Current Search:  Electronic Theses & Dissertations (x) » Doctor of Nursing Practice (DNP) Project (x)

View All Items

  • CSV Spreadsheet
(1 - 5 of 5)
A Team Approach to Comprehensive Pain Assessment in the Skilled Nursing Facility
Title
A Team Approach to Comprehensive Pain Assessment in the Skilled Nursing Facility.
Creator
Akhavan-Yazdi, Amir
Abstract / Description
Objective: The purpose of this DNP Project is to implement an evidence based-team approach pain assessment protocol in a skilled nursing facility in Southwest Florida. Significance: Untreated pain is a problem currently being faced by many older adults residing in the skilled nursing facility. The presence of this pain can lead to decreased levels of independence, functional decline of activities of daily living, depression, and anxiety. With the utilization of a team approach, the issue of...
Show moreObjective: The purpose of this DNP Project is to implement an evidence based-team approach pain assessment protocol in a skilled nursing facility in Southwest Florida. Significance: Untreated pain is a problem currently being faced by many older adults residing in the skilled nursing facility. The presence of this pain can lead to decreased levels of independence, functional decline of activities of daily living, depression, and anxiety. With the utilization of a team approach, the issue of untreated pain has a larger chance of being addressed. Methods: A DNP project based on the approach of utilizing a team approach in the skilled nursing facility was developed. A series of education presentations was conducted, and data was compared pre- and post-intervention utilizing Centers for Medicare reported Minimum Data Set 3.0. Conclusion: The need to promote the team approach to pain assessment and management in the skilled nursing facility exists. This is done by creating a team and educating them on the methods of pain assessment. Unfortunately, the results of this DNP project were unable to show significant improvement in ability to assess or manage pain by utilizing a team approach due to the limitations in data collection. Keywords: Pain assessment, pain management, skilled nursing facility, nursing home, team approach, and multidisciplinary
Show less
Date Issued
2020-04-28
Identifier
fgcu_ETD_0330
Format
Document (PDF)
Implementing an Advance Care Planning Protocol During the Medicare Annual Wellness Visit
Title
Implementing an Advance Care Planning Protocol During the Medicare Annual Wellness Visit.
Creator
Settanni, Julianne
Abstract / Description
Objective: Advance care planning discussions are not routinely done during the Medicare Annual Wellness Visit, even though there is no charge to the patient. This project implemented an advance care planning protocol at the time of the annual wellness visit. Significance: As healthcare technology increases, the reality of more people living with and ultimately dying of a chronic disease has created new challenges for patients and their healthcare providers, which require primary care...
Show moreObjective: Advance care planning discussions are not routinely done during the Medicare Annual Wellness Visit, even though there is no charge to the patient. This project implemented an advance care planning protocol at the time of the annual wellness visit. Significance: As healthcare technology increases, the reality of more people living with and ultimately dying of a chronic disease has created new challenges for patients and their healthcare providers, which require primary care providers to identify and understand patients’ wishes and values around future care and end of life. Currently, ACP is an optional component of the Medicare Annual Wellness Visit (AWV). Opportunities for discussion of ACP in the primary care setting have been identified; however, all too often, there is no conversation about ACP or the patient’s treatment wishes. Methods: An evidence-based education regarding ACP during the AWV protocol was initiated in one primary care office in Southwest Florida. Conclusion: This evidence-based protocol project demonstrates an increase in the amount of ACP discussions that occurred during AWVs with the use of the appropriate CPT code modifiers. These findings may suggest that when appropriate strategies and support for advance care planning are utilized, barriers to advance care planning in the primary care setting can be minimized.
Show less
Date Issued
2020-04-29
Identifier
fgcu_ETD_0329
Format
Document (PDF)
Obstructive Sleep Apnea: Quality Improvement Project to Identify Patients at Risk in the Primary Care Setting
Title
Obstructive Sleep Apnea: Quality Improvement Project to Identify Patients at Risk in the Primary Care Setting.
Creator
Fisheku, Orjena
Abstract / Description
Abstract Background: Obstructive Sleep Apnea (OSA) is caused by a partial or a complete blockage of the airways and is the main sleep disorder affecting patients with chronic complex conditions. Unfortunately, 82% of women and 92% of men are undiagnosed and are considered to have moderate to severe sleep apnea. Healthy People 2020 recognizes OSA as a national significance, and if not addressed, this can negatively affect one’s health and quality of life, and increase healthcare expenditures....
Show moreAbstract Background: Obstructive Sleep Apnea (OSA) is caused by a partial or a complete blockage of the airways and is the main sleep disorder affecting patients with chronic complex conditions. Unfortunately, 82% of women and 92% of men are undiagnosed and are considered to have moderate to severe sleep apnea. Healthy People 2020 recognizes OSA as a national significance, and if not addressed, this can negatively affect one’s health and quality of life, and increase healthcare expenditures. Objective: The purpose of this evidence-based project (EBP) was to screen high risk patients for OSA, by using the STOP-Bang Questionnaire, to identify variables that place patients at risk for OSA. Overall risk for OSA was determined using eight questions among 17 patients over the age of 50, who met criteria for blood pressure (BP) exceeding 140/90 mmHg, and body mass index (BMI) over 35 kg/m2. Other variables such as gender, neck circumference, snoring, feeling tired during the day, and observed stopped breathing, were evaluated to determine if they were at risk for mild, moderate, or severe risk of OSA. Results: There were 17 patients (11 males and 6 females) who met criteria and were screened for sleep apnea. Of this sample population, 12 % were classified as a moderate risk for OSA and 88% were classified as a high risk for OSA. Of the variables screened, there was a moderately strong relationship between neck circumference and sleep apnea risk (r = .49, p < .05). Conclusion: The STOP-Bang Questionnaire is a valuable tool in identifying at risk patients for OSA. Screening and assessment for OSA, in high risk patients’, needs to be a priority in the primary care setting, which should lead to earlier and more frequent detection for sleep referrals. Keywords: obstructive sleep apnea, STOP-Bang Questionnaire, blood pressure, body mass index, screening, primary care setting.
Show less
Date Issued
2020-04-27
Identifier
fgcu_ETD_0332
Format
Document (PDF)
The Healthy Eating and Activity Responsibility Training (HEART) Program
Title
The Healthy Eating and Activity Responsibility Training (HEART) Program.
Creator
Dean, Abbey, Marieb College of Health & Human Services
Abstract / Description
Background: The United States is facing an obesity epidemic as the number of individuals who are overweight and obese continues to rise, with nearly 40% of adults considered obese and approximately 93.3 million individuals affected by obesity. An epidemic of overweight and obesity exists in the young adult population, particularly college students, as they are exposed to common obesity risk factors including poor nutrition and lack of physical activity. Alarmingly, one in three college...
Show moreBackground: The United States is facing an obesity epidemic as the number of individuals who are overweight and obese continues to rise, with nearly 40% of adults considered obese and approximately 93.3 million individuals affected by obesity. An epidemic of overweight and obesity exists in the young adult population, particularly college students, as they are exposed to common obesity risk factors including poor nutrition and lack of physical activity. Alarmingly, one in three college students are overweight or obese, with an average weight gain of four to eight pounds during their first semester of college. Problem: The PICO question guiding this project was: In freshmen college students, how does an evidence-based, health promotion program The Healthy Eating and Activity Responsibility Training (HEART), compared to no intervention, affect the nutrition and physical activity behaviors, weight, and body mass index (BMI) of freshmen students during the first semester in college? Methods: The HEART program was a blended learning nutritional program for select college freshmen at a university in southwest Florida. Pre-and post-questionnaire data were obtained to compare effectiveness of the program. Intervention: There were 91 participants in the HEART program and 61 students in the usual group. However, only 44 questionnaires from the intervention group, and 9 questionnaires from the usual group, were included in the data analysis as these participants correctly provided their unique identifier to compare pre-and post-results. Results: Females in the intervention group lost an average of five pounds compared to the average weight gain of females in the usual group of 17 pounds. Males in the intervention group gained an average of two pounds, whereas males in the usual group lost an average of two pounds. Additionally, students reported increased ability to identify select foods high in fiber (bananas p < .014), added sugar (tomato Ketchup p < .017), and added salt (cereal p < .001). Conclusion: Participants in the HEART program had less weight gain compared to those in the usual group. Females appeared to be more likely to decrease their weight compared to males. Additionally, participants in the HEART program revealed improved awareness and recognition of foods high in fiber, added salt, and added sugar.
Show less
Date Issued
2020-05-03
Identifier
fgcu_ETD_0333
Format
Document (PDF)
The Importance of Screening and Early Identification of Depression in College Students
Title
The Importance of Screening and Early Identification of Depression in College Students.
Creator
Nino, Elizabeth, Marieb College of Health & Human Services
Abstract / Description
Abstract Background: The prevalence of depression among college students has significantly increased in the past decade. Depression is twice as common among college students than compared to the general population. Without early identification and treatment of depression, it can negatively impact important outcomes such as social connectedness, academic performance, academic retention, and future economic productivity. Objective: Early identification and depression screening should be a...
Show moreAbstract Background: The prevalence of depression among college students has significantly increased in the past decade. Depression is twice as common among college students than compared to the general population. Without early identification and treatment of depression, it can negatively impact important outcomes such as social connectedness, academic performance, academic retention, and future economic productivity. Objective: Early identification and depression screening should be a priority among the college population. The purpose of this quality improvement project was to develop an evidence-based Depression Screening Protocol for an identified college health center utilizing the patient health questionnaire-2 (PHQ-2) and the patient health questionnaire-9 (PHQ-9) integrated in the electronic medical record. Various meetings with the healthcare providers, directors, and staff were held to share rationale for the development of the depression screening protocol and helped to identify the questions and concerns regarding implementation of the Depression Screening protocol. Results: Of the college students receiving health services at the identified college health center, a total of 1,741 college students were screened for depression, 1,719 students completed the PHQ-2, 22 students completed the PHQ-9, and 13 students were referred to counseling and psychological services. Conclusion: The Doctor of Nursing Practice (DNP) project demonstrated that the implementation of an evidence-based Depression Screening Protocol at a college health center was manageable and sustainable. This quality improvement project was successfully integrated into the identified health college center and it improved early identification of depression among college students.
Show less
Date Issued
2020-04-28
Identifier
fgcu_ETD_0331
Format
Document (PDF)