Tarana Warfield, MSN, FNP-C
DNP project title: Educating Health Care Professionals on the Assessment, Management, and Screening of Suicide Risk in a Primary Care Setting
Abstract: Suicide is a growing health problem in the United States. Suicide rates have increased drastically, by approximately 30% from 1999 to 2018 (CDC, 2018). Forty-five percent of persons who commit suicide visited their primary care provider within 1 month of their death (McDowell, Lineberry, & Bostwick, 2011). Even more disturbing, primary care providers discuss suicide in only 11% of encounters with patients who test positive for suicidal ideations. When surveyed, less than one-fourth of primary care providers reported they frequently or always screen adolescents for suicide risk. Educating health care professionals on the assessment, management, and screening of suicide risk is thus vitally important. Educating health care professionals will help identify those persons at risk for suicide and assist health care providers in managing suicidal patients.
Aim and Goals: This project aimed to develop a 20 – to 30-minute educational session intervention in which health care providers will be taught how to assess, screen, and manage suicide risk in a primary care setting. The hope is that this intervention will provide health care providers the education needed to assess, screen, and control for suicide risk. The specific goals for this intervention are: (1) increase PCP use of the Patient Health Questionnaire–9 (PHQ-9), and (2) increase health care providers’ management of suicide risk in the primary care setting. The PICO questions to be addressed were: 1) Will use of the PHQ-9 screening tool by health care provider participants increase after attending the 20- to 30-minute educational session compared to 1 month before the educational session? 2) What effect did the 20- to 30-minute educational session have on the assessment, management, and screening of suicide risk in a primary care setting by health care provider participants compared to the assessment, management, and screening of suicide risk in the month before the educational session?
Design: This quality improvement project utilized a pre-/post-intervention design to assess changes in provider use of the PHQ-9 and management of patients at risk for suicide. Data from a monthly clinic report provided information on the number of PHQ-9s administered. The number of PHQ-9s reported in the month before the intervention was compared to the number reported in the month after the intervention. Patient charts were reviewed before the educational session to determine how many patients have been assessed, managed, and screened for suicide risk.
Results: Both of the PICO questions were answered. Use of the PHQ-9 screening tool did not increase after participants took part in the 20 – to 30-minute educational session compared to the 1-month period before the educational session, as the PHQ-9 was already used by all three of the providers who participated in the intervention. However, the assessment and management of these patients improved after the 20 – to 30-minute educational session compared to the 1-month period before the educational session.
DNP Project committee: Dr. Sharisse Hebert, chairperson, Dr. Dr. Benjamin Garner, Dr. Gloria Rose, and Dr. Jerrel Moore.
Ms. Warfield received an undergraduate degree from Xavier University of Louisiana, in New Orleans and the BSN and MSN degrees from Prairie View A & M College of Nursing in 2005, and 2010.
LaTanya Ford, MSN, FNP-C
DNP project title: Assessing Parental Perceptions of Child Weight Status to Reduce Pediatric Obesity
Abstract: The prevalence of childhood obesity has risen dramatically in recent years, reaching epidemic proportions as more than a quarter of children in the United States are considered obese. It is particularly concerning that obesity is disproportionately common among minority children in the United States. Current research points to a potential association between pediatric obesity and parenting styles and practices. There is substantial evidence that parents worldwide and throughout different cultures and child age groups face challenges in accurately perceiving their child’s weight status. Many parents cannot recognize their children as overweight or obese, causing some parents with an overweight or obese child to perceive that child as being of normal weight or even underweight. Parents must identify their child’s weight status correctly to address the health risks associated with obesity. The purpose of this study was to determine if the use of an evidence-based visual aid to educate Black and Hispanic parents during pediatric office visits would improve the accuracy of parents’ perception of their overweight child’s body mass index (BMI). The study also examined whether an improvement in parents’ perception of their child’s BMI led to a reduction in their child’s weight. A Child Feeding Questionnaire (CFQ) assessed parents’ perceptions of their child’s weight status in an outpatient clinic. The study sample consisted of 53 parents and 53 children 2–14 years of age who met the criteria for being overweight or obese (BMI at the 85th percentile or above). Upon completion of the CFQ, the parents were counseled on their child’s clinically defined weight status using a color-coded visual aid. Ninety-five percent of parents in the study had an inaccurate perception of their child’s BMI status at baseline. Four to six weeks after the initial visit, the participants returned for a follow-up visit and completed another CFQ.
Wilcoxon signed-rank tests compared the responses to the CFQ at baseline and follow-up. The results showed that the parents’ perceptions of their child’s weight status were more accurate at the follow-up visit than at baseline. A paired-sample t-test indicated an overall reduction in the children’s mean weight between the baseline and the follow-up visit. These results suggest that the intervention using the color-coded BMI chart was a useful tool to educate parents about their child’s weight status and beneficial if used in routine clinical practice. A chi-square analysis to determine if there was a relationship between the parents’ perceptions of their child’s weight and children’s weight was inconclusive. Future research should examine whether the ability to identify children’s weight status accurately influences the likelihood that parents will implement long-term lifestyle changes that promote healthy weight in their children.
DNP Project committee: Dr. Abida Solomon, chairperson, Dr. Vivian Dawkins, Dr. Sharisse Hebert, and Dr. Jerrel Moore.
Ms. Ford received the BSN and MSN degrees from Prairie View A & M College of Nursing in 2007 and 2012.
Laqueisha J. Hamilton, MSN, FNP-C
DNP Project title: Improving Postpartum Return Visit Rates through Implementation of an Educational Teaching Tool: A Quality Improvement Project
Abstract: The postpartum period being a critical time in a new mother’s life due to the various changes her body and mind may experience is also a time in which evaluation of physical and mental health is important. The postpartum period Postpartum return visits are currently underutilized in the United States and world-wide. The purpose of the study was to evaluate whether the implementation of a postpartum educational brochure would have an impact on postpartum return visit rates at 3-weeks postpartum and 6-weeks postpartum. A prospective and retrospective review of postpartum return visit rates were evaluated after the implementation of the postpartum educational tool at University of Texas Medical Branch Regional Maternal Child Health Program Pasadena, Angleton and Texas City.
Data from the three locations were compiled for analysis. The total number of patients who delivered at UTMB Hospital Galveston Campus (N=1266) were compared to the number of patients who returned for a 3-week postpartum visit (N=772) and 6-week postpartum visit (N=619) among the three locations in which the intervention was distributed. An asymptomatic difference of 0.381 was shown in the 3-week postpartum return visit rates indicating no statistical difference when the intervention was distributed. An asymptomatic difference of 0.003 was shown in the 6-week postpartum return visit rates indicating a positive difference when the intervention was distributed. Therefore, distribution of a postpartum educational brochure has a positive impact on postpartum return visit rates at 6-weeks postpartum.
DNP Project committee: Dr. Gloria Rose, chairperson, Dr. Abida Solomon, Dr. Ruby Benjamin-Garner, and Dr. Roshunda Steele.
Ms. Hamilton received the BSN and MSN degrees from Prairie View A & M College of Nursing in 2004 and 2009.