The Nutritional Management And Glycemic Control In Adolescents With Diabetes, Jennifer Durham

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this literature review is to explore the relationship of nutritional management on glycemic control amongst adolescents who have diabetes. The adolescent population has significant negative or positive peer influence on the management of their diabetes (Yang, 2018, p.104). These peer perceptions can include empathy, curiosity, knowledge seeking, enthusiasm, fearfulness, and bullying (Yang, 2018, p.104). These influences directly affect nutritional management, blood glucose levels, and insulin management. When the peer influence is negative the individual is less inclined to acknowledge their medical condition (Yang, 2018, p.105). Other influences on the management of diabetes include technology, physical exercise, and …

Evaluating The Impact Of A Team-Based Model Of Primary Care On Provider Burnout And Patient Experience, Kimberly A. Moreland

Doctor of Nursing Practice Scholarly Projects

Background: To assure high quality, safe, affordable, and accessible health care, organizations are embarking on quality improvement initiatives to work toward the triple aim of patient satisfaction, improving the health of populations, and reducing the cost of care.

Description of the Problem: Primary care is the backbone of the health care system, but it is a challenging environment with high rates of clinician burnout. Clinician burnout undermines the ability of organizations to meet the triple aim. Innovative new care delivery models are needed that can meet the triple aim while also mitigating burnout.

Available Knowledge: A PRISMA review of the …

A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith

Evidence-Based Practice Project Reports

Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

Compassion Satisfaction, Burnout, And Secondary Traumatic Stress Among Heart Transplant Nurses In A Hospital Setting, Marissa Potts

DNP Projects

Abstract

Purpose: The purpose of this study was to assess whether or not, and the degree to which compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) are present among inpatient acute-care heart transplant nurses. Perceived presence of other contributing factors that contributed to CS, BO, and STS was also assessed.

Design: A cross-sectional survey-based mixed methods study with an explanatory sequential design was used to assess baseline levels of CS, BO, and STS and identify any other factors at work or home that may impact these constructs.

Methods: A Qualtrics survey was sent to potential participants. A convenience …

Improving Patient Portal Enrollment Through Education And Technology At Rural Family Practice, Kelsey Crampton

Doctoral Dissertations & Projects

Background: Patient portals are available through many healthcare offices. They offer the opportunity to improve patient engagement and quality of patient care, but few patients enroll. At a small rural primary care office, less than 20% of the patients were enrolled in the patient portal.

Objective: The purpose of this quality improvement project was to address the barriers reported by patients at this clinic and determine whether changes in portal enrollment volume occurred. Reported barriers included a lack of knowledge about the portal and difficulties with the sign-up process.

Methods: Over three months, strategies included the development of a …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

The Effect Of Contingency Management On The Recovery Of Patients With Substance Use Disorder: A Systematic Review Of The Literature, Emily A. Gilman, Alexis Mccrossin, John R. Massey

Thinking Matters Symposium

Substance use disorder (SUD) is traditionally managed with behavioral therapy and medication. Contingency management (CM), a therapeutic method that reinforces positive behaviors with incentives, may be a useful adjuvant to enhance treatment engagement and efficacy for those who struggle with SUD. This systematic review of literature was conducted using databases CINAHL, Cochrane, and PubMed from January 2010 to July 2021. The search yielded 132 initial records. Studies were included if they were written in English, peer reviewed, and randomized control trials. Six final studies rendered results for 650 patients with varying substance use disorders including cannabis, tobacco, and opioids. Studies …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Adverse Childhood Experiences Screening In Adulthood: Knowledge, Attitudes, And Self-Efficacy Among Tennessee Nurse Practitioners, Megan M. Wanca

DNP Projects

Despite the prevalence of adverse childhood events (ACEs) and the relationship with negative health outcomes in adults, research shows clinical use of ACE screening is low among healthcare providers including nurse practitioners (NPs). The scholarly project’s purpose was to examine how Tennessee NP knowledge, attitudes, and self-efficacy influence intentions to screen for ACEs related to childhood trauma or abuse in adult patients. Using the Information-Motivation-Behavioral Skills Model as the theoretical framework, a cross-sectional and exploratory design assessed the association of NPs’ ACE screening knowledge, attitudes, and self-efficacy on the NPs’ intention to screen for ACEs in adult patients. A reliable …

Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett

Honors College Theses

Studies have shown that nursing students experience a greater-than-normal amount of anxiety and decreased clinical confidence when in settings involving infants and children, which is said to have a negative impact on the learning experience (Lassche, 2013; Moscaritolo, 2009). Patient education is a vital aspect of nursing, but one that the student nurse may not feel comfortable taking part in, either because of their lack of nursing experience or because of a lack of experience with infants and infant safety (Potter, 2020; Lassche, 2013). This project attempts to assess for a change in clinical confidence after providing a subject specific …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment Recommendations: A Scoping Review, Charles W. Stewart Cpnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: Pediatric health is significantly affected by social determinants of health. Screening for and addressing social determinants of health helps to decrease negative effect on health outcomes. The purpose of this project is to determine if there is an association between addressing or not addressing social determinants of health by the healthcare provider and parents’ adherence to treatment recommendations in children with urinary tract infections.

Methods: Between October 2020 and November 2021, a literature review was performed to obtain data from studies regarding urinary tract infections, social determinants of health and adherence to treatment recommendations. The University of Tennessee Health …

Reducing Adverse Events: Medication Reconciliation In Primary Care, Jacklyn Halpin

Epsilon Sigma at-Large Research Conference

Abstract

Title

Reducing Adverse Events: Medication Reconciliation in Primary Care

Purpose

Primary care patients experience high levels of adverse drug reactions due to inaccurate medication reconciliation practices. Project Aims

The project aims to improve medication reconciliation in a primary care setting. Outcome Measures

Outcomes measures include identified medication discrepancies, staff satisfaction related to the use of the MATCH tool, and patient age ranges and gender.

Methods

Over a 4 week period, the clinic staff integrated the evidenced based instrument, Medication at Transitions and Clinical Handoff (MATCH) tool. Initially, the office manager provided a MATCH tool and a copy of the …

Applying Scaffolding Methodology To Structure Dnp Intensive Skills Education, Candice Short, Jean Hemphill, Victoria Pope

Epsilon Sigma at-Large Research Conference

The Doctor of Nursing Practice (DNP) Family Nurse Practitioner (FNP) curriculum was developed to incorporate learning outcomes and experiential opportunities for students to attain the core FNP knowledge for doctoral education. Historically, challenges related to developing clinical skills in blended/online programs has been problematic. The appeal of online FNP education has challenged educators to develop new ways to provide students opportunities to experience hands-on clinical skills within the subspecialties of the DNP, FNP role. With limited clinical sites, and now with more clinical access constraints imposed by the COVID-19 pandemic, it is imperative that new models of instruction provide students …

The Benefits Of Different Birthing Positions, Sydney Miller, Maci Cloninger

Epsilon Sigma at-Large Research Conference

Many babies are delivered by using the standard lithotomy birthing position. However, evidence shows several benefits to an upright birthing position. The purpose of this study is to discover birthing positions that lead to more positive outcomes in laboring women delivering in hospitals. This research was conducted by examining previous studies conducted on a similar topic. However, the studies found mainly focused on the benefits of squatting positions and the implementation of devices that helps achieve an upright position. All findings support an upright birthing position provides a more optimal position for birthing a child due to the force of …

Sexual Health History Screening Implementation For Providing Quality Clinical Services In Primary Care: A Quality Improvement Project, Grace Unbehaun

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: With the US reporting 20 million newly diagnosed STI/HIV cases annually, clinical guideline compliance and EBP recommendation implementation necessitate provider practice changes for high-quality routine sexual and reproductive health services. The project's purpose was to improve sexual health history-taking (SHH) and documentation in a private primary care practice (PPCP) serving high-risk populations. The DNP project aims to determine the effect of conducting a 30-minute educational session and implementing the CDC's 5Ps on a PCP's clinical guideline adherence to SHH recommendations and documentation with patients presenting for annual wellness exams, well-woman exams, family/contraceptive counseling, or acute urogenital complaints in …

Implementing Systematic Sexual Orientation And Gender Identity (Sogi Data) Collection At An Inpatient Hospital Located In The Southern Region Of The United States, Shawn Malugin

Epsilon Sigma at-Large Research Conference

Purpose

LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge.

Aims

The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization.

Processes

To understand how to provide high-quality care to LGBTQ patients, providers receive instruction …

Limiting Potentially Inappropriate Medications In Long-Term Care, Clare M. Ironside

Doctor of Nursing Practice Scholarly Projects

Aim: This project aimed to assess the effectiveness of the STOPP/START tool in identifying and reducing potentially inappropriate medications among multi-morbid, older, long-term care residents in a metropolitan area of a Southwestern state.

Design: In this quality improvement project, seven prescribers working within four long-term care facilities were trained to assess for potentially inappropriate medications using the STOPP/START tool. The medication lists for long-term care residents (n =45) over age 65 were collected at baseline and again at three months post-intervention and assessed for overall medication use, psychotropics, and proton pump inhibitors. The project also assessed prescribers’ comfort and …