Family Practice Nursing Commons^™

Primary Hypertension, Leslie Mcchesney

Nursing Student Class Projects (Formerly MSN)

The intent of this poster is to provide an understanding of the pathophysiology of primary hypertension and its impact on nursing. This is a disease affecting millions of Americans daily and with proper understanding of the disease process, diagnosis and management can be initiated early before life altering consequences impact the patient.

The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Reducing Antibiotic Use In Pediatric Upper Respiratory Infection: A Multifaceted Parent-Clinician Approach, Sydnee H. Lucas Dnp, Aprn, Sydney Thompson Dnp, Arnp, Fnp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The goal of this QI initiative was to decrease inappropriate antibiotic for the treatment of pediatric upper respiratory infection (URI) in the retail clinic setting. The approach included the use of a protocol to treat viral upper respiratory illness, a visual aid decision-making tool for guideline adherence, prescription pad for nonprescription remedies, and shared decision-making techniques for providers to involve patients and parents in management plans regarding nonprescription remedies, supportive treatment, and signs and symptoms that would warrant a return visit. An improvement trend during the first 3 months of the initiative showed a shift in antibiotic avoidance from a …

Prevalence Of Binge Eating Disorder In An Insurance-Based Weight Management Center, Kimberly M. Kittleson Dnp, Fnp, Karen Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc

Doctor of Nursing Practice Final Manuscripts

Purpose: This project was anticipated to demonstrate an increase in the number of those diagnosed with BED according to Diagnostic and Statistical Manual (DSM) 5 criteria, diagnosed with ICD-10 code F50.8 or R63.2 and treated according to best practice guidelines.

Background: Binge eating disorder (BED) is the most common eating disorder in the United States, more than both anorexia and bulimia combined. It affects 3.5 percent of women, 2 percent of men and 30 percent of those seeking weight management.

Design: This evidenced-based project consisted of a retrospective analysis of 150 patients seen in a weight management …

Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidenced-based project was to increase chlamydia pre- screening and screening in women under age 25 presenting with urinary symptoms. Interventions included chlamydia pre-screening alerts embedded into the electronic medical record. Three-month evaluation showed a chlamydia pre-screening rate of 100% and an increase in chlamydia screening by 9%.

Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)

Doctor of Nursing Practice Final Manuscripts

Background
Veterans are disproportionately affected by chronic pain. Conventional pain management lacks emphasis on self-care and relies heavily on prescription opioids. Primary care providers (PCP) are able to educate veterans on self-care management; however, frequent follow-up is needed to improve overall pain and quality of life.

Objective
To implement a Nurse Practitioner (NP) telephone follow-up guided by the 5A’s framework among veterans with chronic pain in a primary care setting. This pilot evidence-based project (EBP) aimed to improve follow-up of self-care management in order to decrease pain, increase quality of life, and decrease pain medication use.

Materials & Methods
The …

Evaluating An Employee Health Tobacco Cessation Program For Enhanced Success, Leah Griffiths, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated …

Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Promotion Of Advance Care Planning For Individuals Experiencing Homelessness, Sarah A. Hubbell

Doctor of Nursing Practice (DNP) Projects

Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Standardization Of Shift Report By Implementing A Nursing Report Sheet And Addressing Patient Values To Meet Patient Needs, Roman A. Salas

Master's Projects and Capstones

Bedside shift report is a complex process, which involves the transition of care from one clinician to another. The Agency for Healthcare Research and Quality (AHRQ) (2013) reported that approximately 70% of patient adverse events are attributed to communication failures between healthcare providers. Nurses remain inconsistent with information sharing during bedside shift report leading to communication gaps. The object of the clinical nurse leader (CNL) internship project is to provide true patient-centered by standardizing bedside shift report by implementing a nursing report sheet and addressing patient needs. The project was conducted in a level-one trauma center in San Diego, CA …

Preserving Dignity In The Long Term Care Of Actively Dying Residents, Libby-Rose Cronican

All College Thesis Program, 2016-2019

As one goes through the process of aging and approaches death, they experience a series of losses: from the loss of physical or mental ability to the ultimate loss of life. These losses make the individual vulnerable to harms that can come from a variety of sources. One source is found within the everyday interactions of long-term care nurses and aides with their elderly, dying residents. Creating this harm stems from a poor nursing practice where the nurse or aide fails to recognize and promote the resident’s dignity and autonomy. The normal notion of dignity and autonomy does not encompass …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Attitudes And Perceptions Of Advanced Practice Nurses Towards Health Information Technology And Its Effects On Caring, Debbie Ramos Shih

Doctoral Projects

Technology is rapidly, constantly evolving, and affecting healthcare. While it has the ability to improve healthcare outcomes, it is important to realize the impact this technology has on the relationships between patients and nurses (Korhonen, et al., 2015). Interactions with patients are increasing through computer technology and decreasing by physical presence and touch, potentially compromising the development of a trusting relationship and thus affecting patient quality outcomes (Sandelowski, 2002).

This cross sectional study explored the attitudes and perceptions of APRNs towards HIT and its effects on caring. 150 Advanced Practice Clinicians in a Northern California healthcare was surveyed, using the …

Preconception Care Of Women On Prescribed Opioids, Rebecca-Maria Norwick

Doctoral Projects

The landmark 2015 report from the Center for Disease Control (CDC) posited that too many women of reproductive age received prescribed opioids. This is significant because fetal exposure to a known teratogen can have catastrophic outcomes. Furthermore, women are often ambivalent about birth control and many pregnancies are unplanned. Fortunately, women identify interactions with health care providers as acceptable cues for preconception decision making. Data has shown that Medicaid populations are disproportionately prescribed opioids compared to insured populations. However, the CDC defines reproductive status by age only. Therefore, the purpose of this research project was to identify women’s actual risk …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

African American Men And Ostrich Behavior, Debbie Slack-Gay

Doctoral Projects

This project explores why African American men choose Ostrich Behavior when it comes to health care prevention and maintenance as related to hypertension. The population was African American men, ages18–80, in Northern California. Men were recruited while getting a haircut or waiting for one or after church services. Blood pressure readings were taken and a health questionnaire was administered. The results show that even if hypertension is known, men ages 18–45 go to fewer office visits than African American men in other age groups, and older men tend to seek medical care and take medication if prescribed.

Implementing A Home-Based Blood Pressure Monitoring Program To Improve Hypertension Management, Nicole S. Bello

Georgia College Student Research Events

Hypertension is a major problem in the United States. It is critical to identify effective strategies to treat and manage hypertension. An experimental design was utilized to determine the effectiveness of home-based blood pressure monitoring (HBPM) in the management of prehypertension, newly diagnosed, or uncontrolled hypertension. A randomized convenience sample of 20 adults was recruited into a control (n=9) and experimental (n=11) group. The translational care project was conducted over 60 days where participants measured their blood pressures as instructed for the intervention and control groups. An independent t-test was conducted to analyze the effectiveness of HBPM on the participants’ …