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Impacting nursing stress: The implementation of a standardized referral process in the outpatient pediatric care setting
(2018-06-25)
Aim. This DNP project was aimed at reducing process time and stress levels perceived by nurses working in three outpatient pediatric offices.
Background. Nursing stress has been studied for decades. Research studies have ...
Identifying depression in primary care: An evidence-based intervention
(2018-05-31)
Identifying depression in primary care is an urgent concern locally and nationally. Due to lack of screening or inquiry by primary care providers, as well as an insufficient number of mental health professionals, depression remains under-detected. This problem has been identified locally as a result of a 2014 population health survey in Huron County, Ohio. The population reported multiple reasons for not seeking out a program or service within the county to address symptoms of depression, anxiety, or emotional problems. The 2016 recommendation by The United States Preventative Services Task Force is to screen the general public as long as there are resources to provide appropriate treatment. Providers should assess risk factors with the patient by discussing the results of the screen and to decide necessary care such as investigating causative factors, monitoring symptoms, pharmacotherapy, and/or referral to mental health professionals. The purpose of this evidence-based practice improvement project was to add to the knowledge of depression screening by evaluating for patient satisfaction of the newly implemented two-step method in a primary care practice in an effort to improve depression identification. The Rosswurm and Larrabee updated version of the Model for Evidence-Based Practice Change was used to guide the project.
In a primary care practice setting, patient satisfaction of a new two-step screening method was assessed over a two-week period of time using a six-question satisfaction survey administered to participants chosen by simple randomization. Of the participants (n=86), nearly all (n=84) were satisfied with the new method....
Evaluating the effects and process of nurse bedside shift report on nurse’s perceptions of communication patterns, nurse satisfaction, and patient involvement
(2018-03-26)
Background: A growing body of evidence identifies transitions of care as vulnerable points in the care continuum where vital information is often omitted and inadequate communication occurs. Nurse shift report has been ...
Breastfeeding: An evidence-based intervention for neonatal abstinence syndrome
(2018-02-07)
Opioid drug use during pregnancy is a national and local emergent concern. The state of Ohio has experienced a dramatic increase in neonates born with neonatal abstinence syndrome (NAS). NAS occurs after the neonate is born and no longer receives a supply of opioids from the mother. NAS occurs in approximately 55 to 94 percent of neonates exposed to opioids in utero and if left untreated can become life threatening. Nationally, an estimated $1.5 billion is spent annually for NAS treatment equating to $53,400 per infant hospitalized. Non-pharmacological supportive care measures such as breastfeeding can aid in managing NAS symptoms. The purpose of the evidence based practice improvement project (EBPIP) was to provide continuing education (CE) for maternal newborn care staff in Erie County Ohio on the national standards of care and recommended practice guidelines that encourage and support opioid dependent postpartum women in medication assisted treatment (MAT) programs to breastfeed their neonates. The goal of the project is to foster maternal decision making to breastfeed as a means to decrease the occurrence of NAS symptoms, decrease the need for pharmacological interventions, and decrease the length of stay (LOS) in an acute care hospital setting for affected neonates. The Model for Evidence-Based Practice Change was used to guide project implementation. The CE program titled Breastfeeding’s Role in Neonatal Abstinence Syndrome was presented to maternal newborn care staff (N= 133) of Erie County Ohio. The program provided education on NAS and the national standards and guidelines for breastfeeding and maternal substance use. A comparison of the pre and post questionnaire demonstrated gains in staff knowledge and comfort level regarding the implementation of breastfeeding guidelines for opioid dependent women in MAT. The use of standardized evidence-based guidelines ensures nonpharmacological treatments (such as breastfeeding) are supported for the neonate born to opioid dependent mothers who are participating in an MAT program....