Digital Commons Network^™

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Health Professional Students' Experiences With Gender-Identity Inclusive Content In The Classroom And Supervised Clinical Learning, Perry Xinyi Zhang, Aria Grabowski, Olivia S. Anderson

Internet Journal of Allied Health Sciences and Practice

Purpose: Gender-identity diverse populations have unique healthcare needs, but they experience stigmatization leading to negative health outcomes. Healthcare professionals have reported obstacles to delivering affirming care to gender-identity diverse patients due to limited training. We assessed how health profession students encounter gender-identity content and how students’ perceived preparedness to provide care for gender-identity diverse populations. Methods: A survey distributed to students enrolled in health professional programs at a large mid-western university included close-ended questions about exposure to gender-identity diverse curricular content in didactic and supervised clinical settings and perceived preparedness to work with gender-identity diverse populations. Open-ended questions asked what …

Promoting Maternal Health Through Community-Based Education: A Quality Improvement Initiative On Hypertension And Pregnancy Complications In An Outpatient Setting, Areli Mendez

Doctor of Nursing Practice Projects

Background

Hypertensive disorders during pregnancy remain one of the leading causes of maternal and fetal complications worldwide, particularly among underserved and minority populations. Spanish-speaking women often experience barriers related to language, limited health literacy, and reduced access to culturally appropriate education, which may delay the recognition of warning signs associated with pregnancy complications. Early education and awareness are essential to improve maternal outcomes and promote timely medical intervention.

Purpose Statement

The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness of a culturally tailored educational intervention designed to improve maternal knowledge regarding hypertension during pregnancy …

Staff Education For Prevention And Management Of Obesity In Adolescents From Underserved Communities, Doris Mtarubukwa

Walden Dissertations and Doctoral Studies

This DNP project implemented a targeted staff education intervention designed to bridge the practice gap in obesity management among adolescents in underserved communities. A comprehensive chart review of 45 patients revealed that only 3% of encounters adequately addressed obesity using evidence-based practice (EBP) guidelines, establishing the urgent need for healthcare provider education and competency development. Adolescents in underserved communities face complex barriers to health and wellness, with obesity representing a critical public health concern. The literature demonstrated that childhood and adolescent obesity serves as a significant risk factor for multiple chronic conditions in adulthood, including Type 2 diabetes, hypertension, coronary …

Pressure Injury Prevention In Intensive Care Units, Michael Loya

Walden Dissertations and Doctoral Studies

This project addressed the critical practice problem of formation of Stage III/IV pressure injuries in adult patients admitted to the long-term acute care (LTAC) intensive care unit (ICU) department, which has been linked to increased lengths of stay, mortality rates, and treatment costs for the facility. Thus, development of a clinical practice guideline (CPG) focused on a nurse-driven protocol to identify patients in the ICU department at high risk of developing a Stage III/IV pressure injury and initiating prevention measures formed the primary purpose of the Doctor of Nursing Practice (DNP) project. The practice focused question addressed whether an evidence-based …

Improving Diabetes Care: Staff Training On Updated Ada Guidelines, Jeffrey Wilson

Doctor of Nursing Practice Projects

The incidence of diabetes is rising, requiring clinical staff to stay current with the American Diabetes Association (ADA) Standards of Care. A lack of knowledge and outdated practices were revealed during the needs assessment at the project site. This quality improvement (QI) project sought to determine whether ADA‑centered educational training could impact staff members' knowledge of diabetes. Orem’s Self‑Care Deficit Nursing Theory and Lewin’s Change Theory served as the theoretical frameworks to promote provider competence and adherence to evidence‑based diabetes treatment. Quasi‑experimental pre–post design was used with a convenience sample of four clinical staff at a rural outpatient clinic. Study …

Staff Education To Improve Provider Knowledge In Addressing Sdoh-Related Barriers Affecting Medication Adherence, Andrea Latimore

Walden Dissertations and Doctoral Studies

This Doctoral of Nursing Practice (DNP) project focused on improving provider knowledge in addressing social determinants of health (SDOH) that contribute to medication nonadherence. There is a gap in provider knowledge in addressing SDOH-related barriers that contributes to poor health outcomes. Increasing provider awareness of SDOH improves patient outcomes. The practice-focused question guiding this doctoral project asked whether an educational module on SDOH improved provider knowledge in addressing SDOH-related barriers to medication adherence among adult patients with chronic illnesses. The program consisted of a pretest, an educational module delivered via a PowerPoint presentation, and a posttest. A total of 20 …

Post-Operative Hernia Site Infections, Agatha Francesca Inga Gittens-Stay

Walden Dissertations and Doctoral Studies

This doctoral project was a clinical practice guideline (CPG) focused on the development of a perioperative guideline for patients undergoing various types of hernia repairs. Hernia repair is a common surgical procedure to address various types of hernias.. To assure continued compliance with nationally set benchmarks and minimize the rate of postoperative hernia infections, a systematic review of evidence-based practices (EBP) to foster infection prevention was initiated at a hospital in England. The practice-focused question used was: For patients who underwent hernia repair surgery, what evidence informs CPG recommendations on the type of material, surgical interventions, and nursing interventions to …

Staff Education To Prevent Falls Among Older Adults In Primary Care, Chioma Nwosu

Walden Dissertations and Doctoral Studies

Falls are a significant health concern for the elderly population and a major cause of injury and functional decline among older adults, yet fall prevention practices are inconsistently applied in primary care. The purpose of this project is to evaluate the impact of staff education on fall risk screening and prevention for adults aged 65 years and older using the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) framework. This project employs a pre–post quality improvement design in a primary care clinic. Clinical staff received education on STEADI-based fall risk assessment, documentation, and evidence-based interventions. Data were collected through chart …

Staff Education Using A Workplace Violence Reduction Bundle, Julla Panneh

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project addressed the ongoing issue of workplace violence (WPV) among medical-surgical nurses in an acute care setting. WPV poses significant risks to staff safety, psychological well-being, and the overall care environment. Guided by current evidence and professional guidelines, the project implemented a structured educational intervention focused on the Workplace Violence Reduction Bundle, incorporating the Broset Violence Checklist (BVC) and evidence-based de-escalation strategies. Medical-surgical nursing staff participated in tailored educational sessions; knowledge was assessed through pre- and post-intervention surveys, and program acceptability was evaluated through staff feedback. Data analysis revealed modest improvements in …

Staff Education Project Staff Education To Integrate Nutrition Into Mental Health Care In An Acute Medical Setting, Yolene Auguste

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative designed to support the implementation of a protocol that integrates nutrition and mental health screening in an acute medical setting. The practice problem addressed inconsistent identification of nutrition-related needs and mental health concerns, along with variable follow-through on referral pathways, limiting holistic care and contributing to unmet needs during and after hospitalization. Nutrition and mental health are bidirectionally related, with dietary quality and lifestyle factors influencing mental health outcomes and overall well-being (Dubois & Giroux, 2025). The practice-focused question guiding this project was: In adult patients receiving care …

Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Staff Education To Improve Tirzepatide Education And Lifestyle Counseling, Daisy Asemota

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a practice-focused staff education initiative designed to improve clinical staff knowledge, confidence, and readiness to educate adult patients enrolled in a Tirzepatide weight-management program. Tirzepatide has demonstrated superior weight-loss outcomes compared to other glucagon-like peptide-1 (GLP-1) receptor agonists; however, inconsistent staff education practices related to medication administration, adverse-event management, and lifestyle counseling present a gap in practice. Variability in staff knowledge and teaching approaches may reduce confidence, contribute to inconsistent patient education, and limit the effectiveness of evidence-based care delivery. The purpose of this DNP project was to address this practice gap …

Staff Education On Implementing Exercise For The Management Of Depression In Adults In A Comprehensive Mental Health Facility, Afolasade Jarrett

Walden Dissertations and Doctoral Studies

In a comprehensive mental health facility, patients diagnosed with major depression continue to experience depressive symptoms despite treatment. Despite using standard treatment with antidepressants and psychotherapy, facility data showed that 40% of these patients are still experiencing depression symptoms that negatively impact their overall functioning and quality of life. There is evidence supporting exercise as an effective strategy for depression treatment. Therefore, a staff education project was proposed to educate staff about exercise for depression management in adults. A thorough literature search in four databases yielded 12 articles with high quality evidence supporting educating staff to use exercise for depression …

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

Caring For Post Icu Patients: Knowledge And Attitude Among Nurses Working In General Wards, At Tertiary Hospitals, Dar Es Salaam, Tanzania, Nazahed Mkiramweni, Kahabi Isangula, Masunga Iseselo, Dickson Mkoka, Emmanuel Mlay

School of Nursing & Midwifery, East Africa

Introduction: Caring for patients from the Intensive Care Unit (post-ICU) in general wards iscritical in determining patient outcomes. As primary caregivers, nurses provide hour-to-hour care and are essential in monitoring and addressing any signs of deterioration during this crucial transition period. Adequate knowledge and a positive attitudeare vital for ensuring the timely identification and management of complications. This study aimed to assess the knowledge and attitudes of nurses caring for post-ICU patients in general wards.

Methods: A hospital-based descriptive cross-sectional study wasconducted from May to August 2021 at Muhimbili National Hospital (MHN), Muhimbili Orthopedic Institute (MOI), and Jakaya …

The 24 Hour Rule: Science Over Subds Improving Newborn Physiological Stability, Paige Orth, Grace Brown, Jena Rhoads, Erin Robinson

Posters-at-the-Capitol

The first few hours after birth are the most crucial period in a newborn’s life. Adapting to a world outside of the womb can be both challenging and stressful, leaving the neonate susceptible to many health complications. The purpose of this project is to explore if delaying the first bath for 24 hours improves the physiological stability of the newborn. Bathing time policies vary among hospitals, and there is no clear set time to follow. The importance of this project is to address the inconsistencies throughout hospital bathing policies and implement a specific 24-hour policy. Multiple databases were used to …

Bringing The Heat: Optimizing Current Feed Warming Practices For Hospitalized Infants, Kaitlyn Ballard, Christine Nguyen, Madison Pavelka, David Rice, Yesica Rivas, Hannah Gabrielle Sellers, Nathan Xie

2025

No abstract provided.

Teaching Staff About Pressure Ulcers, Ann Maria Stewart

Walden Dissertations and Doctoral Studies

Pressure ulcers are local injuries to the skin and underlying tissue primarily caused by prolonged pressure, friction, or shear forces. These preventable complications are prevalent among immobile patients and can lead to poor patient outcomes and increased healthcare costs. Despite the availability of evidence-based prevention strategies, significant gaps in practice continue due to limited staff knowledge, ineffective communication systems, and inconsistent implementation of established guidelines. This Doctor of Nursing Practice (DNP) project focused on enhancing nursing staff knowledge through an evidence-based educational strategy designed to educate staff on strategies for preventing pressure ulcers. The education program included a PowerPoint presentation …

Need For A Psychiatric Facility To Develop A Clinical Practice Guideline On Self-Care To Give To Patients Upon Discharge, Judith Agwu

Walden Dissertations and Doctoral Studies

The project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for …

The Effects Of A Nurse-Led Peace Program On Perceived Peaceful End-Of-Life And Quality Of Life Among Head And Neck Cancer Patients Undergoing Concurrent Chemoradiation, Sirinya Pimvichai, Yaowarat Matchim, Tanadej Sinthusake, Kiratiya Wongkalasin

Journal of Health Research

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT).

Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at …

Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was purposed with closing critical gaps in staff knowledge and adherence to diabetes self-management protocols in a busy primary care clinic. Rising readmission rates and uneven use of American Diabetes Association (ADA) standards signaled an urgent need for a structured approach to staff education. To address this, a one-hour interactive training session was created that blended teaching, evidence-based handouts, and a practical diabetes care checklist. Staff learning was measured through pretest and posttest, confidence and adherence used a 5-point Likert-scale survey, and 21day readmission data tracked patient outcomes. The project question asked if …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

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

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

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

As metformin may …

The Association Of Social Determinants Of Health On Mortality Among Adults With End-Stage Kidney Disease: A Systematic Review And Meta-Analysis, Prince Agyapong, Lauren Longacre, Patti Brooks, Hossein Moradi Rekabdarkolaee, Surachat Ngorsuraches, Aine O'Connor, Semhar Michael, Brandon Varilek

Journal Articles: College of Nursing

RATIONALE/OBJECTIVE:: Synthesize evidence from published studies on end-stage kidney disease (ESKD) mortality and determine associations between social determinants of health (SDOH) and ESKD mortality.

STUDY DESIGN:: This PRISMA-guided study examined all published research across four electronic databases.

STUDY POPULATIONS:: Adults with ESKD living in the United States.

SELECTION CRITERIA FOR STUDIES:: Clinical trials, observational, cross-sectional, and prospective/retrospective cohort studies were considered if one or more of the five domains of SDOH were present in the analysis.

EXTRACTION/ANALYSIS:: Extraction was performed independently by two reviewers using a standardized form that captured study purpose and design, outcomes, SDOH domain, setting, participant characteristics, …

Chronic Dislocations And Pain In A College Athlete, Rachel Joseph, Trina Walker, University Of Wisconsin - Madison, Rebecca Kronk, Karen J. Whitt, Deborah O. Himes

Faculty Publications and Presentations

This diagnostic case study describes an 18-year-old woman and competitive gymnast who presents with recurrent joint dislocations, chronic musculoskeletal pain, and dermatologic findings suggestive of a heritable connective tissue disorder. Early recognition of connective tissue disorders is essential for accurate diagnosis, genetic evaluation, injury prevention, and long-term management planning.

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

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

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

Design

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

Methods

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

Results

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