Doctor of Nursing Practice
Permanent URI for this communityhttps://hdl.handle.net/11274/11104
The DNP Project is a final deliverable that brings together didactic and clinical work in the DNP program. The DNP Project is translational work in which the student uses existing research evidence to improve outcomes for patient populations and healthcare systems. This translational work generally begins with the student identifying a gap (or need for improvement) in a healthcare system which could include acute care, population, and community-based care. The DNP student is expected to plan, implement, evaluate, and disseminate their DNP Project. The DNP student’s program of study throughout their educational experience builds towards this goal, assisting the student to identify and refine their original ideas, using tools to engage interprofessional teams in impactful work that is rigorous, and sustainable. The student earns a Doctor of Nursing Practice (DNP) degree upon completion of their coursework and a final DNP project. DNP graduates are prepared to analyze systems, identify problems, and apply evidence-based solutions to improve the outcomes of the people for whom they provide care. The findings of their DNP project will be presented to the academic community prior to graduation.
Browse
Browsing Doctor of Nursing Practice by Title
Now showing 1 - 20 of 40
- Results Per Page
- Sort Options
Item A1c Point of Care Testing with Type II Diabetes Patients to Increase Patient Engagement and Improve Glycemic Control(2021) Mills, KimberlyBackground: Diabetes is at the forefront of chronic disease management. As the 7th leading cause of death in the United States, 34.2 million Americans are diagnosed with diabetes, and 95% have type 2 diabetes. Uncontrolled diabetes can result in long-term complications, increased hospitalizations, and premature deaths. Patient and provider partnerships are essential to increasing patient engagement to improve health care outcomes. Patient engagement, inclusive of collaboration with healthcare providers, promotes shared decision-making, enhancing patient self-care behaviors and effective disease self-management. Evidence supports that implementing point-of-care A1c testing (POCT HbA1c) in primary care settings promotes patient engagement with diabetes self-management resulting in improved patient glycemic control and attainment of organizational benchmarks for diabetic Value-Based Care quality metrics. Purpose: The purpose of this quality improvement project was for uncontrolled (HbA1c>8%) Type II diabetes patients to use POCT HbA1c to improve their glycemic control. Methods: Bandura’s Self-Efficacy Theory provided the theoretical framework. The RE-AIM model with PDSA cycles guided the project implementation. Data analysis consisted of descriptive and inferential analyses to track the implementation effectiveness of POCT HbA1c to improve glycemic control. Results: Data tracking demonstrated that implementation of POCT HbA1c increased diabetes patient self-management and improved glycemic control as evidenced by decreased HbA1c and FBS results. SES scores did not demonstrate statistical significance but there was clinical significance with increased patient engagement. Conclusions/Implications for Practice: The project outcomes supported that uncontrolled Type II diabetes patients who engage in the use of POCT HbA1c increase self-management resulting in improved glycemic control. Health care providers managing uncontrolled Type II diabetes patients should strongly consider using POCT HbA1c for diabetes patient self-management. Positive financial outcomes for both the patient and healthcare system can be a benefit with the use of POCT HbA1c. Project alignment with organizational initiatives is essential for obtaining support for implementation changes and long-term sustainability by conducting subsequent PDSA cycles.Item Advanced practice provider initiated advance care planning discussions to enhance patient-centered end-of-life care(2019) Goswami, PoonamAdvance Care Planning (ACP) is the process by which patients, with their healthcare provider and family establish values, goals, and preferences for future care, and include discussions on End of Life (EOL) care options. Advance Directives (AD) provide written documentation of patient’s wishes for future care and comprise of a Medical Power of attorney, living will document, and an Out-of-Hospital Do Not Resuscitate (OOHDNR) order. Institute of Medicine (IOM) in their 2014 report, Dying in America, identified an urgent need for improvement in health care at the end of life. The IOM also called for patient-centered EOL care that honors individual preferences and promotes quality of life. Cancer patients experience the high cost of care, may also receive unwanted treatment towards the EOL, and additional suffering, which may not reflect their values and goals. The problem exists that only 20% of the patients have completed AD documents in the Department of Investigational Cancer Therapeutics (ICT), and admitted patients’ resuscitation status remains a full code, which includes a cardiopulmonary resuscitation, and endotracheal intubation with mechanical ventilation. This Doctoral of Nursing Practice project consists of designing, implementing, and evaluating the effect of ACP discussions initiated by an Advanced Practice Provider with advanced cancer patients and their family members in the ICT department. The project aims to enhance patient-centered EOL care with a goal to increase the AD completion and /or a change in code status of the patients referred to ICT department.Item Barbershop blood pressure program: A quality improvement project(2019) Kirkpatrick, Whitney; Oquin, Charli LoisBlack males suffer from hypertension at far greater rates than any other demographic group. Such disproportions are due to complex, multifaceted factors ranging from perceived discrimination, physician bias, lack of culturally fluent healthcare providers, and an overall distrust of medicine marred by racist medical experimentation. Targeted healthcare delivery models have been shown to results in better outcomes when compared to current, traditional models. This project capitalized on the pre-existing trust between black barbers and their black male clients. Barbers administered blood pressure screenings at time of grooming services. This intervention brought the healthcare directly to the patient in a familiar place of comfort. Over 45 days, barbers conducted blood pressure checks on a combined 456 clients. Analysis of the blood pressure checks was performed with the Mann-Whitney U test and the Chi-Square test. Variables included systolic pressure, diastolic pressure, age, previous referral for hypertension, and medications. The findings did not suggest a statistically significant difference in blood pressures amongst those screened after being notified of their elevated pressure. However, the study shed light on the problem, fostered dialogue, and prompted black men to see a healthcare provider.Item Comparison of GLP-1 and SGLT2 diabetes medication: A quality improvement initiative(2019) Dilliard, Julia; Chrostowski, SusanThis quality improvement research project was undertaken to compare the efficacy of glucagon-like peptide agonist (GLP-1) and sodium-glucose cotransporter-2 inhibitor (SGLT2) medications in the treatment of Type II Diabetes Mellitus. Literature review reveals that both these new medications have shown efficacy in lower A1c and weight in Type II diabetics but have not been studied in a head to head trial. The objective of this project was to determine if one of these medications provides more HgA1c lowering than the other. This information is be useful for practitioners when choosing the most appropriate treatment. This project was a retrospective chart review of 128 charts divided evenly between patients who had been prescribed GLP-1 medication or SGLT2 medications between the years 2013 and 2018. A1c was measured when the medication was initiated and then measured at three-month and six-month intervals for data comparison. Repeated measures of ANOVA were conducted and showed that both medications provided A1c and weight loss at 3-months that were similar (p=.000). At 6 months the GLP-1 medication group showed a more substantial drop in A1c levels than the SGLT2 medication group and was statistically significant (p=0.046). This project revealed that a GLP-1 medication lowered A1c more than SGLT2 medications at the end of 6 months. These findings indicate GLP-1 medication may be more efficacious than SGLT2 medication in achieving glycemic control for Type II diabetic patients.Item Decreasing psychotropic medication use for nursing home residents with dementia(2020) Gore, Tundike; Bailey, Catherine; Roussel, LindaSkilled Nursing Facilities (SNFs) provide care for long-term care residents with multiple medical concerns as well as dementia. The number of the geriatric population showing dementia-related behavioral symptoms, such as agitation or screaming to get attention, is increasing. The traditional ways of using psychotropic medications to calm these residents have come under scrutiny. According to the Centers for Medicare and Medicaid (CMS), the practice of administering these medications to manage residents is no longer acceptable. In a selected SNF, there was a perceived need to implement a quality improvement project to replace nonpharmacological interventions with psychotropics as a solution to resolving the behavioral problems. Although there were limitations to the project, the findings indicated that the project effectively met the objectives of reducing the frequency of using psychotropic drugs for the residents of this SNF.Item Early recognition of postpartum depression through education: A quality improvement initiative(2019) Ekeocha, LaSteshia; Oquin, Charli LoisMany women have misplaced high expectations after giving birth to care for themselves, the newborn, the home, and breastfeeding with little to no sleep. As a result, they may feel inadequate in their role and ashamed to ask for assistance and suffer from postpartum depression (PPD). Although the mother may not be willing to admit these feelings and concerns, if properly educated, her support systems may recognize early signs of PPD and encourage her to seek medical attention. Studies have shown that the support system of the woman plays a crucial role in the prevention, diagnosis and effective treatment of PPD. This quality improvement (QI) initiative utilized the existing literature to formulate an educational pamphlet geared towards the support system. The initiative was implemented over four weeks in a women’s health clinic. A sample size of 183 participants partook in a pre and post-test in order to measure the knowledge gained. Categorical variables were evaluated using the Chi-square test between the pre and post questions. Continuous variables were evaluated using t-test between the percentage of pre and post proportion correct. The findings of the study suggest that support system education increases PPD awareness and knowledge.Item The effect of simulation on the self-confidence of newly licensed graduate nurses(2019) Mante, Rosario; Smith, MelanieNewly licensed graduate nurses (NLGNs) enter practice with basic critical thinking skills and minimal experience. However, they are often placed in clinical areas based on the needs of the facility rather than their clinical interest or expertise. New graduate nurses are assigned roles that are not based on their levels of proficiency but the needs of the facility. The transition from nursing student to independent practice causes stress as they apply their learning to real-world practice. They experience reality shock when exposed to the complexity of patient care, heavy workloads, technological advances, and lack of communication skills. All these factors contribute to role dissatisfaction and nurse turnover. Nurse turnover is costly and negatively impacts hospital budgets, staff, and patient outcomes. Ninety-one percent (91%) of NLGNs feel stressed by their jobs. Within 1–2 years, 33% leave their first nursing job. In January 2018, Nursing Solutions Incorporated (NSI) published the results of their study that showed 28.3% of all new registered nurse (RN) hires left within a year and 49.8% exited after less than two years of service. New graduate nurses benefit from additional training through continuing education and simulation during their first year as licensed graduate nurses. Additional training helps to minimize the transition gap between student and independent practice (Dyess and Sherman, 2009). New graduate nurses who successfully transition reduce the rate of nurse turnover, thereby helping healthcare organizations show a positive return on investment to (Silvestre et al., 2017). This project study explored NLGNs’ perceptions of their simulation experiences and determined that there is no sufficient evidence that simulation has an impact on enhancing self-confidence. However, there is evidence that simulation has an impact on the overall anxiety level when making clinical decisions. The results of this study demonstrate the value of using simulation as a supplement to traditional standard clinical experiences and identify ways to enhance NLGNs’ self-confidence and decrease anxiety when making clinical decisions. The data may assist nursing educators in creating educational programs that improve NLGNs’ self- confidence in practice as registered nurses.Item Epilepsy knowledge profile and epilepsy self-management: A quality improvement study(2019) Kamau, Catherine; Haley, Sheila M.BACKGROUND AND PURPOSE: Epilepsy is a chronic neurological disorder marked by recurrent seizures. It affects approximately 60 million people worldwide and is the most prevalent chronic neurological condition globally. This quality improvement study was conducted to evaluate whether there was a correlation between general epilepsy knowledge and epilepsy self-management practices in adult patients with epilepsy. METHOD: A descriptive cross-sectional survey was conducted between January 2019 to February 2019 in a metropolitan adult neurology clinic. Two standardized questionnaires, the Epilepsy Knowledge Profile- general (EKP-Q) and the Adult Epilepsy Self-Management Measurement Instrument (AESSMI), were emailed using a PsychData link to patients diagnosed with epilepsy. RESULTS: A total of 39 participants responded to the survey. Four only filled out the demographics part and did not complete the questionnaires. Thirty-five completed both questionnaires but only 29 had valid data on the AESSMI part of the questionnaires. A simple bivariate analysis was completed using the variable EKP-Q and AESSMI. A weak positive correlation between epilepsy knowledge and epilepsy self-management was found with a Pearson correlation coefficient (r=0.378). The level of correlation significance was established at a p-value of 0.05. DISCUSSION: The hypothesis for this study expected a strong positive correlation between epilepsy knowledge and epilepsy self-management. The results found a weak positive correlation due to limitations of time and missing data. Recommendations for future studies is for data to be collected over more extended periods with incentives given to participants for completing the surveys. It is also recommended that future patient education programs focus on both aspects of knowledge and self-management for improved patient outcomes in epilepsy.Item Evaluation of an Evidence-based Algorithm for Patients with Acute Respiratory Failure: A Quality Improvement Project(2022-01-20) Wilson, LaTisha; Thaxton, Cheryl; Smith, MelanieBackground: The past decade, and particularly the past few years, there has been an increased focus on early recognition and responding to deteriorating hospitalized patients. One emerging approach gaining support is the use of early warning scoring (EWS) systems. These systems are designed to detect potential patient deterioration which can lead to initiate early intervention and management, such as increasing nursing attention and informing the provider. However, many hospitals across the United States are not utilizing these systems (Casserly, 2015). The Epic Deterioration Index (EDI) is an EWS. For patients at risk for acute respiratory failure (ARF), the utilization of EDI can promote early detection, which will lead to timely intervention and improve patients’ outcomes. In addition, the EDI can help promoting awareness of the need for institutions to independently validate evidence-based practice algorithms for timely intervention to prevent failure to rescue in patients with ARF. The purpose of this quality improvement (QI) project is to evaluate the implementation of an ARF evidence-based algorithm in the intermediate unit (IMU) to help facilitate timely intervention to patients at risk. Method: IMU providers were given instruction and training in the use of EDI in the context of the hospital’s electronic medical records system. Post-intervention data associated with patient intubation or unplanned transfers to the intensive care unit (ICU) was collected and analyzed against similar pre-intervention data. Statistical analyses of changes in patient care were based in the Pearson’s chi-square procedure. Results: There was a reduction but not statistically significant in the difference of pre- and post-intervention on intubation rates and unplanned transfer to the ICU. However, there was a statistically significant in the use of EWS reports to prompt use of the evidence-based clinical algorithm and promoting appropriate patient care. Conclusion: The evidence-based algorithm utilization is a valid tool to alert healthcare providers in identifying a deteriorating patient condition for timely escalation of care.Item Evaluation of an Evidence-Based Guideline for the Management of Immune-Mediated Diarrhea/Colitis(2022-03-29) Saji, Alice; Thaxton, Cheryl A.; Smith, Melanie; Tietze, MariCancer is the second leading cause of death in the United States as well as in Texas. The introduction of Immune checkpoint inhibitors (ICIs) has been extremely promising for cancer treatment in the last decade. Immune-mediated diarrhea and colitis (IMDC) are one of the main toxicities related to ICI treatment. Early diagnosis and proper management of IMDC helps patients to achieve clinical remission, which ultimately helps patients restart their cancer treatment. This quality improvement (QI) project compared outcomes between patients admitted to the inpatient setting with IMDC in 2017 and 2019 after implementing an IMDC practice guideline in 2018 for standardizing the IMDC practice. Baseline demographic and clinical data were obtained through chart review. The final cohort included 126 patients. Consultation to GI was completed in 55 (82%) in 2019 and 31 (53%) of the patients in 2017 during their first hospitalization for IMDC. Endoscopy evaluation was done for 37 (55%) patients in 2019, and for 20 (34%) patients in 2017. The readmission rate was significantly reduced in 2019 compared to 2017: 30 (51%) patients had multiple hospitalizations in 2017 compared to 17 (25%) patients in 2019. The recurrence of IMDC occurred in only 16 (24%) patients in 2019 compared to 29 (49%) patients in 2017. For the 2019 cohort, 34 (51%) patients followed up in the GI clinic compared to 19 (32%) in 2017. As the number of patients with ICI treatment increases, the number of patients with IMDC also increases. Early GI intervention with endoscopic evaluation and medical management and proper follow-up in GI clinic will help in reducing the readmission rate, recurrence rate, and remission rate for IMDC.Item An Evaluation of the Utilization of Telehealth for Patients with Hypertension- A Quality Improvement Project(2022-06-20) Grant-Mirle, Keely; Chrostowski, Susan; Thaxton, CherylBackground and purpose: Hypertension is the contributing cause of death for nearly half a million people living in the United States each year. Although this condition increases an individual’s risk of stroke, heart attack, and kidney failure, only one out of four people who have been diagnosed with hypertension have their blood pressure under control. The purpose of this project is to determine if patient engagement via a patient portal can be used effectively for improving blood pressure readings in patients with hypertension. Objective: This quality improvement project aims to enhance patient engagement, improve communication between patient and provider, and reduce blood pressure < 140/90 for those patients with hypertension. Methods: A quasi-experimental design study was performed at a community health clinic in the Northeast area of Tarrant County. Forty-three patients agreed to participate. Blood pressures were compared before and after application use. The Patient Activation Measure survey was selected to assess patient engagement. Findings: Paired t-test revealed an improvement of blood pressure readings after portal implementation, and the Pearson coefficient confirmed that patients who consistently accessed the system had better outcomes in their readings. Conclusion: Increased demands are being placed on healthcare providers. Alternative methods to provide care should be considered. Patient portals are an effective form of utilizing technology to manage hypertension.Item Evidence-Based Practice Remote Patient Monitoring Curriculum Development: A Descriptive Pilot Project(2020-12) Wolf, Irene; Roussel, Linda; Tietze, Mari; Bailey, CatherineThe purpose of this project was to build a remote patient monitoring (RPM) evidence-based practice (EBP) curriculum using a curriculum matrix. The curriculum matrix includes technology, patient safety/quality, role, industry, and clinical skills to complete learning objectives regarding RPM information, applications, and clinical decision-making. Methodology: This quality improvement project used subject matter experts were used to obtain a Content Validity Index (CVI) score on pre- and post-test surveys that measured RPM knowledge, experience, and attitude. The pre-test survey, RPM module, and post-test surveys were presented to online students obtaining a master’s or doctorate. Results: Quantitative results indicated that knowledge and experience were significantly improved with RPM content. There was no difference in the attitude score, which may be related to the students themselves because of a high pre-survey score of 9.4 for attitude. The significant results from this pilot project warrant expansion to a larger sample and other universities.Item Faith-based culturally-tailored diabetes prevention program for African Americans(2019) Manning, Carol; Roussel, LindaBackground: The prevalence of prediabetes and type 2 diabetes mellitus (T2DM) in the United States (U.S.) continue to increase. African Americans (AAs) are disproportionately affected by T2DM, thus delivery of diabetes prevention programs (DPP) in a church setting is an effective way to disseminate health information and/or encouraging AAs to adopt healthy lifestyles. Purpose: The purpose of this study was to evaluate the effectiveness of an 8-week culturally-tailored DPP in mitigating the risks for the development of T2DM (also called “diabetes”) in a sample of AA church members through the implementation of the “Power to Prevent” DPP. The DPP was scripturally based and delivered in a church setting. The Diabetes Risk Test (DRT) was used to screen for eligible participants, with a score of five or greater indicating one’s risk for the development of T2DM. Methods: Baseline, and 8-week outcomes measures assessed: (a) knowledge of diabetes prevention strategies, (b) nutrition knowledge, (c) physical activity level, (d) body mass index (BMI) and, (d) weight loss of 5% to 7% of baseline bodyweight. Findings: Seventeen participants (56.6%) completed the study. The mean DRT score was 5.52. Knowledge of diabetes prevention strategies (p = 0.040), and healthy nutrition (p = 0.000) were significant. Physical activity (p = 0.188), and BMI (p = 0.109) did not improve significantly. Mean percentage weight reduction was 1.69%. Conclusion: Ongoing implementation of DPPs which target AAs in real-world settings such as their places of worship are needed to stem the tide of the diabetes epidemic in the U.S.Item Fall reduction program among elderly residents in skilled nursing facility(2019) Jacob, LathaFalls are the leading cause of fatal and non- fatal injuries among the elderlies. Falls threaten seniors’ safety and independence & generate enormous economic and personal costs (NCOA, 2018). The specific aim of the project is to provide an intervention that would reduce incidence of falls among elderly residents in a skilled rehab facility. The QI study will consist of analyzing the application of intervention which mainly includes forming a Fall prevention team, fall risk assessment tool, fall leaves signs, yellow skid socks for high-risk patients, hourly rounding and post fall huddle. The researcher will collect data from EHR of the number of falls before and after interventions and analyzed. Since falls are a leading cause of injuries in skilled rehab facility, addressing this issue is a priority as it has so many consequences. As staff knowledge and implementation of fall prevention interventions increase, patient fall rate will correspondingly decrease.Item A family-based intervention targeting childhood obesity among Ghanaian immigrants: Quality improvement project(2019) Asomani, Gladys; Abraham, AnnieChildhood obesity is an epidemic in developed and undeveloped countries. Obesity and being overweight are said to have a significant effect on physical health, as well as social and psychological consequences in children. The effects of environmental factors, lifestyle behavior, and cultural beliefs play a significant role in this epidemic. Most parents do not identify their children as obese or overweight due to their lack of understanding of childhood obesity. Obesity in the Ghanaian culture is viewed as a positive implication in life; therefore, the quality improvement (QI) project is centered on providing knowledge to influence change regarding obesity. This QI project of a family-based intervention targeting childhood obesity among Ghanaian immigrants using a diet and physical activity approach will help bring awareness and knowledge change. The specific target population for this project was Ghanaian mothers who reside in the United States, who are between the ages of 21 and 43 years, and who have children in a faith-based location. The instrument used in this project was the Family Eating and Activity Habits Questionnaire (FEAHQ), which is categorized into four phenomena, including activity level, eating style, eating related to hunger, and stimulus exposure. Concerning activity levels, the M scores were 1.51 for mothers, 1.28 for fathers, and 2.08 for children. The eating style category was higher at posttest for mothers, at t (22) = 10.04, p =.000. In the eating related to hunger category, 80% of children will delay eating when not hungry compared to a pretest response of 32%. The M score for families eating in restaurants decreased from 1.80 pretest to 1.04 posttest.Item From Taboo to Accepted: Increasing Gun Safety Counseling in Pediatric Primary Care(2021) MacFarlane-Okongo, Shauna; Roussel, LindaFirearm injuries are a leading cause of death among the pediatric population. Previous studies have shown that gun safety at home, meaning that firearms are locked up, unloaded, with ammunition locked up in a separate location, can help to reduce pediatric firearm injuries. Effective interventions, such as pediatric primary care health care providers (HCPs) doing firearm injury prevention (FIP) counseling while giving anticipatory guidance during a well child check, can have a strong impact on decreasing the number of firearm injuries. The evidence-based practice project used an existing evidence-based bundle approach to educate and train HCPs from primary care clinics within a large pediatric healthcare organization to consistently offer FIP counseling during as many well child checks (WCC) as possible. A pre-intervention survey distributed to HCPs was used for baseline measurements, with a bundled educational intervention and post-intervention survey 4 weeks later to assess for anticipated increased confidence, self-efficacy, and frequency in providing FIP counseling. Based on the findings of the project, recommendations were made for ongoing FIP training for HCPs.Item Identifying effective PHQ-9 cut-off points for depression in adolescents(2019) Wheat, Janet; Kubin, LauraPURPOSE: The purpose of this evidence-based practice project was to identify an optimal PHQ-9 Depression screening tool cut-off point in identifying depression in the adolescent population in a primary care setting. METHODS: A plan-do-study-act model was utilized for the implementation of this project. A retrospective chart review was conducted including statistical analysis and interpretation of the PHQ-9 cut-off points in a primary care practice. A matched pairs t-test was used to analyze the practice-wide use of the PHQ-9 Depression Screening tool in the adolescent population. RESULTS: Archival data for 90 adolescents was collected. The mean age of participants was 14.97 years. Participants were predominantly Caucasian and female. Thirty-seven (41.1%) of the adolescents were diagnosed with depression based on a mean score of 12.57 on the PHQ-9. Adolescents meeting the criteria for depression had statistically significant higher PHQ-9 scores than those having no diagnosis of depression. The average or mean score for adolescents diagnosed with depression using the PHQ-9 screening tool was 12.57, however, the analysis demonstrated that a score as low as 7.5 could indicate depression. Therefore, a score of > 7.5 was determined to be the optimal cutoff point for maximizing sensitivity of the PHQ-9 without loss of specificity. CONCLUSIONS: The volume of adolescents seen in the primary care setting affords a rich opportunity in identifying depression in the adolescent population. Current evaluation suggests that using the validated PHQ-9 depression-screening tool with cut-off points of 7.50 or greater would be more effective in the current primary care setting, allowing for purposeful interventions to improve screening for depression in the adolescent population and their outcomes.Item Identifying opportunities to improve transitional care of patients diagnosed with heart failure and diabetes: A quality improvement(2020) Butuk, Regina; Roussel, Linda; Smith, MelanieDiabetes mellitus (DM) and heart failure (HF) are intensifying public health concerns because of their mounting prevalence, high hospitalization and mortality rates, subsequent complications, and comorbidities. DM is characterized by high glycemic levels, and, in HF, the heart cannot efficiently pump oxygenated blood throughout the body. Individuals with DM are two to four times more likely to develop HF than those without DM. DM and HF have become pandemics at local, national, and global levels. As such, they affect all people, and their occurrences are projected to double over the next two decades. DM and HF share pathophysiological characteristics, which worsen the progressions of both diseases, decrease patients' quality of life, and increase healthcare costs. Lack of glycemic control may lead to impaired structural and mechanical functions in cardiovascular diseases (CVDs). It is, therefore, necessary to identify the risk factors related to glycemic control and to guide providers in managing DM and HF patients, offering options that may slow disease progression, improve the patients' quality of life, and reduce healthcare costs.Item Identifying preeclampsia through patient education: A quality improvement initiative(2019) Silas, Kyanna; Menendez-Bobseine, MargaritaPreeclampsia is a major problem in the United States that increased risk of neonatal and maternal morbidity and mortality. Will educating patient and support persons that accompany patients to clinic visits increase awareness of early signs and symptoms of preeclampsia? This quality improvement initiative will consist of a pretest on preeclampsia, followed by an educational sheet on preeclampsia, and then a posttest to confirm successful education. This confirmation should result in a sample size of 80 with an 80% power to detect a mean of paired differences of 0.2 with an estimated standard deviation of differences of 0.6 and with a significance level of 0.05 using a two-sided paired t-test. Validation of success is measured by an increase of 20% on the posttest. The findings will suggest that educating patients and support persons should result in seeking early medical attention when signs and symptoms of preeclampsia arise.Item Identifying risk factors to reduce readmission rates for patients with psychiatric disorders: A quality improvement project(2020) Sancho, Anastasia; Olayiwole, FolasadeThis QI project was a response to increased 30-day readmissions at an inpatient psychiatric facility in SW Texas, identified as the project site. The long-term goal is to decrease 30-day readmissions by patients with schizophrenia and/or bipolar disorder at the project site. An audit tool was created for this QI project by combining the READMIT clinical risk index and site-specific variables that were identified by site experts. Findings showed the numbers of repeat readmission (p = .000) and the age (p =.031) demonstrated statistical significance in 30-day readmissions. There was an association between the number of repeat readmissions and the READMIT Tool Score (rs = 0.57, p < .001). The correlation coefficient between the two variables was (rs = .0575), which is moderately significant. There was a significant positive association between the READMIT Tool Score and repeat numbers of readmissions: (rs = 0.57, p < .001). Findings also indicate two statistically significant risk factors (age and number of readmissions). One clinically significant variable (discharge on injectable long-acting antipsychotic medication) and higher READMIT clinical risk index scores were associated with 30-day readmissions. Recommendations include adding the top-three risk factors identified (age, number of readmissions, injectable medications at discharge) to the admission and discharge process implemented by repeated PDSA cycles. Other recommendations are to join a state or national registry to help track 30-day readmissions and to conduct a one-year study, including chart audits, to access changes in the specific population.