Family Practice Nursing Commons^™

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 …

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 …

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 …

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 …

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.

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 …

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 …

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’ …

Group Education In Hypertension, Abby Lara

Scholars Week

Abstract Title: Group Education in Hypertension

Presenter: Abby Noisworthy APRN, FNP-BC

Category: Clinical Concerns for Practicing APRNs

Purpose/Goal Statement: Evaluate the effectiveness of group education in improving knowledge and self-reported compliance.

Clinical Question: In hypertensive patients, does increased education, including group educational seminars, increase knowledge and therefore self-reported compliance?

Methods: 45-minute group seminar designed to increase knowledge and promote compliance. Pre- and post-tests administered to evaluate effectiveness. Pre- and post-test means were calculated using Microsoft Excel. Eight-week follow up phone calls were made to evaluate self-reported compliance.

Findings: Mean pre-test score was 69%. Mean post-test score was 98%. A 29% …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Implementation Of The 2012 American College Of Rheumatology Guidelines For Management Of Gout In A Sample Of Midwestern Native Americans, Myrth C. Condon

Doctor of Nursing Practice Scholarly Projects

Gout is a well understood, yet poorly treated condition that is associated with many co-morbidities including hypertension, renal and cardiac disease, metabolic syndrome, central obesity and type-2 diabetes. The American Indian population is at risk for gout due an increased incidence of type-2 diabetes, chronic kidney disease, hypertension, and alcohol abuse. The purpose of this scholarly project was to implement the 2012 American College of Rheumatology (ACR) guidelines in a sample of Tribal members within mid-western portions of the United States. This scholarly project utilized a quasi-experimental research design with pretest – posttest methods to measure uric acid levels at …

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

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

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 pre-hypertension, 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 …

Educating Mothers Of Obese Hispanic Preschoolers To Create Lifelong Healthy Habits, Lynette Marshall

Doctor of Nursing Practice Projects

Problem and Background: Childhood obesity has doubled in children and quadrupled in adolescents in the past 3 decades, increasing from 5% to 17% in one generation. The highest rates of childhood obesity are among Mexican Americans. Obesity can increase health morbidities, and as obese children continue to grow, these health concerns progress to adulthood. In spite of enhanced education and communication between mothers of obese children and their primary care providers, minimal improvement has taken place in terms of outcomes and lifestyle changes.

Methods: Fourteen obese Hispanic 2- to 5-year-olds and their mothers participated in the study. The children’s BMIs …

Increasing Primary Care Hepatitis C Screening In The 1945-1965 Birth Cohort, Maria M. Shimizu

Doctor of Nursing Practice Projects

Background: Over 3.2 million American citizens have been infected with the Hepatitis C virus (HCV). It is estimated three fourths of this population are from the birth cohort born between 1945 and 1965, otherwise known as Baby Boomers. Despite the Centers for Disease Control and Prevention (CDC; 2014) recommendations to screen this population at least one-time regardless of risk factors, screening practices in the primary care setting have been suboptimal (American Association for the Study of Liver Diseases [AASLD], 2015).

Aim: The aim of this project was to identify barriers to HCV screening of the Baby Boomer population in the …

The Effect Of A Patient And Provider Education Program On Antibiotic Overuse In Respiratory Tract Infections In A Rural Primary Care Population, Erin Chiswell

DNP Projects

Objective: In the “walk-in” portion of the Jessamine Medical and Diagnostic Center (JMC) primary care (PC) practice in Jessamine County, Kentucky, a combination patient and provider education program was implemented to assess its effects on antibiotic prescribing in respiratory tract infections (RTIs). The goal was to conduct an evaluation of the patient and provider education program at JMC, by specifically examining changes in immediate antibiotic prescribing in RTI (i.e., prescription given during visit to start taking immediately) one-year after implementation of the education program (March 1, 2015- February 28, 2016).

Methods: Utilizing a quasi-experimental pretest-posttest design, a retrospective electronic medical …

Assessment Of An Intervention To Improve Clinical Inertia In Patients With Uncontrolled Hypertension In A Primary Care Setting, Alyssa M. Sutton

DNP Projects

Purpose: A quality improvement project was undertaken in an internal medicine clinic to evaluate provider adherence with the Eighth Joint National Committee (JNC 8) hypertension (HTN) medication management guidelines for adult patients diagnosed with HTN, evaluate characteristics associated with clinical inertia (CI) in patients with uncontrolled HTN, and evaluate the utility of a brief educational intervention to decrease CI.

Methods: The project used the plan-do-study-act method to assess JNC 8 prescribing guideline adherence by consenting providers. Medical records were randomly selected from patients with HTN seen at provider visits 10 days before (January 31-February 13, 2017) and 10 days after …

Losing Weight With Five A’S (5 A’S): Assess, Advise, Agree, Assist, Arrange Framework And Motivational Interviewing (Mi) For Health Behavior Change Counseling, Jacqueline Baer

Theses and Dissertations

According to the Centers for Disease Control and Prevention (CDC), obesity has reached epidemic levels and has associated with increased risk of morbidity and mortality rates. The increasing prevalence of obesity is a major public health concern. Researchers calculate that health care costs are 44% higher among moderately and severely obese older persons than for persons at normal weights. Seventy-five percent of African American (AA) women are overweight and obese according to data from the CDC and The State of Obesity: Better Policies for a Healthier America. Compared to any other racial ethnic group, AA women are more likely to …

Assessing Provider Adherence To The 2013 Acc/Aha Hyperlipidemia Guideline, Adrienne Johnston

DNP Projects

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and accounts for more than 17.3 million deaths per year with hyperlipidemia as one of the leading risk factors. The 2013 American Heart Association/American College of Cardiology (AHA/ACC) hyperlipidemia guideline recommends healthy lifestyle habits, risk estimation of the development of cardiovascular disease using a risk calculator, and intensity dosed statin therapy. There has been controversy among providers resulting in confusion and inconsistent application of the guideline. Purpose: The purpose of this project was to examine provider adherence to the AHA/ACC hyperlipidemia guideline in a primary …