Parenting Stress And Its Association With Parental Technoference: An Integrative Literature Review, Emily S. Machuca

Honors Undergraduate Theses

Introduction: Today, digital devices are a part of daily life, but can serve as a distraction that interrupts important relationships, a process referred to as technoference. In the context of parenting, device use during child interactions may reduce parental attentiveness and engagement, with potential implications for child development and behavior. Parenting stress may influence how and why parents engage with digital devices in the presence of their children. However, the association between parenting stress and parental technoference remains unclear in the current literature. This integrative literature review aimed to synthesize existing evidence examining the relationship between parenting stress and parental …

Examining The Effectiveness Of Icu Diaries In Reducing Post–Intensive Care Syndrome (Pics) Psychological Symptoms: A Rapid Review Of United States–Based Studies, Lananh Tran

Honors Undergraduate Theses

Background: The growing recognition of Post-Intensive Care Syndrome (PICS) has prompted investigation into interventions, such as ICU diaries, to mitigate the long-term psychological effects of PICS. Intensive care unit (ICU) diaries – journals written by clinicians and loved ones during an ICU admission – are a tool that can help patients reconstruct the events of their critical care experience. Entries in the diary may include clinical updates, explanation of treatments, and encouraging words from loved ones or staff. Previous research in European countries found ICU diaries may be effective in reducing psychological effects post ICU admission.

Research question: The aim …

Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

Implementing A Change Process To Support Respectful Communication In Newborn Units In Kenya: A Qualitative Study, Mwanamvua Boga, Peris Musitia, Dorothy Oluoch, Dyuti Sen, Hiza Dayo, Ane Haaland, Lisa Hinton, Jacinta Nzinga, Mike English, Sassy Molyneux

Institute for Human Development, East Africa

Background: In contexts of high workloads, resource shortages, and environmental inadequacies, neonatal nurses in many low- and middle-income countries face high levels of stress and burnout, as well as significant communication challenges. Advancing care in these ‘on the edge’ emotionally fraught contexts requires a multi-layered systems approac:, including context-sensitive courses that support respectful communication.

Methods: We share our learning from the implementation of a communication and emotional competence training process in two public hospital newborn units in Kenya. We adapted an existing course in collaboration with newborn unit nurse managers, with the aim of enhancing relationships among staff and …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Dnp Repository: Using Technology To Help Nurse Leaders Make A Global Impact, Cynthia Plonien, Cathy Brown, Vanessa Garrett

Nursing Faculty Publications & Presentations - Archive

No abstract provided.

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …

Paternal Involvement And Bonding In Neonatal Intensive Care Unit: Evaluating Daily Caregiving, Emotional Well-Being, And Father-Infant Connection, Ava G. Kinyon

Nursing | Senior Theses

Background: Premature birth and serious neonatal conditions frequently require infants to obtain care in the NICU, producing psychological and emotional obstacles for families. Despite the fact that skin-to-skin contact has been extensively researched for its strengths in encouraging stability and bonding, there persists restricted importance and understanding on paternal participation in routine caregiving tasks such as feeding, diapering, temperature checks, and swaddling. Purpose: This study aims to evaluate paternal participation in daily NICU caregiving tasks to address gaps in comprehending how these experiences impact bonding and emotional well-being among fathers of hospitalized infants. Methods: This study will employ a quasi-experimental …

The Impact Of Home Birth Integration On Maternal-Neonatal Outcomes And Patient Satisfaction: An Integrative Review, Mary E. Hillaker, Jennifer K. Jacobitz

All Electronic Theses and Dissertations

Introduction: Home birth is a safe option for low-risk populations. As awareness of home birth increases, so do the families choosing home birth. Governing bodies recommend well integrated maternal health systems, yet the impact of level of integration on perinatal outcomes and patient satisfaction has not been specifically examined. The purpose of this integrative review is to identify the impact home birth integration has on maternal and neonatal outcomes, patient satisfaction, and how communities can improve their integration level.
Methods: A keyword search of current literature was conducted using CINAHL, PubMed, and Scopus databases. An additional hand search of 2 …

A Descriptive Study Of Cancer Care Experiences And Burden Of Rural South Dakotans, Sarah Mollman, Teddi Dowling, Patricia Woolridge, Jamie Hillmer, James Odom, Marie Bakitas, Hossein Moradi Rekabdarkolaee, Brandon Varilek

Journal Articles: College of Nursing

BACKGROUND: American Indian (AI) persons with advanced cancer (PwAC) in South Dakota have seen increased rates of cancer incidence and mortality compared to national rates. These inequities are driven by social determinants of health. Providing early palliative care is highly important for rural PwAC but is sparsely available in rural South Dakota.

OBJECTIVE: To explore cancer care experiences and patient symptoms and caregiver burden among AI and rural PwAC, and their family caregivers (FCGs), to understand the barriers and opportunities for adapting an early palliative care intervention.

DESIGN: Descriptive study design reporting on the qualitative and quantitative data collected.

METHODS: …

Treatment Manual For Nonsequential Format Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course), Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment Manual and 5 Appendices for NonSequential Format.  Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

Video Instructions For Pre And Post Procedure Care: Evidence-Based Quality Improvement Project, Lynn V. Wojton

DNP Projects

Background: Patient adherence to pre- and post-procedure instructions is essential to ensuring optimal outcomes and patient satisfaction in cosmetic dermatology. However, patients frequently overlook or misunderstand written instructions, leading to suboptimal preparation and recovery experiences.

Project Purpose: The purpose of this quality improvement initiative was to evaluate whether the implementation of short, accessible video-based instructions could improve patient understanding, adherence, and satisfaction compared to standard written instructions alone.

Methods: The project was conducted in a high-volume cosmetic dermatology practice in the Northeastern United States. A HIPAA-compliant platform using a video-based educational intervention was developed and implemented to supplement or replace …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Reducing Live Discharges In Hospice Care Through A Bundled Intervention, Fiona P. White

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction

 Among Medicare fee-for-service hospice beneficiaries, the national live discharge rate increased from 16.9% in FY2021 to 19.1% in FY2025. At a Medicare-certified hospice agency in a southern state, the pre-intervention live discharge rate of 35.3% substantially exceeded national norms, with 68.7% of events representing patient-initiated revocations.

Methods

 A pre-post quality improvement design guided by the Plan-Do-Study-Act framework was implemented over 8 weeks at a single site with 106 newly admitted hospice patients and 15 clinical staff. The four-component bundled intervention comprised Revocation Risk Assessment administration within 24 hours of admission, structured patient and caregiver education within 72 hours of …

Toolkit To Prevent Venous Thromboembolism Among Surgical Patients, Carine Wawa

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: According to the Centers for Disease Control and Prevention, approximately 900,000 people in the United States are affected annually by venous thromboembolism (VTE) (CDC, 2025). The surgical patient population is vulnerable to VTE due to factors such as immobility, tissue injuries, and inflammatory responses. The lack of standardized protocols for surgical patients causes practice variability among healthcare providers and potentially increases the risk for preventable VTE events.

Methods: A toolkit to prevent VTE was developed utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC). A literature review was conducted, reviewed, and graded using the …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.

Purpose

This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).

Methods

In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they …

Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

Evaluating The Effectiveness Of Scenario-Based Virtual Escape Rooms To Improve Student Confidence In Dosage Calculations, Jennifer A. Cuevas

Theses

Abstract

Background: Accurate dosage calculations (DCs) are critical for patient safety, as medication errors contribute to approximately 7,000-9,000 preventable deaths annually. Nearly 30% of nursing students exhibit weakness in foundational mathematical skills, and a significant confidence gap exists: 70% feel confident in mathematical abilities, yet only 45% feel confident in clinical application, necessitating innovative educational interventions.

Purpose: The purpose of this project was to implement and evaluate a scenario-based virtual escape room intervention to enhance undergraduate nursing students' confidence in DCs.

Methods: Grounded in Kolb’s experiential learning theory, this online asynchronous intervention engaged students through concrete experience, reflective observation, abstract …

Dnp Final Report: Poverty Stigma: The Effects Of A Poverty Simulation On Undergraduate Nursing Students And Their Attitudes Toward Caring For Impoverished Patients, Jessica P. Bowen

DNP Final Reports

Background: Current evidence demonstrates that stigma toward individuals living in poverty persists among undergraduate nursing students and negatively influences patient outcomes. Evidence-based educational strategies addressing social determinants of health have been shown to improve nursing students’ perceptions of vulnerable populations.

Purpose: This quality improvement project intended to evaluate the feasibility of integrating an interactive Community Action Poverty Simulation© (CAPS) activity into an undergraduate nursing (BSN) program at an academic health system university in East Texas.

Methods: Guided by the Plan Do Study Act (PDSA) quality improvement framework and The Johns Hopkins Evidence-Based Practice (JHEBP) Model, Missouri's Community Action Poverty Simulation …

Dnp Final Report: Reducing 30-Day Readmissions Through Follow-Up Appointments In An Acute Care Setting, Sukhnandan Kaur

DNP Final Reports

Thirty-day hospital readmissions remain a persistent quality and financial concern for acute care organizations. Poorly coordinated discharge processes, inconsistent follow-up appointment scheduling, and gaps in care transitions may increase the risk of avoidable readmissions among adult medical-surgical patients. The purpose of this quality improvement project was to implement a standardized follow-up appointment scheduling workflow prior to hospital discharge and evaluate its effect on follow-up scheduling compliance and 30-day readmission trends in a 93-bed acute care hospital. The intervention was implemented over 12 weeks on an adult medical-surgical unit from September through December 2025. The standardized workflow included electronic health record …

Enhancing Postoperative Esophagectomy Outcomes With Preoperative Education: A Quality Improvement Project, Gaelyn Kattman

DNP Projects

Title

Enhancing Postoperative Outcomes with Preoperative Education for Esophagectomy Patients

Background/Significance

Esophageal cancer is an aggressive disease and the fourth most common gastrointestinal cancer. A surgical treatment for a patient with esophageal cancer who is a surgical candidate is an esophagectomy. Immediate postoperative complications may include pneumonia, arrhythmias or anastomotic leaks, all of which can potentially increase the patient’s length of stay. Delayed discharges can lead to a backup throughout the hospital, limiting the amount of available inpatient beds for patient care.

Purpose 

The DNP project purpose was to implement an additional preoperative telehealth visit in order to provide  patient …

Improving Awareness And Use Of The First-Responder Alerting Application, Pulsepoint Respond, In The Nursing Profession, Maclaine Matties

DNP Projects

Background/Significance

Out-of-hospital cardiac arrest (OHCA) is a sudden, life-threatening emergency that can occur anywhere and to anyone. In 2023, the American Heart Association identified OHCA as a public health crisis, with survival rates around 10%. Outcomes depend heavily on rapid intervention, as each minute without cardiopulmonary resuscitation (CPR) significantly reduces survival. Mobile phone–based alert systems help bridge the gap between collapse and emergency medical services (EMS) arrival by notifying nearby trained responders. In a county in the Northeast, PulsePoint Respond serves this role. However, despite 1,302 registered responders as of November 2025, only 7 registered nurses were enrolled, highlighting an …

Implementation Of An Updated Opioid Overdose Response Policy To Address Xylazine-Involved Overdoses In A Federally Qualified Health Center, Dana Umbro

DNP Projects

The increasing prevalence of non-opioid adulterants like xylazine, a veterinary tranquilizer, has introduced significant challenges in overdose recognition and management. Non-opioid adulterants cause central nervous system depression, respiratory compromise, and severe soft tissue injury that is not reversed by naloxone. Many healthcare organizations lack standardized clinical guidance for managing overdoses involving non-opioid adulterants, resulting in variability in care and increased risk for adverse outcomes. The purpose of this Doctor of Nursing Practice project was to update and implement an opioid overdose response policy incorporating evidence-based guidance for the recognition and management of overdoses potentially involving non-opioid adulterants. This was conducted …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer

DNP Projects

Background/Significance

Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of morbidity, mortality, and increased healthcare costs. Alcohol-based nasal decolonization is an evidence-based strategy to reduce MRSA transmission; however, staff compliance with decolonization protocols is often suboptimal, limiting effectiveness in inpatient medical-surgical settings.

Purpose

The purpose of this evidence-based quality improvement (EBQI) project was to evaluate whether implementing a structured, evidence-based nasal decolonization protocol improved staff compliance and reduced missed administrations and patient refusals among eligible medical-surgical inpatients.

Methods

This EBQI project was implemented on five inpatient medical-surgical units at a large academic medical center. Interventions included standardized staff education, …

Leveraging Technology To Improve Throughput: A Qi Project Utilizing Electronic Sbar, Suzy Candito

DNP Projects

The DNP practice site, a high-acuity Level I trauma center and regional referral hub, experiences persistent emergency department (ED) crowding and prolonged admission throughput times. Regional data show average ED wait-times near 252 minutes, underscoring the urgency of reducing delays between bed assignment and bed occupancy (assigned-to-occupied time). Inefficient or varied written handoffs contribute to calls for clarification, omissions, and transition delays, where structured, electronic SBAR tools are associated with improved completeness, standardization, and workflow efficiency. At the systems level, prolonged ED boarding is linked to higher daily hospital costs and safety risks, making communication optimization an operational and patient-safety …

Enhancing Postoperative Outcomes: The Impact Of Instruction Format On Patient Satisfaction In Ambulatory Surgery An Evidence-Based Quality Improvement Project, Gillian Shelby

DNP Projects

Background

Effective postoperative discharge communication is essential in ambulatory surgery centers, where short recovery periods and rapid patient turnover increase the risk of misunderstanding postoperative care instructions. Inconsistent delivery of discharge education may contribute to decreased patient satisfaction and reduced adherence to postoperative plans. Project Goals

The goals of this DNP quality improvement project were to: (1) implement standardized dual-format postoperative instructions using written and verbal education reinforced with the teach-back method, and (2) improve patient satisfaction and confidence in understanding postoperative care instructions. Methods

Following IRB exempt approval on September 10, 2025, implementation occurred from November 20,2025 to February …