Family Practice Nursing Commons^™

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …

Palliative Care Quality Of Life Outcomes In Adults With Chronic Illness, Jackie Steigerwald

Master of Science in Nursing Family Nurse Practitioner

In adult populations with chronic illnesses, implementation of palliative care may provide the opportunity to slow the disease process, manage symptoms, and improve patients' overall quality of life. Without palliative care implementation, the aspects of psychosocial needs may go clinically unaddressed with disease progression. Palliative care provides an opportunity for multidisciplinary providers to make interventions to improve all aspects of quality of life. The aim of this project is to evaluate the implementation of palliative care services in patients with chronic illnesses, the World Health Organization Quality of Life Abbreviated (WHOQOL BREF) quality of life scale and compare them with …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

The Effect Of Obesity On Comorbidities: A Benchmark Study, Kaley Nolen

MSN Capstone Projects

Obesity is distinguished by a body mass index (BMI) greater than 30. Tremmel et al. (2017) reports obese individuals are at a greater risk for developing cardiovascular disease, diabetes, and cancer. In 2014, approximately 641 million adults were classified as obese (Zhang et al., 2018). This epidemic has drastically worsened over the last two decades resulting in obesity ranking as the fifth most common cause of death globally (Safaei et al., 2021). Okunogbe et al. (2021) states, slowing the incidence rate of obesity by 5% will save approximately $3.3 billion annually between 2020-2060. The pathophysiology and cause of obesity is …

Improving Effective Care In Obese Patients In A Primary Care Clinic, Amy Miller

Journal of Interprofessional Practice and Collaboration

Background: Obesity is a preventable epidemic and costs the United States $200 billion annually. The leading causes of death are linked to obesity.

Local Problem: In a chart review, 53% of patients at a northeast Louisiana primary care clinic were obese. However, none were offered comprehensive lifestyle intervention. The aim was to increase the percentage of patients with BMI < 30 kg/m2 to 60% over 8 weeks.

Methods: A rapid-cycle quality improvement initiative was implemented using four Plan-Do-Study-Act cycles over 8 weeks. Each cycle produced tests of change related to screening, patient and team engagement, and assessing effective care. Run charts and aggregate tables were used to analyze …

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

Results Of Nursing Training Reforms: Estimating The Scope Of Nursing Practice, Marat Serikbayev, Saltanat Mamyrbekova, Ainur B. Kumar, Lyazzat Kosherbayeva, Akmaral Abikulova, Laura Seiduanova, Elmira Serikbayeva

Journal of Health Research

Background: With the adoption of the Astana Declaration on primary health care, modern approaches are being introduced in the Republic of Kazakhstan. The created national foundations of the nursing management system in Kazakhstan are a visible manifestation of a new organizational culture. In connection with the large-scale reform of nursing and the creation of a new position of nurses that meets modern social challenges and international requirements, the role of nurses in healthcare has increased significantly. In this study, we measured the actual scope of nursing practice among nurses in the medical organizations in the Republic of Kazakhstan.

Methods: …

Role Of Hand Hygiene In The Prevention Of Central Line-Associated Bloodstream Infection In Intensive Care Unit Patients: A Benchmark Project, Meliana Amazan

MSN Capstone Projects

CLABSI (Central Line Associated Blood Stream Infection) is one of the most common hospital-acquired infections in the ICUs (Intensive Care Unit). Not only it is cost prohibitive, but it also prolongs hospitalization. However, it is avoidable. This condition needs to be reviewed to improve patients’ outcomes in the ICUs. This project aims to decrease or eliminate the incidence of CLABSI among ICU patients through proper and mindful hand hygiene. Healthcare providers should be aware of the different care bundles that contribute to decreasing CLABSI and be able to apply them correctly. Articles were searched on different databases such as Cochrane …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Assessing The Impact Of Daily Chlorhexidine Baths In Prevention Of Central Line Associated Bloodstream Infections: An Evidence Based Project, Brooke Rea

MSN Capstone Projects

Background: The rates of central line associated bloodstream infections (CLABSI) is a major concern in the healthcare industry. It is imperative that healthcare professionals take every precaution to prevent these life-threatening infections to the already critically ill patient.

Objective: The reason for this paper is to assess the effectiveness of the use of daily chlorhexidine baths in patients with central lines in the prevention of CLABSIs.

Narrative Review: A narrative review of evidence was conducted to assess the effectiveness of daily chlorhexidine bathing in patients with central lines. Twelve studies were moved forward in the project. Each of the twelve …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Use Of Electronic Health Record Reminders To Improve Primary Care Providers’ Colorectal Cancer Screening Recommendations., Terra Renee Schrembs

Doctor of Nursing Practice Papers

Background: Colorectal cancer (CRC) is the third most common worldwide cause of cancer morbidity and mortality. CRC mortality is preventable through regular screening. Electronic health record (EHR) reminders for providers can increase providers’ CRC screening recommendations and lead to earlier CRC diagnosis. According to the National Cancer Institute’s Screening and Risk Factors Report for Kentucky by County 2008-2010, 62.7% of adults in a rural Kentucky county aged 50-75 had completed a home based FOBT in the past two years or have ever had a colorectal endoscopy.

Purpose: The purpose of this DNP project was to implement and evaluate an …

Remote Blood Pressure Monitoring Program: Program Evaluation., Brittany Walker

Doctor of Nursing Practice Papers

The prevalence of hypertension is high at the local, state, and national levels. In 2021, 39% of Kentucky adults were diagnosed with high blood pressure (CDC, 2021). Primary care providers are utilizing remote blood pressure monitoring (RBPM) to assist with the management of hypertension. Literature reveals that remote BP monitoring alone, without the use of other interventions such as counseling and education, may not effectively control blood pressure (Uhlig K, et al, 2013). This project evaluated the RBPM program utilized at a federally qualified health center in Louisville, KY. Patient engagement within the RBPM program includes BP measurement, communication with …

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 …

Exploring The Influence Of Postnatal Depression On Neonatal Care Practices Among Mothers In Western Kenya: A Qualitative Study, Florence Achieng, Alloys K’Oloo, Hellen Barsosio, Simon Kariuki, Helen Nabwera

Obstetrics and Gynaecology, East Africa

Background: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality.

Objectives: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya.

Design: A cross-sectional study.

Methods: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale.

Results: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to …

Providers’ Effective Approach: Reducing Resistance To Insulin Treatment In Type 2 Diabetic Patients With Hyperglycemia, Eden A. Tsegay

Electronic Theses and Dissertations

Resistance to insulin therapy is primarily due to emotional and intellectual perceptions among patients with type 2 diabetes (T2D) new to insulin therapy. Providers’ effective approach to diabetes education equips patients with knowledge, which can reduce resistance to insulin therapy. This project included patients with T2D between the ages of 18 to 70 whose glycated hemoglobin (HgbA1c) was ≥ 8.5% taking two or more oral antidiabetic agents and not on insulin therapy. Data were collected using the Insulin Treatment Appraisal Scale (ITAS), a 20-item instrument that contains 16 negative and four positive statements that appraise an individual’s perception of insulin …

The Routine Use Of Tympanometry To Prevent Unnecessary Antibiotics In Patients With Otalgia: An Evidence-Based Practice, Quality Improvement Project, Leslie Leffler

Graduate Theses, Dissertations, and Capstones

Abstract

Background: The use of Tympanometry to diagnosis Otitis Media with Effusion (OME) in adults is not routine practice in primary care, although it is supported by evidence and clinical practice guidelines. The misdiagnosis of OME frequently leads to inappropriate antibiotic prescribing, contributing to the rise in drug resistant infections.

Purpose: This evidence-based practice, quality improvement project sought to determine if the use of tympanometry by Family Nurse Practitioners (FNPs), to assess adults visiting primary care clinics, improved the accuracy of otitis media diagnoses and decreased unnecessary antibiotic therapy. The project also evaluated whether experience using the tympanometer …

Back To Basics: Improving The Quality Of Blood Pressure Measurement, Heather Sailor

Student Scholarly Projects

Practice Problem: Hypertension is a leading cause of death and disability worldwide. Blood pressure measurement (BPM) is at the forefront of diagnosing and treating hypertension, however, it is often measured inaccurately.

PICOT: The PICOT question that guided this project was: In outpatient adult patients (P), what is the effect of implementing a standardized blood pressure measurement protocol (I) versus standard measurement (C), on the quality of blood pressure measurement (O) within 8 weeks (T)?

Evidence: Implementation of a blood pressure measurement protocol has been shown to improve the quality of blood pressure measurement.

Intervention: A blood pressure measurement protocol …

Implementation Of A Vestibular Disorder Screening Tool In An Urgent Care, Kathleen A. Probst

Dissertations

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use …