Public Health and Community Nursing Commons^™

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Optimizing Healthcare Utilization: Distinguishing Between Emergency And Urgent Care, Madilyn Calkins, Molly Dupar, Wintana Gherie, Marcin Janczak, Angela Lee, Lena Zhang

Nursing Leadership in Community Engagement Projects

Optimizing Healthcare Utilization: Distinguishing Between Emergency and Urgent Care

Over the past two months, our group of six nursing students worked with a local transitional housing program for families. Per the facility report, a large portion of the program’s current residents are immigrants and have had little to no exposure to the American healthcare system and their options for care. The issue we targeted for our project is the increased number of 911 calls and emergency room (ER) visits for non-emergent healthcare concerns by our target population. By creating education materials on self-triaging, ER vs. Urgent Care services, and how …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Addressing Gaps In The Continuum Of Care: A Quality Improvement Project Focused On Adolescent Youth With Depression Symptoms At A School-Based Health Clinic, Leah Nigon

Theses and Graduate Projects

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

A Multimodal Intervention To Aid In Smoking Cessation, Lauren Druzbicki

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC; 2023a) notes there are 28.3 million smokers in the United States. In Indiana alone, nearly 29% of adults currently use tobacco, with 19% of the total being cigarette smokers (Indiana Department of Health, 2022). The purpose of this evidence-based practice (EBP) project was to implement a multi-modal intervention to aid in smoking cessation in adults aged 18 and older who are cigarette smokers. The intervention included physician/nurse advise using the ask, advise, refer (AAR) model, the SmokefreeTXT program, and FDA approved smoking cessation medications. The project took place at a primary care …

Understanding Healthcare Worker Experiences And Personal Protective Equipment (Ppe)-Related Skin Reactions/Injuries During The Covid-19 Pandemic: A Mixed Methods Approach, Susan Solmos

Theses & Dissertations

Personal protective equipment (PPE)-related facial skin reactions/injuries occurred in 75.13% of healthcare workers during the COVID-19 pandemic. Critical appraisal of cross-sectional studies identified methodological gaps as the majority of survey questions were not content-validated and those that were lacked descriptions of methods and psychometrics for the survey questions/tool. The aims of this dissertation study were to describe the nature, severity, and distribution of selfie captured PPE-related facial injuries using a validated tool (quantitative) and describe the contextual factors associated with PPE-related facial injuries and what factors influence nurses and Health Care Workers (HCWs) to share their experiences (qualitative). The setting …

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 …

The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen

Evidence-Based Practice Project Reports

Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

Integrative Review: Factors Impacting Effective Delegation Practices By Registered Nurses To Assistants In Nursing, Carol Crevacore, Elisabeth R. Jacob, Linda L. Coventry, Christine Duffield

Research outputs 2022 to 2026

Aim

To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals.

Design

An integrative review.

Data Sources

Database searches were conducted between July 2011 and July 2021.

Review Methods

We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments.

Results

Nine studies were included. Delegation between the Registered Nurse and the …

Technology For Faith Community Nursing Practice, Katrina Goodrich

International Journal of Faith Community Nursing

Technology is an ever-expanding tool that can be utilized by Faith Community Nurses to enhance their practice. Technology offers options for organizing and promoting services, collaborating with others on an international level, education of both the Faith Community Nurse and their clientele, and multiple instruments for tracking and managing wellness plans.

Instituting A Preceptor Program In Home Health, Abbi Arnold

Master's Projects and Capstones

Problem: Staff being unfamiliar with the role of being a preceptor impacts their ability to perform the job well. Insufficient understanding of a new role creates stress and uncertainty which can lead to poor employee retention or high job dissatisfaction.

Context: The setting for this project is a large hospital-based home health agency that has an average daily census of 375 patients. The project was a collaboration between home health management and the quality department.

Measures: A measurement strategy was developed to meet the outcome measure, process measure, and balancing measure. The outcome measure was increasing the nurses’ understanding of …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

A Multimodal Approach To Decreasing Hesitancy And Increasing Uptake Of The Covid-19 Vaccine In The Family Care Setting, Meghan Zwierzynski

Evidence-Based Practice Project Reports

Since December 2019, the coronavirus disease 2019 (COVID-19) has swept across the world, infecting and killing millions of people, making it one of the worst pandemics in history (WHO, 2021). However, the rates of confirmed cases and deaths have slowed since the discovery of the COVID-19 vaccine. The purpose of this evidence-based practice (EBP) project was to decrease vaccine hesitancy and increase uptake of the COVID-19 vaccine in the family care setting. The Iowa Model-Revised (Iowa Model Collaborative, 2017) is a practical, effective multi-step change process that acted as a guide for the EBP project. A review of literature showed …

Behavioral Intervention To Increase Condom Use Among Men Who Take Pre-Exposure Prophylaxis And Have Sex With Men, Marek J. Piszczatowski

Evidence-Based Practice Project Reports

In the absence of an effective vaccine, the introduction of pre-exposure prophylaxis (PrEP) in 2012 offered a promising new approach to human immunodeficiency virus (HIV) prevention. However, the introduction of a single-pill regimen which helps to prevent HIV transmission created, in men who have sex with men (MSM) population, a phenomenon referred to as risk compensation resulting in PrEP replacing consistent condom use as a preventive measure (Freeborn & Portillo, 2018; Kumar et al., 2020; Montaño et al., 2018; Ramchandani & Golden, 2019; Traeger et al., 2018). The purpose of the evidence-based practice project was to implement a single, one-on-one …

Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis

Evidence-Based Practice Project Reports

Osteoporosis is caused by caused by low bone mass, microarchitecture disruption and increase in skeletal fragility (Rosen & Drezner, 2021). This disease presents as a silent disease without any clinical manifestations and increases risk for bone fracture. The purpose of this Evidence-Based Practice (EBP) project was to increase screening rates for osteoporosis in the female population by mailing a patient reminder letter to the home of qualifying patients in the primary care setting and to determine if mailing a patient reminder letter would increase screening rates. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare professionals (JHEBP) model was used …

Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder

Evidence-Based Practice Project Reports

Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin …

Perceived Sources Of Stress Related To Burnout Amongst Emergency Department Staff Due To The Covid-19 Pandemic: A Literature Review, Sydney Craig

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Emergency departments (ED) are usually considered high stress environments. The effects of the COVID-19 pandemic and the accompanying challenges such as frequent exposure to the novel virus, lack of personal protective equipment (PPE), being over worked and underpaid, and the uncertainty surrounding the overall trajectory of the COVID-19 pandemic have resulted in an increased level of burnout for ED staff, especially nurses. This study involves a meta-analysis of current literature surrounding ED burnout including incidence rate and causes during the COVID-19 pandemic. Because studies indicate upwards of three fourths of ED staff reporting increased stress and burnout, finding ways to …

Health Promotion Within High-Risk Communities: Become An Agent Of Change To Enhance Vaccination Acceptance In Communities, Natalie A. Fischetti Dr., Susan Mee Dr.

Open Educational Resources

This is a course of six self-paced modules for nursing students to learn about vaccines, vaccine safety and patient education regarding vaccines.

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson

Evidence-Based Practice Project Reports

The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those …

Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli

Evidence-Based Practice Project Reports

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …