Family Practice Nursing Commons^™

Hypertension And African Americans: A Retrospective Review Of Provider Education On Lifestyle Counseling And Medication Management, Danielle Bundrent

DNP Projects

Purpose: The purpose of this study was to evaluate current provider practice of the management of hypertension among African Americans in a primary care clinic in Louisville, KY. Specific aims of the study were to: 1) assess provider adherence to the JNC 8 guidelines related to African Americans with hypertension and, 2) assess provider adherence to hypertension lifestyle education and counseling.

Methods: This descriptive study used a retrospective chart review to evaluate provider management of hypertension. Medical records of African American men and women in a primary care practice in Louisville, KY were reviewed. A random sample of 100 charts, …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Beers Medication: Empowering The Elderly Through Education, Amanda J. Parker

DNP Projects

The elderly population (those aged 65 years and older) has an increased risk of experiencing adverse effects from their prescribed medications. These adverse effects are due to many reasons, one being changes that naturally occur in the aging body, such as diminished kidney function or decreased gastrointestinal motility. This project explores the prescribing practices of one primary care practice setting. Specifically, this project sought to determine the number of patients in a primary care practice who were prescribed medications on the Beers list and whether or not the patients received education on adverse effects. The results concluded the most frequently …

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

Evaluating Adherence To Colorectal Cancer Screening, Jaime Bradley-Miller

DNP Projects

Purpose: The purpose of this project and literature review was to determine provider documentation practices of colorectal cancer (CRC) screening, identify the percent of clinic patients who need to be screened, and develop a set of recommendations and targeted interventions which will increase CRC screening rates.

Methods: A retrospective chart review including males and females of all ethnicities between the ages of 45 and 80 was performed in one primary care practice. A randomized sample of 360 office visits between February and November of 2015 were selected, of which 281 met the inclusion and exclusion criteria. Patient demographics and characteristics …

Meaningful Use: Secure Electronic Messaging And The Use Of Mychart, Dava O. Helton

DNP Projects

Purpose: The purpose of this project was to understand providers’ views of electronic messaging through MyChart and find out the essential tools needed to comply with Stage 3 criteria of Meaningful Use. The objectives were to: 1) Discover providers’ current thoughts/opinions about electronic messaging, 2) Identify perceived benefits and barriers to using secure electronic messaging between providers and patients, and 3) Discover the perceived essential tools needed to meet Stage 3 criteria.

Methods: A needs assessment was performed through a provider survey. Providers at primary care offices with reliable Wi-Fi were approached about the project. Volunteer participants were given a …

Evaluation Of Treatment For High Cholesterol And Prevention Of Cardiovascular Disease In Primary Care, Cristina Bolin

DNP Projects

Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and more than 610,000 people die every year from ASCVD related causes such as myocardial infarction (MI) or stroke. High cholesterol is one of the leading modifiable risk factors for prevention of ASCVD events. The 2013 American College of Cardiology/American Heart Association guidelines recommend treatment of high cholesterol as primary prevention for ASCVD in adults by lifestyle changes, CV risk estimation with an ASCVD calculator, and intensity dosing of statin medication. Effective strategies to support these recommendation exist in the clinical practice guidelines but evidence …

An Evaluation Of Providers' Interventions And Patients' Adherence In Diabetes Management, Hoang Ngo

DNP Projects

Background: Diabetes is one of the leading causes of death and disability in the United States including Kentucky. Despite advances in medicine, the current management of type 2 diabetes mellitus (T2DM) remains challenging. Poor self-management coupled with the increasing complexity of the disease can lead to poor glycemic control.

Purpose: The purpose of this project was to examine current practices related to insulin-using patients’ treatment adherence and management of T2DM. In addition, providers’ perceptions on the management of T2DM were also assessed.

Methods: A retrospective chart review and semi-structured interviews were conducted. Patients (N = 84) with T2DM, over the …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

An Assessment Of Current Nicotine Screening Rates And Practices Within Primary Care, Kathryn A. Dunlap

DNP Projects

Purpose: The purpose of this project was to explore the current practices related to nicotine screening in the primary care setting within the Norton Healthcare System. The objectives were to assess: 1) the current compliance rate for nicotine screening and documentation per visit for patients who are seen in a primary care office, and 2) documentation of tobacco cessation counseling and pharmacologic management for patients seen in a primary care office.

Methods: A retrospective chart review was conducted to assess the current compliance rate for nicotine screening and documentation per visit for patients who are seen in a primary care …

Nursing Attitudes Towards Suicidal Patients In The Emergency Department: Assessment Interview Training, Belinda Beaver

Theses and Dissertations

This project sought evidence for the effectiveness of pedagogy in professional nursing continuing education and its effect on emergency department nurse attitudes towards patients seeking crisis intervention for suicide. Approximately 12 million emergency department (ED) visits annually were for patients suffering with mental illness and/or suicidal ideation. Emergency department staffs were often not adequately prepared to manage these problems. The purpose of this project was to examine the impact of an educational initiative on nurses’ attitudes about patients expressing suicidal ideation in the emergency departments 2 rural southeastern towns.

The project question was; in two different rural community emergency departments …

Fnp Led Mobile Health Services For The Homeless Population, Tenzin D. Lama

Doctor of Nursing Practice (DNP) Projects

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing …

Family Centered Care In Icu Settings, Victoria Kingsinger

Honors Theses

More than 5 million patients are admitted each year to Intensive Care Units (ICUs) in the US, and approximately 55,000 critically ill patients are cared for each day. ICU patients are a diverse population that has a need for an increased level of care. These patients often require ventilatory or cardiovascular support, invasive monitoring, and intense nursing and physician observation (Society of Critical Care Medicine, 2015). There are five primary admitting diagnoses for adults, which include respiratory failure, postoperative management, ischemic heart disorders, and sepsis. The mean age of patients is rising, particularly due to the baby boom generation, and …

Restoring Digestive Health, Kristin M. Corbin, Dnp, Aprn, Fnp-C

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

Purpose: The purpose of this translational research project was to outline the healthcare problems associated with Functional Gastrointestinal Disorders and to explore the effectiveness of a gastrointestinal protocol utilized at Atlanta Center for Holistic and Integrative Medicine. The goal of this protocol is to restore digestive health with probiotics, digestive enzymes, and glutamine.

Background: Functional Gastrointestinal Disorders affect one in every four adults in the United States. These disorders encompass a variety of symptoms including diarrhea, constipation, cramping, abdominal pain, flatulence, reflux, and bloating without an identified physiological cause. There is currently no cure for Functional Gastrointestinal Disorders and treatment …

The Epigenetics Of Post-Traumatic Stress Disorder In Women And Ptsd In Women Veterans: Implications For Health Policy, Cheryl R. Brubaker Msn, Sdnp, Fnp-Bc, Judith Milner Psyd

DNP Forum

Women have long served in the military during war whether recognized or unrecognized, whether praised or unpraised, whether there by choice or not there by choice. Men and women both feel the wounds of war. So many times those wounds are very hard to ignore, and often those wounds are not so visible yet take their toll. Post-traumatic stress disorder (PTSD) is commonly associated with combat, with war, and with being a veteran (Fischer, 2014). Our understanding of women formally deployed as soldiers into combat and the consequences for these women is less well defined. Through a meta-synthesis of published …

Understanding Veteran’S Health Beliefs: An Essential Part Of A Patient-Centered Approach To Treatment Adherence, Susan E. Phillips Dnp, Mph, Pmhcns, Mary Dolansky Rn, Phd

DNP Forum

Background: Patient centered care is a mechanism to encourage healthcare consumers to work together with health care professionals to achieve quality outcomes In the VA, non-adherence to treatment recommendations is problematic. Non-adherence results in poor use of VA resources as veterans come in for care but do not follow through with recommended treatment plans. Besides asking veterans about their health goals and preferences, understanding the veteran’s orientation regarding health beliefs and motivators for adherence to recommended treatment plans is essential for nurses who aim to help the veteran achieve healthy lifestyle behaviors.

Objective: The purpose of this study was to …

The Effects Of Long-Term Use Of Stimulant Medication For Attention Deficit Hyperactivity Disorder, Melissa M. Jones

Graduate Research Projects

No abstract provided.

The Role Of The Faith Community Nurse In Fostering Spirituality In Those With Alzheimer's Disease, Verna Carson Phd, Pmh/Cns-Bc

International Journal of Faith Community Nursing

Alzheimer ’s disease (AD) strips individuals of memories and abilities that have defined them as productive adults throughout their life. While the decline in memory is real and results in a ‘loss of self’ this does not equate to a ‘loss of soul.’ AD patients continue to have spiritual needs throughout their life as do the family, and/or caregivers. This article explores the spiritual needs and care of AD patients and families and the unique opportunity faith community nurses have to help the AD patient and their support system. The Reisberg Functional Assessment Staging System is used to explain the …

A Quality Improvement Project To Increase Diabetes Self-Efficacy In A Rural Primary Care Clinic Through Patient Utilization Of A Diabetic Logbook, Margo D. Sutton

Doctor of Nursing Practice (DNP) Projects

The prevalence of type 2 diabetes mellitus (T2DM) has increased substantially in the United States in recent years. Teaching self-management to diabetic patients is essential to help them control their chronic disease. Albert Bandura’s theory of self-efficacy is commonly used in chronic disease self-management programs and is the theoretical framework upon which this Doctor of Nursing Practice (DNP) pilot project was built.

This evidence-based change in practice project took place in a rural primary care clinic in the central valley of California, and involved the development of a diabetes logbook, which was a tool for patients to use to learn …