Digital Commons Network^™

Commit To Sit: Does Purposefully Sitting With Adult Medical-Surgical Patients At A Rural Hospital Impact Patient Satisfaction?, Jolie A. Puckett

Doctor of Nursing Practice Projects

Background: Patient satisfaction surveys encourage patients to provide feedback about their experiences with healthcare organizations, and the surveys also play a critical role in identifying gaps in care that may contribute to patient harm. Effective communication between nurses and patients is crucial for delivering high-quality healthcare; therefore, initiatives to enhance this communication should be explored and implemented.

Purpose: This quality improvement project aimed to evaluate whether sitting with patients improved patient satisfaction scores for a medical-surgical unit within a Northwest Georgia inpatient facility.

Project Design: A pre- and post-design method was utilized to compare patient satisfaction scores before and after …

The Impact Of A Nurse Navigator On The Completion Of Medicare Annual Wellness Visits, Nanette L. Snyder

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Despite being a covered service designed to support individualized prevention planning, the Medicare Annual Wellness Visit (MAWV) remains underutilized at a rural Federally Qualified Health Center (FQHC). Barriers include low patient awareness, inconsistent outreach, and a reactive scheduling process that excludes patients without upcoming appointments. These issues limit the FQHC’s ability to meet preventive care goals and sustain performance in value-based reimbursement models.

Aim of the Project: This quality improvement project evaluates the impact of implementing a nurse navigator on MAWV completion. The intervention incorporates proactive scheduling and cohort engagement to address barriers related to awareness, access, and outreach. …

Psychometric Evaluation Of The Thai Version Of Emotional Labor Scale (T-Els) In Thai Nurses, Vachira Posai, Wisarut Srisintorn, Paramee Thongsuksai, Chanokporn Jitpanya

Journal of Health Research

Background: Nurses often face emotional strain due to emotional labor (EL), which involves concealing or modifying genuine feelings to meet their job requirements. This response can lead to physical, psychological, and behavioral issues. The Emotional Labor Scale (ELS), originally in English, has not been translated into Thai, leaving its psychometric properties unexamined in the Thai context. This study aimed to translate the ELS into Thai and evaluate its psychometric properties among Thai nurses.

Methods: A cross-sectional study design was used. The 14-item scale, which includes surface acting, deep acting, and expression of naturally felt emotions dimensions, was translated using forward …

Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha

Walden Dissertations and Doctoral Studies

This project was developed as a staff education program using the analyze, design, develop, implement, and evaluate (ADDIE) model with a focus on discharge planning in a medical clinic in northern Maryland. There is a gap in discharge planning for older adults due to shortage of providers and inadequate education related to care transitions among the elderly. The care transition process can be improved through education. The practice focused question was: “Does an educational project for nurses on care transitions for the elderly increase knowledge as compared pre-to post education?” The Johns Hopkins evidence-based practice model (Appendix A) was the …

Dementia Care: The Role Of Experiential Learning In Nursing Education, Jeannie Simpson

Wisdom & Compassion: The LUSON Journal

The escalating global prevalence of dementia necessitates enhanced educational strategies to prepare nursing students to care effectively for individuals living with dementia. Traditional methods in nursing education predominantly focus on pharmacological treatments and basic caregiving strategies, often neglecting innovative approaches like the Music & Memory® program, Virtual Dementia Tour®, and Montessori dementia. By including these innovative approaches, future nurses will be better equipped to develop and implement person-centered care for individuals living with dementia to improve their quality of life. The integration of these approaches will also meet the growing demands of dementia care, aligning with global health mandates.

A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson

Walden Dissertations and Doctoral Studies

The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided …

Staff Education To Increase Knowledge And Education Of Urinary Tract Infection To Reduce Rehospitalization, Yia Lor

Walden Dissertations and Doctoral Studies

Urinary tract infections (UTIs) are considered the most common infections in healthcare, particularly in nursing homes. If appropriate preventive measures are taken, infection rates will be reduced. The DNP project aimed to enhance clinicians' knowledge to reduce and prevent UTIs in nursing homes. This knowledge expansion also significantly has potential to reduce the risk of unnecessary hospitalizations. A knowledge gap was identified that focused on the necessary preventive measures to impact patient outcomes positively. Addressing this in nursing is essential because it can help reduce mortality risks. The participants consisted of six registered nurses and six certified nurse assistants who …

Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason

Walden Dissertations and Doctoral Studies

In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …

Staff Education On Medicaid And Medicare Programs, Angela R. Smith

Walden Dissertations and Doctoral Studies

Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Improving Patients' Confidence In Self-Care Management And Preventing Hospital Readmission Within 30 Days Of Discharge In The Heart Failure Population, Kelly Carroll

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Heart failure (HF) is a chronic, progressive condition and a leading cause of hospital admissions nationwide. The 30-day readmission rate for HF patients is approximately 23.4%, contributing to increased morbidity, mortality, and significant healthcare costs. Each HF-related readmission is estimated to result in a financial loss of $15,789 per patient due to reduced reimbursement from both private and public insurers. This underscores the critical need for timely follow-up care, particularly within the first 30 days post-discharge.Without adequate follow-up and patient education, many individuals lack the confidence and knowledge necessary for safe and effective self-management in the outpatient setting, …

Interprofessional Collaboration Between Primary Care And Occupational Therapy, Ellen Modlin, Phd, Otr/L, Bcp, Caps, Deana Shevit Goldin, Phd, Dnp, Arnp, Fnp-Bc

Journal of Interprofessional Practice and Collaboration

Purpose: This article explores the utilization of occupational therapy (OT) in interprofessional health care teams in adult populations. Primary care settings are typically the first point of contact for individuals seeking health care services; therefore, primary care practitioners (PCPs) are in a unique position to initiate collaboration with specialty clinicians to optimize the use of health care resources.

Method: Peer- reviewed literature from primary care and OT research was reviewed and summarized. The search focused on barriers and potential opportunities for collaboration between primary care and occupational therapy in adult populations.

Results: Occupational therapy (OT) is underutilized, as lack of …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Implementation Of An Evidence-Based Hearing Education Project For Patients And Their Care Partners, Jennifer Mahoney

Doctoral Projects

Hearing loss is a significant communication issue that impacts relationships, safety, and mental and physical health. There is an increased risk of dementia as well as increased mortality associated with untreated hearing loss. Hearing aids are one of the main treatments for hearing loss, but they are frequently not used. Cognitive impairment, osteoarthritis of the hands, cost and complexity are some of the reasons that hearing aids do not get utilized. But research has shown that involving family members and care partners in trainings on how to use hearing aids may increase use of them. The goal of this project …

A Quality Improvement Project On Implementing A Nurse-Driven Foley Catheter Removal Protocol Using Modified Houdini Criteria For Oncology Patients To Reduce The Catheter-Associated Urinary Tract Infection (Cauti) And Catheter Days In The Intensive Care Unit (Icu), Rittu K. Justin

Doctor of Nursing Practice Final Project Abstract

Purpose: This scholarly project aimed to develop modified criteria for oncology patients regarding Foley catheter removal guidance and implement a nurse initiative in the ICU to reduce CAUTI and catheter days.

Background: CAUTIs are considered preventable nosocomial infections; hence, a nurse-driven Foley catheter removal protocol has become an essential strategy in healthcare to reduce CAUTIs. The project was implemented in a 43-bed ICU in an academic hospital at the Texas Medical Center. The 12-week pilot project included adult patients with a primary diagnosis of cancer.

Methodology: A quantitative design with a PDSA framework was employed. The institutional infection control trend …

Diabetes Self-Management Education For Older Adults In Primary Care, Makilah Rae Furlan

Doctor of Nursing Practice Scholarly Projects

Type 2 Diabetes (T2DM) is a chronic disease that impacts 27.2 million seniors 65 and older. Evidence-based care for T2DM includes a combination of medication and disease-management behaviors. Access to education to teach patients healthy behaviors to manage their disease is limited and even less accessible to geriatric patients with aging learning needs. The scholarly project addresses this gap in patient education by implementing evidence-based diabetes self-management education for geriatric patients to increase patient knowledge and confidence in implementing self-management behaviors. The scholarly project aims to assess health behaviors in patients aged 65 and older with established type 2 diabetes …

Longevity And Cardiovascular Health: Lessons From The Mediterranean Blue Zones, Lyndsay Bancroft, Miranda Daley, Hitomi Tanizawa

NURS 464: Evidence-Based Nursing Capstone

Cardiovascular diseases are the leading cause of death globally, and poor diet is a leading risk factor for adverse cardiac events (Ahmed et al., 2023). The Mediterranean diet provides protection against coronary heart disease, regardless of the common risk factors for cardiovascular diseases like smoking, hypertension, diabetes, etc (Legrand et al., 2019). Those living in the blue zones of Greece and Italy have far fewer deaths from cardiovascular disease than populations living in other parts of the world (Legrand et al., 2021). This project aims to investigate how the Mediterranean diet has influenced the rates of cardiovascular disease amongst the …

Nursing Faculty Experiences Of Teaching Dementia Care: A Transcendental Phenomenological Study, Jeannie Simpson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the experiences of nursing faculty teaching dementia care to nursing students in Texas. The theory guiding this study was Kolb’s experiential learning theory as it offers a structured framework for examining how experiences lead to learning. This theory also introduced the concept of the Experiential Educator profile, specifically delineating the role of educators in facilitating knowledge acquisition (Kolb, 2014). This study bridged the gap in existing literature regarding the experiences of nursing faculty in teaching dementia care to nursing students and provided a comprehensive look at dementia education in nursing schools. …

Implementing Nutrition Education For Patient’S Being Initiated In Semaglutide: Quality Improvement Project, Liliane Colbert

DNP Projects

Significance and Background: The nutrition literacy assessment instrument (NLit) and healthy eating habits assessment, are underutilized tools, as components in providing nutrition education for patients in primary care. There is a lack of knowledge of their availability, thus leading to missed opportunities to provide a more targeted approach to improve nutrition literacy. In the primary care setting, no formal approach is utilized in providing nutrition education to patients being seen for medical weight-loss management. Another element missing from the current process, is a tool that medical providers can utilize, to understand a patient’s baseline nutrition literacy and eating habits. Thus, …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Changing Intimate Partner Violence Screening And Intervention: Focus Group Perspectives, Colleen M. Galambos, Teresa Jerofke-Owen, Heidi Paquette, Linda B. Piacentine, Erin C. Schubert, Mychoua Vang, Erica Arrington, Nilanjan Lodh, Kimberly S. Gecsi

College of Nursing Faculty Research and Publications

Background: Many survivors of intimate partner violence (IPV) remain unconnected to professional help. Screenings in health settings may improve connections to support services.

Purpose: The purpose of this study was to gather data to help inform an IPV screening intervention in an obstetrics/gynecology health clinic.

Methods: A qualitative analysis was employed using a summative content analysis approach of the transcripts of 2 focus groups consisting of health care providers, advocates, and survivors of IPV.

Results: Four thematic categories and additional subcategories emerged from the analysis, including (1) current process (what is done); (2) need (what is not done); (3) concerns …

Video Animation: Improving Older Adults Patients Knowledge And Motivation Related To Hypertension Diet, Gusti Ayu Kade Budiarti, Sri Susanty, Ruslan Madjid, Ramadhan Tosepu

Jurnal Keperawatan Indonesia

Hypertension is a dangerous medical condition that can increase the risk of heart, brain, and renal problems, among other issues. A balanced diet is an essential hypertension control intervention. This study seeks to examine the efficiency of employing animation media to explain the application of diets that prevent hypertension and boost the understanding and motivation of senior patients at Bahteramas Regional General Hospital. In both the control and intervention groups, a quantitative-quasi-experimental design was adopted, with pre-test and post-tests. Data was obtained via questionnaires from 92 respondents chosen using a purposive sampling approach, with 46 in the intervention group from …

Staff Education On Evidence-Based Educational Content For Patient Fall Prevention Measures, Ogochukwu Vera Nnakwe

Walden Dissertations and Doctoral Studies

Patient falls continue to be a challenge due to the injury associated with them. They can be disabling, costly, and most often lead to increased morbidity and mortality. Falls at home lead to hospitalization of the patient and complication of other health issues and/or aggravation of preexisting health problems. The practice problem was that the clinic did not have patient education content in place for fall prevention measures to discuss with patient at discharge. The practice-focused question was, Will a staff education on evidence-based falls prevention measures result in an increase in staff knowledge on fall prevention? The purpose of …

Effects Of The Vitality Acupunch Exercise Program On Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study, Brittany Murley, Kuei-Min Chen, Christine S. Gipson, Kevin Gosselin, Jenna Thornhill, Allison Ross, Kennedy Gladding, Beth Mastel-Smith

Nursing Faculty Publications and Presentations

Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants …

A Nurse-Led Blood Pressure Program To Improve Blood Pressure In The Underserved Population Of Patients With Hypertension, Kyiana P. Adams

Doctoral Dissertations and Projects

Hypertension is one of the most chronic conditions in the United States and worldwide. Patients with lower socioeconomic class tend to have poor control of their blood pressure and higher morbidity and mortality rates. The scholarly project was conducted to identify if a nurse-led eight-to-10-week telehealth program improves blood pressure in the uninsured and underinsured community. The project was conducted in a community cares clinic that is part of a large organization. The criteria included adults aged 18 and older diagnosed with hypertension without resistant hypertension. Participants were required to agree to having a phone call once weekly for four …

Executive Summary: Clinical Practice Guideline Primary Care Management Of Overweight/Obesity In Adult Women, Getrude Tate Nguatem

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a clinical practice guideline project focused on overweight and obesity management of adult women in primary care. The practice problem identified was the lack of an evidence-based clinical practice guideline to manage overweight/obesity in adult women. It was important to address this problem because overweight and obesity were significant health concerns at this clinical site in the United States and the world. The practice-focused question was the following: “Does the evidence support the development and Appraisal of Guideline for Research and Evaluation (AGREE) II instrument quality scoring of a clinical practice guideline on …

An Educational Intervention Focused On The Care Of Older Adults, Michele Orzehoski

Walden Dissertations and Doctoral Studies

It is estimated that by 2050, individuals ages 65 and older will comprise 20% of the U.S. population. Further, research has demonstrated that among these aging adults, 80% have one chronic condition with 77% having at least two chronic conditions. Given this, the Institute for Healthcare Improvement (IHI) developed the Age-Friendly Health System framework for the care of older adults centering on what matters, medication, mentation, and mobility, or the 4Ms. In the local organization, leadership determined there was a need for an older adult-centered care model given their population includes aging individuals. Thus, the purpose of this doctor of …

Associations Between Older Hispanics’ Diabetes Control And Their Caregiver’S Health Literacy, Jorge Rico

Nursing Dissertations - Archive

Background: Older Spanish-speaking Hispanics are a rapidly growing population in the United States that face disproportionally high rates of diabetes and inadequate health literacy. Familism is valued among Hispanics and caregivers may play an important role in overcoming the social determinants of health facing this vulnerable population. Methods: This descriptive correlation study sought to explore correlations between the caregiver’s health literacy and the patient’s control of diabetes. Findings: Mixed effects model found a significant correlation between the caregiver’s print literacy and the patient’s hemoglobin A1c. Conclusion: The findings are encouraging for future research to explore interventions that target the caregivers …