"Reducing Heart Failure Readmission Rates Through Implementation Of Heart Failure Diuretic", Caley Tatrn, Yvonne Weideman, Venkatraman Srinivasan

Doctor of Nursing Practice (DNP) Manuscripts

Background and significance: heart disease was the number one cause of death in the United States in 2021, with 696, 962 deaths (Leading Causes of Death, 2022). There are about 6.2 million individuals in the U.S. total with heart failure (Kilgore et al., 2017). About one-quarter of patients with heart failure are readmitted within thirty days of discharge, while one-quarter of hospital readmissions are preventable. Between 2010-2017, over seven million patients were admitted for heart failure in the United States. Eighteen percent had a readmission within thirty days and thirty-one percent had a readmission within ninety days (Khan et …

Guide And Algorithm Creation For Hepatitis B Vaccination And Tuberculosis Testing Requirements For A Nursing Program., Jumoke Owolabi

Doctor of Nursing Practice Papers

This project developed a guide and algorithm for hepatitis B vaccination and tuberculosis (TB) testing requirements for nursing students at the University of Louisville [UofL] School of Nursing [SON] before clinical placement. Clarifying the requirements for hepatitis B vaccination, testing, and tuberculosis testing was paramount for clinical compliance because the current policy was determined to be ambiguous. The literature review revealed discrepancies with policies for hepatitis B and TB among countries and with individual institutions confirming the need for aligning with evidence-based vaccination guidelines. Based on these findings, an evidence-based guide and algorithm were created. Feedback from the clinical compliance …

Decreasing No-Show Rates In An Outpatient Specialty Clinic, Edward L. Barraza

Master's Projects and Capstones

Decreasing Patient No-Show Rates in an Outpatient Specialty Clinic

Abstract

Problem: Non-attendance or no-shows of patients in an outpatient clinic is a prevalent occurrence that impacts the quality of patient care and cost utilization in the clinic.

Context: A collaborative effort was undertaken with the clinic nurse manager to implement a quality improvement intervention to reduce patient no-shows in the optometry and otolaryngology clinics. The electronic health record EPIC data analysis revealed language variability in the occurrence of no-shows, indicating the need for improvements.

Interventions: Tools were employed to gather comprehensive information regarding the factors contributing to patient …

Hands-Only Cpr Education In Tarrant County, Courtnee C. Cross

Electronic Theses and Dissertations

The purpose of this project was to identify the impact of in-person, hands-only CPR education for community members on their confidence and ability in performing CPR. Bystander-initiated CPR is an important aspect in the survival and outcomes of those that experience a cardiac arrest in the community. The hands-only CPR method was developed to help increase bystander-initiated CPR and improve outcomes for those experiencing a cardiac arrest at home. This project was quasi-experimental, using pretest and posttest data. Community members took the Basic Resuscitation Skills Self-Efficacy Scale (BRS-SES) before and after the hands-only CPR education video to determine how the …

A Practice-Based Inquiry Into The Correlation Between Nursing Retention Rates And Resiliency, Kelly J. Watson

Electronic Theses and Dissertations

Nurses are the frontline in the security of the United States. Their wellbeing and retention in the workforce is of the utmost of importance. Nurses are leaving at increasing levels with just over 27% turnover rates across the nation in 2021. Organizations are experiencing increasing fiscal losses and the average loss for a nurse leaving is just over $46,000. The prioritization of nurses’ wellbeing and taking steps to address policy that promotes the sustainability of this very valuable workforce has the potential to pay high dividends for nurses individually, the security of the nation, and the good of the organization. …

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …

Critical Education In Community Health Literacy For Brazilian Nurses: A Course Evaluation, Margareth S. Zanchetta, Walterlânia S. Santos, Onislene A. E. De Almeida, Katarinne Lima Moraes, Maria Wanderleya L. Coriolano-Marinus

Journal of Educational Research and Practice

This article presents an immediate evaluation of a professional development course in community health literacy for Brazilian nurses. An evaluation based on an applied thematic analysis of the accounts of 63 attendees in three Brazilian cities (January 2020) was guided by the following themes: (a) expansion of understanding about community health literacy as a pillar for planning and providing health care; (b) encouragement of innovation in research and/or practice; and (c) plans to incorporate the information shared in the course into professional projects. The evaluation disclosed the complexity of social contexts for health literacy, which is intertwined with ethnocultural diversity …

Promoting Positive Sexual Health Behaviors Among Rural College Students: Results Of A Targeted Sti Prevention Program, Julie Loyke

Doctoral Projects

Sexually transmitted infections (STIs) are a significant public health concern, with 26 million new cases diagnosed annually in the U.S. Emerging adults aged 18 to 25 years, which are included in the age group of Americans who have the highest rates for the three most common STIs: chlamydia, gonorrhea, and HPV (cdc.gov., 2020). Unfortunately, there is a paucity of research on the effects of STI education interventions on the attitudes and knowledge regarding STIs in this age group, especially in rural youth. While STI rates are high among adolescents and young adults nationally, rural youth have different behavioral risk factors …

Hypertension Education To Enhance Health Literacy, Kylee Westrip

Student Scholarly Projects

Practice Problem: The health of patients suffers greatly when their health literacy is not addressed through evidence-based education material.

PICOT: The PICOT question that guided this project was, in adult patients with hypertension (P), how does evidence-based education material (I) compared to the current state of verbal instructions provided (C) affect health literacy rates based on the high blood pressure health literacy scale (O) within 12-weeks (T)?

Evidence: The literature evidence revealed three strong themes, which included information on who is most at risk for low health literacy levels, education delivery methods, and specific education to be used.

Intervention: …

Faith And Information To Treat Hypertension, Tiffany Bell

Student Scholarly Projects

Practice Problem: The prevalence of stroke and hypertension (HTN) in African Americans in the United States is among the highest in the world (American Heart Association, n.d.) with cultural norms as a contributing factor.

PICOT: The PICOT question that guided this project was in African American adults (>18 y/o) (P), how does a faith-based hypertension management program (I), compared to standard hypertension management (C), affect blood pressure measurements (O) within an 8-week timeframe (T)?

Evidence: The integration of motivational interviewing with therapeutic lifestyle changes along with HTN education using a community-based participatory approach delivered in the …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …

Determinants Of Nurse Turnover In Rural Primary Health Centres And Policies Adopted In India- A Systematic Integrative Review Protocol, Ponnambily Chandy Ms, Bart Criel Dr, Lakshmi L Dr

Manipal Journal of Nursing and Health Sciences

Background: Nurses act as the major workforce of the primary health care delivery system by representing nearly half of all health professionals in India. Nurse turnover in rural Primary Health Centers (PHCs) is receiving a great deal of attention around the world in both professional publications and media. We have conducted a rapid literature review and from thereon developed an analytical framework on the determinants of nurse turnover in rural PHCs and policies adopted in India to overcome it. Literature reviews on studies addressing the turnover of registered nurses working in the rural PHCs are scarce. The current review aims …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Using Physical Therapy As First Line Treatment For Sciatica Vs. Invasive Intervention, Christina Mohammed

Master of Science in Nursing Family Nurse Practitioner

Sciatica nerve pain affects a large part of the human population. Evaluation by a primary care provider and a referral to physical therapy as first line treatment, may help reduce sciatic nerve pain and result in reduced need for invasive surgical intervention.

Chronic Diseases And Inpatient Care Among The Middle-Aged And Elderly People In Indonesia, Ema Madyaningrum

Journal of Health Research

Background: The prevalence of chronic diseases contributes to an increase in healthcare utilization that results in increased vulnerability in middle and old age. This study aims to determine the factors that influence in-patient care among the middle-aged and elderly.

Methods: We conducted a repeated cross-sectional study using the Indonesia Family Life Survey 4 (IFLS 4) in 2007 (10,754 participants) and IFLS 5 in 2014 (12,058 participants). Chronic diseases include hypertension, diabetes mellitus, tuberculosis, asthma, coronary heart diseases, liver diseases, cancer, arthritis, gout, high cholesterol, prostate illness, kidney diseases, and digestive diseases. We used the frequency distribution, and logistic regression to …

Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio

Nursing Leadership in Community Engagement Projects

Introduction

The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger

Nursing Leadership in Community Engagement Projects

Wound Care For Unhoused Youth

Introduction

We partnered with a non-profit organization designed to serve the unhoused youth, ages 18-25, who have a day program as well as an overnight shelter. They have 30 beds and reserve 20 of those beds for individuals who are “residents,” who commit to staying for several nights and work towards finding more permanent options. The other 10 beds are for individuals to use for a single night, but these are not always guaranteed, you must sign up to save a spot. The day program has various activities ranging from painting to resume workshops and …

Women’S Shelter Health Needs Assessment, Asmait Woldu, Kelly Dona, Anna Frediani, Andrea Herrejon-Duran

Nursing Leadership in Community Engagement Projects

Women’s Shelter Health Needs Assessment

Introduction

Homelessness is currently one of the biggest societal issues in the United States and evidence indicates it is increasing, particularly for women (McGeough et al., 2020). A group of nursing students from Seattle Pacific University teamed up with a women’s homeless shelter in a Metropolitan city. The agency provides shelter and warm meals as well as laundry, toiletries, bus tickets and more. But even with the resources that they do provide, the residents have other needs that are not fully met, particularly with regard to their health. This is due in large to a …

Resources To Promote Senior Independence, Amanda Anderson, Sheree Mae Cacal, Sophia Gallego, Madyson Grant, Lola Wallace

Nursing Leadership in Community Engagement Projects

Resources to Promote Senior Independence

Introduction

Our group of five students from Seattle Pacific University's Lydia Green nursing program assessed the community of an independent senior apartment complex that provides affordable housing for adults aged 65+ in the Seattle area run under Sustainable Housing for Ageless Generations (SHAG). This assignment is for our leadership project and occurred over an 8-week period. During this time, we applied the nursing process to assess, diagnose, plan, and implement an intervention specific to a population's needs. The community faced issues of resource access, exacerbated by the population's low income and age. Our focus was …

Supportive Resources For Unhoused Individuals & Families, Grace Felder, Jordyn Henson, Kial Neang, Nasha Phansangiam, Taylee Thain

Nursing Leadership in Community Engagement Projects

Introduction

Since 2016 King County’s unsheltered homeless individuals have increased by 24% and families experiencing homelessness have increased by 26% (National Alliance to End Homelessness, 2021). In the past 5 years, homelessness has risen by 10% in King County alone (NAEH, 2021). Our agency was an emergency family shelter located in King County that “ensures that no child sleeps outside by centering equity and opportunity for women and families” (Mary’s Place Seattle, n.d.-a). This facility has 5 other family center facilities that provide shelter and resources. Since 1999, our agency with its 6 facilities have aided thousands of women and …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Social Determinants Of Health And Health Confidence, Laura Truman

Dissertations

Purpose/Aims: The purpose of this study was to investigate the relationship among social determinants of health (SDOH), select sociodemographics, and health confidence level in adults receiving care at an urgent care center.

Background/Rationale: To improve overall health and reduce health inequities during a global pandemic and unprecedented rates of inflation, the relevancy and urgency of identifying how patient-level SDOH impact health confidence level are even greater. Extant research indicates a relationship between the number of unmet social needs and low health confidence. Low health confidence predicts poor involvement in self-care and is associated with an increased use of costly health …

Developmental Boxes, Karina Ryabinina, Lauren Kelly, Marissa Bankey, Kaila Medeiros, Sammy Schultz

Nursing Leadership in Community Engagement Projects

Developmental Boxes

The assigned facility is a resource center that operates to assist families in need. Services offered include housing placement, homelessness prevention, securement of affordable childcare, after-school programs, and health education. The center has served the Mount Baker community for nearly three years and intends to continue partnering with public services to end the cycle of poverty and create brighter futures for those who need it most (Mercy Housing, 2021).

Our team conducted a windshield survey of the community served by the facility and determined there to be limited access to childcare in the area as well as minimal …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Jessica Lee

Master's Projects and Capstones

Sepsis is a deadly condition if not treated promptly and urgently. To help lower the mortality rate from Sepsis, education on Sepsis is essential for nurses at all levels and experience. Opportunity at a healthcare organization in Northern California arose when it was found through a survey that about 6 percent of Medical-Surgical nurses have "expert knowledge" of the sepsis bundle elements. Only about 35 percent of these nurses who reported having "expert knowledge" are confident in treating sepsis patients. A team of clinical nurse leader students implemented a quality improvement project. The project was designed to expand nurses' knowledge …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Gregory James Trevino

Master's Projects and Capstones

Problem: Providing high-quality sepsis care in a San Francisco Bay Area emergency department (ED) is an organizational priority, however Centers for Medicare & Medicaid Service (CMS) SEP-1 sepsis bundle compliance has decreased to an average of 79% compliance since October of 2022. It was revealed that CMS SEP-1 sepsis bundle compliance issues have resulted in increased patient fallouts.

Context: A microsystem assessment was conducted by the quality improvement team to help identify gaps in practice. After an assessment survey of nursing staff, it was revealed that barriers such as physician order sets, lack of communication, lack of staffing during peak …