The Impact Of Parental Mental Health On Infant Outcomes In The Neonatal Intensive Care Unit: Length Of Stay, Feeding, Bonding, And Developmental Progress, Andee L. Plaskett

Nursing | Senior Theses

Background: The neonatal intensive care unit (NICU) can be a highly stressful environment for both infants and their parents. Poorer infant outcomes, including longer hospital stays, feeding difficulties, and delayed developmental progress can all be a reflection and outcome of elevated parental distress. Currently, mental health distress and infant screening tools are used in most NICUs but are not seen in all practices, it is also important to provide interventions based on the screening results. Screening tools are used to identify a problem but interventions should be implemented to try to alleviate the problem. Objective: By implementing a standardized screening …

Blister Packaging Versus Bottles: Caregiver Accuracy And Child Safety In Pediatric Medication Gummy Administration, Paolo Olimpiada

Nursing | Senior Theses

The safety of medication in pediatric settings has become an increasing concern as gummy-formulated medications have gained popularity in children’s care. Gummy-formulated medications have a close resemblance to candy, and this may mislead children to ingest additional doses or more than what was prescribed. Children also depend a lot on their caregivers for medications. Therefore, the design of packaging would be impactful in supporting medication dosing accuracy. And studies have evaluated safety features of packaging related to adherence, misuse, and unintended administration. However, limited studies have examined the influence of medication packaging on the dosing accuracy at the time of …

Development Of An Educational Toolkit For Clinical Staff At Little Rivers Health Care To Guide Shared Decision Making For The Expanded Age Range Of The Hpv Vaccine, Maureen B. Boardman

DNP Scholarly Projects

BACKGROUND: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States (CDC, 2024). Unlike other common STI's, persistent infection with HPV increases the risk of cancer. A Human Papillomavirus (HPV) vaccination was approved in the United States in 2006 for girls and women aged 9 to 26 and in 2009 it was approved for boys and men in this same age range. Despite 20 years of data on the efficacy and safety of the HPV vaccine, rates of completed HPV vaccine series remain low. In 2019 the Advisory Committee on Immunization Practices (ACIP) expanded …

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Ask, Advise, And Act: A Smoking Cessation Bundle For Cancer Patients, Crystal Tencate

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Smoking is the number one cause of preventable illness and death in the United States. For patients undergoing cancer treatment, continued tobacco use poses serious risks. In surgical oncology, smoking is associated with poorer treatment outcomes, increased postoperative complications, delayed wound healing, and higher mortality. For patients requiring reconstructive surgery, smoking-related complications can be devastating, sometimes resulting in significant wound complications or loss of the reconstruction. Despite these well-established risks, smoking cessation interventions are not consistently integrated into clinical practice.

To address this gap, a quality improvement project was implemented to strengthen smoking cessation efforts among advanced practice providers (APPs) …

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

DNP Scholarly Projects

Abstract

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

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

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

Master's Theses and Capstones

Abstract 

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

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

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

Protecting Your Largest Organ: A Journey In Skin Cancer Education, Prevention, And Early Detection, Krista Schneider

Master's Theses or Doctor of Nursing Practice

Rates of skin cancer diagnoses continue to increase globally, making skin cancer one of the most commonly diagnosed malignancies. Despite rising incidence, many individuals lack knowledge of risk factors, warning signs, and effective prevention strategies. This quality improvement project aimed to improve skin cancer awareness by providing targeted skin cancer education to young adults enrolled at a university in the Midwestern United States. Conducted from August 18 to December 1, 2025, this project followed the Plan-Do-Study-Act framework. Educational presentations were delivered to students enrolled in freshman seminar courses over a two-day period, accompanied by distribution of digital flyers and pamphlets. …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

The Impact Of Night Shift On New Nurses: Effects On Mental Health And Work-Life Balance, Avery Windham, Abby Maruskin, Elizabeth Yoder

Williams Honors College, Honors Research Projects

This research examines the impact of night shift schedules on new nurses' mental health and work-life balance as they transition into professional practice. The transition from nursing school to the workforce presents challenges that are further compounded by shift work, which can disrupt circadian rhythms and contribute to stress, fatigue, and reduced job satisfaction. The purpose of this research is to evaluate how starting on night shift versus day shift influences nurses’ self-evaluation of work-life balance within their first year of practice. This systematic review synthesizes findings from peer-reviewed sources to assess the physical, emotional, and professional consequences of night …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Does Guideline-Directed Breast Mri Improve Early Identification In The High-Risk Breast Cancer Population, Cemile Littlepage

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: In the United States, one in eight women will be diagnosed with breast cancer. The American Cancer Society's 2007 guidelines (Onishi & Kataoka, 2020) and the American College of Radiology recommend that MRI screening, alongside annual mammography, be used for women at high risk for breast cancer (Lamb et al., 2023; Sardanelli et al., 2024). Currently, there are various screening models, and no standardized tool or national guideline exists for MRI screening in high-risk patients. This guideline project aims to establish a screening model and recommendations for MRI screening in high-risk women for use in primary care.

Methods: A …

Evaluating The Implementation And Use Of A Standardized Screening Process To Increase Flu Vaccine Uptake In A Rural Health Primary Care Clinic, Mackenzie L. Pierce

DNP Projects

Background: Research has shown that an annual influenza vaccine is the most effective way to both prevent and reduce the risk of hospitalization and severe health complications of the flu. A yearly influenza vaccination is recommended for everyone age 6 moths and older.

Local Problem: Rural communities have lower rates of influenza vaccination which can be due in part to a lack of screening and education on vaccines and their importance. No process for influenza vaccine status screening existed at the project site prior to this project.

Methods: A quality-improvement project was conducted to evaluate the implementation of a standardized …

Evaluation Of A Nicotine Prevention Program In A Third Grade Classroom, Jennifer A. Pile

DNP Projects

Purpose: The purpose of this project was to increase knowledge of nicotine products and promote negative perceptions of nicotine use among third-grade students through early prevention education.

Background: Prevention is key and to prevent nicotine use, there must be an educational program with that aim in a much younger population. Third grade encompasses 8-, 9-, and 10-year-olds. This group is in the middle childhood stage and begin more complex thinking and problem-solving skills. There is physical and emotional development among this group.

Methods: This is a quasi-experimental study among third grade students in Breckinridge County Kentucky with pretest and …

Advancing Rural Health Equity Through Systematic Sdoh Screening- A Quality Improvement Initiative, Laura C. Combs

DNP Projects

Background: Social determinants of health (SDoH) significantly affect health outcomes and healthcare utilization, particularly in rural communities. In 2024, the Centers for Medicare & Medicaid Services mandated SDoH screenings in the inpatient setting, with recommendation to implement in rural clinics without specifying a standardized tool, resulting in inconsistent identification of needs, e.g., food insecurity, housing instability, mental health concerns, financial strain, and transportation barriers.

Purpose: This quality improvement initiative implemented a standardized SDoH screening tool in a rural outpatient clinic to evaluate changes in referral rates to community-based resources pre- and post-implementation and to improve patient reporting of social needs. …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

A Qualitative Analysis Of Counseling And Nurse Practitioner Trainee Experiences Engaging With An Integrated Behavioral Health (Ibh) Training, Alexander M. Fields, Margaret Emerson, Stephanie Burge, Jill R. Reed, Therese L. Mathews Ph.D., Aprn, Bcba-D, Abby L. Bjornsen

Teaching and Supervision in Counseling

Integrated behavioral health (IBH) is recognized as the standard for holistic healthcare, addressing the intersection of mental and physical health. As IBH gains prominence, graduate healthcare programs must equip students with strategies to meet its demands. However, limited research exists on training methods that address diverse professional identities and the unique needs of graduate students. Our novel IBH training incorporates interprofessional education (IPE) through modules and simulations grounded in Bandura’s (2001) social cognitive theory. We explored the experiences of 12 counseling, family nurse practitioner, and psychiatric/mental health nurse practitioner students through focus groups. Through interpretative phenomenological analysis (IPA), we analyzed …

The Relationship Between Religious Attitude And Breastfeeding Attitude: A Cross-Sectional Study From Türkiye, Melike Yavaş Çelik, Cuma Tunçkaşık

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: This study was conducted with 203 mothers with babies aged 0–24 months. Simple random sampling was used in sample selection. The Religious Attitude Scale and Breastfeeding Attitudes of the Evaluation Scale were used in data collection.

Results: A significant relationship was found between religious attitudes and breastfeeding attitudes. Additionally, mothers' negative breastfeeding attitudes and positive breastfeeding attitudes were found to be close to each other. The time it took for mothers to start breastfeeding their …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Enhancing Flu Vaccination Rates Through Improved Electronic Health Record User Workflow Training, Grace Sayre

Master's Projects and Capstones

A quality improvement project was implemented at an urban community health clinic primarily serving low-income, underinsured, and Latinx individuals. The site had a history of poorly organized flu vaccine rollout and low vaccination rates among the patient population. Seasonal influenza infects millions of people across the US each year, resulting in hundreds of thousands of deaths (Garza et al., 2023), and vaccination is the best prevention. Electronic health record training has been shown to reduce user burnout and improve efficiency (Gordon et al., 2022). The QI project aims to increase medical assistant satisfaction with the flu vaccine rollout by 15%, …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Reducing Falls In The Acute Care Setting: A Quality Improvement Project, Elorm M. Adzokpa

Doctor of Nursing Practice Final Project Abstract

Falls remain one of the most common adverse events in acute care settings and are associated with increased morbidity, extended hospital stays, and higher healthcare costs. Orthopedic and trauma patients are particularly vulnerable due to mobility limitations, postoperative recovery, and complex medical conditions. The purpose of this quality improvement project was to reduce inpatient falls on an adult orthopedic and trauma unit by implementing a visual aid to reinforce the 5P fall-prevention framework. A pre–post quality improvement design was used during an eight-week implementation period. The intervention included a standardized fall prevention bundle that reinforced existing Fall TIPS board use …

Implementing The Steadi Fall Risk Screening Initiative Within A Primary Care Setting To Improve Patient Safety, Haleigh Marie Brown

Doctoral Projects

Falls among older adults are a significant public health issue and the leading cause of injury-related illness and death in people aged 65 and older. While evidence-based guidelines exist and awareness of fall risks has increased, many primary care settings do not use standardized fall risk screening protocols. This gap results in missed opportunities for early identification and prevention. To address this need, the Centers for Disease Control and Prevention (CDC, 2019) created the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Toolkit, which offers healthcare providers a structured approach to assess, manage, and reduce fall risk.

This doctoral project aims …

Evaluating The Impact Of Evidence-Based Guidelines On Corticosteroid Prescribing For Acute Upper Respiratory Infections In Outpatient Primary Care, Cody Allen Boyd Hyatt

Doctoral Projects

Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.

The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …

Integrating Artificial Intelligence And Evidence-Based Guidelines Into Nursing Education, Allyson Kornahrens, Kerriann Latten

International Journal of Transformative Teaching and Learning in Higher Education

Artificial Intelligence (AI) and emerging technologies are transforming the healthcare system and patient care delivery. Due to this, there is an essential need for faculty to incorporate AI into the nursing curriculum to educate students about its use and improve preparation for clinical practice. This practice-based article addresses the integration of AI into nursing education for students using AI-driven academic learning activities. These activities, created in alignment with the American Association of Colleges of Nursing (AACN) Essentials, explore clinical decision-making by comparing AI recommendations to evidence-based guidelines. Students are tasked with reflecting on AI’s accuracy and the ethical implications of …

Implementation Of A Patient Engagement Program In A Federally Qualified Health Center, Cami A. Stone

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project is implementation of a patient engagement program at a Federally Qualified Health Center (FQHC) clinic. This program intends to increase patient self-management of disease without increasing tasks of the clinic staff.

Background

FQHCs have limited resources and staff; their populations are marginalized and transient. The care gap is between the clinic’s resources and patient self-management of disease, specifically hypertension. Evidence shows that personalized coaching of patients aids them with disease self-management.

Methodology

This project delivers personalized coaching via weekly brief phone calls from two assigned nurses to patients, without disrupting clinic duties. Calls involve …