Family Practice Nursing Commons^™

Implementation Of Point-Of-Care Tick-Borne Disease Powerplan™ And Algorithm For Early Detection And Treatment Of Tick-Borne Diseases, Ashley Pinkham

DNP Scholarly Projects

Abstract

Local Problem: The Concord Hospital system, serving 30+ communities, is situated in the heart of New Hampshire surrounded by densely wooded forests, lakes, and mountains and is a mecca for camping, vacationing, and sightseeing, doubling its population of 1.6 million residents during spring, summer, and fall months. Despite the serenity, there is a predator that lingers among the hiking trails and lake shorelines. From January 2021 through August 2022 there were a total of 41 hospitalizations from tick-borne diseases, some with life threatening symptoms. Unfortunately, nearly half (43%) of patients presented to their primary care provider first where the …

Cabg Vs. Pci: Greater Outcomes For Severe Coronary Artery Disease, Haejin Cho

Master's Projects

Coronary artery disease is the leading cause of mortality in the United States. The lifetime probability of developing coronary artery disease after 40 is 40% in men and 32% in women. Cardiac revascularization for patients with complex coronary artery disease is performed commonly. Two common procedures for cardiac revascularization are coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this systemic review is to compare long-term outcomes of CABG and PCI in patients with severe artery disease. This review concluded that PCI was associated with higher rate of repeat revascularization compared to CABG, but the incidence …

Pet Loss And Grieving Strategies: A Systematic Review Of Literature, Ruth E. Cervantes

Master's Projects

The impact that companion animals have on human lives has been explored in many aspects including therapy and emotional support. In some cases, these types of pets have been deemed necessary for pet owners with medical problems. However, pets are not only a medical necessity for some humans, but they are also companions, and most are included as family members. The loss of a pet often brings on intense grief that is not often acknowledged in the workforce. Bereavement leave for immediate family members is a benefit offered to employees, and as we will read in this literature review pet …

Efficacy Of Gabapentin Versus Benzodiazepines In The Management Of Alcohol Withdrawal Syndrome, Douglas R. Fredona

Master's Projects

Alcohol abuse, complicated by a dependency relationship, is the third leading modifiable cause of death in the United States. In patients with chronic alcohol use disorder who experience a sudden cessation or significant decrease in alcohol consumption, half will experience symptoms of alcohol withdrawal syndrome. Benzodiazepines are the typical first line treatment for alcohol withdrawal. However, benzodiazepines carry with them significant risks and side effects. As a result, ongoing research has taken place to find either an alternative treatment or a method of reducing total benzodiazepine dosage during treatment. Gabapentin is a medication that is primarily used for seizure control …

A Systematic Review: Relationship Between Medication Adherence And Hypertension, Monica Chan

Master's Projects

Chronic diseases are defined as conditions that are present for over one year and limit activities of daily living or require ongoing medical attention. Heart disease is the number one leading chronic disease in the United States, making up one third of all deaths. In turn it costs the health system $216 billion per year (Center for Disease Control and Prevention, 2023). Uncontrolled blood pressure is a key risk factor for heart disease and stroke. 1 in 2 adults will need to take prescription medication to control blood pressure and lower the risk of having a cardiovascular event. This systematic …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …

Efficacy Of Utilizing A Discharge Checklist At A Northern California Hospital, Becky Le

Master's Projects

Standardization of patient discharges by utilizing a discharge checklist would address discharge barriers, improve discharge times, enhance communication among the multidisciplinary team, and improve efficiency of care. A 5-week pilot, which was a quality improvement study, explored whether the utilization of a discharge checklist would improve discharge times and communication among the multidisciplinary team. This study was conducted in a northern California county hospital, on 2 medical- surgical units, with a participating physician team, case managers, and approximately 150 medical- surgical registered nurses. The study yielded results of improved discharge times by 1 hour, and improved efficiency of care by …

The Impact Of Utilizing The Eat, Sleep, Console Model On Pharmacologic Interventions And Length Of Stay, Kareena Parks

Master's Projects

Purpose: This systematic review seeks to explore whether utilizing Eat, Sleep, Console (ESC) over the Finnegan Neonatal Abstinence Scale (FNASS) in the neonatal abstinence syndrome (NAS) population decreases length of stay or pharmacological interventions.
Method: Systematic literature review utilizing CINAHL, PubMed and Google Scholar databases.
Results: Utilizing Eat Sleep Console, over FNASS decreased length of stay and pharmacologic intervention.
Conclusions: There is compelling research suggesting a change in NAS treatment from FNASS to ESC with a decrease in length of stay and pharmacologic intervention. However, there is an opportunity for further studies providing higher levels of evidence as the current …

The Impact Of A Blood Pressure Reduction Program In Optimizing Control Of Hypertension Amongst Adult Females In An Outpatient Ambulatory Clinic, Brooke Englert

DNP Projects

Background: Hypertension (HTN) is a public health problem that, when well-controlled, can significantly reduce the risk of stroke, coronary heart disease, heart failure and death. Effective patient-provider communication strongly incentivizes an improvement in medical outcomes. Communication with patients can often be effectively delegated to other clinical staff, such as registered nurses (RNs) or clinical service technicians (CSTs) (Tavakoly Sany, Behzhad, Ferns & Peyman, 2020).

Purpose: Given the increased risk of all-cause and cardiovascular disease mortality of uncontrolled HTN, the purpose of this study was to implement and evaluate a standardized, evidence-based practice intervention via communication between APRN providers and patients …

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams

DNP Projects

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.

Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Impact Of Physical Activity Vital Sign Screening On Physical Activity Counseling And Referrals In Primary Care, Anna Selepina

DNP Projects

Background/Purpose: Physical Activity Guidelines for Americans recommend 150-300 minutes of moderate-intensity physical activity each week for adults; however, half of the adults do not meet this goal, which leads to increased chronic health conditions and poor health outcomes. The physical activity vital sign (PAVS) screening tool is an evidence-based assessment tool associated with increased physical activity counseling, which can lead to increased physical activity and improved patient outcomes.

Objective: The purpose of this study was to examine the impact of PAVS screening on physical activity counseling and referrals in primary care.

Methods: This prospective study took place in a small …

Evaluating The Effect Of Electronic Health Record Patient Portal Use On Medication Adherence In Adults With Chronic Conditions, Jennifer Averbeck

DNP Projects

Background Medication non-adherence is prevalent among fifty percent of the United States population. This behavior leads to increased morbidity and mortality as well as increased healthcare costs for both the patient and the healthcare system. More than two-thirds of nonadherence exists in those aged over 65 years old who are diagnosed with Multiple Chronic Conditions (MCC). Several studies have researched and trialed interventions to improve rates of adherence, limit poor health outcomes, and decrease overall cost of care. The patient portal is an interactive tool which encourages participation of the patient in their healthcare management. Implementation of this tool has …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Evaluating Providers’ Knowledge, Attitudes, And Intentions Toward Utilizing First Post-Discharge Visit Checklist In Primary Care To Reduce Readmissions In Heart Failure Patients, Binu Bashyal

DNP Projects

Background and Significance: Heart failure (HF) affects approximately 6.2 million adults in the United States and 40 million people globally. HF is one of the leading causes of emergency department (ED) visits and hospitalizations in adults. Twenty percent of patients admitted for HF are readmitted within thirty days, and up to fifty percent are readmitted by six months. A First Post-Discharge Visit checklist could help mitigate the problem of readmission.

Purpose: The purpose of this DNP project was to evaluate primary care providers’ knowledge, attitudes, and intentions towards utilizing the First Post-Discharge Visit checklist to reduce hospital readmissions among …

Knowledge & Attitudes Towards Pediatric Pain With Needle-Based Procedures In The Emergency Department Setting, Charlstyn Paige Brown

DNP Projects

PURPOSE: By the time a child enters kindergarten, they may have faced as many as thirty-three vaccine-related injections. Throughout these experiences, parents and patients associated pain and fear regarding the administration of multiple vaccines concurrently to a child has played a role in vaccine hesitancy and refusal. Parents and patients experience associated fear and pain regarding the administration of multiple concurrent scheduled vaccines, thus leading to vaccination hesitancy and refusal. In addition to scheduled immunizations, there is also the possibility of unexpected needle-based procedures taking place when emergencies arise. The purpose of the study is to explore the current …

Evaluation Of Patient And Clinical Staff Perceptions Of Screening For Social Needs In An Underserved Population, Alysha Greenwell

DNP Projects

Abstract

Background. Despite ample strong evidence linking social determinants of health (SDOH) and unmet social needs to higher healthcare costs and worse health outcomes across the lifespan, only 16% of healthcare practices screen their patients for social needs. Various barriers contribute to low screening rates, including uncertainty about best methods for screening, the amount of time it takes to screen, and lack of confidence in knowing what to do once needs have been identified. As movements toward value-based models of care change the healthcare landscape, healthcare systems must find practical and effective methods to effectively screen for social needs utilizing …

Using Motivational Interviewing To Improve Self-Care In Adults With Congestive Heart Failure, Krista Martinez

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Heart Smart Holidays: Coping With Stress, Staying Active, And Healthy Cooking Strategies For Seniors In Cleveland County, Lauren Ridgeway

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice Project assessed whether attending community group meetings focusing on stress, staying active, and healthy eating during the holidays, could influence cardiovascular disease awareness, mental health awareness, and quality of life of senior citizens in Cleveland County. A convenience sample of 6 participants attended the Coping with Stress and Staying Active event while 10 participants attended the Healthy Cooking Strategies event. The objectives were measured using a pretest posttest design before and after the presentations. There was strong evidence (t(9) = -13.597, p < .05) that the group seminar on managing stress and staying active during the holiday season improved the mental health awareness of participants. Data also showed a significant increase in Cardiovascular Disease Awareness from pretest to posttest (t(5) = 3.246, p < .05) after the seminar on healthy cooking strategies. The project raised community awareness to the importance of managing stress, staying active, and making small nutritional changes to positively impact the cardiovascular health of Seniors.