Digital Commons Network^™

Improving Obesity Management In Primary Care Through Provider Education, Natalie Anderson

Doctor of Nursing Practice Projects

Background: Childhood obesity is a significant public health concern associated with metabolic, cardiovascular, and psychosocial complications. Despite the availability of evidence-based pediatric obesity management guidelines, adherence to these guidelines remains inconsistent in primary care settings. Purpose: This evidence-based quality improvement project aimed to determine whether provider education on the 2023 American Academy of Pediatrics (AAP) Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, combined with implementation of an electronic health record (EHR) clinical decision support prompt, improved provider knowledge and adherence to guideline-recommended obesity management practices. Method: A pre-post quasi-experimental study was …

The Effects Of Education And Training On Clinical Staff’S Knowledge, Perception, And Clinical Practice Of The Medication Reconciliation Process, Stephanie A. Williams

Doctor of Nursing Practice Projects

Medication-related harm affects approximately one in 30 patients in healthcare settings. Accurate medication reconciliation (MedRec) is essential for identifying medication discrepancies, preventing medication errors, and reducing adverse drug events. Clinical staff play a critical role in ensuring the accuracy of medication lists in primary care settings.

This evidence-based quality improvement project evaluated the effect of a structured MedRec training intervention on MedRec knowledge, perceptions, and practices among clinical staff in a primary care clinic in Southeast Texas. The project used a single-group, quantitative, quasi-experimental design. A convenience sample of 32 clinical staff members completed knowledge and perception assessments before and …

Food Insecurity And Parent Engagement In Pediatric Therapy: A Comparative Study Of Feeding, Speech-Language, And Combined Services, Kendra Kendra Rosales

Open Access Theses & Dissertations

Pediatric feeding disorders and food insecurity represent two compounding challenges for families navigating pediatric therapy services, yet their intersection has received little empirical attention. This study examined food insecurity rates across three pediatric therapy groups and explored the relationship between food insecurity and parent engagement in therapy. A cross-sectional online survey was administered to 175 caregivers of children actively receiving feeding therapy only (n = 34), speech-language therapy only (n = 93), or combined feeding and speech-language therapy (n = 48). Food insecurity was assessed using the USDA Household Food Security Survey Module: Six-Item Short Form, and parent engagement was …

The Future Midwife: A Prisma Scoping Review Of Education, Transition, And Work Readiness Among Midwifery Students, Danielle Gleeson, Tracey Tulleners, Jessica Elliott, Dianne Stratton-Maher, Liz Ryan, Jillian Mcculloch, Geraldine Roderick, Thenuja Jayasinghe, Joanne Buckley, Jamie May Newman, Helen Nutter, Jo Southern, Lisa Beccaria, Georgina Sheridan, Tess Trinder, Haiying Wang, Tao Wang, Sita Sharma, Linda Ng, Jing Yu Tan, Daniel Terry

Research outputs 2022 to 2026

Background: Preparing midwifery graduates to be confident, competent, and resilient is essential for workforce sustainability, yet students report a disconnect between academic preparation and clinical realities. Increasing care complexity, workforce shortages, and variable clinical learning environments globally highlight the need to examine how educational strategies support effective transition to practice. Objective: To map and synthesise the evidence regarding educational approaches, learning experiences, and transition-to-practice factors that influence preparedness for professional practice among midwifery students, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.

Methods: A PRISMA-ScR-guided scoping review was conducted across seven databases. …

Utilization Of An On-Site Primary Care Clinic – An Evaluation, Joulvous Jarvis Drake

Doctor of Nursing Practice Projects

Background: Employers incorporate on-site primary care clinics into their workplace health strategies to improve employees’ access to timely care and chronic disease management and reduce absenteeism and healthcare-related costs. Yet despite the demonstrated organizational and health benefits, many worksite clinics experience lower-than-expected utilization. Purpose: This evaluation project aimed to identify the behavioral and structural factors that influenced employee utilization of a corporate on-site primary care clinic. Method: A quantitative, cross-sectional design was used to evaluate the factors contributing to employees’ low utilization of the on-site primary care clinic. Approximately 1,000 eligible full-time employees at a large corporate campus in Texas …

Increasing Human Papillomavirus Vaccination Rates Among Adolescents In The Primary Care Setting: A Quality Improvement Project, Chioma Rosemary Ike

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is the most common viral infection of the reproductive system, and it is responsible for most cervical cancer cases worldwide. Many HPV-related cancer deaths can be prevented simply through vaccination. The vaccine is most effective when administered before exposure to the virus. Despite the HPV vaccine’s proven safety and efficacy, its uptake remains suboptimal. Purpose: This quality improvement (QI) project trained providers at a pediatric and family clinic in an effective communication strategy to increase HPV vaccination uptake among adolescents. It encouraged providers to …

Telling Their Intensive Stories: Black/African American Intensive Care Unit Nurses And Their Perceived Encounters With Icu Workplace Racism, Sharon M. Butler

Theses & Dissertations

The 2022 American Nurses Association (ANA) study on racism and racial inequality within the nursing profession both acknowledges the presence of racism in nursing and provides evidence of the diverse negative social and psychological effects of racism on minority nurses. Although the 2022 ANA study sets a precedent and shows evidence of racism’s effects across the broader professional nursing workforce, there is limited nursing research literature that offers a focused presentation and understanding of the lived experiences of minority nurses and their personal perceptions of workplace racism. There is also limited nursing research on how workplace racism impacts cultural and …

The Tension Of Retention And Retirement: A Narrative Study Of Full-Time Nursing Faculty Within Five Years Of Retirement At Public, Four-Year Institutions In Texas, Shelley Hunt

Electronic Theses and Dissertations

This narrative inquiry, qualitative study explored the retirement decision-making process of nursing faculty at public, four-year institutions who were within five years of retirement. Through purposive sampling, 11 participants across eight institutions consented to participate and were interviewed via Zoom. Due to the nursing faculty shortage, the researcher hypothesized that nursing faculty nearing retirement may be retiring not only as a natural progression of their career but also because of factors that lead other early and mid-career faculty members to leave academia. Through thematic analysis, four themes emerged: Finding Meaning and Fulfillment in the Nurse Faculty Role, Institutional Factors Shaping …

The Impact Of Enhanced Pediatric Asthma Simulation Prebriefing On Perceived Psychological Safety In Associate Degree Nursing Students, Amy G. Burtram

Theses

Background: Simulation is a core teaching strategy in nursing education, yet student anxiety may negatively impact learning outcomes. Psychological safety has been identified as a critical factor in effective simulation-based student learning.

Purpose: The purpose of this project was to examine whether an enhanced simulation prebrief improved perceived psychological safety among second-semester associate degree nursing students during a high-fidelity pediatric asthma scenario at a rural community college in Alabama.

Methods: A quasi-experimental one-group pretest–posttest design evaluated changes in psychological safety following a structured, evidence-based prebrief grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards …

Exploring Perceptions Of Self-Efficacy Among Newly Graduated Nurses In The Labor And Delivery Unit After The Use Of Rapid Cycle Deliberate Practice For Obstetric Emergencies, Amber L. Hulsey

Dissertations

Background: The average turnover rate among newly graduated nurses (NGNs) in the United States is 25-30% within their first year, with increased rates in high-stress units like obstetrics and critical care. Many risk factors contribute to the high turnover rate of NGNs, but one modifiable factor is feelings of self-efficacy. Studies have shown that simulation training can increase self-efficacy in obstetric emergencies. This study was conducted to explore feelings of self-efficacy among NGNs working in the labor and delivery unit after a rapid cycle deliberate practice (RCDP) simulation of an OB emergency.

Methods: The study used a descriptive …

The Use Of A Sepsis Escape Room Simulation To Enhance Undergraduate Nursing Student's Clinical Judgment, Alaina Peterson

Dissertations

Background: Less than 10% of new graduate registered nurses meet practice-ready expectations for clinical judgment competencies, and 52% of critical care nurses are unable to adequately define sepsis. Traditional clinical rotations offer inconsistent exposure to high-acuity, low-frequency events such as sepsis, leaving new graduates unprepared for independent practice. Escape room simulations use the proven effectiveness of high-fidelity simulations with gamification to develop clinical judgment through active learning, teamwork and problem-solving.

Objective: The purpose of this project was to determine the effectiveness of a sepsis escape room simulation to improve perceived clinical judgment skills of undergraduate nursing students. The intervention was …

Increasing Postpartum Appointment Attendance Rates, Tanya Lister

Doctor of Nursing Practice Scholarly Projects

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

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

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

Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project addressed the lack of standardized workflows and clinical confidence regarding geriatric mental health screening and safe antidepressant initiation at a rural primary care clinic. Utilizing the FOCUS-PDSA framework, a 15-minute staff education module and a clinical pocket guide were implemented to train Medical Assistants (MAs) on integrating PHQ-9 and GAD-7 screenings during triage, and to equip providers with EHR SmartPhrases and 2023 AGS Beers Criteria prescribing guidelines. A pre- and post-intervention 5-point Likert scale survey evaluated the knowledge and clinical confidence of the clinic staff (n = 12). Results demonstrated a …

Early Post-Cesarean Anxiety, Nausea, Vomiting, And Pain Under Spinal Anesthesia: Trajectories And Modifiable Predictors, Indah Susanti, Eza Kemal Firdaus, Septian Mirova Sebayang, Amelia Andini, Alicia Dumes Berg, Margaret Atwood, Rantiningsih Sumarni, Mesya Mesya, Asmat Burhan

Jurnal Keperawatan Indonesia

Recovery after caesarean under spinal anesthesia remains a quality gap, with scarce evidence on modifiable anesthetic practices improving recovery. Data linking the neuraxial technique, nausea, anxiety, and pain remain limited. The objective of this study was to describe postoperative nausea and vomiting, anxiety, and pain at 6, 12, and 24 hours after caesarean section under spinal anesthesia and to examine whether intrathecal adjuvant use, sensory block level, fasting duration, and American Society of Anesthesiologists (ASA) physical status were associated with these outcomes. Cross-sectional study across five hospitals; 534 women undergoing caesarean under spinal anesthesia. Exposures: intrathecal adjuvant, sensory level (≤ …

Effects Of Montessori-Based Stimulation On Fine And Gross Motor Development Among Children With Stunting: A Quasi-Experimental Study, Indah Rahmadaniah, Tukimin Bin Sansuwito, Rini Anggeriani, Rinda Lamdayani, Ade Marlisa Rahmadayanti, Aris Citra Wisuda

Jurnal Keperawatan Indonesia

Stunting affects not only physical growth but also several aspects of child development, including gross and fine motor skills. Early stimulation interventions, such as Montessori-based activities, have been proposed to enhance developmental outcomes through structured sensorimotor experiences. This study aimed to evaluate the effects of Montessori-based stimulation on motor development among children with stunting and to compare its outcomes with those of conventional stimulation. A quasi-experimental study with intervention and control groups was conducted among 120 children with stunting aged 36–59 months. Participants were allocated to either a Montessori group (n = 60) or a conventional stimulation group (n = …

Emotional Intelligence, Work Engagement, And Turnover Intention Among Hospital Nurses: A Hierarchical Component Analysis, Catrin Catrin, Christopher Wisnu, Pauline Henriette Pattyranie Tan

Jurnal Keperawatan Indonesia

High turnover intention among hospital nurses poses serious challenges to healthcare organizations, affecting service quality and workforce stability. Understanding the psychological and organizational factors associated with turnover intention is essential for developing effective retention strategies. This study aimed to examine the relationships among emotional intelligence, work engagement, and turnover intention among hospital nurses, including health-promoting leadership, workload, and burnout as contextual variables within the model. A cross-sectional study was conducted among 98 nurses working in inpatient units using validated questionnaires. The data were analyzed using partial least squares structural equation modeling (PLS-SEM) with hierarchical component analysis. Emotional intelligence significantly predicted …

Evaluating Mobile Palliative End-Of-Life Advanced Care Enhancement (Mpeace) Usability And Technology Acceptance: Mixed-Methods Design, Ni Luh Putu Inca Buntari Agustini, I Gede Putu Darma Suyasa, Israfil Israfil

Jurnal Keperawatan Indonesia

Palliative End-of-Life Care (PEoLC) is a process requiring timely assessment, effective communication, and personcentered decision-making to support patients and families. Although the process can be strengthened through digital health innovations such as Mobile Palliative End-of-Life Advanced Care Enhancement (M-PEACE), its use in PEoLC remains limited. Therefore, this study aimed to evaluate M-PEACE usability and technology acceptance through an explanatory sequential mixed-methods design and explore user experiences in describing quantitative results. The quantitative phase was conducted to assess usability through an adapted System Usability Scale (SUS), and technology acceptance was measured using a modified Technology Acceptance Model (TAM) questionnaire. A total …

Knowledge, Attitudes, And Practices By Women In Cartagena Regarding Breast Self-Examination, Rafael Arnedo Martínez, Keidis Ruidiaz Gómez

Jurnal Keperawatan Indonesia

Breast self-examination (BSE), especially when adopted by vulnerable populations, serves as a vital mechanism for the timely detection of breast abnormalities indicative of cancer. As a result, this decreases the public health burden associated with treatment at advanced stages. Therefore, assessing knowledge, attitudes, and practices (KAP) regarding this simple early detection method is a priority. This study examines the relationship between KAP concerning BSE among women in Cartagena, Colombia. A cross-sectional correlational study was conducted with 322 women attending a healthcare facility. Data were gathered using two tools: a sociodemographic profile and a KAP questionnaire. Results showed that most participants …

Supportive And Palliative Care: Addressing The Unspoken Burden Of Cancer On Significant Others, Esmeraldo C. De Las Armas Iv

Jurnal Keperawatan Indonesia

A diagnosis such as cancer can cast a long-lasting gloom that affects not only the patient but also their loved ones. This concept analysis represents an effort to understand and explore the nuanced world of supportive and palliative care for significant others of cancer patients, a population that has often been overlooked. Rodgers’ evolutionary model of concept analysis was utilized to examine the concept of supportive and palliative care for significant others of cancer patients. Positive outcomes for both significant others and patients included improved coping mechanisms, reduced caregiver burden, enhanced communication, and better quality of life. However, several challenges …

Development Of A Culturally Tailored Care Model For Chronic Disease Management In The Coastal Community: A Modified Delphi Study, Laode Saltar, Heltty Heltty, Sitti Mikarna Kaimuddin

Jurnal Keperawatan Indonesia

Chronic noncommunicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, are increasing in Indonesia’s coastal communities including the Bajo population in Southeast Sulawesi. Limited healthcare access, cultural barriers, and low preventive health engagement exacerbate the disease burden in these communities. Culturally tailored interventions are needed to enhance self-awareness and improve chronic disease management. This study aimed to develop and validate a culturally sensitive care model for chronic disease management in the Bajo coastal community. A three-round modified Delphi method was used with 26 panelists representing health professionals, community leaders, policymakers, and family members recruited through community health centers and …

Limited Australian Clinical Guidelines For Pain Assessment In Hospitalized Older Adults With Cognitive Impairment: Implications For Safe And Quality Care, Rosemary Saunders, Kaoru Nosaka, Seng Giap Marcus Ang, Natasya Raja Azlan, Aaron Alejandro, Rohini Sharma Bhardwaj, Olivia Gallagher, Irene Ngune, Amineh Rashidi, Yan Hui Celestine Wee, Nilufeur Mckay

Research outputs 2022 to 2026

Introduction – Pain assessment remains challenging in healthcare settings in patients who are unable to self-report their pain. More than 50% of individuals with dementia and other forms of cognitive impairment (CI) experience pain daily. However, pain is frequently overlooked and inadequately assessed by healthcare professionals due to their lack of knowledge and guidelines to inform pain assessment. Pain is also a leading cause of hospital presentation and inappropriate pain assessment can impact on pain management and compromise safe and quality care. Evidence-based guidelines that inform appropriate pain assessment and management are therefore essential. This scoping review aimed to explore …

Targeted Nursing Bootcamps For Critical Access Hospital Nurses: A Program Evaluation., Nicholas Popp

DNP Projects

Background: Registered Nurses employed in critical access hospital settings are required to care for patients across the lifespan with varying levels of acuity. The registered nurse (RN) must be competent in providing medical, surgical, pediatric, obstetric, and intensive care-level services. However, the additional training they receive to care for their patients may be minimal or nonexistent, leading them to seek employment at other facilities due to safety concerns. Leadership within the organization believed that implementing targeted monthly nursing skills boot camps could increase nurses’ competence, confidence, and retention in critical access hospital settings.

Aims: This program evaluation project aimed to …

Bridging The Gap: Development And Implementation Of A Caregiver Educational Guide For Post-Lung Transplant Caregivers, Megan Aller

DNP Projects

Background: Caregivers of post-lung transplant recipients play a critical role in postoperative recovery, as patients require continuous support during the first three months after transplant. Despite this responsibility, caregivers frequently experience burden, stress, and challenges adapting to the complex demands of the caregiving role.

Aim: To evaluate the feasibility and preliminary outcomes of a tailored caregiver education and support guide for caregivers of lung transplant recipients.

Local Problem: Within the local transplant program, caregiver education primarily relied on verbal instruction with limited caregiver-specific take-home resources.

Methods: This quality improvement project used a two-group pretest–posttest design to evaluate the …

Evaluating Preoperative Education Modalities For Orthopedic Surgery Patients, Hannah Johnson

DNP Projects

Effective preoperative education is essential as total joint arthroplasty (TJA) procedures shift to outpatient care, yet traditional education methods may not be meeting patients’ diverse learning styles. This Doctor of Nursing Practice (DNP) project aimed to evaluate the impact of multimodal preoperative education (in-person, virtual, hybrid video modules, or a combination) on patient-reported anxiety and discharge readiness, as well as length of stay (LOS), surgical site infections (SSIs), and 30-day readmissions. The in-person portion could not be implemented due to staffing constraints. The pre-post evaluation was conducted with a sample of 273 patients undergoing elective hip and knee arthroplasty (pre …

Evaluating An Educational Intervention On Penicillin Allergy De-Labeling Among Graduate Nursing Students, Allison Desmond

DNP Projects

Background
Approximately 10% of patients report a penicillin allergy; however, up to 90% of these individuals are not truly allergic. Inaccurate penicillin allergy labels contribute to inappropriate antibiotic use, increased healthcare costs, and antimicrobial resistance. Education on penicillin allergy testing remains limited among future Family Nurse Practitioners (FNPs).

Methods
A quantitative quality improvement project using a pretest-posttest design was conducted among second- and third-year Doctor of Nursing Practice–Family Nurse Practitioner (DNP-FNP) students enrolled in Pharmacology II or Advanced Practice Nursing III at a Midwestern liberal arts college. Participants completed a 15-minute voiceover PowerPoint educational intervention on penicillin allergy testing and …

Registered Nurse Procedural Sedation In Operating Room: An Analysis Of Patient Safety And Nurse Confidence Efficacy Of 2 Years Post Implementation, Cassandra Fredrickson

DNP Projects

Background
A Midwest hospital implemented a registered nurse (RN) procedural sedation program to provide safe, cost-effective sedation for selected operating room procedures under physician supervision, improving patient access while optimizing anesthesia resources.

Methods
A retrospective descriptive program evaluation examined 1,117 patients who received RN-administered procedural sedation for vascular and neurovascular procedures during 2022 and 2024. Outcomes included anesthesia consultation, anesthesia takeover, reversal agent use, and adverse events. Patient demographics and procedure duration were analyzed. Six procedural sedation nurses completed a self-efficacy survey assessing confidence in sedation-related competencies. Descriptive statistics and qualitative review of adverse event narratives were performed.

Results
Among …

Enhancing Nursing Self-Efficacy In Advance Care Planning Conversations Through Role-Play Education: A Quality Improvement Project, Rachel Williams

DNP Projects

Background:
Advance care planning (ACP) conversations are essential for ensuring that patient healthcare preferences are understood and respected; however, nurses often report limited confidence and self-efficacy when initiating these discussions. Educational interventions that emphasize communication skills may improve nurses' preparedness to engage in ACP conversations.

Methods:
A quality improvement project utilizing a pre-post intervention design was conducted on three adult inpatient medical units within a regional Midwestern hospital. Registered nurses participated in an educational intervention consisting of ACP education, role-playing case scenarios, guided discussion, and debriefing. A modified 22-item Advance Care Planning Self-Efficacy Questionnaire was administered before and after the …

Dnp Final Report: Enhancing Self-Regulated Learning And Metacognition For First-Semester Undergraduate Nursing Students, Carla S. Biondillo

DNP Final Reports

Background. First-year undergraduate nursing students often struggle to adapt their learning strategies to the higher-order thinking and clinical reasoning demands of nursing education. Ineffective study habits, low academic self-efficacy, and limited self-regulated learning (SRL) skills are consistently identified as predictors of attrition, which ranges from 20–50% nationally and internationally.

Purpose. At an academic medical center in rural East Texas, first-semester students report academic overwhelm and inadequate study strategies, consistent with national trends. A structured, evidence-based faculty coaching intervention targeting SRL and metacognition was found to be feasible within the collaborative, student-centered organizational culture.

Methods. A quality improvement (QI) design …

Exploring Caregiving Choice In The Adult Cancer Population, Jennifer L. Huggins

MUSC Theses and Dissertations

ABSTRACT Purpose Although extensive research examines family caregivers (FCs) across populations, less attention has been paid to how lack of choice in assuming the role affects quality of life (QOL) among FCs of adults with cancer. Understanding choice could guide interventions protecting this invaluable, often invisible workforce. Aims (1) Synthesize what is known about perceived choice among informal caregivers of adults with serious illness; (2) assess relationships between caregiving choice and caregiver QOL, burden, sleep, depression, stress, and social determinants of health; (3) describe experiences of FCs of adults with cancer providing care with no, little, or some choice. Design …

Proposal For A Comprehensive Workplace Violence Program In An Acute Care Facility, Christin V. Timmons

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) in healthcare is a growing threat to caregiver safety, workforce stability, and patient outcomes. At a newly opened acute care facility, the absence of a comprehensive WPV prevention program posed a gap in practice, creating safety risks and regulatory vulnerability. A literature search was conducted using CINAHL, PubMed/ MEDLINE, ProQuest Nursing & Allied Health collection, and Google Scholar. A total of 50 articles were identified with 11 articles meeting all inclusion criteria. Collectively, findings supported comprehensive, multicomponent WPV prevention programs to integrate leadership engagement, structured governance, staff education, environmental controls, and continuous data monitoring to improve safety …