Family Practice Nursing Commons^™

Reducing Ed Re-Admissions In Post-Op Neuro Patients Utilizing A Np Telephone Follow-Up Protocol, Katherine Curran

Doctor of Nursing Practice Final Manuscripts

Reducing ED Re-admissions in Post-Op Neuro Patients utilizing a NP Telephone Follow-up Protocol

Background

Post craniotomy patients discharging from the hospital to home, commonly present to the emergency department (ED) with incisional concerns. Complaints stem from minimal post-op education, poor incision management, and lack of knowledge relational to infection. Unanswered questions prior to discharge lead to unnecessary ED visits, anxious calls after discharge, and poor patient satisfaction. ED admissions lead to fortuitous costs that can be prevented through evidenced based interventions.

Purpose/Aim

Post craniotomy patients at a large hospital system in Southern California will have decreased ED visits correlated to …

Spreading The News About Peanuts: Implementing An Infant Allergy Risk Assessment, Kelly E. Kotula

Doctor of Nursing Practice Final Manuscripts

Peanut allergies are the leading cause of death from food anaphylaxis. In 2017, the National Association of Allergy and Infectious Disease (NIAID) issued a guideline for use by primary care providers to identify infants who would benefit from early peanut consumption. Many providers have not yet implemented these guidelines in clinical practice. The purpose of this project was to implement a practice change to improve assessment of risk factors for peanut allergies utilizing the NIAID guideline in infants at their six-month well-child examination at a pediatric primary care practice. Risk factors assessed included: a history of eczema and/or egg allergy …

Standardizing Mammogram Screening In Primary Care: Integrating An Evidence Based Approach, Lacrisha Go

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Mammogram screening for surveillance and detection of breast cancer has long been recognized as a preventative health measure for women. However, easily recognizing when to screen individual women, based on age and risk factors, lacks clear guidance and often ends in fragmented and inconsistent practices among providers.

Methods: By developing and implementing the Screening Mammogram Initiation Protocol (SMIP), the desired goals of this project were to: a) align breast cancer screening recommendations to better meet individualized patient needs in primary care utilizing best practice guidelines, b) increase the rate of breast cancer screening across various demographics, and c) …

Are Students’ Being Distracted Drivers, Jill Buchholz, Ronda Christman

Adventist Human-Subject Researchers Association

The life of a nursing student can be very fast paced. Trying to keep up with friends and family while studying can be a challenge. Learn how frequently students are driving distracted, are on social media, and have personal devotions.

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Using An Electronic Health Record Alert System To Screen And Manage Patients With Diabetes Mellitus Type 2 In A Rural Primary Care Setting, Simon Katumu

Doctor of Nursing Practice Projects

Diabetes Mellitus type 2 is the 7th leading cause of death and affects nearly 10% of the US population. Early detection of this condition leads to the initiation of treatment and lowers the risk for complications and better outcomes. Frequent testing of hemoglobin A1Cs in those already diagnosed also leads to better management, glycemic control and improves health outcomes. This project utilized a feature in the electronic health record system of a rural primary care clinic to remind providers to screen at-risk patients and retest those who were either due or overdue for hemoglobin A1C testing. Hemoglobin A1C readings were …

The Implementation Of A Behavioral Intervention Program In Obese Elderly Patients, Zandra Brown

Doctor of Nursing Practice Projects

Abstract

The prevalence of obesity is increasing in American and patients are living longer. Research suggests that behavioral lifestyle interventions help optimize elderly patient’s health and improve their quality of life. A successful behavioral weight loss program had been in place in one clinic within a large healthcare organization. The need at another metropolitan Midwest location seemed even greater due to having a patient population consisting of elderly, demographics, obesity trends, and high rates of obesity linked morbidities such a diabetes, hypertension, and heart disease. Thirteen elderly obese patients with ages ranging from 65-75 years old were enrolled in an …

Provider Awareness Associated With Lifestyle Interventions And Adult Obesity, Reilly Tackett

Doctor of Nursing Practice Scholarly Project

The obesity epidemic cannot be solved through a single solution. A complex problem like obesity requires an intricately designed approach, comprised of both behavioral and environmental changes (Centers for Disease Control, 2015). Obese adults who attempt to alter their lifestyles often experience barriers to success. One such barrier is a provider who may be unfamiliar with evidence-based lifestyle interventions. Research suggests large variances both in provider knowledge levels and practice recommendations associated with adult obesity. This study’s purpose was; to determine if provider recommendations reflected clinical practice guidelines (CPG) associated with adult obesity, to measure current levels of provider knowledge, …

Improving Diabetic Foot Exams And Education In A Primary Care Clinic, Haley Duff

The Eleanor Mann School of Nursing DNP Capstone Projects

Diabetes is one of the most common chronic diseases worldwide. The persistent nature of the disease increases the risk of complications, including blindness, kidney failure, lower limb amputation, and cardiovascular disorders. In the United States, there were a total of 7.2 million hospital discharges in 2014, with diabetes as the diagnosis. It was estimated that 108,000 of those discharges were for a lower-extremity amputation (Centers for Disease Control and Prevention [CDC], 2017). The American Diabetes Association recommends that all adults with diabetes should undergo a comprehensive foot evaluation at least annually, and daily foot care education should be provided. Preventive …

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Educational Program For The Management Of Low Back Pain, Amanda Johnson

The Eleanor Mann School of Nursing DNP Capstone Projects

Low back pain is one of the most common reasons that patients seek care from their primary care provider as well as the number one cause of disability worldwide. While low back pain is a prevalent condition that is seen in primary care, the outcomes of treatment continue to remain poor. Facilitating effective care for patients with pain is a major public health concern. Clinical practice guidelines are published but it often takes time for the recommendations to be translated into practice. Dissemination of information is needed. An educational program was created for providers within the Mercy Hospital Rogers system. …

Perceptions Of Adult Patients Accessing Telehealth In An Urban Medical Group, Katharine Shepherd West

Doctoral Projects

Problem: Although implementation of in-patient electronic healthcare records is nearly complete in the United States, this achievement has not translated into consumer-to-business telehealth in the primary care setting. Because there are few studies that describe how and why patients select telehealth, the aim of this study was to learn about perceptions of adult patients in an urban setting when telehealth options are available. Research questions included a) How do patients select any type of appointment? b) How do patients perceive and use telehealth options? c) How and when might telehealth be useful in the future?

Methods: A qualitative study design …

Identifying Perceived Barriers To Primary Health Care Access In Rural, Medically Underserved Areas, Suzanne Hewitt

Doctoral Projects

Persons living in rural areas designated as having primary care provider shortages often lack access to timely and appropriate levels of care, frequently forcing them to forego care, delay treatment, or seek care in an emergency department for non-urgent complaints. This qualitative study reviewed evidence-based research and data generated from two focus groups sessions to generate a body of distinctive knowledge of the barriers to primary healthcare access as perceived by members of this rural, medically-underserved area of northern California. The theme that was identified, through conventional qualitative content analysis, as most prevalent among subjects was the inability to schedule …

Research, Evidence-Based Practice And Quality Improvement, Tonya Traylor

DNP Final Reports

Background: The United States is in the midst of an opioid epidemic. In 2012 alone there were approximately 259 million prescriptions written by primary care providers for opioids painkillers. The U.S. Center for Disease Control (CDC) now has new guidelines and recommendation due to the opioid analgesic epidemic. Education has been found to raise provider awareness and, subsequently, has decreased opioid use. Provider education helps with reinforcing the short-term use of opioids and adjunctive therapies and helps reinforce the idea of an individualized treatment plan for patients. Purpose: The purpose of this intervention is to increase provider education on opioid …

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

Effects Of An Obstructive Sleep Apnea Screening Program On Providers' Adherence, Kelsie A. Tokarczyk

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) is a widely prevalent chronic disease estimated to affect 22 million Americans, with 80 percent of moderate to severe cases undiagnosed (American Sleep Apnea Association [ASAA], 2017). Unmanaged OSA has been associated with numerous detrimental health outcomes including hypertension, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular conditions (ASAA, 2017). The purpose of this evidence-based practice project was to determine if the implementation of a screening protocol would affect providers’ adherence to screening for OSA. The Theory of Planned Change was used as a guide to optimize providers’ adherence to the protocol at a family …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

Diabetes Shared Medical Appointment: An Evidence-Based Innovation Project, Mohamed Bojang

DNP Final Reports

The purpose of the evidence-based practice innovation project (EPIP) is to address uncontrolled diabetes by implementing an evidence-based shared medical appointment (SMA) intervention which based on the body of the evidence will help improve diabetes outcomes. A pilot implementation and retrospective chart review were conducted. Data was collected on outcome indicators such as blood pressure, lipid values, body mass index, A1C, and knowledge. The results of a pilot SMA implementation revealed that patients who participated in the weekly SMA saw an improvement in post-mean values compared to pre-mean values. Mean A1c dropped to 7.0% from 7.11%; systolic blood pressure improved …