Using An Immunization Tool For School Nurses In A Primary School Setting, Cathy Loiselle

DNP Scholarly Projects

BACKGROUND: School nursing has a foundation in population health and an essential role within the community, which needs to be structured by the developing field of health informatics in order to compete and communicate with all stakeholders. This quality improvement project specific aim was to improve the electronic medical record (EMR) usability and clinical efficiency.

METHODS: A school district with three elementary, one high and one middle school was chosen, using the school information system (SIS)/EMR currently in place at each school health office. The school health staff participating in this project included 5 registered nurses and 5 clinic assistants. …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Reproductive Health Needs Among Women In Treatment For Substance Use Disorder, Jaanki Bhakta, Elizabeth Morse, David Phillippi

DNP Scholarly Projects

Integrated care models for substance use disorder (SUD) and reproductive health care have been proposed as a strategy to increase access to reproductive health care for women in treatment for SUD. This cross-sectional, survey-based study measured how women of childbearing age in residential treatment report their demand for and access to reproductive health care, their pregnancy intention, contraceptive utilization and preference for integrating reproductive health care with their current SUD treatment milieu. Eighty-five percent of the women interviewed (N=108) expressed a desire to prevent pregnancy in the next year, although only one-third (33.6%) were using a form of contraception at …

Community Of Immunity: A Process Improvement To Increase Influenza Vaccination Uptake, Macy Ball

DNP Scholarly Projects

Background & Review of Evidence: Annual flu vaccination has been recommended for everyone over the age of six months (National Foundation for Infectious Disease [NFID], 2016). A low flu vaccination rate among college students living in a residential community poses the risk for spreading a highly-contagious respiratory illness caused by the virus. Students have the ability to spread the disease to everyone around them in their dormitories, classrooms, shared restrooms and via social gatherings (NFID, 2016). College students who contract the flu virus experience approximately eight or more days of the illness (NFID, 2016).

Purpose: The purpose of …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

Moodle-Based Chlamydia Awareness Project To Increase Intention To Test In College Freshmen Males: A Dnp Scholarly Project, Adam Burri

DNP Scholarly Projects

In 2016, there were over 1.5 million cases of chlamydia reported in the United States with prevalence rates highest in people under 25 years of age (Centers for Disease Control and Prevention, 2017). Researchers have suggested that college aged adults (age 18-25) should be targeted for chlamydia educational programs because these individuals are lacking in knowledge about chlamydia prevention, infection, symptoms, and screening methods (Goundry, Finlay, & Llewellyn, 2013; Rutledge, Siebert, Chonody, & Killian, 2011). This scholarly project utilized a quasi-experimental, single-group pretest-posttest design and used a modified version of the Sex, Drugs, and Rock’n’Roll Questionnaire designed by Lim et …

Oral Health Literacy In Parents And Care Providers Of Young Children, Rachel Nye

DNP Scholarly Projects

Tooth decay ranks first as the most common chronic disease in childhood (U.S. Department of Health and Human Services [HHS], 2000). In addition to the morbidity directly related to cavities, there are a myriad of other systemic implications of this disease. The purpose of the study was to determine baseline oral health literacy levels for a sample of pediatric caregivers living in the Upper Peninsula and to determine the impact of a community based education program on these levels. The program was offered at three locations. A paired sample t-test of sixty-four complete data sets demonstrated a statistically significant increase …

Depression Screening And Care Management In Diabetes Patients At Rural Health Clinics In Primary Care: Quality Improvement, Marcy Doyle

DNP Scholarly Projects

Depression is one of the leading causes of disease and disability, often found in patients with long-term chronic physical conditions such as diabetes. Collaborative care, which includes care managers, has shown to improve depression outcomes in patients; usual care has been shown to be inadequate. This quality improvement project screened patients with diabetes for depression. Patients with an elevated depression screening score were provided care management support and rescreened every two weeks to evaluate depression symptoms. A small cohort of patients from two rural health clinics participated in the improvement project. The practices noted improvement in depression screening; patients who …