Family Practice Nursing Commons^™

Home Telemonitoring In Heart Failure, William Huff

MSN Capstone Projects

Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive …

Hpv Vaccination Knowledge, Attitudes, And Uptake In College Nursing Students, Joanna Marie Plumb, Jeannie Giese, Martha Buckner, David Phillippi, Robin Cobb

DNP Projects

Background: The human papillomavirus (HPV) is a preventable, sexually transmitted infection. The vaccines for HPV are safe and effective, but previous research demonstrated that nursing students have low knowledge levels and vaccine uptake. Low knowledge and attitude levels in nurses and nurse practitioners can influence parental and patient decision making for HPV vaccination. Purpose: The purpose of this scholarly project was to evaluate HPV knowledge and attitudes and their association with vaccination uptake in college nursing students. There is limited research in the United States on HPV knowledge, attitudes, and uptake of the vaccine among nursing students. Methods: This project …

Cultivating Appropriate Prescribing In A Primary Care House Calls Practice: A Quality Improvement Project, Sarah J. Marzolf

Doctor of Nursing Practice Projects

Problem Description: Polypharmacy in the frail elderly can lead to suboptimal management of medical issues. Primary Care Providers (PCPs) often lack knowledge of best practices regarding deprescribing and lack a systematic process for assessing mediation appropriateness. A quality improvement project was developed and executed at Housecall Providers, a home-based primary care practice in Portland, Oregon to facilitate the incorporation of deprescribing into daily practice.

Interventions: Following a literature review, a curriculum was developed and utilized during an educational intervention for PCPs regarding deprescribing best practices. A system for introducing new PCPs to evidence-based deprescribing for the frail elderly. This information …

Effectiveness Of An Aquatic Exercise Program For Reducing Weight, Body Fat And Chronic Low Back And Joint Pain, Terilyn Darley

Doctor of Nursing Practice Scholarly Projects

According to the World Health Organization (WHO), obesity has risen at an alarming rate and has reached epidemic proportions throughout the world (WHO, 2017). In the U. S., approximately 93.3 million U.S. adults are obese with an overall prevalence of 39.8 %. Chronic pain is another public health issue in the U.S, affecting almost 100 million people and is associated with significant annual healthcare costs and lost productivity (National Center for Complementary and Integrative Health [NCCIH], 2017). Exercise is considered one of the most effective prevention strategies for reducing obesity and has been documented to decrease chronic pain. The purpose …

Avoiding Common Weight Gain In Kidney Transplant Recipients Via An Activity Program, Uchenna Egbosimba

The Eleanor Mann School of Nursing DNP Capstone Projects

Kidney transplant recipients have shown to have substantial post-transplant weight gain within their first year after transplantation (Henggeler, C. K., Plank, L. D., Ryan, K. J., Gilchrist, E. L., Casas, J. M., Lloyd, L. E., Collins, M. G., 2018). After the development of end stage renal disease, a reduction in physical activity can occur as well as postoperative recovery stress (van Adrichem et al., 2018). Evidence has shown that increasing physical activity post-transplantation has various beneficial effects on the metabolic profile, body composition, and quality of life of kidney transplant recipients (Chan et al., 2019). A home-based exercise walking program …

The Mental Health Experience Among Parents Of Children With Autism, Thao Tran

Doctoral Projects

Parents of children diagnosed with autism spectrum disorder (ASD) face challenges, stress, and mental health issues than parents of children without autism. Mental health experience of parents in underserved communities are not adequately studied. This qualitative study used a phenomenological approach to understand the mental health experience of eight parent caregivers residing in San Joaquin Valley, California. All parents reported the journey was stressful but not all parents described the point when they received the diagnosis as being more stressful than before and after the ASD diagnosis. Parents’ responses to the semi-structured interview that assesses for the degree of ambiguous …

Inappropriate Antibiotic Use: A Survey Of Provider Prescribing Behaviors, Brice I. Saunders

Doctor of Nursing Practice Scholarly Project

Antibiotics save lives and are one of the most widely used medications of modern medicine. However, the widespread use of antibiotics has led to the development of antimicrobial resistance (AMR). AMR is a major public health crisis with disastrous consequences on national and global healthcare systems. AMR is associated with increased healthcare costs, increased morbidity and mortality, longer hospital stays, increased readmission rates, and overall poorer patient outcomes. The use of antibiotics is the single most important leading factor involved in the development of resistance. Current estimates suggest that at least 30% and up to 50% of all antibiotics prescribed …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Predictors And Outcomes Of Invasive Mechanical Ventilation, Ailin Puckett

DNP Research Projects

Objective: Invasive mechanical ventilation (IMV) is lifesaving and one of the most common interventions implemented in the intensive care unit (ICU). More than half of the patients in the ICU require IMV within the first 24 hours after ICU admission. This project aimed to evaluate and predict the mortality rate of hospitalized patients on IMV by examining their risk factors, such as patient demographic characteristics, disease status, social environment, and discharge status.

Methods: The National Inpatient Sample (NIS) database 2016 was used to identify patients requiring IMV. Mortality was the dependent variable. Independent variables had four major categories. First, patients’ …

Barriers To Care Among Uninsured Patients With Chronic Disease In A Free Clinic: A Quantitative Study, Stephanie Jinright

DNP Research Projects

No abstract provided.

Breastfeeding Issues Leading To Early Cessation, Brandy Kirstein

DNP Research Projects

Breastfeeding has come to the forefront in modern research as a necessary and important phenomenon to understand and address due to the vast amount of evidence revealing its health benefits for both Mom and baby. Disparities exist related to socioeconomic status, education level, poverty, young age, obesity, alcohol use, smoking, and living in rural areas. This project aims to discover the areas that need the most awareness and change specific to the state of Tennessee to increase the prevalence of exclusive breastfeeding for six months (EBF6) creating healthier future generations and society. This project was a non-experimental, retrospective, correlational design, …

Reducing Hypertension Through Faith Community Nursing, Michelle White

DNP Research Projects

Hypertension affects approximately 31.1% of adults (1.39 million) worldwide. It continues to be a significant risk factor for cardiovascular disease and strokes, the leading causes of death in the United States (Mills, Stefanescu, & He, 2020). Hypertension is expected to increase due to the aging population and unhealthy lifestyle choices of the American people (American Heart Association [AHA], 2018a). Therefore, effective strategies are required to manage hypertension in order to decrease stroke and cardiovascular events that can save the lives of many Americans. National programs such as Healthy People 2020 are working to achieve blood pressure control within the United …

A Diabetes Crash Course In A Primary Care Setting To Improve Diabetes Self-Care: A Pilot Project, Michelle L. Macdonald

Doctor of Nursing Practice Projects

Diabetes (DM) is a deadly disease affecting millions. Lack of proper DM self-care management can lead to numerous complications and even death. The American Diabetes Association (ADA) recommends lifestyle change as a first-line treatment along with diabetes self-management education (DSME). However, according to the Centers for Disease Control and Prevention (CDC) only a fraction of those diagnosed attend. The purpose of this project was to improve DM self-management behaviors following a patient focused unique DMSE designed to meet community needs. A customized crash course style DM educational session was offered to all DM patients in a rural primary care clinic. …

Biopsychosocial Variables Associated With The Development Of Chronic Low Back Pain In Healthcare Workers, Jena Pauli

Theses and Dissertations

ABSTRACT

Purpose: Worldwide the incidence and prevalence of acute low back injury with pain (ALBIP) is increasing in healthcare workers (HCW). Approximately 27% of ALBIP result in chronic low back pain (CLBP). The primary aim of this study was to identify biopsychosocial factors that contribute to the development of CLBP. A secondary aim was to examine the predictive value of reliable and valid screening instruments to identify individuals at highest risk for CLBP.

Significance: Low back pain is the second most commonly reported pain condition in the United States, one of the leading causes of sick leave and …

Technology-Based End-Of-Life Planning For An Underserved Population, Haley Kirkpatrick

Doctor of Nursing Practice (DNP) Projects

Problem: Research indicates a low-income status and ethnic and racial diversity is a barrier to ACP engagement.

Context: This project took place at a Federally Qualified Heath Center located in Northern California which serves approximately 200,000 diverse and economically disadvantaged patients.

Methods: The primary intervention was dissemination of an email to patients 50 and older, via their health system email account. The email included a direct link to PREPARE, an online advance care planning technology tool. A secondary intervention was a presentation to primary care providers that focused on end-of-life-care planning tools and communication strategies.

Results: The email was distributed …

Creating Restful Environments: Applying Evidenced-Based Interventions To Increase The Patients Perceptions Of Room Quietness At Night, Timothy Marks

West Chester University Doctoral Projects

Florence Nightingale first described the detrimental effects of noise on patients as an element nurses could control. Hospitalized patients who sleep in the hospital are at risk for poor periods of rest from unwanted noise in the care environment. This Doctor of Nursing Practice Project will assess interventions aimed at increasing the patient’s perception of quietness around the care environment at night for a pilot population. Swanson’s Theory of Caring will be utilized as a framework for the project. Outcomes of nursing interventions were reviewed for the improved patient perception of the care environment at night and resultant health outcomes. …

Heart Failure Self-Care At Home, Dinah Warren

West Chester University Doctoral Projects

Abstract

This evidence-based quality improvement project was implemented to improve self-care behaviors in homebound heart failure patients. Heart failure is a complex disease with significant challenges for patients, caregivers, healthcare providers, and the healthcare system. Educating and engaging patients in self-care management skills can reduce the clinical and financial burden of this disease. Heart failure self-care management skills can decrease 30-day readmission rates, improve quality of life, and reduce mortality. The self-care management program was implemented over a 6-week period. The Self-Care of Heart Failure Index (SCHFI) was administered at baseline to assess self-care and reevaluated after 6-weeks. During the …

It Matters Who You Live With. The Relationship Of Living Arrangement And Medication Adherence In Patients With Heart Failure, Rana Lindsay-Rahman

Theses and Dissertations--Nursing

Medication adherence is an ongoing challenge for patients with heart failure (HF) that can adversely affect mortality, morbidity, and quality of life. Living with a spouse has been associated with better adherence while living alone has been associated with poor adherence. Other factors demonstrated to affect adherence include medication complexity, perceived barriers to adherence, and depressive symptoms. Interestingly, the effect of these latter factors on adherence has not been examined in the context of the patient’s living arrangement. The purpose of this dissertation was to investigate the relationships among medication complexity, perceived barriers, and depressive symptoms with medication adherence across …

Caring For Young Adults With Cancer: A Systematic Review, Sarah M. Pelletier

All Graduate Theses, Dissertations, and Other Capstone Projects

Young adulthood is unique period of life in which critical developmental milestones are achieved amid dynamic physical, emotional, and social changes. During this period of life, young adults are charged with establishing personal and social independence. When challenged with a cancer diagnosis, the already turbulent late teens, twenties, and thirties are dramatically and permanently altered. Hence, the needs of young adults vary from that of their pediatric and older adult counterparts. The aim of this systematic review of the literature was to identify what age-specific needs must be addressed by healthcare professionals to enhance quality of care and outcomes for …

Metformin’S Role In The Prevention Of Type 2 Diabetes In Individuals Diagnosed With Prediabetes: A Systematic Literature Review, Jillian Williamson

All Graduate Theses, Dissertations, and Other Capstone Projects

The United States is facing a growing epidemic of unchecked and untreated individuals with prediabetes. While lifestyle interventions have remained the gold standard of treatment, has this been enough? A literature review was carried out to identify metformin’s role in treatment and management of prediabetes as well as perceived barriers to its prescribing. A total of 24 articles met inclusion criteria. Main findings include (a) metformin is effective in reducing the incidence of diabetes, though not as effective as lifestyle interventions; (b) certain populations did benefit more from metformin usage then other populations; (c) there was more treatment compliance with …