Family Practice Nursing Commons^™

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …

Evaluating An Online Family Assessment Activity: A Focus On Diversity And Health Promotion, Paul Smith, Melissa Jones

Faculty Publications

This article describes the development, implementation and evaluation of a family assessment activity that was designed for a transition course in an RN-BSN program. The family assessment activity emphasized diversity and health promotion as key curricular concepts highlighted through the use of constructivist teaching strategies in the online classroom. The activity was developed and implemented by utilizing the Family Health Systems (FHS) approach to family assessment and Healthy People 2020 as a framework for family health promotion. The activity was evaluated through faculty observation and student feedback which is discussed in the article.

Risk Factors In Women For Postpartum Depression Versus Postpartum Psychosis: An Integrative Literature Review, Briana Jamieson

Honors Undergraduate Theses

The purpose of this literature review was to identify differentiating risk factors in women for postpartum depression and postpartum psychosis. By understanding differentiating risk factors health care professionals, and nurses in particular, can be alert to women who are at higher risk for postpartum depression or postpartum psychosis. This information allows for early nursing intervention and the development of appropriate treatment plans. Fifteen peer-reviewed, English language research articles published between 2000 and 2015 were analyzed for the purpose of this literature review. Study results were inconclusive for the intention of this review, but do provide valuable information on independent risk …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis, Monika U. Mróz

Theses and Dissertations

Sepsis is a condition that arises from the host’s own exaggerated response to an infection, directed towards pathogens, but causing multiple organ failure. Sepsis is one of the most common causes of death, and a considerable absorber of healthcare resources. This frequently fatal condition, despite progress in technology and improving knowledge of pathophysiology, is still poorly understood, carries high mortality and morbidity rates, and survivors are often left with permanent disabilities and poor health outcomes.

Initial presentation of sepsis is often nonspecific, making diagnosis difficult, and causing lifesaving treatment delays. Sepsis guidelines are derived from emerging evidence-based research. While there …

Therapy Options For Winged Scapula Patients: A Literature Review, Samantha L. Normand

Honors Undergraduate Theses

Winged scapula is a condition characterized by lateral or medial protrusion of the scapula caused by nerve damage leading to muscular paralysis. The purpose of this systematic review of literature is to evaluate the current research literature related to the effectiveness of therapy options for winged scapula. Eleven peer reviewed English language research articles published from 1998 to present were included for evaluation. Study results revealed positive therapeutic outcomes for physical therapy and scapular bracing. Results also showed positive outcomes for the use of transcutaneous electrical nerve stimulation and acupuncture for the treatment of nerve related conditions similar to winged …

Mysleep101©: An Educational Mobile Medical Application For Sleep Health In Primary Care, Sonya Cook

Theses and Dissertations

Insufficient sleep has emerged over the past few decades as a public health concern. As little as 1 to 2 hours of sleep loss can produce extreme fatigue and physiological drives similar to thirst and/or hunger which increases the risk of motor vehicle accidents, work related mistakes and injuries. Sleep restriction whether voluntary or involuntary has produced a culture of chronic sleep deprivation that can be seen throughout the population. Chronic lack of quality sleep has been shown to adversely affect cardiovascular health, cognitive function, memory, immune responses and hormonal regulation among other homeostatic functions. Sleep disorders represent the cause …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Evaluating Provider Knowledge Of The Hpv Vaccine In Kentucky, Madeline A. Wilson

DNP Projects

According to the CDC, about 79 million Americans are currently infected with Human papillomavirus (HPV) with an additional 14 million infected annually, most of which are teenagers and young adults. Of these 14 million newly diagnosed cases, approximately 27,000 are diagnosed with a cancer caused by HPV. Kentucky’s HPV vaccination initiation and completion rates are below national estimates.

In 2013, Kentucky’s vaccine completion rate for girls age 13 to 17 was 26.8 percent compared to United States completion rate of 37.6 percent. Kentucky vaccine completion rate for boys age 13 to 17 was 19 percent compared to a United States …

An Evaluation Of Childhood Overweight And Obesity Screening And Management In The Primary Care Setting, Stephanie Horning

DNP Projects

Background-In Kentucky, 19.7% of children ages 6-11 years old are obese ("Center for Disease Control and Prevention (CDC)," 2013). Approximately 50% of these children will become obese adults (Lazarou & Kouta, 2010). It is imperative that interventions are initiated to normalize weight in childhood to offset the long term physical and psychosocial risks associated with obesity.

Purpose-The purpose of this gap analysis was to evaluate the screening and management of childhood overweight and obesity in one of Norton’s healthcare primary care setting.

Methods-The electronic medical records of 35 children aged 10 to 11, who had BMIs > 85 …

Evaluation Of Serum Vitamin D Levels In Older Adults Who Fall And Sustain A Fracture: A Retrospective Chart Review, Suzanne L. Pilon

DNP Projects

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in …

Assessment Of Blood Pressure Control In Patients Diagnosed With Hypertension In A Primary Care Setting, Lauren Prince

DNP Projects

Purpose: To evaluate provider adherence to the current hypertension management guideline, JNC 8, by assessing blood pressure control in individuals diagnosed with hypertension in an internal medicine clinic.

Methods: A retrospective chart review was conducted to assess the percentage of patients diagnosed with essential hypertension meeting the blood pressure goals set forth in JNC 8. In the absence of blood pressure control, provider intervention was assessed. Data collected included blood pressure, use of home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three office visits. In addition, current …

Compliance With The 2015 American Diabetes Association Screening Guidelines For Diabetes Mellitus Type 2 In Primary Care, Krista L. Johnson

DNP Projects

Purpose: The purpose of this project was to evaluate provider use of hemoglobin (HgA1c) measurement as a method of screening for Type Two Diabetes Mellitus (T2DM) per the 2015 American Diabetes Association screening guidelines in a multidisciplinary primary care clinic in Kentucky.

Methods: A retrospective electronic medical record review was conducted in a large ambulatory care clinic. A master list was compiled of all patients aged 45-89 years who were seen for any reason the first week of November 2015. A total of 127 records that met inclusion criteria were randomly selected. The proportion of patients who were appropriately screened …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Increasing Healthcare Providers’ Documentation Of Advance Directives In A Primary Care Setting, Ashley Wellman

DNP Projects

Background: Advance directives (ADs) are a proactive, patient-centered tool to facilitate communication about end-of-life wishes between patients, family members, and healthcare providers. Increased importance on ADs is now emphasized in primary care settings; however, findings from recent studies indicate poor documentation of AD discussions or decisions in primary care.

Purpose: To assess current AD documentation practices in an internal medicine primary care department and to explore provider perceptions of facilitators and barriers for discussion and documentation of end-of-life preferences.

Methods: This descriptive study was conducted in three phases: 1) assessment of current state of AD documentation by retrospective chart review …

Evaluating Hepatitis C Screening In Primary Care, Nicole A. Brink

DNP Projects

Purpose: The purpose of this study was to evaluate primary care provider screening for hepatitis C virus (HCV) in three high risk populations. The specific aims were to determine the percentage of patients born between 1945-1965 who had a one-time screening for HCV, to determine what proportion of patients with a history of human immunodeficiency virus (HIV) or intravenous drug use (IVDU) have been screened for HCV, and to examine providers’ thoughts on their HCV screening practices.

Methods: A retrospective chart review of patient electronic medical records (EMR’s) from 2015 was conducted in an urban primary care site. SPSS was …

Documentation Of Smoking History And Adherence To The Uspstf Recommendation For Lung Cancer Screening: A Retrospective Chart Review, Laura A. Golden

DNP Projects

Purpose: The purpose of this project was to evaluate provider compliance with documentation of smoking history and, if criteria met, referral for lung cancer screening as recommended by the United States Preventive Services Task Force in 2013.

Methods: A retrospective chart review was conducted using an electronic medical record (EMR) at a large, rural community family practice clinic. Patients meeting inclusion criteria of having a smoking history (current or past) of 30 pack years, aged 55 to 80 years, and no history of lung cancer diagnosis were included for randomization. One hundred patients were selected from 300 randomized charts; five …