Nursing (Doctor of Nursing Practice)

A social-learning group was used to train caregivers of school-age augmentative and alternative communication (AAC) users. Training was aimed at the caregiver of emergent AAC users and occurred in the home and community settings using a modeling strategy. Instruction was primarily delivered in three 15-minute training sessions using Facebook. In addition to social media instruction, the caregiver-child teams met with other participants to practice and implement newly learned skills during community activities. Meetings were approximately 1-hour in length and included coaching and feedback. A single subject AB design was used to evaluate the effects of community instruction on caregiver AAC modeling. Frequency of caregiver modeling is the dependent variable measured by direct observation. Module development utilized behavior skills training techniques consisting of (a) instruction (b) modeling (c) practice (d) feedback and coaching in the community setting.

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 5 African 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 than 1 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.

Surgical site infections (SSI’s) are a major concern for patients, providers, and healthcare organizations worldwide. SSI’s remain the costliest and most common of all hospital-acquired infections (HAI’s) (Septimus, 2019). It is estimated that SSI’s occur in 2 percent to 5 percent of all patients undergoing surgery, translating to 160,000 to 300,000 people annually at a cost of $3.5 to $10 billion (Ban et al., 2017). An SSI substantially increases morbidity and mortality as patients are twice as likely to die, are 60% more likely to be admitted to the
intensive care unit (ICU), and the readmission rate is five times higher than patients who do not have a hospital-acquired SSI (Darouiche, 2019).

Did the intervention of preoperative nasal decolonization using the Profend Nasal Decolonization Kit, 10% povidone-iodine (PVP-I), reduce surgical site infections in patients undergoing an orthopedic surgery with implantation, to include total joint arthroplasty (TJA) and an orthopedic fracture repair, in a 12-month period preintervention compared to a 12-month period post-intervention?

Background: Substance use disorders have increased in the U.S. in the past 20 years, with opioid abuse causing over 70,000 deaths from 1999 to 2019. The growing public health problem necessitates developing a patient-centered educational toolkit. Patients on benzodiazepines who are at increased risk of morbidity and mortality are not engaged in their benzodiazepine management and need a specific educational tool to provide the necessary knowledge for medication management. In addition, there is currently no patient education to improve benzodiazepine safety or evidence-based program to enhance the partnership between the prescriber and the patient in many offices. Method/Design: The investigator developed an evidence-based patient education toolkit to enhance patients' knowledge about the safe use of Benzodiazepines and the risks of chronic Benzodiazepine use. Forty-one participants completed a voluntary pre, and post-survey focused on benzodiazepine-related knowledge and willingness to decrease or cease use. This improvement project aimed to (i) educate and improve the patients' understanding of safe Benzodiazepine use. (ii) Increase patient's readiness to decrease or ease long-term Benzodiazepine use. Participants: A convenient sample of 41 patients prescribed benzodiazepines at the behavioral health clinic was selected. Results: Results of linear regression indicated that patients improved their knowledge regarding safe benzodiazepine use after using the patient-centered toolkit. However, no statistically significant changes were observed in patient willingness to decrease or cease benzodiazepine use. Conclusion: The patient-centered toolkit is useful in improving patient knowledge regarding safe usage of benzodiazepines. However, the toolkit was not beneficial in changing the patients’ willingness to cease or decrease benzodiazepine usage. Nevertheless, findings are helpful in nursing practice and should be used to inform current practice. Future investigators should improve the toolkit by completing projects focused on how the toolkit can be made more effective or used in more focused interventions.

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., Copyrights are retained by the author. Please contact Neal Garverick for further use of this material.

Can seniors learn what is included in an AWV through an educational presentation, thus leading to an increase in participation and possible improving of overall health? This study aims to investigate if an educational presentation will be effective in increasing the knowledge of an AWV for senior citizens through a pre and post-test. The pre- test and post test will assess their level of knowledge. It will be a quantitative study using a 10 question survey. The seniors will take the survey once before the presentation and then again after the presentation. The participants will be using a Likert scale to rate the importance of a variety of questions that are included in an AWV. Participants over the age of 65 will be eligible for the study, regardless of sex, gender, religious affiliation, or cultural background.

Breast cancer affects people all ages, genders, and races. The ways in which providers prevent and detect breast cancer have change significantly over the years. Healthcare providers have a number of resources to utilize to screen patients for breast cancer appropriately. However, providers do not always follow the guidelines that are recommended likely due to lack of knowledge. The purpose of this evidence-based quality improvement project was to increase healthcare provider knowledge about current breast cancer screening guidelines and recommendations. In August of 2024 over a two-week period, healthcare providers at a federally qualified health center look-alike were asked to participate in an evidence-based quality improvement project concerning breast cancer screening guidelines. Participants completed a pretest and posttest questionnaire to measure if there was an increase in knowledge after completing the presentation. Fifteen participants completed both the pretest and posttest. A paired-samples t-test was utilized to analyze data which resulted in a statistically significant finding. These results conclude that a breast cancer screening guidelines presentation helps to increase provider knowledge.

Cardiac arrest is a global issue. Research has been done over the years to create the golden standard within the American Heart Association (AHA) that chest compressions matter. The research now is advancing beyond just the quality aspect. The new knowledge of the quality has led more researchers into the specific timing which is known as the ratio of chest compression fraction (CCF) time. The initiative behind the implementation of this project was to address the problem that the institution did not have any means of measuring either the quality of manual compressions or the CCF. CCF is the time doing compressions divided by the overall time of the cardiopulmonary resuscitation event.

Education was provided to staff on ways to reduce interruption: pre-charge defibrillator, establish pulse prior to holding compression and hoover over the chest for next compressor on the opposite side of the patient. In addition to education on current protocols, a manual compression feedback device was used to monitor real-time feedback. Quality improvement implementation of the measurement of CCF. Data was collected by using a manual feedback device. Reviewing the quality % of compressions. Data was collected for baseline, then post-implementation of education regarding the importance of measuring CCF.

Data were compared for pre and post-intervention, by reviewing overall patient outcomes and looking at the 30-day post resuscitation mark. The post-intervention data included 10 patients. Six of the patients had CCF greater than 80%, Four events used the manual compression feedback device, and two with the mechanical compression device. Four patients had a return of spontaneous circulation at the time of the resuscitation event. However, there were zero survival patients at the 30-day post-resuscitation mark. The data had no difference between the pre and post-interventions for the 30-day survival rate.

Clinical inertia is the failure to initiate or intensify treatment in a timely manner in people with type-2 diabetes mellitus (T2DM) in primary care (PC) where collaborative care can be an approach to overcome inertia. Diabetes care network (DCN) is a telehealth based collaborative care model to address clinical inertia in the PC environment. In DCN, initial care was delivered via E-Consult by hub diabetes team for Veterans with A1c of 9% or higher and the longitudinal collaborative care delivered by PC liaison with weekly team huddle. To study the difference in the clinical outcomes with DCN vs PC practices, we compared the DCN cohort (97.7% male, 90.8% white, with a mean age 67.2 (8.9), with a PC cohort (100% male, 94.9% white, mean age: 68 year (10.5), with A1C >9%). Methods: Means (SD), frequencies. and percentages were presented. The DCN cohort had a significant decline in the baseline A1C of 10.2% (1.4), to 8.1% (0.99), 7.6% (0.96), 7.5 % (0.86) at 3, 6, and 12 months while A1c in PC cohort stayed poor with baseline A1C of 10.1% (0.89), to 10.2% (1.69), 9.7% (1.74) and, 9.5% (1.83) at 3, 6, and 12 months. Patients who achieved A1c less than 8% in DCN cohort were 38 (43.6%), 56 (64%), and 56 (64%) at 3, 6, and 12 months and were 1(1.7%), 5(8.5%), and 6(10.2%) at 3, 6, and 12 months in PC cohort. An A1c of less than 7% was achieved in DCN cohort in 10 (11.4%), 21 (24.1%), and 23 (26.4%) patients at 3, 6, and 12 months and only 1(1.7%), 0(0%), and 0(0%) patients achieved A1c less than 7% at 3, 6, and 12 months in PC cohort. Our study shows participation in the DCN telehealth program for 1 year was associated with significant improvement in A1c. This improvement was not seen within the PC with traditional care practices. Thus, addressing clinical inertia in PC will need a paradigm shift in current practices. The proposed collaborative approach of DCN can overcome clinical inertia in PC and improve care for people with T2D by supporting PC access to specialty care expertise, decreasing the burden of diabetes care for patients and PC providers.

Compassion fatigue, also known as secondary traumatic stress disorder, results from repeated exposure to the suffering of others, eventually exhausting his or her ability to show compassion. Self-care has been suggested as a potential preventative or treatment strategy in compassion fatigue however there has been limited documentation to validate this relationship. This study utilized a non-experimental, descriptive correlational design in order to determine if EMS professionals in Northwestern Pennsylvania, who practice self-care, experience less compassion fatigue than those who do not. A survey which was comprised of The Professional Quality of Life (ProQOL) scale, a validated tool for assessing compassion fatigue by evaluating secondary traumatic stress, burnout, and compassion satisfaction, as well as the Health Promotion Lifestyle Profile (HPLP) II, a tool to evaluate health promotion/self-care, was completed by 164 EMS professionals in Northwestern Pennsylvania. Spearman’s rank correlation coefficient was utilized to determine the relationship between self-care and compassion fatigue. The results demonstrated a negative correlation between self-care and burnout (p<.000), a negative correlation between self-care and secondary traumatic stress (p<.000), and a positive correlation between self-care and compassion satisfaction (p<.000), suggesting lower levels of compassion fatigue in those who practice self-care. These findings suggest that the implementation of self-care may result in decreased compassion fatigue, improving the EMS professional’s quality of life as well as patient outcomes.

During the COVID-19 outbreak in the spring of 2020, the nursing department responsible for facility-wide heart failure (HF) interdisciplinary communication was disbanded and redirected to other hospital needs. With that change and the subsequent lack of cohesive educational efforts, the hospital readmission rate climbed to 29.85%. This hospital system has consistently had readmission rates greater than the Centers for Medicare & Medicaid Services (CMS) national benchmark of 21.9%, which is both detrimental to our patients and the hospital to incur readmission penalties yearly. Before this program began there was no process to transition care from inpatient to outpatient for the HF population; key members that touched HF patients operated in silos. Based on consistently high readmission rates and the need for improved outcomes, a comprehensive HF discharge program was designed and implemented house-wide. Transitional care coordination includes providing education, scheduling post-discharge follow-up appointments, and providing HF toolkits. There was a retrospective analysis of data three months after the implementation of QI initiatives. Our facility’s all-cause 30-day readmission rate has progressively declined by 7.63% since the HF transitional program’s implementation (Study period 25.37% down to 17.74%). Readmission average rate for 2019 was 24.9% (n=241) (July 6-September 30, 2019) and compared to after implementation in 2020 was 22.56% (n=195) (July 6-September 30, 2020). Overall, we have found having an advanced practice provider (APP) led multi-disciplinary program to be the best practice for the HF population while improving outcomes and the ability for self-care while decreasing 30-day readmission.

Urinary tract infections (UTIs) are the most commonly treated infection among nursing home residents; patients are commonly treated even in the absence of signs or symptoms of a UTI being present. This research study’s objective is to reduce the amount of unnecessary antibiotic prescribing and assess the impact of educational interventions in nursing home residents that have asymptomatic bacteriuria (ASB). The design of this research study is quasi-experimental. The setting is Butler Memorial Hospital, a non-profit organization and an independent community hospital with 296 beds located in rural Pennsylvania. Population of interest includes nursing home residents that present to Butler Memorial Hospital’s Emergency Department with consecutive positive urine cultures. A multifaceted educational intervention will be provided to Emergency Department staff to reduce the number of unnecessary antibiotic prescribing in ASB cases. There were 105 in the sample population that resided in an institutional facility for the elderly that were seen in Butler Health System’s Emergency Department. Out of the DEFERRING ANTIBIOTIC PRESCRIBING IN NURSING HOME RESIDENTS WITH ASYMPTOMATIC BACTERIURIA 4 105-sample population, 73 were encountered before educational intervention. Twelve out of the 73 pre-educational sample population met the study’s inclusion criteria. Out of the 105 sample population, 32 were encountered after educational intervention. 4 out of the 32 post-educational sample population met the study’s inclusion criteria. In conclusion, this pilot study showed that there was a 3.9 percent overall reduction in nursing home residents that were being inappropriately diagnosed with a UTI and placed on unnecessary antibiotics when in fact they had ASB and met the criteria to defer prescription. While this was a small change the potential for changing prescribing habits with educational programs is encouraging and more studies should be done with larger samples sizes.

Background: According to the Centers for Disease Control, (CDC, 2018) at least thirty percent of outpatient antibiotics are unnecessary. A retrospective 2018 study by Incze, M.A., Redberg, R.F. and Katz, M. found forty nine percent of antibiotic prescriptions in the urgent care setting were for inappropriate diagnosis. The aim of this study was to educate providers on one method of reducing antibiotic prescriptions and incorporate new patient instructions into the electronic health record. Participants included physicians associates and nurse practitioners.
Methods: The Quality improvement approach of Plan Do Study Act was utilized for this project. A literature review was completed to study methods of antibiotic stewardship. The electronic health record system was queried for delayed prescribing discharge instructions. Informal discussions among providers revealed absence of a cohesive approach to reducing unnecessary prescriptions for antibiotics.

Interventions: A PowerPoint was emailed to all providers on the use of delayed prescribing for antibiotics along with a Likert-Scale survey on provider perceptions of implementation. New instructions for patients on delayed prescribing of antibiotics was added to the existing electronic health record system. For a period of 30 days the number of times delayed prescribing instructions sheets were printed for patients was monitored along with the number of patients seen at each location. The provider survey was also reviewed.

Results: Provider survey demonstrated favorable attitudes toward antibiotic stewardship. The delayed prescribing instruction set was utilized twenty-seven times over the thirty-day period. There were 2,579 patient encounters during the study for a 0.9% utilization rate.

Conclusions: This was a new process in the clinic where the study was completed and though the utilization was low there was favorable consensus among providers on the value of antibiotic stewardship. There are many opportunities going forward including tracking diagnosis codes along with antibiotic prescriptions and following up to determine how many delayed prescriptions were filled. This research can provide a starting point for any outpatient facility looking to decrease rates of antibiotic prescribing.

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.

Patients who are receiving comfort-directed care at the end of their lives will be cared for by nurses throughout their hospital stay. Providing bedside end-of-life care requires specialty assessment, communication, and intervention skills. Nurses who provide bedside end-of-life care in the acute care setting may not receive specialty palliative care training as part of their undergraduate education. To address this an educational curriculum was designed by members of the Palliative Care team and a Palliative Superuser training program was developed. Guided by the Comfort ALways Matters (CALM) framework the course focused on specialized assessment and symptom management, holistic approaches to patients and their caregivers, and communication instruction. Course description is a four-hour workshop presented by certified registered nurse practitioners from the inpatient palliative care team. Nurses who complete the superuser training will act as mentors to their peers and will continue to receive educational updates every two months. A goal of training ten percent of nurses in the acute hospital setting was set. Individual class size is limited to 10 attendees to facilitate small group discussion. Program availability was advertised by email and flyer to the managers of all inpatient units. Nurses who expressed interest and volunteered to attend were chosen by their managers and enrolled in the class. Pre- and post- testing of nurses who volunteered for the training revealed improvement in knowledge, confidence, and comfort in providing end of life care after completing the initial training session. Early positive results of the QI initiative suggested that ongoing training will be valuable to the institution and the patients.

Background: The problem of interest is focusing on an increase for education within the forensic interviewing process for individuals within the multidisciplinary team and community stakeholders. The PICO question is: Does the development of an assessment tool kit for the child forensic interviewing process increase knowledge of qualified observations evidence by the multidisciplinary team and stakeholders. The Theoretical foundation for this research will aim to develop and present a toolkit that will enhance and positively affect the knowledge and practices of the forensic interview, based on the Iowa Method of Evidence-Based Practice and a Knowledge-to-Action structure.

Methods: Methods utilized a pre-survey, presentation, and post-survey; which entailed an example of setting the stage introduction, rapport, encouraged narrative, facilitators, interview instructions, narrative practices, and follow-up questioning. The analysis of the forensic interview consisted of a model structure in which the multidisciplinary team was given a pre-survey questioning acquired knowledge from previous education, a presentation entailing a structured conversation with a child intended to elicit detailed information about a possible event or events that the child has experienced or witnessed, and a post-survey that measured knowledge gained.

Results, conclusion, implications, and recommendations: The scholarly project gathered information through the pre/post surveys focusing on assessing the information interviewers typically review prior to conducting the forensic interview. The surveys revealed a lack of uniformity within the protocols and the preparation practice, as well as the observational viewers. Summary of data collected, there were limitations to the results which stemmed from a lag in the post survey sent out, as well as a decrease in response from the attendees. In conclusion, there was evidence of learning, which was observed through the results obtained.

The Pearson correlation was used with the result sought after to determine if there was a linear relationship between two quantitative variables, whether a positive or negative correlation. In this scholarly study, the variables were the pre and post survey measuring gain of knowledge by participants. Each question results were reviewed as data to the survey response, with a total of ten questions; both pre and post survey. The pre-survey there were 19 responses. The post-survey resulted in nine out of nineteen responses. Four questions had no statistical significance, however, the remaining questions relating to rapport with the child, impartial attitude, ground rules of the interview, appropriate process, open-ended questioning, and a value with discoverable evidence demonstrated a statistical significance.

This study evaluates the impact of training on providers’ confidence about using the MinuteClinic (MC) hypertension (HTN) guideline to conduct HTN management visits in MC. MC providers who participated or did not participate in the training/webex education sessions provided prior to the commencement of HTN chronic care services were surveyed and their confidence scores measured. T-test analysis did not show any statistically significant difference between the Trained group and the Non-Trained group. Factors enabling the lack of significant difference between the two groups and suggestions for further studies are discussed.

Nurse residency programs (NRPs) have been instrumental in assisting to bridge the theory-to-practice gap commonly experienced by new graduate nurses (NGNs). NRPs have also proven useful in improving retention, work satisfaction, confidence, and competence (Spector, et al., 2017; Ulrich, et al., 2010; Rosenfeld, & Glassman, 2016). Despite the overwhelming literature to support implementation of NRPs in all hospitals, to date, in the United States, only 31 hospital sponsored NRPs are accredited by the Commission on Collegiate Education in Nursing (CCNE) (AACN, 2019). Currently, public documentation on the number of NRPs accredited by the American Nurses Credentialing Center (ANCC) are unavailable. Additionally, in Pennsylvania, only 2 hospital sponsored NRPs have obtained national accreditation. NRP accreditation holds health care organizations accountable and proves these programs have demonstrated quality. For an organization to undergo a significant change initiative, such as accreditation, a state of readiness must be present or created (Franquiz & Seckman, 2015).

Human Papillomavirus (HPV) is the most common sexually transmitted infection causing cervical, oropharyngeal cancers and genital warts. In the United States (U.S.), it is estimated that one in four individuals are infected, with an additional 14 million new cases of HPV infections occurring annually. HPV contributes to 17,600 cancers in women and 9,300 cancers in men annually. HPV vaccine is the most effective way to protect against HPV related cancers. However, there is a lag in HPV vaccination due to barriers such as: health care providers hesitancy to promote the HPV vaccine, low baseline knowledge of HPV and HPV vaccine, safety concerns, cost and system barriers. Studies show that there is low overall knowledge of baseline HPV and HPV vaccine among college students. The purpose of this study is to determine if an educational video intervention increases baseline knowledge of HPV and HPV vaccine in the attendees on a college campus in Northwestern Pennsylvania. To test this, a study design consisting of an educational session that utilizes an HPV educational video, followed by a brief question and answer session was developed. A questionnaire is implemented pre- and post-intervention to analyze HPV knowledge in participants. There were 22 participants who completed the study. Comparison analysis between the pre- and post-knowledge assessments show statistically significant improvement of results after viewing the educational documentary on HPV. The likelihood of getting a perfect score on the assessment increased by 13.7%, equating to a 70 percent reduction of incorrect answers from viewing the educational video.

This study examined whether use of an electronic medical record (EMR) to prompt screening of eating disorder risk among a college female population improved identification of risk for the disease. Data were obtained via a convenience sample of patients accessing a university health service gynecology clinic. The SCOFF tool is a well-validated 5-item questionnaire with sensitivity of up to 87.5% and specificity of 95% for bulimia nervosa and anorexia nervosa. Clinicians were prompted by EMR to administer the tool to all gynecology patients seeking care not related to eating disorder symptoms. A comparison of positive identification of eating disorder risk from the previous year, during the same time frame when EMR prompt was not embedded, was conducted via an EMR data search. Results show a relationship between eating disorder risk identification and EMR prompt (p = .0047). The study concludes that ease of use of the SCOFF tool combined with the EMR prompt improves screening for eating disorders in the college health setting.

Background: Hypertension, or high blood pressure, is a chronic medical condition characterized by elevated blood pressure levels persistently exceeding the normal range. Hypertension is a crucial public concern and the leading cause of kidney disease and cardiovascular diseases, including heart attacks and strokes, and is the most frequent diagnosis seen in medical treatment in the US and worldwide. Adequate education, lifestyle modifications including physical activity, heart-healthy diets, and medication adherence are essential for patients with high blood pressure to be able to manage their disease and live with the best quality of life. Many studies have indicated the effectiveness of educational programs in reducing blood pressure and improving the health status of patients with hypertension.

Aims and Objectives: The purpose of this evaluation is to determine whether a formal single hypertension educational program will improve knowledge of management, increase motivation to change health behavior, and improve and promote medication adherence among the senior population.

Design: A pre-test and post-test study were conducted.

Methods: In this evidence-based education program, 33 older adult patients were recruited from the senior citizen community-based center in Philadelphia, PA. The intervention included education focused on improving knowledge of blood pressure, lifestyle changes, medication adherence, and motivation for behavior change. Outcomes were measured utilizing The Hill-Bone Compliance to High Blood Pressure Therapy Scale (HB-Scale) and Hypertension Knowledge Test (HKT), a 12-item National Heart Lung & Blood Institute questionnaire.

Results: The program showed promising results that have positive implications for future practice and research. Of the participants that completed the study (N=33) of African descent, 27.7% were of Caucasian descent, 72.3%, 60.61 % were women, and 39.39% were men. The data collected reflected the participants' intentions regarding disease knowledge, medication adherence, and behaviors pre- and post-intervention. Findings suggest that community-based tailored education programs can successfully produce better HTN management by increasing hypertension knowledge, improving adherence to treatment regimens, and encouraging lifestyle changes among senior adult populations.

Conclusion: This educational intervention successfully identified improvement in senior adults' knowledge and increased motivation to change their blood pressure management health behaviors, leading to improved blood pressure control. It is hoped these results will be more widely used. Further investigation and future research would be more effective in meeting these goals in later programs to gain a more in-depth understanding of managing hypertension among senior adult communities.

In the United States, childbirth represents a significant reason for hospitalizations among reproductive women. There is potential for postpartum complications that may require the mother to go back to the hospital for needed treatment after discharge. Early postpartum interventions have shown promise in reducing the rates of readmission. One such intervention is to conduct a discharge phone call to support the transition from frequent prenatal visits and hospital stay monitoring to home. The discharge phone calls present an opportunity to enhance patient education and care, which could potentially lower readmission rates. Early recognition and interventions have proven to improve overall morbidity and mortality for postpartum women. This program evaluation assessed whether implementing discharge phone calls within seven days would reduce the 30-day all-cause readmission rate among postpartum women aged 18 years and older at a tertiary care hospital. A quasi-experimental, pre-post design compared data collected from March 2023 to August 2023 with data from March 2024 to August 2024. Retrospective chart reviews were utilized to capture readmission data and related variables. Discharge phone call data was collected using the healthcare system network standard discharge phone call form. The findings suggest that timely discharge phone calls can enhance post-discharge care by addressing patient concerns and reducing the likelihood of readmission.

Alcohol Use Disorder (AUD) is a chronic medical condition characterized by an impaired ability to control or stop the use of alcohol, despite the adverse social, occupational, and health consequences (APA, 2013; Witkiewicz, Litten & Leggio, 2019). The purpose of this study was to identify the presence of stigma and perceived negative attitudes of nurses working with patients diagnosed with AUD in all areas of practice, with the aim of decreasing stigma and enhancing positive attitudes in nurses caring for patients with AUD through an educational intervention. The literature is well established that nurses feel unprepared educationally to care for patients with AUD, and also hold negative attitudes and perceptions of working with patients with AUD (Haskins, et. al, 2014). This research will conduct a pre-and post-survey of registered nurses’ attitudes and perceived stigma followed by an educational intervention to evaluate whether the education is a positive critical element that can help to reduce stigma and improve negative attitudes nurses may hold toward caring for patients with AUD. This research is a quality improvement project to collect and use data that is meant to drive change that has practice and policy changing implications. The Seaman-Mannello Survey was used as a pre-and post-survey to measure the efficacy of the interventional education video. A convenience sampling of 76 registered nurses from three Northwestern Pennsylvania hospitals was used. The goal of this research study was to investigate the effectiveness of an educational intervention that, if significantly effective, can be used on a larger scale to decrease stigma and improve attitudes of nurses toward patients with AUD. The results found no significant relationship between the provided educational intervention and reduced stigma or improved attitudes of nurses while working with patients with AUD. Although a positive relationship could not be established, it was inferred from the pre-and post-survey scores, ongoing education is still needed and may impact the care of individuals with AUD.

Heart failure (HF) readmissions are incredibly burdensome to hospitals across the country. In 2020, approximately $563 million in penalties from the Center for Medicaid and Medicare Services (CMS) were assigned based on higher than average admission rates (Allen, 2019) with a significant portion related to HF. Our facility has consistently had readmission rates higher than the CMS national benchmark. This is both detrimental to our patients and the cause of assessed yearly CMS reimbursement penalties, which significantly impacts payment for care delivered. There has historically been a very incomplete and disjointed care transition post-discharge for our HF population.

Research has supported health literacy as one of the determinants in diabetes management (Fang et al., 2020; Kim & Utz, 2019; Robatsarpooshi et al., 2020; Van der Heide et al., 2014). Low health literacy has led to poor health outcomes in diabetes management (Poureslami et al., 2017; Van der Heide et al., 2014; Wang et al. et al., 2016). Research lacks interventions aimed at improving diabetes self-management for individuals with low health literacy (Jiang et al., 2019; Kim & Utz, 2019; Vandenbosch et al., 2018). This doctoral quality improvement project aims to evaluate the relationship between health literacy and diabetes self-management skills after participation in a web-based educational pilot program for adult patients with Type 2 diabetes in a rural community in Western Pennsylvania.

In hospitalized patients, the transition from hospital to home can lead to adverse events, negative outcomes, ER visits, and hospital readmissions (Backman et al., 2021). A poor transition of care can also be reflected in low Care Transition scores in HCAHPS surveys. The Care Transition questions reflect how well the patient felt prepared to manage their own care at home.

This quality improvement initiative answered the following research question: “In hospitalized adult patients, how does collaborative care transition planning compared with traditional discharge planning affect Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores one month after implementation”?

The theoretical framework is Larrabee’s model of Evidence-Based Practice. Methods include comparing the Care Transitions scores the month prior to implementation to those from the month following implementation.

There was a decrease in scores the month during implementation, but then increased in the month after. While not a part of the initial data collection, there was also an improvement in patients’ average length of stay. It can be concluded that the increase in communication amongst the healthcare team during the huddle did play a part in the efficiency of managing patients’ plan of care.

The nursing implications include the need for increased communication. When the healthcare team works together, it improves the patients’ transition from hospital to home. Future research may focus on length of stay as an important variable. A limitation of this study was a lack of consistency in collaborative rounding. Additional research in this area is needed.

On average, humans spend one-third of their lives fulfilling basic sleep needs (Cirelli, 2019). Theories suggest that sleep improves immune responses, reduces energy, allows for the recuperation of cognitive functions, and removal of waste; however, the exact function is unknown (Zielinski, McKenna & McCarley, 2016). Research has revealed when sleep is chronically disrupted the individual experiences a reduction in their quality of life, an increased risk for mortality as well as cerebrovascular and cardiovascular events (Chattu, Sakhamuri, Kumar, Spence BaHammam & Pandi-Perumal, 2018). Ever changing variables that affect sleep in the hospital setting have created a need to ask the question, what happens when such disruptions occur in an environment like the hospital? Therefore, the primary purpose of this study was to identify adverse outcomes associated with insufficient sleep experienced by hospitalized non-critical older adults in literature.

A lack of support and understanding by healthcare professionals can contribute to cascading events in the quality of their patients, newborns, and communities’ lives from experiencing birth trauma. Women who experience a traumatic birthing experience without support can hinder their feelings of having more children, create relationship problems, negatively affect the bonding with their newborn, and they may avoid medical interventions that are like their birthing experience such as pap smears (Birth Trauma Association, 2018). This project aims to answer, “Does implementing trauma-informed care practices education to perinatal nurses increase their knowledge, attitudes, and practices of trauma-informed care after educational implementation?” Trauma-informed care (TIC) is a concept that is grounded in a set of four assumptions and six principles. A trauma-informed approach to nursing care is inclusive of trauma-specific interventions; whether it includes assessment, treatment, or recovery supports, it also incorporates key trauma principles into the targeted organizational culture. The results of the project noted a positive Pearson correlation from p= 0.1 to 0.6 in all areas of the nurse’s knowledge, attitude, and practices (KAP) from pre- to post-survey results. These results conclude that educating perinatal nurses does positively impact their KAP and is beneficial to implementation. This implementation impacts future perinatal nursing and maternal newborn dyads for generations. The ability to change cultural thinking from “What is wrong with you?” to “What happened to you”? This demonstrates an improvement in care and is the first step in healing for all past and future trauma survivors.

Homeless people with chronic disorders need routine follow up to control chronic diseases and prevent exacerbations. Returning to the clinic for appointments or other interdisciplinary collaboration without a reminder is challenging. An intervention that involves automatic text message reminders could increase the return to the clinic for follow-ups, minimize ‘no shows’, and improve the overall health of homeless people with chronic diseases.

Background: Alcohol use disorder (AUD) has among been reported in 10-32% of hospitalized patients. The evidence suggests the need for screening and early management of alcohol withdrawal syndrome (AWS). Methods: This project included 2 phases - retrospective and prospective chart reviews. Demographic variables (age, gender, race) and length of stay were examined. Statistical tests were conducted to compare data from the phases. The outcome variables examined were the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) and the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale. Results: Of 61 patients in phase 1, most (72.5%) were males, had an average age of 47.1 years, and a length of stay of 8.1 days. Most (96.7%) of the patients were placed on CIWA at admission. In one patient, there was not a prompt initiation of the CIWA protocol and alcohol withdrawal treatment, which may have resulted in a reduced incidence of delirium and a shorter hospital stay. Of the 16 patients in phase 2, most (81.3%) were males, Caucasians (62.5%), with an average age of 49.3 years and a mean length of stay of 5.5 days. There were no significant differences at p<.05 between characteristics in the two phases of the study. In phase 2, 7 of 16 patients (43.8%) had a PAWSS score >=4, indicating that these patients were at high risk. 5 of these 7 patients experienced severe withdrawal symptoms making this a true positive PAWSS score. The PAWSS scores were not recorded for 9 patients in this study phase, and 7 of these patients had CIWA score >=16, indicating that the patients may experience severe withdrawal symptoms. Conclusion: As the problem of AUD continues to exist, more detailed information about the use of PAWSS and CIWA to assess alcohol withdrawal is needed. Improving strategies to evaluate the effect CIWA management may be warranted.

Crisis events, both manmade and natural, could materialize at any time on the campus of a higher education institution, and often have a detrimental impact to the mental health of those experiencing the event. There is already a high prevalence in mental health disorders in college-age individuals and crisis events can often precipitate immediate and long-lasting effects to mental health regardless of an individual’s mental state. Educational institutions have a duty to develop comprehensive crisis management plans that address safety of mental health, as well as physiological, before, during, and after crisis events.

Social media plays a significant part in the lives of many teens. Inappropriate use of social media can cause negative consequences. Studies show that cyber-bullying, lack of family interaction, lower self-esteem and depression are among these consequences. Unfortunately, studies also show that many parents lack the knowledge to monitor their children’s social media use.