Digital Commons Network^™

Improving The Detection Of Refractive Errors In First And Third Graders, Tameka J. Bolden

Doctor of Nursing Practice Projects

Background: Vision is a crucial component of the learning process, with academic tasks being heavily dependent on visual acuity. Undetected or diagnosed visual impairments can significantly alter a student’s educational performance and overall development. Currently, in Alabama, kindergarten, second, and fourth grade students are the only students to receive routine vision screenings; therefore, regular screening for visual acuity and eye issues is critical for school health programs. Early screening, diagnosis, and correction of refractive errors prevent permanent visual impairment and support academic success by reducing educational barriers and delayed cognitive impairment.

Purpose: This project aims to improve the early detection …

Influenza And Chronic Obstructive Pulmonary Disease: Correlating Adult Immunization With Exacerbation Reduction After Implementation Of The Global Initiative For Obstructive Lung Disease Recommendations In A Rural Clinic, Jessica Semyonova

Doctor of Nursing Practice Projects

Background: Patients with chronic obstructive pulmonary disease (COPD) may experience exacerbations of the disease, leading to disease progression, decreased lung function, increased mortality, and decreased quality of life. However, one of the clinician’s best tools in preventing exacerbations may be the distribution of annual influenza immunizations.

Purpose: This project aimed to determine whether implementing an influenza vaccination protocol would increase influenza vaccination uptake and decrease COPD exacerbation rates.

Project Design: An influenza vaccination protocol was implemented over an eight-week period. During that time, data was gathered and compared to data from the previous year when a vaccination …

Evidence-Based Pain Management Bundle For Pediatric Postoperative Orthopedic Patients, Samantha Firmstone

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postoperative pain management in pediatric orthopedic patients is often inconsistent due to variability in provider practices and a lack of standardized protocols. At a Central Texas pediatric orthopedic clinic, all patients received opioid prescriptions post-knee surgery regardless of procedure severity, leading to frequent caregiver calls for clarification. This practice revealed a critical gap in preoperative education and multimodal pain management strategies, contributing to patient safety concerns and increased clinic workload.

Aim of the Project: The primary aim of the project was to improve pain control, reduce opioid reliance, and decrease postoperative pain-related follow-up calls by implementing a standardized, evidence-based …

Improving Depression Screening For Young Adults In Outpatient Settings, Addie Smith

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Depression among young adults aged 25 to 35 years in the United States has been among the second highest at 19.9%. Depression underdiagnosis stems from many patient-level causes, including a lack of standardized screening, inadequate provider education, and stigma of mental illness. Untreated depression results in low quality of life, comorbidities, suicidality, and socioeconomic issues.

Aim of the Project: The aim of this project was to address the gap in practice by implementing a standardized screening process for young adults to enhance diagnoses and increase screening rates.

Review of the Evidence: A comprehensive review of the evidence …

Improving Colorectal Cancer Screening Referrals In A Rural Health Clinic, Kysha Mcbee

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Colorectal cancer is the second leading cause of cancer death in the United States. Preventive screening for colorectal cancer has been associated with early detection and improved 5-year survival rates. The referral rates for colorectal cancer screening at the practicum site were 17.7%, well below the national benchmarks of 71.8%.

Aim of the Project: The aim of this project was to increase the screening referral rates in adults aged 45 to 75 years by 50% over a ten-week period by implementing an evidence-based toolkit.

Review of the Evidence: Literature review highlighted barriers to colorectal cancer screening, such as knowledge …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

Fall Prevention In Long-Term Care, Steven Zissler

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls among older adults residing in long-term care facilities continue to rise, resulting in injuries that contribute to adverse outcomes, a reduced quality of life, and increased healthcare costs. Despite existing safety interventions, falls persist, indicating a gap in effective, sustainable fall prevention strategies. Repeated failures to reduce falls among adults aged 65 years and older highlight the need for a structured, evidence-based approach aimed at addressing this critical patient safety issue.

Aim of the Project: The aim of this project was to reduce falls and fall-related injuries by 25% for older adults residing in a long-term care facility …

A Mixed Methods Study Exploring The Lived Experience Of Shared Trauma In Psychiatric Nurses During Covid-19, April Lynne Hutto

Theses and Dissertations

Introduction: Psychiatric nurses (PNs) had a unique lived experience of shared trauma (ST) during the COVID-19 pandemic. These nurses experienced the same traumatic event, COVID-19, with associated trauma symptoms as their patients. This mixed methods study aims to triangulate data on ST in PNs using a quantitative and qualitative study. Methods: PN (N=24) completed a semi-structured interview during the summer and fall of 2024. A quantitative study PN (N=552) in spring 2023, using the Shared Trauma and Professional Posttraumatic Growth (STPPG) inventory, was completed with descriptive and inferential statistics using SAS 9.4. A thematic analysis of the interviews was completed …

A Cross-Sectional Examination Of Missed Infection Control Practices Among Nurses In The Jordanian Hospitals, Muhammad Ahmed Alshyyab, Rania Ali Albsoul, Gerard Fitzgerald, Diana Arabiat

Research outputs 2022 to 2026

Background: Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined. Methods: A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using …

Women Managing Heart Disease: Involvement Of Spouse And Non-Spouse Care Partners, Elizabeth Richards

School of Nursing Faculty Publications

Purpose: Heart health is integral to promoting women’s overall health and healthcare. Following a cardiac event, engagement in recommended health-related activities (e.g., maintaining a healthy diet) speeds recovery and improves health. We investigate women’s perception of care partners who are involved in helping manage their heart disease. Methods: Data were drawn from two pilot studies (N = 54); interviews with women from hospital-based outpatient cardiac rehabilitation centers (study one), and online surveys completed by women with heart disease (study two). We compared women’s reports of involvement of their care partner (spouse vs non-spouse) in their health-related activities. Results: The proportion …

Staff Education On Evidence-Based Interventions To Reduce Fall Rates Among Hospitalized Adult Psychiatric Patients, Blessing Rita Ugbor

Walden Dissertations and Doctoral Studies

A staff education initiative was implemented in an inpatient psychiatric facility in the Southern United States to address the significant practice problem: inadequate knowledge of fall prevention strategies among psychiatric nurses. The identified knowledge gap impairs the nurses’ ability to recognize fall risk factors and apply evidence-based interventions. Psychiatric inpatients are particularly vulnerable to falls, which compromise patient safety, increase health care costs, and contribute to poor outcomes. The project was guided by a practice-focused question addressing whether staff education on evidence-based fall prevention strategies would enhance nurses’ knowledge and reduce fall rates. The purpose of the project was to …

Implementation Of An Education Program For A Ptsd Screening Tool To Increase Knowledge Among Providers Within The Primary Care Setting, Kimberly Inez Schat

Doctoral Dissertations and Projects

Post-Traumatic Stress Disorder (PTSD) is frequently underdiagnosed or misdiagnosed in primary care settings, leading to delays in treatment and poorer patient outcomes. This scholarly project aims to enhance primary care providers' knowledge and application of PTSD screening tools, specifically the PC-PTSD-5, through a structured educational intervention. The project follows a quasi-experimental pre-test/post-test design, assessing providers' baseline knowledge, delivering targeted education, and measuring changes in knowledge and confidence post-intervention.

Data analysis revealed a statistically significant improvement in providers' ability to identify PTSD symptoms, utilize appropriate screening tools, and refer patients for timely treatment. The project highlights the clinical significance of routine …

Staff Education To Educate Healthcare Providers On Effective Communication And Support Strategies For Child Sexual Abuse Victims, Njideka Ajemba

Walden Dissertations and Doctoral Studies

With this project, I sought to enhance the quality of care provided to child sexual abuse (CSA) survivors by improving healthcare providers’ skills in trauma-informed communication and support strategies. The project was undertaken at a large, private behavioral health facility located in the mid-Atlantic region of the United States, where an assessment of the practice environment revealed a critical gap in provider training. This gap often resulted in missed indicators of abuse, limited emotional support, and poor therapeutic outcomes for children affected by sexual abuse-related trauma. To address this, the project implemented a targeted educational intervention grounded in current evidence …

Quality Improvement Project Impact Of Weekly Mentorship On Compassion Fatigue In Critical Care Nurses, Susan Livengood

Doctor of Nursing Practice Projects

Compassion fatigue is defined as the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period. Without proactive intervention, compassion fatigue will continue to affect healthcare workers, leading to dissatisfaction in the workplace. Mentorship is an intervention that has been identified for improving the incidence of compassion fatigue. This quality improvement project implemented and evaluated a mentorship program for critical care nurses in a 227-bed acute care facility that has a 36-bed intensive care unit. The project evaluated the impact of weekly mentoring sessions on compassion fatigue in critical …

Staff Education Project On Genetic Testing In A Psychiatric Facility, Chinenye Vivian Akpuaka

Walden Dissertations and Doctoral Studies

The project was an educational DNP project that aimed to improve staff knowledge on genetic testing. The practice focused question was “Will an education module on best practices for genetic testing increase self-reported knowledge among health care professionals in a mental health clinic?” The purposes of genetic testing in psychiatry are to improve pharmacological therapy through better prescription of the right medications (Pinzón-Espinosa et al., 2022). The implementation of genetic testing at the project site is limited due to gaps in knowledge and attitudes as well as efficacy of this intervention. The leaders at the practicum site supported the potential …

Quality Improvement Project Educating Family Of Patients Dealing With Substance Use Disorder, Emmanuella Edekobi

Doctor of Nursing Practice Projects

Substance Use Disorder (SUD) creates significant hardships for individuals and their families. Although families play a vital role in recovery, they may not know how to provide effective support. To address this, a Doctor of Nursing Practice (DNP) quality improvement project introduced a structured educational program for non-professional caregivers at an outpatient psychiatric clinic. The goal was to enhance caregivers' confidence and readiness to support their loved ones during recovery (Filiz & Polat, 2022). Participants completed the General Self-Efficacy Scale (GSE) before and after the intervention. Statistical analysis showed a significant improvement in confidence (t(9) = -26.00, p < .001, Cohen's d = 8.22), supported by the Wilcoxon Signed-Rank Test (z = -2.88, p = .004) (Rezaie et al., 2022). The project was grounded in Bandura’s Social Cognitive Theory, using observational learning, reinforcement, and real-life examples. Caregivers gained practical strategies, emotional support, and a clearer understanding of their role (Mardani et al., 2023). Initial uncertainty gave way to increased comfort through group support. These findings suggest that even low-cost, brief interventions can strengthen caregiver self-efficacy. Incorporating family education into addiction treatment may improve outcomes in outpatient mental health settings (Kellar & Kelvin, 2020).

Quality Improvement Project Implementing A Hand Hygiene Compliance Program, Daisy Jean-Pierre

Doctor of Nursing Practice Projects

Hand hygiene remains a cornerstone of infection prevention in healthcare, yet gaps in compliance persist among nursing staff, contributing to preventable healthcare-associated infections (HAIs) and patient harm. The purpose of this Doctor of Nursing Practice (DNP) project, conducted at Piedmont Henry Hospital, was to implement and evaluate an educational intervention targeting nurse managers, with the aim of enhancing their knowledge, self-efficacy, and leadership in promoting hand hygiene compliance. The project addressed the identified problem of inconsistent hand hygiene practices among frontline staff, which was linked to insufficient leadership engagement and ongoing barriers such as time constraints and resource limitations. The …

Quality Improvement Project Improving Employee Satisfaction And Retention Through A Structured Training Process, Dawn Lundgren

Doctor of Nursing Practice Projects

The DNP project aimed to evaluate the impact of a structured new-hire training program on employee retention and job satisfaction within a hospice organization. Insufficient training for new employees can lead to a high staff turnover rate, stress, decreased job satisfaction, and poor quality of care. The quality improvement project utilized a pre-post intervention design over an eight-week period, comparing retention rates and job satisfaction scores before and after project implementation. Employee retention was measured as a binary outcome (retained or left), and job satisfaction was assessed through a seven-item survey rated on a five-point Likert scale. A total of …

Quality Improvement Project Impacting Provider Efficiency And Burnout With Standardized Ordering Tools, Carly Meredith

Doctor of Nursing Practice Projects

The adoption of electronic health record (EHR) systems promises better interoperability, transparency, patient safety, and care quality. However, concerns about increased provider stress and burnout are rising, suggesting a link between burnout and EHR use. This project aimed to evaluate whether improving EHR efficiency could reduce burnout rates. While literature highlights the need for enhanced training, effective methods remain unclear and challenge whether there is data supporting improvements or merely the perceived usefulness of these activities as identified through the Technology Acceptance Model. For this project, a preference list was created for commonly used orders with pre-selected defaults to streamline …

Quality Improvement Project Improving The Management Of Diabetes In A Primary Care Setting Through Staff Education, Chibuzo Okereke

Doctor of Nursing Practice Projects

Managing chronic disease, such as type 2 diabetes, requires effective patient education. This quality improvement project aimed to improve staff knowledge and confidence in delivering diabetes education using the evidence-based teach-back method. Eight staff members (physicians, nurse practitioners, nurses, medical assistants, and a clinic manager) of a suburban primary care clinic in Houston, Texas, were involved in the project by participating in structured educational sessions. The Always Use Teach-Back Conviction and Confidence Scale (CCS) and a Diabetes Knowledge Test 2 (DKT2) were validated instruments to measure data pre- and post-intervention. A quasi-experimental pre- and post-test design was used, and the …

Enhancing Pre-Licensure Bsn Students' Clinical Knowledge And Confidence In Blood Transfusion Via Postpartum High-Fidelity Simulation, Tresia Rouse

Doctor of Nursing Practice Projects

Blood transfusion administration is a complex nursing skill registered nurses require in bedside settings, regardless of experience level. Nursing students are expected to be practice-ready upon graduation. A significant concern in nursing academia is the insufficient exposure to administering blood products, which many pre-licensure nursing students lack in clinical and educational environments. This gap in nursing curricula can compromise students’ preparedness to perform this skill in real-world scenarios. The core purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to enhance clinical knowledge and impact self-confidence regarding blood transfusion administration and management, specifically by implementing a …

Quality Improvement Project Enhancing Self-Efficacy In Managing Patient No-Shows: A Staff-Focused Intervention, Aaron Wabang

Doctor of Nursing Practice Projects

No-shows are widely reported in behavioral health venues. They hinder continuity of care, decrease clinic efficiency, and compromise patient care. The solution requires addressing patients’ behavior and internal facility processes. This quality improvement (QI) project aimed to reduce no-show rates by providing staff with tools and enhancing their self-efficacy in managing appointments. The project was conducted in a rural East Texas behavioral clinic. Clinic staff reported challenges with patient reminders, scheduling, and follow-up issues that cause increased no-shows. The QI project aimed to empower staff by providing evidence-based scheduling strategies and decision support resources to enhance their confidence and attendance …

Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson

Walden Dissertations and Doctoral Studies

Nurse turnover has become a critical concern in healthcare, as low retention rates lead to decreased patient care quality and increased operational costs. A critical issue for hospital stakeholders is that many nursing leaders lack strategies to improve nursing retention. Grounded in the leader-member exchange theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful leadership strategies used by nurse managers in the Pacific South region of the United States to improve nurse retention. The study included interviews with six nurse managers who successfully implemented retention strategies. Data were collected through semistructured interviews and publicly available …

Measuring Nursing Student’S Performance, Attitude And Psychological Impact Of Different Evaluation Approaches In Simulation Education At Arab American University- Palestine, Mohammad Asia, Maysa Kassabry

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

This study aimed to compare the competency and psychological impact of using the objective structured clinical examination (OSCE) to the traditional evaluation methods (TEM) in evaluating cardiology skills among nursing simulation students. Thirty-two students were initially assessed using TEM, and one week later using the OSCE. Scores of the student competency were compared using paired sample t-tests, while semi-structured interviews were used to expand on qualitative measures. Students' mean scores were significantly higher in using OSCE than in TEM (p< 0.001). Students' attitudes and perceptions of both approaches showed favorable attitudes towards OSCE on most of the items. The qualitative data showed that students with lower GPAs and utilizing the OSCE approach experienced higher anxiety. The psychological impact of evaluation approaches requires additional investigation.

Quality Improvement Project Enhance Self-Efficacy And Knowledge In Pediatric Emergency Care For Nurses In An Adult Acute Care Facility, Tiffany Daniel

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project addresses the significant gap in emergency nursing preparedness for managing pediatric emergencies in adult-focused emergency departments. A quasi-experimental pre/ post intervention design was used to implement a pediatric-specific training intervention consisting of didactic education and simulation-based learning. A total of 87 night shift ED nurses participated. Knowledge and self-efficacy were measured using pre- and post-intervention surveys and assessments. The training equipped nurses with critical skills to manage pediatric emergencies more confidently and competently, addressing both clinical and emotional barriers. Knowledge scores significantly improved, t = -20.45, p < 0.001, with post-test means rising from 5.56 (SD = 1.58) to 9.03 (SD = 0.32). Post-intervention self-efficacy scores also increased significantly, t(86) = -21.57, p < .001, indicating greater confidence in pediatric emergency care. These findings validate the effectiveness of structured pediatric emergency training in enhancing nurse competency and self-efficacy. Lewin's change theory and Newman’s systems model guided this quality improvement project. The results support the continuation of the program in population-specific education and simulation as part of annual competency development. This project demonstrated that targeted pediatric training improves nurse preparedness and has the potential to enhance patient outcomes in a setting traditionally focused on adult care.

Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning For High-Risk Mental Health And Substance Use Disorder Populations, Margaret Phillips

Doctor of Nursing Practice Projects

A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- …

Quality Improvement Project The Introduction Of Gratitude Journaling To Decrease Test Anxiety In Prelicensure Bachelor Of Science In Nursing Students, Jourdan Scoggins

Doctor of Nursing Practice Projects

Test anxiety is a substantial barrier to success among prelicensure nursing students, given the heavy course load and high academic pressure of the educational environment. The purpose of this quality improvement project was to measure the impact of gratitude journaling on levels of test anxiety in first-semester Bachelor of Science in Nursing (BSN) enrolled in a nursing math course at a regional university in Arkansas. Following a quasi-experimental design, students participating in the project completed the Westside Test Anxiety Scale (WTAS) before and after five weeks of gratitude journaling. Thirty-two students participated in the intervention and 24 of those completed …

Quality Improvement Project Building Community Of Practice Through An Affiliate App Virtual Forum, Patricia J. Pease

Doctor of Nursing Practice Projects

Establishing community and support for pediatric hematology and oncology Advanced Practice Providers can be challenging. Asynchronous working schedules, lack of protected time, and geographical distance hinder these efforts. Extending professional support and collaboration to providers is vital to ensure communication, interprofessional teaming, and collaborative care of the high-acuity patient population. Given the availability of virtual forums, this project explores the ability of a virtual, synchronous Community of Practice (VCoP) to enhance interprofessional collaboration for affiliated Advanced Practice Providers (APPs). This project utilizes the validated Assessment of Interprofessional Team Collaboration II (AITCS-II) to assess pre- and post-intervention interprofessional collaboration via a …

Peer Mentor Training Program: A Policy Proposal, Laura Paul

Doctor of Nursing Practice Projects

Peer mentoring is an evidence-based strategy to improve student retention. However, for this approach to be sustainable, the students providing mentoring must be intentionally prepared for this role. This project introduces an evidence-based policy for training Bachelor of Science (BSN) students as peer mentors to enhance student outcomes and retention of first-year students. This policy was created for a small BSN program at a work-study college with a financially disadvantaged student body, which places the students at increased risk of not persisting in their degree. The training policy is intended to be implemented with nursing lab staff who are students …