DOCTOROF NURSINGPRACTICE - Nursing.vanderbilt.edu
DOCTOR OFNURSING PRACTICE
2017DOCTOR OF NURSING PRACTICE PROJECTS
WELCOME
FOREWORDCongratulations Doctor of Nursing Practice graduates!You have met the rigorous standards of this program and achievedindividual scholarly accomplishments showcased in this booklet.You chose the Vanderbilt University School of Nursing to learn, transformand apply knowledge in new ways and you have certainly reached thosegoals. The Institute of Medicine’s landmark Future of Nursing reportcalls for significantly more doctorally educated nurses to advance healthcare and you are prepared to implement that recommendation. You arenow well equipped to make meaningful contributions within your owncommunity, your interest area and throughout the world of health care.We are proud of you, and look forward to the difference you will make.Sincerely,Linda Norman, DSN, RN, FAANValere Potter Menefee Professor of NursingDean, Vanderbilt University School of Nursing
FROM THE DIRECTORThe future of nursing is now as our 2017 DNP graduates leadinterprofessional teams in creating meaningful innovations. Thescholarly projects of the 2017 graduates cross geographical anddiscipline boundaries in identifying gaps in evidence and practice.Self-described change masters, their impact on quality outcomesfor patient-centric health care will be recognized across myriadorganizations globallyTerri Allison, DNP, RN, ACNP-BC, FAANPAssociate Professor of NursingDirector, Doctor of Nursing Practice
FACULTY & PROGRAM DIRECTORSSUSIE ADAMSALICE BERNETMICHELLE COLLINSPhD, RN, PMHNP-BC, FAANPFaculty Scholar for Community EngagedBehavioral HealthPhD, RN, PMHNP-BCInstructor of NursingPhD, CNMLINDA BEUSCHERNurse-Midwifery ProgramSHEREE ALLENPhD, GNP, BCAssistant Professor of NursingCOLLEEN CONWAY-WELCHDNP, APN, CPNP-AC/PCInstructor in NursingDirector, Pediatric Acute CareMELANIE ALLISONDNP, RN, ACNP-BCAssistant Professor of NursingAssociate Professor and Specialty DirectorSHARON E. BRYANTDNP, RN, ACNP-BCAssistant Professor of NursingSTEVEN BUSBYPhD, CNM, FAAC, FACNMNancy & Hilliard TravisProfessor of NursingDean EmeritaPhD, FNP-BCAssistant Professor of NursingCOURTNEY J. COOKDNP, RN, ACNP-BC, FAANPAssociate Professor of NursingDirector, Doctor of NursingCAROL CALLAWAY-LANEInstructor in NursingDNP, ACNP-BCClinical Instructor in NursingTERRI DAVIS CRUTCHERANGEL ANTHAMATTENRAMEELA CHANDRASEKHARTERRI ALLISONDNP, ADM, FNP-BCAssistant Professor of NursingK. MICHELLE ARDISSONDNP, RN, ACNP-BCAssistant Professor of NursingPre-Specialty Clinical InstructorAG-ACNP Specialty InstructorMA, PhDAssistant Professor of BiostatisticsLEENA CHOIDNP, ACNP-BCDNP, RNAssistant Professor of NursingAssistant Dean, Clinical and CommunityPartnershipsPhDAssociate Professor of BiostatisticsMICHAEL CULLTOM CHRISTENBERYAssistant Professor of NursingPhD, RN, CNEAssistant Professor of Nursing6PhD, PMHNP-BCDirector, Education and Dissemination,Office of Quality and Patient Safety
KAREN C. D’APOLITOMARY JO GILMERJENNIFER G HENSLEYPhD, APRN, NNP-BC, FAANProfessor of NursingDirector, Neonatal Nurse PractitionerSpecialtyEDD, CNM, WHNP-BC, LCCEAssociate Professor of NursingMELISSA DAVISPhD, MBA, RN-BC, FAANProfessor of NursingProfessor of Pediatrics, Monroe Carell JrChildren’s Hospital at VanderbiltCo-Director, Pediatric Palliative Care ResearchTeamMSN, CNM, FNPInstructor of Clinical NursingMELISSA GLASSFORDSHARON HOLLEYSARAH DAVISDNP, APRN, AG-ACNP-BCInstructor in NursingCo-Director DNP Critical Care FellowshipSTEFANI DAVISDNP, WHNP-BCInstructorSHARON FLEMINGDNP, RN, CPNP-PC, CNSInstructor in NursingSARAH C. FOGELPhD, RNAssociate Professor of NursingMARK E FRISSEMD, MS, MBAProfessor of MedicineDNP, FNP-CInstructor in NursingROBIN L. HILLSDNP, RN, WHNP-BC, C-MCAssistant Professor of NursingDNP, CNM, APNAssistant Professor of NursingMICHAEL D. GOOCHDNP, ACNP-BC, FNP-BC, ENP-CInstructor in NursingJEFF GORDONPhDProfessor of Educational InformaticsVANYA HAMRINDNP, RN, PMHNP, B.C.Associate Professor of NursingLESLIE HOPKINSDNP, APRN-BC, FNP-BC, ANP-CAssistant Professor of NursingDirector, AGPCNP ProgramCATHY IVORYPhD, RN-BC, RNC-OBAssistant Professor of NursingPAM JONESDNP, ANP-BCInstructor in NursingDNP, RN, NEA-BCAssociate ProfessorSenior Associate DeanClinical and Community PartnershipsQUEEN HENRY-OKAFORSHARON KARPKAREN HANDEPhD, APRN, FNP-BCAssistant Professor of Nursing7PhD, RN, CPNPAssistant Professor of Nursing
FACULTY & PROGRAM DIRECTORSBECKY KECKSTEVE KRAUMELANIE LUTENBACHERDNP, RN, NEA-BCSenior Associate DeanAdministration & OperationsChief Administrative OfficerPhD, RNPhD, MSN, FAANAssociate Professor of NursingAssociate Professor of Nursing with tenureBETSY B. KENNEDYDNP, RN, FAANPhD, RN, CNEAssociate Professor of NursingDirector of Faculty DevelopmentAssociate Professor of NursingMICHELE MARTENSJANA LAUDERDALEInstructorCHRISTIAN KETELPhD, RNDNP, RN-BCInstructor in Clinical NursingAssociate Professor of NursingJENNIFER KIMDNP, GNP-BC, FNAPAssistant Professor of NursingAG-PCNP Co-Director,Vanderbilt Hartford Center for GerontologicalNursing ExcellenceJOAN KINGAssociate Professor of Medicine (secondary) –MARY LAMBERTGeneral PediatricsAssistant Dean for Cultural DiversitySUSIE (TREASA) LEMING-LEEDNP, MSN, RN, CPHQAssistant Professor of NursingHealth Systems ManagementKANAH MAY LEWALLENDNP, RN, PMHCNS-BCDONNA McARTHURPhD, FNP-BC, FAANPProfessor of NursingDNP Program Director, 2008-2012ELIZABETH R. MOOREPhD, RN, IBCLCAssociate Professor of NursingGINNY MOOREPhD, RNC, ACNP, ANPProfessor of NursingDirector for the Acute Care Nurse PractitionerProgramDNP, RN, AGPCNP-BCAARON M. KIPPPhD, FNP-BC, ACHPNBRITTANY NELSONAssistant Professor of NursingDNP, RN, CPNPPalliative Care Focus CoordinatorAssistant Professor of NursingPhD, MSPHResearch Assistant ProfessorDNP, WHNP-BCInstructor in NursingAssistant Professor of NursingKATHRYN LINDSTROM8Director WHNP Program
LINDA NORMANCOURTNEY J. PITTSPATTI SCOTTDSN, RN, FAANValere Potter MenefeeProfessor of NursingDeanDNP, MPH, FNP-BCDirector, Family NP SpecialtyAssistant Professor of NursingDNP, APN, NNP-BC, C-NPTAssistant ProfessorNeonatal Nurse Practitioner Program andDNP ProgramMELISSA OTTPhD, ANP-BCInstructor in NursingAdult Gerontological Primary Care NursePractitioner ProgramDNP, RN, PMHNP-BC, FNP-BCAdjunct for VUSN, PMHNP programABBY PARISHDNP, MSN, RN, APN-BCAssistant Professor of NursingMARY LAUREN PFIEFFERDNP, FNP-BC, CPNInstructor in NursingJULIA PHILLIPPIPhD, CNM, FACNMAssistant Professor in NursingBONNIE PILONDSN, RN, BC, FAANProfessor of Nursing, Health SystemsManagementSenior Associate Dean for Clinical andCommunity PartnershipsCARRIE PLUMMERGERI C. REEVESAPRN, PhD, FNP-BCAssistant Professor of NursingANNA RICHMONDDNP, FNP-CInstructor in NursingJESSICA SEARCYDNP, FNP-BC, WHNP-BCInstructor in NursingSANDRA SEIDELDNP, RN, PMHNP-BCAssociate in PsychiatryPATRICIA P. SENGSTACKDNP, RN-BC, CPHIMSChief Nursing Informatics OfficerMEGAN SHIFRINMICHELLE RUSLAVAGEDNP, MSN, RN, NE-BC, CPEInstructorMAVIS N. SCHORNPhD, CNM, FACNMAssistant Dean for AcademicsDirector, Nurse-MidwiferyAssociate Professor9DNP, RN, ACNP-BCInstructor, AGACNP programHEIDI J. SILVERPhD, RD, LDNResearch Associate Professor of MedicineDirector, Vanderbilt Nutrition and DietAssessment CoreMEGAN SIMMONSDNP, RN, PMHNP-BCInstructor in Nursing
FACULTY & PROGRAM DIRECTORSK. MELISSA SMITHBETSY WEINERDNP, ANP-BCInstructor in NursingPhD, RN-BC, FACMI, FAANSenior Associate Dean for InformaticsCentennial Independence FoundationProfessor of NursingProfessor of Biomedical InformaticsCLARE THOMSON-SMITHMSN, RN, JD, FAANPAssistant Dean for Faculty PracticeDirector, Center for Advanced PracticeNursing and Allied HealthR. JASON THURMANMD, FAAEM, CPPSChief Medical OfficerTRISH TRANGENSTEINPhD, RN-BCSpecialty Director, Nurse Informatics ProgramProfessor, Nursing InformaticsDAWN VANDERHOEFPhD, DNP, PMHNP/CS-BCAssistant Professor of NursingRICK WATTERSPhD, RNClinical Associate Professor of NursingPAMELA WAYNICK-ROGERSDNP, APRN-BCInstructor of NursingCAROL ZIEGLERBRIAN WIDMARPhD, RN, ACNP-BC, ACNPC, CCRNAssistant Professor of Nursing &Anesthesiology, Critical Care DivisionCoordinator, AG-ACNP Intensivist SubspecialtyJENNIFER WILBECKDNP, APRN-BC, CENAssociate Professor of NursingFNP/ACNP-ED Program CoordinatorCHRISTOPHER “TY” WILLIAMSDNP, RN, ACNP-BC, FNP-BCInstructor in NursingTERRY WITHERINGTONDNP, CPNPDirector of the Pediatric Nurse PractitionerPrimary Care ProgramKELLY A. WOLGASTDNP, MSS, RN, FACHEColonel, U.S. Army (Ret)Assistant Professor10DNP, NP-C, MS, RDAssistant Professor of NursingFamily Nurse Practitioner ProgramGlobal Health Initiatives
DNP PROJECTS CLASS OF 2017JENNIFER ALLYNSTEFANI DAVISIdentifying Barriers to Family Presence During Emergency DepartmentImplementation of the Female Sexual Function Index Adaptation forBreast Cancer Survivors in an Outpatient Surgical Breast Practice. 23Resuscitative Efforts. 17JANELLE DELLEMEGHAN ANDERSONCapturing ASD in the Trauma Population. 24Implementation of a Unit-Based Clinical Practice Guidelinefor the Management of Febrile Infants.18MADDIE DICKERSONBROOKE BAILEYIncreasing Appropriate Use of Mechanical VenousThromboembolism Prophylaxis. 25Development and Implementation of a Critical Care UltrasonographyMARLENA DIDONATOWorkshop for Advanced Practice Providers.19Measuring Utilization of Infant Massage Therapy in the NeonatalIntensive Care Unit.26PATRICIA BAISENurse-Patient Medication Communication:CATHERINE DURBINImpact of Teach-Back on Patient Satisfaction.20Development of a Training Guide to Mitigate Disruptive Behaviorin the Emergency Department: A Patient Safety Initiative. 27ANNA BROWNLIZANNE ELLIOTTAccess & Barriers to Utilization of Palliative Carein Pediatric Pulmonary Hypertension. 21Implementation of a Diabetic Foot Exam Tool in a Rural,Mobile Primary Care Clinic.28RODNEY CHENAULTSUSAN GRANTEvaluating Incidence of Unreported Blood and Body Fluid ExposureStrategies and barriers to engaging dual-eligible beneficiariesin hospital patient and family advisory programs.29at a Large, Urban Adult Teaching Medical Center: A Pilot Study.2211
DNP PROJECTS CLASS OF 2017STEPHANIE GUSTMANJENNIFER JAMISON-GINESTransformational Leadership and the Impacton Patient Satisfaction.30Impact of Critical Care Pain Observation Tool Education on Intentto Change Practice in a Military ICU.36ELIZABETH HANEYJASON JEANThe Use of Positive Psychology and Strength Identificationin Women Living in Poverty. 31Effects of a Coding and Documentation Improvement Programfor Ambulatory Care Nurse Practitioners. 37KRISTIN HAYESEUNICE KIMEffectiveness of Utilizing an After-hours Telemedicine Service forResidents of Select Skilled Nursing Facilities to Reduce HospitalReadmission Rates. 32Impact of Educational In-Service on Provider Utilization of the PatientHealth Questionnaire in Measurement-Based Care for Patientswith Depressive Disorders.38DAVID HOUSETRACEY LEE-JONESPreceptor Preparedness for Nurse Practitioner Clinical Education.33Care Coordination of Mental Healthcare:Creating a Referral Pathway from Primary Care.39MARIA HURTJESSICA LEIBERGAssessing Potential Usefulness of a Peer Education Program Developedfor Homeless Patients Receiving Care from Mobile Health Clinics.34Early Transplant Referral for the Patientwith Severe Alcohol Hepatitis. 40PATRICIA JALOMOASHLEY LOVEPiloting a Program to Evaluate the Effectiveness of Pelvic FloorRehabilitation in the Treatment of Female StressUrinary Incontinence.35Comparing a Crisis Stabilization Unit with a Psychiatric Unit:A Cost-Effectiveness Analysis.4112
DNP PROJECTS CLASS OF 2017MICHAEL McFARLANDJANINE PALMImplementing the I-PASS Handoff Tool to Standardize theHandoff Communication Process.42A Proof of Concept Implementation of a Patient Activation Measure as aSupportive Tool for Care Coordination of a High Risk Population.48NIKKI MILLERKAREN PAYNEFacilitating Successful Post-Acute Care Patient Transition ThroughEffective Hospitalists’ Discharge Documentation.49Establishing an Evidence-Based Educational Framework for theImplementation of the Role of the APN-NP into Abu Dhabi.43LARA RIVERACYNTHIA MORRISONLong-Acting Reversible Contraception to Decrease UnintendedPregnancy in College Women.50Measuring the Impact of the “5-2-1-0 Let’s Go!”Evidence-Based Childhood Obesity Prevention Programat a Community Mental Health Center.44SUSANNA RUDYJANET MULROYStandardization of National ENP Post-Graduate Fellowships:A Proposed Curriculum. 51Initiating a Peer Led Support Group for Patients Living withNontuberculous Mycobacterial Infection.45WILLA SHIELDSAn Assessment of Provider Barriers to Postpartum DepressionTreatment.52PETER O’DONNELLDescription of Monitoring Patterns of Metabolic Side Effectsof Atypical Antipsychotic Agents at a Northeastern U.S. VeteransHealthcare Facility.46NICOLE SOVEYAMANDA O’MALLEYCHRISTA SZABOProvider Adherence to Adolescent Sexual Behavior Risk ReductionAssessment Guidelines.53Adherence to an Adult Evidence-Based Sepsis Guideline in a CriticalAccess Emergency Department: A Quality Improvement Project. 47Improving Provider Implementation of the AAP Oral RiskHealth Assessment Tool in Pediatric Primary Care.5413
DNP PROJECTS CLASS OF 2017SHERIN TAHMASBILYDIA YEAGERAssessment of medication adherence among low-income patientswith hypertension at the Clinic at Mercury Court.55Barriers to the Implementation of Pediatric Overweight and ObesityGuidelines in a School Based Health Center.62CARLA TEASDALEEnhancing Patient Safety and Quality through the Analysisof a Health lnformation Technology lncident Response Program.56ALEXANDRA THOMPSON-BATEMANPatient Absenteeism in Developmental Medicine. 57JENNIFER TOURVILLEParental Education to Reduce Emergency Department Visitsfor Children with Fever.58HANNAH WACHTMEISTERImplementation and Evaluation of An Oral HealthEducation Program.59MARQUITA WALLACEStudying the Effects of Communication Strategies on EmergencyDepartment Length of Stay and Perceptions of Teamwork. 60PAULA WYATTDeveloping an Evidence-Based Educational Session to ImproveMammography Awareness.6114
An Honorto Join.A Benefitto Belong.FOR MORE INFO VISITnursingsociety.org/Membership
2017 DNP PROJECTScongratulationsdnp graduates!
Identifying Barriers to Family Presence DuringEmergency Department Resuscitative EffortsPURPOSEFamily presence duringresuscitation (FPDR) is definedas the practice of allowingfamily members to remain atthe bedside during resuscitationof their loved one. Common inmany inpatient units, FPDR isless frequently practiced in theemergency department (ED).The purpose of this project wasto gain the perspective of healthcare providers in a particular EDin the Southeastern U.S., anddetermine what, if any, barriersexist that would inhibit FPDR inthat department.METHODOLOGYA survey of emergencydepartment health care providerswas conducted to gather bothqualitative and quantitative dataabout ED provider and nurseperceptions of, and experiencewith, FPDR. Quantitative datawas graphically depictedwhile qualitative data wasthematized, with participantdata exemplars provided.RESULTSSurvey responses indicatedthat the two greatest barriersto implementing FPDR inthe ED were concerns thatwitnessing resuscitation wouldbe too traumatic for familiesand that family presence wouldplace increased stress on theemergency team. Years ofexperience working in emergencymedicine had no measurableeffect on whether individualssupport FPDR, while personaland professional experience withthe practice seemed to makethose individuals more accepting.17Finally, nurses and nursepractitioners appear to favoreducation and implementationof a formal FPDR policy, whilephysicians and physicianassistants do not considerthese components of potentialimplementation as important.IMPLICATIONS FOR PRACTICEEvidence shows that allowingfamily members to be present atthe bedside during resuscitativeefforts not only promotes holisticpatient and family-centered carebut also facilitates grieving andis therapeutic for the emergencycare team. Project data revealsthat providers and nurses largelysupport the implementation ofthe practice, and suggests thatthe need for education and aclear FPDR policy are importantfactors in doing so.JENNIFERALLYNDNP, AG/ACNP-BC,FNP-BC, APRNEMERGENCY NURSEPRACTITIONER
2017 DNP PROJECTSImplementation of a Unit-Based Clinical Practice Guidelinefor the Management of Febrile InfantsPURPOSEMEGHANANDERSONDNP, MSN, CPNP-ACCERTIFIED PEDIATRICNURSE PRACTITIONERACUTE CARERecent studies havedemonstrated significanttreatment variation amongproviders in the managementof febrile infants in emergencydepartments, which canincrease patients’ risk of pooroutcomes. The primary objectiveof the quality improvementproject was to increase the useof evidence-based practicerecommendations for themanagement of febrile infantsin a Pediatric EmergencyDepartment (PED) to ensurethat patients receive therecommended testing andtreatment.METHODOLOGYThe project was conducted ina large, urban PED. A clinicalpractice guideline (CPG) wascreated based on the Philadelphiacriteria and the highest level ofevidence for the managementof infants with HSV. The projectparticipants and PED providerswere asked to complete a datacollection form to indicatewhether patients’ labs, antibiotics,and disposition were orderedaccording to the CPG during afive week data collection period.RESULTSSeventy-six percent of febrileinfants were treated inaccordance to the CPG. Thepercentage of infants less thanor equal 28 days of age whoreceived laboratory workup,antibiotics, and disposition inaccordance to the guidelinewere 100%, 100%, and 66.7%,respectively. One hundredpercent of infants 29 to 6018days of age received laboratoryworkup, antibiotics, anddisposition in accordance tothe CPG.IMPLICATIONS FOR PRACTICEThe recommendations from theCPG help prevent unnecessarylabs and hospitalizations inpatients who can be safelydischarged home. Additionally,the CPG recommendations helpavoid occurrences of missedserious bacterial infections orHSV in infants.estiae imus serio.Porpor maxim facimperumdolut precea debit, con corumdoluptatur,
Development and Implementation of a Critical CareUltrasonography Workshop for Advanced Practice ProvidersPURPOSECritical care ultrasonographyis emerging as a standard ofcare in the management ofcritically ill patients. Therefore,advanced practice providers(APPs) working in the intensivecare unit require competencyin this skillset. Currently,there is no formal educationrequirement for ultrasonographyfor APPs. The aim of this projectwas to create a critical careultrasonography workshop forAPPs to fill this void.METHODOLOGYA prospective study evaluatingknowledge acquisition relatedto ultrasound technique, imageidentification, and interpretationwas performed. Providerconfidence was evaluated.Knowledge acquisition wasevaluated using a 25-question,multiple choice anddemonstration test. Participantswere tested using the sametest before and after workshopattendance.RESULTSTwenty-nine participants,including currently practicingadvanced practice providersand adult gerontology acutecare nurse practitioner students,completed the workshop. Themean pre-test score was 11.5(41%) compared to a mean posttest score of 21.5 (86%). Themean difference between preand post-tests was 10.2 (40.8%).Post-test scores improvedsignificantly when comparedto pre-test scores (t 13.11, p 0.001). Participants ratedconfidence through multiple-19choice questions using a 5-pointLikert scale. Mean confidencelevels increased from 2.48 to4.32 on a 5-point Likert scale.IMPLICATIONS FOR PRACTICEImplementing a critical careultrasonography workshopfor APPs improves providerability to perform, identify, andinterpret ultrasound imagingand may be a useful tool inmanagement of patients in theintensive care unit.BROOKEBAILEYDNP, MSN, AGACNPADULT-GERONTOLOGYACUTE CARENURSE PRACTITIONER
2017 DNP PROJECTSNurse-Patient Medication Communication:Impact of Teach-Back on Patient SatisfactionPURPOSEThe purpose of this scholarlyproject was to implementthe teach-back method, astandardized medicationcommunication process betweennurses and patients, in aninpatient medical-surgical unit toimprove patient satisfaction.METHODOLOGYPATRICIABAISEDNP, RN, NEA-BCHEALTHCARE LEADERSHIPThe medical-surgical unit’sstakeholders and project leaderreviewed patient satisfactionscores with nurse-patientmedication communication,identified the aims of the project,and developed a timeline forimplementation of the teachback method. The project teamleader taught the teach-backmethod to forty-two nurses.The nurses implemented themedication communicationprocess for 30 days. The patientsatisfaction data collected duringthe implementation period wascompared to data collected priorto the deployment of the teachback method.RESULTSPatient satisfaction scores withoverall nurse-patient medicationcommunication increased by5% after implementing theteach-back method. Patientsatisfaction increased 12.8% withnurse-patient communicationabout the purpose of anadministered medication.IMPLICATIONS FOR PRACTICEThe project’s results suggestan improvement in patientsatisfaction with nurse-patientmedication communicationusing the teach-back method.20The method provides a concise,structured method to ensure twoway communication between thenurse and patient. Stakeholderbuy-in to implement the teachback method as a standardpractice will be essential tomaintain patient satisfaction.
Access & Barriers to Utilization of Palliative Carein Pediatric Pulmonary HypertensionPURPOSEThe primary purpose of thisproject was to assess accessto palliative care servicesamong pediatric pulmonaryhypertension programs. Thesecondary aim was to describebarriers to utilization of palliativecare services.METHODOLOGYA survey using multiple choiceand analog scale was distributedin May 2016 to query accessand utilization of palliative careamong pulmonary hypertensionspecialists in North Americaas well as attitudes regardingaspects of palliative careas it relates to pulmonaryhypertension patients. Resultswere analyzed descriptively andreported as percentages andmedians (interquartile range).RESULTSOf 30 surveys completed,93% reported having accessto palliative care. 82% ofrespondents with accessreported they had utilizedpalliative care in the past, butonly 64% in the last 12 months.The most common reason forreferring to palliative care wasfor psychosocial, emotional,and/or spiritual needs related toterminal illness (86%). Conceptsidentified as barriers werenegative connotation, timing ofreferral, increased anxiety, andlack of palliative care education.IMPLICATIONS FOR PRACTICEAdequate access to palliativecare is reported, howeverutilization is suboptimal. Referralis also delayed, which mayresult in patients being less21prepared for end of life. Providerperceptions of palliative caresupport the notion of palliativecare, but incorporation of theseservices is difficult due to itsnegative connotation, lack ofknowledge surrounding palliativecare, fear of increased anxietywith referral, and difficultyknowing when to refer.ANNA BROWNDNP, MSN, BSN, APRN,CPNP-PCCERTIFIED PEDIATRICNURSE PRACTITIONER
2017 DNP PROJECTSEvaluating Incidence of Unreported Blood and Body Fluid Exposureat a Large, Urban Adult Teaching Medical Center: A Pilot StudyR. DUKECHENAULTDNP, MSN, ACNP-CACUTE CARE IONS FOR PRACTICEMillions of occupationalexposures to bloodbornepathogens occur annually(Prüss-Üstün, Rapiti, & Hutin,2005). The CDC estimates thatonly 50% of these are reportedand recommends anonymoussurveys for quality assuranceof reporting programs (CDC,2004). The frequency ofunreported occupational bloodand body fluid (BBF) exposuresat a hospital is currentlyunknown.A CDC developed survey wasadapted into an online surveyfor distribution to adult ER,ICU and OR hospital employeesthrough departmental emaillists.Of the 22 exposures(needlesticks and splashes)that occurred over the last year,54.55% (12) were unreported.Low risk exposure type was themost common reason cited fornot reporting.The results of 54.55% unreportedexposures are consistent withCDC estimates. The survey fulfillsOSHA regulations requiringsoliciting and documentingemployee input regarding BBFexposures.Medical center education effortscould focus on reasons citedfor not reporting exposures,increasing employee familiaritywith reporting processes.Additionally, future implicationsfor practice from the increased22BBF exposure reporting datagenerated by this project will helpbetter identify unsafe practices,procedures and devices, leadingto stronger recommendationsto hospital management fordevice purchasing, practice andprocedure modification as wellas reduction in the incidence offuture exposures and their manyassociated costs. Institutionallythis survey could be usedannually going forward tomonitor the true incidence of BBFexposures and the subsequenteffectiveness of BBF exposureprevention, education andreporting processes. Lastly, giventhe recent push in healthcare forquality driven reimbursement,there are potential implicationsfor occupational blood andbody fluids exposure rates to bemonitored as a quality indicator.
Implementation of the Female Sexual Function Index Adaptation forBreast Cancer Survivors in an Outpatient Surgical Breast PracticePURPOSEThe purpose of this project wasto implement the Female SexualFunction Index adaptation (FSFIBC) screening tool among breastcancer survivors to identify sexualdysfunction following breastcancer treatment and allow forevaluation of a practice changefor quality improvement.METHODOLOGYPatients meeting inclusioncriteria received an informationletter discussing the screeningtool and project purpose uponclinic visit check-in. Consentedparticipants completed ascreening tool and demographicinformation sheet, de-identifiedto maintain confidentiality,prior to their office visit. Theproject leader scored the databased on clinical interpretationguidelines and shared resultswith participants during the visit.Those who screened positivefor sexual dysfunction weregiven the opportunity to discusstreatment options and referral toappropriate specialists.RESULTSDuring a three-week datacollection period, 49 of 66patients who met inclusioncriteria participated in theproject. Forty (81.6%) of theparticipants met criteria forfurther evaluation of sexualdysfunction. Five (10.2%)participants had equal or bettersexual functioning as prior totheir diagnosis. Four (8.2%)participants were excluded dueto missing data. Twelve (30%)participants who met criteria forfollow up were distressed about23their sexual function at leasthalf the time. Twenty-two (55%)participants were not distressedabout their sexual function,and six (15%) were excluded formissing data. Overall, it is clearsexual dysfunction is prevalent inthis patient population; however,the degree of distress it causesvaries considerably.IMPLICATIONS FOR PRACTICEAdvanced practice nurses serve acritical role in the comprehensi
Director, Doctor of Nursing ANGEL ANTHAMATTEN DNP, ADM, FNP-BC Assistant Professor of Nursing K. MICHELLE ARDISSON DNP, RN, ACNP-BC Assistant Professor of Nursing Pre-Specialty Clinical Instructor AG-ACNP Specialty Instructor ALICE BERNET PhD, RN, PMHNP-BC Instructor of Nursing LINDA BEUSCHER PhD, GNP, BC Assistant Professor of Nursing SHARON E .
Health Questionnaire in Measurement-Based Care for Patients with Depressive Disorders . 38 TRACEY LEE-JONES Care Coordination of Mental Healthcare: Creating a Referral Pathway from Primary Care . 39 JESSICA LEIBERG
Vanderbilt Divinity School 411 21st Avenue South Nashville, TN 37240 (615) 343-3981 Email: forrest.e.harris@vanderbilt.edu EDUCATION Doctor of Ministry, Vanderbilt Divinity School Program Thesis: Theology and Praxis: Social Ministry in the Black Church, 1988-90 Master of Divinity, Vanderbilt Divinity School .
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quality results of AGMA Class 10 with a double cut cycle and AGMA Class 9 with a single cut cycle can be expect-ed. The 100H weighs 7,100 lbs with a cube size of 78” X 64” X 72” high. For more information, contact Bourn & Koch at (815) 965-4013, Boeing F/A-18E/F Super Hornet Completes First AESA Flight In a press release dated August 13, 2003, it was announced that the Boeing F/A-18E/F .
