One page per peer response, 2 references per peer response

PEER ONE:

My name is Nina Biasi. which is pronounced Nee-na Bi-ah-see. My pronouns are she/her. I currently live with my husband and 3 kids on the beautiful north coast of Oregon. I love the outdoors and running and for the past 10 years or so I have jumped headfirst into the world of trail and ultrarunning. I started my career in healthcare as a CNA years ago and while I still consider CNA work to be some of the hardest there is, I have a huge appreciation of the knowledge and compassion I gained working those years as an aide. I graduated from nursing school in 2010 and have worked in many areas of healthcare since; small and large hospitals, progressive care, ER, OB, outpatient scope center, and home health and hospice. Currently I am working nights on a med/surg floor at my local rural hospital. I am in the BSN to FNP-DNP program and looking forward to advancing in my practice and career.  

The type of DNP project I am planning to develop is a quality improvement project that is focused on improving vaccination rates for people experiencing homelessness (PEH) through utilization of a mobile health clinic intervention. Quality improvement (QI) focuses on the best patient care outcomes by improving quality in delivery systems and care processes (Reavy, 2016). Homelessness is an increasing problem in the US and PEH experience barriers to receiving primary and preventative care. Some of the barriers to adequate primary and preventative care include lack of transportation, lack of finances or insurance, stigmatization, and challenges with activities of daily living (Christian et al., 2024). Homeless populations have decreased rates of vaccination as well as vital health screenings due to this lack of primary care. Literature has shown that mobile health clinics (MHCs) are a means to reaching this patient population’s healthcare needs and increasing vaccination rates (Bouchelle et al., 2017). The site I plan to implement my project at is with the mobile health van that is operated by the local Public Health Department in my area.  

References 

Bouchelle, Z., Rawlins, Y., Hill, C., Bennet, J., Perez, LX., & Oriol, N. (2017). Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts. International Journal for Equity in Health, 16(1), 1–10. https://doi-org.proxy.library.maryville.edu/10.1186/s12939-017-0688-6Links to an external site.

Christian, N. J., Havlik, J., & Tsai, J. (2024). The Use of Mobile Medical Units for Populations Experiencing Homelessness in the United States: A Scoping Review. Journal of General Internal Medicine, 39(8), 1474–1487. https://doi-org.proxy.library.maryville.edu/10.1007/s11606-024-08731-9Links to an external site.

Reavy, K. (2016). Inquiry and Leadership: A Resource for the DNP Project. F.A. Davis 

PEER TWO:

 My name is Brandi Biswell, prounced Brandee Bizwell. My pronouns are she/her. I reside in a suburb of Kansas City called Olathe, KS, with my husband of twenty-five years. We have two kids, both of whom are at K-State University. We live on eleven acres; thus, I spend five to six hours a week mowing. We have a two-acre pond that is my pride and joy. Anytime I am stressed, I sit on the dock. I can feel my parasympathetic nervous system kick in. I have an exaggerated stress response most of the time. My HRV is never in range, leaving me emotionally exhausted (Schmid et al., 2024). I graduated from nursing school in 1999. I completed my MSN in administration in 2013. I work at a local hospital in the behavioral health unit.

     My quality improvement project is designed to significantly enhance patient care by increasing nurses’ adherence to CIWA-AR reassessments after nurse-initiated alerts. I work in a dual diagnosis unit where patients often face the challenge of withdrawing from alcohol while also dealing with an underlying mental illness. This can profoundly affect their care (Elefante et al., 2020). Making it more challenging to assess for symptoms of withdrawal.

     I will implement the project on my inpatient behavioral health floor. We are the only inpatient behavioral health unit located inside and affiliated with a hospital in the Kansas City metro. The evidence-based intervention will involve nurse-initiated prompts following the administration of PRN medication after a patient scores an eight or above on the CIWA-AR. When nurses fail to follow through with the reassessment, patients are vulnerable to seizures and delirium tremens.

                                                                                          References

Elefante, R., Batkis, M., Nelliot, A., Abernathy, K., Rocha, K., Jenkins, F., Rastegar, D., & Neufeld, K. (2020). Psychometric properties of the revised clinical institute withdrawal alcohol assessment and the brief alcohol withdrawal scale in a psychiatric population. Journal of Addiction Medicine, 14(6), e355–e358. https://doi.org/10.1097/adm.0000000000000655Links to an external site.

Schmid, R., Thomas, J., & Rentzsch, K. (2024). Individual differences in parasympathetic nervous system reactivity in response to everyday stress are associated with momentary emotional exhaustion. Scientific Reports, 14(1). https://doi.org/10.1038/s41598-024-74873-9Links to an external site.