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The Use Of Pressure-Mapping Technology To Decrease Pressure Injury Prevalence, Acadia Morse Bsn, Rn

Nurse Residency

Does the use of pressure-mapping, as compared to a standard repositioning schedule, decrease the rate of pressure injuries in acute care patients at a high risk of skin breakdown?

The Healthcare Transition Experiences Of Emerging Adults With Congenital Adrenal Hyperplasia, Leslie Noojin Pitts

ETDs from 2020-2029

Congenital adrenal hyperplasia (CAH) is a group of disorders characterized by enzyme deficiencies impairing adrenal hormone production and requiring lifelong management. Individuals with CAH experience increased morbidity and mortality due to the underlying condition, steroid exposure, and inadequate preventative care. Despite clinical guidelines recommending a structured healthcare transition (HCT), little is known about the HCT experiences of emerging adults with CAH. Understanding these experiences is critical for identifying practice gaps and developing interventions to improve health outcomes. This qualitative descriptive study explored the HCT experiences, challenges, and outcomes of emerging adults with CAH, as guided by the refined Social Ecological …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Birth Satisfaction, As Measured By The Birth Satisfaction Scale–Revised (Bss-R), And Its Role In Predicting Breastfeeding Duration, Maternal-Infant Attachment, And Postpartum Depression, Molly Parker

University Honors Theses

Birth satisfaction has been consistently associated with improved maternal outcomes such as reduced postpartum depression (PPD), stronger maternal-infant attachment, and longer breastfeeding duration. However, the extent to which birth satisfaction independently predicts these outcomes remains unclear. This study examined whether birth satisfaction, as measured by the Birth Satisfaction Scale–Revised (BSS-R), predicts postpartum depression, maternal-infant attachment, and breastfeeding duration in a longitudinal cohort.

Data were drawn from the Prenatal Environmental And Child Health (PEACH) study. Birth satisfaction was assessed at 12 months postpartum using the BSS-R. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS), maternal-infant attachment using the …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Innovating Adhd Care: A Doctoral Capstone On A Pilot Adult Adhd Diagnostic Clinic Implementation, Fozia Aman

Doctor of Nursing Practice Final Manuscripts

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed …

Sleep Tight: A Sleep Hygiene Bundle For Adults To Improve Sleep Quality In A Skilled Nursing Facility, Meaghan Corbin

Doctor of Nursing Practice Final Manuscripts

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, …

Improving Transition To Adult Care: Assessing Health Insurance Literacy In Adolescent Patients With Congenital Heart Disease, Kaitlyn V. Mudge

Doctor of Nursing Practice Final Manuscripts

Background: With advances in surgery and medical management, 95% of children with congenital heart disease (CHD) survive into adulthood. Transition to adult care is an intricate process. Up to 60% of adolescents fail to follow through with cardiology care, facing three times the risk of needing emergency services. Only 25% of young adults with CHD knew of the need to change their care to an adult provider and to acquire health insurance as an adult. One barrier to successful transition is a lack of insurance coverage and limited insurance health literacy. Higher insurance literacy is associated with increased utilization …

Improving Antihypertensive Medication Adherence Through Education And Follow- Up Phone Calls In A Primary Care Setting, Sarah Peterson

Doctor of Nursing Practice Final Manuscripts

Hypertension affects nearly half of adults and significantly increases the risk of stroke and cardiovascular disease; however, poor medication adherence remains a primary barrier to effective blood pressure management. The purpose of this evidence-based practice (EBP) project was to improve antihypertensive medication adherence among adult patients in a primary care setting. Guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care, the project utilized a pre-test/post-test design at a private practice clinic. The sample included adults with a hypertensive diagnosis and active prescriptions. Medication adherence was defined as the Morisky Medication Adherence Scale (MMAS-8) scores, measured before and …

Closing The Gap: Integrating A Standardized Depression Screening In Primary Care, Cyndy Marie Oreas

Doctor of Nursing Practice Final Manuscripts

Objective: The purpose of this evidence-based practice (EBP) project is to implement the routine use of the Patient Health Questionnaire-9 (PHQ-9) screening instrument in the primary care setting to improve early diagnosis, treatment, and referrals to mental health.

Background: Depression is frequently underdiagnosed in primary care despite its significant impact on health outcomes. Inconsistent screening practices and a lack of standardized workflows contribute to missed opportunities for early identification and intervention. Routine PHQ-9 screening has been shown to improve detection and facilitate timely referral to behavioral health services.

Methods: A standardized PHQ-9 screening was implemented for adult patients aged 18 …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Assessing Impact Of Heat Waves On Pregnancy And Lactation Amidst Climate Change: A Scoping Review., Susan Anyango, Grace Nakate

School of Nursing & Midwifery, East Africa

Background: The escalation of heat waves, attributed to climate change, represents a global public health concern, with pregnant
and lactating women identified as particularly vulnerable due to Physiological and hormonal changes.

Aim: To review the existing research on the effects of heat waves on pregnancy and lactation, identifying potential health risks and outcomes.

Methods: A structured search across PubMed, Scopus, Web of Science, and Google Scholar was conducted using terms related
to heat waves, pregnancy, lactation, and climate change. Inclusion criteria focused on peer-reviewed empirical
studies in English.

Results: Heat waves are linked to increased risks of preterm labor, low …

Descriptive Qualitative Study Of Nursing Students' Perceptions And Behaviors During Student-Led Class Sessions In Uganda, Proscovia Nakaye, Veronica Nakkonde, Mercy Muwema, Grace Nakate

School of Nursing & Midwifery, East Africa

Introduction: Student-led class sessions are a pedagogical approach where students actively engage in the learning process, influencing content, activities, and pace. This method fosters independent learning, communication skills, and teamwork. While some studies have shown the effectiveness of student-led sessions, nursing students often exhibit challenges, such as inattention and negative attitudes, affecting the quality of learning and patient care. Understanding nursing students' perceptions and behaviors in this context is essential for improving nursing education.

Methods: This descriptive qualitative study aimed to explore nursing students' perceptions and behaviors during student-led class sessions at Uganda Christian University. Sixteen direct-entry nursing students …

Prevalence Of Teenage Pregnancy And Associated Factors Among Adolescent Girls In Bobi Subcounty, Northern Uganda., Grace Auma, Margaret Alioru, Geoffrey Kaujju, Grace Nakate

School of Nursing & Midwifery, East Africa

Methodology: A Cross-sectional study design. A survey was conducted among 4893 married girls aged 15-19 years using quantitative methods. Quantitative data was collected through the structured questionnaire, which was administered, data was collected and entered in EPI-INFO 2020 software, and was cleaned and analyzed using STATA version 15.0. Binary logistic regression was done to examine the factors independently associated with teenage pregnancy. A multistage sampling technique was used.

Results: Our study showed that the prevalence of teenage pregnancy in Bobi Sub-County, Omoro District, is high at 27.5%. Significant Factors contributing to the likelihood of teenage pregnancy included those …

Misconduct Among Nurses And Midwives: A Retrospective Descriptive Study Of Cases Handled At The Uganda Nurses And Midwives Council From 2017 To 2021, Barbara Okiror, Christine Nimwesiga, Patience Muwanguzi, Tom Ngabirano, Mercy Muwema

School of Nursing & Midwifery, East Africa

Background: Media reports on the misconduct of nurses and midwives, including cases of fake credentials, drug theft, and incompetence, are on the rise. However, there are no published studies currently addressing this issue in Uganda. Therefore, to inform effective regulation of the profession, we analysed the misconduct cases involving nurses and midwives reported to the Uganda Nurses and Midwives Council between 2017 and 2021.

Methods: The study retrospectively described misconduct cases received and handled at UNMC from 2017 to 2021 and their outcomes. Following total population sampling, data were extracted from case files and then input into a …

Richmond Agitation-Sedation Scoring Implementation In A Critical Access Hospital, Jasmine A. Hobbs

Doctor of Nursing Practice Scholarly Projects

Mechanically ventilated patients who are boarding in rural emergency departments face an increased risk of inconsistent sedation management due to the lack of standardized protocols and the extended transfer times to higher levels of care. The variability in sedation practices can lead to both under- and over-sedation, which negatively affects patient comfort, safety, and clinical outcomes. Research suggests that sedation protocols incorporating the Richmond Agitation-Sedation Scale (RASS) can shorten mechanical ventilation duration and improve clinical outcomes. The purpose of this project was to evaluate the effectiveness of a targeted educational intervention on improving nursing knowledge and comfort with the RASS …

Parent-Focused Resource And Staff Crisis Tool For Addressing Teen Suicidal Ideation, Maya Ewing, Jasmine Crisan, Delaney Fewel, Brandon Fung, Kaylee Cornejo, Alyssa Arthur, Christine Elayda

Nursing Leadership in Community Engagement Projects

The team of seven Seattle Pacific University nursing students partnered with an agency that functions as a family resource center. The agency provides emergency shelter, mobile outreach, and basic needs to families in King County. The team created an evidence-based solution focused on education for suicide prevention. Additionally, the team identified a gap in available staff clinical resources during emergencies.

Staff Education To Improve Treatment Adherence Among Young Adults With Mental Health And Substance Use Disorders In An Outpatient Behavioral Health Clinic, Nkechinyere Eririma Nwachukwu

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Antihypertensive Medication Adherence Through Patient-Centered Assessment In Rural Primary Care, Tiesha Keoni Mathis

Walden Dissertations and Doctoral Studies

No abstract provided.

An Emotional Intelligence Staff Education Program For Patient-Aligned Care Team (Pact) Members, Linda Rogers

Walden Dissertations and Doctoral Studies

No abstract provided.

Probiotic Intake Related To Hemoglobin A1c Among U.S. Veterans With Type 2 Diabetes Mellitus, Maryann Martin

Walden Dissertations and Doctoral Studies

No abstract provided.

Experiences Of First-Generation Immigrant Parents In Caring For Children With Type 1 Diabetes, Nahel Kibreab

Walden Dissertations and Doctoral Studies

No abstract provided.

Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …

Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

Standardizing Preoperative Screening: A Color-Coded Triage Tool Quality Improvement Project, Lyn Green

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Ambulatory surgery centers (ASCs) require effective preoperative screening to ensure appropriate patient selection and minimize day-of-surgery (DOS) cancellations, which affect patient safety, operational efficiency, and financial performance.

Local Problem: In a Northern California ASC serving a racially diverse, predominantly older-adult population with a high burden of chronic diseases, the DOS cancellation rate was 3.84%, exceeding the 2.3% institutional benchmark. Inconsistent preoperative screening contributed to avoidable cancellations.

Methods: A pre- and post-intervention quality improvement design evaluated the effect of a standardized screening tool and staff education on DOS cancellations.

Interventions: The Preoperative Stoplight Tool, a color-coded triage system classifying …