Doctor of Nursing Practice (DNP) Final Projects Collection

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2016 2017

The reactionary nature of the current healthcare delivery system in the United States has led to increased healthcare spending from acute exacerbations of chronic disease and unnecessary hospitalizations. Those who suffer from chronic diseases are particularly at risk. The dynamics of health care must include grappling with the complexities of where and how people live and attempt to manage their health and disease. Team-based care may offer a solution due to its interdisciplinary focus on proactive, preventative care delivered in outpatient primary care. Studies examining the effects of team-based care have shown improvement in; HbA1c, blood pressure, lipids, healthcare team ...

Contributors
Cody, Erin, Moffett, Carol, Velasquez, Donna
Created Date
2017-05-02

The purpose of this project was to evaluate the utilization of a smartphone application for diabetes self-management education (DSME) into a family practice office. Cochrane review of technological options for DSME identified the smartphone as the most effective option. All patients with diabetes presenting in a family practice office for appointments with the clinical pharmacist or the physician were asked if they would participate in the project if they met the inclusion criteria including the diagnosis of diabetes, owning a smart-phone, and over 18 years old. Exclusion criteria were pregnancy, end-stage kidney disease, or use of an insulin pump. The ...

Contributors
Schaub, Kate, Moffett, Carol
Created Date
2017-05-05

Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects. While emphasis on preconception and prenatal care has increased nationwide, attendance at this important visit is on the decline. The purpose of this project was to investigate how enhanced prenatal education and concurrent scheduling of a well-baby visit at four weeks, instead of the traditional six weeks, could increase adherence to recommended follow-up care at a federally qualified health clinic in the Southwestern United States. The Theory of Reasoned Action ...

Contributors
Russo, Leah, Link, Denise
Created Date
2017-05-01

Vasomotor symptoms (VMS) associated with menopause vary greatly, as do the multitude of available treatment options. It can be difficult for clinicians to manage these symptoms while balancing patient safety concerns and preferences. Shared decision-making (SDM) can assist both the provider and patient to navigate the various treatment options, minimizing gaps between their preferences. To assess the effect of SDM in a nurse-led practice in the Southwest, two nurse practitioners (NP) were invited to use a menopausal decision aid (DA). Women aged 40 to 64 years experiencing VMS were invited to participate in the project. Following a visit with the ...

Contributors
Puttbrese, AnnMarie, Link, Denise
Created Date
2017-05-03

Heart failure (HF) is one of the most common and costly conditions for hospital readmissions in the United States (Conway, 2015). Cardiac rehabilitation (CR) programs are effective in decreasing hospital readmission rates (Koukoui, Desmoulin, Lairy, Bleinc, Boursiquot, Galinier, & Koukoui, 2015). Medicare has established new requirements for qualification into a CR program; thus, patients are at risk for readmission in the six-weeks post discharge. To reduce HF hospital readmissions and to increase enrollment into the HF program, an infrastructure was implemented beginning in January 2016. This quality improvement project employed a patient chart audit reviewing overall hospital readmission rates for ...

Contributors
Montez, Nicol, Rauton, Monica
Created Date
2017-05-01

Emergency department (ED) overcrowding is expected to increase at a rate of 1.9% yearly, leading to the inability to provide efficient and timely care, causing preventable medical errors and delays in time sensitive care. The Agency for Healthcare Research and Quality estimates that 21-33% of all ED visits are non-emergent and increased age correlates with increased use of Pre-hospital EMS systems and emergency rooms. This study aimed to determine if an advance practice nurse (APN) in an older adult pre-hospital setting could reduce the use of 911 for non-urgent calls and transports, using the para-medicine model of care. Available evidence ...

Contributors
Apolinar, Lisa, Rauton, Monica
Created Date
2017-05-01

In today’s healthcare environment, there is ample evidence to support early identification of disease and implementation of effective treatment to improve patient outcomes. The objectives of this clinical intervention were twofold; the implementation of an innovative change within an organization, allowing for systematic screening through incorporation of the Mood Disorder Questionnaire (MDQ), and evaluation of mental health provider’s willingness to incorporate practice change. A pre and post quasi-experimental design evaluated the attitude of providers regarding practice change using the Evidence-Based Practice Attitude Scale and the utilization of the MDQ following educational intervention. Parametric testing was used to explore the relationship ...

Contributors
Quade, Cara, Root, Lynda
Created Date
2017-05-01

Purpose: Improve chronic obstructive pulmonary disease (COPD) screening in primary care by implementing Global Initiative for Chronic Obstructive Lung Disease (GOLD) screening criteria. Background and Significance: Evidence shows primary care providers (PCPs) are not adhering to the GOLD Guidelines for COPD screening. Methods: Guideline education with pre/post-intervention survey and percent of eligible participants screened. Results: Pre-intervention surveys (n=10) and post-intervention surveys (n=8) completed. Significant increase in knowledge regarding the CAT score (M score = 11.50, U = 24.000, p<.05). Part 2) 24% (n=6) of participants were screened with the CAT questionnaire. Conclusions: PCPs are aware of the GOLD Guidelines, but ...

Contributors
Manng, Jillian, Nunez, Diane
Created Date
2017-04-30

Purpose: Reduce or prevent readmissions among heart failure (HF) patients and increase quality of life (QOL), self-care behavior (SCB) and satisfaction through an advanced practice registered nurse (APRN) led transitional care program (TCP) in collaboration with an Accountable Care Organization (ACO). Background: Hospital readmissions place a heavy financial burden on patients, families, and health care systems. Readmissions can be reduced or prevented by providing a safe transition through care coordination and enhanced communication. Research demonstrates implementation of APRN led home visits (HV) along with telephonic follow-up are cost effective and can be utilized for reducing readmissions among HF patients. Methods: ...

Contributors
Sugathan, Kala, Nunez, Diane
Created Date
2017-05-02

Functional GI disorders are categorized as a group of chronic symptoms that are considered to have no abnormalities that can account for patient’s illnesses. Included in this category are those patients with irritable bowel syndrome. Functional GI issues are an important public health concern as they are becoming increasingly more common; they can be disabling and can cause significant socioeconomic burden in regard to health care costs, productivity and disability. There is strong evidence that probiotics have the potential to reduce IBS symptoms. Unfortunately, probiotics are underutilized in the clinical setting. The purpose of this project is to increase knowledge ...

Contributors
Tyner, Maureen, Baker, Laurie
Created Date
2017-05-04