A Guideline For Underserved Adult Residents In Need Of Affordable Transportation Access To Healthcare, Tammie E. Walker

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

During the development of the 2022 Tarrant County Public Health Community Health Assessment, two gaps were identified that contribute to disparities: transportation and access to healthcare in areas of high need (Y. M. Wingate, Ed.D., Community Health Assessment Division Manager, Tarrant County Public Health, personal communication, June 20, 2025). As of 2017, 5.8 million individuals reported delaying medical care due to a lack of accessible transportation in the U.S. (Wolfe et al., 2020). The National Health Interview Survey (NHIS) of 2022 reported that 5.9% of residents living in the West South-Central region, which includes Texas, found that, within the …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Succession Planning As A Tool For Nursing Recruitment, Retention, And Resilience, Natalie Kennett

DNP Scholarly Projects

Background: Healthcare is facing a significant nursing shortage. This shortage not only impacts bedside nurses but also nurse leaders. Succession planning is a method for recruiting, retaining, and building resilience among nurse leaders.

Purpose: This quality improvement project applied principles of succession planning, including leadership education, training, and assessment of leadership retention and resilience.

Methods: Two interventions were implemented in this quality improvement project. The first was an assessment of a modification in nursing leadership organizational structure that was made in 2024 with the purpose of improving succession planning. This evaluation was completed with the use of …

Enhancing Psychiatric Education And Training For Family Nurse Practitioners In Rural Health Settings, Jared Sanders

DNP Scholarly Projects

Abstract

Title: Enhancing Psychiatric Education and Training for Family Nurse Practitioners in Rural Health Settings

Background: Mental health conditions represent a significant and growing proportion of primary care encounters, particularly in rural and underserved regions where psychiatric specialist access remains critically limited. In these settings, Family Nurse Practitioners (FNPs) frequently serve as the sole point of contact for patients presenting with mental health concerns, often without the benefit of embedded behavioral health support or readily available consultation. Despite carrying this clinical responsibility, many FNPs report gaps in formal psychiatric training, particularly in psychopharmacology and diagnostic differentiation, that contribute to variability …

Nurse Leader Burnout: Exploring Ways To Improve Wellness And Resilience, Kimberly Leger Kenney

DNP Scholarly Projects

BACKGROUND: Burnout among nurse leaders is a growing concern, driven by increasing workload, operational demands, and challenges with work-life balance. Addressing burnout is critical to maintaining stability within the leadership team and to delivering high-quality patient care.

LOCAL PROBLEM: Prior to the development of the QI proposal, engagement survey results showed scores 0.11 points below the benchmark in leadership responsiveness, and more than 50 nurse leader positions have turned over in the past 5 years. The specific aims of this project include: 1. 75% of nurse leaders report that they would implement an activity from the toolkit. 2. Fewer than …

Implementing An Electronic Referral System In A Community Mental Health Clinic To Streamline Patient Care: An Evidence-Based Quality Improvement Project, Judith Ngante

Master's Theses or Doctor of Nursing Practice

Inefficient referral processes in community mental health clinics contribute to delayed access to care, fragmented communication, and increased administrative burden. Traditional referral methods, including phone, fax, and paper-based systems, often result in prolonged wait times and documentation errors, negatively impacting patient outcomes. Evidence supports electronic referral (e-referral) systems as effective tools for improving care coordination, reducing delays, and enhancing provider satisfaction. This Doctor of Nursing Practice (DNP) quality improvement project aimed to implement an e-referral system in a community mental health clinic in metropolitan Texas to streamline patient care and reduce referral wait times by at least 30% over a …

Improving Staff Perceptions Of Effective Communication Through Frequent Micro-Team Huddles: A Quality Improvement Initiative, Sara Krslovic

Master's Theses and Capstones

Abstract 

Background: Effective communication among interdisciplinary team members is essential for safe, coordinated patient care. An outpatient primary care clinic identified inconsistent and non-inclusive communication within assigned micro-teams, particularly between nurses and providers, creating an opportunity to implement a structured communication strategy.

Local Problem: Communication within micro-teams lacked a standardized process, and nurses were often excluded from routine communication with providers. Prior to implementation, no formal micro-team huddles had occurred within the previous six months.

Methods: A four-week quality improvement initiative was conducted using the Plan-Do-Study-Act (PDSA) framework. Weekly, micro-team huddles were implemented between nurses, providers, and the medical assistant …

Improving Early Ambulation After Cardiac Surgery Using Nurse Education And Workflow Cues: A Quality Improvement Project, Nathan Seeley

Master's Theses and Capstones

Background: Early ambulation following cardiac surgery is an evidence-based practice that promotes postoperative recovery, reduces complications, and supports earlier discharge (Cook et al., 2024; Engelman et al., 2019; Kanejima et al., 2020). Despite its recognized benefits, consistent implementation remains challenging in busy inpatient settings due to workflow demands, competing priorities, and patient-related barriers.

Local Problem: Inconsistent early ambulation practices were identified on the Cardiac Surgical Step-Down Unit, creating an opportunity to improve adherence to evidence-based postoperative mobility practices.

Methods: This quality improvement project used the Plan-Do-Study-Act (PDSA) model to evaluate the impact of a brief nurse-focused educational intervention on early …

Improving Operating Room First-Case On-Time Starts And Reducing Turnover Times: A Quality Improvement Project, Ashley Cote

Master's Theses and Capstones

Abstract

Background: Delays in first case on-time starts (FCOTS) contribute to decreased operating room (OR) efficiency, increased healthcare costs, workflow disruptions, and reduced staff and patient satisfaction. Evidence suggests that standardized workflows, improved communication, and Lean Six Sigma methodologies can improve perioperative efficiency and reduce delays.

Local Problem: Baseline data from a local OR microsystem demonstrated an FCOTS rate of 77%, below the organizational benchmark of 80%. Root cause analysis identified inconsistent preoperative workflows, communication gaps, and variable staff adherence to standardized processes as primary contributors to delayed first-case starts.

Methods: A quality improvement project utilizing the Define, Measure, Analyze, …

A Quality Improvement Initiative: Implementing An Effective Massive Transfusion Protocol Cognitive Aid Tool Within An Operating Room & Post-Anesthesia Care Unit Setting, Jenna L. Farrell

Master's Theses and Capstones

Abstract

Background: Massive Transfusion Protocol (MTP) activations are low-frequency, high-acuity events in the post-anesthesia care unit (PACU) setting.  These events necessitate the rapid formation of codes teams, interdisciplinary communication amongst unfamiliar providers, critical decision-making, high-volume rapid blood transfusions, and critical laboratory marker monitoring.

Local Problem: Due to the infrequent nature of hemorrhagic events in the PACU, nurses may have limited experience participating in these protocols at their institutions, resulting in potential for documentation errors from retrospective back charting, decreased confidence regarding blood product sequencing and laboratory draw timing, and increased cognitive workload overall.  This quality improvement (QI) project implemented …

Barriers And Facilitators Of Diabetes Educational Knowledge Retention Among Black Women: An Exploratory Sequential Mixed Method Study Of Black Diabetes Educators, Alicia Mott

Nursing Theses and Dissertations

Problem: There is a gap in understanding the culturally specific barriers affecting diabetes education knowledge (DEK) among Black women with Diabetes Mellitus (DM). This study explores the barriers and facilitators to improving education retention from the perspectives of diabetes mellitus educators and health care providers.

Theoretical Framework: The Campinha-Bacote Model (CBM) was utilized to identify the facilitators and barriers of Black women with DM.

Design: An exploratory sequential mixed method was used to identify barriers and facilitators of DEK among Black women. A sample of six Black diabetes experts participated in the qualitative study, and seven professionals participated in rounds …

Effectiveness Of Post-Discharge Interventions Following Psychiatric Hospitalization On Readmissions And Suicide Prevention Among Adolescents, Maria Paz Eladia Posadas

Nursing | Senior Theses

Background: Suicide is a pervasive and far-reaching issue. Psychiatric hospitalization is often used as an intervention for individuals, including adolescents, experiencing suicidal ideation and/or behavior. However, post-discharge care may lack structure or clearly defined follow-up services, which can result in rehospitalizations and increased suicidality. Objective: The goal of the proposed research study is to investigate how implementation of peer support groups for adolescents following psychiatric hospitalization can assist in reducing readmissions and mitigating suicide risk. This can also help shape strategies for managing care after discharge. Method: The proposed research study utilizes a quantitative quasi-experimental design to determine the efficacy …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Senior Theses

Background: Quality patient handoff from Emergency Medical Services to the Emergency Department is a crucial transition of care that directly impacts patient safety, medical intervention, and patient outcomes. If concise, effective communication is not achieved, critical details can be left out resulting in medical errors, delayed intervention times, and lack of identification of clinical deterioration.

Aim: This study aims to understand how paramedic to nurse handoff quality impacts a nurse’s early identification of clinical deterioration.

Proposal:

Methodology: A quasi-experimental study of mixed-method research.

Recruitment strategy: A fire department in Marin County, CA and ED nurses from the base trauma center …

Routine Guided Meditation In Nicu Nurses: A Coping Strategy For Nicu Nurses Dealing With Newborn Deaths, Gianna Wong

Nursing | Senior Theses

Purpose: This research study aims to investigate the emotional impact of newborn deaths on Neonatal Intensive Care Unit (NICU) nurses in addition to evaluating their perceptions of routine guided meditation as an effective coping mechanism to manage professional grief and enhance psychological well-being. Methods: Utilizing an exploratory descriptive research design grounded in Pender’s Health Promotion Model (HPM), this study examines the lived experiences and health-promoting behaviors of neonatal nurses following newborn deaths. Data: Anticipatory collection of data will be from a sample of NICU nurses based in California through a twelve-question survey featuring open-ended questions. Qualitative content analysis will be …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Senior Theses

Background: Islam is currently the fastest growing religion in the world and the chances of nurses having a Muslim patient is exceptionally high yet many nurses lack the knowledge and resources on how to accurately provide culturally sensitive care to Muslim patients. Hospitals lack educational sessions/training as well as Epic tools to help nurses provide culturally sensitive care to Muslim patients which leads to a knowledge deficit in cultural sensitivity of Islamic beliefs, values, and practices. Purpose: This thesis paper proposes a research design for a nurse education/training program on Islamic beliefs, values, and practices along with an implementation of …

Stronger Together: A Resident-Led Initiative Advancing School Nurse Readiness In Pediatric Seizures And Pediatric Cardiology, Shana-Kay Lambert-Johnson, Amy Nguyen-Pham, Tony Do, Devika Adusumilli, Jorim Parmar, Dimitar Semerdzhiev, Elizabeth White, Joanna John, Myrna Garcia, Nicholas Gerden, Tasaduq Mir, Michele Mccarroll

North Texas GME Research Forum 2026

BACKGROUND: School nurses play a vital role in safeguarding the health and safety of children by serving as frontline providers within the school setting. Timely recognition and appropriate management of acute medical conditions can reduce morbidity, prevent unnecessary emergency department utilization, and improve long-term outcomes. Needs assessment surveys identified knowledge and confidence gaps among school nurses related to pediatric seizure management and pediatric cardiology.

METHODS: This prospective educational quality improvement initiative was conducted across the Dallas–Fort Worth (DFW) region during the 2025-2026 academic year. Over 25 residents served as curriculum developers and educators, creating and delivering evidence- and case-based education …

Ask Me 3® In Action: Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

2026

This evidence-based practice project evaluated the implementation of the Ask Me 3® health literacy tool in a pediatric perioperative setting to improve caregiver understanding of medical information and communication with healthcare providers. Findings suggest that Ask Me 3® supports health literacy and caregiver engagement, while patient experience measures related to nurse communication, listening, and caregiver comfort improved following implementation.

Precision In Practice: Subject Matter Expert Integration To Support Excellence In Population-Specific Documentation, Sara Pump, Mary Hawes, Lauren Spain, Virginia Kasenic, Meagan Talent, Alivia Stewart, Carrin Shaw, Chad Gautreaux, Dori Cousin, Ponesea Allen, Jonathan Rowe

2026

This poster describes a quality improvement initiative that integrated psychiatric resource nurses as subject matter experts (SMEs) into clinical documentation workflows to improve documentation compliance for high-risk behavioral health patients. The intervention resulted in substantial improvements in charting accuracy and compliance, including an increase in emergency department documentation compliance from 28% to 95% over seven months, while enhancing staff education, collaboration, and patient safety.

Responding To Social Isolation: The Tole Of Chaplaincy In Addressing Social Determinants Of Health (Sdoh) In Pediatric Contexts, Adam Lubbers, Forest Melton, Simbarashe Sigauke, Sophie Le

2026

This poster describes a pilot program that integrated chaplaincy services into the care pathway for pediatric patients and families who screened positive for low social support, a key social determinant of health. The findings suggest chaplain-led interventions provide effective emotional, spiritual, and practical support, helping address social isolation, caregiver burden, financial insecurity, and other health equity concerns while offering culturally responsive care.

No One Left Behind: Identification Of Healthcare Needs Through System-Wide Social Determinants Of Health Screenings, Rose Dela Cruz, Amanda Marquez, Madison Lemmons

2026

This poster describes a system-wide quality improvement initiative designed to increase completion rates of Social Determinants of Health (SDOH) screenings by addressing workflow barriers, educating staff, and implementing standardized processes across clinical teams. The project demonstrates how interdisciplinary collaboration, nursing engagement, and structured screening workflows can improve identification of social needs and connect pediatric patients and families with resources that support health equity and better health outcomes.

Improving Sdoh Screening Compliance In Pediatric Settings: Addressing Health Literacy In East Texas, Katie Bien, Shannon Blalock, Donna Procell

2026

This poster focuses on efforts to improve compliance with social determinants of health (SDOH) screening in pediatric healthcare settings, with a particular emphasis on addressing health literacy challenges in East Texas. The project examines how health literacy considerations may influence the effectiveness and consistency of SDOH screening practices among pediatric patient populations.

Scaling Up Health Literacy Practices Through A Champion Program, Cameron Stine, Kelli Williams, Diana Montoya, Leslie Moore, Carol Howe

2026

This poster describes the development and expansion of a Health Literacy Champion Program designed to improve the consistent use of health literacy best practices across a healthcare organization. The program successfully expanded from ambulatory nursing to 13 disciplines, using champion training, newsletters, clinical observations, and peer influence to promote plain language communication, information chunking, and teach-back techniques that support patient understanding and safety.

Nativity And English Language Use In Relation To Undiagnosed And Diagnosed Diabetes In U.S. Adults, Aliya Kuerban Phd, Fnp-Bc, Ms, Ma, Rn

Nursing: Faculty Presentations

Introduction and Objective: Diabetes detection varies across demographic and immigration-related groups. Foreign-born adults and individuals with limited English proficiency may be less likely to have diabetes identified, even when the disease is present. This study examined demographic, socioeconomic, and immigration-related correlates of undiagnosed and diagnosed diabetes among U.S. adults.

Methods: Data from the National Health and Nutrition Examination Survey (NHANES, 2011-2023) were analyzed using survey-weighted multinomial logistic regression. Diabetes status was categorized as no diabetes, undiagnosed diabetes, or diagnosed diabetes based on self-report and laboratory criteria. Models sequentially adjusted for age, sex, race/ethnicity, nativity, English language use, income, and education. …

Opioid Abuse: Community Education, Meggan N. Wolff-Jackson

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has persisted for over two decades and has become one of the leading causes of accidental deaths nationwide (Robert et al., 2022). The opioid crisis represents a widespread public health emergency that extends beyond individual and community boundaries, imposing burdens on both the national economy and the healthcare system (Kyei et al., 2024). Although the opioid epidemic is a global concern, it is particularly concerning in the target community located in the western part of North Carolina. This region has some of the highest rates of opioid overdoses within the state, with 118 …

Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …