DNP Projects Making a Difference

dnp-projects

The Doctor of Nursing Practice (DNP) degree program at Chamberlain College of Nursing culminates in an evidence-based final project, challenging students to take the latest nursing research and apply it to a specific issue at their practicum site.

These projects result in real, sustainable change that helps raise the level of patient care, whether that be by impacting healthcare policies, stronger leadership skills for nurses or increased access to care. These DNP students are stepping up to be policy makers, leaders, educators and mentors, fostering positive transformations in healthcare for healthier communities.

Read on to learn more about just a few of the amazing projects our recent DNP graduates have implemented.


Treating Mental Health in Primary Care

Jennifer Keller, DNP, CPNP, PMHS
Chamberlain DNP ’15

jennifer-kellerDr. Keller, a Philadelphia-area pediatric nurse practitioner, noticed that patients with mental health concerns often slip through the cracks in the primary care setting – especially adolescents with depression or anxiety.

Parents are often advised to call the mental health number on the back of their insurance card, or are simply provided a list of referrals. Waitlists to see a mental health professional can be long; insurance authorizations don’t always come through.

Even though she is certified as a primary care mental health specialist, Dr. Keller explained there was very little she could do when a patient expressed a mental health concern within her clinical practice structure and its 15-minute consult slots.

“That’s what primary care is turning into – it’s no longer the provider telling the patient to do this. It’s all about health and wellness for the body, spirit and mind. We are partners with the family to guide them throughout life.”
– Jennifer Keller, DNP, CPNP, PMHS
Chamberlain DNP ’15

“I’d have to refer them out because I didn’t have time to address it,” she said. “I felt I was doing a disservice to these patients. Nobody wants to divulge a personal, private problem and have you say, ‘I hear you. You’re going to have to go somewhere else to deal with that.’”

With her DNP project, she set out to make a change. Dr. Keller worked with an established model for treating mental health within the primary setting, adapting it to her practice. After overcoming the initial challenges, she says, “It’s completely taken off.”

Today, in addition to treating both sick and well children, Dr. Keller has four to five 45-minute consult slots per week specifically for mental health. She assesses patients, prescribing prescriptions when appropriate, following strict guidelines from the Pediatric Nurse Certification Board. She’s also built relationships with area social workers, therapists and psychiatrists, so that she can provide trusted referrals and a level of continuity in the patient’s treatment plan.

The response from families has been resoundingly positive. “They are relieved someone is there to help them navigate,” said Dr. Keller. “That’s what primary care is turning into – it’s no longer the provider telling the patient to do something. It’s all about health and wellness for the body, spirit and mind. We are partners with the family to guide them throughout life.”


Strengthening Business Acumen for Nurse Leaders

Melissa Burdi, DNP, MS, RN
Chamberlain DNP ’15

melissa-burdiFor her DNP project, Dr. Burdi started at the top, developing a program to help strengthen the leadership skills of nurse managers. She explained that in many organizations, nurse managers rarely receive much formal training in the skills they need to successfully lead teams – skills such as strategic planning, risk management and workforce planning.

“Oftentimes, nurse leaders attain leadership positions based on their clinical competence,” Dr. Burdi said. “They’re a really strong practicing nurse, so they become the charge nurse. As a charge nurse, they’re asked to manage healthcare as a business – that takes a different knowledge base. Depending on their academic background, they may not have had exposure to this information.”

“It was a good ‘a-ha’ moment for the organization. It showed them where and how to focus their training efforts…”
– Melissa Burdi, DNP, MS, RN
Chamberlain DNP ’15

To identify and address this gap, she aligned Patricia Benner’s “Novice to Expert” framework with the five nurse leader competencies established by the American Organization of Nurse Executives (AONE) – communication, knowledge of the healthcare environment, leadership, professionalism and business skills.

She measured the perceived competencies of 35 nurse leaders of varying levels of experience at a large Chicago-area hospital. She then developed and delivered a formalized leadership training program addressing their greatest needs.

Following implementation of the leadership training program, a post-survey showed a significant increase in participants’ business acumen – areas such as financial management, conducting a gap analysis, and understanding legal and ethical issues.

“The nurses who participated in the program appreciated the investment in them,” said Dr. Burdi. “But it was also a good ‘a-ha’ moment for the organization. It showed them where and how to focus their training efforts to help their nurse managers provide even more effective leadership.”


Helping Teen Moms Delay a Second Pregnancy

Leslie Schoenberg DNP, RN, PHN, CPNP, CNE
Chamberlain DNP ’15

leslie-schoenbergFor her final project, Dr. Schoenberg developed an evidence-based contraception education program for Nurse-Family Partnership (NFP), a home visiting program for vulnerable first-time moms and their babies.

The goal: to help reduce the rates of early subsequent pregnancy among the organization’s clients. Studies show that increased spacing between births is correlated with improved outcomes.1

Dr. Schoenberg’s education program presented the entire range of birth control options but emphasized long-acting reversible contraceptives (LARCs), such as IUDs and implants, which have been shown to be most effective for teens.2

It was designed so nurses could introduce the topic at one visit and follow up during subsequent visits – a structure aimed at addressing the unique needs of NFP’s clients.

“Literature shows that teens have to be presented with facts in several different ways, and it needs to be reinforced,” says Dr. Schoenberg. Her program was piloted at six branches of the agency in Southern California and resulted in a doubling of nurses’ knowledge about LARCs and a 17.7 percent increase in the frequency of LARC education during home visits.

Confident that these results will translate into lower subsequent pregnancy rates among their clients, NFP now plans to implement her education program at its agencies across the country.


Calling Out Incivility

Evelyn Hollingquest, DNP, RN, NE-BC
Chamberlain DNP ’16

evelyn-hollingquestIn her 29 years as a nurse, Dr. Hollingquest has witnessed her fair share of incivility from fellow nurses or other colleagues – a behavior that the American Nurses Association (ANA) defines as “one or more rude, discourteous or disrespectful actions that may or may not have a negative intent behind them.”3

As part of the spectrum of behaviors that includes bullying and workplace violence, incivility can have a negative impact on staff morale, nurse safety and patient safety.

For her DNP project, Dr. Hollingquest decided to take a hard look at incivility among nurses and to determine whether specific steps – including incivility awareness seminars, role-playing and a code of conduct – would help increase nurses’ sense of respect and job satisfaction.

Results included changed perceptions about incivility and decreased staff turnover.

She piloted her program in the operating room of a Chesapeake, Virginia, hospital. Results included changed perceptions about incivility, decreased staff turnover and increased reporting of discourteous behavior in the workplace.

Interestingly, reporting wasn’t just limited to nurses. As a result of the program, nurses also began to speak up about disrespectful behavior from other healthcare professionals.

“They weren’t so silent anymore,” said Dr. Hollingquest.

Noting the positive outcomes of her pilot, the hospital plans to expand the program to other nursing departments.

1. DeFranco, E. A., Seske, L. M., Greenberg, J. M., & Muglia, L. J. (2014). Influence of interpregnancy interval on neonatal morbidity. AJOG, 212, 1.e1-1.e9. doi: http://dx.doi.org/10.1016/j.ajog.2014.11.017

2. 
Waggoner, M. L., Lanzi, R. G., & Klerman, L. V. (2012). Pregnancy intentions, long-acting contraceptive use, and rapid subsequent pregnancies among adolescent and adult first-time mothers. Journal of Child and Adolescent Psychiatric Nursing, 25, 96–104.= doi:10.1111/j.1744-6171.2012.00326.x

3.
http://www.nursingworld.org/Bullying-Workplace-Violence


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