Integrating An Sms Text Reminder Program For Smi Patients To Combat Provider Appointment No-Shows, Philip Spreter Bsn

Doctor of Nursing Practice Final Manuscripts

Abstract

We are in the digital age in all avenues of life, especially healthcare. The standard of care is no longer just a paper reminder card and a call from the office to confirm the patient is going to make it in the week of their appointment. Cards get lost and more people are screening their phones due to a rise in robocalls and scams, which is leading to more people corresponding via text. This is why text-based reminders are now the new, preferred standard for reminding patients of their appt. With that said, there appears to be a deficit …

Improving Equity In Women's Stroke Outcomes, Lindsay M. Warner

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project is to review research-based evidence evaluating the inequities in women’s stroke research and treatments and how this effects women’s stroke outcomes. This paper sought to identify current recommendations for improving sex equity for women’s stroke research and identify further areas of policy change to ensure that women’s health outcomes are prioritized in this historically underrepresented population.

Background: An area of critical importance to society is the significant cause of gender-based inequity in healthcare and research. Historically medical research has primarily involved males and the findings have been …

Why Throughput Is Group-Put, Edward Sales

Doctor of Nursing Practice Final Manuscripts

Introduction: University of California San Francisco (UCSF) Saint Mary’s Health, has two hundred forty licensed beds to utilize for patient care, ninety one that can be used for inpatient medical surgical patients. Throughput is a challenging issue, especially at Unit seven west which houses thirty beds. Post op surgical orthopedic patients, medical surgical patients from the emergency department (ED), intensive care unit (ICU), and telemetry downgrades are waiting for inpatient beds, which causes delays in care and increases length of stay.

Background: Unit seven west is a surgical ortho floor with a high admission census consisting of three to ten …

Improving Social Drivers Of Health Screening In An Inpatient Setting For Sdoh Data, John P. Lussier

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose

Title of the Project: Improving Social Drivers of Health Screening in an Inpatient Setting for SDoH Data

Purpose: This evidence-based practice project aimed to increase social drivers of health (SDoH) screening compliance by redesigning the workflow to distribute responsibility between nursing and case management, ultimately improving identification and referral of patients with supportive service needs.

Background: Screening for SDoH needs facilitates the provision of appropriate supportive services. The existing workflow required nurses to conduct initial screening in five domains (Housing Stability, Utility Difficulties, Food Insecurity, Interpersonal Safety, and Transportation Needs), with positive responses triggering additional investigative questions. These …

Crisis Without Cops: Trauma-Informed Mental Health Care For Bipoc Communities, Amanda Carson

Doctor of Nursing Practice Final Manuscripts

This policy paper advocates for a structural transformation in mental health crisis response, moving beyond police-led interventions toward trauma-informed, community-rooted models grounded in public health and equity. Drawing on Critical Race Theory (CRT), neuroscience, and program evaluations of models like CAHOOTS, 988, Denver’s STAR, and Durham’s HEART, it examines how systemic racism, institutional mistrust, and implicit bias contribute to disproportionate harm for BIPOC individuals. The paper highlights the effectiveness of peer-led, culturally responsive alternatives that reduce force, hospitalization, and disengagement from care. Using Kingdon’s Multiple Streams Framework, it proposes actionable, scalable policy strategies supported by recent federal momentum, including the …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementation Of A Tracheostomy Discharge Education Class For Nicu Nurses, Todd N. Chamoy

Doctor of Nursing Practice Final Manuscripts

Infants who are ventilator-dependent or have anatomic anomalies of their airway frequently require tracheostomy placement prior to discharge from the hospital in order to be cared for safely at home. At this large quaternary children’s hospital in Southern California, preparing these infants for discharge after tracheostomy placement has not been the role of the NICU nurse. There was no system in place on how to train caregivers, and the NICU staff felt unprepared. Evidence supports use of intensive educational programs to improve nurse knowledge and skills of tracheostomy care, allowing NICU nurses to provide improved care and pre-discharge teaching.

A …

Suprathel Burn Dressing Versus Standard Care: Impact On Hospitalization Duration And Post- Discharge Outpatient Visits, Isaac Awolola

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project is to determine the effectiveness of Suprathel a synthetic, one-time application, wound dressing that acts as a temporary skin substitute, particularly effective for partial-thickness burns and deep dermal burns vs, the standard of either Polysporin or Santyl, Xeroform, gauze on the frequency of outpatient (OP) visits after a patient’s discharge. A secondary aim of this project was to investigate whether Suprathel burn dressing significantly decreases the length of stay (LOS) for patients with second-degree burns involving < 20% total body surface area (TBSA). The results showed that the use of Suprathel dressings resulted in a shorter hospital stay 7.05 vs 9.35 days with a higher number of outpatient visits 5.47 vs 2.69 visits, compared to conventional dressings. The use of Suprathel dressings as a standard practice reduces inpatient hospitalization but increases outpatient visits and resource utilization. The use of Suprathel dressings shortens the length of hospitalization and may augment patient comfort, and decrease overall healthcare costs associated with hospitalization. Due to the reduction in need for painful daily dressing changes, Suprathel dressings constitute a potentially preferred option in burn care and could thereby influence treatment protocols and enhance patient outcomes.

Keywords: Wound care, Suprathel dressing, total body surface area, Outpatient Visits, Second-degree Burn, Length of stay, Gauze

Implementation Of One Key Question® Screening Tool To Increase Reproductive Life Planning At A Community Health Clinic, Laura D. Adams

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.

Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is …

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 …

Implementing The Fib-4 Tool For Liver Fibrosis Screening In Diabetic Patients In Primary Care, Robert I. Montillano

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-non-alcoholic fatty liver disease (NAFLD), affects over 1 in 3 adults with type 2 diabetes mellitus (T2DM) and is a leading cause of advanced liver fibrosis. Despite guideline support from the American Diabetes Association (ADA) and American Association for the Study of Liver Diseases (AASLD), screening practices remain inconsistent in primary care. The Fibrosis-4 (FIB-4) index is a validated, low-cost, noninvasive tool for fibrosis risk stratification, yet it remains underutilized despite its availability in many electronic health record (EHR) systems.

Purpose: This Doctor of Nursing Practice (DNP) evidence-based practice (EBP) project …

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …

Nurse-Led Medication Reconciliation Protocol In The Adult Outpatient Mental Health Setting, Grace Gu

Doctor of Nursing Practice Final Project Abstract

This scholarly project implemented a medication reconciliation protocol within the adult outpatient mental health clinic setting. The protocol aimed to increase the medication reconciliation rate from 55% to 60% within three months by May 2025, as well as improve the perception of medication reconciliation among nursing staff. The project was implemented within an outpatient mental health clinic, part of a local community mental health center in Austin, Texas. Patients often see multiple healthcare providers, leading to risks of polypharmacy. This can lead to adverse reactions, medication interactions, and hospitalizations. A flowsheet protocol was created to help guide nursing staff on …

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 …

Electronic Medical Record Clinical Decision Support Across The Ob Continuum Of Care: Enhancing Doula Education And Usage, Jonese D. Randall

Doctor of Nursing Practice Final Manuscripts

Background: The United States is seeing an uptick in maternal deaths by 159% since 2019, with maternal mortality higher with cesarean procedures (Hoyert, 2020; Riches et al., 2024[LC1] ). UC San Diego Health NTSV C-Section rates between September 2024 – October 2024 ranged between 22-54%, well above the benchmark of 23.4% in California (Slone, n.d.). Doulas are trained to care for the mother before, during, and after birth by being an advocate, providing physical and emotional support, and being a continuous support person (Dekker, 2017). Doulas have been shown to improve birthing outcomes by providing these support mechanisms, particularly …

Increase Knowledge And Competency Of Point Of Care Ultrasound (Pocus) Among Emergency Nurse Practitioner Students Incorporating Web-Based Videos And Clinical Benchmarks., Andrew N. Walsh

Doctor of Nursing Practice Final Manuscripts

Background: Point of care ultrasound (POCUS) is a critical skill in Emergency Medicine (EM), and Emergency Nurse Practitioner (ENP) students are increasingly expected to demonstrate proficiency. ENP students often face limited opportunities for hands-on practice compared to EM residents. Research suggests that the didactic component of POCUS training delivered through e-learning is as effective as in-person instruction. The American College of Emergency Physicians (ACEP) supports the flipped classroom model, which maximizes simulation time and focuses on psychomotor skills and clinical application, allowing didactic portions to be delivered online. Additionally, ACEP recommends a benchmark of at least 25 POCUS examinations to …

Parent’S Health Literacy And Stress Level In The Inpatient Pediatric Setting, Tina C. Smith

Dissertations

Purpose: This study examined the relationship between parent health literacy and stress levels during their child’s inpatient hospitalization.

Background: In 2019, over five million pediatric hospitalizations occurred in the United States. Parents are central to their child’s care, but stress and sociodemographic factors may hinder their ability to understand and apply health information. This study explored how stress and other variables impact parent health literacy during hospitalization.

Methods: A cross-sectional design included a demographic survey, the Perceived Stress Scale (PSS-10), and the Newest Vital Sign (NVS). Bivariate analyses (Chi-square, t-tests) and logistic regression were used to assess …

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

Dissertations

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

Enhancing Access To Medication-Assisted Treatment (Mat) For Minority Inmates In The San Diego Prison System: A Quality Improvement Through Culturally Competent Approach, Douglas Seangmany

Doctor of Nursing Practice (DNP) Projects

Abstract

Background The opioid crisis disproportionately affects racial and ethnic minority groups, particularly in correctional settings. In San Diego’s prison system, only 20% of incarcerated individuals with Opioid Use Disorder (OUD) receive Medication-Assisted Treatment (MAT), highlighting significant care disparities.

Local Problem Limited access to MAT among minority inmates contributes to poorer health outcomes, higher overdose rates, and increased healthcare costs. Addressing these disparities is crucial for improving health equity within the prison system.

Methods A review of 10 studies emphasized the importance of culturally competent care in improving treatment engagement and outcomes among minority populations. To address disparities, the intervention …

Staff Education On Physical Activity As A Therapeutic Option For Anxiety And Depression, Suja Paul

Walden Dissertations and Doctoral Studies

This project’s aim was to educate staff on physical activity (PA) as a therapeutic option for anxiety and depression to relieve psychotic symptoms, enhancing patients’ quality of life. PA enhances cognitive functioning, reduces anxiety and depression, and decreases the risk of cardiovascular conditions and early death. Patients with severe mental illnesses face barriers to PA and exercise, so providers and policymakers must create an environment that encourages participation. A knowledge gap for staff exists in promoting PA in mental health patients. Healthcare professionals should recommend the right amount of PA for each patient. This initiative aims to increase staff confidence …

Influence Of Nurse’S Knowledge And Attitudes On Caring Behaviors For People With Opioid Use Disorder, Inyene E. Essien-Aleksi, Don Roosan, Tracie Mcpadden, Leslie Rideout, Michael Martin, Paula-Jo Beniers, Amy Lund, Danielle Leone-Sheehan, Alysse Wurcel

Health Sciences Faculty Publications

Background: Opioid use disorder (OUD) remains the leading cause of preventable substance use-related deaths in the U.S. Each year, more than 1 million Americans seek hospital care for OUD-related issues. However, they often receive inadequate treatment and face barriers such as limited overdose prevention education, delays in medication initiation, and insufficient post-discharge follow-up. Nurses are well-positioned to improve inpatient OUD treatment, yet qualitative research suggests they often have limited knowledge and negative attitudes toward OUD, which can decrease the level of compassion and empathy nurses have toward people with OUD. Validated instruments, such as the Care Behavior Index (CBI-6) and …

Pain Management Educational Module For Nursing Staff, Kathyrina Lucy Pham

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in pain management among nursing staff in the rehabilitation unit. Frequent pain-related patient calls contributed to inconsistent clinical practices. This project aimed to evaluate whether a brief, evidence-based educational intervention could enhance nurses’ knowledge of pain management. 47 registered nurses participated in an educational module delivered during both day and night shifts. Pre- and post-test scores were collected and analyzed to assess knowledge acquisition. T-test results indicated a statistically significant improvement in nurses’ pain management knowledge. The findings support the effectiveness of brief, targeted education in promoting clinical outcomes …

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 …

Clinical Practice Patient Education Guideline For Patients With Substance Use Disorders, Josephine Nandzo

Walden Dissertations and Doctoral Studies

The Veteran’s hospital for which this DNP clinical practice patient education guideline (CPPEG) was developed has made strides in addressing the needs of patients with substance use disorders (SUDs). However, the problem identified for this project was the need for veterans with SUDs to obtain information about resources available in the hospital, community, or state to manage their recovery. The project question was as follows: Will a CPPEG on resources for patients with SUDs meet the optimal threshold of 7 on the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument? The purpose was to plan, implement, and evaluate …

Examining The Relationship Between Hospital Nurses' Structural Empowerment, Missed Nursing Care And Quality Of Care: A Cross-Sectional Study, Arlene Travis, Joyce J. Fitzpatrick

Student Scholarship

Aim: To examine relationships between structural empowerment, missed nursing care and quality of care among hospital-based, direct-care nurses. Design: Cross-sectional study. Methods: A convenience sample of 161 nurses completed the Conditions for Work Effectiveness-II Questionnaire, the MISSCARE and a single-question rating of quality of care. Correlation, T-tests, regression and ANOVA were used to analyse data. Results: Nurses reported high structural empowerment (total CWEQ-II = 22.8). Higher empowerment was significantly correlated with less missed care. Most nurses (77.7%) worked at Magnet hospitals; however, no difference in missed care was found between Magnet and non-Magnet nurses. The average number of patients on …

From Awareness To Action: Enhancing Medication Safety Culture To Improve Outcomes, Joseph A. Mensah

Doctoral Dissertations and Projects

The purpose of this project was to evaluate how a culture of medication safety can improve healthcare outcomes. Medication errors persist and remain the leading cause of preventable injury, highlighting the necessity to enhance the culture of medication safety in healthcare. The population for this project included clinical staff within a military healthcare setting. A quantitative survey assessed perceptions of medication safety, confidence levels, and obstacles to error reporting within the organization. The survey results revealed that 28% of clinical staff had not received medication safety training in the past year, 55% were not confident in medication administration, and 25% …

Improving Patient Satisfaction With Discharge And Recovery Preparedness, Leanne N. Davis

Doctoral Dissertations and Projects

The Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS-CAHPS) survey is a standardized tool healthcare organizations utilize to measure patient perceptions of care. The survey results are linked to reimbursement by many insurers, making it prudent for health systems to work toward increasing patient satisfaction with their care. This evidence-based practice project followed the Iowa Model of Evidence-Based Practice to implement a quasi-experimental pilot that would determine whether providing written and verbal patient discharge education in both the preoperative phase of care and the postoperative phase of care compared to only the postoperative phase of care …

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

Doctoral Dissertations and Projects

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

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

A Qualitative Study Of Registered Nurses’ Perceptions Of The Impact Communication Modalities Have On Patient Care Outcomes In Primary Care, Eleanor M. Chapital

Doctoral Dissertations and Projects

Communication plays a vital role in the provision of patient care and directly impacts patient care outcomes across the care continuum. The purpose of this qualitative study was to explore and determine registered nurses’ perceptions of the communication modalities that facilitate optimum patient care outcomes in the primary care setting. Registered nurses play a critical role in the provision and coordination of patient care. Therefore, it is imperative to study their experiences and perceptions to facilitate communication within primary care teams. The central research question for this study was the following: How do registered nurses describe their use of communication …