Christine E. Lynn College of Nursing

Childhood and adolescent obesity are significant public health concerns in the United States, with about 19% of children and adolescents aged 2-19 years being obese. Obesity is associated with several health risks, including type 2 diabetes, cardiovascular disease, and mental health issues. However, in many families there is a significant knowledge deficit in terms of risks and prevention for childhood and adolescent obesity. This Doctor of Nursing Practice project aims to address the gap in knowledge and awareness of childhood and adolescent obesity by implementing a screening, education, and counseling program within the Primary care setting. The project identified overweight and obese young adults between the ages of 12-21 years old, as well as providing education and counseling about co-morbid conditions. A 4-point Likert scale, created by the project leader, was given to participants to assess their baseline knowledge at the beginning of the project. Throughout the duration of the project, we worked to provide participants with strategies necessary for healthy lifestyle modification. The project utilized evidence-based interventions to help the participants learn how to adopt healthier habits, in an effort to increase knowledge about childhood/adolescent obesity, its subsequent co-morbidities, and the importance of continual screening, education, and counseling. The same 4-point Likert scale was given to participants as a post-study comparison. At the conclusion of the program, paired sample t-tests and Wilcoxon signed rank tests were used to analyze study data. The paired samples t-test and Wilcoxon signed rank test showed a significant reduction in BMI over the course of the project; furthermore, physical activity, understanding of balanced nutrition, and health food knowledge significantly increased over the course of the project. The implementation of this project has the potential to increase education, awareness, and may improve health outcomes. Future studies designed to empower families and healthcare providers with knowledge and tools to prevent and manage childhood and adolescent obesity, have the potential to make strides towards a healthier and more equitable society.

Obstructive sleep apnea affects an estimated 936 million people worldwide (Pivetta, 2021). Untreated OSA can lead to adverse metabolic, cardiovascular, and neurocognitive consequences, possibly reducing one’s lifespan. Education and screening can spread awareness among a community which typically has limited access to resources and may promote early recognition and treatment.
In a Christian-based prison reentry residential community, a pre-test survey was provided to a total sample of 19 participants to measure baseline knowledge of OSA. After administration of the pre-survey, education was provided in a group setting, using a detailed brochure the DNP student created. After participants read through the material and questions were answered, the post-survey was administered to measure if knowledge regarding OSA increased. Screening using the STOP-Bang questionnaire occurred after the post-surveys. The DNP student followed up with participants found to be at high risk for OSA patients over a 3-month period. A 37% of participants scored high risk for OSA, 37% scored intermediate risk, and 26% scored low risk. The p-value calculated to measure pre-and-post OSA knowledge using the survey total score was statistically significant (< .001.). Of the seven total participants who scored high risk, two were newly diagnosed with OSA after referral to a PCP for a sleep study with the help of the telephonic phone sessions. Education and screening demonstrated to be beneficial, resulting in positive outcomes. Project partakers were successfully able to define OSA, list risk factors, and describe how to diagnose and treat the condition. Participants who were newly diagnosed, previously diagnosed, or refused the sleep study managed to adjust modifiable risk factors over the summer such as weight loss, diet, and management of chronic conditions.

Sleep disorders can affect the length and subjective quality of sleep (insomnia). Numerous research studies have investigated how insomnia affects sadness and anxiety. Nowadays, the term "insomnia" is typically used to describe a disorder in which patients have trouble falling asleep and have difficulties functioning throughout the day. People may not even get enough sleep, or their sleep may not be of high quality. Thus, to gauge the efficacy of insomnia treatments, sleep quality should be measured (Ferini‐Strambi, 2021). Numerous studies have consistently demonstrated that achieving a healthy sleep length and quality can have a positive impact on a wide range of other health outcomes and metrics. Finding and treating the root causes of short sleep durations and poor sleep quality is worthwhile. While it has been demonstrated that enhancing sleep habits can improve assessments of many of these disorders, inadequate sleep has been linked to heart troubles and other metabolic difficulties (Loredo, 2006). For instance, getting continuous positive airway pressure (CPAP) therapy for sleep apnea can enhance the quality of a person's sleep, reduce their risk of developing metabolic and cardiovascular conditions, and stop people with prediabetes from becoming clinical diabetes.

This project will examine Self-care and Burnout amongst Emergency Room (ER) Nurses. This Quality Improvement (QI) project will be conducted at a 26-bed emergency room in a Southeast Florida hospital over 4 weeks. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) by Mind Garden will be administered to nurses pre and post intervention. The intervention will consist of a self-care health promotion presentation that provides information regarding the importance of self-care, self-care tips and examples of implementing these activities in their daily practice. The Maslach Burnout Inventory (MBI) was developed as a research instrument to assess burnout using three dimensions: Emotional Exhaustion, Depersonalization and reduced personal accomplishment. Each participant will be given a link to sign on and complete the Maslach Burnout Inventory by Mind Garden prior to the health promotion presentation and 3 weeks after pre-and post-assessment MBI HSS results. Data was collected from 9 participants. Data was collected in Excel and the data analysis was conducted using Intellectus Statistics (2023). Upper-tailed paired samples t-tests were conducted to examine whether emergency room nurses reported decreases in Emotional Exhaustion and Depersonalization from pretest to posttest. Likewise, a lower-tailed paired sample t-test was used to examine the increase in personal achievements from pretest to posttest. There were decreases in feelings of depersonalization and increases in personal accomplishments were noted after the self-promotion presentation. Self-care may be a simple, cost-effective tool to reduce nurse burnout and promote retention.

Problem: This project addresses the prevalent mental health disparities experienced by older adults in underserved rural areas. Depression, anxiety, and loneliness can be exacerbated by factors such as social isolation, significantly impacting this population's well-being. The implementation of the Program to Encourage Active and Rewarding Lives (PEARLS) aims to bridge the gap and improve mental health outcomes in these communities.
Population: The participants for this project included four older adults over the age of 50 from the underserved rural communities of Belle Glade and Pahokee all of whom reported symptoms of depression, anxiety, and loneliness.

Background: Suicide ranks as the tenth leading cause of death in the United States. Those with substance use disorders face a 10-14 times higher risk of suicide The facility implemented nurse assisted suicide safety plans for patients at moderate or high risk of suicide on the initial Columbia Suicide Severity Rating Scale (C-SSRS). Based on nurses’ comments about the new implementation, it became evident that there was a knowledge gap and education may be able to improve the confidence and knowledge of nursing staff.
Purpose: The DNP project aimed to assist licensed nurses at the project site in enhancing their expertise, understanding and competence in the implementation of suicide safety planning. The suicide safety plan utilized by the facility helps patients identify personal coping strategies and people who can help in times of suicidality and crisis.

Background: Postpartum depression (PPD) is a devastating illness that can produce detrimental outcomes for mothers, families, and communities. Depression screening during the early postpartum period is essential as it assist health care providers in identifying “high-risk” cases of PPD, including women suffering from major depression, hallucinations, or suicidal thoughts (Couto et al., 2015). Postpartum depression is highest in African American (AA) women under the age of 35 years who are single mothers, women who are victims of domestic violence and those who reside in under-resourced communities. Education on how to effectively screen for and treat PPD at the provider and community level is vital in combating the disparities in black maternal mental health.
Objective: The purpose of this project is to implement a quality improvement project that will identify the lack of screening for PPD in AA women <35 years by healthcare providers, and educate and train clinical providers on how to effectively screen and diagnose PPD using a standardized screening tool during the early postpartum period of AA women < 35 yrs.

This paper presents a Quality Improvement project aimed at increasing physical activity in Hispanic patients aged 45 to 55, through a Get Active program with the goal of reducing the risk of cardiovascular disease (CVD). The project involves implementing a bi-weekly physical activity session as well as a Zoom session to increase activity as well awareness surrounding CVD prevention. The project's outcomes will inform medical staff on how to create more Zoom sessions to help patients implement a physical exercise program. A total of twenty-five participants were eligible to participate, and only 8 took part in the study. This initiative has the potential to make a significant impact on public health by reducing the incidence of CVD among the Hispanic population.

Premenstrual symptoms have the potential to impact all women of reproductive age. Roughly 70-90% of women experience some level of premenstrual discomfort, while 3-8% experience the most severe, complex form, PMDD (Mishra, Elliot, and Marwaha, 2022). PMDD symptomatology is complex, and therefore overlaps with other diagnoses, which has complicated the diagnostic process. There is a growing body of evidence to support that PMDD has been misdiagnosed or disregarded, and stigmatized by providers, and improvements are needed in both the education about the diagnostic process, as well as the diagnostic process itself. The purpose of this quality improvement project was to improve the quality of the assessment, diagnosis, and management of PMDD, and gain insight into the lived experiences from those living with the disorder as well as insight into the management of the disorder from clinicians. The populations of interest were menstruating females, age 18-45, documented history of mood instability or mood changes, in addition to treating clinicians at an outpatient psychiatric clinic. Practice changes that were implemented were as follows: implementation of the premenstrual symptoms screening tool (Appendix A) within the medical record; creation and distribution of informative/educational pamphlet/PDF for clinicians about PMDD diagnosis, assessment and treatment (Appendix B); creation and distribution of likert and open ended survey to measure perception of patients regarding diagnostic process, treatment and care overall; creation and distribution of likert and open ended survey to measure perception of clinicians regarding the use of the tool and how it affected their clinical decision making. Outcomes focused on screening practices and results, documentation in the medical record, engagement, and patient perception. Data was analyzed using clinical record reviews, interviews, Likert-type scales, and coding. Descriptive statistics were used to describe the population, and pre/post intervention changes. Relevant insight was gained on the knowledge gap and under recognition of Women's Health disorders such as PMDD and on screening practices. The project was successful in improving knowledge base of PMDD in both patients and clinicians. The limitations focused on patients’ engagement in the survey on follow up, as well as clinician engagement in the project overall. To further improve the diagnostic process, increase education and reduce stigma, future research may focus on improving engagement of clinicians and patients, and/or assessing current screening practices or treatment regimens for PMDD.