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Increasing Postpartum Appointment Attendance Rates, Tanya Lister

Doctor of Nursing Practice Scholarly Projects

Background: Postpartum visits provide an opportunity to detect and address potential complications, monitor healing and recovery, and offer guidance and support during the transition into motherhood. Current research shows that appointment reminders increase healthcare appointment attendance rates, whether delivered via text messages or phone calls.

Purpose: The purpose of this academic project was to plan, implement, and evaluate a process change within a single health facility to increase postpartum visit attendance rates.

Methods: This evidence-based scholarly project used telephone calls to remind patients scheduled for postpartum visits of their appointment dates and times. Appointment reminder phone calls were completed the …

Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth

Walden Dissertations and Doctoral Studies

Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical …

Dnp Final Report: Improving Rehospitalization Rates And Caregiver Quality Of Life In Outpatient Hospice, Carrie M. Judd

DNP Final Reports

Background: Hospital readmissions among home hospice patients disrupt continuity of care, increase healthcare costs, and may compromise end-of-life preferences.

Purpose: This quality improvement project evaluated the feasibility of implementing a telehealth communication intervention in an outpatient hospice organization. Project aims were to reduce Type I live hospice discharges by at least 2.5% and improve caregiver quality of life (QOL).

Methods: Zoom for Healthcare® video visits and three-way telephone communication supplemented standard nurse practitioner hospice visits during a three-month implementation period. Type I live discharge rates were compared with the organization's baseline quality metrics. Caregiver QOL was measured pre- and post-intervention …

Exploring Academic–Practice Partnerships In Community Settings: A Narrative Review, Laura C. Sarver

College of Nursing Faculty Papers & Presentations

Purpose: This narrative review explored the literature on academic–practice partnerships in community settings within prelicensure nursing education. Methods: A search of three databases—MEDLINE, CINAHL, and Scopus—led to the review of 12 articles exploring academic–practice partnerships in community settings within prelicensure nursing education. Results: Emergent themes encompassed components for planning, implementing, and evaluating academic–practice partnerships. Planning themes included completing community assessments, considering financial resources, and identifying guiding frameworks or models. Implementation themes included diverse nursing education and community partners and settings, academic–practice partnership initiatives, and integration of partnerships in prelicensure nursing education curricula. Lastly, evaluation themes included the exploration of a …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Staff Education To Improve End-Of- Life Pain Management Confidence Among Long-Term Care Nurses, Andrea Osuji

Walden Dissertations and Doctoral Studies

No abstract provided.

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Beat By Beat: Empowering Communities With Lifesaving Cpr Skills, Allyssa Mb Hutchins

Doctor of Nursing Practice Projects

Introduction: This doctoral project was created to increase bystanders' willingness and ability to perform CPR by building their confidence in performing it effectively. A total of 13 participants participated in this project to increase knowledge and confidence in CPR interventions.

Background: Cardiac arrests remain a leading cause of death, yet research indicates that rural communities have lower rates of bystanders trained and willing to assist. Increasing CPR awareness and eliminating barriers to care for classes can improve CPR confidence and have a positive community impact.

Methods: Three 4-hour CPR classes were held in Zirconia, NC, at no …

Advancing Palliative Care Competency Through An Evidence-Based Educational Intervention For Healthcare Providers, Lauren Elizabeth Griffin

Walden Dissertations and Doctoral Studies

A major gap in acute care is the delayed initiation of palliative consultations. Although over 58 million people worldwide could benefit, only 14% receive such care. Despite evidence that early involvement improves outcomes, providers often overlook their value, leading to late referrals, typically after repeated hospitalizations or near end-of-life, when hospice may be more appropriate. This Doctor of Nursing Practice (DNP) educational intervention addressed a critical practice-focused question to enhance healthcare providers’ understanding of palliative care improve hospital-based patient outcomes. The intervention aimed to demonstrate a ≥20% knowledge gain from pretest to posttest scores related to distinguishing palliative care from …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Evaluation Of Palliative Care Awareness Among Hospitalized Patients And Their Relatives In Türkiye, Füsun Uzgör, Ayşe Özkaraman, Hülya Özen

Makara Journal of Health Research

Background: Today, with the advances in medical knowledge and technology, chronic diseases have increased worldwide in parallel with the prolonging life expectancy and the aging of the population. This has increased the need for palliative care in the delivery of medical services. This study aimed to evaluate the palliative care awareness and level of knowledge of inpatients receiving health services in a university hospital and their relatives in Türkiye.

Methods: This cross-sectional study was carried out with 360 patients and their relatives who volunteered to participate in the research. The study data were collected in face-to-face interviews using …

Addressing And Recognizing Secondary Traumatic Stress In Hospice And Palliative Care Clinicians, Laquisha La Chelle Jackson

Walden Dissertations and Doctoral Studies

In the emotionally demanding field of hospice and palliative care, the well-being of clinicians is critical. This Doctor of Nursing Practice (DNP) project focused on implementing a staffing education initiative to address secondary traumatic stress (STS). I designed this staffing education project to enhance clinician awareness, resilience, and coping strategies while informing organizational leadership on how improved staffing models and support systems can mitigate STS. Hospice and palliative care clinicians are uniquely vulnerable to STS due to constant exposure to trauma, death, and grieving families. The guiding question for this project was: In hospice and palliative care clinicians, how does …

Implementation Of A Pediatric Skills And Simulation Workshop Among Rural Nurses, Cassandra Grabiel

Doctor of Nursing Practice (DNP) Practice Innovation Projects

No abstract provided.

A Nurse-Driven Protocol To Increase Music Therapy Referrals To Manage Patient Pain And Anxiety In The Medicine Intensive Care Unit, Ashley Fox

DNP Projects

Background: Critically ill patients often suffer from pain and anxiety. Music therapy is a safe and effective treatment option. However, most nurses never receive education or training on it, resulting in a lack of awareness of its value and its actual usage in care.

Purpose: The purpose of this project was to increase the number of music therapy referrals to manage pain and anxiety in eligible medicine intensive care unit (MICU) patients via a music therapy protocol that increased nurses’ knowledge, attitudes, and skills related to the use of music as an alternative treatment option for pain and anxiety in …

Exploring The Reassessment Of Palliative Home Care Clients: A Mixed Methods Study, Maya Canham

Theses and Dissertations (Comprehensive)

Introduction: The timely reassessment of clients receiving palliative home care (HC) is critical for supporting clinicians with care planning and service delivery. However, there is little information on the frequency of reassessments and factors driving reassessment in palliative HC clients.

Objectives: The objectives of this study were to: (i) determine the proportion of palliative HC clients reassessed with the interRAI Palliative Care (interRAI PC) instrument, (ii) calculate the average interRAI PC reassessment interval, (iii) identify the key factors driving interRAI PC reassessment at various intervals, and (iv) explore the factors that influence palliative HC clinicians to reassess their clients in …

Measures Of Success: Making The Case For Advanced Practice-Sensitive Quality Indicators, Ruth Kleinpell, April Kapu, Cynthia Borum

HCA Healthcare Journal of Medicine

Advanced practice registered nurses (APRNs) are key health care providers in a variety of settings. Often APRNs are grouped in a collective category, along with physician assistants, and referred to collectively as advanced practice providers. As APRNs assume an increasing role in patient care management in hospital, outpatient, and community settings, such as clinics and rural practices, measuring the impact of their care on patient outcomes and quality of care becomes a necessary component of performance evaluation. APRN-sensitive outcome indicators are an important way to identify the impact of the role. While a number of studies have been conducted that …

Examining The Relationship Between Ethnocentrism, Perspective-Taking And Cultural Competence In Medical-Surgical Nurses, Lori Ann Palmieri

Seton Hall University Dissertations and Theses (ETDs)

This descriptive correlational study explored the relationships between cultural competence, ethnocentrism, and perspective-taking in practicing medical-surgical nurses living in the United States (US). Participants (N=111) were recruited from the New Jersey Board of Nursing (NJBON) and from the Academy of Medical-Surgical Nurses (AMSN). The survey consisted of three validated instruments a) the cultural competence assessment instrument (CCA-I); b) the generalized ethnocentrism scale (GENE); c) the perspective-taking (PT) subscale of the interpersonal reactivity index (IRI), and d) demographic profile questions. Data were collected via Qualtrics and analyzed with IBM SPSS Statistics (Version 28/29). Ethnocentrism and perspective-taking explained 30.2% of the variance …

Undergraduate Nursing Students’ Simulation Experiences With End-Of-Life Care In A Rural Setting: A Scoping Review, Christopher Norman Msn, Aprn, Gnp-Bc, Jodi Sutherland Phd, Rn, Acrn, Cne, Lori Marie Sprague Phd, Rn, Chse, Deborah Palmer Ms, Rn, Alma Rood Msn, Rn, Laura Lipke Ms, Mlis, Ahip

Nursing Faculty Scholarship

Objective: The purpose of this scoping review is to provide nurse educators and nurse leaders in practice with the findings on the state of the science surrounding undergraduate nursing education simulation-based experiences focused on end-of-life (EOL) care in rural settings. This scoping review aims to identify undergraduate nursing student experiences with EOL care in the rural setting and identify key simulation-based educational strategies utilized in undergraduate nursing programs to inform educational programs about simulation practices. The outcome of this review is intended to advance nursing education to better prepare future nurses for practice and to develop competence in providing EOL …

How Do Older Adults Define A Good Death? A Scoping Review, Ellen L. Csikai, Quentin R. Maynard

Midwest Social Sciences Journal

A scoping literature review of the concepts of ‘good death’ and ‘dying well’ among older adults was conducted. The purpose was to identify aspects that older adults specifically considered important in defining a ‘good death’. The search revealed five articles published between 2005 and 2019 that met inclusionary criteria for the review. Primary among the views of the older adults in these studies of a ‘good death’ was the desire to avoid being a burden to families; done so by dying pain-free/peacefully (preferably in sleep) and preparing in advance by involving family in decisions and funeral/estate planning. Family support throughout …

The Pause: Impacting Moral Distress In Our Caregivers, An Integrative Review, Bethany Corinne Furman

Doctoral Dissertations and Projects

Moral distress is endemic to healthcare in the emerging post-covid era. Moral distress is defined as the knowledge of the correct or ethical action but the repeated inability to act in that manner. First studied in nursing, it has been found in nearly every facet of healthcare and is strongly associated with clinician burnout, intent to leave position, and behaviors that can in turn compromise patient safety. Intensive care unit (ICU) nurses experience moral distress at higher rates than other subspecialties. Prevention of and recovery from moral distress is complex, but various forms of debriefing have long been suggested to …

Undergraduate Baccalaureate Nursing Student Knowledge And Attitudes Towards Neonatal And Pediatric Pain Management Practices, Jordan Lee Slowik

Doctoral Dissertations and Projects

Research has indicated that pain management practices amongst registered nurses is inadequate across all age groups; however, it is frequently noted that children receive less analgesia in comparable situations than adult clients leading to harmful and costly consequences. There is a distinct gap in nursing educational research understanding nursing student knowledge and attitudes towards neonatal and pediatric pain management practices. Using a convenience sample from a private, Christian-based university in the southeastern United States, this study used a quasi-experimental, one-group pretest/posttest design to understand the impact of elective nursing courses on undergraduate baccalaureate nursing student knowledge and attitudes towards neonatal …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Understanding Hospital-Based Nurse End-Of-Life Care, Knowledge, And Comfort: A Quality Improvement Project, Emma Doran

Honors Theses and Capstones

Providing physical, emotional, and spiritual care to patients at the end of life (EOL) can relieve their suffering and the pain experienced by loved ones in their presence. As death approaches, patients’ symptoms may require increased comfort measures, and it is imperative that all nurses be properly trained and prepared to provide this care. In this quality improvement (QI) project, the End-of-Life Professional Caregiver Survey (EPCS) and demographic and experiential questions were administered in the form of a Qualtrics survey to nurses working on an acute care inpatient unit at a healthcare organization in New England. 18 survey responses were …

Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson

Theses & Dissertations

Background:

Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.

Purpose:

The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity …

Palliative Care Integration Into Critical Care In People With Terminal Conditions, Arielle Westfall

Honors Undergraduate Theses

Palliative care is of value to the quality of life in people with terminal conditions when initiated early. The purpose of this literature review was to identify barriers to early initiation of palliative care consultation. The secondary purpose was to examine characteristics that prompt palliative care consultation. The TLC model of palliative care was used to explore palliative care in the critical care setting in people with terminal conditions. The concepts of the model support optimal palliative care as collaborative and comprehensive, with shared decisions made by the patient, practitioners, and loved ones. A literature review was conducted to identify …

Palliative Care And Quality Of Life Improvement: A Benchmark Study, Rebecca Daniels

MSN Capstone Projects

This project provides an overview of the standard and regular implementation of palliative care versus early implementation of palliative care in patients with chronic or terminal illnesses. Palliative care is an essential component of healthcare that focuses on improving the quality of life and providing support to patients through holistic elements to patients and their families facing chronic and terminal illnesses. With evidence-based research, many articles have been published with implementation of early palliative care showing improvement in patient and even caregiver quality of life. This project includes evidence gathered from mixed methods of systematic review of existing literature, randomized …

Nurses’ Perceptions Of Using Volunteer Support In Health Care Settings: A Systematic Scoping Review, Kate Crookes, Rosemary Saunders, Vivien Kemp, Olivia Gallagher, Manonita Ghosh, Caroline Bulsara, Karen Gullick, Bev O'Connell

Research outputs 2022 to 2026

Aims: To understand nurses’ perceptions of volunteer support in health care settings. Background: Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses’ perceptions of volunteer support. Methods: A scoping review was conducted following the PRISMA-ScR checklist. A mixed-methods convergent integrative approach was taken guided by the JBI framework. Quantitative data were transformed into qualitative data for synthesis and descriptive thematic analysis. Six databases were searched (CINHAL+, EMBASE, PubMed, Scopus, PsycInfo, ProQuest Health and Medical Collection) on 24 January 2022 using terms related to nurses, perceptions, …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Improving Nursing Provision Of Patient Care In High Acuity Medical Units And Fostering Their Wellbeing By Providing Education On End-Of-Life Care And Finding Joy And Meaning In Work: A Quality Improvement Project, Donna Durant

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Palliative care employs a multidisciplinary approach focusing on the quality of life for patients and their families experiencing the complexity of serious illness (Nelson, 2021). Due to shortages of palliative care specialists and a lack of nurse proficiency in caring for people with serious illnesses, integrating a palliative care approach is an ethical obligation for nursing (Parekh de Campos, 2022). Gaps in palliative care and end-of-life education for new nurses coming to the acute care setting in a large tertiary hospital in Southwestern Pennsylvania were identified.

Evidence-based education was delivered by advanced practice providers trained in this content area. …

Improving Patient Self-Efficacy, Readiness, And Completion Of Advance Care Planning Documents Using Prepare Documents And Advance Care Planning Group Referral, Marie Vassiliadis

Doctor of Nursing Practice Final Manuscripts

Advance Care Planning (ACP) is an ongoing discussion about medical decision making between a provider, patient, and support person. ACP can also include legal documentation in the form of an advance directive (AD). Nationally, only 36.7% of adults complete any form of AD for end-of-life care. Recently, ACP has become an important quality metric that many organizations are prioritizing. The purpose of this evidence-based project is to improve ACP readiness, self-efficacy, and documentation among patients at an internal medicine clinic using the PREPARE program and referral to an ACP group meeting. PREPARE for Your Care is an online program aimed …