Family Practice Nursing Commons^™

Environmental Concerns Of Women In Appalachia, Kristen Montgomery, Adebayo Adeeko, Jessica Binns, Sarah Hall, Paula Hawkins, Allyson Newer, Michaela Outlaw, Karenna Turley

Epsilon Sigma at-Large Research Conference

Purpose: Environmental contamination is rampant in the United States and other parts of the world. There are potential health implications related to environmental contamination.
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Aims: The purpose of this study was to investigate how concerned women in Appalachia are regarding the environment. The following research question was addressed: What concerns do women have regarding the environment? The objective of this study was to understand how women perceive their environment and to evaluate what concerns they have regarding the environment. We also evaluated demographic factors to see if any demographics contributed to particular concerns related …

A Jewel In The Crown Is Better Than Money In The Pocket": Historical Data On The Role Of Midwives In Caring For Families In Southern Appalachia, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

Background: Midwives have provided care to women since the beginning of time. Early midwives had little training but learned their craft from experienced women. Later, formal training became available. Midwives have a rich history in Appalachia.

Purpose: to explore the rich history of all types of midwives in Appalachia.

Methods: Materials from the Archives of Appalachia were reviewed. Both written and oral materials were evaluated. This included a review of the document, identification of themes, and then comparing those themes with previously identified themes. Documents were reviewed in a random order by two researchers who met to discuss results.

Results: …

Improving Admissions Planning In A Specialized Adult Foster Care Program, Jessie Sullivan

Doctoral Dissertations & Projects

Background: Specialized adult foster care (AFC) programs have the unique ability to facilitate and coordinate continuity of care with an interdisciplinary approach internally and with community provider collaboration. The lack of communication in the transition of care admissions process leads to negative patient safety outcomes.

Purpose: The purpose of this quality improvement project was to identify barriers to improve communication, continuity of care, reduce negative health outcomes, and provide a culture of safety.

Methods: The Systems Engineering Initiative for Patient Safety (SEIPS) guided this quality improvement project. Assessment of quality measures and outcomes included the administration of pre- and post-implementation …

Implementing A Standardized Colorectal Cancer Screening Protocol To Enhance Screening Rates In A Primary Care Setting, Sam Terranova

Doctoral Dissertations & Projects

Colorectal cancer (CRC) is a significant health concern in the United States, ranking third in incidence and mortality among all cancers. Despite established screening guidelines, adherence often falls short in primary care settings. This quality improvement project aimed to enhance CRC screening rates in a Midwest primary care practice through implementation of a standardized screening protocol. The intervention was two-fold and consisted of the routine ordering of fecal immunochemical test (FIT) kits to eligible patients and the use of electronic health record (EHR)-based patient reminders. Screening completion rates were monitored over a four-month period and compared to pre-intervention rates from …

The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy

Theses and Graduate Projects

BACKGROUND: In 2020 a pandemic created dangerous workloads leading to many nurses quitting their careers due to chronic stress. This project will create the green room, which is the name of this recharge room, where staff can go to experience a moment of peace to decrease their stress levels. This room had a spa aesthetic with comfortable seating and green plants. METHODS: This quality improvement project follows the plan-do-study-act model. When participants arrived, they filled out a questionnaire before using the room. They were then shown all the things they could do to utilize the room. After they were done …

The Cruciality Of Early Recognition Of Postpartum Depression In Neonatal Intensive Care Unit (Nicu) Mothers, Shelby Clark

Scholars Week

Postpartum depression is a serious complication of childbirth that is largely dismissed by society for a variety of reasons. Unfortunately, the condition is intensified for NICU mothers. If left untreated, postpartum depression can have detrimental effects. This quality-improvement project focused on early recognition of postpartum depression symptoms in mothers of infants admitted to a neonatal intensive care unit in Western Kentucky. The goal of the project was education for and recognition of postpartum depression in NICU mothers. Methodology for the project included utilizing the Edinburgh Postnatal Depression Scale to determine the severity of symptoms of postpartum depression for NICU mothers. …

Aprn Transition To Primary Care Practice Program: A Quality Improvement Project, Melissa R. Baker

Graduate Theses, Dissertations, and Capstones

Transitioning to independent practice presents challenges for advanced practice registered nurses (APRNs) new to primary care. This quality improvement project addressed gaps in training and support through a structured Transition to Primary Care Practice (TTPCP) program across multiple primary care clinics in the southeastern United States. Over 12 months, the program provided weekly didactic sessions, monthly specialty rotations, and bi-weekly feedback. Guided by the Plan-Do-Study-Act framework, the initiative tracked structure, process, and outcome measures. Among 20 participants, attendance and schedule ramp-up reached 100%. Knowledge scores improved by 44%, and self-assessments increased by 23%. All assessed participants were rated Proficient or …

Empowering Staff Wellbeing: A Team-Based Qi Initiative, Rebecca Lauren Smith, Elizabeth Morse, David Phillippi

SPARK Symposium Presentations

Project Title: Empowering Staff Wellbeing: A Team-Based QI Initiative

Keywords: Burnout, wellbeing, DNP, primary care, QI methodology

Background and Rationale: The consequences of burnout in healthcare are alarming: worse patient outcomes, lack of continuity of care, higher turnover, and increased cost to employers. Many studies of burnout and wellbeing of clinicians focus on larger institutions such as hospitals and Federally Qualified Health Centers. Over the past several years, burnout has been discussed among our small, eight-person clinician team working in a small, non-profit primary care clinic. Yet, there has been no formal assessment of the level of burnout among …

Defining Sexual Assault, Consent, And Resources To Empower Students: A Dnp Project, Sarah Powers

SACAD: Scholarly Activities

Abstract

Sexual assault (SA) remains a pervasive issue on college campuses in the United States, often compounded by underreporting and a lack of knowledge about available resources. This Doctor of Nursing Practice (DNP) project aims to educate first-year college students about SA, sexual consent, and available resources to empower students in preventing assaults and seeking help when needed. The intervention, which was integrated into mandatory freshman seminars at a four-year university, was guided by Knowles' Adult Learning Theory. A presentation provided critical information, and knowledge gains were assessed through pre- and post-presentation surveys. Initial findings indicated significant increases in understanding …

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Addressing Vaccine Hesitancy In Vulnerable Populations, Suzanne Chenette

Student Scholarly Projects

Vaccine-preventable disease outbreaks and the spread of misinformation on vaccines throughout the United States are growing public health problems. Marginalized and vulnerable communities nationwide have seen a substantial rise in parental vaccine hesitancy that has negatively affected early childhood immunization rates, intensified healthcare disparities, and decreased patient care outcomes. Advanced Practice Registered Nurses primarily work in clinical settings, but these healthcare professionals can reach the public locally and nationally by actively participating in healthcare policy development. The following PICOT question guided the objective of this policy project: In the early childhood population (P), how does the development of a comprehensive …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

The Ethical Justification Of Application Of Long-Acting Reversible Contraception In Patients With Intellectual Disabilities, Kelly Savitri

Journal of Health Ethics

This paper explores the ethical justification for the use of Long-Acting Reversible Contraception (LARC) in patients with intellectual disabilities, particularly in scenarios where patients cannot provide informed consent. The tension between respecting autonomy and ensuring beneficence presents a complex challenge for healthcare providers. Drawing on historical context, current reproductive justice issues, and evolving societal attitudes towards individuals with intellectual disabilities, this essay argues for a semi-discrete model that recognizes the need to prioritize patient health and safety while valuing their autonomy. By examining the implications of both past and present practices, this study highlights the necessity for healthcare providers to …

Treatment Safety In Pediatric Atopic Dermatitis, Malia Ecalnir

Nursing | Senior Theses

_Purpose

The purpose of this study is to compare the safety and long-term effects of topical calcineurin inhibitors (TCIs) and topical corticosteroids (TCS) in pediatric patients diagnosed with atopic dermatitis (AD), and to compare the prescribed treatment use for 6 to 12 months. By providing evidence on prescribed topical treatments, their safety differences, and long-term effects, healthcare professionals can make informed decisions to minimize risks and choose the safest appropriate treatment for children.

_Method

This study will employ a quasi-experimental design, and participants aged 2-18 years will be selected from a clinic. Participants and their families will complete an initial …

Mental Health Stigma As A Barrier To Care, Whitney Grant

Regis University Student Publications (comprehensive collection)

Abstract

Mental health stigma is a major barrier to care. The mental health stigma as a problem is relevant due to its influence on increasing the burden of mental health issues due to a lack of help-seeking, contributing to increased healthcare costs, and increasing adverse health outcomes. Currently there is no action consistently taken to assess or address this stigma in the primary care setting. Healthcare professionals can help to reduce the perceptions of stigma and lessen stigma as a barrier to care. A quality improvement project was implemented to evaluate if an education intervention by a primary care provider …

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …

Implementation Of The Nurse-Driven Palliative Care Referral Protocol: A Quality Improvement Project, Khrystyna Lacombe

Doctor of Nursing Practice Scholarly Projects

Implementation of the Nurse-Driven Palliative Care Referral Protocol

Background and Purpose: Palliative care enhances quality of life, symptom management, and patient–family communication for individuals with serious illness. Despite strong evidence and national recommendations for early integration, referrals remain inconsistent and often occur late. At Advocate Sherman Hospital, only 17.9% of eligible oncology inpatients received palliative care consults. The absence of standardized referral criteria, reliance on provider discretion, and misconceptions equating palliative care with hospice contributed to delayed or missed consults. The purpose of this quality improvement (QI) project was to increase palliative care referrals by 20% within eight weeks through …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …