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Weight Recidivism Post-Bariatric Surgery: A Lifestyle Modifications Educational Intervention, Kimeshia N. Johnson

Electronic Theses and Dissertations

Weight recidivism after bariatric surgery is a frustrating phenomenon for bariatric surgery patients and healthcare professionals. A 90-day lifestyle modification intervention for patients at least 18 months postsurgery was performed in the primary care setting to determine if a structured program could promote or maintain weight loss. The intervention aimed to investigate if participation in a structured lifestyle modification program would impact the body mass index of bariatric patients at least 18 months postsurgical intervention. In coordination with a nutritionist specializing in addiction and obesity education, a booklet detailing the guidelines for a 12-week program was provided to 41 bariatric …

Implementation Outcomes And Associated Constructs From The Consolidated Framework For Implementation Research Among Churches Trained Online To Implement Faith, Activity, And Nutrition In A National Implementation Study, Sara Wilcox Phd, Ruth P. Saunders Phd, Andrew T. Kaczynski Ph.D., Caroline Rudisill Ph.D., Msc, Ye Sil Kim Phd, Jasmin Parker-Brown, Kelsey R. Day

Faculty Publications

Churches hold promise for reaching populations with high rates of chronic disease, yet few faith-based large-scale implementation studies exist. The study purpose was to examine 12-month implementation outcomes and associated Consolidated Framework for Implementation Research (CFIR) constructs after converting in-person training to online for an evidence-based intervention designed to improve church organizational practices related to physical activity (PA) and healthy eating (HE). US churches recruited from 2020 to 2022 participated in eight online lessons prior to implementation. Each church’s coordinator completed an online baseline and 12-month survey assessing church practices for PA/HE components targeted in the Faith, Activity, and Nutrition …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer

Doctoral Dissertations and Projects

Burnout is an international occupational phenomenon that can negatively impact one’s physical, emotional, and psychological well-being. Although burnout affects all occupations, professionals working in the healthcare field are known to be at high risk for occupational burnout secondary to factors such as high-stress environments, critically ill patients, increased patient care requirements, frequent exposure to mortality, and shiftwork with long hours, among other factors. Of the subgroup of healthcare providers, it is also widely known that nurses who have a high exposure to death, such as hospice nurses, are at an even higher risk for occupational burnout. At a hospice care …

Prearrival Phone Call Initiative To Decrease Procedural Cancellations And Delays, Fazali Nkoloma

Walden Dissertations and Doctoral Studies

This doctor of nursing practice project evaluation of an organizational quality improvement initiative focused on evaluating the effectiveness of implementing a prearrival phone call process for interventional radiology patients scheduled for procedures requiring moderate sedation or anesthesia. Adherence to NPO guidelines is crucial for patient safety before moderate sedation and anesthesia. The practice problem identified was the number of procedures that were canceled or delayed because of patient nonadherence with NPO guidelines. The practice-focused question that guided this project was, Can the implementation of prearrival phone calls in the preprocedural radiology surgical services help improve patient adherence with NPO protocol …

The Implementation Of A Blended Learning Course To Enhance Leadership And Management Capabilities In Liberian Student Nurse Anesthetists, Donnell Carter

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Leadership plays a crucial role in the functioning of a health system, particularly in resource-constrained settings like Liberia. Effective leadership is essential for identifying solutions and leading teams towards achieving important objectives. Improving leadership competencies among emerging Liberian nurse anesthetists is key to enhancing anesthesiaoutcomes in Liberia. The delivery of high-quality, safe anesthesia in Liberia is contingent on this.

METHODS: This quality improvement project (QI) implemented a transnational blended learning leadership andmanagement course to increase the knowledge, skills, and confidence of Liberian student nurse anesthetists. We used quantitative methods to organize and describe selected outcomes. We also used qualitative …

Engagement In Responsible Conduct Of Research: A Descriptive Case Study Of The Factors Of Organizational Culture And Implementation Drivers That Influence Research Integrity Practice, Cortni Beth Romaine

Doctor of Philosophy in Translational Health Sciences Dissertations

This qualitative descriptive case study investigates the relationship between organizational culture and the Responsible Conduct of Research (RCR) across multiple research institutions. Utilizing elements of the Cultural Dynamics Model and the Implementation Drivers Framework, the study examines how institutional structures and cultural norms shape research integrity practices. Data collection involved in-depth interviews with faculty, postdoctoral researchers, and graduate students, as well as an artifact review of institutional policies, training resources, and guidance for research best practices.

Findings revealed three key themes: (1) Microculture Experiences, where RCR engagement is largely dictated by localized lab cultures, with principal investigators (PIs) playing a …

Bedside Nursing Report: Changing The Practice In The Hospital And How It Affects Patients, Holly Burns

Undergraduate Theses and Capstone Projects

This literature review explores barriers and obstacles that have prevented bedside shift reports to be the standard of practice for hospitals nation-wide. By analyzing existing research from 2019-2024, the review was able to explore data from both qualitative and quantitative research studies. The analysis reveals that there are benefits of the bedside shift report style for nurses and their patients. Nurses are able to gain more knowledge and information on their patients while being less distracted by their surroundings when completing a report at the bedside. Patients will also benefit in the bedside shift reports because it allows for an …

Knowledge, Skills, And Barriers To Palliative Care Referrals By Oncology Providers, Audra Meador, Bailey Waldron

Doctor of Nursing Practice Projects: College of Nursing

Palliative Care is an evidence based and integrative aspect of cancer care that has demonstrated improved quality of life and diminished symptomology, however, barriers to referrals exist. With the growing interest in and demand for specialized healthcare services, more research on integration and referral practices surrounding palliative care is necessary. This study aimed to explore the knowledge, attitudes, perceptions, and barriers to referring cancer patients to outpatient palliative care at a teaching and research hospital. In one cancer center, 50 physicians, Advance Practice Providers, and nurse case managers responded to an electronic survey regarding interest and support for palliative care …

Reducing Medical Supplies Waste By Managing Healthcare Resources In A Clinical Setting In The United States: Lessons Learned From The Covid-19 Pandemic, Chiatuogu Anna Ukaga

Walden Dissertations and Doctoral Studies

The gap in practice identified for my DNP capstone project is reducing medical supplies waste by managing healthcare resources in a clinic setting in the United States of America. The Organizational Change Process (OCP) Evaluation project assessed a tracking and exchange system to track the inventory of supplies used in different worksite clinics and their expiration dates. Knowledge of the expiration dates enabled exchange or shift to high-utilization areas before the supplies expired, thereby reducing waste, costs, and environmental pollution. The healthcare organization was a mix of ambulatory clinics and hospitals of varying scopes and sizes. The small clinics served …

Making Training Stick: Transferring Learning Back To The Job, Amanda Woods Herron, Phoebe Hessen, Katelyn J. Cavanaugh, Wykesha C. Hayes, Victor Hassid, Courtney L. Holladay

Advances in Cancer Education and Quality Improvement

Communication remains a central priority in healthcare, making it a key component of many training efforts. The positive impacts of communication training in healthcare settings have been well-established; however, the linkage of communication training to key organizational outcomes (e.g., engagement, performance, retention) remains underexplored. The present study investigated a training program targeting interpersonal communication within a large academic oncology center. We drew from Cognitive Load Theory and Social Cognitive Theory to evaluate the impact of the training on participant learning (retention and utilization), transfer (communication, decision-making, performance), and results-level outcomes (engagement and turnover). The program centered around a personality framework …

Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Stress And Burnout Among Icu Nurses, Jaspreet Kaur

2025 Spring Honors Capstone Projects - Archive

Burnout is a significant occupational hazard for Intensive Care Unit (ICU) nurses. High patient acuity, staffing shortages, and long shift hours increase stress and diminish well-being among nurses, affecting patient care outcomes. This study examined the prevalence of stress and burnout among ICU nurses to identify contributing factors and potential interventions. An anonymous online survey was conducted among 110 ICU nurses, utilizing the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale(PSS). Findings revealed that 42.5% of nurses reported high emotional exhaustion, while 37.5% felt they had little to no control at work. The most frequently cited workplace stressors were …

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

Improving Oral Hygiene Practices In A Long-Term Care Setting For Individuals With Advanced Dementia: A Quality Improvement Initiative, Rachel L. Mcinerney

Capstone Experience: Master of Public Health

This quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its …

Evaluating The Nebraska Medical Center's Repatriation Of Inter-Hospital Transfers, Natalie Crump

Capstone Experience: Master of Public Health

Background: Bed capacity challenges at large academic medical centers delay the transfer of rural patients, negatively impacting their safety and quality of care. Repatriating inter-hospital transfer (IHT) patients to referral facilities upon completing specialized care can improve tertiary hospital bed capacity and community hospital financial sustainability.

Objectives: This project aims to identify the barriers and facilitators to successful IHT repatriation and the process and outcome variables influenced by the Nebraska Medical Center’s reverse transfer program.

Study Design: A retrospective observational cohort study was conducted to identify barriers and facilitators of NM’s IHT repatriation program.

Methods: Descriptive and comparative analyses of …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

Implementation Of Houdini Guidelines Nurse-Driven Protocol To Lower Catheter-Associated Urinary Tract Infections And Foley Utilization Days, Tammie N. Collins

Electronic Theses and Dissertations

Catheter-associated urinary tract infections are a common issue in healthcare settings. These issues contribute to hospital-acquired infections and can lead to complications and increased healthcare costs. The quality project evaluated the impact of the HOUDINI guidelines nursedriven protocol to reduce infection rates and Foley utilization days. A structured guideline for Foley catheter safe removal was implemented using a quantitative method. Catheter-associated urinary tract infection rates and Foley utilization days pre- and postintervention were tracked. Data were collected using the electronic health records, infection control data sheets, and the HOUDINI checklists. A baseline assessment of catheter-associated urinary tract infections rates was …

Expert Consensus For Key Components Of A High-Quality Ventral Hernia Repair Operative Note, Jonathan S Lall, Said Maldonado, Nicole B Lyons, Gina Adrales, Karla Bernardi, Anne P Ehlers, Hobart Harris, Julie Holihan, William Hope, Jeffrey E Janis, Michele Loor, Clayton Petro, Luke Putnam, Caroline E Reinke, John Scott Roth, Christopher Senkowski, Kendell Sowards, Shirin Towfigh, Daniel Dante Yeh, Zuhair Ali, Mike K Liang

Faculty, Staff and Students Publications

Background: Ventral hernia repair (VHR) is one of the most commonly performed procedures by surgeons; however, there remains a lack of consensus for key components of operative reporting. Prior literature has identified several key elements that are recommended for inclusion in ventral hernia repair operative notes, but it is unclear whether these details alone make for a high-quality operative note. This study sought to determine whether experts agree on what factors make a ventral hernia repair operative note high-quality.

Study design: A prospective exploratory sequential survey-based mixed-methods design was used for round 1. Conclusions via thematic analysis from survey responses …

A Qualitative Study: Patients' Expectation Of Private Hospitals, Sarah Jada, Jessy Jacob, Ahmad Nasrallah

Patient Experience Journal

Objectives: This study was conducted to explore patients' expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients' experience of their healthcare encounters and …

Quality Improvement Project Enhancing Patient Care In Nurse Practitioner Private Practices: A Train-The-Trainer Approach To Implementing Evidence-Based Chronic Mental Disease Management Interventions, Chioma Waters

Doctor of Nursing Practice Projects

Chronic mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are frequently treated by nurse practitioners (NPs) in outpatient private practices. Despite the evidence supporting Cognitive Behavioral Therapy (CBT) as a first-line intervention, its utilization remains limited in NP settings, often due to lack of training and confidence. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether a structured train-the-trainer program could improve NP confidence in applying CBT in practice. Guided by the Iowa Model and Kotter’s 8-Step Change Model, this quality improvement project utilized a quasi-experimental, pre-post survey design to assess …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Quality Improvement Project Staff Development For Fall Prevention In Community Living Center, Morayo Olatunbosun

Doctor of Nursing Practice Projects

Falls among elderly residents in the community living center continue to be a serious public health concern, increasing mortality, morbidity, and healthcare costs. Despite existing prevention measures, fall-related incidence remains high. The purpose of this quality improvement project is to reduce fall rate in a community living center by implementing structured staff training. A facility needs assessment revealed gaps in fall prevention knowledge, inconsistent protocol use, and limited staff confidence in managing fall risks. In the methodology used to answer the PICOT question, the Donabedian Model guided structure, process, and outcome evaluation, while Kotter’s Change Model informed implementation strategies. The …

Quality Improvement Project Provider Burnout Related To Patient Satisfaction, Sherita Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Organization Change Process Initiative Recurrent Emergency Room Visits By Mental Health And Substance Use Patients, Julie Marie Tucker

Walden Dissertations and Doctoral Studies

The rising rates of patients diagnosed with mental health and substance use disorders (MHSUD) signify a critical national crisis, worsened by the COVID-19 pandemic, as reported by the United States Department of Health and Human Services. This increase has reduced access to essential resources and treatment options, resulting in overcrowded emergency rooms (ER) and extended wait times. Addressing these issues is vital for nursing practice, as they significantly influence patient care and health outcomes, especially for vulnerable populations. This doctoral project explores whether an organizational change designed to raise awareness of updated community resources impacts MHSUD patient visits to the …

Examining The Effects Of Work-Related Musculoskeletal Disorder Pain On Healthcare And Allied Health Professionals' Quality Of Life, Nicole Simone Richmond

Doctoral Dissertations and Projects

The purpose of this phenomenological study is to understand the effects work-related musculoskeletal disorder pain has on the quality of life of high body mass indexed healthcare and allied health professional women. This qualitative research incorporated virtual semi-structured interviews, via zoom, of 10 clinically obese female healthcare and allied health workers employed at a hospital, clinic, or private health practice; and have been diagnosed by a medical doctor with a case of chronic work-related musculoskeletal disorder pain within the past six months. The study utilized a virtual setting of participants who reside and work within the United States. Data collection …

Nursing Education On The Health Benefits Of Animal Assisted Therapy, Sara C. Barker, Allie P. Dunlap, Daniel T. Do, Charde Willis

SPARK Symposium Presentations

Background: Does nurse education for pediatric oncology families teaching daily animal-assisted therapy (AAT) health benefits reduce anxiety from 35% to 18% compared to current practice?

Methods: A literature search was conducted using CINAHL (356 articles), PubMed (412 articles), and Google Scholar (289 articles) with keywords including animal-assisted interaction, pediatric cancer, pet therapy, psychological support, caregivers, and psychosocial outcomes. Filters applied included peer-reviewed articles, English language, full text, publication within the last five years, randomized controlled or quasi-experimental study design, and relevance to nursing practice. 4 articles were chosen due to being directly relevant to education related to AAT and psychosocial …

Facilitating The Use Of Sbar By Nursing Staff For Handoff Communication, Amarillis L. Tompkins

Student Scholarly Projects

Practice Problem: Clear communication during shift handoffs is crucial to minimize errors and ensure patient safety in intensive care. The current SBAR framework used in the MICU is constrained by limited documentation space, which led to communication inefficiencies and heightened risks for patient care.

PICOT: The PICOT question that guided this project was: In the NFSG VA MICU, will staff nurses (P) using a revised SBAR communication tool with a checklist (I), compared to the current outdated SBAR tool without a checklist (C), improve the accuracy and completeness of patient handoff communication (O) over eight weeks (T)?

Evidence: The project …

The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy

Theses and Graduate Projects

BACKGROUND: In 2020 a pandemic created dangerous workloads leading to many nurses quitting their careers due to chronic stress. This project will create the green room, which is the name of this recharge room, where staff can go to experience a moment of peace to decrease their stress levels. This room had a spa aesthetic with comfortable seating and green plants. METHODS: This quality improvement project follows the plan-do-study-act model. When participants arrived, they filled out a questionnaire before using the room. They were then shown all the things they could do to utilize the room. After they were done …