Family Practice Nursing Commons^™

Preventing Childhood Obesity With Increased Education On Responsive Feeding Practices In Parents Of Newborns In A Community Health Center, Heather Burns

Doctor of Nursing Practice Scholarly Project

This project sought to increase healthcare providers’ responsive feeding education to parents of newborns at a community health center in Southeast Kansas. An educational offering was held for participating providers who provided health services throughout infancy. The offering reviewed the projects’ methodology, instruments, and intervention to increase responsive feeding education. Parents of newborns who met the inclusion criteria and who presented for an initial newborn visit with their healthcare provider were invited to participate. Parents completed surveys prior to receiving education at the initial appointment and the a follow-up survey at the infant’s two-month well child appointment to analyze parental …

Recruiting And Retaining Np Preceptors, Angelica Renteria

DNP Qualifying Manuscripts

It is estimated that by 2020, the shortage of primary care providers will reach over 20,000. This has led to a surge of nurse practitioner (NP) programs across the nation. Recruiting and retaining preceptors is of paramount importance. Barriers and incentives to precepting must be identified in order to maximize teaching capacity. More effective ways of training NP students (NPs) need to be explored to capitalize on the time preceptors invest with students. The adoption of the OMP teaching model may facilitate training for the preceptor and improve the learning of NPs due to its simplicity and efficiency.

Wound Care Education For Primary Care Providers At A Regional Medical Center, Zaira Torres

Doctor of Nursing Practice (DNP) Projects

Problem. Due to the aging population and the high prevalence of chronic diseases such as diabetes and cardiovascular disease, in the US, millions of people suffer from chronic wounds secondary to these chronic conditions. Wound care treatment is very expensive, costing the US health care system approximately $10 billion annually. San Mateo Medical Center treats many patients with wounds. However, the treatment is suboptimal as most primary care providers (PCPs) are not trained to perform wound care according to best practice. This creates several problems such as a large number of referrals to the Vascular Clinic, visits to the emergency …

Initiating Prep In Primary Care: Addressing The Adolescent And Young Adult High Risk Populations, Igor G. Mocorro

Doctor of Nursing Practice (DNP) Projects

Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers.

Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult …

Unaddressed Challenges For The “Most Honest And Ethical Profession:” A Pilot Study Of Web-Based Learning Strategies To Prevent Moral Distress, Kelly Straight

Doctor of Nursing Practice (DNP) Projects

Background: Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and because of widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Even with codified ethical standards, unresolved and/or ongoing ethical questions and dilemmas pose further issues such as the development of moral distress. This pilot project was designed to help NPs and other healthcare workers …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Dnp Final Report: Diabetic Foot Care In Hispanic Females With Type Ii Diabetes: An Evidence-Based Quality Improvement Initiative, Barbara Chapman

DNP Final Reports

Diabetes affects 30.5 million people in the United States at an annual cost of approximately 245 billion dollars. 176 billion dollars are spent on debilitating often life threatening complications affecting the heart, kidney, eye, and nervous system. Over 69 billion dollars are spent on reduced workforce productivity. Approximately 9.9% of the United States population has diabetes, the diabetic population in Texas is 11.4% and in Collin County population is 10.2%. Hispanic populations are at a higher risk of developing diabetes at approximately 12.2% nationally.

Peripheral neuropathy commonly occurs in the lower extremities of diabetic patients increasing risks of foot complications …

The Role Of Allergy Testing In Eczematic Patients: A Benchmark Study, Ashley E. Cox

MSN Capstone Projects

Eczema or atopic dermatitis (AD) is the first visible sign that indicates a much bigger and more complex problem within the body. The first presentation of symptoms is typically in individuals less than six months of age. Concerned parents bring their child to the pediatrician where a course of topical corticosteroids is prescribed, according to current AD treatment guidelines (Weston, & Howe, 2019). Long term use of corticosteroids has proven to be detrimental to the patient’s health, especially pediatric patients, in many ways such as gynecomastia, hypertrichosis, staphylococcal infections, skin atrophy, and worsening of skin diseases, just to name a …

Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger

Evidence-Based Practice Project Reports

Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …

Efficacy Of A Mobile Application In A Chronic Kidney Disease Population, Jennifer R. Zamora

Evidence-Based Practice Project Reports

Chronic kidney disease (CKD) is associated with high healthcare costs, poor health outcomes and low quality of life (Donald et al., 2018). The US CKD prevalence is 15%, costing Medicare $79 billion in 2016 (United States Renal Data System, 2018). Self-management could reduce CKD burden (Jeddi, Nabovati, and Amirazodi, 2017). Mobile technology offers a low-cost, ease-of-access platform for chronic disease self-management (Whitehead & Seaton, 2016), potentially slowing disease progression and improving health outcomes (Jeddi, 2017). The purpose of this project was to utilize a CKD-specific mobile application, CARELogiQ, to facilitate symptom management; increasing patient satisfaction and decreasing hospitalizations and ER …

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice …

An Examination Of The Night Burn Clinic Transition To Nurse Practitioner Coverage, Kevin J. Maxwell Dnp, Fnp-Bc

Dissertations

Background/Significance: Burns are dynamic, evolving wounds requiring prompt attention and treatment (Morgan et al., 2018). Many studies have been conducted comparing physician outcomes to those of APNs showing no difference (McCleery, Christensen, Peterson, Humphrey, & Helfand, 2011; Naylor & Kurtzman, 2010; Pioro et al., 2001; Roche, Gardner, & Jack, 2017; Spetz, Skillman, & Andrilla, 2017). Time delays which allow for progression of the injury have a negative impact on patient outcomes. Any pathway allowing for quicker review of the burn by a burn specialist should be welcomed (Kelly et al., 2013). APNs can augment physician efforts and expand access to …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Supporting Positive Lifestyle Changes Among Patients With Diabetes Mellitus Type 2, Alison Tynan

Nursing | Senior Theses

The following thesis is a compilation of literature reviewed to formulate background research for a pilot study. The literature reviewed pertains to the potential benefit of added case management for patients with diabetes mellitus type 2. A proposed pilot study, based off of this research, aims to identify topics, tools, facts, and changes that can be made to case management to improve not just the biological aspects, like HbA1c levels, but the mental and emotional as well to allow for whole person care.

The primary question being asked is “what types of support do people with diabetes mellitus type 2 …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong

Evidence-Based Practice Project Reports

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et …

A Protocol To Increase Referral Rates To Diabetic Education, David M. Rokser

Evidence-Based Practice Project Reports

In 2015, approximately 30.3 million Americans, including 10.5% of the population of Minnesota, had been diagnosed with diabetes mellitus (American Diabetes Association, 2019). Increased risk of diabetic complications including neuropathy, retinopathy, nephropathy, cardiovascular disease, and chronic wounds has been associated with an elevated hemoglobin A1C (HgA1C). Formal diabetic education has been shown to be a cost-effective intervention to reduce HgA1C. The Office of Disease Prevention and Health Promotion published an objective within HealthyPeople 2020 that seeks to increase the percentage of diabetics receiving formal diabetic education in the United States from 46.9% of adults to 58.4%. The purpose of this …

Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free

Evidence-Based Practice Project Reports

Childhood obesity is one of the most chronic childhood illness worldwide (Centers for Disease Control and Prevention [CDC], 2019; World Health Organization [WHO], 2019). The prevalence of childhood obesity has been described as one of the most common chronic childhood conditions (CDC). The purpose of this evidence-based practice (EBP) project was to reduce the BMI scores of obese children using a multi-component intervention program that incorporates healthy eating, physical activity, and family involvement. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was used to facilitate the implementation of this EBP project. The synthesis of the appraised literature established that utilizing …

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

Evaluating The Clinical Impact Of Providing Home Blood Pressure Monitors To Patients With Elevated Or High Blood Pressure, Theresa La Guardia Asmus

Doctoral Projects

Many clinicians continue to diagnose hypertension based on office-based readings, despite the 2015 United States Preventive Services Task Force recommendation for the use of home or ambulatory blood pressure monitoring to confirm the diagnosis of hypertension prior to initiating treatment. Without obtaining blood pressure readings outside of the clinic environment, it is impossible to correctly diagnose hypertension, particularly regarding masked hypertension and white coat hypertension.

Stanford Health Care implemented a quality improvement project that provided patients with a home blood pressure device to monitor out of clinic blood pressure readings. The purpose of the project was to improve clinical care …