Nursing (Doctor of Nursing Practice)

Overweight and Obesity is defined, according to the CDC, as a weight higher than what is considered healthy for a given height (CDC, 2021). This is calculated using a screening tool for overweight and obesity. Overweight is regarded as a BMI of 25-30, and obesity is greater than 30. The latest data shows that adult overweight and obesity is increasing and has become a major global epidemic. Overweight and Obesity is a very complex health issue that has resulted from a combination of factors, including behaviors. This includes poor dietary patterns and inactivity. Lack of education in healthy nutrition is one of the issues contributing to overweight and obese adults. Other reasons can be psychosocial barriers that can include fear of judgment and uncertainty about the process of seeking help if one is obese. Other obstacles can consist of time commitment and the cost of programs. Being overweight and obese can lead to increased health risks like diabetes, heart disease, stroke, and certain cancers. According to the CDC, obesity is also associated with the leading causes of death in the United States (CDC, 2021). With this comes a significant economic impact as well. This small pilot study used participants in a brief online asynchronous. The criteria were people ages 18-65. Each volunteer participant gave written consent to participate and be evaluated during the program. Each volunteer participant answered the preprogram questionnaire, watched the virtually based PowerPoint presentation linked under YouTube, and then answered the same questionnaire to assess their new knowledge and willingness to change to a healthier lifestyle. The General Nutrition Knowledge Questionnaire was the tool used for evaluation. This questionnaire is a valid measure of nutrition knowledge that is consistent and reliable.

The virus responsible for Covid-19, acknowledged as a public health threat, has been causing global disease since it was first discovered in December 2019 in China. The CDC (2021) issued a call for action through its Science Agenda for Covid-19 to identify evidence-based interventions for interrupting disease progression in vulnerable populations such as those in emergency shelter settings.

This project focused on Covid-19 and its impact on the homeless population in northwestern Pennsylvania. The theoretical framework was the John Hopkins Evidence-Based Practice Model (JHEBP). A survey collected self-reported data on the practice and barriers to using personal non-pharmaceutical interventions (NPIs). Participants were adults ages 18 and over in one of two emergency shelters on the data collection date.

Health literacy is a critical determinant of health outcomes, influencing patient engagement, health care costs, and readmission rates. Despite its importance, many hospitals lack standardized tools to assess health literacy, leading to inadequate patient education, especially among vulnerable populations. This study evaluates the impact of implementing the BRIEF Health Literacy Assessment Tool in an inpatient setting to improve nurses' ability to identify low health literacy and tailor patient education accordingly.

Orem's Self-Care Deficit Nursing Theory (SCDNT) underpins this study, emphasizing the importance of assessing patients' ability to understand and manage their health. A quantitative correlational design was used. Nurses on a medical-surgical unit administered the BRIEF Health Literacy Assessment Tool to patients upon admission. Patients identified with low health literacy received supplemental education. Data on patient outcomes (length of stay, 7-day and 30-day readmission rates) and nurse feedback were collected and analyzed. Of the 40 patients assessed, 37.5% were identified with low health literacy. No significant differences were found in patient outcomes. However, nurses reported the tool as valuable and feasible, enhancing their ability to provide equitable patient education. While the tool is valuable to nursing, further research with larger sample sizes is needed to evaluate its impact on patient outcomes.

This study suggests that integrating such tools into nursing practice can enhance care quality and equity. Future research should involve larger sample sizes, multiple units, and longer implementation periods to better understand the impact of health literacy assessments on patient outcomes.

Sepsis is a clinical condition that requires early identification and initiation of evidence based interventions to improve mortality and outcomes. A quality concern that has been
identified is that the emergency department at the practice site is not actively screening for sepsis patients. This has resulted in difficulty meeting three-and six-hour sepsis
bundle metrics. The purpose of this quality improvement project is to implement a sepsis screening methodology to correct this gap in practice. The door to lactic acid collection metric will be used to determine if any statistical improvement was made after the implementation of a sepsis screening tool. The screening tool selected for the project will be the qSOFA tool as this is one of the easiest tools to use and implement. The quality improvement project used a quantitative methodology with quasi-experimental design. The results demonstrated a statistically significant improvement in the collection times of lactic acid post-implementation. The results further support the use of sepsis screening in the emergency department setting for rapid identification and treatment of sepsis conditions. Emergency nursing plays a pivotal role in the identification and treatment of this condition as nurses are often the first healthcare professional a septic patient will encounter.

Atrial fibrillation is the most common dysrhythmia and has significantly impacted healthcare staff and systems. Catheter ablations remain the most effective tool in the treatment of
atrial fibrillation, and yet these have often contributed to hospital admissions and costs. Sameday discharges are a safe and cost-saving method being used more in this patient population. This study was completed to evaluate and compare same-day discharge versus admission following catheter ablation.

In the study, there were 321 patients who underwent catheter ablation for atrial fibrillation over 12 months from July 2021 to July 2022. Of these 321 patients, there were 74 same-day discharges. 30-day readmission rates for both samples were similar, with 4 (4%) patients readmitted following same-day release and 3 (2%) patients readmitted following observation or inpatient admission. 90-day readmission rates for both samples were also similar at 2.7% for same-day discharges and 1.2% for observation/inpatient admissions. There was a cost savings of at least $37,000 using same-day discharge versus at least $123,000 in costs for admission for observation or inpatient. Based on this study, the use of same-day discharge in catheter ablation for atrial fibrillation is reaffirmed as safe and cost-effective and should be considered in routine practice.