Cervical cancer is the most common human papilloma virus (HPV) -associated cancer and is the second leading cause of death in the world. Vaccination against HPV is essential to reduce the incidence of HPV and subsequent morbidity and mortality. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV. The site for this DNP project was a 163-bed facility with inpatient and outpatient services in the southern United States. The vaccination rate at the site was 48%. The facility lacked educational interventions to prepare and remind providers to offer HPV vaccine. The purpose of this DNP project was to address a significant gap by increasing clinician knowledge through the development of educational materials, the design and implementation of training sessions for staff, and the development of protocols that require providers to offer the vaccine to every eligible patient and to call the patient and remind them of appointments for vaccine injections. The academic center for evidence-based practice star model was used to translate knowledge into nursing practice to improve outcomes change. For this project, a panel of 10 experts from the facility was formed to conduct a formative and summative evaluation of the educational materials and protocols. The findings of the study showed an acceptance of the plan suggesting the importance of the educational materials and the educational process to increase HPV vaccination rates, which can thereby reduce death and disease associated with HPV through the empowerment of the clinicians to provide necessary and appropriate care.

Research-informed practice is crucial to ensure best possible decisions are made during care delivery. In reality, research-based evidence often does not reach patient care due to many elements that impede the implementation process. The purpose of this phenomenological study was to discover the lived experiences of nurses involved in implementing evidence-based practice (EBP) in clinical settings within hospitals in United Arab Emirates. The theoretical and conceptual basis for the study was derived from Promoting Action on Research Implementation in Health Services framework for knowledge translation and Benner's Novice to Expert theory. Twelve nurses who had experience implementing evidence to practice were the participants of this study. Data were collected through semi-structured interviews and analyzed using a qualitative hermeneutic phenomenological approach. Three themes emerged from the study that included the significance of EBP, the process of evidence translation, and the outcome of evidence translation. Nurses in the clinical settings had basic understanding of EBP and were motivated to translate evidence, but their knowledge and skill in EBP were still limited. The implication for positive social change of this study is the recommendation that leaders in healthcare and nursing, as well as educators, and researchers to recognize the need for building EBP capabilities among nurses. Organizations must include current theories, frameworks, and tools of evidence translation to cultivate a culture of EBP as a foundation for patient care.

The purpose of this study is to investigate the factors of social worker and allied professional’s professional quality of life, particularly the impact of the professional’s childhood psychological abuse on compassion fatigue and compassion satisfaction scores. Variables such as perceived resilience, social support, childhood psychological abuse, evidence-based practice training, years of experience, percentage of clients with trauma narratives, and case-load number are explored both conceptually and as risk or protective factors to social worker and allied professional’s compassion fatigue and compassion satisfaction. A conceptual model is provided to visually show the direction of the proposed research. The sample to be used in this research consists of two-hundred-eighteen social worker and allied professionals in the United States who predominantly have a master’s degree or higher. A simple correlation analysis will be used to see any direct correlations between variables used in this study: childhood psychological abuse and its three components, compassion satisfaction, burnout, compassion fatigue, perceived resilience, social support and its three components, evidence-based training, education level, caseload, percentage of client trauma, and years of experience in the field. Multiple regression analysis will also be utilized in this research study to identify any relationship between the aforementioned variables and compassion satisfaction and compassion fatigue. In focusing on the research question for this study, an examination of the simple correlational matrix found, for this sample of MSW social workers and allied professionals, no significant correlation between childhood psychological abuse and compassion fatigue or compassion satisfaction. Additionally, in running two separate regression models, one for predicting compassion fatigue and one for predicting compassion satisfaction, childhood psychological abuse was not a significant predictor for this sample’s study. Findings from this study disagree with the only study that attempts to measure childhood psychological abuse of the social worker and their reaction to secondary traumatic stress (Nelson-Gardell & Harris, 2004). There are two main differences between the two study samples: education, training level, and work experience, perhaps suggesting that social workers who are master’s level educated or higher are better protected from compassion fatigue related symptomology, or that the Nelson-Gardell & Harris study’s predominantly child welfare worker sample is encountering client trauma in a way that is unique from this study’s sample. Implications from this study’s findings are explored suggesting further research into the effects of education and evidence-based training as a protective factor from the effects of childhood psychological abuse on compassion fatigue and compassion satisfaction.

Many children with ASD partake in escape maintain behaviors for numerous reasons. Children with autism might have difficulty attending to long tasks, can get overwhelmed with novel activities, and the challenging behaviors may heighten when too many demands are placed on them. As a result, teachers, parents and interventionists may start to witness children’s challenging behaviors increase. Many of the challenging behaviors are thought to have an escape function from the long or difficult task at hand. This paper will find and address various strategies that may be applied to decrease escape maintained behaviors in children with ASD. The aim for this review study is to describe and evaluate research findings of antecedent-based strategies and evidence-based practices used to assist in decreasing escape maintained behaviors in children with ASD. This study is to suggest educational implications for interventionists and parents. Keywords: autism, escape, escape maintained behaviors, decrease challenging behaviors, alternative behaviors, antecedent based intervention, evidence based practices

Students with autism spectrum disorder (ASD) present challenges for principals supervising both general and special education teachers. Evidence-based practices designed to address the challenging behavior and academic needs of this population exists, but there are numerous contextual factors that affect the ability of principals to effectively assist their teachers in implementation. The purpose of this research was to examine the relationship between principal leader’s demographic characteristics, the influence of contextual factors, and leadership attitudes that affect their development and priorities for their schools. The implementation science framework and collective impact theory was investigated as a conceptual framework to analyze these critical research areas. Elementary principals responded to a researcher-designed survey instrument to identify contextual factors and priorities for development. Information was analyzed using one-way analysis of variance tests (ANOVA) and survey response patterns. Findings will provide direct guidance for principal development and leadership practices.

High quality mental health services do not reach the youth who need them, leading to efforts to implement effective treatments more broadly. One focus of these efforts concerns training the mental health workforce, of which master’s-level social workers represent a large proportion. However, the curricula of master’s in social work (MSW) programs do not often emphasize evidence-based approaches. One possible solution is Managing and Adapting Practice (MAP; PracticeWise, LLC), a system that allows clinicians to (1) identify clinically indicated evidence-based programs by searching a growing evidence-base of randomized controlled trials (RCTs) and (2) build individualized evidence-informed treatment plans by focusing on common practice elements. MAP may also address the concerns about manual-based programs (e.g., inflexibility). Although some MSW programs have integrated MAP, the benefits of MAP training within MSW education have not yet been evaluated. This project evaluated multiple mechanisms of training in a semester-long MSW-focused MAP course relative to curriculum-as-usual control at a large public university. Participants were advanced MSW students (mean age = 27, SD = 5.8; 92.3% women; 59% white) either enrolled in the MAP course (n = 17) or enrolled in curriculum-as-usual (n = 22). The MAP course was co-taught by an expert MAP trainer and a MAP-trained social worker. Pre- and post-semester, participants completed a battery that included: (1) role-plays with standardized patients that were videotaped and coded using the Therapy Observational Coding System of Child Psychotherapy – Revised Strategies scale; (2) a written task that was subsequently coded to assess participants’ clinical decision-making skills during different phases of a standardized case; and (3) attitudinal factors that may be predictive of future MAP usage, such as attitudes toward evidence-based practice and the acceptability and feasibility of MAP. Results indicate significant uptake of cognitive and behavioral therapeutic strategies in the MAP condition. Overall, participants endorsed positive attitudes toward evidence-based practice broadly and MAP specifically. Findings may be used to inform the development of more effective evidence-informed curriculum for master’s-level clinical programs and future workforce training initiatives. Methodological considerations may inform advances in instrumentation to measure multidimensional training outcomes

Diaper dermatitis, an acute inflammatory reaction of the skin, is one of the most common forms of dermatitis among neonatal and pediatric patients. The problem addressed in this quality improvement project was the absence of an evidence-based practice (EBP) guideline for perineal care which resulted in 4 unexpected cases of diaper dermatitis per 100 hospital days at a non free standing children's hospital. Framed within Rosswurm and Larrabee's model for EBP, the purpose of this project was to develop an educational initiative encompassing an EBP guideline for perineal care, an educational curriculum plan for staff members, and a Power Point presentation to leadership on the educational initiative. A master's prepared pediatric nurse educator served as content expert to evaluate the educational curriculum plan using a dichotomous scale (not met = 1/met = 2) format for the 8 objectives. Each of the 8 items was scored a 2, meaning all objectives were covered in the curriculum. The expert recommended that the methods and procedures used should be placed in the employee orientation process. The educational initiative was presented to the leadership team (n = 11) who evaluated the project using a Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). An average score of 5 was given, revealing that the objectives of the presentation were met. The leadership team recommended that the project be implemented. Positive social change may result from this DNP project by facilitating neonatal/pediatric skin integrity through evidence-based nursing care thus promoting patient well-being and prevention of hospital acquired infections.

The push to generate professional nurses has raised questions about the competency level of the novice nurses that are entering the workforce. Utilization of simulation laboratories is being viewed as an option for bridging the gap for the shortage of nurses, nurse educators, and clinical sites. The theory of goal attainment was used to guide this project, which aimed to develop and validate an ER simulation scenario that mimics a clinical setting as a tool for measuring nursing skills. An additional purpose, to be accomplished after graduation, will be to implement a pilot project to determine the impact of the validated simulation scenario within the nursing skills laboratories on the quality of care provided by novice nurses to patients. The validation of the ER simulation scenario was completed by having 10 local experts review the developed ER simulation scenario. The experts then completed a 5-question Likert-type scale survey. Descriptive analysis was used to evaluate the results of the survey and validate the simulation scenario tool. Results revealed that all experts strongly agreed that the ER scenario was visually appealing and had enough subject content. Most experts strongly agreed that it was easy to read and follow. Post-graduation and with the assistance of the education organization, the second part of this proposal will occur with a pilot study implementation. The significance of this project to the nursing practice is to utilize simulation as a bridge to real life practice settings. This project may contribute to the American Nurses Association Standards of best practice which works to improve patient safety as well as quality nursing care.

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to SSC and RIC. The obstetric nurses received educational content related to SSC and RIC based on Kotter's model of change. A pre and postintervention evaluation showed a significant increase in the rates of SSC and RIC from pretest of 10%, to posttest of 96%; and RIC from pretest of 10% to posttest of 92%. Using a Wilcoxon test, a significant difference was found from pretest to posttest for every subscale score of the Mother-Newborn Skin-to-Skin Contact Questionnaire and Nurse Attitudes and Barriers to nonseparation Scale (p < 0.001), with the exception of belief about obstacles for SSC, which yielded a nonsignificant change (p = 0.57). This DNP project led to changes in the organization's culture, including the closure of the well-baby nursery. This project promoted social change across the organization, in that the team health care providers delivered evidence-based, standardized, unbiased, and family-centered care to the mother-baby dyad.

Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap via this quality improvement, pre/posttest pilot project. Multiple frameworks guided the project: the nursing process, Lewin's change management model, the Johns Hopkins Nursing EBP model, and the Five Practices of Exemplary Leadership-® model. A comprehensive literature search validated the design using EBP facilitators: educational interventions, transformational leadership, strategic planning, and a systems perspective. Pre/posttest data garnered from 14 non-direct care nurse leaders on the Organizational Culture and Readiness for System-Wide Integration of EBP Scale, the EBP Beliefs Scale, and the EBP Implementation Scale was analyzed using 2-sample t tests. Individual questions on the scales revealed statistically significant differences correlating to the facilitative interventions, yet overall aggregate scores did not change significantly. The limited findings contribute to the existing body of knowledge, while positive social implications include resolving public health and safety issues, reversing fiscal irresponsibility, and overcoming resistance to change.