Doctor of Nursing Practice (DNP) Projects

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https://hdl.handle.net/20.500.14394/414

Now showing 1 - 5 of 347

Evaluating Health-Related Quality of Life for People with Multiple Sclerosis: A Quality Improvement Project to Promote Peer Support
(2017-01-01) Caron, Nicole
Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system, resulting in symptoms of fatigue, numbness, tingling, weakness, dizziness, pain, spasticity, gait disturbance, and depression. How individuals cope with MS may shape adjustment, impacting health outcomes both physically and psychologically. The difficulties that MS may present can result in patients experiencing depression and decreased quality of life. Peer support has been shown to help reduce problematic health behaviors and depression, and to improve medication behavior adherence. While peer support is known to be beneficial in many types of chronic illness, it is unclear whether peer support is beneficial for people with MS. Purpose: The purpose of this DNP project was to execute peer support interventions to evaluate how peer support may impact health-related quality of life (HRQOL) in people living with MS. Methods: Peer support groups were held once a week for six weeks for participants who are living with MS. Participants completed questionnaires before the first peer support group, and then at 3, 6, and 9-weeks, using quality of life as an outcome measure to evaluate the effectiveness of this peer support program. Results: Health-related quality of life was not consistent in participants during the peer support sessions. Conclusion: People with MS have symptoms and circumstances that vary on a daily basis, and this can impact their health-related quality of life.
Hypertension: Enhancing Lifestyle Management Through Patient Education and Pender’s Health Promotion Model
(2017-01-01) Holcomb, Katherine
Background: Uncontrolled hypertension is a significant problem in the United States with 46% of hypertensive adults not achieving adequate blood pressure control. Inadequately treated HTN results in increased risk of renal disease, cardiovascular disease, and associated mortality. Interventions aimed at improving blood pressure control have targeted providers, patients, or a combination of providers and patients. Methods: The objective of this project was to enhance lifestyle management of patients with uncontrolled hypertension as measured by patient self-report in post-discharge interviews. The intervention incorporated education for patients on lifestyle management recommendations for hypertension as well as health promotion strategies inspired by Nola Pender’s Health Promotion Model. Patients chose a goal behavior and collaborated with this DNP student to identify facilitating factors and barriers to achieve these goals utilizing a health promotion worksheet. This intervention also targeted planning strategies by providers and facilitated the development of patient-specific care plans. This DNP project was conducted on two inpatient medical/surgical units outside of Boston, MA. Results: This intervention was completed with a convenience sample of 20 patients. Outcomes, as measured by patient self-report using a Likert scale, revealed that 11 patients always completed the goal behavior (55%), 4 patients sometimes completed the goal behavior (20%) and 3 patients reported never achieving their goal behavior (15%); the outcomes of 2 patients were unknown (10%). Discussion: Although there are several limitations to be considered this intervention shows promise in enhancing lifestyle management of patients with uncontrolled hypertension.
Improving Overall Health Outcomes through Public Health Workforce Development
(2017-01-01) Blackwell, Zienna
Poor health outcomes among South Carolinians, indicated by an overall U.S. health ranking of 42 (America's Health Rankings, 2016) may be the result of an underdeveloped public health workforce. This can be mediated through a thorough assessment of the public health workforce followed by the implementation of a workforce development plan. The purpose of this quality improvement project was to assess the competency level of the South Carolina public health workforce and to develop, implement, and evaluate a workforce development plan to address the weaknesses identified through the assessment process. The Competency Assessment for Public Health Professionals developed by the Council on Linkages between Academia and Public Health Practice was used to assess the competency level of the six Midlands Region Program Managers within the eight domains of the instrument: 1) Analytical/Assessment, 2) Policy Development/Program Planning, 3) Communication, 4) Cultural Competency, 5) Community Dimensions of Practice, 6) Public Health Sciences, 7) Financial Planning and Management, and 8) Leadership and Systems Thinking. Training was developed based on the composite assessment scores for all program managers and was prioritized by the areas with the lowest scores. Pre and post test and focus group findings were used to measure the effectiveness of specific training focused on the Public Health Sciences domain of the Core Competency Assessment tool. Keywords: public health workforce development, health outcomes, public health competency assessment
The Impact of Spinal Manipulation Therapy (SMT) for Nonspecific Low Back Pain in the Military Population: An Integrative Review with Presentation of the SMT Toolkit to Primary Care Providers
(2017-01-01) Ress, Kelsey
Background: Nonspecific Low Back Pain (NLBP) continues to be a frequent cause for medical care and creates significant direct and indirect costs for the patient and healthcare system. Military members are a unique patient population that is at increased risk for experiencing NLBP. Evidence supports spinal manipulation therapy (SMT) for the treatment of NLBP and clinical practice guidelines (CPG) recommend the use of SMT in the treatment of NLBP. Purpose: The purpose of this integrative review was to determine if SMT is an effective intervention for the military population experiencing NLBP. Presentation and Toolkit: An educational presentation and SMT Toolkit were created, formally presented, and distributed to providers that treat and manage active duty military. The SMT Toolkit is a comprehensive yet consolidated practice guide that includes current evidence, the CPG, local SMT referral options and criteria, provider resources, and patient education information. The DNP student created the SMT algorithm and patient education handout, which are embedded within the toolkit. Outcomes/Discussion: Based on the project’s outcomes, ultimately the integrative review with educational presentation, and SMT Toolkit succeeded in increasing providers’ knowledge and awareness and influenced their practice behaviors. Conclusion: The need to determine the most beneficial, conservative, and cost effective treatment options for NLBP like SMT is more important than ever. Users would benefit from using this DNP project, either through utilization in patient care, replication, or expanding further in a similiar quality improvement project. Future investigators should consider factors that improve utilization and sustainment of practice toolkits.
An Evaluation of the Feasibility of Implementing the National Institute of Children’s Health Quality (NICHQ) Physical Activity and Nutrition Survey in Pediatric Primary Care
(2017-01-01) Greene, Candice
Pediatric obesity is a growing problem in the United States of America causing both immediate and long-term health implications including: cardiovascular disease, diabetes, bone and joint problems, sleep apnea, and social and psychological problems (Centers for Disease Control and Prevention, 2015). The purpose of this quality improvement project is to implement and evaluate an evidence-based screening tool for identifying modifiable risk factors for childhood obesity in children in a pediatric primary care office. The National Institute for Children’s Health Quality (NICHQ) Physical Activity and Nutrition Survey (Appendix A) was administered to 25 pediatric patients ages 2-18 presenting to their primary care office for a well care visit. The evaluation of this project was based on identifying risk factors, ease of use, and usefulness and feasibility. The implementation of the NICHQ Physical Activity and Nutrition Survey was found to be both useful and feasible at primary care well child visits. Risk factors for obesity were identified, patients and families found the survey easy to complete, and providers found the survey to be helpful in starting conversations with families about healthy activity and nutrition. In future practice a survey such as the NICHQ Physical Activity and Nutrition Survey can be used to help identify modifiable risk factors for pediatric obesity and as a catalyst for meaningful conversations about activity and nutrition. Through screening and education pediatric obesity can be prevented.

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