Evaluating The Efficacy Of A Progressive Mobility Protocol Among Adult Icu Patients, Clayton Chroust

DNP Projects

Background: Many intensive care unit (ICU) patients are critically ill and require ventilator support, and they often do not receive any progressive mobility interventions until after they are liberated from the ventilator or receive transfer orders out of the ICU. Current literature suggests that patients in the ICU face deconditioning, increased ventilator days, development of deep vein thrombosis, pressure ulcers, pulmonary embolism, muscular atrophy, and increased days in the ICU which can be attributed to a lack of mobility. Current evidence-based research identifies that utilization of a progressive mobility protocol is one way to improve patient outcomes and reduce …

Implementation Of A Process To Improve Compliance With A Nurse Driven Foley Catheter Removal Protocol In Nursing Staff Of A Medicine Intensive Care Unit, Kendall L. Pfister

DNP Projects

Background: Catheter associated urinary tract infections (CAUTI) are the most prevalent healthcare acquired infection (HAI) in the acute care setting. Unfortunately, CAUTIs can lead to high morbidity and mortality rates, longer length of stay (LOS) and increased healthcare costs. Unfortunately, in critically ill patients which often suffer multi-organ failure/injury, there remains an increased risk for infection and poor outcomes.

Purpose: The purpose of this project is to increase medical intensive care unit (MICU) nursing staffs’ knowledge of existing nurse driven indwelling urinary catheter removal protocol and to implement an electronic medical record (EMR) prompt for removal of unnecessary urinary catheters …

Utilizing Integrative Medicine Services For Yoga To Reduce Cancer Related Fatigue, Leah R. Yeager

DNP Projects

Background: Cancer related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by individuals undergoing cancer treatment. In fact, many patients report CRF as more debilitating than pain itself. CRF is characterized by persistent, severe exhaustion that is not alleviated by sleep and is not linked to prior exertion. Despite its widespread impact, the options available to manage CRF are limited, typically including practices like good sleep hygiene, balanced nutrition, mindfulness, and supplements. Integrative medicine, particularly yoga, has emerged as a promising intervention for reducing CRF. However, yoga is underutilized as a therapeutic approach to combat …

Implementation And Evaluation Of A Competency-Based Phased Orientation Program For Nurse Practitioners In The Intensive Care Unit Setting, Meredith Sherer

DNP Projects

Background: Research has demonstrated that structured orientation helps to integrate new nurse practitioners (NPs) into practice, ease role transition, decrease NP turnover, and lead to better patient care. However, at University of Kentucky HealthCare (UKHC) clinical orientation programs for NPs are not standardized.

Purpose: The purpose of this project was to implement and evaluate a competency-based phased orientation program for NPs in the intensive care unit (ICU) setting at UKHC.

Methods: This project utilized a prospective, single group, presurvey-postsurvey design to examine the effect of a three-phased competency-based orientation program on the outcome variables of NP confidence, autonomy, proficiency of …

Evaluating Knowledge, Skills, Attitudes, And Suicide Hotline Referrals In Aprns Screening Children For Depression And Suicide In Primary Care, Brooklyn D. Higginbotham

DNP Projects

Background: Suicide is the 2nd leading cause of death in adolescents across the United States (US). Primary care providers (PCPs) are often the first people an adolescent sees for depression or suicide symptoms; however, evidence shows PCPs may not be comprehensively screening for suicide in the primary care setting by using the Patient Health Questionnaire (PHQ) alone. Screening tool usage for depression and suicide among PCPs is currently at rates as low as 26% due to lack of knowledge and insufficient resources. Evidence-based education on American Academy of Pediatrics (AAP) recommendations can improve PCPs’ knowledge, skills, and attitudes when assessing …

The Effect Of A Hospital Community Garden On Healthcare Workers’ Professional Quality Of Life, Madelyn Renee Cline

DNP Projects

Background: Healthcare professionals experience a variety of stressors which negatively impact their professional quality of life (ProQOL) potentially leading to increased turnover and nurse shortages in hospitals. There are growing studies addressing ways to improve healthcare ProQOL, yet few have examined the impact of alterations to the workplace on these outcomes.

Purpose: The purpose of this project was to evaluate the effect of a dedicated outdoor green space for nurses during shift breaks on their ProQOL.

Methods: This project used a one-group pretest-posttest design. Data analysis was completed using descriptive and inferential statistics using SPSS software. The Professional Quality of …

Implementation Of A Pilot Post-Code Debrief Tool Initiated By The Chaplains And Unit Lead Nurses Within The Medicine Intensive Care Unit, Sarah Stigall

DNP Projects

Background: Post-code debriefs are shown to improve teamwork and communication, increase performance, and reduce burnout. According to the University of Kentucky HealthCare (UKHC) policy, teams are to perform a post-code debrief immediately after an in-hospital cardiac arrest (IHCA). However, the current policy does not provide guidance on what to include during a debrief session. At UK post-code debrief sessions are documented as occurring 60-72% of the time; however, personal observation and discussions with other bedside and rapid response nurses suggest that post-code debriefs are underperformed when compared to the documentation. Purpose: This study aimed to explore barriers to post-code debriefs …

Nurse-Led Cbt For Depression In Heart Transplant Patients: A Feasibility Study, Matthew R. Wallace

DNP Projects

Background: Heart transplant recipients are at an elevated risk of experiencing depressive symptoms compared to the general population. Those with depression post-transplant face increased complications, e.g., infection, organ rejection, prolonged hospitalization, and higher mortality rates. However, specific psychotherapeutic interventions tailored for heart transplant recipients remain limited. Nevertheless, there is substantial evidence supporting the effectiveness of various interventions for adults with heart failure, a condition frequently diagnosed in these patients. This suggests that successful strategies for managing depressive symptoms in heart failure patients could be adapted for heart transplant recipients.

Purpose: The purpose of this project was to evaluate …

Effectiveness Of A Multi-Departmental Nursing Tiered Orientation Model On Service Line Culture, Self-Efficacy Of Nurses, Positive Patient Outcomes And Nurse Satisfaction, Kimberly Thompson

DNP Projects

Abstract
Background: Nurses who transition into specialty practice areas in healthcare settings may demonstrate a lack of confidence and a high level of stress. Decreased levels of nursing engagement, self-efficacy, and interdepartmental team collaboration may also be seen. Multi-departmental tiered orientation models can help facilitate the development of increased confidence and competence and ultimately lead to improved patient outcomes.

Purpose: The purpose of this doctoral project was to evaluate the effectiveness of a multi-departmental tiered orientation model for nurses hired into a specialty area. The specific objectives included were to a) determine the effectiveness of the model on service line …

Evaluation On The Effectiveness Of A Virtual Reality (Vr) Guided Meditation Intervention On Pre-Procedural Anxiety In An Outpatient Dental Clinic, Anansa Thompson

DNP Projects

Background: Mental health issues, particularly anxiety, represent a significant public health concern in the United States, with dental anxiety affecting anywhere between 50% and 80% of adults (White et al., 2017). Pre-procedural anxiety in outpatient dental clinics complicates patient care and can lead to avoidance of necessary dental treatments, impacting both oral and overall health. Non-pharmacological interventions, such as immersive virtual reality (VR) guided meditation, offer promising solutions to address anxiety in healthcare settings.

Purpose: This study aims to evaluate the effectiveness of VR guided meditation on pre-procedural anxiety among adults undergoing painful dental procedures at an outpatient …

A Triage Process To Decrease Door To Ekg Times For Adult Patients With Suspected Cardiac Abnormalities In The Emergency Department, Khay Douangdara

DNP Projects

Objective: The emergency department (ED) triage process for adult patients presenting with suspected cardiac abnormalities should be reliable; however, delays in identifying significant cardiac rhythms can negatively impact patient outcomes. The American Heart Association (AHA) and the American College of Cardiology (ACC) recommend that patients presenting to the ED with cardiac-related concerns undergo an electrocardiogram (EKG) within 10 minutes of arrival. This project aimed to educate ED nurses and implement changes in the triage process to reduce door-to-EKG times for adult patients with suspected cardiac abnormalities.

Methods: This quasi-experimental study utilized a pre- and post-intervention design to evaluate the effectiveness …

Implementation And Evaluation Of Diet And Physical Activity Screening Tools For Adults With Type 2 Diabetes Mellitus In Primary Care, Ashley O. Dalton

DNP Projects

Background: Only half of individuals with type 2 diabetes mellitus (T2DM) have a hemoglobin A1C (HbA1c) of less than 7%, indicating poor glycemic control and contributing to a global diabetes epidemic. Diabetes is considered a diet-sensitive disease and an individual’s diabetes-related nutrition knowledge is one of the most challenging aspects of the treatment plan. Empirical evidence supports that a combination of dietary and physical activity interventions is more effective than nutrition education alone. Performing a dietary evaluation is fundamental to establishing nutrition goals. The use of the Starting the Conversation (STC) tool, which assesses an individual’s dietary practices, and Physical …

Screening For The Unseen: Depression Detection Through Phq-9 And Provider Education In Pain Management, Veronica Shaw

DNP Projects

Background: Depression leads to significant economic and health burdens, causing 200 million lost workdays and costing employers $17 to $44 billion annually (CDC, 2022). It accounts for 4.3% of the global disease burden and is a leading cause of disability worldwide (WHO, 2021). Chronic pain, affecting 20.9% of United States adults, often exacerbates depression, creating a vicious cycle of physical and emotional suffering (Rikard et al., 2023). Despite the availability of effective treatments, depression is frequently missed in primary care settings, with 50% of cases undiagnosed (Hawkes, 2019). Addressing both depression and chronic pain through improved screening and holistic care …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

Utilization Of Organ Inventories In The Primary Care Setting: Two Questions To Increase Usage, Siobhan A. Lister

DNP Projects

Background: The Transgender and Gender Diverse (TGD) population experiences significant health disparities in accessing preventative care when compared to their cisgender counterparts. These disparities often occur with organ-specific screenings and lead to poorer health outcomes, due to patients having organs that do not match their sex assigned at birth. The evidence recommends a two-question method of gender identification to identify those patients whose gender does not match their sex assigned at birth. Using the 2-question method can help identify patients who need an organ inventory completed, which will lead to appropriate preventative health screenings being done.

Purpose: The purpose was …

Evaluating The Outcomes Of An Educational Intervention For Providers And Two-Week Home Blood Pressure Monitoring In Adults, Michelle Ann Schuler

DNP Projects

Abstract

Background: Approximately 1.28 billion adults worldwide have hypertension (HTN), which greatly increases the risk of morbidity and premature death. Home blood pressure monitoring (HBPM) has been shown to increase efficacy of treatment decisions, but is underused in primary care. About 46% of adults are unaware that they have hypertension and only about 21% of those who have been diagnosed have it controlled.

Purpose: The purpose of this project is to evaluate a previous practice improvement project and improve the HBPM process for sustainability.

Methods This HBPM study utilized a retrospective study design combined with a practice improvement project …

Facilitating Caregiver Involvement In Reducing Delirium Among Critically Ill Children In The Pediatric Intensive Care Unit, Emma R. Bilberry

DNP Projects

Background: The pediatric intensive care unit (PICU) is a dynamic, fast-paced, and high-acuity unit where children are prone to the development of pediatric delirium (PD). PD is a condition of neurologic dysfunction increasing risk of morbidity and mortality among patients. Literature on PD is rapidly expanding, providing an opportunity for increased research on how to manage PD. Caregivers know their children, are often readily available at the bedside, and invested in being included in care. Additionally, literature shows that caregiver presence at the bedside is one non- pharmacological intervention that can aid in reducing PD. The development and implementation of …

Primary Nurse Framework: All-Registered Nurse Staffing Model In A Twelve Bed Critical Care Unit, Jeanette E. Sanders

DNP Projects

Background: Registered Nurses (RNs) comprise one of the largest professions in healthcare, and they play a critical role in delivering patient-centered care. The nursing shortage exacerbates inadequate nurse staffing levels, leading to increased workloads, higher patient-to-nurse ratios, and a high-stress work environment.

Purpose: This project aimed to evaluate the implementation of a primary-nurse-led care delivery model with an all-RN staffing design and its effects on nurse-sensitive patient outcomes, patient length of stay, nurse-sensitive related outcomes, and associated financial implications in the Intensive Care Unit (ICU) setting. Nursing knowledge and opinions about the all-RN staffing model were also assessed.

Methods: Staffing …

Evaluating The Effect Of A Mindfulness App On Pediatric Nurses Caring For Adolescent Patients Diagnosed With Disordered Eating, Kaitlyn Green

DNP Projects

Abstract

Background. The health and wellbeing of nurses are affected by the demands of their workplace and the people that they care for. In turn, nurses’ wellbeing affects their work and patient outcomes. There are opportunities to address certain workplace structures, systems, and policies that create stressors and lead to burnout, fatigue, and poor mental and physical health. For nurses to continue to provide quality care in environments that have increasing demands, they must first feel healthy, well, and supported themselves. Healthcare leaders have a role in ensuring the wellbeing of their nursing staff. Compassion fatigue is a large focus …

The Impact Of Code Lavender On Compassion Fatigue And Burnout Of Pediatric Bedside Staff, Sara L. Castle

DNP Projects

Background: Compassion fatigue is a significant problem in healthcare that can impact staff retention, job satisfaction, and patient outcomes. Code Lavender combats compassion fatigue by serving as a crisis intervention tool using evidence-based relaxation techniques, paired with increased support from Leadership.

Purpose: The purpose of this project was to evaluate the impact of Code Lavender on reported levels of compassion fatigue and burnout amongst pediatric bedside staff working on a 12-bed progressive care unit at a Children’s Hospital in a large Academic Medical Center.

Method: This study employed a pilot evaluation design, consisting of pre- and post-surveys utilizing questions from …

Evaluation Of A Brief Mindfulness-Based Intervention Of Work-Related Stress, Job Satisfaction, Retention, And Quality Care: A Quality Improvement (Qi) Project, Laura M. Bragg

DNP Projects

Burnout among advanced practice providers (APPs) remains a significant concern nationally and within the University of Kentucky Healthcare system, with post-COVID evidence showing persistently elevated stress and emotional exhaustion. This quality improvement (QI) project implemented and evaluated a brief, app-based mindfulness intervention using the Headspace “Learn the Basics of Meditation” program for work-related stress, job satisfaction, mindfulness, and retention intentions among APPs. A one-group pre-post design was implemented, with 45 APPs completing the pre-intervention survey and four completing both the pre- and post-intervention surveys. Although no statistically significant improvements were observed, nonsignificant decreases in emotional exhaustion, fatigue, and turnover intention …

Evaluating The Impact Of Epic Integration And Dual Registered Nurse Check-Off On Pressure Injury Prevention Workflow Compliance, Darlene Y. Olowu

Doctor of Nursing Practice Final Project Abstract

Background

Hospital-acquired pressure injuries (HAPIs), particularly sacral and heel injuries, remain a persistent challenge in critical care settings, leading to increased morbidity, mortality, and healthcare costs.

Purpose

This quality improvement project aimed to improve compliance with a pressure injury prevention (PIP) workflow by integrating a dual RN check-off system within EPIC, thereby reducing sacral and heel pressure injuries. The project sought to enhance accountability, standardize documentation, and optimize compliance with evidence-based PIP measures.

Methodology

A Plan-Do-Study-Act (PDSA) framework guided the project implementation in an oncologic intensive care unit (ICU). Key interventions included: (1) EPIC integration of a dual RN check-off …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

Implementation Of Behavioral Emergency Response Team In Triage, Brianna Millen

Doctor of Nursing Practice Final Project Abstract

Introduction: The aim of this project is to improve the admission process of psychiatric patients in the emergency department (ED) by implementing a Behavioral Emergency Response Team (BERT). The goal is to reduce wait times, decrease patient aggression, and enhance overall patient and staff safety.

Background: Emergency departments are experiencing an influx of psychiatric patients presenting with acute psychosis. Long wait times often lead to increased agitation, requiring physical or chemical intervention. Literature suggests that timely care can reduce aggression and psychiatric admissions. Currently, no similar interventions exist at Houston Methodist West Hospital.

Methodology:

This quality improvement project follows a …

Enhancing Engagement In Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (Mtm) In An Underserved Population Of Memphis, Tennessee, Lindsey H. Dao

DNP Projects

Enhancing Engagement in Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (MTM) in an Underserved Population of Memphis, Tennessee

Functional And Traditional Medical Management Of Endometriosis: An Integrative Review, Madison G. Daniels

Senior Honors Theses

Endometriosis, a progressive disease that affects many women worldwide, has been managed primarily through hormonal medication, pain management and surgical intervention. However, there is a growing desire among women to use more natural and holistic methods to control the progression of this disease as well as effectively manage the severe symptoms that accompany it. This integrative review examines the efficacy of functional management as compared to traditional medical management. The pathophysiology of each treatment method and provide statistical evidence as to its efficacy. The progression of the disease, symptom management, and related side effects are all taken into consideration in …

Post-Traumatic Stress Disorder Among Critical Care Nurses Caring For Covid-19 Patients, Marwa Abdo

Nursing

Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, with a substantial number of severe cases requiring admission to isolated intensive care units (ICUs). This unprecedented situation exposed critical care nurses (CCNs) to a highly stressful traumatic environment, placing them at increased risk for developing post-traumatic stress disorder (PTSD). Early identification and intervention for PTSD are crucial to mitigate the negative consequences for nurses' well-being, job performance, and overall quality of life. Aim: This study aimed to assess post-traumatic stress disorder among CCNs caring for COVID-19 patients. Method: A descriptive cross-sectional design with a convenience sample of 109 CCNs …

Everyday Decision-Making Involvement Among Hispanic & Latinx Dementia Caregivers And Its Associations With Daily Anxiety And Daily Depressive Symptoms, Abigail Poe

All ETDs from UAB

Background: Hispanic and Latinx (H&L) caregivers of individuals living with Alzheimer’s disease and related dementias (ADRD) experience elevated caregiving burden and poorer mental health outcomes compared to caregivers from other racial and ethnic groups. Limited research has examined H&L caregivers’ involvement in everyday decision-making for persons living with dementia (PLWD), particularly how this involvement may relate to daily mental health symptoms such as anxiety and depression. Purpose: This study examined baseline decision-making involvement (DMI), its associations with individual-level factors, and its relationship with daily anxiety and depressive symptoms in H&L ADRD caregivers. Methods: A secondary analysis was conducted using data …

Nursing Professional Liability: Bridging Rn & Aprn Perspectives On Risk, Coverage & Evolving Practice Authority, Michelle Hileman Msm, Rn, Cnm, Parkview Health

Nursing Publications, Posters, & Presentations

Presented at the 2025 Parkview Nursing Research Symposium.

The purpose of this literature review is to explore professional liability for RNs and APRNs. Specific objectives include:

• Identify patterns in malpractice claims for RNs and APRNs

• Compare employer-provided and personal malpractice coverage

• Examine the impact of scope-of-practice laws on APRN liability

• Clarify principles of vicarious liability

• Recommend lifelong strategies for education, risk management, and professional practice

Provider Perspectives On Produce Prescription Programs In A Rural Community, Heather Ward Dnp,Fnp-Bc, Sarah Giaquinta Md, Mph, Susan Storey Phd, Rn, Aocns

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium.

Purpose:

• To evaluate healthcare provider perspectives on PPPs in a rural community
• To identify barriers and facilitators to implementing a PPP
• To lay the groundwork for the successful implementation of a PPP in the Count