Digital Commons Network^™

Enhancing Care For Psychiatric Patients Boarding In The Emergency Department, Abby Ford

Doctor of Nursing Practice Scholarly Project

Psychiatric boarding in the emergency department has become a common phenomenon in emergency departments throughout the United States. The purpose of this DNP Scholarly Project was to create a quality improvement project to enhance the care that psychiatric patients receive while they are boarding in the emergency department (ED). This quality improvement project consisted of an educational PowerPoint module for ED nursing staff and the dissemination of a care plan that nursing staff utilized while caring for psychiatric patients in this specific ED. The target population for this scholarly project was emergency department nursing personnel in a 40-bed metropolitan ED. …

Increasing Formation Of Advance Directives In Acute Care Through Staff Education, Piper E. Parres

Doctor of Nursing Practice Scholarly Project

In the acute care setting, the condition and stability of patients can change in an instant. Oftentimes, patients that were ambulatory, independent, and high functioning may be rendered critically ill and unable to communicate due to the rapid onset of an illness. When this happens, the care team must act quickly to stabilize the patient by any means necessary. With the wealth of medical knowledge and technology available in modern healthcare, life may be sustained indefinitely with the help of machinery such as ventilators, continuous renal replacement therapy, or extracorporeal membrane oxygenation. While some patients may welcome these interventions, others …

Educating Community Health Workers: To Improve Maternal And Infant Health In Rural Areas, Katerina Markova Shikhvarg

Doctor of Nursing Practice (DNP) Projects

Background

Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.

Local Problem

Despite the benefits of CHW involvement, they lack standardized training that could improve their services.

Methods

A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse …

Leading The School Team: A Professional Development Training On Eating Disorders For School Nurses, Michelle Samaniego Concepcion

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The COVID-19 pandemic sharply increased the prevalence of eating disorders (EDs) among youth. These conditions are associated with high treatment costs and have the second-highest mortality rate among mental illnesses, surpassed only by opioid overdose, making them a critical concern for school communities.

Local Problem: A learning needs assessment conducted by the Alameda County School Nurses Network identified gaps in school nurses’ knowledge and confidence regarding ED identification, referral, and care coordination. Methods: In response, a Doctor of Nursing Practice (DNP) student scholar developed and implemented an evidence-based, virtual professional development training focused on EDs. The module was …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Staff Education Program On The Vanderbilt Adhd Diagnostic Rating Scale, Rabiatu Bangura

Walden Dissertations and Doctoral Studies

This DNP project evaluated the effectiveness of a structured staff education program designed to enhance healthcare professionals’ knowledge and utilization of the Vanderbilt ADHD Assessment Scale (VAS) in children aged ≥2 to ≤18 years. The practice problem addressed in this project was the inconsistent use and limited knowledge of the VAS among healthcare staff, which can lead to underdiagnosis or delayed diagnosis. The practice-focused question was: Will a staff education program specifically designed to instruct healthcare professionals on using the Vanderbilt ADHD Assessment Scale in children ≥2 years to ≤18 years increase their knowledge? Targeted educational sessions were implemented, and …

Enhancing Patient Outcomes: Improving Hcahps Scores Via Implementing Pressure Injury Prevention Care Bundle Education In Acute Care Setting, Jasmeen Kaur

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) have a powerful effect on patient outcomes, satisfaction, and health costs. In the face of multiple interventions, nurse-patient communication failures and decreased HCAHPS scores reveal patient safety hazards. Aim: The purpose of this quality improvement effort was to enhance HCAHPS nurse communication scores by instituting a Pressure Injury Prevention Care Bundle (PIPCB) on a 93-bed medical-surgical/telemetry unit. Methods: The intervention was nurse-implemented education through educational posters and education cards distributed at admission and shift report. Nurse participation and education delivery were measured through pre- and post-intervention questionnaires and observations. The change in the HCAHPS nurse …

Teaming Up For Better Health: An Interprofessional Collaborative Approach To Older Adult Oral Care, Deborah Dowd, Jodie Lopez, Jennifer Goodman

Utah Conference on Community Engagement

Oral health is a critical component of overall health, significantly influencing systemic diseases and the quality of life in older adults. Conditions such as xerostomia, swallowing difficulties, and poor oral self-care are associated with aspiration pneumonia. Integrating oral health into healthcare in long-term care facilities (LTCFs) is essential for preventing various conditions and improving quality of life. Effective oral hygiene is crucial in avoiding non-ventilator hospital-associated pneumonia by reducing oral biofilm and lowering the risk of pneumonia. Nurses' knowledge and care in oral health across healthcare settings are vital for positive health outcomes. Revising nursing curricula to incorporate oral health …

The Nicu Nurse’S Aptitude In Teaching Neuroprotective Care To Caregivers Of Neonates, Lucy Bradley

Honors College Theses

Preterm neonates are at risk of developmental delays, behavioral problems, and mental health challenges. Neuroprotective care is essential to mitigate these risks, and nurses play a crucial role in educating caregivers on these practices. This study aims to investigate neonatal nurses' knowledge and confidence in teaching caregivers about neuroprotective care and to determine the extent to which caregivers implement these practices. A mixed-methods research design will be employed, using a survey to collect data from neonatal nurses who have at least one year of experience working in a NICU. The survey will assess nurses' understanding of neuroprotective care, their confidence …

Perceptions Of Perinatal Depression Among Immigrant Mothers: Screening Practices In Nurse Home Visitation, Silvia E. Arabia

Doctoral Projects

Screening for perinatal depression is a recommended strategy aimed at prevention and timely management of mood disruption in pregnancy and the postpartum (ACOG, 2024). Screening for perinatal depression is often integrated in evidence-based home visitation curriculums. The aim of this qualitative descriptive quality improvement project was to explore perceptions of perinatal depression among immigrant mothers engaged in nurse home visitation to identify barriers, if any, to disclosure and treatment of perinatal depression among a group at increased risk of developing perinatal depression (Gennaro, S., et al, 2016). Immigrant mothers residing in a large urban county in the San Francisco Bay …

Staff Education To Improve Gestational Diabetes Knowledge In Family Practice Staff, Lawretta Udogadi Aghomon

Walden Dissertations and Doctoral Studies

The project was a staff education program on gestational diabetes mellitus (GDM) that was carried out in an outpatient primary health facility to help improve staff knowledge of GDM. GDM is a pregnancy complication where women with no history of diabetes become hyperglycemic during their gestational period. According to the Centers for Disease Control and Prevention, the percentage of mothers giving birth who received a diagnosis of diabetes during pregnancy has increased in the last 10 years. Limited healthcare staff knowledge is a constraint in preventing the increase of GDM incidence. The practice-focused question was: Among healthcare staff at a …

The Experience Of Non-English Speaking Hispanic Patients During Kidney Transplant Evaluation, Ana Ivette Merced-Castro

Walden Dissertations and Doctoral Studies

There has been an increase in the incidence of Hispanics being diagnosed with end stage renal disease (ESRD), which has evolved from the rise in type 2 diabetes and hypertension. However, Hispanics and African American people are less likely to receive kidney transplants than non-Hispanic White individuals, and many Hispanics referred for transplants often do not complete the evaluation process due to its complexities. The purpose of this qualitative narrative descriptive study, guided by the socioeconomic model, was to explore the lived experiences of non-English-speaking Hispanic patients during the kidney transplant evaluation process. Six participants were recruited for the individual …

A Virtual Wellness Program To Enhance Well-Being For Pediatric Oncology Staff During The Covid-19 Pandemic, Karen Moody, Maria Swartz, Zachary Gresham, Martha Askins, Laura Cahalan, Pavilia Francis, Christine Geistkemper, Amy Heaton, Ruitao Lin, Melissa Melo, Alakh Rajan, Madeline Smith, Priti Tewari, Keyana R. Williams, Cheng-Han Yang, Rhonda Robert

Advances in Cancer Education and Quality Improvement

In response to the COVID-19 global health crisis and mandated social isolation, Pediatric leadership at MD Anderson Children’s Cancer Hospital was concerned for the psychological impact on its workforce and encouraged wellness programming. A grassroots wellness taskforce was assembled for the Division of Pediatrics. The task force’s primary mission was to promote the well-being of clinicians and non-clinical staff members through a broadly accessible, sustainable, and effective virtual wellness program. Guided by the Stanford Model for Professional Fulfillment, a virtual program entitled, “Weekly Wellness Webex” for Pediatrics staff was launched. Weekly Wellness Webex is a 1-hour live-streamed program with varied …

Keep Me Upright, Joscelyn C. Zimmerman, Kamrie L. Peterson

Doctor of Nursing Practice Projects: College of Nursing

Background: As our society ages, falls have emerged as a leading cause of accidental injury and death globally, significantly impacting older adults’ quality of life (Matchar et al., 2017; WHO, 2021). The consequences of falls are profound, encompassing physical injuries, psychological distress, and substantial healthcare costs. In the U.S., Medicare spends approximately $31.3 billion annually on fall-related care (Gettel et al., 2020). These statistics underscore the need for standardized fall prevention strategies in primary care.

Purpose: This Doctor of Nursing Practice (DNP) project aimed to implement a standardized systems-level process change for fall risk screening and education during Medicare Annual …

Cardiovascular Health In The Transition From Adolescence To Emerging Adulthood: A Scientific Statement From The American Heart Association, Jewel Scott Phd, Rn, Fnp-C, Anandita Agarwala, Carissa M. Baker-Smith, Matthew J. Feinstein, Karen Jakubowski, Jill Kaar, Niyati Parekh, Kershaw V. Patel, Janna Stephens

Faculty Publications

Cardiovascular disease remains a leading cause of death in the United States, with an alarming rise in the proportion of young adults experiencing cardiovascular events. Many adolescents enter adulthood with significant cardiovascular disease risk factors. This scientific statement addresses the critical need for cardiovascular health promotion during emerging adulthood, a transitional stage between the ages of 18 and 25 or 29 years of age. We discuss the significance of social determinants of health and the interplay between individual-level risk factors and developmental changes, including shifts in substance use, social connections, and emotional well-being. We conclude by outlining strategies for optimizing …

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

A Multicomponent Quality Improvement Initiative For The Early Identification, Prevention, And Management Of Delirium In The Medical-Surgical Setting, Sarah K. West

Doctor of Nursing Practice Scholarly Projects

Hospital-acquired delirium affects older adult patients, across the healthcare continuum. The incidence in frail older adults is high, costly, and often deemed preventable. Hospital-acquired delirium is associated with a multitude of short- and long-term complications, resulting in an increased rate of morbidity and mortality. The challenges of early recognition and management are prevalent in healthcare literature. While published guidelines exist, hospital systems continue to struggle with the standardization of geriatric delirium care. Given medical-surgical nursing is the cornerstone of hospital care, it is imperative to establish a standardized delirium prevention and management guideline, at this level of care, to optimize …

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

Doctor of Nursing Practice Scholarly Projects

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

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Quality Improvement Project Impact Of Multidisciplinary Patient Education On Heart Failure 30-Day Readmission Rate, Jeanne P. Williams

Doctor of Nursing Practice Projects

Patients diagnosed with heart failure are at an increased risk for readmission to the hospital within 30 days of discharge, and their care costs are projected to continue to increase. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to implement an evidence-based initiative to mitigate the increased heart failure 30-day readmission rate on a 30-bed medical-surgical telemetry unit in an acute care facility. Using the teach-back communication method, multidisciplinary patient education was implemented to prepare patients diagnosed with heart failure to manage their condition once discharged home. The theoretical and implementation frameworks used were Lewin’s Change Model, …

Executive Summary: Development Of An Evidence-Based Prevention Bundle To Reduce Falls On An Inpatient Psychiatric Detoxification Unit, Ramatu Dougrey Jalloh

Walden Dissertations and Doctoral Studies

Following a 16% increase in patient falls from 2023 to 2024 in an inpatient psychiatric detoxification unit, a quality improvement education project was implemented to assess the impact of an evidence-based fall prevention bundle on fall rates and nursing compliance. Nurses received education through a PowerPoint presentation to enhance understanding and implementation of the bundle, which included Edmonson reassessments after high-risk medication administration, ISHAPED bedside shift handoffs, care plan updates, and SWIFT daily safety huddles. Posttests identified that the objective score of 80% knowledge for nurses was met. During the 10-week implementation, the goal was 100% compliance with all bundle …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

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

NURS 464: Evidence-Based Nursing Capstone

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

Unraveling The Impact Of Oxidative Stress On Sperm Quality, Nicole Macasa, Olivia Mcmahon, Mónica Vidal-Franco

NURS 464: Evidence-Based Nursing Capstone

A substantial body of scientific research has identified oxidative stress (OS) as a main culprit in the development of male infertility. OS is mediated by free radicals, which can result from lifestyle, environmental factors, endocrine imbalances, and infection (Skoracka et al., 2020). Free radicals are unstable molecules with an unpaired electron in their outer shell, making them highly reactive and prone to causing OS damage to other molecules in the body (Łakoma et al., 2023). Spermatozoa are particularly vulnerable to oxidative damage due to their lack of robust cytoplasmic enzyme systems that repair damaged DNA (Saleh & Agarwal, 2002). This …

Promotion Of Women’S Preventative Health Behaviors For Breast And Cervical Cancer, Shelby Lopez

Doctor of Nursing Practice Scholarly Project

Women’s health prevention is typically not a significant topic for discussion. Health prevention measures are often discussed after a new diagnosis, rather than being a proactive approach toward improving women’s health. Breast and cervical cancer continue to be prevalent today and, to decrease the number of women diagnosed with late-stage cancer, this scholarly project will focus on improving the participation in prevention behaviors among women 18-45 years of age, but also acknowledge the role self-efficacy and perception of health behaviors has on the participation in prevention measures. Pender’s Health Promotion Model will help acknowledge how social-behavioral factors affect prevention behaviors. …

Promoting Increased Consumption Of Fruits And Vegetables In Older Adults Through Self-Efficacy And Social Cohesion, Ashley Lynn Nelson

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project was to design and offer a nutrition education program on fruit and vegetable consumption to a group of rural adults aged 65 and older. It was hypothesized that the nutrition program would directly motivate older adults to increase dietary consumption of fruits and vegetables. The project utilized the Health Promotion Model as the theoretical framework. To incorporate this project into a quantitative design, the methodological design that was applied is a non-experimental or observational design. This project included a four-week educational program in the Spring of 2023 that provided information on the importance of …