Medicine and Health Sciences Commons^™

Dexmedetomidine As An Adjuvant In Intrathecal Anesthesia Vs. Opioids - Evaluating Adverse Events: A Scoping Review, Autumn Holloman Bsn, Rn, Paige Blackstock Bsn, Rn, Rasmia Ibrahim Bsn, Rn, Chase Logan Bsn, Rn, Hunter Turner Bsn, Rn, Dwayna Accardo Dnp. Crna, Faana, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background 

Spinal anesthesia is widely used in surgical practice because it provides effective anesthesia and analgesia while reducing the need for intravenous anesthesia. Opioids are commonly used as intrathecal adjuvants; however, their use is associated with adverse effects such as pruritus, postoperative nausea and vomiting (PONV), urinary retention, and respiratory depression. Dexmedetomidine, a selective α2-adrenergic agonist, has gained attention as an alternative to opioids due to its sedative and analgesic properties without the opioid side effect profile. This scoping review evaluates current evidence comparing intrathecal Dexmedetomidine and opioids as adjuvants to spinal anesthesia in adult surgical patients.

Methods

A scoping …

Mortality Risk Comparison Of Doacs And Warfarin In Geriatric Adults With Dementia And Atrial Fibrillation, Laraya Gunter Bsn, Rn, Mariah Cloud Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Atrial fibrillation and dementia frequently coexist in older adults, creating complex challenges for anticoagulation management. Although anticoagulation is recommended to reduce thromboembolic risk in atrial fibrillation, current clinical guidelines lack dementia specific recommendations. Resulting in uncertainty regarding optimal therapy in this population. The purpose of this scoping review was to examine and synthesize current evidence comparing mortality risk and adverse events associated with direct oral anticoagulants (DOACs) versus warfarin in adults age 65 and older with atrial fibrillation and dementia.

Methods

A scoping review was conducted using PRISMA-ScR methodology. Peer-reviewed articles published between 2019 and 2023 were identified through …

Optimizing Glycemic Control In Type Ii Diabetes: Continuous Glucose Monitoring : A Scoping Review, Sarah Poe, Bsn, Rn, Bailey Li, Bsn, Rn, Tracy Mcclinton, Dnp, Aprn, Ag-Acnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Individuals with Type II diabetes mellitus (T2DM) experience increased risk of cardiovascular disease and higher mortality rates relative to non-diabetic populations. Continuous glucose monitoring (CGM) enables more precise analysis of glucose patterns and trends compared to conventional self-monitoring of blood glucose (SMBG). CGM provides frequent measurements and generate meaningful metrics, such as time in range (TIR), time above range (TAR), and time below range (TBR), allowing evaluation of glucose stability and variability. Despite these advantages, evidence comparing CGM and SMBG remains inconsistent. This scoping review aims to evaluate how CGM compares with SMBG across reported outcomes, including TIR, TAR, …

Evaluating The Screening And Referral Process For The Use Of Phq-9 Screening Tool In Middle-School Aged Students: A Scoping Review, Kaythi Soe, Msn, Pmhnp-Bc, Fnp-Bc, Margaret Harvey Phd, Acnp-Bc, Fhrs, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

No abstract provided.

Home-Based Vs Clinic-Based Stool Testing For Detecting Early Cancer Markers: A Scoping Review, S. Elizabeth Brock, Jacqueline Giles, Sydney James, Cha'landria Mccall, Bobby Bellflower Dnsc, Nnp-Bc-Faanp, Fnap, Faan

Doctor of Nursing Practice Projects

Purpose/Background 

Colorectal cancer (CRC) remains a significant public health concern in the United States, with screening rates below national targets due to persistent socioeconomic and structural barriers, particularly among underserved populations. Stool-based screening modalities offer accessible alternatives to colonoscopy, and emerging evidence suggests that home-based delivery models may improve screening uptake; however, implementation strategies vary and comparisons between home-based and clinic-based approaches remain limited. This scoping review examines current evidence on strategies that support CRC screening uptake, with a focus on stool-based modalities, including fecal immunochemical testing (FIT), fecal occult blood testing (FOBT), and multitarget stool DNA testing (mDNA), and …

How Does Cognitive Behavioral Therapy (Cbt) And Antipsychotics Compare To Antipsychotics Alone Impact Inpatient Length Of Stay: A Scoping Review, Morgan E. Johnson, Hailey M. Wade, Y'Esha V. Williams-Click, Rocquell Duncan, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Background

Psychosis in adults is a serious psychiatric condition that often necessitates inpatient hospitalization for stabilization and the initiation of medication. Untreated psychosis can lead to poor outcomes, including longer hospital stays, loss of occupational functioning, and a decreased quality of life. While antipsychotic medications are typically the first line of treatment, they can have severe side effects, which may lead to patients discontinuing their use. Cognitive Behavioral Therapy (CBT) for psychosis is an evidence-based intervention that targets maladaptive behaviors associated with the condition. CBT may improve treatment responses when used alongside antipsychotic medication. However, there is limited research on …

Impact Of Provider Confidence And Psychiatric Referrals Through Education And Implementation Of The Gad-7 Anxiety Screening Tool In An Outpatient Family Clinic, Maceline E. Check

Doctor of Nursing Practice Projects

Gaps in provider and nurse confidence in identifying and managing anxiety disorders in outpatient family clinic settings contribute to underdiagnosis, delayed intervention, and reduced psychiatric referrals. This quality improvement project evaluated the impact of provider education and implementation of the Generalized Anxiety Disorder-7 (GAD-7) screening tool on provider and nurse confidence and appropriate psychiatric referral rates, with the goal of improving clinical decision-making and standardizing anxiety screening practices. The project was guided by Lewin’s Change Theory and the Iowa Model of Evidence-Based Practice. Using a quasi-experimental pre- and post-intervention design, providers and nurses in an outpatient family clinic received structured, …

Moving Toward Standardization Of Breast Cancer Screening: A Scoping Review Comparing Uspstf And Acs Recommendations For Women Aged 40–74, Gerita F. Perry, Krystal D. Hester-Smith, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose 

To compare U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) breast cancer screening guidelines for women aged 40–74, and to recommend adopting one consistent, standardized guideline in practice. Standardization can improve care continuity, patient adherence, reduce anxiety, support early detection, and lower mortality.

Background 

Breast cancer is the second leading cause of cancer-related death amongst women. The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. The ACS recommends an annual mammogram. Differences between the two organizations for screening emphasize the need for a common alignment to reduce breast cancer mortality. As breast …

Staff Educational Impact On School-Based Mental Health Services: A Scoping Review, Daniel J. Kim, Di'yana Fisher, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

            Trends are consistently increasing among adolescents in regard to mental health diagnoses and suicide risks, which emphasizes the necessity for early identification via school-based psychiatric screenings. The Patient Health Questionnaire-9 (PHQ-9) has proven effective in uncovering symptoms of depression; variable application and limited staff knowledge continue to be substantial hurdles. This scoping review examined the influence of staff education and training on the efficacy of school-based psychiatric screening.

Methods

            PubMed, CINAHL, Medline, Elsevier, Google Scholar, and JAMA were utilized to conduct this scoping review. Peer-reviewed studies published between 2020 and 2025 were included if they involved adolescents aged 13-18, …

Quality Improvement Project: Evaluating The Effectiveness Of Chlorhexidine Gluconate Bathing Education On Staff Perceived Knowledge, Kaonta Spencer

Doctor of Nursing Practice Projects

A community hospital set strategic goals to achieve Vizient top-decile performance and drive continuous improvement by reducing surgical site infection (SSI) rates. The purpose of this quality improvement project was to support this goal by implementing an evidence-based educational intervention to improve nurses' perceived knowledge and self-reported ability with the chlorhexidine gluconate (CHG) bathing protocol for hysterectomy patients. Guided by Lewin's Change Theory, the Iowa Model Revised, and the Iowa Implementation Framework, the educational intervention applied a structured approach to address behavioral and organizational barriers contributing to protocol noncompliance. A quantitative, quasi-experimental pre- and post-intervention design was used to evaluate …

Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

Implementation Of A Nurse-Led Discharge Protocol To Impact Nurse Confidence And Optimize Transitional Care Management, Jessi-Ann Elrod

Doctor of Nursing Practice Projects

Heart failure (HF) remains a leading cause of hospitalization and readmission, with the transition from hospital to home representing a vulnerable period for patients. Variability in discharge education and follow-up scheduling contributes to poor self-management and adverse outcomes. This quality improvement (QI) project evaluated whether implementing a standardized nurse-led HF discharge protocol impacted nurses' confidence and the rate of 7–14-day transitional care management (TCM) follow-up appointments. Guided by Meleis’ Transitions Theory and Lewin’s Change Theory, a one–group pretest–posttest QI design was implemented on a cardiac step-down unit. Twelve discharge nurses participated. The intervention included a structured education session and the …

Quality Improvement Project Reducing Attrition Rates In Nursing Students: Evaluating The Enhanced Student Success Program, Jason Grigg

Doctor of Nursing Practice Projects

The high attrition rate in the Associate of Applied Science in Nursing (AASN) program created an opportunity to develop the enhanced Student Success Program (eSSP). This is a faculty-based quality improvement project designed to increase support for students at risk of withdrawal from the AASN program. The aim of eSSP is to reduce attrition rates, however, this project evaluated only short-term changes in faculty confidence. Using Lewin's Change Model and the Theory of Planned Behavior as a guide, this QI implemented a one-group pre-post experimental design to determine whether a short eSSP training program, combined with a 5-week implementation period, …

Quality Improvement Project : Educating Critical Care Nurses On Braden Scale And Sskin Care Bundle To Impact Pressure Injuries, Andrea Garrett

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) increase patients' risk of infection, prolonged hospitalization, death, and healthcare costs. The Agency for Health Research and Quality (AHRQ) has shown that implementing a standardized skin assessment process and a care bundle helps prevent skin injuries. A critical care unit (CCU) at an acute care 339-bed hospital in Southaven, MS, has seen an increase in HAPIs. This quality improvement project aimed to educate CCU nurses about the Braden Scale and the SSKIN care bundle to impact pressure injuries in the CCU within 8 weeks. Education on the Braden Scale and the Skin, Sensory, Keep Moving, Incontinence, …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Quality Improvement Project: Faculty Development For Understanding And Utilization Of Exam Data, Deanne Hutchens

Doctor of Nursing Practice Projects

This quality improvement project focused on inconsistent use and understanding of exam data among Associate Degree in Nursing (ADN) faculty, which can influence teaching decisions and student success. Many nursing faculty enter education with strong clinical backgrounds but limited experience working with exam statistics such as item difficulty, discrimination values, and Kuder-Richardson 20 (KR-20) reliability. Without a consistent approach, exam results may not be fully used to guide remediation or adjust instruction. This Doctor of Nursing Practice (DNP) project examined whether a structured faculty development session could improve faculty confidence and ability to interpret and apply exam data. A pre- …

Quality Improvement Project: Evaluating The Impact Of Provider Education On Sbirt On Screening For Suds, Faith Ogala

Doctor of Nursing Practice Projects

Substance use disorder (SUD) is a serious public health issue in people with psychiatric disorders. However, diagnosis and treatment are often delayed, leading to poor treatment outcomes and increased social and economic costs. The purpose and aim of this Doctor of Nursing Practice (DNP) project was to educate providers on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model to facilitate the timely diagnosis of SUDs in patients with dual diagnoses. The key outcomes were provider knowledge and SBIRT implementation rates. The Donabedian Model of Healthcare Quality assessed the outcomes, whereas Lewin’s Change Model guided implementation. The project employed …

Establishing A Standardized Suicide Risk Screening Policy For Psychiatric Providers: Closing Gaps In Provider Accountability And Clinical Documentation, Fadekemi Olude

Doctor of Nursing Practice Projects

Psychiatric providers in outpatient settings often experience inconsistent confidence and incomplete documentation when conducting suicide risk screening, contributing to missed opportunities for early identification of at-risk patients. This quality improvement project addressed the need for standardized suicide risk screening at an urban outpatient psychiatric clinic. The purpose was to evaluate documentation using the Columbia-Suicide Severity Rating Scale (C-SSRS). Using a pre-post intervention design guided by Lewin's Change Theory and the Donabedian Model of Quality Improvement, a 60-minute training session was delivered to 31 psychiatric providers. Participants completed pre- and post-intervention General Self-Efficacy Scale (GSES) surveys. Chart audits (N = 1,970) …

Quality Improvement Project Ai-Powered Conversations: Enhancing Nursing Students’ Interview Skills, Judy K. Staley

Doctor of Nursing Practice Projects

Professional communication is an essential skill for nursing students, particularly in job interviews. Deficits in professional communication can negatively impact future employment and accreditation outcomes. Current practices in faculty-led mock interviews can be limited by time constraints and the need for consistent feedback, underscoring the need for a more consistent and effective method supported by current evidence-based literature. The purpose of this quality improvement project is to evaluate whether integrating AI-assisted mock interviews into faculty-led practices influences faculty perceptions of student preparedness. Guided by Kotter’s Change Model and supported by the constructivist framework, the project aimed to enhance the effectiveness …

New Nurse Faculty Mentorship: A Quality Improvement Project, Kimberly B. Porter

Doctor of Nursing Practice Projects

The ongoing nursing faculty shortage limits program capacity and makes it harder to retain novice nurse educators transitioning from clinical practice to academia. The literature highlights issues such as insufficient mentorship, role confusion, and a lack of structured support as key factors contributing to early faculty attrition. This quality improvement (QI) project aimed to implement and evaluate an evidence-based mentorship program to improve perceptions of mentorship effectiveness among new-to-academia nurse faculty in a School of Nursing in Arkansas. The purpose was to implement and evaluate a mentorship program designed to improve perceptions of mentorship among new-to-academia nurse faculty. The project …

Quality Improvement Project: Impacting Staff Confidence In Recognizing Hiv Medication Adherence, Joy Nwansi-Iro

Doctor of Nursing Practice Projects

Medication adherence to antiretroviral therapy is essential for viral suppression and improved outcomes among individuals living with human immunodeficiency virus (HIV). Despite advances in treatment, healthcare providers lack confidence in recognizing medication adherence challenges and implementing appropriate interventions. Evidence suggests that provider education using standardized adherence assessment tools improves adherence monitoring and clinical decision-making. The purpose of this quality improvement project is to evaluate whether an educational intervention and a standardized workflow using the CASE Adherence Index would impact healthcare staff confidence in recognizing HIV medication adherence. Lewin’s Change Theory guided the project through the stages of unfreezing, change, and …

Quality Improvement Project: Enhancing Staff Delivery Of Non-Pharmacological Interventions In Serious Mental Illness Care, Kimberly Vann

Doctor of Nursing Practice Projects

Serious mental illness places a significant burden on global healthcare systems, increasing hospital utilization and critically impairing patients' functional status. Often crippling, these illnesses are mostly treated with medication therapy despite proven research to show effective outcomes with holistic and non-pharmacological therapies. Non-pharmacological interventions (NPIs) are often underutilized in outpatient mental health settings. The purpose of this quality improvement project was to determine whether structured training impacted staff confidence in delivering NPIs and impacted documentation frequency in the electronic health record (EHR). The project was guided by the Iowa Model of Evidence-Based Practice and implemented using the Plan-Do-Study-Act (PDSA) cycle, …

Quality Improvement Project Bridging The Gap In Scholarly Productivity: An Educational Workshop For Tenure-Track Nursing Faculty, Britney Thorne

Doctor of Nursing Practice Projects

Tenure-track nursing faculty often balance teaching, service, and scholarship responsibilities, which can be overwhelming when promotion and tenure expectations are unclear or insufficiently supported. At a historically Black university, a school of nursing identified gaps in scholarly productivity and limited guidance for early-career faculty, highlighting the need for structured support. Guided by Knowles’ Adult Learning Theory and Lewin’s Change Theory, this Doctor of Nursing Practice (DNP) quality improvement project examined whether structured faculty development workshops could improve faculty knowledge of scholarly productivity, engagement in scholarly activities, and perceptions of tenure and promotion expectations. A quasi-experimental pre-post design was implemented over …

Quality Improvement Project: Integrating Depression Screening Into Adult Wellness Visits In A Primary Care Clinic, Nina Denchukwu

Doctor of Nursing Practice Projects

Depression is a prevalent and debilitating mental health condition that remains significantly underdiagnosed in primary care, despite national recommendations for universal adult screening. At the project site, less than 40% of adults completing annual wellness visits had documented depression screening. The purpose of this quality improvement project was to evaluate whether integrating the evidence-based Patient Health Questionnaire (PHQ)-2 and PHQ-9 into the electronic health record (EHR) would improve completion of depression screening, documentation, and referrals to treatment. The project was guided by Rogers' Diffusion of Innovations Theory and the Plan-Do-Study-Act (PDSA) framework. A quantitative pre–post intervention design linked with the …

Quality Improvement Project: Impact Of Faculty Competency And Classroom Application Of Artificial Intelligence (Ai), Clydea Hale

Doctor of Nursing Practice Projects

The rapid integration of artificial intelligence (AI) in healthcare has created a growing need for nursing faculty to develop competency in AI to adequately prepare students for modern clinical practice. Despite this need, limited faculty knowledge and low classroom application of AI persist. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of an evidence-based AI educational intervention on nursing faculty competency and classroom application. Guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory, a quasi-experimental pretest-posttest design was implemented with nursing faculty at a rural community college in …

Promoting Trauma-Informed Practices Through Staff Education, Ediomi Enebong Oduwole

Doctor of Nursing Practice Projects

Front office staff in outpatient psychiatric settings are often the first point of contact for patients experiencing anxiety and emotional distress. However, existing evidence indicates that non-clinical, front office staff often lack formal training in trauma-informed care (TIC). This gap may limit early recognition and response to patient distress. This quality improvement project addressed this gap by evaluating the impact of a trauma-informed educational intervention of staff confidence and documentation of patient distress. The project was guided by Pender’s Health Promotion Model and Lewin’s Change Theory. It used a pre-and post-intervention quantitative design with sample of five front office staff …

Quality Improvement Project: Improving Adn Faculty Professional Development Through Simulation Training, Sharon Haley Peace

Doctor of Nursing Practice Projects

Lack of structured simulation training for nursing faculty, which has been identified as a gap in the literature, can negatively impact the quality of simulation-based education and student learning outcomes. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to develop, implement, and evaluate an evidence-based training intervention aimed at improving faculty self-efficacy and competence in simulation facilitation. The project was guided by Lewin’s Change Theory and Kolb’s Experiential Learning Theory to support faculty development. A quantitative, quasi-experimental pre-post design was used with a convenience sample of nine associate degree nursing faculty at a rural community …

Quality Improvement Project: Improving Provider Workflow And Documentation For Routine Mental Health Screening In An Outpatient Psychiatric Clinic, Sharon Uchechi Joshua

Doctor of Nursing Practice Projects

Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change …

Embedding Social Determinants Of Health Into Maternal Simulation Scenarios: Enhancing Nursing Staff Awareness Of Equity-Based Education, Sherina Evans

Doctor of Nursing Practice Projects

Despite growing evidence emphasizing the importance in addressing disparities in maternal health outcomes, maternal health simulations often lack integration of social determinants of health (SDOH) and cultural considerations. The purpose of this Doctor of Nursing Practice quality improvement project was to enhance nursing faculty cultural awareness through simulation scenarios that incorporate SDOH and culturally responsive elements. This project was guided by Lewin’s Change Theory and the Jeffries Simulation Framework. The aim was to strengthen faculty awareness and skills to support the development of culturally inclusive simulation experiences. Descriptive statistics were utilized to analyze results which was a limitation. Nursing faculty …

Improving Monitoring And Documentation Of Long-Acting Injectable Antipsychotic Adherence In Patients With Schizophrenia Through Staff Education And Refill History Review, Stacy Ann Bruce

Doctor of Nursing Practice Projects

Schizophrenia is a chronic psychiatric disorder associated with relapse, hospitalization, and poor outcomes when medication adherence is suboptimal. Nonadherence increases morbidity and healthcare utilization (World Health Organization, 2022; Zhao et al., 2025). Long-acting injectable (LAI) antipsychotics improve adherence and reduce hospitalization, but inconsistent monitoring and documentation in outpatient settings hinder early identification of missed doses (Lieslehto et al., 2022). This Doctor of Nursing Practice (DNP) quality improvement project aimed to evaluate whether staff education and structured refill-monitoring processes improve identification and documentation of nonadherence to LAI antipsychotics. Using Kotter’s Change Management Model and the Plan-Do-Study-Act framework, the project focused on …