Doctor of Nursing Practice (DNP) Capstone Projects Copyright (c) 2013 University of Massachusetts - Amherst All rights reserved. http://scholarworks.umass.edu/nursing_dnp_capstone Recent documents in Doctor of Nursing Practice (DNP) Capstone Projects en-us Thu, 23 May 2013 01:36:57 PDT 3600 The Blood Pressure Effect of the Addition of the DASH Diet and Exercise to the Treatment Plan of Both Pre-hypertensive and Hypertensive Rural Adults http://scholarworks.umass.edu/nursing_dnp_capstone/22 http://scholarworks.umass.edu/nursing_dnp_capstone/22 Tue, 21 May 2013 06:35:23 PDT Hypertension is a significant problem in the United States. This is especially true of rural populations who have diets high in saturated fat and sodium and low in fruits, vegetables and potassium. Furthermore, research has shown that a large number of rural residents do not engage in regular physical activity. These lifestyle characteristics have been associated with increased blood pressure and the risk for the development of cardiovascular disease. Conversely, adoption of the Dietary Approaches to Stop Hypertension (DASH) diet and exercise has been associated with decreases in blood pressure in pre-hypertensive/hypertensive patients. Purpose: The purpose of this project was to observe how the adoption of the DASH diet and increased physical activity affected the blood pressures of pre hypertensive/hypertensive rural adults. Theoretical Framework: The Transtheoretical Model of Behavior Change (TTM) allowed for an assessment of the readiness to change and accounted for relapses. Method: Participants consisted of males/females (N=7) ages 24-78 years old with a diagnosis of pre-hypertension/hypertension. Using a qualitative design that utilized unstructured interviews and telephone follow-ups allowed the recording of information as it occurred. Results: At the conclusion of the project, 86% (n=6) of participants increased plant-based nutrition, 43% (n=3) decreased dietary saturated and 57% (n=4) increased physical activity. Forty-three percent (n=3) of participants decreased the systolic blood pressure by 8-10 mm Hg. Conclusion/Implications: This was a pilot project to assess the need/ value of conducting future detailed projects with rural populations. This project served as an indicator of the value and effectiveness of implementing educational programs concerning chronic disease and lifestyle changes in rural clinics.

]]> michel, marian Improving Advance Directive Completion Rates in the Primary Care Setting http://scholarworks.umass.edu/nursing_dnp_capstone/21 http://scholarworks.umass.edu/nursing_dnp_capstone/21 Tue, 21 May 2013 06:30:30 PDT As technology has improved and the ability to artificially prolong life has increased dramatically, so has the need to draw attention to end-of-life care issues (Duke, Thompson, & Hastie, 2007). The Federal Patient Self-Determination Act (PSDA) of 1991 first brought attention to the importance of advance directives (ADs), (Government, 1995). Increasing the focus on advance directives for adult patients in the primary care setting could assist in increasing completion rates, prior to hospitalization.

The purpose of this project was to test a model to increase AD completion rates, to provide more complete patient centered care. Many programs and interventions have been implemented since the PSDA was enacted in 1992, some have been able to increase rates; other interventions have had little impact. It has been estimated that only 5%-15% of all patients have completed ADs (Ramsaroop & Adelman, 2007). This indicates a need for programs to educate and empower patients and providers to ensure ADs are completed.

An appropriate setting to complete advance directives is in the primary care setting due to the importance of having ADs prior to hospitalization. There are multiple reasons to support this setting for a focus on advance directives completion. These include the ability to develop a strong patient-provider rapport, the length of professional relationship and the ability to have multiple patient-provider interactions over time to discuss patient wishes and to potentially complete the AD during the interaction.

]]> Donahue, Esperanza Postpartum Breastfeeding Support: Promoting Infant Health http://scholarworks.umass.edu/nursing_dnp_capstone/20 http://scholarworks.umass.edu/nursing_dnp_capstone/20 Tue, 21 May 2013 06:30:29 PDT Abstract

Health experts agree that breastfeeding provides essential nutrients to infants for optimal health. But despite the known benefits, breastfeeding rates remain low in the United States. Several strategies, including postpartum follow up phone calls and breastfeeding support groups, have been identified to improve breastfeeding rates. The problem is that postpartum follow up phone calls have been lagging for up to 3 months post discharge. The purpose of this quality improvement project was to conduct the postpartum phone calls within 10 days post discharge and to determine if the intervention increased breastfeeding rates. Methods of data collection were (1) follow-up postpartum phone call and (2) satisfaction survey. Results. A total of 25 mothers responded to the postpartum phone call, with 88% feeling good after discharge. Breastfeeding rate at discharge was 76% and 84% were breastfeeding at the time of the call. Among the breastfeeding population, 19% of the participants had already consulted a lactation consultant post discharge while 9.5% requested a referral to a lactation consultant. Discussion. Postpartum follow up phone calls assessed the condition of the mother and infant post discharge, answered questions and concerns pertaining to self-care, infant care and breastfeeding. Problems associated with postpartum depression and breastfeeding, including sore nipples and difficult latch, were identified and appropriate referrals were made.

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