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Implementation of the Modified Early Obstetric Warning System (MEOWS) in Obstetric Patients Within a Level IV Maternal Care Facility
Get PDFPractice Problem: Incidences of increasing maternal morbidity and mortality are often preceded by a period of unrecognized deterioration. The lack of an obstetric early warning system in a high-risk Level IV Maternal Care Facility further contributed to delayed identification and intervention of deteriorating mothers.
PICOT: The PICOT question that guided this DNP project was, in obstetric patients, 18-years or older (P), does the Modified Early Obstetric Warning System (MEOWS) (I), compared to current standard practice (C), affect the number of patients transferred to the ICU (O) within a six-week time frame (T)?
Evidence: Nine evidence-based articles were included in this DNP project, consisting of quasi-experimental, nonexperimental, and systematic review designs. The evidence overwhelmingly supported the use of an obstetric specific early warning system due to the physiologic and hemodynamic changes associated with pregnancy, labor, delivery, and postpartum period.
Intervention: The Modified Early Obstetric Warning System (MEOWS) was an early warning system designed to recognize signs of early deterioration in obstetric patients, which prompted actions from the healthcare team. The system included nine parameters scored by the bedside nurse, the higher score indicated higher acuity. Based on the score, the healthcare team implemented appropriate interventions.
Outcome: Two out of 117 patients (0.81%) were transferred to the ICU within the six-week DNP project timeframe. In the previous year, 25 out of 3,097 patients (1.71%) were transferred to the ICU. ICU transfers increased by 111% and the MEOWS was not statistically significant (p = 1.000).
Conclusion: Emphasis was placed on the clinical significance of a standardized method to recognize deteriorating obstetric patients across multiple disciplines, increased support of the bedside nurse, and improved patient care
An Occupational Therapy Based Guidebook for Young Adults Transitioning into Adulthood with Sickle Cell and Renal Medullary Carcinoma
Get PDFThis poster displays the key points within my capstone project of creating an occupational therapy-based guidebook for young adults with sickle cell anemia, and renal medullary carcinoma.https://soar.usa.edu/otdcapstonesspring2025/1068/thumbnail.jp
Exploring Occupational Identity and Cultural Belongingness of Chinese Transracial Intercountry Adoptees: A Qualitative Study
Get PDFChinese transracial intercountry adoptees may experience discrimination, microaggressions, and stereotyping by not feeling like they fit in with White American or traditional Chinese cultures due to an upbringing of a different race and ethnicity. These barriers may result in a lack of engagement in cultural experiences further impacting their sense of identity and cultural belongingness. A qualitative phenomenological research approach was used to understand how seven Chinese transracial adoptees identity development and sense of cultural belongingness relate to their occupational participation during their early adulthood years. Data was collected through a 45-minute, audio-recorded virtual semi-structured interview via Microsoft Teams and coded using Braun and Clarke method of reflexive thematic analysis. Results suggest that adoptee’s perceptions on cultural socialization practices shifts from childhood to cultural engagement or occupational engagement in adulthood in which six themes emerged reflecting feelings related to discomfort, adoptees’ journey through self-discovery, perception of their adoptive parents and family structure, emerging into diverse communities, and motivations for engagement in cultural experiences as an adult. This study brings insight on the complexity Chinese transracial intercountry adoptees experience in early adulthood to better inform occupational therapists working in community-based or mental health practice settings who may encounter transracial adoptees.https://soar.usa.edu/otdcapstonesspring2025/1080/thumbnail.jp
Implementation of Artificial Intelligence for Scribing in an Outpatient Mental Health Clinic
No full textPractice Problem: Traditional documentation practices place a significant burden on psychiatric mental health nurse practitioners (PMHNP) in outpatient mental health clinics (MHC), contributing to provider burnout and negatively impacting the patient-provider relationship. Preserving practicing PMHNPs is essential across the United States, but imperative in medically underserved areas where mental health services are limited.
PICOT: In PMHNPs (Population), does the use of AI scribing software (Intervention) compared to traditional documentation methods (Comparison) reduce documentation time and increase provider satisfaction (Outcome) over a ten-week period (Time)?
Evidence: This Doctor of Nursing Practice (DNP) scholarly project was informed by evidence obtained from 15 articles, including one randomized controlled trial, four quasi-experimental studies, seven non-experimental or qualitative studies, and three expert opinions or case studies. The body of evidence supported the use of AI scribes to reduce documentation time, improve documentation quality, and enhance the experience of both patients and providers.
Intervention: AI scribing software was employed to improve documentation efficiency for a PMHNP at an outpatient MHC. Efficiency was evaluated by measuring documentation time, documentation quality, and user satisfaction.
Outcome: The use of AI scribing software led to an average reduction of 4 minutes and 47 seconds per note and a 2.23% improvement in documentation quality, both of which were found to be statistically significant by the Mann-Whitney U test. Additionally, results from a 5-point Likert scale survey indicated user satisfaction and the intention to continue using the AI scribe after project completion.
Conclusion: This pilot DNP project supports the use of AI scribing software as a strategy to reduce documentation time while improving documentation quality and potentially alleviating burnout experienced by PMHNPs in outpatient MHCs
Empowering Independence: Strategies for Safe Aging in the Home and Community for the Older Adult Population
No full textThis capstone project created an occupational therapy–based guidebook to promote safe aging in place for community-dwelling older adults. The guidebook includes fall prevention exercises, home safety strategies, and community resources to support independence in daily activities. Implementation showed increased safety awareness and confidence, reinforcing occupational therapy’s role in fostering independence and quality of life.https://soar.usa.edu/otdcapstonessummer2025/1012/thumbnail.jp
Enhancing Medication Communication in the Acute Care Setting to Strengthen Patient Comprehension and Retention
No full textPractice Problem: Research has shown that breakdowns in communication, especially in the context of medication education, play a critical role in the delivery of safe and effective patient care. These findings underscore the need to prioritize effective communication in medication education. In the acute care setting, effective communication is essential for ensuring patient safety, adherence, and improved patient-centered outcomes.
PICOT: In clinical staff providing direct patient care in the acute care setting (P), does the implementation of the evidence-based teach-back method (I), as compared to current practice (C), improve patient knowledge, understanding, and self-management upon discharge (O), over ten weeks (T)?
Evidence: Research demonstrated that the teach-back method significantly improved patient outcomes, medication adherence, understanding, and self-management, supporting its integration into acute care teaching practices for this quality improvement project.
Intervention: Ten nurse participants (n = 10) completed identical surveys at three intervals to evaluate their usage and confidence in the teach-back method. An observation tool was also used to validate the impact of the intervention.
Outcome: Over the course of 10 weeks, there was a significant increase in the use of the teach-back method. Following the implementation of the intervention, both nurse-patient communication and patient outcomes showed meaningful improvements.
Conclusion: Effective training using the teach-back method has proven effective in promoting nurse-patient communication, resulting in improved patient outcomes and self-management
Magnet Council Toolkit for Organizations Seeking Magnet Status and Recruitment
No full textPractice Problem: The problem was a lack of a standardized or structured process for the development of Magnet Councils. There is no clear pathway or materials to initiate the process, and one must start by applying to the American Nurses Credentialing Center (ANCC) with little guidance prior to seeking help on the Magnet Journey. PICO Question: The PICO question that guided this DNP Project Toolkit development was as follows: For healthcare organizations pursuing Magnet status (P), how does the development of a structured Magnet Council Toolkit (I) compared to the absence of a formal toolkit (C), contribute to the validation of a resource that supports the establishment and sustainability of shared governance structures(O)? Evidence: Reviewing the literature showed very little specific support or toolkits designed to help with the establishment of a Magnet Council. However, the literature continues to emphasize the positive outcomes that organizations have achieved when they have followed the Magnet Journey and become recognized by the ANCC as a Magnet Hospital. Intervention: A toolkit on starting a Magnet council was created, including a library of resource samples and documents required to set up a Magnet Council. Within the toolkit, a pre- and postsurvey, as well as education tools, were provided for use in establishing a Magnet council. Outcome: Three subject matter experts with experience in nursing and nursing leadership reviewed the toolkit to provide feedback. The SME review provided agreement of the toolkit based on the Fleiss Kappa calculation. Conclusion: This DNP Scholarly project developed resources and gathered the literature to provide key topics and themes required to develop and start a successful Magnet Council
Improving ICU Decolonization Compliance Among Nursing Staff
No full textPractice Problem: Hospital acquired infections (HAIs) burden patients and health care organizations by influencing extended hospital stays, increasing mortality risk, and increasing healthcare spending.
PICOT: The Doctor of Nursing Practice (DNP) Scholarly Project was guided by the PICOT question: In ICU nursing staff (P), how does the implementation of a standardized process with visual reminders and checklists (I) compared to no reminders or checklists (C) impact compliance with the decolonization protocol for HAI reduction (O) over four weeks?
Evidence: A review of evidence-based literature demonstrated efficacy in the reduction of HAIs through once daily bathing with 2% chlorhexidine gluconate (CHG) and the application of 2% mupirocin ointment intranasally for five days during an ICU admission.
Intervention: The organization’s ICU decolonization policy was posted at the nursing station and standardized checklists were placed in patient rooms to document daily CHG bathing and mupirocin application. Staff compliance was measured as fully completed, partially completed, or not completed and was evaluated weekly.
Outcome: A two-tailed one-sample t-test demonstrated statistically significant improvement in compliance with a p-value \u3c 0.0001. Clinical significance was also demonstrated through improved visibility of the decolonization protocol within the ICU.
Conclusion: Ongoing engagement from stakeholders and improved integration of the decolonization protocol into the current workflow are essential components for the DNP scholarly project’s sustainability
Accessible Outdoor Recreation for Individuals with Physical Disabilities: An Educational Series
No full textThis capstone paper explores the effects of physical disabilities on outdoor recreation. An educational workshop was designed and delivered to occupational therapy students at the University of St. Augustine for Health Sciences. The purpose of the workshop was to increase their awareness of accessible outdoor recreation that way they can better mitigate barriers experienced by their future clients when trying to participate in desired outdoor activities. A pre- and post-survey was administered and analyzed to determine the applicability and effectiveness of the workshop in delivering the information.https://soar.usa.edu/otdcapstonessummer2025/1008/thumbnail.jp
Fostering Inclusive Care: Advancing Cultural Humility in Healthcare Professional Education: A Micro-Credential
No full textHealth outcomes are the results of healthcare and rehabilitative therapy interventions and describe what a client can accomplish through the rehabilitative therapy process. To achieve positive outcomes, practitioners identify possible barriers impacting clients’ participation in tasks and administer interventions to address these barriers in order to facilitate participation. As a result, cultural humility has been labeled as “paramount in therapeutic practice” (American Occupational Therapy Association [AOTA], 2020) due to it being a foundational principle underpinning effective client care and professionalism. Cultural humility is an ongoing process of acknowledging one’s biases and limitations through self-reflection and self-critique, while actively seeking to learn to honor another person’s values, beliefs, and culture through collaboration (Stubbe, 2020). Cultural humility promotes quality care and positive health outcomes by encouraging practitioners to acknowledge that clients’ identities are complex and that physicians will never be entirely competent in an individual’s ever-evolving identity and experiences (Hook et al., 2013). Due to cultural humility being a newer concept compared to broader and earlier ideas like cultural awareness and cultural competence, there is limited literature describing cultural humility training within rehabilitative therapy education (Foronda et al., 2018). As a result, the presence or absence of cultural humility in rehabilitative therapy can vary depending upon individual practitioners, settings, and systemic factors. While speaking with occupational, physical, and speech therapy faculty at the University of St. Augustine for Health Sciences (USAHS) Austin campus, there was a consensus that there is a lack of cultural humility exercises available in the curriculum (E. Frank, L. Johnston, and L. Spark, personal communication, 2024). Therefore, this micro-credential course will provide several cultural humility training opportunities for USAHS students and faculty to develop cultural humility.https://soar.usa.edu/otdcapstonessummer2025/1020/thumbnail.jp