Journal of Doctoral Nursing Practice最新文献

{"title":"Identifying Human Trafficking: Implementing a Screening Tool in an Adult Emergency Department.","authors":"Ciara A Culler, Suzanna Fitzpatrick, Carolyn Greely","doi":"10.1891/JDNP-2024-0032","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0032","url":null,"abstract":"<p><p><b>Background:</b> Human trafficking (HT) is \"the recruitment, transportation, transfer, harboring or receipt of people through force, fraud or deception, with the aim of exploiting them for profit\" and affects approximately 17,000 individuals annually in the United States. The project site was in an adult emergency department (AED) in a large urban academic medical center, where routine HT screening did not occur. <b>Objective:</b> The purpose of this project was to implement a validated HT screening tool in an AED to identify victims and connect them to community resources. <b>Methods:</b> Staff nurses were educated on the Rapid Appraisal for Trafficking (RAFT) tool. Eligible patients presenting to the AED were screened for HT using the RAFT tool. If the patient answered in the affirmative to any of the RAFT items, they were offered a community resource list and an evaluation by social work. <b>Results:</b> Of 11,925 patient encounters, 195 patients were screened using the RAFT tool (1.6%). Among these, 139 screened negative, 10 screened positive, and 46 met the exclusion criteria. Resource acceptance varied among RAFT-positive patients: 80% (8/10) declined all resources, 10% (1/10) accepted only the community resource list, and 10% (1/10) accepted all available resources. Staff participation was limited to 36.5% (23/63) of nurses. Survey results (<i>n</i> = 23) showed strong support for the intervention, with 91.3% finding screening feasible to implement and 87% considering it necessary, while 95.6% rated the tool as easy to use. <b>Conclusions and Implications for Nursing:</b> Routine HT screening in the emergency department can increase the recognition of those experiencing HT for resource provision, including staff education, referral services, and reevaluation measures for an underserved population.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth Empowerment in Health Care Mentorship Program.","authors":"Felicia Edoghotu","doi":"10.1891/JDNP-2024-0042","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0042","url":null,"abstract":"<p><p><b>Background:</b> Providing students with resources and knowledge about health care occupations and preparation for a professional role will have a long-term effect on their career path and the public health of their communities. <b>Objective:</b> The purpose of this project was to determine if a four-phase educational session would affect the knowledge of high school students to choose a health care-related career. <b>Methods:</b> Nursing models were incorporated to support the evidence-based practice, theoretical framework, and biblical framework. Implementation of this project occurred in an urban inner-city high school located in Texas. Consent forms were distributed to the classroom teacher 1 month before the project implementation. Both the parents and the students required signatures. All participants completed the questionnaires electronically. Subsequently, the project was approved by the Colorado Christian University Internal Review Board, informed consents were signed prior to participation, and agenda items were provided to students and school administrators before implementation. Educational information was disseminated to students using a PowerPoint presentation created by the project manager which served as a guide for the classroom sessions. <b>Results:</b> The findings of the educational sessions provided support that the students did gain knowledge. <b>Conclusion:</b> The sessions impacted their decision to pursue a health care-related field after graduation.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist Circumference Measurement: Not a Waste of Time.","authors":"Laura Lunger, Diane Whitehead","doi":"10.1891/JDNP-2023-0039","DOIUrl":"https://doi.org/10.1891/JDNP-2023-0039","url":null,"abstract":"<p><p><b>Background:</b> The following executive summary is a summation of an education seminar completed as part of the requirements for a Doctor of Nursing Practice capstone project. The gap in practice is a need for more knowledge among health care professionals regarding waist circumference measurement (WCM) in the outpatient clinical setting. A lack of knowledge may lead to an underutilization of WCM and a missed opportunity to identify patients at higher risk for cardiovascular and cardiometabolic disease. <b>Objective:</b> To address the practice problem, an evidence-based practice question was developed to assess if an education seminar would increase the knowledge of health care professionals on WCM. Several sources of evidence support the importance of WCM, including multiple evidence-based practice guidelines recommending the use of WCM and body mass index to assess patients' cardiovascular and cardiometabolic risk. <b>Mothods:</b> A five-question rating scale assessment via Zoom polling was given to the participants before and after the education seminar. <b>Results:</b> Ten participants participated in the education seminar. Preassessment results revealed that 50% of the participants had little or no knowledge of WCM. Postassessment results showed that all participants indicated having knowledge or being very knowledgeable about all five questions. <b>Conclusions/Implications for Nursing:</b> Recommendations are to continue to present education seminars to health care professionals in the outpatient setting to increase the overall understanding of WCM. Ideas to increase recruitment include hosting the education seminar within prescheduled meetings at health care organizations, including local university faculty, offering incentives such as continuing education credits to participants, and sending reminders of the event. This increase in knowledge can translate to better preventative care for patients by utilizing WCM as a standard practice. More research must be completed to assess if increased utilization of WCM will lead to patients having fewer chronic diseases and healthier lives.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a Delirium Protocol Bundle for Older Adult Postop Patients With Hip Fracture.","authors":"Ann E Hendrickson, Chondra N Butler","doi":"10.1891/JDNP-2023-0067","DOIUrl":"https://doi.org/10.1891/JDNP-2023-0067","url":null,"abstract":"<p><p><b>Background:</b> Older adult patients with hip fractures are three times more likely to develop delirium on the first postoperative day. Delirium results in higher rates of functional decline and increased discharges to nursing home placement. Lack of an evidence-based delirium assessment/intervention protocol negatively affects patient recovery and discharge destination. <b>Objective:</b> The project aim is to decrease delirium prevalence through the implementation of an evidence-based delirium assessment/intervention protocol bundle. <b>Methods:</b> Participants in this pre-post implementation design pilot project included postoperative patients with hip fractures aged 50 years and above (<i>N</i> = 22) admitted to an orthopedic unit of a community hospital in south central Pennsylvania. Data were collected on the number of patients with documented delirium symptoms and delirium protocol bundle in place as compared with the number of patients with documented delirium symptoms in the same time frame of the previous year without delirium protocol bundle in place. <b>Results:</b> Implementation of the delirium protocol bundle resulted in a 68% delirium prevention rate, 27.5% reduction in delirium incidence on the first postoperative day, and a 36% increase in discharges to rehabilitation centers compared with long-term nursing home placement. <b>Conclusion:</b> Implementation of a delirium protocol bundle resulted in a clinically significant decrease in delirium prevalence. <b>Implications for Nursing:</b> The delirium protocol bundle provides an evidence-based resource to improve patient outcomes and enhance nurses' professional practice.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing New Patient No-Show Rates at a Mental Health Clinic by Process Improvement.","authors":"Meagan Carson","doi":"10.1891/JDNP-2021-0061","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0061","url":null,"abstract":"<p><p><b>Background:</b> Patients in the mental health community are at risk for worsening symptoms and declining mental health without treatment. Missed psychiatric appointments are both costly and detrimental to patient outcomes. <b>Objective:</b> The purpose of this project was to implement evidence-based strategies to improve workflow and scheduling with the goal of decreasing the new patient no-show rate. <b>Methods:</b> Policy change for how new patients were scheduled was implemented, and other improvements were made. <b>Results:</b> The no-show rates decreased from an average of 21% preintervention to an average of 13% postintervention. <b>Discussion:</b> No-show rates decreased by 43% during the intervention period, which is an estimated annual financial gain of $17,840. Although after project implementation the new patient no-show rate declined, staff compliance throughout project implementation was inconsistent. <b>Conclusions:</b> In an outpatient mental health clinic, the implementation of multifaceted, evidence-based process improvement strategies successfully reduced no-show rates for the first appointments. <b>Implications for Nursing:</b> Evidence-based interventions to reduce new patient no-shows can be effectively implemented across all outpatient mental health clinics, enhancing access to care and minimizing revenue loss.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making in Heart Failure.","authors":"Sarah Young, Kelly Bosak","doi":"10.1891/JDNP-2024-0075","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0075","url":null,"abstract":"<p><p><b>Background:</b> Pulmonary artery (PA) pressure can be monitored remotely by a microelectromechanical sensor permanently implanted in the PA. This allows fluid overload in heart failure to be managed in a more timely manner. <b>Objective:</b> This study aimed to explore patient and provider perceptions of shared decision-making (SDM) for the cardio-microelectromechanical system PA pressure monitoring device. <b>Methods:</b> A convenience sample of eight patient-provider dyads at an academic cardiology clinic completed the SDM questionnaire in the clinic before the procedure. <b>Results:</b> The majority of providers reported complete agreement that SDM occurred. Patients' survey responses varied but remained positive. <b>Conclusions:</b> Dyad perceptions of SDM for implantation of the pulmonary pressure monitoring device were positive and concordant. Future interventions to promote specific behaviors for SDM may be beneficial. <b>Implications for Nursing:</b> This investigation has implications for advanced practice nursing to initiate the SDM process.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Time to Antibiotic Administration in Pediatric Oncology Patients With Fever.","authors":"Christina M Cotton","doi":"10.1891/JDNP-2025-0004","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0004","url":null,"abstract":"<p><p><b>Background:</b> Timely administration of antibiotics in pediatric oncology patients undergoing chemotherapy is critical, particularly for those presenting with fever and a central line, due to their increased risk of severe infections. <b>Objective:</b> This quality improvement project aimed to reduce the time from patient presentation to antibiotic administration in a pediatric oncology center. <b>Methods:</b> Current practices were evaluated through retrospective data analysis, identifying delays and inefficiencies in the workflow. Interventions included staff education, streamlined communication protocols, and implementation of a standardized clinical pathway. Findings: Initial results indicate a significant reduction in antibiotic administration times, improving patient outcomes and enhancing adherence to national guidelines. <b>Conclusions:</b> This project highlighted the importance of process optimization and interdisciplinary collaboration in delivering timely, evidence-based care to high-risk pediatric populations. Future steps involve sustaining the improvements and expanding the model.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the Healthy LifeStars Program for Children.","authors":"Sara Edwards, Jeanie Bochenek, Kate Sustersic Gawlik, Randee Masciola","doi":"10.1891/JDNP-2024-0039","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0039","url":null,"abstract":"<p><p><b>Background:</b> Childhood obesity continues to rise globally with the potential for serious consequences to a child's physical and mental health and alarming economic impacts. In the United States, approximately one in five children is obese. The literature suggests that providing young children with foundational knowledge and skills to lead a healthier life can change the trajectory of chronic disease, improve population health outcomes, and lower health care costs across the United States. <b>Objective:</b> Second graders receiving a 12-lesson healthy habit program will demonstrate a 10% increase in healthy behaviors and beliefs 4 weeks postprogram completion. <b>Method:</b> This quality improvement (QI) initiative was delivered at three elementary schools using a consistent coach, the Healthy LifeStars Program, an evidence-based healthy habit education program that included 12 lessons and began with a mindfulness activity. Pre- and postintervention surveys were used to assess students' health behaviors and beliefs. <b>Results:</b> The pre- and postintervention survey scores indicated a small effect, as measured by Cohen's d, clinical significance, and an overall positive shift toward improved health behaviors and beliefs. One of the three participating school districts demonstrated a 7.5% increase in healthy behaviors 4 weeks postprogram completion. <b>Conclusion:</b> The QI initiative illustrates how implementing a school-based intervention can address the global health concerns of childhood obesity and increase the overall health and wellness of children. <b>Implications for Nursing:</b> As leaders in health, nurses are in an opportune position to lead, collaborate, and organize initiatives with interdisciplinary teams and families to promote improved health outcomes in children.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Best Practices Through Policy: Keeping Patients on Chronic Opioid Therapy Safe in Primary Care.","authors":"Sen Zhao, Carrie Ann Matyac","doi":"10.1891/JDNP-2024-0070","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0070","url":null,"abstract":"<p><p><b>Background:</b> The Centers for Disease Control and Prevention opioid prescribing guidelines for chronic pain were developed to combat morbidity and mortality associated with the escalating opioid crisis; however, implementing these guidelines is challenging. Clinic policies focused on treatment recommendations for chronic opioid therapy (COT) are needed to assist clinicians in safely managing pain. The purpose of this quality improvement project was to assess whether the implementation of a COT clinic policy improved provider adherence to evidence-based opioid prescribing guidelines based on state regulations in a nurse-led primary care clinic. <b>Objectives:</b> This project aimed to establish chronic opioid management best practices to improve provider adherence to state guidelines in a nurse-led primary care clinic. <b>Methods:</b> A quasi-experimental pre-post-intervention design was utilized with a sample of five providers and 33 COT patients. <b>Results:</b> Paired-sample <i>t</i> tests were used to assess the effect of COT policy implementation. Overall, no statistically significant differences were noted; however, policy implementation resulted in improved documentation of six key COT measures. Medium effect sizes were observed for completed opioid contracts (Cohen's d = .43), utilization of nonopioid pain therapies (d = .36), and urine drug screens (d = .39), indicating a moderate impact of the intervention in these areas. <b>Conclusions:</b> The findings suggest that education and implementation of a clinic opioid policy in primary care practice are effective in meeting evidence-based practice guidelines for COT. The importance of broad stakeholder engagement and ongoing support for policy adoption was highlighted. <b>Nursing Implications:</b> This project provides valuable insights into improving the safety of pain management in primary care to improve prescribing practices and mitigate risks associated with COT.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WhatsApp Mentorship Group: An Intervention to Provide Mentorship to Advanced Registered Nurse Practitioners Learning Reproductive Health Procedures.","authors":"Beth S Long, Kayla A Harvey","doi":"10.1891/JDNP-2024-0047","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0047","url":null,"abstract":"<p><p><b>Background:</b> Access to manual uterine aspiration (MUA) training in the United States is precarious and fraught. WhatsApp, the instant messaging platform, is used in medical education and peer collaboration. Advanced registered nurse practitioners (ARNPs) lack sufficient access to mentorship for learning MUA. <b>Objective:</b> This pilot study examines the effect of participation in a WhatsApp Mentorship Group on perceived mentorship for ARNPs learning MUA. <b>Methods:</b> Study design was quasi-experimental. ARNPs attending a reproductive health conference completed a survey measuring mentorship. Participants were invited to join the WhatsApp Mentorship Group. Within the group, mentors posted predetermined questions biweekly to stimulate conversation, answer clinical practice questions, and provide access to educational media files. <b>Results:</b> Following participation in the WhatsApp Mentorship Group, mean informational support levels increased by a statistically significant 5% (<i>p =</i>03). <b>Conclusion:</b> WhatsApp may be a viable option for expanding mentorship among ARNPs. <b>Implications for Nursing:</b> ARNPs may benefit from further inquiry into the use of WhatsApp for mentorship, including fellowships. Engagement data from this study suggest a bimodal level of mentorship perception.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}