Family Practice Nursing Commons^™

Contraceptive Accessibility And Reproductive Outcomes In Adolescents Seeking Care At School-Based Health Centers: A Systematic Review, Jamie Jenkins

All Graduate Theses, Dissertations, and Other Capstone Projects

Context: Adolescent pregnancy continues to be a public health concern in the United States. School-based health centers are an ideal setting for providing affordable, accessible, and confidential reproductive services for adolescents that can help prevent unintended pregnancies. However, there are great variations in the reproductive services offered at school-based health centers across the United States. Objective: This study aims to explore the question: Do school-based health centers that provide on-site contraception access have lower adolescent pregnancy rates and higher reported contraception use when compared to school-based health centers that do not provide on-site contraception? Methods: A literature …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

The Role Of Parents In Providing Sexuality Education To Their Children, Nur Azira Fideyah Binti Abdullah, Siti Mariam Muda, Norhasmah Mohd Zain, Siti Hazariah Abdul Hamid

Makara Journal of Health Research

Background: Parents have an important role in delivering sexuality education to their children. However, Asian parents are reluctant to discuss sexual matters with their children owing to the sensitivity of the topic and their lack of sexual health knowledge. This study aimed to examine Malaysian parents’ knowledge, attitudes, and practices in providing sexuality education to their children.

Methods: A self-administered questionnaire was used to conduct this cross-sectional study featuring 200 Malaysian parents. Descriptive and univariate analyses were performed using Statistical Package for Social Study (SPSS) version 23.0.

Results: Among the majority (79.5%) of the parents having good …

Knowledge, Attitudes, And Practices Of Adolescents Regarding Sexuality And Reproductive Issues In The Cordillera Administrative Region Of The Philippines, Eddieson Pasay-An, Judith Odanee G. Magwilang, Petelyne P. Pangket

Makara Journal of Health Research

Background: This study investigates the knowledge, attitudes, and practices (KAP) concerning reproductive health (RH) and sexuality among in- and out-of-school adolescents in the Cordillera Administrative Region (CAR), Philippines.

Methods: Using a quantitative, cross-sectional approach, this study examined 739 in- and out-of-school adolescents who were recruited through snowball and simple random sampling.

Results: Statistically significant differences were noted in the knowledge, attitudes, and practices regarding sexuality based on age. Age was associated with knowledge, attitudes, and practices concerning RH. Educational attainment toward sexuality also caused statistically significant changes in knowledge, attitudes, and practices. The KAP regarding sexuality and …

Association Between Dietary Macronutrient Intake And High-Sensitivity C-Reactive Protein Levels Among Obese Women In Kuantan, Malaysia, Siti Zuhaidah Shahadan, Azlina Daud, Muhammad Ibrahim, Muhammad Lokman Md. Isa, Samsul Draman

Makara Journal of Science

Elevated high-sensitivity C-reactive protein (hs-CRP) levels may be associated with an increased risk of cardiovascular disease (CVD). In general, an individual’s dietary intake may influence the hs-CRP level. However, evidence on the influence of dietary macronutrient intake on hs-CRP levels among obese Malaysian women remains fragmented. Therefore, this study aims to investigate the association between the hs-CRP level and dietary macronutrient intake of obese adults living in Kuantan. The assessment of 24-hour dietary recall and venous hs-CRP levels were investigated in 67 women with a body mass index of 27.5 to 39.9 kg/m². The findings revealed that obese women living …

Postpartum Depression: Educating The Provider And Staff About The Importance Of Screening, Referrals, Follow-Up And Adherence To The Maternal Mental Health Safety Bundle Toolkit, Natalie Regis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Postpartum depression (PPD) affects approximately 10%-20% of women after childbirth. PPD is a disabling condition that can have serious health implications on mothers and their infants. Experts estimated that only 50% of women with PPD are diagnosed. Lack of education about screening practices can cause the disorder to go undiagnosed and untreated.

Purpose: The purposes of this quality improvement (QI) project were 1). To increase the provider and staff knowledge about the importance of screening with the implementation of a standardized screening tool 2). To increase PPD screening rates to 100% 3). To increase appropriate referrals to mental …

An Evaluation Of Adolescent Concussion Management And Guidelines By Primary Care Providers In The Outpatient Setting: Dnp Scholarly Project, Mary Beth Newkirk

Doctor of Nursing Practice Scholarly Project

Understanding the pathology of a concussion has been a challenging task for many experts in healthcare. An agreed upon definition has yet to be developed and many health care providers are not properly educated to assess and care for those suffering from a concussion. Management of concussion in adolescents, a vulnerable population, requires even more consideration and training. The purpose of this study was to determine the knowledge current providers in the four-state region regarding sport-related concussion management in the adolescent population, to improve patient care and outcomes, and to improve knowledge learned through exposure to a clinical practice guideline-based, …

Improving Frequency Of Hand Hygiene Education From Providers To Patients, Christopher Sutton, Nancy Moran, Vanessa Hernandez

Master's Projects and Capstones

Hand hygiene compliance is one of the most simplest forms of preventing infection. This paper focuses on improving the frequency and standardizing hand hygiene education to patients delivered by health care professionals from a primary care clinic. The ambulatory suburban community clinic in Oakland primarily serves the underserved population. The target population are the following providers: Physicians, Physician Assistants, Nurse Practitioners, Registered Nurse, Licensed Practical Nurse, and Medical Assistants. A survey was adapted from evidence-based studies, WHO, and CDC to collect data on current hand hygiene education provided to patients from healthcare professionals. An additional survey was given to patients …

Nurse Practitioners In Healthcare Benchmark, Jun Cho

MSN Capstone Projects

With the shortage of physicians and rise of healthcare costs, it is imperative that healthcare start looking at the best alternative to take care of patients. With average life expectancy increasing and baby boomers entering Medicare, there will be more in need for providers. There are many uncertainties and questions concerning nurse practitioners practicing independently, compared to physicians, about overall care and patient satisfaction. There have been many evidence-based researches that shows nurse practitioners can provide just as efficient and safe care as compared to physicians.

Cpm Machine Protocol For Knee Replacements, Lacy White

MSN Capstone Projects

A benchmark project was conducted regarding the use of a CPM machine postoperatively to increase standardization of care for total knee replacement patients while also increasing the patient’s range of motion of the knee and decreasing the post-surgical pain. Over a six week period of time, each patient was given a CPM machine no later than 2 hours post op after the total knee replacement surgery and each patient was discharged after a one night stay in the hospital under observation instead of inpatient. When the patient were discharged they would be followed by a home health service who will …

A System Intervention Of Tetanus, Diphtheria, And Pertussis Vaccination For Pregnant Women In Primary Care, Tarshera Reyna

Doctor of Nursing Practice

The health care system in the United States has been described as having a deficit in care for women during pregnancy (IOM, 2019), and as a result there has been a resurgence over the last decade in diseases like pertussis, which is a severe respiratory infection that is particularly dangerous for infants less than 3 months of age (Tan & Gerbie, 2013). The primary objective of this project was to implement a Tdap vaccination program and increase the rates of Tdap vaccinations of obstetrical patients at a San Antonio clinic. The intervention included: 1) establishing standing orders for the Tdap …

Is Anybody Listening?: Factors Affecting Pain Management In Veterans Within An Acute Care Rehab Setting, Laura Oseghae

Doctor of Nursing Practice

Background: In the United States, pain is a widely discussed issue due to the opioid epidemic stemming from a history of pain mismanagement. Clinical guidelines for successful pain management techniques are readily available for providers to incorporate into the individualized patient care plan.

Purpose: The purpose of this project is to improve pain management through implementation of the VA pain management guidelines and improved interdisciplinary team communication.

Objectives: This project aims to decrease the number of patients reporting moderate to severe pain, enhance staff/provider communication, and improve the provider’s overall process for managing pain with an individualized treatment plan.

Interventions: …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

Patient-Centered Implementation Of Statin Therapy In Patients With Type 2 Diabetes, Giovanna P. Favarato

Doctor of Nursing Practice

Heart disease is the leading cause of morbidity and mortality in Americans with type 2 diabetes mellitus. The American Diabetes Association recommends statins and lifestyle modifications for all patients with type 2 diabetes mellitus for the prevention of atherosclerotic cardiovascular events. A patient-centered approach to primary prevention is encouraged, yet there are no specific instructions regarding implementation. The Statin Choice Decision Aid is a tool designed to facilitate shared decision-making between the patient and the provider in the clinical setting. The 2018 American College of Cardiology/American Heart Association guidelines for the primary prevention of atherosclerotic cardiovascular disease for patients with …

Increasing Adherence To Measurement-Based Depression Management In Primary Care, Renad Saadat

Doctor of Nursing Practice

Background and Review of Literature. Approximately 11 million Americans 18 years or older experienced a severe symptom of depression leading to impairment in 2017. The severity of depressive symptoms is often miscalculated in primary care as measurement-based tools for the diagnosis and ongoing reassessment varies. Purpose. The purpose of the project was to increase provider adherence in using the patient health questionnaire-9 (PHQ-9) for ongoing evaluation of the severity of depressive symptoms in patients with depression at a primary care clinic in San Antonio, Texas. Objectives. The main objective of this Doctor of Nursing Practice project is …

Establishing A Structured Mentorship Program For Novice Advanced Practice Registered Nurses In The Veterans Health Care System, Rodney Duckett

Doctor of Nursing Practice

Background. Mentorship is an age-old strategy still widely sought after to increase integration into the workforce. Employers of new APRNs must be aware that newly graduated APRNs are inexperienced. To maximize the employers’ investment, training on proper integration should be a high priority. This Doctor of Nursing Practice (DNP) project addressed this quality improvement issue through the implementation of a structured mentorship program to improve the overall transitioning of newly hired APRNs in the Veterans Health Care System (VHCS). Problem. The VHCS lacks a formalized, structured mentorship program for newly graduated APRNs entering the VA System. Intervention. Seven APRN mentors …

Implementation Of An Electronic Alert For Improving Adherence To Diabetic Foot Exam Screenings In Type 2 Diabetic Patients In Primary Care Clinics, Ruby Denson

Student Scholarly Projects

Practice Problem: Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of complications including foot ulcerations (Harris-Hayes et al., 2020). Preventive care is essential for the early detection of foot ulcers but despite the advantages of preventive screening, a limited number of primary care providers perform annual foot exams (Williams et al., 2018).

PICOT: The clinical question that guided this project was, “In adult patients with T2DM receiving care in a primary care setting, will the implementation of an electronic clinical reminder alert (ECR) increase provider adherence to performing an annual diabetic foot exam and risk …

Hpv Vaccination In Adults 18 Through 45: Reducing Missed Vaccination Opportunities In The Primary Care Setting, Ashley Hernandez

Doctor of Nursing Practice

HPV is the most prevalent sexually transmitted infection in the United States and is linked to six different types of cancer cell development. Prevention of infection from this virus could save hundreds of thousands of lives worldwide. An evidence-based quality improvement project was designed to increase the identification of HPV vaccination opportunities in the adult primary care setting to improve HPV vaccination rates. A protocol and patient eligibility algorithm were developed to align primary care practice with recently updated CDC guidelines. Interventions included clinic staff and provider education, designation of a vaccination champion, a flag within the patient chart to …

Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes

Electronic Theses and Dissertations

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall …

Implementation Of Comprehensive Foot Exams In Primary Care: A Quality Improvement Project, Dora Elia Trevino

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase performance and documentation of provider comprehensive foot exams (CFEs) by 50% among patients with Type 2 diabetes (T2DM) in a small clinic in the southwestern United States.

The project leader assessed clinic systems including the electronic health record (EHR) to identify means to increase CFE completion and documentation rate for patients with T2DM being seen for a chronic disease management (CDM) appointment. A process was created to incorporate a hardcopy CFE documentation form into the EHR and create a pop-up care reminder notification system. Staff and the provider were educated …