Christine E. Lynn College of Nursing

Background: The aim of this project was to describe a quality improvement program for Afro-Americans and Afro- Caribbean with hypertension that implemented a self-management program to enhance knowledge and self-management strategies to lower hypertension (HTN) and body mass index (BMI) within a twelve-week period. These markers addressed variables such as blood pressure monitoring, prevention, or reduction of hypertension.
Method: This quality improvement project consisted of six volunteer participants. The participants were comprised of two males and four females of Afro- American and Afro-Caribbean descent with a history of hypertension who received the Hypertension Knowledge-Level (HKL) scale questionnaires used as a pre-and post-intervention, American Heart Association (2018), pre-training demographic questionnaire, and evidence-based educational guidelines materials about hypertension and self-management.

Background: Alcohol use disorder (AUD) is a serious problem that has affected countless of people in the United States. This disorder is difficult to treat and despite evidence-based treatments, there continues to be a problem. Treatment centers often attempt to address AUD with personalized detox protocol based on tradition and evidence that attempt to target pertinent factors that may increase the likelihood of sustained abstinence. Purpose: To conduct a program evaluation of thedetox protocol for patients diagnosed with AUD at a treatment center in south Florida. This program evaluation will yield important information regarding the outcomes of an established program. This project identified strengths, opportunities for improvement, and opportunities to support current practice at this facility.

Substance abuse, specifically opioid abuse, continues to be one of the largest epidemics in the United States. Death caused by overdose has seen a steady increase over the past few decades, and despite public health initiatives such as clean needle exchange programs, methadone clinics, and Narcan, there continues to be a concerning rise in the number of drug usage and death secondary to drug overdose in the young adult. Recently, Narcan became approved for over-the-counter usage to combat the increased incidents of overdose. Scholarly evidence shows that opioid use disorder is most effectively treated with a combination of medication and psychotherapy, particularly Cognitive Behavioral Therapy (CBT). Although Medication-Assisted Therapy (MAT) remains the gold standard in the treatment of opioid use disorder, the evidence and literature presented throughout this project will document how much more effective treatment is when patients are engaging in psychotherapy. The evidence shows that patients have a reduction in cravings, there is a reduction in relapse, and in many cases the patients can maintain long-term sobriety utilizing the tools learned in psychotherapy sessions. This project is a quality improvement project, in which I assessed the current processes in place to assess current treatment of patients seeking initial psychiatric evaluation, as well as of those engaging in follow up visits for the treatment of OUD. From there, I realized that my project site did not have a current process in place unique to patients being seen for OUD. I developed a questionnaire, based on similarities between our patients seen for OUD, that would be used with patients to establish a baseline and used to gauge effectiveness of treatment at increments. Ten patients were followed from May to October to generate these findings that will be presented. In the end, this project has provided a promising conclusion: combined therapy with MAT and psychotherapy for treatment of OUD is effective in optimizing sobriety.

Purpose: Hypertension is a major concern in healthcare today, especially in African Americans. Causes of high blood pressure are multi-factorial and may include poor lifestyle choices, medication adherence, ineffective follow-up care and patient health care knowledge deficit. All aspects of blood pressure reduction are multifactorial, so they need to be addressed for adequate health control.
Methods: The participants for this project included eight older adults ages 40-85 years in an Urban African American church in Port Saint Lucie. This project aims to determine if a 3-month educational class that involves Dash diet, exercise planning, and antihypertensive adherence will improve blood pressure in African Americans.

Deficits in patient and provider knowledge in the use of complementary and integrative care (CIC) methodologies resulted in the planned creation of a future CIC educational course for outpatient advanced practice registered nurse practitioners (APRNs) who often serve as a primary source of health education for their patients. A survey, which was based upon the Theory of Bureaucratic Caring and the Canadian Institutes of Health Research’s (CIHR) knowledge-to-action (KTA) cycle, and incorporated elements of the Complementary and Integrative Health Assessment for Practitioners (CIAHP) and the Complementary and Alternative Medicine Beliefs Inventory (CAMBI), was created to assess the CIC educational needs of APRNs employed in primary care/outpatient settings. Survey participants identified their preferred method of instruction, top areas of CIC topics of interest and occupational applicability, and preferences for CIC educational course design and delivery. A low ratio of survey respondents versus completion rate and the lack of participant occupational and demographical diversity were observed challenges. Survey data supported the need for the creation and implementation of a pending CIC educational course with a goal of mirroring the educational needs of advanced practice registered nurses.

Geographical and health-related obstacles frequently prevent veterans from receiving care from civilian hospitals and the Veterans Health Administration. Due to poor patient education and lack of access to mental health care, many patients with serious mental health illnesses have no choice but to go to emergency care for mental health treatment that could be treated effectively in an outpatient setting. An initiative identifying the factors that lead veterans to the emergency room for preventable mental health services has the potential to improve public health. Home-based mental health care can be provided in many modalities, including telehealth, video conferences, and in-person (face-to-face; In addition to eliminating transportation issues, improving access to mental health services, and reducing the stressors of waiting for appointments in outpatient clinics.
The project was conducted with veterans enrolled in a home-based primary care program at a Southwest Region Hospital. A total of 15 male veterans between the ages of 55 and 85 agreed to participate. Six were African American (40 %), 5 were White (33 %), and four were Hispanic (26.6 %). A repeated measures ANOVA was conducted on PSS-10 scores. The main effect for the within-subjects factor was significant, F(3, 42) = 41.59, p < .001, indicating there were significant differences between the values of Pre-Intervention PSS-10 scores, Month 1 Pss-10 score Month 2 Pss-10 score, and Month 3 PSS-10 scores. A Repeated Measure ANOVA was conducted on Psych ER visits. The main effect for the within-subjects factor was significant, F(1, 14) = 93.04, p < .001, indicating significant differences between the values of Pre-intervention Psych ER visits and Month 3 Psych ER visits.

Substance use disorders (SUD) are associated with an excessive number of hospital and emergency room visits, as well as noncompliance with medical guidance. Many low-barrier substance abuse treatment bridge clinics are hospital-based outpatient operations that are not licensed as opioid treatment facilities (OTPs). The aim of this quality improvement project is to reduce ER readmissions for patients suffering from substance abuse disorders. Improvements were seen in patients after three months of participation in the provided BRIDGE program using the shared technique. The Agency for Healthcare Research and Quality's (AHRQ) SHARE Approach to Decision-Making assists healthcare clinicians in partnering with patients to make the best decision possible for them. The frequent emergency room visits by people suffering from SUD inspired our project. The DNP student visited with SUD patients in the ED and engaged in collaborative decision-making with them. This project aims to educate individuals who visit the Broward Health Medical Center emergency room about the importance of a substance abuse treatment program. Nonparametric statistics were utilized to determine the extent to which the individual was active in the decision-making process. Descriptive statistics were used to describe the participants who consented and refused to participate in the BRIDGE Program, as well as to calculate the percentage of participants who agreed to participate in the BRIDGE Program and whether any of them were readmitted during the program.

In the United States over 37 million people have diabetes. The condition damages blood vessels and tissues leading to peripheral neuropathy and impaired wound healing. The loss of protective sensation associated with diabetes can prevent patients from recognizing when they have a wound or some other kind of skin damage present. Delayed identification of wounds in a diabetic patient can have dangerous consequences, most notable amputation of the affected body part. In fact, diabetes is the strongest influence in non-traumatic lower extremity amputations. The purpose of this project was to increase patient knowledge of proper foot-care as well as improve foot self-care behaviors at home. The project team members sought to achieve this by implementing a standardized patient education program for diabetic patients in addition to performing a diabetic foot exam (DFE) with the patient in the primary care setting. The education sessions included verbal and written instruction that were developed using the American Diabetes Association (ADA) proper foot care guidelines. After the implementation of the project, scores on both the basic diabetes foot-care questionnaire and the diabetes foot self-care behavior scale (DFSBS) increased.

Background Interprofessional collaboration and knowledge of how to care for older adults are important components of high-quality care for a multitude of healthcare disciplines. The aging population presents unique challenges to healthcare professionals, and education on how to care for older adults can equip them with the knowledge and skills needed to provide optimal care. Florida Atlantic University’s (FAU) Office of Interprofessional Education and Practice (IPE&P) designed a Foundational Level Program which includes the Canvas modules for IPEP 2022-2023 and the Senior Adult Geriatric Educator (SAGE) visits. This program is an example of an academic initiative that aims to improve interprofessional collaboration among healthcare professionals regarding education and assessment of the aging population.
Aim This program evaluation aimed to examine the current SAGE Mentor program that is presented through Florida Atlantic University’s Office of Interprofessional Education and Practice and to evaluate whether students who participated experienced enhanced competency upon completion of this Foundational Level Program.

In the aftermath of the Covid-19 pandemic, bereavement and grief have become two widely used terms in modern day society. The terms are often used interchangeably to describe a feeling of deep sorrow felt after the loss of a loved one. Often it can be difficult for individuals to cope with the loss of a loved one, and it is estimated that 20% of bereaved individuals will experience complicated grief (NAMI, 2021). Complicated grief, often referred to as a prolonged grief disorder, can be defined in several ways. Today, the most widely accepted definition of complicated grief is grief that persists for longer than one year and significantly interrupts an individuals’ ability to complete daily functions (Cleveland Clinic, 2022).
Each year, there are roughly 2.6 million deaths in the US alone, leaving behind approximately 13 million individuals (about twice the population of Arizona) to grieve (U.S. Census, 2021). A study conducted in 2019, surveyed 1,084 US adults and found that 32% had experienced grief following the death of a loved one in the past three years (The Grief Experience, 2019). Furthermore, of U.S. adults over the age of 65, 71% reported experiencing bereavement in the previous 30 months (Williams & Sawyer, 2017).