Family Practice Nursing Commons^™

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 …

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 …

Wecan Implementation For Parents Of At-Risk Hispanic Adolescents In Middle School, Shannon Leigh Devita

Doctor of Nursing Practice Final Manuscripts

Abstract

CDC-reported childhood obesity rates have tripled in the past three years. Among children in grades five, seven and nine, 30% are overweight or obese, with Hispanic students more likely to be overweight than White students. This evidence-based project examined the effectiveness of NHLBI’s WeCan! for at-risk middle-school-age Hispanic children and parents. The program was implemented at school in two weekly sessions, and its effectiveness was evaluated using the WeCan! survey. The program resulted in improved knowledge, behaviors, and attitudes related energy balance, portion size, healthy foods, physical activity, and screen time and may be useful in other school settings.

Telephone Calls To Reduce 30-Day Readmissions For Older Adults With Heart Failure, Juanette G. Clark

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this evidenced based practice project was to evaluate the effectiveness of discharge follow-up calls for heart failure (HF) patients recently discharged from a private hospital.

Background: HF is the number one discharge diagnosis among patients 65 years and older. It affects 5.8 million people in the United States. HF admissions total (1) million annually, however, 24% of these patients are readmitted within 30 days of discharge. Re-hospitalizations are associated with high mortality rates and expenditures approximated at $13,000 per patient contributing to the overall annual expenditure of $33.7 billion. In 2012, the Centers for Medicare …

Heart Failure Patient Self-Care: An Evidence-Based Outpatient Management Program, Christine Marie Ensign, Shelley Hawkins, Barry Greenberg

Doctor of Nursing Practice Final Manuscripts

Background: According to the American Heart Association, there are over 5 million people in the United States with heart failure (HF) and projections suggest the prevalence of HF will increase by 46% through 2030. HF is the most common cause of hospital admissions in the United States for patients age 65 years or older and despite improvement outcomes, national readmission rates remain high at 23%. Current guidelines recommend health professionals provide comprehensive HF education and counseling that is not only focused on knowledge, but also on skills of management and self-care behaviors. In order to achieve quality patient-centered care, …

Improving Utilization Of 2012 Asccp Guidelines In A Family Practice Setting, Michelle M. Mccormick, Mary Barger

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project is to decrease unnecessary colposcopy referrals using provider education and user friendly tools. This is accomplished by increasing utilization of the 2012 American Society for Colposcopy and Cervical Pathology (ASCCP) Guidelines at a Military Treatment Facility Family Practice Clinic. Despite clear cervical cancer screening guidelines, nationwide, women are continuing to have unnecessary Pap testing regardless of HPV status. Over screening can result in an increase in false positive results, leading to rising healthcare costs, additional office visits, and stress to the patient from procedures that yield little useful information or decrease in morbidity. Although …

Improving Asthma Symptoms Using Asthma Action Plans, Ryan Daniel Thebo, Michael Terry

Doctor of Nursing Practice Final Manuscripts

Asthma is a chronic disorder characterized by airflow obstruction, causing chest tightness, wheezing, coughing, and shortness of breath. In California, 7.9% of patients have an asthma diagnosis. The 2007 NHLBI Expert Panel Report 3 recommended using asthma action plans in asthma management (NHLBI, 2007). Patients with asthma were taught to use an AAP to improve asthma control. Overall, 80% of patients improved by at least one EPR3 asthma control category.

Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien

Doctor of Nursing Practice Final Manuscripts

Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.

Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Improving Hpv Vaccinations In Military Women, Sarah Beth Wedel

Doctor of Nursing Practice Final Manuscripts

Project Purpose: The purpose of the project was to implement Human Papillomavirus (HPV) patient education during every well woman exam (WWE) to improve patient knowledge and HPV vaccination rates in military women aged 18-26 years.

Background: The Human Papillomavirus (HPV) has been identified as the biggest risk factor for cervical cancer and, despite the availability of a vaccine; HPV continues to be the most common STI in the U. S. (American Cancer Society, 2013). Approximately 79 million Americans are currently infected with HPV, and 14 million individuals will become infected annually, leading to more than 10,000 cases of cervical cancer …

Supporting Self-Management In Veterans With Chronic Pain: A Policy Perspective, Erin W. Lind

Doctor of Nursing Practice Final Manuscripts

The purpose of the project was to do an evidence-based review of the effectiveness of promoting self-care on pain levels and quality of life among veterans with chronic pain at a national level. A review of current chronic pain management policies for veterans in southern California was also conducted. Active self-management initiatives permit more diverse, patient-centered treatment, promote self-management, and are relatively safe and cost-effective. Our results have confirmed that chronic pain is on the forefront of priorities for the Veterans Health Administration (VHA) due to an increasing rate of both chronic pain and opioid overdoses.

Implementation Of An Evidence-Based Educational Workshop And Toolkit: Menopausal Women's Healthcare Needs For The Primary Care Provider, Pamela Doerr-Kashani Dnp, Rn

Doctor of Nursing Practice (DNP) Projects

This evidence-based change of practice project involved the development of an educational workshop for primary care providers (PCPs). The intent of the project was to improve PCP’s knowledge of menopausal health, and to create their comfort level when discussing menopausal healthcare with clients. The workshop Menopausal Women’s Healthcare Needs for the Primary Care Provider (Doerr-Kashani, 2014) was created in response to an identified gap in knowledge among PCPs nationally on menopause-related health issues. The workshop was designed as a resource to support PCPs to competently address women’s menopause-related health issues, and enable them to provide comprehensive, evidence-based care within the …