Nursing Commons^™

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 …

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 Early Mobilization Strategies In The Mechanically Ventilated Patient Population, Katherine B. Stewart

DNP Projects

Purpose

This practice inquiry project was designed to evaluate current mobility practice and identify associations between mobility practice and specific patient characteristics in a cardiovascular intensive care unit.

Population and Setting

The sample consisted of electronic medical records of adult patients that required mechanical ventilation in a 16-bed cardiovascular intensive care unit in a private, urban hospital in Southern U.S. Of the selected participants, 48 were male and 52 were female with an average age of 64.49 (SD = 14.58).

Inclusion Criteria

Inclusion criteria for this study were patients who 1) were aged 18 and older; 2) were mechanically ventilated …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

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 …

Review Of Current Mobility Practice In Non-Surgical Mechanically Ventilated Intensive Care Unit Patients, Catharine Morgan

DNP Projects

Purpose: The purpose was to: (i) conduct a retrospective electronic medical record review to evaluate current practice related to mobility, (ii) determine the association between current mobility practice patterns and characteristics specific to the patient population, and (iii) make recommendations for the implementation of an evidence-based progressive early mobility protocol for non-surgical mechanically ventilated patients.

Population: Non-surgical, ventilated patients in the Intensive Care Unit (ICU)

Inclusion Criteria: Ventilated patients at least 18 years old who have been ventilated for at least 48 hours and did not have major surgery lasting more than one hour at any point during their hospital …

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 …

Preventing Delirium Through The Implementation Of The Abcde Bundle And Pad Guideline Into Everyday Care In A Community Hospital Intensive Care Unit: Opportunities For Practice Improvement, Mary Zody

DNP Projects

This DNP project focuses on the reduction of delirium through improvement of nursing knowledge of delirium and implementation of evidence based bundle ( Awake, Breathing, Coordination, Early Mobility, and Pain, Agitation, Delirium) into a twelve bed intensive care unit located in a 150 bed community hospital. Specifically, this project will review the literature supporting the evidence based bundle and report on a comprehensive gap analysis which was done to determine areas for practice improvement to reduce delirium and improve patient outcomes. The gap analysis included a comparison of current practice to the evidence, a review of administrative policies/ statements of …

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 …

Evaluation Of Provider Recommendation Of Colorectal Cancer Screening In A Primary Care Setting, Emmanuel E. Nwaogu

DNP Projects

Objectives: The overall objective of this practice inquiry project was to evaluate whether providers in a primary care clinic in Louisville, KY were following the United States Preventive Services Task Force (USPSTF) screening guidelines regarding colorectal cancer for patients aged 50 -75. The study examined the types of screening recommended, and whether completion of screening was documented in the medical record. Finally in this study, provider recommendation for Colorectal Cancer Screening (CRC) was evaluated to determine if types of screening recommended, and documentation varied based on the ethnicity of the patients.

Methods: This was a descriptive study using a retrospective …

Smoking Cessation And Nursing, Isabelle Mccormack

Senior Honors Theses and Projects

Smoking is currently the leading cause of preventable death and disease in the United States, and is responsible for nearly 20% of deaths each year (U.S. Department of Health and Human Services [USDHHS], 2014). Ten times as many Americans have died prematurely from cigarette smoking than have died in all wars fought by the United States (USDHHS, 2014). Cigarette use negatively effects users' health, increases healthcare costs, is a financial burden, and negatively impacts the lifestyle of its users. This thesis will explore current cigarette use in the United States, the effects on its users, and the plan of action …

Mennonite College Of Nursing Annual Report, 2015-2016, Mennonite College Of Nursing

Annual Reports - Mennonite College of Nursing

Annual report of the Mennonite College of Nursing at Illinois State University

Mennonite College Of Nursing Annual Report, 2016-2017, Mennonite College Of Nursing

Annual Reports - Mennonite College of Nursing

Annual report of the Mennonite College of Nursing at Illinois State University