Nursing Commons^™

Identify And Overcome The Barriers To Care From A Patient And Provider Perspective In Adult Patients With T2dm In A Rural Federal Qualified Health Clinic (Fqhc): A Quality Improvement (Qi) Project, Jill Miscovich

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created …

Barriers, Facilitators, And Competencies In Advocating For Adults With Intellectual Disabilities With Health Disparities, Carol Adams

Electronic Theses and Dissertations

Background: Nurses working in the specialty of intellectual disabilities are positioned to advocate for individuals with intellectual disabilities and other health disparities. This study explored nurses’ perceived competencies, barriers, and facilitators when advocating for improved health status in adult patients with intellectual disabilities.

Methods: Twenty-five nurses working in the specialty of intellectual disabilities were interviewed using semi-structured interviews, and the data were analyzed using thematic analysis.

Results: Barriers identified in advocacy were: Funding, Communication, Negative Perceptions and Misperceptions, Lack of access, and Diagnostic Overshadowing. Nurses were also facilitated in advocating for improved health status in people with intellectual disabilities. Facilitators …

School Nurses And Administrators Perceptions Of School Preparedness: A Focused Ethnography, Deborah Horton

Electronic Theses and Dissertations

Background: Disasters are dangerous for schools where many children are located in one area. Children were significantly impacted by a biological incident during the 2009 H1N1 influenza pandemic, and more recently the COVID-19 pandemic. Research is needed to determine the values, perceptions, and beliefs of school disaster preparedness through a cultural lens.

Methods: A focused ethnography was used to interview school administrators and nurses from April-December 2022 to explore and understand the unique culture of school disaster preparedness. Data was analyzed according to Leininger’s Four Phases of Data Analysis.

Results: Twenty-four participants from K-12 public schools were interviewed resulting in …

Impact Of An Electronic Human Papillomavirus Vaccination Catch-Up Module For Women With Criminal-Legal System Involvement, Shawana Moore

Electronic Theses and Dissertations

Introduction: Cervical cancer can often be prevented with targeted strategies such as Pap smear screenings and the human papillomavirus (HPV) vaccination, now also recommended for those aged 27-45 who have not received the vaccine previously. However, women involved in the criminal-legal system often miss out on primary and secondary prevention measures and are at increased risk for the development of cervical cancer caused by HPV. Purpose: The purpose of this study was to examine the feasibility and acceptability of an electronic HPV catch-up module for women in the criminal-legal system aged 27-45. The study, guided by the Health Belief Model, …

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operations Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Christian-Based Health Promotion Program, Amber Vail

Doctor of Nursing Practice Scholarly Project

Chronic diseases are on a rise and placing hardship on healthcare in the United States. Regular physical activity and consumption of fruits and vegetables have proven to have health benefits related to decreasing chronic disease and improving the management of chronic diseases. A majority of the United States adult population do not meet the guidelines that are set forth by the CDC that will have a positive effect on the reduction of chronic diseases.

The purpose of this six-week Christian-based health promotion program was to improve the health of individuals in the congregation by increasing each individual’s weekly physical activity …

From Crisis To Aftermath: The Role Of Nursing Professional Development Educators During The Covid-19 Pandemic: A Realist Case Study, Kimberly Kanner

Theses and Dissertations

The purpose of this qualitative, realistic inquiry case study was to examine and understand the experiences of NPD educators as they assisted new graduate nurses transitioning into clinical nursing practice during the COVID-19 pandemic in acute care hospitals in the state of New York. Moreover, this research study sought to understand how the COVID-19 pandemic brought about changes to the NPD educator's role and their ability to assist new graduate nurses transitioning into clinical practice post-pandemic. The sample included NPD educators from acute care hospitals in the state of New York. Data collection included semi-structured interviews and document collection. The …

Low Vitamin B12: The Need For Updated Provider Education, Tracy Coltharp

Doctor of Nursing Practice Scholarly Project

Vitamin B12 deficiency is a notable clinical problem with multi-factorial risk factors and a multitude of clinical manifestations. It is associated with polyglandular autoimmune syndromes, some familiar and some lesser well known. The specific aim of this scholarly project was to evaluate whether education aimed at providers such as nurse practitioners, nurse practitioner students, physician assistants, and physicians regarding updated diagnostic criteria for vitamin B12 deficiencies as well as associated diseases, specifically autoimmune gastritis, and pernicious anemia, increased their knowledge and ultimately improved clinical practice. The project utilized a pre-test/post-test design with education provided in between. There was an improvement …

The Effect Of Education Path And Nursing Specialty On Knowledge And Attitude Survey Regarding Pain Scores, Justin Cope

Doctor of Nursing Practice Scholarly Project

Pain is reported as the number one fear of patients, and has been shown to stop patients from seeking necessary medical treatment in a timely manner. Therefore, it is important that health care professionals be able to properly assess and treat pain. One area not previously studied is how degree path affects knowledge acquisition.

The purpose of this study is to determine the effect of structured education and clinical experience on general pain knowledge between traditional and non-traditional Bachelors of Science in Nursing students. Participants of this study include RN-BSN students and pre-licensure BSN students who have completed the Adult …

Dnp Final Report: Central Line Dressing Change Regimen To Decrease Central Line-Associated Bloodstream Infections, Ann Campbell

DNP Final Reports

Central line associated bloodstream infections (CLABSI) are dangerous and costly occurrences in healthcare facilities. This evidence-based project's purpose is to implement interventions to reduce CLABSIs in a healthcare facility that has higher than the national average of reported cases. The practice problem PICOT question is: In inpatients with indwelling central venous access devices at the facility, (P) how does implementation of evidence-based guidelines for central line dressing changes every seven days and as needed (I) compared to the current practice of dressing changes on Fridays (C) affect CLABSI rates over a three-month period (O). The body of evidence obtained in …

Enhancing The Culture Of Safety Among Hospital Personnel By Implementing A Just Culture Program: A Quality Improvement Project, Lawson Stuart

Doctor of Nursing Practice (DNP) Manuscripts

Objectives

The purpose of this study was to assess employee perceptions of a healthcare organization’s existing climate of psychological safety regarding reporting patient care errors or near-miss events. Based on data obtained from the use of a valid and reliable survey tool, a plan was developed for the introduction and implementation of Just Culture throughout a large multi-hospital healthcare system.

Methods

Employee perceptions of the organization’s culture and current barriers to improving patient safety were identified by administering the JCAT survey to a population of 25,893 frontline staff, middle leaders, and senior leaders (clinical and non-clinical) at 26 separate hospitals …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Bridging The Gap Between Primary Care And Mental Health: A Quality Improvement Project, Coreyann Fluker

Doctor of Nursing Practice (DNP) Manuscripts

Establishing a robust connection between primary care and mental health services is crucial for fostering a patient-centered healthcare model. This quality improvement project addresses the pressing issue of limited access to mental health services in rural areas of the United States, leading to unmet mental health needs for patients. These challenges were identified within a Federally Qualified Health Center (FQHC) in Southwestern Pennsylvania. Implementing a collaborative care approach seeks to enhance triage practices by facilitating warm handoffs from primary care to mental health providers while integrating an informative triage tool, the SAD PERSONS Scale.

This collaborative approach enhances patient outcomes …

Integrating Health-Related Quality Of Life And Evidence-Based Polycystic Ovarian Syndrome Management: A Quality Improvement Initiative, Kami Beveridge Wast

Doctor of Nursing Practice (DNP) Manuscripts

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age, characterized by symptoms such as irregular menstrual cycles, infertility, and metabolic issues (Fatemeh et al., 2021). Despite its prevalence, the management of PCOS remains challenging due to its manifestations and impact on quality of life. Current treatment paradigms often fail to adequately address the comprehensive needs of this patient population, highlighting a substantial gap in care.

Utilizing the Plan-Do-Study-Act (PDSA) methodology, this quality improvement (QI) project aimed to enhance the management of PCOS and improve the quality of life for patients in a …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Improving Patient Care For Individuals With Autism Through An Evidence-Based Education Video: A Pilot Feasibility Project, Emily Santillan, Katreena Collette-Merrill, Terisa P. Gabrielsen, Petr Ruda

Student Works

Autism Spectrum Disorder (ASD) affects approximately 1 in 36 children in the United States, presenting challenges in healthcare provision due to varied severity and frequent comorbidities. Despite increased healthcare utilization by individuals with ASD, they often encounter barriers to receiving adequate care, including communication difficulties and untrained healthcare providers. Consequently, there is a pressing need for autism-friendly healthcare environments.

This study aimed to assess the feasibility of improving healthcare provider self-efficacy in caring for patients with ASD through an evidence-based online educational video. Following Bandura's Self-Efficacy Theory, the project developed a video outlining simple accommodations for ASD patients in ambulatory …

Instructor Characteristics That Increase Self-Efficacy In Nursing Students, Kaycee Jodean Jacobson

Walden Dissertations and Doctoral Studies

With the current nursing shortage, finding ways to increase nursing retention in graduate nurses can help ease the shortage. Self-efficacy is a factor that contributes to an individual’s well-being and can affect their professional accomplishments. The purpose of this study, guided by Bandura’s theory of self-efficacy, was to identify instructor characteristics that may impact student perceived self-efficacy in the clinical setting. Bandura identified self-efficacy as a factor that contributes to an individual’s well-being as a whole and can affect their professional accomplishments. A sample of 19 nursing students who were enrolled in a clinical course were recruited and completed the …

Enhanced Bariatric Surgery Preoperative Support To Improve Postoperative Surgical Outcomes, Jeffrey Eavey

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

Bariatric surgery is a procedure known to eradicate disease and improve the quality of life for patients suffering from obesity. The pathway to bariatric surgery is a comprehensive and lengthy process; therefore, patients require additional support from the multidisciplinary healthcare team and their support system. The accrediting body of an academic medical center bariatric surgery program (BSP) requires the program to limit and reduce 30-day all cause postoperative emergency department (ED) visits and 30-day all cause postoperative readmissions. A telemedicine visit within two weeks prior to surgery was added with the intent to assess patients for knowledge deficits and …

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …