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Sleep Menus: A Personalized Approach To Enhancing Patient Rest And Improving Sleep Quality, Justin W. Dorman

Doctor of Nursing Practice (DNP) Manuscripts

Sleep disruptions among hospitalized patients can negatively impact healing, recovery, and patient satisfaction. Hospital noise remains a persistent barrier to restful sleep, yet previous hospital-based noise reduction strategies have shown limited sustained success. This quality improvement project aimed to enhance patient-perceived sleep quality by implementing a patient-centered Sleep Menu offering patients earplugs or sound machines. A pre-post design was employed, using the Richard-Campbell Sleep Questionnaire (RCSQ) to assess patients' sleep quality before and after the Sleep Menu intervention. Sixty patients were approached; 25 chose earplugs, and 7 selected the sound machine. Despite environmental decibel levels remaining above the WHO recommendations …

How Ot Is Improving Aspects Of Daily Living In Children With Asd: An Integrated Review, Elizabeth Mearse, Reagan Mcgee, Elshaday Solomon, Zoe Curtis, Larissa Brooks

Student Scholar Symposium

This presentation aims to show how affective Occupational therapy is in improving aspects of daily living in children under 18.

Staff Education To Improve Patient Medication Adherence For Schizophrenia Using Long-Acting Injectables, Adela Ghogomu

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education initiative based on a comprehensive literature review that emphasized the importance of staff education in improving healthcare outcomes. The practice problem identified was a lack of staff knowledge and education regarding long-acting injectables (LAIs) in clients with schizophrenia, which contributed to inconsistent support for client medication adherence. It was essential to address this issue because nurses play a crucial role in medication management, patient education, and adherence support. The practice-focused question explored was: Will staff education regarding the use of long-acting injectables in clients with schizophrenia to enhance medication adherence improve …

Enhancing Readiness Of Novice Nurse Educators To Use Concept Mapping As An Active Learning Strategy, Kaitlyn Dutch

MSN Student Capstones

No abstract provided.

Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a quality improvement (QI) initiative. Nephrologists were inconsistent in ordering iron studies and sometimes delayed the initiation of erythropoiesis-stimulating agents (ESAs) on admission to the inpatient site. These delays often led to suboptimal outcomes. The practice-focused question guiding the project asked whether a nurse-driven iron protocol would improve adherence to anemia management guidelines. The project’s purpose was to evaluate the impact of the evidence-based nurse-driven protocol. I used descriptive and inferential statistics for data analysis. Findings demonstrated a statistically significant improvement in the timely completion of iron studies and in intravenous (IV) iron …

Nursing Faculty Attitudes Toward Artificial Intelligence: A Quantitative Causal-Comparative Cross-Sectional Study, Micaela Mcspadden

Doctoral Dissertations and Projects

The rapid growth of artificial intelligence (AI) in healthcare has highlighted the importance of understanding how nursing faculty perceive this technology. Although prior studies have explored public views, nurses’ perceptions, and faculty attitudes toward technology and curriculum change, limited research has focused on nursing faculty perspectives toward AI. Through the lens of the Theory of Reasoned Action (TRA) and the Technology Acceptance Model (TAM), this study examined factors that influence nursing faculty attitudes toward AI in nursing education. This study used a quantitative, causal-comparative, cross-sectional design with 263 nursing faculty participants from undergraduate pre-licensure programs in the United States. Participants …

Bridging The Gap: Optimizing Outpatient Care Delivery In Rural Kenya Through A Telemedicine Workflow Training Initiative, Elizabeth K. Bennett

Doctoral Dissertations and Projects

Access to timely, high-quality outpatient care in rural Kenya is constrained by workforce shortages, geographic barriers, and inefficiencies in care delivery. This Doctor of Nursing Practice project evaluated the impact of implementing a structured telemedicine workflow and training program for a regional mission hospital in the highlands of Western Kenya and its satellite outpatient clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's Change Theory, and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework, the project employed a quasi-experimental, pre-post design, with eight medical providers participating in structured workshops, interactive telemedicine simulations, and workflow integration exercises. Impacts were …

Workplace Violence: A Paradigm Shift, Ann Marie Hutchens

Doctoral Dissertations and Projects

Workplace violence (WPV) has reached epidemic proportions. WPV poses devastating results on the healthcare industry: affecting quality of care and patient outcomes, contribute to the development of physical and psychological conditions for nurses, and reduce the healthcare teams’ level of job satisfaction and organizational commitment. The United States is already facing a nursing shortage due to baby boomers retiring and an increase chronic disease and the elder population. Although strongly prevalent, WPV is significantly underreported. It is believed that the low rate of reporting is a consequence of apathy that violence is an occupational hazard, and that nothing will change. …

Transition-To-Practice Program For Aprn Msn Graduates, Jennifer Nneoma Nwosu

Walden Dissertations and Doctoral Studies

The transition from graduate education to clinical practice marks a pivotal point in the professional journey of advanced practice registered nurses (APRNs). Despite rigorous preparation, many APRN MSN graduates struggle to adapt to the complex expectations of autonomous practice. The lack of structured mentorship, inconsistent orientation processes, and unclear performance expectations contribute to high stress, role confusion, and early turnover. This Doctor of Nursing Practice Executive Leadership project addressed this critical issue by evaluating whether an interprofessional team could achieve consensus on developing a best practice program to guide APRN MSN graduates’ transition to independent clinical practice. This initiative was …

The Relationship Between Religious Attitude And Breastfeeding Attitude: A Cross-Sectional Study From Türkiye, Melike Yavaş Çelik, Cuma Tunçkaşık

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: This study was conducted with 203 mothers with babies aged 0–24 months. Simple random sampling was used in sample selection. The Religious Attitude Scale and Breastfeeding Attitudes of the Evaluation Scale were used in data collection.

Results: A significant relationship was found between religious attitudes and breastfeeding attitudes. Additionally, mothers' negative breastfeeding attitudes and positive breastfeeding attitudes were found to be close to each other. The time it took for mothers to start breastfeeding their …

Climate Change Anxiety Related To Women’S Health Among Health Sciences Students, Derya Kaya Şenol, Semiha Aydın Özkan, Durdu Cennet Omuş

Makara Journal of Health Research

Background: Climate change impacts are unequally distributed globally, with children, women, pregnant women, the elderly, marginalized populations, and refugees bearing a disproportionate burden. This study aims to determine the levels of related anxiety among female students and to examine the relationship between the anxiety and their perceptions, knowledge levels, and health behaviors related to women’s health.

Methods: The study has a descriptive cross-sectional design. The study population included women students enrolled in the fall semester of the 2023–2024 academic year at the Faculty of Health Sciences of a university between October and December 2023. Personal Information Form and …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

Early Depression Screening In Adults With Opioid Use Disorder, Ekaterina Versace

Walden Dissertations and Doctoral Studies

Abstract This Doctor of Nursing Practice project involved the development and quality appraisal of a clinical practice guideline (CPG) for early depression screening in adults with opioid use disorder (OUD), addressing the absence of standardized, evidence-based screening protocols in addiction treatment settings. Guided by the practice-focused question of whether existing evidence supports the development and evaluation of such a guideline using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, a systematic synthesis of 35 research articles was conducted, with 15 high-level studies informing guideline development. A multidisciplinary panel of four experts evaluated the CPG using the …

Integrating The Five As Framework To Enhance Person-Centered Care For Adults Living With Obesity, Alexandra Charles

Electronic Theses and Dissertations 2020 - Present

Obesity has adverse effects on physical health, emotional well-being, and mental functioning. To effectively address this highly prevalent and multifaceted condition, the use of a structured, evidence-informed framework is essential to support providers in delivering consistent, person-centered care for individuals living with obesity. The Five As is a powerful yet not commonly implemented framework in many primary care practices. The Five As framework (Ask, Assess, Advise, Agree, Assist) offers a structured model to guide clinicians in delivering consistent, supportive, and transformative care for individuals with obesity.

The goal of the project was to implement a timely and cost-effective protocol/tool that …

Impact Of Staff Education To Clinical Documentation Integrity Team, Leyna Belcher

Walden Dissertations and Doctoral Studies

The doctoral project investigates the impact of education on Clinical Documentation Integrity (CDI) nurses in enhancing the accuracy and quality of clinical documentation within healthcare organizations. Clinical documentation plays a crucial role in accurately reflecting patient care and is essential for capturing proper diagnoses, coding, and reimbursement. In contrast, inaccurate or incomplete documentation can lead to misdiagnoses, poor patient outcomes, and financial deficits. Due to frequent updates in clinical guidelines and coding standards, CDI professionals require continuous, specialized training to stay informed with ever-changing medical terminology, disease processes, and coding regulations. By enhancing the CDI education, the aim is to …

A Program Evaluation Of Universal Screening For Depression In The Primary Care Setting, Samantha W. Burns

Doctoral Projects

Depression is a chronic condition affecting millions of Americans annually and is often associated with poor clinical outcomes, multiple co-morbidities, a negative economic impact, and an increased mortality rate. Many primary care settings have implemented universal depression screening programs following the recommendations of governing healthcare entities such as the United States Preventive Services Task Force (USPSTF) and Center for Medicare and Medicaid Services (CMS). Due to positive benefit, universal depression screenings have now been included as a quality measure in the Merit-based Incentive Payment System (MIPS) to increase organizational reimbursement. The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening …

Nurses' Comfort Toward Caring For The Dying: A Cross-Sectional Descriptive Study, Candies Warren

ATU Theses and Dissertations 2021 - Present

The purpose of this quantitative cross-sectional descriptive research study was to explore nurses’ comfort levels toward caring for dying patients and what factors influence the bedside nurses’ comfort levels in providing end-of-life care in an acute care hospital setting. A convenience sample (N=63) of RNs voluntarily participated in an online survey from January 2025 to March 2025 that provided direct patient care. Data was collected through Question Pro. Data collected included sociodemographic questions, questions about current comfort level, factors that influence nurses’ comfort level, and selected items from the Frommelt Attitude Toward Care of the Dying Patient (FATCOD) scale. Institutional …

Effects Of Communication Boards On Improving Communication In Assisted Living Care Facilities, Koleen Beatrice Arribas

Master's Projects and Capstones

Problem: A Residential Care facility utilizes paper charting causing limited access to vital information such as code status, allergies, and/or diet for those caring for the resident.

Context: Exceptional charting only when a resident’s condition changes may not provide enough vital information for the caregiver to administer medication or provide proper support during an emergency, such as the resident’s DNR status.

Interventions: A communication board was placed in a secure space near the nurses’ station with key resident information. Nurses would huddle at the board at before the change of shift and make updates as necessary.

Measures: Staff input in …

Improving Pressure Injury Prevention With Educational Programs For Caregivers And Nurses, Michella B. Kahanding

Master's Projects and Capstones

Problem: Pressure injuries are preventable with adequate interventions and knowledge by healthcare staff; however, skilled nursing facilities struggle with pressure ulcer prevention (PUP). Patient suffering and associated costs with treating these injuries are considerable.

Context: Staff education in knowledge regarding PUP is lacking, and annual PUP education is ineffective in reducing the number of pressure injuries in these facilities.

Interventions: Staff education on prevention strategies includes education, pre- and post-knowledge assessments, return demonstration and product use will be implemented

Measures: Results from the baseline knowledge of appropriate PUP in caregivers, pre- and post-test for knowledge retention, teach back techniques to …

Improving Interdisciplinary Communication And Collaboration With The Standardization Of Doula Care Through An Informatics Tool, Shela Le

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for a month, a post-survey assessed these …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the …

The Pressure Is On: A Quality Improvement Project To Educate Nurses On Hospital Acquired Pressure Injuries, Lance Ward

Master's Projects and Capstones

Objective Hospital acquired pressure injuries (HAPIs) are injuries developed by admitted patients, from treatment interventions that they encounter during their hospital stay. If a patient acquires a HAPI during their stay, the hospital is required to cover all expenses related to the injury. An in-patient trauma unit at a large medical center wishes to improve patient care by educating nursing staff on preventive measures of HAPIs. A review of relevant literature on HAPIs from the past five years was conducted to identify HAPI preventions tools, such as the Braden Scale and SKINS bundle, as well as the best methods to …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …