Journal of Doctoral Nursing Practice最新文献

{"title":"Innovative DNP Evaluation Tools.","authors":"Kathy Shaw,&nbsp;Mary Beth Flynn Makic,&nbsp;Sharon Sables-Baus","doi":"10.1891/JDNP-2022-0013","DOIUrl":"https://doi.org/10.1891/JDNP-2022-0013","url":null,"abstract":"<p><p><b>Background:</b> Innovative strategies are crucial for addressing essential faculty knowledge for teaching and advising Doctor of Nursing Practice (DNP) students, especially during the phase of time-sensitive scholarly projects. Challenges of diverse educational and experiential background of faculty may contribute to inconsistent student advisement and learning. Lack of clear expectations creates barriers to student learning. <b>Methods:</b> Published reports and faculty input were used to develop evaluation tools utilized in DNP project courses. The tools allowed for clear expectations of faculty instruction and advising, student work, and fostered student growth. <b>Results:</b> Rubrics developed for DNP project courses facilitated diverse student learning needs. Evaluation tools, informed by national guidelines, were developed to guide DNP faculty and student success, resulting in consistent evaluation of student scholarly work and attainment of the DNP <i>Essentials</i> <b>Conclusions:</b> Student evaluation tools that reflected the national guidelines facilitated student learning and assisted faculty instruction and advising. These rubrics have positioned our college for the transition to competency-based doctoral education. <b>Implications for Nursing:</b> The tools shared in this article could be adapted to fit other DNP programs aligning critical elements of students' attainment of knowledge, skills, and abilities of the DNP degree in the move toward competency-based education in the newly revised <i>Essentials</i> (2021).</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615833","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":"Barriers and Challenges in Caring for Transgender People: Implications for Clinical Practice and the Experience From a Specialized Center.","authors":"Charalampos Milionis,&nbsp;Eftychia Koukkou","doi":"10.1891/JDNP-2021-0022","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0022","url":null,"abstract":"<p><p><b>Background</b>: Transgender people often experience social exclusion and transphobic attitudes, which have an adverse impact on their socioeconomic life and health status. Within health services, -discriminatory practices and mistreatment derive from the lack of cultural competence by -healthcare providers. <b>Objective</b>: This article features existing barriers in the provision of healthcare to transgender populations and suggests approaches to manage the relevant challenges. <b>Methods</b>: A thorough review of the literature was performed, and the operation of a specialized unit wass presented. <b>Results</b>: Health professionals are often unskilled or unwilling to offer transgender care, while most healthcare service institutions do not offer specialized treatments. Incomplete health insurance coverage and shortages of personal income impede trans individuals' access to healthcare. Certain practices and policies are needed for scientifically and culturally competent services. <b>Conclusions</b>: The social vulnerability and the unique health needs of transgender persons urgently call for accessible and effective care for gender minority individuals. The integration of gender identity issues into continuous medical and nursing education is a key component of transgender-friendly care. <b>Implications for Nursing</b>: The integration of diversity as a core value in health services, the ability of health personnel to deliver transgender care, and the provision of insurance coverage solely based on medical needs are necessary steps to achieve social justice in healthcare.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601237","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":"Using Patient-Reported Outcomes Measurement Information System® (PROMIS) to Identify Physical and Psychosocial Quality of Life Issues in Lung Cancer Survivors.","authors":"Amy Hensley,&nbsp;Tracy Campbell,&nbsp;Clifford Gonzales","doi":"10.1891/JDNP-2022-0018","DOIUrl":"https://doi.org/10.1891/JDNP-2022-0018","url":null,"abstract":"<p><p><b>Background:</b> Lung cancer survivors (LCS) are living longer due to improved screening and treatment but often experience long-term treatment effects. Due to a traditionally poor prognosis, research related to LCS symptomology and associated quality of life (QOL) is lacking. <b>Objective:</b> The objective of this study was to develop a process for identifying symptomology and unmet needs affecting QOL in LCS. <b>Methods:</b> A literature review identified recommended methods of implementing a QOL screening program in LCS. Training guidelines using the best evidence were presented to the survivorship clinic (SC) staff. The Patient-Reported Outcomes Measurement Information System® (PROMIS-29) profile was used to collect data from LCS. The experience of the SC staff (<i>N</i> = 2) and providers (<i>N</i> = 2) in implementing the QOL screening program in LCS was assessed. <b>Results:</b> A 100% compliance rate in completing the PROMIS-29 profile was achieved. Physical function and pain interference were the most impacted QOL domains identified by LCS, while depression was the least. No challenges were identified in assisting LCS with profile completion. Providers agreed that the PROMIS-29 was instrumental in identifying QOL issues. <b>Conclusion:</b> A QOL screening program tailored to LCS-improved compliance and reliability in identifying QOL issues. <b>Implications for Nursing:</b> A QOL screening program using the PROMIS-29 may improve patient-provider interactions and value-based oncology care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601236","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":"An Evidence-Based Approach to Protecting Our Biggest Organ: Implementation of a Skin, Surface, Keep Moving, Incontinence/Moisture, and Nutrition/Hydration (SSKIN) Care Bundle.","authors":"Erin Kennedy","doi":"10.1891/JDNP-2021-0040","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0040","url":null,"abstract":"<p><p><b>Background:</b> The skin, surface, keep moving, incontinence/moisture, and nutrition/hydration (SSKIN) bundle is a resource to aid in care planning when at risk of pressure injuries. The bundle uses best practices to minimize variations in care. <b>Objectives:</b> The objectives of this quality improvement (QI) pilot project were as follows: (a) increase nurses' knowledge of pressure injury prevention, (b) increase nurses' knowledge of the use of the SSKIN bundle, and (c) to pilot the use of an SSKIN bundle in the clinical setting designed to standardize nursing interventions and documentation. <b>Methods:</b> Nurses completed a module on pressure injury prevention that included a pre- and posttest to determine knowledge. Education on the use of the SSKIN bundle was provided, followed by a posttest to establish understanding and knowledge gained. The bundle was utilized in the acute inpatient rehabilitation unit for 4 weeks, and compliance was assessed using the \"all-or-none\" approach (100% compliance). At the conclusion of the pilot project, staff nurses completed a post-survey created by the QI leader (Likert scale format). The survey included topics on the ease of learning to use the bundle, improved knowledge, perceived reduction in variation of care, perceived facilitation of discussion on skin, opinions on whether the bundle should be instituted hospital-wide, and incorporation of the bundle into the electronic health record (EHR). <b>Results:</b> There was an increase in pressure injury prevention knowledge from an average score of 88.89% on the pretest to 98.15% on the posttest. The mean score on the SSKIN bundle posttest was 93.75%. The bundle ran for 4 weeks and was initiated for ten patients during 74 shifts. Compliance with all components of the bundle was 77%. <b>Conclusion:</b> A pressure injury prevention initiative, such as the SSKIN bundle, can be a useful tool to help standardize nursing interventions and documentation. <b>Implications for Nursing:</b> Results revealed Nutrition as the component with the highest degree of noncompliance. Practice recommendations include documenting every patients nutrition information, regardless of Braden score.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601233","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 Adherence to Treatment Plans in Diabetes Patients With Neuropathic Foot Wounds.","authors":"Ann-Marie Irons,&nbsp;Mary Elizabeth Pounders","doi":"10.1891/JDNP-2021-0050","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0050","url":null,"abstract":"<p><p><b>Background:</b> In southeast states, diabetes continues to rise. Medical expenses are higher for -individuals diagnosed with diabetes-related complications, and poor outcomes are associated with missed appointments for wound treatment. <b>Objective:</b> The aim of this clinical practice contribution was to implement interventions to increase adherence to appointments and treatment plans in an outpatient wound clinic. <b>Methods:</b> Project participants over 18 years of age who were at risk for or have neuropathic foot wounds and are on weekly treatment regimens were recruited. Clinic staff were surveyed on the perceived success of and willingness to continue the interventions. <b>Results:</b> All staff surveyed agreed or strongly agreed that an automated reminder system and incentive program would make a significant impact on the patient's quality of life and worth the time and effort for staff to continue implementation. No patients in the control group required admission to acute care for treatment. <b>Conclusions:</b> Going forward with implications for future practice, these interventions demonstrated both the importance of adherence to outpatient appointments and opportunities to promote patient engagement. <b>Implications for Nursing:</b> Improving attendance at outpatient clinic appointments is significant for the delivery of quality patient care. By managing chronic conditions in the outpatient setting, complications can be reduced.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601234","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":"Family Health of Patients With Heart Failure and Their Family Members Before and During the First COVID-19 Lockdown.","authors":"Mahdi Shamali,&nbsp;Hanne Konradsen,&nbsp;Birte Østergaard,&nbsp;Erla Kolbrun Svavarsdottir","doi":"10.1891/JDNP-2021-0012","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0012","url":null,"abstract":"<p><p><b>Background</b>: Family health plays a vital role in the self-care and lifestyle modifications in families living with heart failure. <b>Objective</b>: To investigate the family health of patients with heart failure and their family members before and during the first COVID-19 lockdown. <b>Method</b>: This was a cross-sectional study design. We included 34 participants before and 34 participants during the first COVID-19 lockdown. Independent <i>t</i>-tests were conducted for comparison of the mean scores of the family health and its dimensions. <b>Results</b>: There was no significant difference between the total score of family health during the first COVID-19 lockdown compared to before the first COVID-19 lockdown in patients and family members. However, the <i>values</i> and <i>ill-being</i> dimensions of family health in patients and <i>ill-being</i> dimension in family members were significantly decreased during the first COVID-19 lockdown. <b>Conclusion</b>: This study indicated the positive and negative impacts of COVID-19 lockdown on family health. <b>Implications for Nursing</b>: Our results may help nurses to identify vulnerable patients with a low level of family health to tailor the best support to them.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40674436","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":"Practicing Upstream: Race-Based Trauma Care Training For Veteran's Health Administration Nurse Practitioners.","authors":"Vanessa Loyd,&nbsp;Karen Scaglione","doi":"10.1891/JDNP-2021-0013","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0013","url":null,"abstract":"<p><p><b>Problem</b>: The Advance Practice Registered Nurses (APRNs) employed by the Veterans Health Administration (VHA) lack race-based trauma training for Veterans that have experienced psychological, physiological, and emotional trauma. The VHA is responsible for the health of this culturally diverse patient population with complex health conditions. APRNs without prior military experience may have trouble obtaining an accurate history and physical exam due to their inexperience with the military's cross-cultural environment. This quality improvement pilot project aimed to incorporate race-based trauma training into a new adult geriatric acute care nurse practitioner's (AGACNP) fellowship curriculum. The study question is: In acute geriatric acute care nurse practitiioner's, what are the effects of race-based trauma training on competency and confidence in providing care to Veterans when hospitalized? <b>Methods</b>: A prospective descriptive design utilized a purposeful sample of senior adult-geriatric nurse practitioner (AGNP) students, due to the unforeseen circumstances of not hiring AGACNPs s for this pilot, for the first 6-weeks of a new acute care fellowship pilot program. Outcome measures included evaluating skills in identifying racial differences and confidence in applying culturally sensitive care. <b>Results</b>: Participant (<i>N</i> = 3) self-reported confidence increased by .33 (20%) in providing culturally competent and race-based trauma care, and an improvement in identifying race-based differences by .33 (17%) at completion of the pilot. <b>Implications</b>: Results indicated improvement in confidence and competence when providing race-based trauma care within 6 weeks. Continued training and evaluation throughout the 12-month fellowship are recommended.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40674437","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":"The Quality of Life After Liver Transplantation-The First Experience from Serbia.","authors":"Branislav Oluić,&nbsp;Stipislav Jadrijevic,&nbsp;Ivana Pantic,&nbsp;Sanja Dragasevic,&nbsp;Dusan Popovic,&nbsp;Milica Stojkovic Lalosevic,&nbsp;Zeljko Vlaisavljevic,&nbsp;Alireza Abdi,&nbsp;Tamara Milovanovic","doi":"10.1891/JDNP-2021-0026","DOIUrl":"https://doi.org/10.1891/JDNP-2021-0026","url":null,"abstract":"<p><p><b>Background</b>: Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, which dramatically effects patient's quality of life (QoL). The aim of this study was to evaluate the impact of socio-demographic and clinical factors on different QoL domains of patients who underwent orthotopic LT. <b>Methods</b>: A cross-sectional study included a total of 43 patients who underwent a LT from 2013 to 2018. Socio-demographic and clinical data were recorded in each patient. The QoL was estimated using two validated questionnaires: 36-Item Short Form Health Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ). <b>Results</b>: Male patients obtained significantly higher scores than women, in the domains of general health perception (83.2 ± 16.3 vs. 71.0 ± 18.4; <i>t</i> = 2.229, <i>p</i> = .031) and physical component summary (69.0 ± 7.2 vs. 62.0 ± 11.4; <i>t</i> = 2.451, <i>p</i> = .019). There were no significant differences in other domains of SF-36 and CLDQ. Etiology of the underlying liver disease and the presence of post-transplant complications showed no effect on score values of SF-36 and CDLQ domains (<i>p</i> < .05). Time from LT showed negative medium correlation with role limitations due to physical health problems (<i>S</i> = -0.417, <i>p</i> = .005), while no other significant correlations were noted in other items of SF-36 and CLDQ. <b>Conclusions</b>: Men had higher scores in the domain of general health perception and physical component summary following LT than women. With the increase in time from LT, patients experience a decrease in limitations due to physical health problems. The audit and improvement of QoL is an essential part of the individualized long-term health-care approach to LT patients.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40674438","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":"Prescribing Opioids for Chronic Pain: A Quality Improvement Project.","authors":"Geetha Ajay","doi":"10.1891/JDNP-2021-0052","DOIUrl":"10.1891/JDNP-2021-0052","url":null,"abstract":"<p><strong>Background: </strong>Several healthcare providers have failed to follow proper opioid prescribing practices to treat chronic pain in recent years. Therefore, the nation is experiencing an epidemic of opioid addiction, which has destroyed many lives. This quality improvement project aims to assess healthcare providers prescribing practices using the Centers for Disease Control and Prevention's guidelines to treat chronic pain.</p><p><strong>Method: </strong>The methodology used was the Plan-Do-Study-Act framework. A total of 120 charts were reviewed before the pre and post-implementation of the CDC's guidelines to assess the prescribing practices of health care providers. Also, the QI project follows SQUIRE's 2.0 guidelines to describe the prescribing practices of providers. SQUIRE is a framework that helps researchers report new knowledge on improving patient care in the health care system. The literature review section in this article illuminates current evidence of using opioid guidelines and had provided guidance on how to improve opioids prescribing practices among providers. The guidelines can be retrieved at http://squire-statement.org/index.cfm?fuseaction=Page.ViewPage&PageID=471 OUTCOMES: Using the CDC's guidelines helps to assess the prescribing practices of health care providers, the prescription rates of opioids dropped from 33.3% pre-implementation to 16.7% post-implementation.</p><p><strong>Conclusion: </strong>Opioid prescriptions are a significant contributor to the rising opioid epidemic; therefore, educating clinicians about safe prescribing practices is crucial.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470272","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":"From Bedside to Webside: Telehealth Education for Doctoral Nursing Students.","authors":"Angela Herrera, Cynthia Foronda","doi":"10.1891/JDNP-2021-0049","DOIUrl":"10.1891/JDNP-2021-0049","url":null,"abstract":"<p><strong>Background: </strong>Telehealth has become a ubiquitous tool for healthcare providers. However, concepts of telehealth are missing from many Doctor of Nursing Practice (DNP) curricula. This quality improvement project aimed to evaluate telehealth education implementation into a Doctor of Nursing Practice curriculum.</p><p><strong>Methods: </strong>The Iowa Model of Evidenced-Based Practice to Promote Quality Care guided the quality improvement project. An online module regarding telehealth was developed based on the American Telemedicine Association (ATA), the Health Resources and Services Administration (HRSA), and HealthIT.gov and was integrated into an existing course. Students completed a pre and posttest regarding telehealth knowledge and levels of satisfaction with the online module.</p><p><strong>Results: </strong>Thirty-seven students participated in the program. Mean knowledge scores increased from 4.9 to 8.6, and the modal for satisfaction and self-confidence was strongly agree.</p><p><strong>Conclusion: </strong>As telehealth is now a mainstream method of clinical practice, schools of nursing must adjust the curriculum to prepare nurses for this form of care delivery. An online module is a sustainable method of providing the foundation of knowledge for future expansion. Practicing via telehealth presents unique strengths and challenges. Nurses must be informed of the nuances and special considerations involved to safely practice using this distinctive care modality.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40423863","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}