Nursing Commons^™

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

What Is The Impact Of An Education Program Designed To Remove The Healthcare Professional As A Barrier To Care For The Transgender And Gender Diverse Community?, Richard D. Dansereau

Doctoral Projects

Healthcare disparities disproportionately affect transgender and gender-diverse (TGD) individuals, often due to implicit biases among healthcare providers. This study examines the impact of an educational intervention designed to address these biases and improve care for TGD patients. Using the Biased Care Model as a guiding framework, the intervention targeted three critical phases of bias: pre-visit assumptions, in-visit interactions, and post-visit decisions. Conducted in the intensive care unit of a mid-sized hospital in Northern California, the study employed a pretest-posttest quasi-experimental design involving multidisciplinary healthcare workers. Participants completed a modified Jefferson Scale of Empathy survey to assess changes in cognitive and …

Strengthening Addiction Recovery In Adults Through Mindfulness, Sara Christenson

Theses and Graduate Projects

Addiction is a significant health issue that affects millions of people. Individuals experiencing addiction face challenges in their everyday lives which often results in health issues, financial and/or legal issues, and broken relationships with family and friends. Additionally, there are often many barriers to seeking treatment which ultimately prevents recovery from substance use disorder. Throughout history, addiction has often been misunderstood, however, it is now recognized as a chronic illness that permanently changes the way the brain functions. Mindfulness is an intervention that promotes a nonjudgmental, nonreactive awareness that can strengthen the recovery process by acceptance of the craving response …

The Impact Of Motivational Interviewing On African-American Men With Type 2 Diabetes Mellitus, Jamekia Kitchens

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

African-American men with type 2 diabetes face an immense health disparity in the United States, with alarming mortality rates compared to their counterparts. This pilot study examined the impact of motivational interviewing on African-American Men with type 2 diabetes mellitus. The researcher conducted motivational interview sessions using the components of the Diabetes Management Self-Efficacy Scale to guide the meetings. Pre- and post-confidence levels and pre- and post-hemoglobin A1c levels were collected and analyzed. After the completion of three motivational interview sessions, participants displayed significantly higher self-efficacy scores with significantly decreased A1c levels. The results suggest that motivational interviewing has a …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

Healthcare Provider Comfort Surrounding Adverse Childhood Events (Aces), Cameo Culcasi

Doctoral Projects

Adverse Childhood Experiences (ACEs) are strongly linked to long-term health outcomes, yet discussions around ACEs in clinical settings remain inconsistent. This study investigates the comfort levels of healthcare providers in addressing ACEs with their patients, identifying barriers and facilitators to such conversations. Using a Quasi-experimental, single group, pretest-post test experimental design, we surveyed a diverse group of physicians, nurse practitioners, and physician assistants working in a primary care setting, providing ACE training, and an opportunity for learning reflection. Preliminary results indicate that while most providers acknowledge the importance of discussing ACEs, many report discomfort due to time constraints, lack of …

Patient Perception Of Nurse Practitioner Care, Nurse Practitioner Scope Of Practice And How That Influences Provider Choice, Naomi Hemp

Doctoral Projects

This project investigates patients' perceptions of nurse practitioner (NP) care versus physician (MD) care, the factors influencing these perceptions, and patients' understanding of NP scope of practice. A cross-sectional design was used, gathering quantitative data through an anonymous one-time survey distributed via Qualtrics, open for three months. Questions were based on The Watson Caritas Patient Score (WCPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). Data were analyzed using Intellectus Statistics software™, with descriptive statistics summarizing the findings. A two-tailed paired samples t-test revealed statistically significant differences in favor of patients' perceptions of NP care versus …

Diabetes Self-Management Education For Older Adults In Primary Care, Makilah Rae Furlan

Doctor of Nursing Practice Scholarly Projects

Type 2 Diabetes (T2DM) is a chronic disease that impacts 27.2 million seniors 65 and older. Evidence-based care for T2DM includes a combination of medication and disease-management behaviors. Access to education to teach patients healthy behaviors to manage their disease is limited and even less accessible to geriatric patients with aging learning needs. The scholarly project addresses this gap in patient education by implementing evidence-based diabetes self-management education for geriatric patients to increase patient knowledge and confidence in implementing self-management behaviors. The scholarly project aims to assess health behaviors in patients aged 65 and older with established type 2 diabetes …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

Exploration Of Advanced Practice Registered Nurses’ Perception Of Barriers To Promoting And Supporting Breastfeeding In Primary Care, Devon L. Stubblefield, Allison L. Scott, Carmel Kruse, Marilou D. Shreve, Hope A. Ballentine

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Breastfeeding is the biological way to provide active and passive immunity, as well as necessary nutrients, to infants while concurrently providing multiple health benefits for mothers. Even though evidence is readily available to support the argument to breastfeed, United States’ breastfeeding rates fall below Healthy People 2030 goals. Advanced practice registered nurses (APRNs) in primary care settings are in a prime position to give education and create care plans to support breastfeeding mothers to improve breastfeeding rates but literature supports APRNs lack confidence to do so. An APRN is likely to defer care to another provider to address …

Promotion Of Women’S Preventative Health Behaviors For Breast And Cervical Cancer, Shelby Lopez

Doctor of Nursing Practice Scholarly Project

Women’s health prevention is typically not a significant topic for discussion. Health prevention measures are often discussed after a new diagnosis, rather than being a proactive approach toward improving women’s health. Breast and cervical cancer continue to be prevalent today and, to decrease the number of women diagnosed with late-stage cancer, this scholarly project will focus on improving the participation in prevention behaviors among women 18-45 years of age, but also acknowledge the role self-efficacy and perception of health behaviors has on the participation in prevention measures. Pender’s Health Promotion Model will help acknowledge how social-behavioral factors affect prevention behaviors. …

The Moderating Effect Of Self-Efficacy On The Interaction Between The Patient-Provider Relationship And Medication Adherence, Jonas M. Manalo

2025 Spring Honors Capstone Projects - Archive

Older adults taking multiple medications are at high risk for experiencing adverse drug events that result in hospitalization. Nurses are one of the first points of contact for patients and serve as patient educators. Many factors influence medication adherence, such as the patient-provider relationship and patient self-efficacy. This study aims to assess what impact patient self-efficacy has on the interaction between the patient-provider relationship and medication adherence.

The sample comprises adults aged 50 or older taking five or more medications. The Medication Understanding and Use Self-Efficacy (MUSE) Scale was used to measure patient self-efficacy and the patient-provider relationship while the …

Produce Prescription Policy Project For The Securement Of A Grant To Address Food Insecurity For Low-Income Type Ii Diabetic Patients, Isabel D. Garcia-Gallegos

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This policy-focused Doctor of Nursing Practice (DNP) quality improvement (QI) project aims to secure grant funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) to implement a produce prescription program at a community clinic in Texas. The program targets low-income adults (18-65 years) with type II diabetes who experience food insecurity and are affected by Medicaid non-expansion.

BACKGROUND

Texas’ decision not to expand Medicaid has exacerbated food insecurity among low-income residents, particularly those managing type II diabetes. This decision creates a healthcare policy gap that this project aims to address with a food-as-medicine program.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) …

Managing Cardiovascular Health In The Hispanic Community: Implementing The Share Approach At A Primary Care Clinic, Jacqueline Molina

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this project was to determine the effectiveness of the Seek, Help, Assess, Reach, and Evaluate (SHARE) approach in the management of cardiovascular disease (CVD) risk factors in the Hispanic population at a primary care clinic while improving health literacy. The aim was that by February 2025, Hispanic patients at the clinic would achieve a 10% reduction in CVD risk factors.

Background: The project was implemented at a small private primary care clinic in Texas. CVD risk factors prevalent include hypertension, mixed hyperlipidemia, and diabetes mellitus.

Methodology: Before implementation provider and staff were educated on the SHARE …

Social Determinants Of Health Screening In The Pediatric Population: Evaluating The Effectiveness Of Staff Education, Brenda Awuah, Kansas S. Logan, Sally Humphrey Dnp, Aprn, Cpnp-Pc, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Social Determinants of Health (SDOH) are conditions that influence health outcomes. SDOHs are screened and addressed in many clinics and hospitals to reduce patients' social needs. Research indicates how unaddressed SDOH can negatively impact chronic illness, along with the daily life of pediatric patients. SDOH's role in pediatric patients includes food security, housing stability, access to healthcare, caregiver education, and parental mental health. Previous research has addressed these factors; however, the lack of staff education prevents effective compliance and follow-up on SDOH screening. Challenges remain in implementing and integrating SDOH into routine well-child visits. This scoping review will evaluate and …

Men’S Preconception Health: Impact On Pregnancy And Awareness Strategies., Kara I. Carr

Honors Capstones

Men’s preconception health plays a critical role in pregnancy outcomes, but it continues to be overlooked in healthcare education. While women are routinely counseled by OBGYN providers on how nutrition, lifestyle, and chronic conditions can affect fertility, men often receive little to no guidance from their primary care providers. This project uses a literature review to look deeper into how limited awareness and involvement in men’s preconception health may impact pregnancy and infant health outcomes. The gap is linked to cultural norms, healthcare practices, and the lack of clear resources for men. This research aims to develop strategies that promote …

Capturing Women's Birth Experiences Through Photos, Kristen Montgomery, Betsy Crabtree, Samantha Grayson, Alyssa Harmon, Rachael Robbins, Sarah Shelton, Hannah Sobas, Alexis Taliaferro, Nolan Willard

Epsilon Sigma at-Large Research Conference

Purpose: Each year 3.5 to 4 million women give birth in the United States. Childbirth is a life-changing event that induces various emotions in women. Many women report having a negative experience due to short staffing, inadequate care, and a loss of autonomy. Aims: The aim of the study was to understand what factors contribute to a positive or negative birth experience.

Methods: A descriptive qualitative study was conducted using photo elicitation. Photos were collected from participants and included a description of how the photo represented the participant’s experience. Demographic data were collected through a survey. Participants …

Utilizing The Mdq For Bipolar I Screening In The Primary Care Environment, Jamie Strozier

Epsilon Sigma at-Large Research Conference

Abstract- Utilizing the MDQ for Bipolar I Screening in the Primary Care Environment

Bipolar disorder is a chronic mental health condition characterized by episodes of depression, mania, or mixed symptoms, affecting approximately 5.7 million adults in the U.S. and 40 million individuals worldwide. Despite its significant impact, bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD) in primary care settings, leading to inappropriate treatment and worsening patient outcomes. Research indicates that 78% of bipolar patients are initially misdiagnosed, with only 32% of primary care providers (PCPs) screening for the disorder. This quality improvement project aims to enhance bipolar disorder …

Environmental Concerns Of Women In Appalachia, Kristen Montgomery, Adebayo Adeeko, Jessica Binns, Sarah Hall, Paula Hawkins, Allyson Newer, Michaela Outlaw, Karenna Turley

Epsilon Sigma at-Large Research Conference

Purpose: Environmental contamination is rampant in the United States and other parts of the world. There are potential health implications related to environmental contamination.
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Aims: The purpose of this study was to investigate how concerned women in Appalachia are regarding the environment. The following research question was addressed: What concerns do women have regarding the environment? The objective of this study was to understand how women perceive their environment and to evaluate what concerns they have regarding the environment. We also evaluated demographic factors to see if any demographics contributed to particular concerns related …

A Jewel In The Crown Is Better Than Money In The Pocket": Historical Data On The Role Of Midwives In Caring For Families In Southern Appalachia, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

Background: Midwives have provided care to women since the beginning of time. Early midwives had little training but learned their craft from experienced women. Later, formal training became available. Midwives have a rich history in Appalachia.

Purpose: to explore the rich history of all types of midwives in Appalachia.

Methods: Materials from the Archives of Appalachia were reviewed. Both written and oral materials were evaluated. This included a review of the document, identification of themes, and then comparing those themes with previously identified themes. Documents were reviewed in a random order by two researchers who met to discuss results.

Results: …

Improving Admissions Planning In A Specialized Adult Foster Care Program, Jessie Sullivan

Doctoral Dissertations & Projects

Background: Specialized adult foster care (AFC) programs have the unique ability to facilitate and coordinate continuity of care with an interdisciplinary approach internally and with community provider collaboration. The lack of communication in the transition of care admissions process leads to negative patient safety outcomes.

Purpose: The purpose of this quality improvement project was to identify barriers to improve communication, continuity of care, reduce negative health outcomes, and provide a culture of safety.

Methods: The Systems Engineering Initiative for Patient Safety (SEIPS) guided this quality improvement project. Assessment of quality measures and outcomes included the administration of pre- and post-implementation …

Implementing A Standardized Colorectal Cancer Screening Protocol To Enhance Screening Rates In A Primary Care Setting, Sam Terranova

Doctoral Dissertations & Projects

Colorectal cancer (CRC) is a significant health concern in the United States, ranking third in incidence and mortality among all cancers. Despite established screening guidelines, adherence often falls short in primary care settings. This quality improvement project aimed to enhance CRC screening rates in a Midwest primary care practice through implementation of a standardized screening protocol. The intervention was two-fold and consisted of the routine ordering of fecal immunochemical test (FIT) kits to eligible patients and the use of electronic health record (EHR)-based patient reminders. Screening completion rates were monitored over a four-month period and compared to pre-intervention rates from …

The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy

Theses and Graduate Projects

BACKGROUND: In 2020 a pandemic created dangerous workloads leading to many nurses quitting their careers due to chronic stress. This project will create the green room, which is the name of this recharge room, where staff can go to experience a moment of peace to decrease their stress levels. This room had a spa aesthetic with comfortable seating and green plants. METHODS: This quality improvement project follows the plan-do-study-act model. When participants arrived, they filled out a questionnaire before using the room. They were then shown all the things they could do to utilize the room. After they were done …

The Cruciality Of Early Recognition Of Postpartum Depression In Neonatal Intensive Care Unit (Nicu) Mothers, Shelby Clark

Scholars Week

Postpartum depression is a serious complication of childbirth that is largely dismissed by society for a variety of reasons. Unfortunately, the condition is intensified for NICU mothers. If left untreated, postpartum depression can have detrimental effects. This quality-improvement project focused on early recognition of postpartum depression symptoms in mothers of infants admitted to a neonatal intensive care unit in Western Kentucky. The goal of the project was education for and recognition of postpartum depression in NICU mothers. Methodology for the project included utilizing the Edinburgh Postnatal Depression Scale to determine the severity of symptoms of postpartum depression for NICU mothers. …

Aprn Transition To Primary Care Practice Program: A Quality Improvement Project, Melissa R. Baker

Graduate Theses, Dissertations, and Capstones

Transitioning to independent practice presents challenges for advanced practice registered nurses (APRNs) new to primary care. This quality improvement project addressed gaps in training and support through a structured Transition to Primary Care Practice (TTPCP) program across multiple primary care clinics in the southeastern United States. Over 12 months, the program provided weekly didactic sessions, monthly specialty rotations, and bi-weekly feedback. Guided by the Plan-Do-Study-Act framework, the initiative tracked structure, process, and outcome measures. Among 20 participants, attendance and schedule ramp-up reached 100%. Knowledge scores improved by 44%, and self-assessments increased by 23%. All assessed participants were rated Proficient or …

Empowering Staff Wellbeing: A Team-Based Qi Initiative, Rebecca Lauren Smith, Elizabeth Morse, David Phillippi

SPARK Symposium Presentations

Project Title: Empowering Staff Wellbeing: A Team-Based QI Initiative

Keywords: Burnout, wellbeing, DNP, primary care, QI methodology

Background and Rationale: The consequences of burnout in healthcare are alarming: worse patient outcomes, lack of continuity of care, higher turnover, and increased cost to employers. Many studies of burnout and wellbeing of clinicians focus on larger institutions such as hospitals and Federally Qualified Health Centers. Over the past several years, burnout has been discussed among our small, eight-person clinician team working in a small, non-profit primary care clinic. Yet, there has been no formal assessment of the level of burnout among …

Defining Sexual Assault, Consent, And Resources To Empower Students: A Dnp Project, Sarah Powers

SACAD: Scholarly Activities

Abstract

Sexual assault (SA) remains a pervasive issue on college campuses in the United States, often compounded by underreporting and a lack of knowledge about available resources. This Doctor of Nursing Practice (DNP) project aims to educate first-year college students about SA, sexual consent, and available resources to empower students in preventing assaults and seeking help when needed. The intervention, which was integrated into mandatory freshman seminars at a four-year university, was guided by Knowles' Adult Learning Theory. A presentation provided critical information, and knowledge gains were assessed through pre- and post-presentation surveys. Initial findings indicated significant increases in understanding …

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …