Medicine and Health Sciences Commons^™

Increasing Referrals To The Lung Cancer Screening Program, Megan Randall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Lung cancer is the leading cause of cancer-related deaths worldwide and is frequently diagnosed at advanced stages when treatment options are limited. A Veterans Administration (VA) primary care clinic demonstrated lower referral rates to the lung cancer screening (LCS) program than a comparable VA clinic despite having a higher prevalence of tobacco users. Existing electronic health record reminders focused on smoking cessation and did not systematically assess eligibility for LCS, contributing to underutilization of the screening program.

Aim of the Project: The aim of this quality improvement project was to increase referrals to the LCS program by improving identification …

Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship In A Long-Term Acute Care Hospital, Lesley Moore

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The opioid crisis continues to negatively affect patient safety and healthcare outcomes across the United States. Long-term acute care hospitals (LTACHs) care for medically complex patients who often require prolonged pain management and are at increased risk for opioid-related adverse events. At the project site, a 32-bed LTACH, 72% of reviewed patient charts included an opioid prescription upon admission, exceeding recommended prescribing benchmarks and identifying a gap in opioid stewardship practices. The absence of a standardized opioid stewardship program (OSP) and opioid risk screening process increased the risk of opioid misuse, dependency, and adverse patient outcomes.

Aim of the …

Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Emergency department (ED) boarding increases overcrowding and delays care. A 200-bed acute care hospital in the southeastern United States has a median time from inpatient bed readiness to ED departure that exceeds its hospital benchmarks, resulting in prolonged boarding and delays. Hospital data showed a median bed-ready-to-departure time of 76 minutes, exceeding the target of less than 45 minutes. Workflow analysis identified delays in transport activation, communication, and accountability as major contributors to inefficiency.

Aim of the Project: ED throughput quality improvement project aimed to reduce the median time from when an inpatient bed is marked ready to …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Improving Timely Hospice Pain Reassessments Through A Quality Improvement Initiative, Brianna Strong-Mosley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a hospice care organization, a practice gap was observed in prompt pain reassessment with an onset or increase of pain, as mandated within a 48-hour timeframe by the Centers for Medicare and Medicaid Services (CMS). Baseline data showed that only 40% of eligible patients with a pain score of ≥ 6 received a documented pain reassessment within 48 hours. Overall patient satisfaction with hospice services was 45%.

Aim of the Project: The quality improvement project aimed to enhance pain management by increasing the percentage of eligible hospice patients with a documented pain score of ≥ 6 from a …

Enhancing Medication Timeliness Through Structured Handoff In A Mental Health Facility, Belinda Zinhu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Delayed medication administration in an adult inpatient mental health facility exceeded organizational benchmarks and posed risks to patient safety, treatment effectiveness, and continuity of care. Baseline electronic health record (EHR) audits showed that about 30% of scheduled medications were administered outside the organization's acceptable timeframe, and inconsistent nurse shift handoffs contributed to the delays.

Aim of the Project: The aim of the quality improvement project was to improve patient outcomes by implementing the I-PASS standardized handoff communication tool to reduce late medication administration from 30% to 15% within 12 weeks.

Review of the Evidence: Evidence supports structured handoff frameworks …

Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls with injury rates had increased for over two years at the project hospital until nurse leaders implemented a new fall-prevention intervention. Patient falls are the most common preventable adverse event in acute care hospitals, with approximately 700,000 to 1 million occurring annually in the United States. Before implementing the Fall Tailoring Interventions for Patient Safety (TIPS) toolkit, the hospital’s program lacked an evidence-based approach and a fall communication board to alert staff, patients, and families about the individual fall risk status, leaving a significant gap in patient-centered care.

Aim of the Project: The aim of the project was …

Implementing The Walking Impairment Questionnaire For Peripheral Artery Disease Screening And Referral, Lisa Doyle

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Peripheral artery disease (PAD) is a leading cause of cardiovascular morbidity, mortality, and lower extremity amputation. At a Level 1 veterans medical center, the absence of a standardized screening and referral process contributed to delayed identification of symptomatic PAD and underutilization of supervised exercise therapy (SET). Between August 2024 and July 2025, only four veterans completed SET despite a large high-risk population, demonstrating a significant gap in evidence-based recommendations and clinical practice.

Aim of the Project: The aim of this project was to improve patient outcomes by standardizing screening for symptomatic PAD using the Walking Impairment Questionnaire (WIQ) to …

Tailoring Interventions For Patient Safety Protocol: A Strategy To Prevent Inpatient Falls, Yashu Adhikari

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inpatient falls were a significant safety issue at the project site, substantially affecting patient outcomes and organizational resources. The identified gap was the lack of individualized, patient-centered fall-prevention strategies despite the presence of standard fall-prevention bundles. The baseline fall rate of 6.04 was 20% higher than the national benchmark of three to five falls per 1,000 patient days, indicating a clear need for improvement.

Aim of the Project: The quality improvement (QI) project aimed to improve patient safety by reducing inpatient falls through implementation of the AHRQ Fall Tailoring Interventions for Patient Safety (TIPS) protocol on a …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.

Staff Education To Improve Lithium Adherence In Bipolar I Disorder Through Staff Education, Queendroline Fundong Nkeh

Walden Dissertations and Doctoral Studies

No abstract provided.

Enhancing Care Coordination Between The Same Day Clinic (Sdc) And Primary Care Group (Pcg) By Facilitating Care Establishment With A Primary Care Provider (Pcp), Saba Zabarah

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this Quality Improvement (QI) project was to connect patients to a Primary Care Provider (PCP). The specific aim was to increase by 25% the percentage of patients without a PCP who established care with a PCP within 30 days of visiting the Same Day Clinic (SDC).

BACKGROUND

The SDC provides episodic care for acute illness, making it difficult to coordinate care for patients who do not have a PCP and require follow-up. The project was implemented in an outpatient clinic that is connected to a larger primary care group in Houston, Texas.

METHODOLOGY

The intervention included …

Climate Change Education For Environmental Sustainability In Health Professions Education: A Modified Delphi, Moses Mutua, Mirriam Kivuva

School of Nursing & Midwifery, East Africa

No abstract provided.

Correlation Between Overthinking And Procrastination Behavior Among Nurses, Mona Hassan Abdelaal

Nursing

ABSTRACT Context: A key challenge in understanding internalizing psychological disorders is identifying the cognitive processes that sustain distress and disrupt effective functioning. Recurrent, hard-to-interrupt thinking patterns may interfere with individuals’ ability to initiate and complete intended tasks. Concurrently, individuals may persistently delay necessary actions despite recognizing their negative consequences, indicating a breakdown between intention and behavior. This pattern of delay appears to be associated with seeking short term emotional relief, reduced consideration of future outcomes, and avoidance of prolonged effort. While these issues have been studied independently, their overlapping mechanisms require further investigation. The potential role of repetitive cognitive processes …

School Of Nursing Newsletter Summer 2026, Southern Adventist University

Southern Nursing - School of Nursing Newsletter

The Summer 2026 issue of the newsletter features information on the Hamilton County Homeland Security emergency preparedness event held in April, an update on the Nursing Simulation Center, the spring RHO IOTA induction ceremony, and mission trip experiences.

Nursing Students' Evaluation Of Primary Health Care Clinical Placements - A Cross-Sectional Study, Debbie Procter, Megan Lee, Debbie Massey, Kylie Mccullough, Karen Strickland

Research outputs 2022 to 2026

Aim: Evaluate quality and satisfaction of nursing students' Primary Health Care clinical placements. Background: There is growing recognition of the need to expand the Primary Health Care nursing workforce, with positive clinical placement experiences considered essential for preparing and inspiring future careers in these settings; however, few graduate nurses choose this career path. Design: A cross-sectional study design using purposive sampling. Participants: Data were sourced from National Placement Evaluation Centre's 2023/2024 dataset using the validated PET–Nursing survey. The tool includes 20 items across two subscales - Clinical Environment and Learning Support, with the final item assessing overall placement satisfaction. Surveys …

The Impact Of Hypertensive Disorders Of Pregnancy On Cognitive Outcomes In Offspring: Systematic Review And Meta-Analysis, Berihun Dachew, Tusa, Getinet Ayano, Kim Betts, Amanuel Gebremedhin, Daniel Rudaizky, Gizachew A. Tessema, Rosa Alati

Research outputs 2022 to 2026

Purpose To synthesis the available research on the association between hypertensive disorders during pregnancy (HDP) and adverse cognitive outcomes in children. Methods PubMed, MEDLINE, Embase, Scopus, CINAHL, and PsycInfo were searched from inception to February 2026 to identify relevant studies. Effect estimates and 95% confidence intervals (CIs) were extracted and pooled using inverse variance–weighted random-effects meta-analysis. Results Thirty-nine observational studies published between 1982 and 2026, covering over 12.5 million mother-offspring pairs, were included in the final analysis. The findings indicate that HDP were associated with a 39% increased risk of Intellectual Disability (ID) (OR = 1.39, 95% CI = 1.30–1.47) …

Digital Teaching In Midwifery Education Since 2021: A Literature Review Of Trends, Technological Advancements And Challenges, Michelle Gray, Kristina Vogel, Annette Bernloehr, Terri Downer, Melanie Welfare, Nicola H. Bauer

Research outputs 2022 to 2026

Aim: To produce an updated synthesis of digital learning and teaching approaches in midwifery education since 2021. Background: Globally, there is an increasing trend towards using digital technologies in midwifery education with little examination of trends, terminology or impact by midwifery academics. Design: A comprehensive literature review. Methods: Ten databases were searched (2021–March 2025) guided by JBI methodology and PRISMA-ScR reporting, resulting in 36 empirical studies focusing on digital technologies used with midwifery students. The review mapped recent technological developments, associated benefits and emerging challenges. Results: Digital innovations were in 15 countries and ranged from immersive virtual reality, augmented and …

Detection And Evaluation Of Biofilm-Producing Clinical Bacterial Isolates By Tcp Method In Karbala-Iraq, Huda Ali Salman Almosawey

Al-Esraa University College Journal for Medical Sciences

Background: A biofilm is a complicated, three-dimensional microbial community that forms at an interface and interacts with its surroundings. To detect the ability of bacteria to form biofilms, the Tissue Culture Plate Method (TCP) is one of the most widely accurate methods and is frequently used with clinical isolates. Objective: This study aims to determine the ability of clinical bacterial isolates to form biofilms using the TCP method and to compare biofilm production between different types of bacteria; to study the relationship between biofilm formation and antibiotic resistance, which helps in understanding the reasons for the failure of some antibiotic …

Epigenetic Regulation Of Immune Responses In Autoimmune Diseases And Cancer: Mechanisms And Therapeutic Implications, Faisal H. Al-Amier, Ammar B. Al-Asadi, Aljuboori M. Nafea, Karar M. Jaleel

Al-Esraa University College Journal for Medical Sciences

Immune tolerance balances immune responses with self-tolerance, a balance that is directive by epigenetic pathways. These mechanisms responsible for gene expression regulation and immune cell activity, and include DNA methylation, histone modifications, and non-coding RNAs. Disruption of mechanisms involved in the autoimmune disorder pathophysiology like systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis through the induction of long term inflammation and breakdown of immune tolerance. In cancer, epigenetic changes allow immune evasion and establish an immunosuppressive tumor microenvironment. Epigenetic markers have been used for diagnosis and prognosis, and epigenetic treatments have the potential to rebalance the immune system and improve …

Socio-Demographic And Clinical Profile Of Diabetic Patients: A Cross-Sectional Study, Ali Kadhim Obyes, Suhair Mohammed Hassoon, Dhakam Mohammed Abbas

Al-Esraa University College Journal for Medical Sciences

Background: Diabetes mellitus is a growing global health crisis, disproportionately affecting low- and middle-income countries. In Iraq, prevalence is estimated at 12–15%, yet comprehensive local data on patient profiles remain scarce. Objectives: To describe the socio-demographic, clinical, nutritional, and laboratory profile of diabetic patients attending a tertiary hospital in Babylon, Iraq. Patients and Methods: A hospital-based cross-sectional study was conducted among 200 adult diabetic patients (type 1 or type 2) admitted to the endocrinology unit of Marjan Teaching Hospital from December 2025 to May 2026. Data were collected via face-to-face interviews, medical records, and laboratory reports. Descriptive statistics (frequencies, percentages, …

Predictors Of Culture-Positive Urinary Tract Infections And Antibiotic Resistance Among Pregnant Females In Al-Hilla City: A Cross-Sectional Study, Zainab Salim Husein, Ishraq Ahmed Chiad, Zeena Jamal Alkhazraji

Al-Esraa University College Journal for Medical Sciences

Background: Urinary tract infection (UTI) is a frequent health problem in women. Patients often present with significant pyuria, and sometimes with no bacterial growth. Objective: The purpose of this study was to investigate the correlations between demographic, clinical, and behavioral factors and urine culture findings and to analyze the antibiotic sensitivity patterns of the isolated uropathogens. Methods: A cross-sectional study was done among pregnant women presenting with elevated pus cells (> 20 cells/HPF). Data on demographic characteristics, pregnancy complications, and hygiene habits were analyzed. Urine culture and comparative antibiotic sensitivity tests were performed for the isolated pathogens (Escherichia coli …

Cleft Lip And Palate: From Genetic Foundations To Psychological Impact – A Multidisciplinary Review, Farah Abdulwahab Al-Saadi, Teeba Fares Hadi, Sura Saleem Albermani

Al-Esraa University College Journal for Medical Sciences

Cleft lip and/or cleft palate consider one of the most known and common congenital disorders of the head causing clear disruption of the normal face structure. Despite being the most seen birth defects, the clefts genetic basis is still not fully comprehended. Clefts have sporadic genetic nature, it can occur duo to rare mutations as part of syndromic disease or it can be isolated, non-syndromic cleft. The contemporary advances in genomic technology have enabled a deeper comprehension of the complex architecture of cleft lip/palate, of these technologies are genome-wide association studies, whole genome sequencing, transcriptome-wide association studies and others. Furthermore, …