Nursing Commons^™

Improving Patient Engagement Post-Percutaneous Coronary Intervention Using The Systematic Introduction Of A Cardiac Rehabilitation Bundle In A Community Hospital: A Quality Improvement Project, Rebecca Vela

Doctor of Nursing Practice Final Project Abstract

PURPOSE This quality improvement project aimed to increase patient participation and program completion rates in cardiac rehabilitation (CR) following percutaneous coronary intervention (PCI) by 10% of the historical baseline within 3 months.

BACKGROUND Heart disease is the leading cause of death in the United States. PCI is a standard treatment for symptomatic heart disease. CR is a post-PCI secondary strategy proven to reduce mortality and improve quality of life. The project addressed below-average CR attendance at a community hospital in the greater Houston area.

METHODOLOGY An evidence-based, multidisciplinary bundle that included education, signage, defined quality metrics and dashboard, patient-centered care, …

Decreasing Compassion Fatigue In Inpatient Nurses Using Debriefing And Group Care Program, Hanh Nguyen

Doctor of Nursing Practice Final Project Abstract

Purpose: The quality improvement project's purpose was to use a group care program to decrease compassion fatigue (work-related stress) in nurses. The project aimed to reduce compassion fatigue in nurses by 25% and nurse turnover rates by 10% post-intervention.

Background: The project was implemented on two inpatient units in Texas. Decrease in compassion fatigue can help improve nurse well-being and nurse retention, promoting safe quality nursing care.

Methodology: The Professional Quality of Life Scale (ProQOL) survey measured compassion satisfaction and burnout pre-intervention. Twelve weekly program sessions were completed using strategies: debriefing, breathing exercise, and muscle relaxation. A …

Increasing Code Blue Education For Staff Nurses To Reduce Stress And Increase Competency, Haris Ali

Doctor of Nursing Practice Final Project Abstract

PURPOSE The goal for this project is to increase code blue education and knowledge for staff registered nurses during new employee orientation at a psychiatric teaching hospital. An educational video will be created consisting of code blue procedures. The goal of this video is to better educate registered nurses on code blue medical emergencies before their time on the unit floor begins.

BACKGROUND A code blue or rapid response team is critical for patients to receive proper medical care. The education of nurses has been shown to increase the knowledge and understanding of medical emergency teams and increase the utilization …

An Educational Intervention Differentiating Between Pressure Injuries And End-Of-Life Wounds, Alicia Perez Verela

Articles, Abstracts, and Reports

No abstract provided.

Improving The Self-Efficacy And Self-Management Of Adult Patients With Type Ii Diabetes (T2dm) Through A Telehealth Program At An Outpatient Clinic, Uchechukwu N. Iwuorie

Doctor of Nursing Practice Final Project Abstract

Purpose

This eight-week quality improvement project implemented a cellphone-based reminder text intervention to improve self-efficacy and self-management practices among adults diagnosed with T2DM at an outpatient clinic in Tomball, Texas.

Background

The clinic serves underserved populations in Tomball. Over 20% of diabetic patients have a Hemoglobin A1c (HbA1c) above 9%. There is no program for T2DM self-management due to resources and staffing.

Methodology

Informed participants completed a recruitment packet and a self-efficacy survey before and after the intervention. Thirteen patients received two text messages biweekly from the clinic, on self-care reminders, recommended by the American Diabetes Association, along with an …

Impact Of Traditional Education And Learner-Centered Education On Standardized Tests, Courtney Marie Winslow

Walden Dissertations and Doctoral Studies

There is a current shortage of approximately 45,000 nurses and nursing faculty to train student nurses, a number that is projected to grow. One proposed method to combat the shortage is to transition from traditional lecture-based classrooms to a learner-centered approach. Asking or requiring faculty to transition an entire nursing program from one teaching method to another without supporting data could be a waste of valuable time and resources. It could also prove detrimental to a program if students were unable to pass the NCLEX-RN exam, and a program was forced to close. The current study examined whether there was …

Increasing Performance Of Bedside Shift Report To Enhance Nurse-Patient Communication, Hannah Schimmer

Doctor of Nursing Practice Projects

Bedside shift report is the recommended form of nursing shift-to-shift handoff and has positive effects on nurse-patient communication, but it is difficult to implement and sustain. The organization’s standard for nursing shift-to-shift handoff is bedside report; however, report was not routinely taking place at the bedside. Key opportunities for nurse-patient communication were lost and the organization’s patient experience scores related to nurse-patient communication were well below state and national averages. A pre- and post-test design quality improvement Doctor of Nursing Practice project was conducted using the Plan, Do, Study, Act framework. The objective of the project was to increase the …

Obesity In Primary Care: A Quality Improvement Project To Improve Diagnosis And Treatment Of Adult Obesity, Lindsey K. Barrett

Doctor of Nursing Practice Projects

Obesity is a common and serious chronic health condition that is impacting individuals, families, and society. According to the Centers for Disease Control and Prevention (CDC), obesity is a body mass index (BMI) of 30 or above (CDC, 2022b). The rate of adult obesity rose from 30.5% in 1999 to 41.9% in 2020 (CDC, 2023). BMI is often measured and documented at adult patient primary care visits but is rarely diagnosed and addressed by primary care providers (PCP) unless it contributes to the patient’s primary complaint or is the patient’s chief complaint. Gaps exist for implementing current evidence-based practice guidelines. …

Improving Obstetric Nursing Competency And Confidence In Shoulder Dystocia Emergencies Using High-Fidelity Simulation, Crystal M. Catron

Doctor of Nursing Practice Projects

Shoulder dystocia is a rare obstetric emergency that can lead to severe maternal and neonatal complications. Obstetric nurses play a critical role in assisting in the specific nursing interventions that aid in the safe delivery of shoulder dystocia emergencies. However, due to this low-volume, high-risk occurrence many nurses lack the confidence and competence required during this obstetric emergency. High-fidelity simulation training can mimic a real-life shoulder dystocia emergency without any risk factors. High-fidelity simulation can allow nurses to practice the critical nursing interventions that are required to safely deliver the infant in a safe risk-free environment. This Doctorate in Nursing …

Reducing Aggressive Behavior In Long-Term Care By Improving Knowledge And Confidence, Jennifer Jo White

Doctor of Nursing Practice Projects

Verbal and physical abuse in long-term care facilities has significantly increased due to the addition of middle-aged adults and elderly residents with dementia-induced behaviors. Aggressive behaviors must be managed with effective de-escalation techniques to reduce behaviors turning violent. Caregivers are not properly educated utilizing a robust training program leaving them with a lack of knowledge and confidence to manage aggression. This project aimed to implement an evidence-based guideline tool that equips the clinical staff with de-escalation techniques to effectively manage residents with aggressive behaviors by decreasing incident reports filed due to behavioral events. A review and synthesis of the literature …

Cultural Food Toolkit For Minorities With Hypertension, Stella N. Benya

Doctor of Nursing Practice Projects

Despite the United States being considered one of the richest countries in the world, the gap in health disparities among minorities is a public health concern. Asian, Hispanic, and African American minorities are more likely to be diagnosed with hypertension (HTN) and have less controlled blood pressure (BP) than Caucasians. It is important to create opportunities for health education, disease management, and shared decision making to tackle the gap in healthcare for minorities. Health care professionals delivering care in the community may lack adequate education and resources to fully address social determinants of health (SDoH) in minority populations suffering from …

Targeted Naloxone Education To Veterans And Its Impact On Naloxone Prescriptions, Annie Cole-Bradley

Doctor of Nursing Practice Projects

Opioid overdoses are the leading cause of drug overdose deaths in the United States. Veterans are a population that are at higher risk for opioid overdoses. Naloxone is a medication that can reverse the respiratory depression associated with an opioid overdose and prevent opioid related deaths. Increasing overdose education and naloxone distribution (OEND) is an essential component of harm reduction to reduce opioid overdose deaths. Following a review of the literature, evidence supports increasing naloxone education and suggests this increase in education has the potential to increase naloxone knowledge and naloxone prescription acceptance. This doctoral quality improvement project created patient …

Utilization Of A Depression Screening Tool In Primary Care, Charla Burchett

Doctor of Nursing Practice Projects

Major Depressive Disorder is a significant health issue among adult patients in the United States, contributing to increased morbidity and mortality (National Alliance on Mental Illness, n.d.). The purpose of this project was to implement routine screenings in a small rural primary care clinic using the Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 (as applicable) to identify patients with depressive symptoms and refer those with positive results to mental health specialists for further evaluation, diagnosis, and treatment. As depressive symptoms can emerge at any time, patients were screened at each clinic visit, resulting in some patients being screened more than once. …

Going Beyond The Exam Room: Increasing Social Determinants Of Health Screenings And Community Referrals In A Community Health Center, Catherine Lightfoot

Doctor of Nursing Practice Projects

Social Determinants of Health (SDH) are factors that affect a patient’s health outcomes but are not medical measurements, prescriptions, or therapies. Instead, they are external forces or social risks a person faces based upon where they live, work, and play. Screening for these risks allows a medical team more information about a patient and their situation and can contribute to personalized care. Screening patients for these determinants in a community health primary care setting is important and is increasingly being aligned with regulations and reimbursements. The purpose of this Doctor of Nursing Practice quality improvement project was to implement change …

Pharmacist-Led Inhaler Education As Part Of A Copd Care Bundle To Reduce Hospital Readmissions, Stephanie Fields

Doctor of Nursing Practice Projects

Pharmacist-Led Inhaler Education as Part of a COPD Care Bundle to Reduce Hospital Readmissions

Stephanie Fields, MSN, RN, APRN, FNP-C

Abstract

Chronic obstructive pulmonary disease (COPD) is a condition that results in decreased quality of life, premature death, and significant economic burden due to recurrent hospitalizations. The importance of proper disease management therefore cannot be overemphasized. The mainstay of COPD treatment is the use of inhaled medications. It is well documented that there are opportunities to improve the use of and adherence to these important medications to optimize quality of life and symptom control with the goal of avoiding the …

Initial Physical Health Screenings For Children In Foster Care, Stephanie D. Mondelli

Doctor of Nursing Practice Projects

Access to healthcare or medical services is a basic human right. Children in the foster care system often face barriers in accessing medical services and continuity of care. These children have lost their biological families who would typically advocate for their healthcare needs. Foster care presents a whole set of new challenges for children, biological families, and foster parents. Child protective services has over 8,000 children in foster care at any given time. Navigating the healthcare system is convoluted but adding the additional stress of foster care on top of navigating the healthcare system can be quite cumbersome. Child protective …

Integrating Body Dysmorphic Disorder Screening Into Aesthetic Medicine Clinics, Michelle Andrus

Doctor of Nursing Practice Projects

As rates of elective cosmetic and dermatological procedures increase, it remains imperative for

aesthetic medicine providers to adequately screen potential patients for body dysmorphic

disorder (BDD). A psychiatric disorder, BDD presents when persons perceive flaws that are not

apparent to others, perform repetitive actions to examine and groom themselves which hinders

daily living activities, and require constant reassurance regarding their appearance. Literature

notes those with BDD seek elective cosmetic surgery at higher rates than the general population

resulting in poor satisfaction and outcomes. Cosmetic Procedure Screening (COPS) is a validated

screening tool for BDD and this quality improvement project sought …

Empowering Nurses: Virtual Mentorship For Local Patient Care, Kimberly Kenney Dr.

Doctor of Nursing Practice Projects

Abstract

Retention of critical care nurses is a challenge for healthcare organizations. Regional critical access hospitals struggle with recruitment and retention of qualified registered nurses (RN). Providing nurses with experienced mentorship can support continued learning and opportunities to provide high quality care. Veteran critical care nurses can provide invaluable mentorship to regional critical access hospitals, aiding them in the establishment of local critical care units. A review of literature provides evidence of the positive impact of RN mentorship programs through noted improvement in role satisfaction, RN retention, improved patient outcomes, and decreased organizational healthcare costs. The literature also identifies positive …

Behavioral Emergency Response Team: Improving Medical-Surgical Nurses' Confidence And Participation In De-Escalation Interventions, Amara Toure

Doctor of Nursing Practice Projects

The most common form of Workplace Violence (WPV) in the United States (US) is patients' aggressive behaviors toward healthcare professionals, predominantly affecting nursing staff. This form of workplace violence can be mitigated by equipping nursing staff with the knowledge, skills, and confidence to de-escalate behavioral emergencies in acute care settings. Bowers’ Safewards de-escalation model was selected as the theoretical framework for this Quality Improvement (QI) project. The QI project aimed to increase nurses’ confidence in participation in de-escalation interventions, including the appropriate activation of a Behavioral Emergency Response Team (BERT) by medical-surgical nurses working at a government hospital in the …

Adolescent Depression: Implementation Of Annual Screening To Improve Mental Health Referral Rates, Crystal R. Prewitt

Doctor of Nursing Practice Projects

Adolescent depression is becoming increasingly prevalent in the United States with an estimated 2.9 million adolescents between the ages of 12 and 18 years old affected by Major Depressive Disorder annually. Adolescent depression increases the risk of academic difficulties, substance abuse, and suicide. Depression screening in the primary care setting is an effective intervention to identify at-risk youth, but screening rates remain low. Primary care providers fail to identify up to 80% of adolescents with depression symptoms and more than 60% of adolescents do not receive needed mental health services. This DNP project implemented an evidence-based practice change for annual …