Harris, Nancy

This project aimed to address the challenge of managing non-motor symptoms in individuals with Parkinson’s disease (PD) through a mindfulness-based intervention. Non-motor symptoms, including mood disturbances, cognitive impairments, and urinary issues, significantly impact the quality of life and are often overlooked in clinical practice. The mindfulness program demonstrated statistically significant reductions in UPDRS Part I scores post-intervention (t(4) = 5.31, p < .01), highlighting improvements in emotional and cognitive symptoms. NMSS data revealed Mood/Cognition and Urinary domains as key areas of concern, further emphasizing the need for targeted interventions. Participants reported enhanced mood, relaxation, and social connection, identifying these as the most valued aspects of the program. Recommendations include expanding access to mindfulness classes, offering tiered options for diverse skill levels, and integrating the program into standard Parkinson’s care. As a Doctor of Nursing Practice (DNP) )-led initiative, this project underscores the critical role of DNPs in implementing evidence-based, patient-centered interventions to address complex healthcare challenges.

This Doctor of Nursing Practice (DNP) project was to enhance primary care providers' self-efficacy in delivering effective care to neurodivergent adults. Despite the growing recognition of neurodivergence, many primary care providers report feeling inadequately prepared to meet the complex healthcare needs of autistic patients, resulting in barriers to care, miscommunication, and suboptimal health outcomes. This project sought to address these gaps by integrating a comprehensive, evidence-based educational resource, Clinical Care for Autistic Adults, into a professional development initiative for primary care providers. The course covers critical topics such as understanding autism spectrum disorder (ASD), recognizing co-occurring health conditions, effective communication strategies, and promoting patient-centered care. Providers participated in the course and completed pre- and post-intervention A.A.S.P.I.R.E surveys to assess changes in their knowledge, confidence, and attitudes regarding the care of autistic individuals. Findings indicated significant improvements in providers' self-reported self-efficacy. The results suggested that implementing education such as the Clinical Care for Autistic Adults can improve providers self-efficacy by helping to equip providers with the tools necessary to navigate a growingly diverse patient population.

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.

In 2019, the leading cause of death in the United States was cardiac disease associated with high blood pressure. High blood pressure has had profound consequences on people’s lives leading to stroke and even death. As a preventive measure, providers have encouraged lifestyle changes in order to help alleviate the burden of this condition. One of these consist of altering eating habits to a strictly plant-based diet. With the help of Doctor Sarah Long DNP, ten participants suffering from high blood pressure have volunteered to alter their eating habits for four weeks to further demonstrate the efficacy of plant-based diets. Thanks to Nola J. Pender’s Health Promotion Model and a paired t-test, this project was able to provide additional insight on the efficacy of plant-based diets while analyzing the participants’ willingness to alter their lifestyles for health promotion purposes. The results further demonstrated the effectiveness of plant-based diets by successfully assisting nine of the ten participants in lowering their blood pressures.

Intimate partner violence (IPV) is a global health problem affecting millions of individuals. The purpose of this DNP project is to compare current IPV practices and recommend use of an IPV screening tool into practice along with staff education to improve screening practices in primary care. The overall goal is to increase screening of IPV in primary care, which rates are currently very low throughout the nation.
To achieve this goal a quality improvement project was conducted with participants at a local clinic in Fort Pierce. The staff and providers received a PowerPoint and verbal presentation, which focused on the ability to identify IPV. They received a pre-intervention survey and a post intervention survey at the completion of the presentation. They were also given information on referrals and resources for patients identified with IPV. 54% of providers responded that they do not currently screen for IPV. Participants showed that they would in the future use a screening tool in practice. They also showed a significant change in perceptions after the intervention. Providers also felt that they do have time to screen for IPV in the future and thus resulting in practice change.

Asthma is a chronic lung disease affecting all age groups worldwide with a need of educational interventions to ensure asthmatic individuals are correctly and accurately using prescribed inhalers. To improve pulmonary function on asthmatic individuals, this doctoral quality improvement project was designed to increase the knowledge of patients with an asthma diagnosis by using traditional teaching methods with the addition of an instructional mobile phone app to treatment plans on inhaler technique and pulmonary function. The purpose of this paper is to address the need for proper and sufficient inhaler education for individuals with an asthma diagnosis requiring a prescribed inhaler to increase FEV1 by using the latest evidence-based research and providing a complete description of this doctoral quality improvement project with recommendations for change of practice. Included will be an analysis of the results, evaluation of the complete project and future practice changes.

The inappropriate use of antibiotics to treat non-bacterial infections has contributed to one of the public health problems resulting in antibiotic resistance (CDC, 2019). The purpose of this DNP project was to analyze providers’ awareness and beliefs regarding antibiotic use and resistance and to evaluate the effect of an antibiotic stewardship program on urgent care providers’ antibiotic prescribing for acute bronchitis. The overall goal is to decrease antibiotic resistant infections by reducing inappropriate antibiotic prescribing for a viral infection. To achieve this goal, a quality improvement initiative was conducted with five participating urgent care providers. Pre-RAMP intervention there was an average of 64% of over prescribing antibiotic for acute bronchitis, post-RAMP intervention was 18% which was a 71.8% reduction of over prescribing for acute bronchitis. With continuation of the RAMP intervention, at a greater scale, it will produce a sample size with enough data to fully support the cause for awareness of antibiotic prescribing for safe and quality patient care.

Ultraviolet radiation exposure (UVR) is the most significant modifiable risk factor in preventing skin cancer. Seeking shade, and wearing hats, photoprotective clothing, sunscreen, and sunglasses are effective sun protective behaviors proven to reduce long-term morbidity and mortality from UVR. To be effective, these behaviors must be practiced consistently and adopted early within childhood. This quality improvement project explores the impact of sun protective behavior counseling in parents with children aged six months or older. Sun protective behavior counseling was given to parents in conjunction with evidence-based supplemental infographics along with examples of appropriate clothing, sunglasses, hats, and sunscreens. Successes of the project were measured with the pre- and post-test Sun Habits Survey and midpoint Sun Habits Diary and analyzed through parametric testing. Significant improvements in post-test scores were seen in sunscreen behaviors and were supported by the diary entries, with significant sunscreen use occurring on both weekend days and weekdays. Due to the favorable outcomes of this project, it is recommended that it be adapted to a larger scale and within communities.

Anaphylaxis is a rapid-onset, severe life-threatening allergic reaction. With as many as 1 in 20 adults experiencing anaphylaxis in their lifetime, it is imperative that the condition can be recognized quickly and accurately. It was identified that there was no consistent manner in which patients seeking treatment were evaluated. Therefore, with the intention to increase awareness of symptoms and introduce a standardized screening process. Over an eight week period, any patient presenting to the urgent care was screened using the Anaphylaxis Rapid Screening Tool (ARST) . 17 Urgent care staff members willing participated in the intervention which included use of the ARST, the Anaphylaxis Case Scenario (pre- and post-) Test, and the East of Use and Confidence Questionnaire. Results: 47% of the staff demonstrated an increase in post-test scores; no staff member scored worse on post-test. 93-100% of staff verbalized ease of use of tool, increased confidence in ability to recognize symptoms of anaphylaxis, and the tool helped them to recognize other signs and symptoms of anaphylaxis. Total patient sample requiring screening was 117. Screening compliance rate of 32.5%. Limitations: small sample size (both of staff and patients screened), short project duration period, limited to a single urgent care location. Recommendation: expand the number of sites implementing the intervention for a minimum of a 12-month period in order to further evaluate outcomes.