Nursing Commons^™

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 …

Standardizing Nasogastric Tube Securement: A Quality Improvement Initiative, Shannon Lee Thompkins

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: At a large academic medical center located in the northeastern United States, nasogastric tubes (NGT) were traditionally secured with tape. The institutional policy was nonspecific with no written procedure. The inconsistent use of nasal bridle securement devices (NBSD) and predominant use of tape has the potential to lead to a high rate of NGT dislodgement.

Background: NGT complication and dislodgement rates range from 2%-36% (Gimenes et al., 2019). Stabler et al. (2018) report 29%-63% NGT dislodgement rates in critically ill patients. Patients with intracranial hemorrhage dislodge NGTs in 25% of patients (Rahman et al., 2022)

Available Knowledge: Based on …

A Quality Improvement Initiative To Reduce Preanalytical Blood Gas Errors, Layla Haver Newbrough

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Introduction: Laboratory testing is one of the most commonly performed procedures in healthcare and resulting data are paramount to clinical decision making. Background: Preanalytical blood gas laboratory errors often stem from the incorrect recording of a patient’s fraction of inspired oxygen (FiO2) within the laboratory collection application. Incorrect FiO2 may cause erroneous results or delays in reporting results that have the potential to negatively impact patient safety and medical management.

Purpose: The purpose of this quality improvement initiative was to reduce the occurrence of preanalytical blood gas laboratory errors. Methods/Interventions: This initiative combined modification of the laboratory collection application …

A Structured Diabetes Continuous Glucose Monitor Education Program To Improve Patient Knowledge And Self-Efficacy, Krystal Abucevicz-Swick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/background: Continuous glucose monitor (CGM) is a recommended method of glucose monitoring for patients living with diabetes who are on insulin or experience documented hypoglycemia. CGM is a tool that can improve patient management of diabetes but works best when paired with education to achieve the maximum therapeutic benefits.

Purpose: The purpose of this project was (1) to develop an evidence-based structured CGM education program toolkit for people with diabetes who are ordered CGM, (2) to implement the CGM education toolkit into the Diabetes Self-Management and Education Services (DSMES) program at the project site, (3) to improve patient knowledge about …

Hack24f: Ai Conversations In Healthcare, Patrick Finger, Hannah Neale, Anthony Ferreira, Ayaz Mohammed

Paul English Applied Artificial Intelligence (AI) Institute Publications

Nursing students often complete clinical hours under the supervision of instructors in traditional hospital settings. However, obtaining individualized, consistent feedback from patients about their interactions with nursing students is often not feasible. This limits students' ability to fully understand how their communication skills are perceived and how they can improve. Currently, there are no models that represent realistic real life conversations with patients. Most virtual simulation models used for nursing students provide scripted responses that do not feel genuine.

The Effectiveness Of Aac Training For Nursing Students To Increase The Knowledge And Success For Communicating With Patients With Complex Communication Needs, Hanna Hill Webb

Murray State Theses and Dissertations

Effective communication is an essential practice for nurses and is fundamental for the care of patients. Nurses have significant difficulties communicating with patients with complex communication needs (CCN), which can lead to communication breakdowns and sentinel events. While AAC is a viable option for communicating with patients with CCN, nurses do not receive any training on how to effectively communicate or use AAC with patients with CCN. Nursing students are in the ideal position for learning how to use AAC and communicate with AAC, as they are in the process of learning and entering the field for medical placements. This …

Nursing Students’ Comfort In The Nursing Program, Camella Bloom, Rebecca Karr, Makenzie Menard

Williams Honors College, Honors Research Projects

This research project’s purpose is to investigate student nurses’ comfort levels within the nursing program. The project focuses on how interactions with RNs impact comfort levels of nursing students. These interactions take place within the student nurses’ clinical experiences or their experiences at their healthcare jobs. The sample was sophomore, junior, and senior-level undergraduate BSN students at The University of Akron, which is about 434 students. The number of participants that completed the survey was 57 nursing students. The independent variables were student level in the BSN program and current employment status in a patient care role. The dependent variable …

"They Are Expecting Us To Stay Strong": How Ambulance Personnel Navigate And Manage Their Emotions In A Rural Region Of Northern California, Tina M. Orton-Owens

Cal Poly Humboldt theses and projects

This research examines how emergency medical service (EMS) workers navigate and manage their calls in Humboldt County, a rural region of Northern California. The primary theoretical framework is drawn from Arlie Hochschild’s theory of Emotional Labor. This paper examines how emotional labor impacts EMS workers within a rural environment and with limited resources. I also look at how COVID-19 complicated EMS workers’ experiences. This paper is based on qualitative research where I conducted 13 mostly face-to-face interviews with EMS workers throughout the County between 2020 and 2022. Interviews consisted of 30 questions and interviews ranged in length from 1 to …

Developing And Implementing A Sexually Transmitted Disease Screening Program To Decrease Chlamydia Cases On A College Campus, Amanda C. Harris

All Capstone Projects

Introduction: Sexually active college students were experiencing a high incidence, spread, and reinfection of the sexually transmitted Disease (STD) chlamydia on a university campus.
Purpose: To determine if implementing of a quality improvement program on campus utilizing a holistic approach would help decrease chlamydia cases. This program focused on fast-track STD screening, increasing knowledge about STDs, and addressing mental health issues.
Methods & Study Design: This was a descriptive/quasi-experimental design. Participants utilized the fast-track STD screening and completed surveys. Descriptive statistics and frequency tables were used to summarize survey responses for 1) the pre-and post-sexually transmitted disease (STD) education survey, …

Fostering Flexibility: How Medicare Advantage Potentially Accelerated Telehealth Benefits, Lisa M. Grabert, Grace Mccormack, Erin Trish, Kathryn L. Wagner

Economics Faculty Research and Publications

In 2018, the US Congress enacted a policy permitting Medicare Advantage (MA) plans to cover telehealth services in a beneficiary’s home and through audio-only means as part of the basic benefit package of services, where prior to the policy change such benefits were only allowed to be covered as a supplemental benefit. MA plans were afforded 2 years of lead time for strategizing, negotiating, and capital investment prior to the start date (January 1, 2020) of the new coverage option. Our data analysis found basic benefit telehealth was offered by plans comprising 71% of enrollment in 2020 and increased to …

Nurses' Knowledge, Confidence, And Compliance With An Ambulatory Surgery Discharge Checklist, Heather Van Marion

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Preventable errors in healthcare are fueling the growth of patient safety cultures. Checklists have been found to increase discharge accuracy and efficiency and detection of patient safety concerns before discharge.
Local Problem: Oversight errors can be traced back to poor communication or outdated workflows. Ad hoc communication and knowledge of physician preferences are no longer sufficient for ensuring complete discharge instructions. Methods & Interventions: A discharge checklist was developed and implemented in an ambulatory surgery department to ensure discharge instructions were complete and accurate. Nurses completed a pre and 3-month post-checklist questionnaire assessing their knowledge and confidence in the …

Implementation Of An Induction Of Labor Protocol, Rebecca A. Erickson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Nationwide focus has been placed on the reduction of incidence of adverse maternal and neonatal outcomes in nulliparous, term, singleton, vertex (NTSV) patients.
Local Problem: Nursing leaders of a maternal child health unit in the upper Midwest recognized a need to reduce the rate of adverse maternal outcomes with evidence-based practice. The facility does not currently have an induction of labor (IOL) protocol.
Methods: The California Maternal Quality Care Collaboration Toolkit to Support Vaginal Birth and Reduce Primary Cesarean Sections was used to create an IOL protocol to prevent adverse maternal outcomes. Categorical outcome data was compared for 6 …

Implementation Of An Oral Sucrose Protocol For Advanced Practice Providers, Cori Shatto

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Pain in infancy due to immunization administration often goes untreated. The pain infants experience leads to negative effects on neurodevelopment and pain response. Needle fear develops in infancy and can extend into adulthood, leading to vaccine avoidance and endemic outbreaks. Methods: In a family practice clinic in an upper Midwest state, an oral sucrose protocol was implemented for use by advanced practice providers (APPs). Prior to education on the protocol, a survey was administered to assess the providers’ knowledge, attitudes, and practice (KAP) in relation to oral sucrose. The providers were educated on the benefits and intended use of …