- Development and Evaluation of a Web-Based Educational Toolkit on the Knowledge, Attitudes, and Practice of Psychiatric Prescribers Regarding Long-Acting Injectable Antipsychotics
- Long-acting injectable antipsychotics (LAIs) are underutilized pharmacological treatment options for those with schizophrenia. Research examining psychiatric prescribers' relationship with LAIs hypothesized that their knowledge deficits, uninformed attitudes, and poor prescribing practices contribute to the underutilization of LAIs in clinical practice. There is a gap in the literature regarding educational interventions to address psychiatric prescribers' knowledge deficits, uninformed attitudes, and poor prescribing practices. The purpose of this Doctor of Nursing Practice (DNP) research project, based on the Knowledge to Action Framework, was to develop and evaluate the impact of a web-based educational toolkit on the knowledge, attitudes,and practices of psychiatric prescribers. A seven-part web-based module that included a presentation of the created educational toolkit regarding LAIs and a before and after knowledge,attitudes, and practices questionnaire was hosted on an online-open source learning management system and disseminated to psychiatric prescribers. Findings indicated that the web-based educational toolkit slightly improved the knowledge, attitudes, and practices of psychiatric prescribers regarding LAIs. It also revealed a relationship between a positive change in attitudes and psychiatric prescribers practicing in a hospital setting. This DNP research project reflects the essentials of the DNP degree. It contributes to the body of knowledge of psychiatric nursing,created a lasting reference tool for prescribing LAIs, filled gaps in the literature regarding LAIs,supports the use of continuing web-based education and toolkits, and serves as a catalyst for other studies regarding LAIs.
- Does the Allegheny Health Network Nurse Residency Program Meet the Standards for National Accreditation by the Commission on Collegiate Nursing Education?
- A study to determine if the Allegheny Health Network Nurse Residency Program was in a sufficient state of readiness to undergo change associated with nurse residency program accreditation and at the capacity to adequately meet Commission on Collegiate Education in Nursing accreditation criteria.
- Effect of an Escape Room Teaching Intervention for New Clinical Nurses Learning About CLABSI, CAUTI, and Falls in an Acute Care Facility
- Hospital acquired conditions such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), hospital acquired pressure injury (HAPI), and falls can be very costly to the hospital and detrimental to the patient. Collectively, these avoidable conditions have been shown to impact the facilities that fail to prevent them and the patients that experience them. This research focused on the questions: Does adding an escape room simulation that covers the four quality initiative measures: CLABSI, CAUTI, HAPI, and falls, affect knowledge on prevention measures for new graduate nurses, and, what is the perception of new graduate nurses toward the escape room educational intervention? An escape room was created and participants completed a pretest, post-test and post activity survey. The study, showed that the nurses’ knowledge did improve by completing the escape room activity and the participants would like to see more educational opportunities presented in this format. Further research could include reviewing a short power point that reviews the hospitals preventative measures they have in place to reduce CAUTI, CLABSI, HAPI and falls before completing the escape room activity with staff and taking the time to review the activities with the participants that they weren’t able to complete in the allotted time.
- Evaluating the Effectiveness of an Educational Program for School Personnel with Students Returning to the Classroom Following a Traumatic Brain Injury: An Evidence Based Project
- This project provided an in-depth analysis of the effectiveness of an educational program for school personnel with students returning to the classroom following a traumatic brain injury (TBI). Through this investigation, lack of requisite TBI knowledge and strengths and weaknesses of familiarity and knowledge of TBI management were recognized. Unintentional feedback gathered during the educational intervention demonstrated students who had suffered more severe TBIs had a profound effect on educators. They recalled how the TBI not only affected the student who experienced the TBI physically, mentally and emotionally, but also how it affected their friends and their social experiences. This study supported the importance that a live interdisciplinary TBI workshop will increase school personnel's TBI knowledge. The findings of this project contributed to the evidence related to uniformity in recognizing and managing a student's cognitive, behavioral, and social functioning following a TBI when returning to the classroom setting. It also contributed to filling the paucity in literature related to uniformity in recognizing and managing a student's cognitive, behavioral, and social functioning following a TBI when returning to the classroom setting.
- Evaluating the Financial Impact of a Heart Failure Transitional Care Program
- TThe Transitional Heart Failure Program was designed to target gaps in care and decrease readmissions through comprehensive, holistic transitional care interventions. Financial data were pulled and comparatives reviewed between the 3rd quarters of 2019 and 2020 to determine correlations between financial data and improvements in care delivery. Results: Productivity data were obtained and analyzed to determine differences in volumes and work RVUs (wRVUs) for Advanced Practice Providers (APPs) designated to provide post discharge and HF care in the outpatient setting. CMS reimbursement penalties were analyzed and compared year over year, and future penalties were extrapolated based on available information. APP wRVUs were positively impacted by the program implementation and reimbursement penalties are projected to decline substantially based on readmission rate improvements.
- Identifying Adverse Outcomes From Insufficient Sleep in the Hospitalized Non-Critical Older Adult Population: A Systematic Review
- The systematic review was used to identify adverse outcomes with the inclusion criteria of non-critical, adults older than 65 years, who have experienced insufficient sleep while hospitalized for more than one night. A secondary review was completed to ensure the quality and validity of the studies reviewed, while data was reported through narrative skills.
- Improving Parental Monitoring of Social Media Behaviors to Reduce Negative Health Outcomes
- The primary aim of this study was to evaluate the effect of the social media educational intervention on change in parent knowledge of their adolescents' social media behaviors.
- An Investigation of Community Members' Knowledge and Willingness to Consider the Alternative Pay Model for Direct Primary Care, Provided by a Nurse Practitioner
- This researcher described the current Fee for Service (FPS) Model to gain information regarding Nurse Practitioner Service awareness in Pennsylvania and introduced the practice model of Direct Primary Care (DPC). The respondents provided information related to the research question of: What are community members' knowledge of alternative pay models for primary care services provided by a Nurse Practitioner? What are community members' willingness to participate in alternative pay models for primary care services rendered by a Nurse Practitioner? The research showed access problems as >70% of respondents indicated difficulty to scheduling an appointment taking more than 24 hours. It was determined that >28% of respondents found the DPC model more attractive than their current care model, an example of perceived value. This research showed scalability potential meaning other Nurse Practitioners who wish to pursue the DPC practice model in their geographical area could reproduce similar data collection efforts to learn the perception in their state or locality. It is believed that burnout associated with healthcare providers is high and DPC provides an alternative practice model to curb burnout, engage patients and heighten health outcomes while focusing efforts on a smaller practice size.
- Nurse Practitioner Wellness Clinic: Development and Strategies for Implementation
- Cardiovascular disease (CVD) is the number one killer of women. Surprisingly, only about half of women are aware of this risk. Statistically, heart disease kills about 1 in 5African American and Caucasian women. Lifestyle behavior choices such as obesity, lack of exercise, consuming an unhealthy highly processed diet, smoking, and an intake of greater than1 drink per day of alcohol increases a women’s risk for CVD. These risk factors are avoidable. These lifestyle behavior choices are modifiable and with improvements to each behavior they will decrease the women’s risk. Health and Wellness Coaching is a proven intervention to improve lifestyle behaviors that negatively impact chronic medical conditions. The development of a tailored lifestyle self-management intervention by a Nurse Practitioner in a Nurse Practitioner Wellness Clinic will address each of the lifestyle behavior choices to ultimately decrease the risk of cardiovascular disease and provide education that allows these changes to be enduring.
- Reducing Same-Day Surgical Delay & Cancellation Occurrences: A Quality Improvement Project in an Outpatient Surgery Center
- Patients presenting for surgical procedures must meet specific criteria in order to be deemed ready for surgery. Same-day surgical delays and cancellations often occur due to patients’ inability to follow preoperative instructions. The goal of this quality improvement project was to decrease the number of same-day surgical delay/cancellation occurrences due to patient nonadherence of preoperative instructions. The Institute for Healthcare Improvement’s Plan-Do-Study-Act (PDSA) Cycle was used in order to test an intervention on a smaller scale in order to determine if it leads to improvement. An evidence-based, standardized preoperative instruction pamphlet was developed and distributed to the patients across three specialties at an outpatient surgery center over a four-week time period. Surgical delay/cancellation occurrences decreased from 4.94% in the pre-intervention phase to 0.57% in the intervention phase. All same-day case cancellations during this project occurred due to patients’ nonadherence to preoperative instructions, more specifically, fasting guidelines. Evidence supports using a standardized, evidence-based, written pamphlet for delivery of preoperative instructions in successfully reducing same-day surgical cancellations. Further research is needed in preoperative instructions for patients speaking languages other than English as well as for patients who cannot read.
- Retention, Structural Empowerment, and Dialysis Nursing: Integrating Kanter's Theory and the Refined Nurse Worklife Model
- During this two-phase project, factors that dialysis nurses experience contributing to stress, retention, and the intentions of staying were examined. The theoretical frameworks of Kanter’s Theory of Structural Empowerment (KTSE) and The Refined Nurse Worklife Model (NWLM) were utilized in the creation of a learning module regarding structural empowerment. In phase one this was reviewed by an expert dialysis nurse focus group from seven different states with experience in dialysis from seven to forty years. During phase one, the expert panel gave high-frequency domain input including access to support, resources, and the need for strong leadership. The module was adjusted based on this input. In phase two this was launched in dialysis user groups. These nurses were asked to give quantitative and qualitative feedback. Phase two participants reported retention and stress factors including the need for information, on-call, education for pandemic procedures and policies, access to supplies, compensation, patient issues, ratios, racial and cultural differences, bullying, respect, favoritism, mental health support, and achievement of a sense of personal accomplishment. As a response to this information project management reflection tools for nurses and nurse leaders were formulated based on KTSE and NWLM. The learning module and tools were designed to facilitate changes that improve the work-life of dialysis nurses and the intention to stay in their specialty. Future studies should look at the outcomes of the implementation of the learning module and the use of the tools in improving the expertise of dialysis care for patients by better retention and empowerment of dialysis nurses.