Medicine and Health Sciences Commons^™

Effect Of Standardized Phone Call Protocol On The Achievement Of Target Hba1c Levels, Felicia Choyce

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Type 2 Diabetes Mellitus is a common chronic illness with far-reaching health and financial consequences. At the project’s primary care clinic, the average hemoglobin A1c among adults with Type 2 Diabetes Mellitus was 9.6%, exceeding the recommended clinical goal of less than 7% (American Diabetes Association, 2023). The absence of a standardized follow-up protocol and inconsistent use of health literacy-based communication contributed to persistent hyperglycemia and failure to reach target HbA1c levels. These factors indicated an urgent need for an evidence-based intervention.

Aim of the Project:
The aim of this project was to reduce HbA1c levels among adults with …

The Answer To Perimenstrual Distress Is Not Automatically Prescription: Review Of Allopathic And Integrative Approaches To Mental Health Care For Pms & Pmdd Symptoms, Grace Oja

University Honors Theses

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) affect a notable percentage of people who menstruate. PMS/PMDD have a wide range of symptoms that negatively impact mental well-being and quality of life. This review is the culmination of a database search to review current allopathic treatments for PMS/PMDD, which often include oral contraceptives and antidepressants, and explore evidence-based methods for integrative and alternative treatments to address some of the limitations of standard allopathic care, including limitations on which symptoms they address and side effects. This paper aims to examine how integrative medicine may expand existing treatments for PMS and PMDD …

Characterization Of Lactobacilli-Containing Catheter Segments Developed By Using Selective Laser Sintered Mold., Caden Maners

Master of Engineering Theses

Catheter-associated urinary tract infections (CAUTIs) are a major healthcare burden with current prevention strategies offering limited success. This study presents a novel, self-coating biomaterial approach using a silicone-based bioink embedded with thermally sensitive probiotic strains (L. crispatus, L. rhamnosus, and L. reuteri). Catheter segments were fabricated via bio-injection molding using 3D-printed CAD molds. These Lactobacilli, selected for their probiotic and antimicrobial potential, serve as a non- antibiotic strategy to reduce infection risk. These segments were evaluated for mechanical strength (Shore A hardness), thermal stability (TGA/DSC), porosity and bacterial presence (SEM), biofilm formation (crystal-violet assay), as well as mass retention in …

Spatially Resolved Transcriptomic Profiles Of Placental Cell Populations In Placental Malaria, Corina A. Mong

Undergraduate Honors Theses

Malaria remains a prevalent infectious disease that continues to cause disease-related morbidity and mortality. Despite preventative efforts, malarial pregnancies still cause birth complications, therefore emphasizing the necessity to study these adverse outcomes in malarial pregnancy. Malaria in pregnancy can lead to placental malaria (PM), which is the presence and accumulation of Plasmodium-infected red blood cells in the placental intervillous space (IVS). Even after treatment, past PM (presence of hemozoin crystals from the parasite in the placenta) can cause a chronic inflammatory response. We predicted that the activation states of the maternal monocytes and fetal macrophages differ within the placenta and …

Effects Of Stressor Exposure And Locus Coeruleus Opioid Signaling On Coping And Anxiety-Like Behavior In Rats, John Arthur Tkaczynski

Theses and Dissertations

Stress is a physiological state of altered neuroendocrine signaling and heightened indices of behavioral vigilance and arousal in response to threatening stimuli. This project aimed to investigate the adaptations to stress that occur in the noradrenergic locus coeruleus (LC) and how these changes affect stress coping behavior. We began by investigating how adolescent restraint and predator odor stress affects coping when presented with a secondary noxious stimulus in the defensive shock probe burying task one week following stressor exposure, finding that stressed male rats demonstrate a more active coping response and stressed female rats demonstrate a more passive coping response, …

Cddo-Me Attenuates Fibroblast And Macrophage Activation In Limited Cutaneous Systemic Sclerosis, Heetaek Yang, Emily A. Morris, Chen-Yu Wang, Nicole M. Orzechowski, Michael Whitfield, Patricia Pioli

Dartmouth College Master’s Theses

Abstract

Systemic Sclerosis (SSc) is a rare autoimmune disease characterized by multiple-organ involvement and notably by fibrosis. Current therapies for SSc focus on symptom managements and treating specific organ related complications. However, heterogeneous nature of the disease further complicates treatment responses and hinders the development of new therapies. Therefore, there is a critical unmet need for the development of patient-specific therapeutics.

The objectives of this thesis were: (1) to evaluate the therapeutic potential of Bardoxolone Methyl (CDDO-Me) in both SSc fibroblasts and SSc macrophages. To achieve these goals, I utilized both wet-lab analysis tools and computational analysis.

As part of …

Staff Education On Evidence-Based Interventions To Reduce Fall Rates Among Hospitalized Adult Psychiatric Patients, Blessing Rita Ugbor

Walden Dissertations and Doctoral Studies

A staff education initiative was implemented in an inpatient psychiatric facility in the Southern United States to address the significant practice problem: inadequate knowledge of fall prevention strategies among psychiatric nurses. The identified knowledge gap impairs the nurses’ ability to recognize fall risk factors and apply evidence-based interventions. Psychiatric inpatients are particularly vulnerable to falls, which compromise patient safety, increase health care costs, and contribute to poor outcomes. The project was guided by a practice-focused question addressing whether staff education on evidence-based fall prevention strategies would enhance nurses’ knowledge and reduce fall rates. The purpose of the project was to …

Engineering Cxcr2-Ligand-Based Fusion Proteins To Modulate Myeloid Cell Trafficking In Pancreatic Cancer, Benjamin N. Christopher

MUSC Theses and Dissertations

Pancreatic ductal adenocarcinoma (PDAC) has one of the lowest 5-year survival rates of all cancers, and limited treatment options exist. Immunotherapy is effective in some cancer types, but the immunosuppressive tumor microenvironment (TME) of PDAC is a barrier to effective immunotherapy. CXCR2+ myeloid-derived suppressor cells (MDSCs) are abundant in PDAC tumors in humans and in mouse models. MDSCs suppress effector cell function, making them attractive targets for restoring anti-tumor immunity. The studies outlined in this dissertation (1) link tumor-intrinsic oncogenic signaling to dysregulated myeloid activity in PDAC, (2) describe a rationally designed fusion protein and potent inhibitor of CXCR2+ myeloid …

Chemical And Physical Characterization Of Verbenaceae Essential Oils Using Modern Analytical Methods And Chemometrics, Aleksandra N. Hilliard

Master's Theses

Essential oils have been used for generations to treat various health issues, including mitigating insomnia, reducing stress, inflammation, and preserving foods, to mention a few. Essential oils have complex chemistry, which defines the essence of the host plant. Recently, increased commercial uses of essential oils have prompted attention at the governmental level to monitor the chemical, physical, or biological activity of essential oils. This study is an attempt to add new information for consumers to the understanding of the composition of essential oils.

Modern analytical techniques including FTIR-ATR, GC-MS, LC-MS-MS, multivariate analysis statistics, and physio-chemical techniques (electrochemistry, DPPH, TRC, and …

Cultural And Structural Barriers Influencing The Mental-Health-Seeking Behaviors Of South Asians In Dallas, Texas, Judith Jose

Walden Dissertations and Doctoral Studies

Despite being one of the fastest growing immigrant populations in the United States, South Asians experience disproportionately high rates of untreated mental health conditions while reporting low utilization of professional mental health services. This qualitative phenomenological study explored the cultural and structural barriers that influence mental-health-seeking behaviors among South Asians residing in Dallas, Texas. Guided by the health belief model and principles of cultural competency, this research investigated how perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy intersect with cultural stigma, religious beliefs, generational dynamics, and systemic obstacles. Semistructured interviews with 12 South Asian adults revealed seven major …

Associations Between Daytime Sleepiness, Obesity, And Sleep Apnea Severity Among Caribbean Women, Melaine F. Mcleod

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea is the most common type of sleep-disordered breathing. Obstructive sleep apnea (OSA) is a global health epidemic that is associated with the obesity pandemic and daytime sleepiness. This quantitative cross-sectional descriptive study aimed to examine associations between daytime sleepiness measured by the Epworth Sleepiness Scale, obesity measured by body mass index (BMI), and severity of OSA measured by the apnea-hypopnea index among Caribbean women residing in the Cayman Islands. The health belief model served as the theoretical framework to guide this research. Daytime sleepiness and obesity were independent variables; the dependent variable was the severity of OSA, …

Provision Of Transportation To Psychiatric Follow-Up Appointments, Eliane Sandrine Tueche Fankam

Walden Dissertations and Doctoral Studies

This quality improvement initiative is focused on the lack of transportation as a significant barrier to obtaining health care services for patients with severe psychiatric disorders. Transportation issues remain an important factor that hinders the attainment of health care services by the members of this population. Transportation challenges should be addressed as much as possible for improving healthcare accessibility and providing timely care. Prior to the implementation of the transportation service, only 30% of patients with severe mental illness (SMI) attended their scheduled appointments, demonstrating the need for intervention. This project focused on whether providing transportation services would improve compliance …

Physical Activity And Functional Mobility In Adults With Hearing Loss: A Series Of Embedded Studies Within A 6-Month Clinical Trial With Hearing Aids, Sarah L. Bochat

USF Tampa Graduate Theses and Dissertations

Adults with hearing loss engage in low levels of physical activity and demonstrate poor performance on measures of functional mobility. The impact of hearing rehabilitation on these outcomes is not fully understood. Previous investigations were largely quantitative and focused on older adults ≥ 65 years of age who may respond differently to hearing intervention than relatively younger adults. They also tended to focus on exercise rather than global engagement in physical activities and did not report hours of hearing aid use, an important indicator of intervention success. One purpose of this dissertation was to determine the feasibility of collecting accelerometry-assessed …

Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was conducted to develop a clinical practice guideline (CPG) to address a gap at a southeastern hospital where frontline nurses often call rapid response teams for severe hypotension without a standard guideline for necessary interventions. Therefore, the practice gap identified at the project site was the lack of a CPG geared for rapid response nurses (RRNs) to use when responding to a call to intervene on a patient with hypotension. RRNs are nurses with advanced clinical training who provide immediate medical care to rapidly hemodynamically declining patients. The guiding question for this DNP …

Staff Education To Educate Healthcare Providers On Effective Communication And Support Strategies For Child Sexual Abuse Victims, Njideka Ajemba

Walden Dissertations and Doctoral Studies

With this project, I sought to enhance the quality of care provided to child sexual abuse (CSA) survivors by improving healthcare providers’ skills in trauma-informed communication and support strategies. The project was undertaken at a large, private behavioral health facility located in the mid-Atlantic region of the United States, where an assessment of the practice environment revealed a critical gap in provider training. This gap often resulted in missed indicators of abuse, limited emotional support, and poor therapeutic outcomes for children affected by sexual abuse-related trauma. To address this, the project implemented a targeted educational intervention grounded in current evidence …

Does Practice Make Perfect? Examining The Impact Of Text-Based Reminders On Adherence In The Helping Our Toddlers, Developing Our Children’S Skills Program, Lauren Patrusky

USF Tampa Graduate Theses and Dissertations

Disruptive behavior disorders (DBDs) are prevalent in approximately 17% of children ages birth to 5 years (CDC, 2023). DBDs can significantly impact a child’s learning, social-emotional wellbeing, and ability to develop and maintain healthy relationship (CDC, 2023). Behavioral parent training (BPT) has been proven effective in reducing disruptive behavior and improving parent-child relationships. However, many families do not fully engage in treatment, leading to poor outcomes for both the child and the family. Chacko (2016) describes BPT engagement as enrolling in treatment, attending weekly sessions, participating in group discussions or role plays in sessions, practicing skills between sessions, and completing …

Quality Improvement Project Reducing Pediatric Anesthesia In Magnetic Resonance Imaging: The Role Of Preparedness And Education, Rachel Turner

Doctor of Nursing Practice Projects

Pediatric hematology-oncology patients undergo general anesthesia (GA) for various medical procedures, including magnetic resonance imaging (MRI) scans. Overexposure to GA increases the potential for long-term neurocognitive effects in pediatric patients. Despite the growing research literature on GA-related neurotoxicity and the Food and Drug Administration's (FDA) warnings, advanced practice providers (APP) often lack the knowledge to advocate for and support reductions in pediatric GA use. The Doctor of Nurse Practice (DNP) quality improvement (QI) project aimed to reduce unnecessary GA in pediatric hematology-oncology patients undergoing MRI scans by addressing the primary clinic APPs' knowledge deficits through interprofessional education (IPE). Structured in …

Quality Improvement Project Impact Of Weekly Mentorship On Compassion Fatigue In Critical Care Nurses, Susan Livengood

Doctor of Nursing Practice Projects

Compassion fatigue is defined as the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period. Without proactive intervention, compassion fatigue will continue to affect healthcare workers, leading to dissatisfaction in the workplace. Mentorship is an intervention that has been identified for improving the incidence of compassion fatigue. This quality improvement project implemented and evaluated a mentorship program for critical care nurses in a 227-bed acute care facility that has a 36-bed intensive care unit. The project evaluated the impact of weekly mentoring sessions on compassion fatigue in critical …

Staff Education Project On Genetic Testing In A Psychiatric Facility, Chinenye Vivian Akpuaka

Walden Dissertations and Doctoral Studies

The project was an educational DNP project that aimed to improve staff knowledge on genetic testing. The practice focused question was “Will an education module on best practices for genetic testing increase self-reported knowledge among health care professionals in a mental health clinic?” The purposes of genetic testing in psychiatry are to improve pharmacological therapy through better prescription of the right medications (Pinzón-Espinosa et al., 2022). The implementation of genetic testing at the project site is limited due to gaps in knowledge and attitudes as well as efficacy of this intervention. The leaders at the practicum site supported the potential …

Quality Improvement Project Educating Family Of Patients Dealing With Substance Use Disorder, Emmanuella Edekobi

Doctor of Nursing Practice Projects

Substance Use Disorder (SUD) creates significant hardships for individuals and their families. Although families play a vital role in recovery, they may not know how to provide effective support. To address this, a Doctor of Nursing Practice (DNP) quality improvement project introduced a structured educational program for non-professional caregivers at an outpatient psychiatric clinic. The goal was to enhance caregivers' confidence and readiness to support their loved ones during recovery (Filiz & Polat, 2022). Participants completed the General Self-Efficacy Scale (GSE) before and after the intervention. Statistical analysis showed a significant improvement in confidence (t(9) = -26.00, p < .001, Cohen's d = 8.22), supported by the Wilcoxon Signed-Rank Test (z = -2.88, p = .004) (Rezaie et al., 2022). The project was grounded in Bandura’s Social Cognitive Theory, using observational learning, reinforcement, and real-life examples. Caregivers gained practical strategies, emotional support, and a clearer understanding of their role (Mardani et al., 2023). Initial uncertainty gave way to increased comfort through group support. These findings suggest that even low-cost, brief interventions can strengthen caregiver self-efficacy. Incorporating family education into addiction treatment may improve outcomes in outpatient mental health settings (Kellar & Kelvin, 2020).

Quality Improvement Project Improving Nurse Self-Efficacy In Completing Person-Centered Care Plans, Divya Iype

Doctor of Nursing Practice Projects

Person-centered care planning (PCCP) is a cornerstone of psychiatric nursing practice, yet many nurses lack the training and confidence to implement it effectively. This quality improvement project addressed a practice gap in nurse self-efficacy regarding PCCP completion at an acute psychiatric hospital. A care plan completion rate of 88%, below the institutional benchmark of 100%, prompted an intervention. This project’s purpose was to enhance nurse self-efficacy in implementing PCCP by providing focused training on trauma-informed care, cultural competence, and person-centered care planning. The project used a pre-post intervention design to assess the impact of the intervention, with self-efficacy measured using …

Quality Improvement Project Implementing A Hand Hygiene Compliance Program, Daisy Jean-Pierre

Doctor of Nursing Practice Projects

Hand hygiene remains a cornerstone of infection prevention in healthcare, yet gaps in compliance persist among nursing staff, contributing to preventable healthcare-associated infections (HAIs) and patient harm. The purpose of this Doctor of Nursing Practice (DNP) project, conducted at Piedmont Henry Hospital, was to implement and evaluate an educational intervention targeting nurse managers, with the aim of enhancing their knowledge, self-efficacy, and leadership in promoting hand hygiene compliance. The project addressed the identified problem of inconsistent hand hygiene practices among frontline staff, which was linked to insufficient leadership engagement and ongoing barriers such as time constraints and resource limitations. The …

Quality Improvement Project The Impact Of Increased Use Of High-Fidelity Nursing Simulation On Transfer Of Knowledge And The Correlation With Course Pass Rates, Debra Kilcrease

Doctor of Nursing Practice Projects

Ongoing nursing shortages and limited clinical preceptor availability have made it increasingly difficult for nursing programs to secure traditional clinical placements. In response, simulation-based learning (SBL) has gained support as an evidence-based strategy to supplement clinical education while maintaining transfer of knowledge. This quality improvement project examined whether increasing SBL hours, as a partial replacement for traditional clinical hours, impacted course pass rates in a practical nursing program. Course pass rates served as an indicator of knowledge transfer. Guided by the Jeffries Simulation Theory, the intervention emphasized learner engagement, structured simulation design, and debriefing to support clinical reasoning. A retrospective, …

Quality Improvement Project Improving Employee Satisfaction And Retention Through A Structured Training Process, Dawn Lundgren

Doctor of Nursing Practice Projects

The DNP project aimed to evaluate the impact of a structured new-hire training program on employee retention and job satisfaction within a hospice organization. Insufficient training for new employees can lead to a high staff turnover rate, stress, decreased job satisfaction, and poor quality of care. The quality improvement project utilized a pre-post intervention design over an eight-week period, comparing retention rates and job satisfaction scores before and after project implementation. Employee retention was measured as a binary outcome (retained or left), and job satisfaction was assessed through a seven-item survey rated on a five-point Likert scale. A total of …

Quality Improvement Project Impacting Provider Efficiency And Burnout With Standardized Ordering Tools, Carly Meredith

Doctor of Nursing Practice Projects

The adoption of electronic health record (EHR) systems promises better interoperability, transparency, patient safety, and care quality. However, concerns about increased provider stress and burnout are rising, suggesting a link between burnout and EHR use. This project aimed to evaluate whether improving EHR efficiency could reduce burnout rates. While literature highlights the need for enhanced training, effective methods remain unclear and challenge whether there is data supporting improvements or merely the perceived usefulness of these activities as identified through the Technology Acceptance Model. For this project, a preference list was created for commonly used orders with pre-selected defaults to streamline …

Quality Improvement Project Improving The Management Of Diabetes In A Primary Care Setting Through Staff Education, Chibuzo Okereke

Doctor of Nursing Practice Projects

Managing chronic disease, such as type 2 diabetes, requires effective patient education. This quality improvement project aimed to improve staff knowledge and confidence in delivering diabetes education using the evidence-based teach-back method. Eight staff members (physicians, nurse practitioners, nurses, medical assistants, and a clinic manager) of a suburban primary care clinic in Houston, Texas, were involved in the project by participating in structured educational sessions. The Always Use Teach-Back Conviction and Confidence Scale (CCS) and a Diabetes Knowledge Test 2 (DKT2) were validated instruments to measure data pre- and post-intervention. A quasi-experimental pre- and post-test design was used, and the …

Enhancing Pre-Licensure Bsn Students' Clinical Knowledge And Confidence In Blood Transfusion Via Postpartum High-Fidelity Simulation, Tresia Rouse

Doctor of Nursing Practice Projects

Blood transfusion administration is a complex nursing skill registered nurses require in bedside settings, regardless of experience level. Nursing students are expected to be practice-ready upon graduation. A significant concern in nursing academia is the insufficient exposure to administering blood products, which many pre-licensure nursing students lack in clinical and educational environments. This gap in nursing curricula can compromise students’ preparedness to perform this skill in real-world scenarios. The core purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to enhance clinical knowledge and impact self-confidence regarding blood transfusion administration and management, specifically by implementing a …

Quality Improvement Project Evaluating The Impact Of Specialized Blood Pressure Measurement (Bpm) Training On Nursing Faculty's Knowledge And Self-Efficacy In Teaching Bpm, Heba Sadaka

Doctor of Nursing Practice Projects

Accurate blood pressure measurement (BPM) is crucial for the proper diagnosis and management of hypertension. However, BPM errors are common and may lead to under- or overtreatment, negatively impacting patients. The purpose of this quality improvement (QI) project was to retrain nursing faculty on BPM practices based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) clinical guidelines. A quasi-experimental pre-/post-intervention design was used. The intervention consisted of an online specialized training video developed by the Idaho Diabetes, Heart Disease, and Stroke Prevention Program. Nursing faculty’s BPM knowledge and self-efficacy were measured before and after the training using the …

Quality Improvement Project Enhancing Self-Efficacy In Managing Patient No-Shows: A Staff-Focused Intervention, Aaron Wabang

Doctor of Nursing Practice Projects

No-shows are widely reported in behavioral health venues. They hinder continuity of care, decrease clinic efficiency, and compromise patient care. The solution requires addressing patients’ behavior and internal facility processes. This quality improvement (QI) project aimed to reduce no-show rates by providing staff with tools and enhancing their self-efficacy in managing appointments. The project was conducted in a rural East Texas behavioral clinic. Clinic staff reported challenges with patient reminders, scheduling, and follow-up issues that cause increased no-shows. The QI project aimed to empower staff by providing evidence-based scheduling strategies and decision support resources to enhance their confidence and attendance …

Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson

Walden Dissertations and Doctoral Studies

Nurse turnover has become a critical concern in healthcare, as low retention rates lead to decreased patient care quality and increased operational costs. A critical issue for hospital stakeholders is that many nursing leaders lack strategies to improve nursing retention. Grounded in the leader-member exchange theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful leadership strategies used by nurse managers in the Pacific South region of the United States to improve nurse retention. The study included interviews with six nurse managers who successfully implemented retention strategies. Data were collected through semistructured interviews and publicly available …