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Improving Staff Knowledge and Confidence in Hypertension Patient Education Through Health Literacy Training
Get PDFSummary This DNP staff education project focuses on providing health literacy training. The practice problem identified at the local project site was inadequate patient education it may have resulted from a number of factors,. poor blood pressure control. The practice-focused question for this project was as follows: “Will staff education on health literacy and patient education improve staff knowledge and confidence in providing HTN patient education?” The purpose of this doctoral project was to enhance healthcare providers\u27 capacity to deliver effective, evidence-based hypertension education. Eventually, providers would acquire effective communication that would improve patient understanding and self-management. Awareness of this issue stemmed from suboptimal hypertension outcomes amid the need for new strategies to improve blood pressure control. Furthermore, the studies confirmed the effectiveness of dedicated educational interventions in improving hypertension management. The results of this project showed increases of 19.3% and 45% in knowledge scores and self-efficacy, respectively. The implications for the organization included immediate enhancement of care quality and improved alignment with national control metrics. The major conclusion for this project is a demonstrated increase in staff knowledge post-education. The recommendations for the future are mandatory annual refresher training and integration of teach-back protocols into the electronic health record system. The potential implications of this project on nursing practice are the potential to improve outcomes in this population of hypertensive patients. This project has the potential to positively impact social change by dismantling communication barriers that disproportionately affect diverse populations, thereby fostering health equity
Relationship Between Time Assessment, Cost Projection, and Project Performance in the U.S. Government
Get PDFProject management roles are growing in terms of importance, yet project failure rates remain significant. Business leaders and stakeholders are concerned about the successful completion of projects because failure can result in significant cost overruns and delays. Grounded in the iron triangle theory, the purpose of this quantitative correlational research project was to examine the relationship between time assessment, cost projections, and project performance. Participants included 84 professionals, including project/program managers and IT analysts in Northern Virginia, who completed the Project Implementation Profile (PIP) tool. Results of Spearman’s Rho correlational test were significant, indicating time (r = 0.240, p = 0.030) and cost (r = 0.273, p = 0.013) had weaker but statistically significant correlations with overall PIP performance. However, the results of the multiple linear regression were not significant, with (F(2, 79) = 2.945, p = 0.058, R² = 0.069). These differing levels of significance suggest that the data may not be entirely linear. A key recommendation for business leaders is to carefully consider budget and time constraints, aligning them more closely with expected outcomes to ensure efficient use of organizational resources. Project findings may contribute to social change, as a rise in project success rates can enhance business performance, create new business opportunities, increase employment prospects, and support local workforces and economies
Enhancing Patient Follow-Up: Creating and Evaluating Clinical Practice Guidelines on Appointment Reminders Using the AGREE II Tool
Get PDFThis report presents the outcomes of a quality improvement (QI) DNP practicum project situated at an outpatient facility. The preparation for the practicum project included a situational assessment to determine feasible changes and an appropriate strategy of change leadership. The target practice problem is missed appointments. Keeping appointments is a defining element of plans for care for medical services that require regular assessments and updates. In psychiatric nursing, reminders dictate schedules for the nurse practitioners because they indicate expected encounters and commitments. At the same time, unplanned changes could demand a change of the appointments or rescheduling. Best practice guidelines could improve long-term outcomes of care, hence the goal to create the best clinical practice guidelines (CPGs). The project’s objectives and assessment metric answered the question, How does creating CPGs around appointment reminders appeal to subject matter experts using the AGREE II Tool? using a panel of four experts (N = 4). Evidence with item ratings from 5 to 7 (highly agree) with Domain scores from 89 to 100 supported the quality of the CPG and using technology-driven interventions for enhancing healthcare outcomes. CPGs emphasize the importance of collaborative practices, which ultimately improve the quality of care by aligning with evidence-based methods. Among these innovations, mobile message-based interventions have shown promise in improving medication adherence across diverse patient populations. Additionally, messaging has demonstrated effectiveness in promoting patient engagement, particularly by serving as reminders that increase attendance at clinical appointments. These encouraging results anchor a need to create or update CPGs to reflect the best current evidence and sustain improvements
Brotherhood: Black Male Perception on the Impact of Mentorship
Get PDFDuring the adolescent stage of development, identity is a foundational aspect of one’s development, and its absence leads to a negative outcome, characterized by role confusion. Positive interventions are necessary to develop a strong sense of self. The purpose of this generic qualitative project was to explore the perspectives of black males and the impact of mentorship on their identity during adolescence. The theoretical framework chosen for this study was Erikson’s identity versus role confusion, the fifth stage of his psychosocial development theory. Based on this concept, the research supported the idea that adolescent Black males should participate in culturally responsive mentoring programs and form supportive relationships to help them achieve at a higher standard. Semi-structured interviews with 10 former mentees who are now adults were used to collect data. The mentees were interviewed via Zoom to gather feedback on the research question. The data included information about how they defined mentoring, how the program influenced their sense of identity, and their perceptions of the program\u27s structure. The data were analyzed using the first cycle and vivo coding, maintaining consistency with the interviewees\u27 language and revealing their common, firsthand themes. These seven common themes were (a) provided academic support, discipline, and accountability, (b) identity, (c) father figures, (d) consistency, (e) representation matters, (f) brotherhood, and (g) providing life skills. Implications for positive social change may develop as social workers use the results of this study as a resource to engage, advocate, and empower at-risk Black male yout
Reducing Missed Appointments in Mental Health Outpatient Care Using SMS Reminders
Get PDFMissed appointments remain a serious problem in mental health outpatient clinics. They break the flow of treatment, waste staff time, and worsen outcomes for patients. In this setting, the practice problem is the lack of an evidence-based system for reminding patients about their visits. This doctor of nursing practice (DNP) project focused on developing and evaluating a clinical practice guideline (CPG) for automated text message (SMS) appointment reminders. The guiding question asked: Can a CPG using SMS reminders help reduce missed appointments in a mental health outpatient setting? A thorough review of CINAHL and PubMed found strong support for this approach, including 11 systematic reviews, 19 randomized controlled trials, 31 quasi-experimental or observational studies, and 22 background reports. Together, these studies confirm that SMS reminders improve attendance rates. The CPG was reviewed by an expert panel using the AGREE II tool. The panel rated the guideline highly for clarity, scope, and rigor based on a Likert scale from 1 (strongly disagree) to 7 (highly agree). The AGREE II results show that most items scored between 5 and 7, indicating generally strong consistency and quality across all evaluated areas, with several items reaching the highest average score of 7. For nursing practice, this project highlights the value of evidence-based tools that support continuity of care. In addition, this initiative supports positive social change by reducing health disparities, improving access for under-served groups, and promoting equity in mental health care
Staff Education Workshop Focusing on Enhancing Nurse Knowledge and Adherence to the TIME (Tissue, Infection/Inflammation, Moisture, Edge) Framework to Improve the Quality of Wound Assessment and Care
Get PDFThis staff educational project focused on implementing training on the tissue, infection/inflammation, moisture, edge (TIME) framework to address gaps in nurses’ knowledge and improve adherence to the TIME framework during wound assessment. Current evidence shows inconsistent use of standardized wound assessment among nurses, which can lead to inappropriate treatment, delayed wound healing, increased infection risk, and higher healthcare utilization. This project’s question sought to assess whether implementing a staff education workshop focusing on the TIME framework would enhance nurse knowledge and adherence to the TIME framework. Six nurses participated in the training. Pre/post questionnaires were used to evaluate knowledge before the training and knowledge changes after the training. Nurses were also assessed using a 10-point checklist covering each element of the TIME framework to assess improvement in adherence rates. The results were summarized using means and frequency using Excel. The average pretraining knowledge score was 79.61% while the average post training score was 97.22%. The mean knowledge scores improved by a 22.12%. This suggests a notable improvement in knowledge of the TIME framework post training. Notably, all nurses’ knowledge score improved post training, illustrating that all participating nurses benefited from the training sessions. The mean adherence rate improved from baseline (M = 5.33 out of 10 points (53.3%) to after the training (M = 9.5 or 95%), demonstrating a 41.7% improvement in adherence to the TIME framework during wound assessment and documentation. These results will translate to improved wound assessment and care at the facility and has significant implications for social change as the project will translate to better care for patients
Improving Staff Knowledge and Competency in Saint Louis University Mental Status Dementia Screening
Get PDFSummary Early recognition of cognitive decline is vital to improving outcomes and maintaining patient safety across healthcare settings. The Saint Louis University Mental Status (SLUMS) screening tool assists nurses in detecting early cognitive changes; however, inconsistent administration and interpretation of the screening tool can reduce its effectiveness. A gap in staff knowledge regarding scoring, education-level adjustments, and documentation accuracy was identified at the practice site. To address this gap in practice, I developed and implemented a staff education program focusing on SLUMS administration and evidence-based clinical response to abnormal scores. The practice-focused question guiding this Doctor of Nursing Practice project was: Will a staff education program on the SLUMS dementia screening tool improve nurses’ knowledge in accurately administering and documenting SLUMS assessments? Nine clinical staff members participated in a 1-day educational session, which included pre- and posttest exams and a summative evaluation. Statistical analysis using the Statistical Package for the Social Sciences (SPSS) Version 30 demonstrated a strong improvement in knowledge from pre- to posttest. The pretest mean score was 65.22 (SD = 9.85), which increased to 93.44 (SD = 4.91) on the posttest, reflecting substantial knowledge gains across participants. Results indicated the training was highly effective in strengthening nurse competency, aligning with current evidence-based practice for early dementia screening and care planning. This practice change holds the potential for positive social change by promoting early identification and intervention for individuals with cognitive decline, thereby improving quality of life
Divorcees’ Experiences of Hubristic Pride in Communication in Previous Marital Relationships
Get PDFPoor communication practices have significantly strained marital relationships, contributing to increased divorce rates in the United States. As a self-conscious emotion, hubristic pride often leads to poor communication, which in turn exacerbates marital discord and contributes to the breakdown of families. The purpose of this basic qualitative study was to explore how divorcees perceive the impact of hubristic pride on communication in their previous marriages. The theoretical framework underpinning this study was Homans’s social exchange theory. Data were obtained from eight divorced participants not actively involved in ongoing custody proceedings through semistructured interviews and analyzed using Saldaña’s descriptive coding methodology. Findings revealed four main themes: emotional immaturity, defense mechanisms, emotional reactivity, and unhealthy interactions. Grounded in emotional immaturity, hubristic pride functioned as a defense mechanism that heightened emotional reactivity and disrupted healthy communication. These findings may promote positive social change by increasing awareness of maladaptive communication patterns, fostering emotionally responsive dialogue within families. It may also inform counseling practices in the development of relational education curricula designed to enhance clients’ interpersonal functioning
The Experience of Modern Day Marriages for Women Who Identify as Strong Black Women
Get PDFThe Strong Black Woman (SBW) schema has been explored during the past two decades; however, limited research has been conducted on the phenomenological experiences of Black women who identify with the characteristics of the SBW schema and their impact on Black and African American marriages. The purpose of this study was to explore the lived experiences of married African American women in modern day marriages who endorse the characteristics of the superwoman schema. This qualitative study was an interpretative phenomenological analysis and focused on the lived experiences of this population. Individual interviews of 12 married African American women who identified as SBW were analyzed. This study used two conceptual frameworks: the superwoman schema and the suffocation model. Study findings indicated that the SBW identity is deeply ingrained in all aspects of a SBW marriage. Emerging themes included SBW identity: resilience and burden, marriage expectations and models, partnership and intimate communication, resilience and renewal, and a subtheme of military marriage as an amplifier. Implications for positive social change include developing culturally responsive counseling practices, premarital education, and community-based support programs as pathways to sustaining healthy marriages for African American women who endorse the SBW schema
Clinical Practice Guideline to Improve Medication Adherence in Posttraumatic Stress Disorder (PTSD)
Get PDFPosttraumatic stress disorder (PTSD) is a chronic and debilitating psychiatric condition characterized by intrusive memories, avoidance behaviors, hyperarousal, and alterations in mood and cognition following exposure to traumatic events. Although evidence-based pharmacotherapy is a cornerstone of PTSD treatment, medication nonadherence remains a pervasive barrier to effective symptom management and functional recovery. The purpose of this Doctor of Nursing Practice (DNP) project was to develop an evidence-based clinical practice guideline (CPG) aimed at improving medication adherence in adults diagnosed with PTSD in outpatient psychiatric settings. Guided by the Johns Hopkins Evidence-Based Practice Model and appraised through the AGREE II instrument, current empirical literature, clinical recommendations, and expert consensus were synthesized to establish standardized, patient-centered practice recommendations. This CPG provides a structured, scalable framework to support advanced practice psychiatric nurses in optimizing pharmacotherapeutic outcomes for individuals living with PTSD