Digital Commons Network^™

Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

Implementation Of A Nurse-Led Discharge Protocol To Impact Nurse Confidence And Optimize Transitional Care Management, Jessi-Ann Elrod

Doctor of Nursing Practice Projects

Heart failure (HF) remains a leading cause of hospitalization and readmission, with the transition from hospital to home representing a vulnerable period for patients. Variability in discharge education and follow-up scheduling contributes to poor self-management and adverse outcomes. This quality improvement (QI) project evaluated whether implementing a standardized nurse-led HF discharge protocol impacted nurses' confidence and the rate of 7–14-day transitional care management (TCM) follow-up appointments. Guided by Meleis’ Transitions Theory and Lewin’s Change Theory, a one–group pretest–posttest QI design was implemented on a cardiac step-down unit. Twelve discharge nurses participated. The intervention included a structured education session and the …

Quality Improvement Project Reducing Attrition Rates In Nursing Students: Evaluating The Enhanced Student Success Program, Jason Grigg

Doctor of Nursing Practice Projects

The high attrition rate in the Associate of Applied Science in Nursing (AASN) program created an opportunity to develop the enhanced Student Success Program (eSSP). This is a faculty-based quality improvement project designed to increase support for students at risk of withdrawal from the AASN program. The aim of eSSP is to reduce attrition rates, however, this project evaluated only short-term changes in faculty confidence. Using Lewin's Change Model and the Theory of Planned Behavior as a guide, this QI implemented a one-group pre-post experimental design to determine whether a short eSSP training program, combined with a 5-week implementation period, …

Quality Improvement Project : Educating Critical Care Nurses On Braden Scale And Sskin Care Bundle To Impact Pressure Injuries, Andrea Garrett

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) increase patients' risk of infection, prolonged hospitalization, death, and healthcare costs. The Agency for Health Research and Quality (AHRQ) has shown that implementing a standardized skin assessment process and a care bundle helps prevent skin injuries. A critical care unit (CCU) at an acute care 339-bed hospital in Southaven, MS, has seen an increase in HAPIs. This quality improvement project aimed to educate CCU nurses about the Braden Scale and the SSKIN care bundle to impact pressure injuries in the CCU within 8 weeks. Education on the Braden Scale and the Skin, Sensory, Keep Moving, Incontinence, …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Quality Improvement Project: Faculty Development For Understanding And Utilization Of Exam Data, Deanne Hutchens

Doctor of Nursing Practice Projects

This quality improvement project focused on inconsistent use and understanding of exam data among Associate Degree in Nursing (ADN) faculty, which can influence teaching decisions and student success. Many nursing faculty enter education with strong clinical backgrounds but limited experience working with exam statistics such as item difficulty, discrimination values, and Kuder-Richardson 20 (KR-20) reliability. Without a consistent approach, exam results may not be fully used to guide remediation or adjust instruction. This Doctor of Nursing Practice (DNP) project examined whether a structured faculty development session could improve faculty confidence and ability to interpret and apply exam data. A pre- …

Quality Improvement Project: Evaluating The Impact Of Provider Education On Sbirt On Screening For Suds, Faith Ogala

Doctor of Nursing Practice Projects

Substance use disorder (SUD) is a serious public health issue in people with psychiatric disorders. However, diagnosis and treatment are often delayed, leading to poor treatment outcomes and increased social and economic costs. The purpose and aim of this Doctor of Nursing Practice (DNP) project was to educate providers on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model to facilitate the timely diagnosis of SUDs in patients with dual diagnoses. The key outcomes were provider knowledge and SBIRT implementation rates. The Donabedian Model of Healthcare Quality assessed the outcomes, whereas Lewin’s Change Model guided implementation. The project employed …

Establishing A Standardized Suicide Risk Screening Policy For Psychiatric Providers: Closing Gaps In Provider Accountability And Clinical Documentation, Fadekemi Olude

Doctor of Nursing Practice Projects

Psychiatric providers in outpatient settings often experience inconsistent confidence and incomplete documentation when conducting suicide risk screening, contributing to missed opportunities for early identification of at-risk patients. This quality improvement project addressed the need for standardized suicide risk screening at an urban outpatient psychiatric clinic. The purpose was to evaluate documentation using the Columbia-Suicide Severity Rating Scale (C-SSRS). Using a pre-post intervention design guided by Lewin's Change Theory and the Donabedian Model of Quality Improvement, a 60-minute training session was delivered to 31 psychiatric providers. Participants completed pre- and post-intervention General Self-Efficacy Scale (GSES) surveys. Chart audits (N = 1,970) …

A Functional Nutrition Literature Review For Brain Fog And Adhd-Like Symptoms In Adults, Natalie Elisani Aldahondo-Matos

Department of Nutrition Student Projects

Attention-deficit/hyperactivity disorder (ADHD) and ADHD-like symptoms, such as difficulty concentrating, mental fatigue, and problems with executive functioning, are increasingly recognized in adults. Although medication is commonly used to manage ADHD, there is growing interest in whether nutrition may also play a role in supporting brain function and attention. Several nutrients involved in brain health including omega-3 fatty acids, vitamin B12, magnesium, iron, and choline  have been suggested as potential contributors to cognitive performance and attention. However, the research examining the connection between diet and ADHD symptoms is still limited and sometimes shows mixed results.

The purpose of this project was …

Quality Improvement Project Ai-Powered Conversations: Enhancing Nursing Students’ Interview Skills, Judy K. Staley

Doctor of Nursing Practice Projects

Professional communication is an essential skill for nursing students, particularly in job interviews. Deficits in professional communication can negatively impact future employment and accreditation outcomes. Current practices in faculty-led mock interviews can be limited by time constraints and the need for consistent feedback, underscoring the need for a more consistent and effective method supported by current evidence-based literature. The purpose of this quality improvement project is to evaluate whether integrating AI-assisted mock interviews into faculty-led practices influences faculty perceptions of student preparedness. Guided by Kotter’s Change Model and supported by the constructivist framework, the project aimed to enhance the effectiveness …

Thinking With The Feet In The Clinic Of Psychosis, Jed Wilson

Middle Voices

In his later work, Lacan makes occasional reference to the idea of “thinking with the feet.” An equivocal formulation, it first seems to suggest that thought and language can be regarded as physical processes—not occurring in some homunculan disembodied brain or mind, but in the real of the body. Equally, it can call to mind the idea of thinking “on” one’s feet, in the manner of adaptive improvisation. Going further, could we not also say that it points to the possibility of setting something in motion (as in walking, dancing, going somewhere—all the things we do with the feet) as …

New Nurse Faculty Mentorship: A Quality Improvement Project, Kimberly B. Porter

Doctor of Nursing Practice Projects

The ongoing nursing faculty shortage limits program capacity and makes it harder to retain novice nurse educators transitioning from clinical practice to academia. The literature highlights issues such as insufficient mentorship, role confusion, and a lack of structured support as key factors contributing to early faculty attrition. This quality improvement (QI) project aimed to implement and evaluate an evidence-based mentorship program to improve perceptions of mentorship effectiveness among new-to-academia nurse faculty in a School of Nursing in Arkansas. The purpose was to implement and evaluate a mentorship program designed to improve perceptions of mentorship among new-to-academia nurse faculty. The project …

Quality Improvement Project: Impacting Staff Confidence In Recognizing Hiv Medication Adherence, Joy Nwansi-Iro

Doctor of Nursing Practice Projects

Medication adherence to antiretroviral therapy is essential for viral suppression and improved outcomes among individuals living with human immunodeficiency virus (HIV). Despite advances in treatment, healthcare providers lack confidence in recognizing medication adherence challenges and implementing appropriate interventions. Evidence suggests that provider education using standardized adherence assessment tools improves adherence monitoring and clinical decision-making. The purpose of this quality improvement project is to evaluate whether an educational intervention and a standardized workflow using the CASE Adherence Index would impact healthcare staff confidence in recognizing HIV medication adherence. Lewin’s Change Theory guided the project through the stages of unfreezing, change, and …

Quality Improvement Project: Enhancing Staff Delivery Of Non-Pharmacological Interventions In Serious Mental Illness Care, Kimberly Vann

Doctor of Nursing Practice Projects

Serious mental illness places a significant burden on global healthcare systems, increasing hospital utilization and critically impairing patients' functional status. Often crippling, these illnesses are mostly treated with medication therapy despite proven research to show effective outcomes with holistic and non-pharmacological therapies. Non-pharmacological interventions (NPIs) are often underutilized in outpatient mental health settings. The purpose of this quality improvement project was to determine whether structured training impacted staff confidence in delivering NPIs and impacted documentation frequency in the electronic health record (EHR). The project was guided by the Iowa Model of Evidence-Based Practice and implemented using the Plan-Do-Study-Act (PDSA) cycle, …

Quality Improvement Project Bridging The Gap In Scholarly Productivity: An Educational Workshop For Tenure-Track Nursing Faculty, Britney Thorne

Doctor of Nursing Practice Projects

Tenure-track nursing faculty often balance teaching, service, and scholarship responsibilities, which can be overwhelming when promotion and tenure expectations are unclear or insufficiently supported. At a historically Black university, a school of nursing identified gaps in scholarly productivity and limited guidance for early-career faculty, highlighting the need for structured support. Guided by Knowles’ Adult Learning Theory and Lewin’s Change Theory, this Doctor of Nursing Practice (DNP) quality improvement project examined whether structured faculty development workshops could improve faculty knowledge of scholarly productivity, engagement in scholarly activities, and perceptions of tenure and promotion expectations. A quasi-experimental pre-post design was implemented over …

Enhancing Ot-Classroom Staff Collaboration: A Usability Study Of A Formalized Sensory Communication Process, Victoria Foo, Neil Harvison, Alyson Pasquale, George Bulger, Jessica Evans

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

Addressing students’ sensory-based behaviors can be challenging when there are no team-based and student-centered approaches in place, making it essential to create an interdisciplinary framework where OTs and classroom staff communicate consistently to blend supports. Effective communication and collaboration involve carryover, explanation, education, and training of sensory processing and sensory-based interventions (SBI) as crucial components in a knowledge translation process.

Assessing The Feasibility Of Integrating Occupational Therapy Services Within A Pediatric Primary Care Setting For Children 0-3 Years Old., Amanda L. Wilbert, Cristina Dumitrescu, Kim Karr

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

The objective of this capstone project was to assess the feasibility of implementing occupational therapy (OT) services within a pediatric primary care office using a manualized service delivery approach. Occupational therapy is inherently grounded in parent coaching and education, positioning the profession to play a critical role in supporting families and promoting early identification of developmental risk. This project aimed to address a documented gap in the inclusion of OT within pediatric primary care by exploring how OT services can support parenting skills and monitor children identified as at risk for developmental, behavioral, or psychosocial concerns. The project was conducted …

Disordered Differentiation And Cellular Senescence In Pediatric Hodgkin Reed-Sternberg Cells, Jennifer E Agrusa, Elmoataz Abdel Fattah, Howard Lin, Jessica Velazquez, Sandra Andrea Salinas, Harshal A Abhyankar, Brooks P Scull, Ryan Fleischmann, M Tarek Elghetany, Andrea N Marcogliese, Choladda V Curry, Jyotinder N Punia, Nmazuo W Ozuah, Olive S Eckstein, Nader K El-Mallawany, Nitya Gulati, Joseph Lubega, Terzah M Horton, Kala Y Kamdar, Kenneth L Mcclain, Tsz-Kwong Man, Carl E Allen

Faculty, Staff and Students Publications

Hodgkin lymphoma (HL) is characterized by inflammatory lesions with relatively few (typically < 1%) pathogenic Hodgkin Reed-Sternberg (HRS) cells. The scarcity of malignant HRS cells in HL has historically limited characterization of these disease drivers, and pathogenic mechanisms underlying HL are incompletely defined. Using multiparameter flow cytometry to purify HRS cells and immune cell populations from pediatric HL lesions and control tonsils, we sought to define transcriptional programs in pediatric HRS cells. HRS cells are thought to arise from transformed germinal center B cells. Interestingly, transcriptomic analysis of HRS cells compared to control tonsil CD30+ cells revealed disordered differentiation with multilineage gene expression patterns, and primary HRS cells had distinct transcriptomes compared to HL cell lines. Further, transcriptomic analysis revealed increased expression of senescence-related genes and downregulation of proapoptotic/mitosis-related genes. Gene expression findings were validated by immunohistochemistry and single-cell imaging. In vitro treatment of primary HRS cells with B-cell lymphoma 2 inhibitor, venetoclax, augmented the induction of apoptosis in HRS cells and other cells of the HL immune microenvironment. These findings support the further study of targeting apoptosis resistance as a potential approach to eliminate malignant HRS cells and dismantle inflammatory lesion formation in pediatric HL.

Outcomes Of Deep Peroneal Neurectomy: A Scoping Review Of Complications, Postoperative Recovery, And Patient-Reported Satisfaction, Krista Elizabeth Samreth, James Hughes, Amayrani Sanchez, Nicholas Obias, Madeleine Mehaffey, Stephanie Campbell Dpm, Aacfas

School of Podiatric Medicine - Student Research

Background: Deep peroneal neurectomy (DPN) evolved as a surgical treatment alternative for patients with painful midfoot arthritis who may not tolerate more invasive surgery such as arthrodesis. This scoping review aims to display current evidence of postoperative recovery complications and patient-reported outcomes specific to alternative surgical treatment of DPN.

Methods: A scoping review was completed using PRISMA-ScR reporting standards. Investigators searched PubMed, Google Scholar, Foot & Ankle Orthopedics, and Journal of Foot and Ankle Surgery for studies from 2002 to 2025 with search terms: “deep peroneal neurectomy,” OR “deep peroneal nerve excision,” OR “peroneal neurectomies” AND “midfoot arthritis”. Exclusion criteria …

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis Thompson, Ashima Singh, Donna Neuberg, Amanda Brandow, Allison King, Sophie Lanzkron, Emily Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William Wood

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Ariana L Garza, Audrey C Choh, John Blangero, Cici X Bauer, Stefan A Czerwinski, Miryoung Lee

Faculty, Staff and Student Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults.

Methods: We analyzed 676 non-Hispanic white adults (18-95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

Serum Metabolites Associated With Depression And Anxiety In The Hispanic Community Health Study/Study Of Latinos, Xinye Qiu, Yu Zhang, Yogesh Purushotham, Qibin Qi, Bing Yu, Jan Bressler, Krista M Perreira, Humberto Parada, Martha L Daviglus, Alejandra Cid Vega, Carmen R Isasi, Linda C Gallo, Tamar Sofer

Faculty, Staff and Student Publications

Omics signatures for psychiatric conditions have been under-investigated. In this study, we used data from a representative observational cohort study of Hispanic/Latino adults to identify serum metabolites associated with symptoms of depression or anxiety and to develop and assess metabolite risk scores (MRSs) of these phenotypes. We conducted a metabolome-wide association study of 768 metabolites with depression and anxiety symptoms, using two separate assay batches measured from baseline samples collected between June 2008 and July 2011 for discovery (batch 1: n = 4002 adults) and replication (batch 2: n = 2178 adults). We estimated the associations via survey-based generalized linear …

Comparative Analysis Of Rectal Dose In Two-Arc Versus Three-Arc Vmat Prostate Cancer Using Spaceoar, Amanda Bookout

Masters Projects

Abstract

Purpose

The purpose of this study is to determine the dosimetric impact on rectal dose by comparing two arc versus three arc VMAT plans on prostate patients who have received SpaceOAR.

Methods

A retrospective planning technique was performed on eight prostate cancer patients who had been previously treated with three-arc VMAT plans. For each plan, a two-arc plan was generated by removing the third arc and re-optimizing the plans using identical constraints and objectives. Dosimetric parameters were analyzed using dose volume histogram (DVH) analysis, including rectal dose metrics, V60 Gy, V65 Gy, V70 Gy, target coverage, PTV V95%, conformity …

Vestibular Schwannoma Microsurgery In The Era Of Multimodal Treatment: Advances In Technique And Patient Selection, Ibrahem Albalkhi, Basel Musmar, Nimer Adeeb, Hussam Abou-Al-Shaar, Jacques J Morcos

Faculty, Staff and Student Publications

Background: The management of vestibular schwannoma (VS) has traditionally prioritized gross total resection to achieve high tumor control, often at the cost of cranial nerve injuries and quality of life impairment. However, advances in surgical approaches and intraoperative technologies, coupled with active surveillance and/or adjuvant treatment, have shifted the management paradigm towards prioritizing patient-centered outcomes, which are as critical as oncological control.

Content: The authors reviewed the technical advances driving this paradigm shift, including endoscopic assistance in the different microsurgical approaches (retrosigmoid, translabyrinthine, and middle cranial fossa approaches) of VS resection and advanced neuromonitoring (facial nerve electromyography and cochlear/auditory evoked …

Risk Of Alzheimer Dementia After High-Dose Vs Standard-Dose Influenza Vaccination, Avram Samuel Bukhbinder, Yaobin Ling, Lauren Jhin, Elizabeth He, Kristofer Harris, Mya Rodriguez, Jenna Thomas, Gabriela Cruz, Kamal Phelps, Yejin Kim, Luyao Chen, Xiaoqian Jiang, Paul E Schulz

Faculty, Staff and Student Publications

Background and objectives: Previous studies, including large cohort analyses comparing vaccinated and unvaccinated adults, suggest that routine immunizations such as inactivated influenza vaccines (IIVs) may reduce Alzheimer dementia (AD) risk. Whether AD risk differs after high-dose IIV (H-IIV) vs standard-dose IIV (S-IIV) remains unexamined. We hypothesized that AD risk would be lower among adults ≥65 years after H-IIV compared with S-IIV.

Methods: This retrospective cohort study analyzed data spanning 2014-2019 from IQVIA PharMetrics Plus for Academics, a US health care claims database. Eligible participants were ≥65 years with ≥2 years of continuous medical and pharmaceutical coverage and no previous diagnostic …

Associations Between Smoking Habits And Weight-Related Behaviors Among People Who Smoke In The United Arab Emirates: A Cross-Sectional Study, Sharifa Alblooshi, Maryam Hassan Dawood, Dana N. Abdelrahim, Marika Lo Monaco, Falak Zeb

All Works

Background: Smoking is one of the leading global public health problems, and is complicated by multiple reasons for its prevalence and associated health problems. An understanding of the influence of smoking activity on weight management is essential to formulate successful health programs. Aim: The objective of the present study was the investigation of the association between smoking habits and weight management among adult people who smoke in the UAE. Methods: A cross-sectional study was conducted with 232 participants who completed a 36-item questionnaire assessing their smoking habits and weight management practices. Results: The sample consisted mostly of males (75.4%) aged …

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND/AIM: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

MATERIALS AND METHODS: Phosphorus (³²P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

RESULTS: A total of 35 out of the 588 genes were differentially expressed, with either log₂ ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤-1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and …

A Novel Approach To Defining Progression In Mds And Precursor Myeloid Conditions In The Mds Natural History Study, Amy E Dezern, Matthew Walter, Et Al.

2020-Current year OA Pubs

Patients at risk for progression from myeloid precursor states (idiopathic cytopenia of undetermined significance [ICUS] and clonal cytopenia of undetermined significance [CCUS]) to myelodysplastic syndrome (MDS) are not well defined. Epidemiologic risk factors, clonal changes for MDS development, and evolution from one MDS state to another were available in the MDS Natural History Study (NHS), a prospective cohort enrolled at diverse US sites. Extensive clinical data and biospecimens were collected at baseline and follow-up. A total of 1177 (56%) individuals with MDS or MDS-related precursor conditions (ICUS/idiopathic dysplasia of undetermined significance [IDUS], CCUS, and MDS/myeloproliferative neoplasm overlap) were enrolled and …

Executive Summary: Executive Leadership System Improvement Improving Depression Screening And Follow Up Processes, Rebecca Geneiveve Hidalgo Salomon

Walden Dissertations and Doctoral Studies

Depression remains a significant public health burden in the United States, contributing to disability, healthcare utilization, and economic cost. Internal 2024 audits at the project site identified variability in Patient Health Questionnaire 9 PHQ 9 screening and follow up processes, with 68% of screenings completed, 55% of follow ups timely, and disparities among patients with limited English proficiency. These findings indicate a systems level reliability and equity gap. This executive leadership system improvement project focused on developing a standardized, nurse led, electronic health record supported workflow to improve PHQ 9 completion and timely follow up. The practice focused question asked …