Quality Improvement Project Improving Advanced Practice Registered Nurse Self-Efficacy And Retention Through A Structured Mentorship Program, James Caleb Kent

Doctor of Nursing Practice Projects

High turnover among Advanced Practice Registered Nurses (APRNs) creates significant challenges for healthcare delivery, continuity of care, and organizational costs. Despite convincing evidence supporting the use of mentorship programs to improve job satisfaction and retention, structured mentor education remains underutilized in many outpatient settings. This quality improvement project assessed the impact of a structured mentor education program on APRN self-efficacy related to mentoring competence. A single-group, pre-post design was implemented in one primary care department. Six APRNs completed an evidence-based mentor education module. Self-efficacy was measured using the Mentor Competence Assessment (MCA) survey administered immediately before and after education. Paired …

Assessing And Improving Provider Knowledge And Comfort With Palliative Care Consultations: A Quality Improvement Project, Summer R. Hess

Doctor of Nursing Practice Projects

Palliative care remains significantly underutilized in the management of heart failure, despite national guidelines supporting its early integration. This underuse limits opportunities for person-centered care in cardiology settings. The purpose of this quality improvement project was to improve provider knowledge and comfort in implementing palliative care consultations. The problem addressed was the low consultation rates for advanced heart failure patients, largely driven by provider misconceptions and a lack of formal training. A quasi-experimental design was initiated by using a brief, evidence-based educational article. Sixteen advanced practice providers at a high-volume cardiology clinic completed pre- and post-intervention surveys using the End-of-Life …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Development Of Policy Related To Test Anxiety In High-Stakes Environment, Jancy J. Sabu

Doctor of Nursing Practice Projects

Many nursing students experience test anxiety (TA) due to the highly stressful learning environment and the high-stakes nature of nursing exams. A community college in Texas has experienced an increase in student attrition from 2018 to 2022, primarily due to course failures, which are linked to TA. Expressive writing (EW) is a proven intervention that allows students to write about their anxieties and fears related to exams, helping them to regulate their emotions and manage TA. This project aimed to develop a policy that implements EW as an intervention and incorporates it into the nursing syllabus. Using the Centers for …

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Barriers To Participation In Follow-Up Services In Oncology, Casey Wagman

DNP Projects

Background
Psychological distress is often seen in cancer patients due to the physical, emotional, and social burdens of diagnosis and treatment. Patient participation in support services remains low despite the readily available psychosocial resources. The Emotional Well-Being Tool (EWBT), a validated psychological distress screening tool, is often used in a Midwest cancer clinic, yet it was noted that its supportive services were underutilized.

Purpose
This quality improvement project aimed to analyze the perspective of cancer patients on the EWBT, their understanding of its purpose and outcomes, and the perceived barriers to utilizing supportive services.

Methods
It was an exploratory design, …

The Use Of Debriefing To Combat Compassion Fatigue Among Cardiac Intensive Care Nurses, Brittany Johnson

DNP Projects

Background:
Compassion fatigue has physical, emotional, and psychological impacts on nurses working in intensive care units. Debriefing sessions can be used to help reduce compassion fatigue by allowing nurses on a cardiac intensive care unit to discuss their thoughts and feelings after the death of a patient who has had a complex hospital stay or traumatic death.

Aim:
The purpose of this project was to assess the perception of compassion fatigue on work life among Cardiovascular Intensive Care Unit (CVICU) nurses and to evaluate whether debriefing sessions following demanding situations enhance nurses' coping abilities and emotional processing.

Methods:
Nurses working …

Staff Education On Depression Screening In Young Adults, Irene Micere Njeru

Walden Dissertations and Doctoral Studies

Summary This doctoral project was on staff education. The practice problem was a knowledge deficit regarding depression screening by staff nurses at a local acute inpatient psychiatric facility. The practice-focused question was as follows: Will education on depression screening for young adults (18-to-28-year-olds) increase knowledge on the use of evidence-based depression screening tools by nursing staff in an inpatient psychiatric crisis facility? The purpose of the doctoral project was to educate staff nurses at a local acute inpatient psychiatric facility on the PHQ-9 depression screening tool for individuals aged 18 to 28 years. The project included a PowerPoint presentation, a …

Exploring The Connection Between Emotional Intelligence And Academic Achievement In Senior Nursing Students, Kimberly Smith

Dissertations

The need for nurses is now greater than ever, with a projected shortage of nearly five million nurses by 2030. Several factors exist that hinder the number of practice-ready nurses, causing nursing programs worldwide to explore and re-examine admission practices and increase student retention rates. The American Association of Colleges of Nursing (AACN, 2024) reported that over 100,000 students were denied enrollment in baccalaureate and graduate nursing programs in 2024, indicating that maximizing admission processes is crucial in addressing the current nursing shortage. This emphasizes the need for greater participation to ensure that all students have access to the educational …

Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …

Importance Of Mobility During Hospital Stays, Jennifer Davis

Nurse Residency

PICOT Question: In hospitalized patients, how does lack of mobility compared to regular ambulation affect mental health during their hospital stays?

Take 3 For Me: Coping With Occupational Stress In Pediatric Oncology Nursing: Quality Improvement., Alexys Nadeau

Doctor of Nursing Practice Papers

Background: High acuity oncology patients increase RN emotional demands, worsening RN compassion fatigue. RNs are more prone to occupational stress/burnout. Maximizing coping self-efficacy can help nurses deal with occupational stress and burnout.

Environment: Implemented at a hospital caring for a pediatrics in a medium-sized Southeastern US city on the hematology/oncology unit, which serves bi-state counties.

Purpose: This QI project uses a Plan-Do-Study-Act framework to assess the levels of stress experienced, implement a stress management program, reassess the stress levels, and evaluate the program’s effectiveness in improving coping self-efficacy.

Procedures: Nurses received education flyers and emails regarding Take3forMe. Then asked to …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

A Program Evaluation Of The Pet Therapy Program At Norton Children’S Hospital’S Ackerly Child Psychiatric Unit., Michael Brockman, Michael Brockman

Doctor of Nursing Practice Papers

Pet therapy is an increasingly utilized intervention in psychiatric care, particularly among adolescents. Within the inpatient adolescent psychiatric setting, pet therapy has been linked to reduced anxiety, enhanced emotional regulation, and improved patient engagement. At Norton Children’s Hospital’s Ackerly Child Psychiatric Unit, pet therapy sessions are offered weekly but had not been formally evaluated. The absence of structured evaluation raised concerns about sustainability, consistency, and the program’s therapeutic impact. This project aimed to take a deeper look at the program by conducting a program evaluation of the existing pet therapy initiative at the Ackerly Unit. The evaluation focused on identifying …

Implementation And Rvaluation Of A Mindfulness-Based Intervention On Compassion Fatigue And Depressive Symptoms In Perioperative Nurses: Quality Improvement, Felicia R. Preston

Doctor of Nursing Practice Papers

Background: Compassion fatigue (CF) and depressive symptoms (DS) impair the well-being of nurses worldwide, contributing to mental health conditions, poor patient care, absenteeism and turnover. Perioperative nurses are vulnerable to developing CF and DS due to demanding working environments, continually managing postsurgical pain, complications, and emotionally intensive procedures. Mindfulness-based interventions (MBI) may enhance a nurse's resourcefulness and offer coping strategies against CF and DS.

Purpose: The purpose of this quality improvement (QI) project was to implement the Three Minute Breathing Space (3MBS), a mindfulness-based intervention (MBI) and to evaluate its effects on CF and DS among perioperative nurses.

Methods: …

Enhancing Postpartum Depression Screening Rates: An Educational Intervention For Primary Care Pediatric Providers: A Quality Improvement Project, Jasmine Shaterra Jones

Doctor of Nursing Practice Projects

This quality improvement (QI) project sought to increase postpartum depression (PPD) screening rates at a single pediatric primary care practice setting by implementing an educational intervention for pediatric providers. Postpartum depression is a common and debilitating mental health condition affecting many mothers worldwide. Postpartum depression impacts many women in the United States and affects all ethnicities, although rates may vary based on demographic and socioeconomic factors. Despite the American Academy of Pediatrics' recommendations for maternal PPD screening at one, two, four, and six months, well-child visits, national screening rates remain low, with a large number of cases undiagnosed. The current …

Improving Hiv Pep Patient Follow-Up Appointment And Laboratory Testing In A Telehealth Setting: A Quality Improvement Project, Ralston Lockett

Doctor of Nursing Practice Projects

The ongoing HIV epidemic in the United States highlights the need for innovative prevention strategies, including non-occupational post-exposure prophylaxis (nPEP). This Doctor of Nursing Practice (DNP) project evaluated a telehealth-based intervention aimed at increasing HIV PEP follow-up appointments and laboratory completion rates, while also enhancing provider knowledge. Dual interventions included a patient reminder system and provider education. While provider knowledge significantly improved post-intervention, based on Cohen’s d effect size of 0.62, clinical significance was demonstrated by follow-up appointment rates declining from 44% pre-intervention to 41% post-intervention. Laboratory completion rates also decreased, with 53% of patients completing labs pre-intervention compared to …

Evaluation Of A Nurse Practitioner-Led Preoptimization Care Management Program’S Impact On Patient Satisfaction For Total Hip And Knee Arthroplasty, Bryttany Chambers

Doctor of Nursing Practice Projects

This evaluation project aimed to assess whether the nurse practitioner-led preoptimization care management program can increase patient satisfaction by improving the quality metrics, such as same-day ambulation post-surgery, discharge to home, and compliance in preoperative education. The evaluation retroactively reviewed 46 charts of primary total knee and hip arthroplasty patients, male (38%) and female (62%), aged 43 to 84. Using Fisher’s exact test to examine the Net Promoter Scores (NPS) for six months of the PCM program, there was no significant increase in patient satisfaction scores, despite PCM patients averaging 89% compared to non-PCM patients at 83%, based on an …

Educating Nurse Practitioners On Music-Based Interventions: An Evidence-Based Project, La’Keshia Henderson

Doctor of Nursing Practice Projects

Background: Arts-based interventions (ABIs) harness the transformative power of art to enhance processes or situations, particularly those related to physiological, emotional, and psychological well-being. There are three types of arts-based interventions: visual, literary, and performing arts. Among these, music therapy, a form of performing arts intervention, has gained recognition as an effective approach for addressing mental health challenges. Music therapy has shown promise in reducing anxiety symptoms, offering a non-invasive and accessible form of support within ABI strategies. Purpose: This project assessed changes in nurse practitioners' knowledge, attitudes, and practices, as well as their intentions to utilize music-based interventions in …

Improving The Screening And Management Process For Mental Health Disorders And Health Risk Behaviors In College-Age Students: A Quality Improvement Project, Brooke L. Styslinger

Doctor of Nursing Practice (DNP) Manuscripts

Establishing a standardized electronic screening process for mental health disorders and health risk behaviors is crucial for early identification and intervention before poor outcomes occur. This quality improvement project addresses a gap in care relating to screening practices in a college health services office which primarily relied on a provider-based interview screening processes in students reporting for care. Pre-implementation data showed providers most often screened for Major Depressive Disorder (MDD), alcohol use, and drug use, with inconsistent screening for Generalized Anxiety Disorder (GAD) or tobacco/vaping use. Follow-up screening form administration was also inconsistent, only given 3.3% of the time for …

Exploring Available Admission Criteria For A Bachelor Of Science In Nursing/Midwifery: A Scoping Review, Jackline Estomihi Kiwelu, Aminieli Usiri, Gadiel Ketto, Tumbwene Mwansisya, Eunice Pallangyo

Libraries

Background: Nursing and midwifery are crucial professions in healthcare systems, and the availability of well-trained professionals in these fields contributes to achieving global and national health goals. The process of equipping nurses and midwives with professional knowledge and skills starts with selecting candidates that are suitable for the profession, and able to complete nursing/midwifery education and become lifelong learners.

Objective: This study aimed to identify and document currently available admission criteria for a Bachelor of Science (BSc) in Nursing/Midwifery.

Methods: This scoping review used Arksey and O’Malley’s five-stage framework to explore admission criteria for BSc in Nursing/Midwifery …

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

Reducing Suicide Ideation Through Healthcare Provider Training In The Use Of The Columbia Suicide Severity Rating Scale (C-Ssrs) In A Rural Community Mental Health Clinic, Lashunda R. Lewis

Doctoral Projects

This doctoral project aimed to address the inconsistent and inadequate assessment of suicide risk by healthcare professionals in a Rural Community Clinic. Staff members do not comprehensively understand the Columbia-Suicide Severity Rating Scale and vary in how they screen patients before the intervention. When we looked at the baseline, we found that only 45% of charts contained suicide risk screening, and C-SSRS was used in only 5% of cases. Some of the main obstacles reported were not properly training staff and keeping patients from sharing their thoughts on this subject.

The main objective of the doctoral project was to test …

Organizational Health Literacy In Pediatric Cardiovascular Programs, Eva Gomez

Graduate Doctoral Dissertations

Health literacy refers to a person’s ability to access, understand and use health-related information in order to effectively manage one's health and navigate healthcare experiences. This responsibility does not rest solely upon the individual; healthcare organizations also have a vital role in assisting individuals in accessing, understanding and using health information through their interactions with the healthcare system. Organizational health literacy (OHL) can serve as a strategy to ensure that all individuals have equitable access to health information and services. The Ten Attributes of a Health Literate Healthcare Organization established the foundational principles of organizational health literacy. The present study …

Compassionate Self-Care For Nurses And Midwives: A Sequential Explanatory Mixed Methods Study, Mary Steen, Shwikar Othman, Jennifer Fereday, Annette Briley, Qunyan Xu, Rachael Vernon

Research outputs 2022 to 2026

Background: Awareness of being kind and compassionate to yourself is often overlooked despite emerging evidence that high levels of self-compassion decrease levels of anxiety and improves well-being. Aim: To explore what being compassionate to yourself means to nurses and midwives and increase knowledge and understanding of how self-compassion may enhance well-being. Methods: Mixed methods study design was utilised to investigate and explore the influence of self-compassion on nurses and midwives' well-being. Phase 1 involved quantitative data collection and analysis. Phase 2 qualitative data were collected to expand on quantitative results. Results: Fifty-four participants responded to a pre-workshop questionnaire, 55 completed …

Enhancing Person-Centred Care In The Final Years Of Life: Insights From Emergency Department Visits And Hospitalisations In Victorian Residential Aged Care (2015/16 To 2022/23), Janine J. Alan, Bridget Laging, Peter Cameron, Rohan Laging, James Boyd, Davina Porock, Sean Randall

Research outputs 2022 to 2026

Objective: To explore emergency hospitalisations from Victorian residential aged care facilities (RACFs). Methods: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23. Main outcome measures: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs. Results: The rate of ED presentations from Victorian RACFs from 2015/16 …

The Impact Of Mindfulness Therapy To Reduce Disruptive Behavior In High School, Wendy Nell Peters

Electronic Theses and Dissertations

The aim of this project was to determine the impact and effectiveness of Gina Biegel’s mindfulness techniques for stressed teens method on adolescent anxiety and the disruptive symptoms that lead to high school adolescents being assigned to detention. This project described a quantitative correlational design research project that investigated a small adolescent sample size, with a goal of decreasing the number of local high school adolescent students who are repeat detention offenders, by implementing Gina Biegel’s mindfulness techniques for stressed teens method on those high school adolescents who were assigned to detention. This was achieved by collecting demographic data from …

Providing An Evidence-Based Miscarriage Care Education Program For Nurses Caring For Women Experiencing An Early Pregnancy Loss, Kailee Draz

DNP Projects

Objective
Women often seek emergency care during an early pregnancy loss. Unfortunately, research shows that women are overwhelmingly dissatisfied with their miscarriage care due to lack of support and guidance, provider knowledge, communication and follow-up care. Mishandled miscarriage situations can cause women to suffer physical and psychological consequences. The purpose of this project was to discover if providing emergency room nursing staff with pregnancy loss bereavement education allows for enhanced support, knowledge, and confidence when caring for women experiencing pregnancy loss. The aim of the project is to measure if perceptions of ER registered nurses support, resources, knowledge, and confidence …

Cholinesterase Enzyme Association With Quality Of Life Among Farmers In Khong Chai District, Kalasin Province, Thailand, Supasin Deeraksa, Mayuree Suuwunnakhot, Khanittha Madngammuang

Jurnal Keperawatan Indonesia

The agricultural sector in Thailand faces challenges that impact farmers' health and quality of life. This study examines the quality of life, cholinesterase enzyme levels, and factors associated with quality of life among farmers in Khong Chai District, Kalasin Province, Thailand. This cross-sectional analytical study was conducted using systematic random sampling. The respondents had a mean age of 54.97 ± 10.50 years (range 25–75 years) and comprised 75.56% females (n = 204), 24.44% males(n = 66). Data collection included demographic information, blood samples to assess cholinesterase enzyme safety levels, and responses to the World Health Organization Quality of Life Brief-Thai …