Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Reducing Potentially Preventable Emergency Department Visits (Ppvs) Through A Telehealth Intervention In Children With Asthma Within A Managed Care Organization (Mco), Renee A. Roker

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma …

Enhancing Heart Failure Transitional Care To Reduce 30-Day Readmission Rate, Thuy Nhu Uyen Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project is to reduce 30-day readmissions for adult patients with heart failure (HF) by implementing a standardized HF pathway beginning in the intensive care unit (ICU) and continuing through discharge.

Background: The project was implemented within a large healthcare organization in Northwest Houston, Texas.

Methodology: This project utilized a pre- and post-implementation design guided by the Plan-Do-Study-Act (PDSA) model. Eligible adult patients (≥18 years) with a primary or secondary HF diagnosis were identified during March 2026. The My Pathway to Wellness HF education pathway was initiated at the time of ICU downgrade …

Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ekstremitas Bawah Pada Pasien Luka Kaki Diabetik, Jannaim Jannaim, Ridha Dharmajaya, Asrizal Asrizal

Jurnal Keperawatan Indonesia

The Influence of Buerger Allen Exercise on Lower Extremity Circulation in Patients with Diabetic Foot Ulcer. Diabetic footulcer (DFU) is a complication of diabetes caused by impaired venous and arterial blood circulation. Buerger allen exercise is a modality therapy with active postural movement. This study aims to assess the effect of buerge rallen exercise on the circulation of lower extremities in DFU patients. The study design was pre experimental pretest and posttest without control. The sampling technique was consecutive sampling and the large sample of 43DFU patients, analysis data was using Wilcoxon test. Increased circulation is measured using the Ankle …

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Advocateai: A Human-In-The-Loop Artificial Intelligence Platform To Improve Diagnostic Trajectories And Patient Empowerment In Chronic Pelvic Pain, Gayatri Bhanot, Ashley Kochans

InnovateHER Meeting 2026

Chronic pelvic pain (CPP) affects up to 27% of women globally^1, yet diagnosis takes 4 – 12 years on average² — a crisis driven by healthcare fragmentation, systemic gender bias, and a 62% rate of symptom dismissal by healthcare providers³. AdvocateAI is a human-in-the-loop AI platform designed to empower patients to accelerate their own diagnostic journey. By synthesizing fragmented medical records and patient-reported symptoms, the tool creates structured clinical summaries and personalized advocacy scripts. Here, we present our findings from discovery, including a landscape analysis of available CPP treatments, a prototype co-designed by patients, and custom …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

A Systematic Review Of Implementing Iot Healthcare Systems: Technological, Organizational, And Ethical Barriers In Rural Settings, Mudzramer A. Hayudini, Angela Joy A. Jimpoy, Jonel T. Alibasa, Aisha A. Carolino, Jenden M. Julkamri, Nagdir B. Muhadja, Al Rajab H. Aming, Hamdoni K. Pangandaman, John Ed Augustus A. Escorial

Jurnal Keperawatan Indonesia

The implementation of Internet of Things (IoT) technologies holds transformative potential for healthcare delivery in rural and underserved regions. This systematic review focuses on technological, organizational, and ethical barriers. A comprehensive literature search across six major academic databases yielded eleven empirical studies published between 2015 and 2025. The review adhered to PRISMA protocols, with data synthesized using the Synthesis Without Meta- Analysis (SWiM) guidelines. Findings revealed that technological challenges—such as unreliable internet connectivity, lack of device interoperability, and power supply issues—are widespread across rural implementations. Organizational limitations included inadequate training, resistance to workflow changes, and financial constraints. Ethical concerns primarily …

Factors Affecting Older Adult Adjustment At A Health Promoting Hospital In Nakhon Phanom, Thailand, Onuma Kaewkerd, Yuttachai Chaiyasit, Phensiri Dumrongpakapakorn, Nuttiya Prommasaka Na Sakonnakhon

Jurnal Keperawatan Indonesia

Elderly adjustment influences quality of life and well-being and informs appropriate health promotion, holistic care, and health services. This study aimed to investigate the factors influencing the adaptation of older adults by focusing on a study conducted at Dong Kwang Health Promoting Hospital in Nakhon Phanom Province, Thailand. A cross-sectional design was used for the study. The sample consisted of 100 older adults and were selected for data collection from March 22, 2023, to April 20, 2023. The research instruments consisted of questionnaires assessing personal information, spiritual well-being, stress, perceived self-care abilities of older adults, quality of life, and older …

The Predictive Ability Of Child Characteristics And Parenting Factors On Four Developmental Domains In Toddlers, Melly Latifah, Dwi Hastuti, Neti Hernawati, Reisi Nurdiani, Raihan Ainun Hasanah

Jurnal Keperawatan Indonesia

Stunting is a chronic condition that has a significant impact on child development. This phenomenon is primarily caused by prolonged nutritional deficiency, especially during the first 1,000 days of life. In addition, as family factors also play a crucial role in children’s development, this study aims to analyze the influence of child and family characteristics, mother–child attachment, parenting practices, and the nutritional status of children (stunted/non-stunted) on children’s gross motor, fine motor, language, and personal–social skills. This study used a quantitative design with an explanatory approach involving 202 mother–child pairs with children aged 12–36 months. The findings show that healthcare …

Transforming Nursing Clinical Education: The Power Of Environment, Student Motivation, And Clinical Instructors, Lia Mulyati, Nur Wulan, Abdal Rohim

Jurnal Keperawatan Indonesia

Clinical learning is an important component in the formation of nursing students’ professional competence. The clinical environment, student motivation, and the role of clinical instructors are factors that influence the achievement of learning outcomes in nursing clinical practice. However, the relationship between these factors is still not fully understood. This study aims to examine the relationship between the clinical environment, student motivation, and the role of clinical instructors, and to determine how these three factors contribute to learning outcomes in nursing clinical practice. A quantitative design with a cross-sectional survey approach was used. The sample consisted of 117 nursing students, …

Association Of Central Obesity And Hypertension In An Urban Area, Chandrayani Simanjorang, Diva Anita Churiana Sudrajat, Ulya Qoulan Karima

Jurnal Keperawatan Indonesia

Hypertension is one of the non-communicable diseases in Indonesia that is closely related to obesity. Therefore, this study aimed to determine the association between central obesity and hypertension in a cohort study group in Bogor City, West Java from 2011 to 2021. A retrospective cohort study design was employed, with multivariate Cox regression analysis performed using secondary data from the Risk Factors for Non-Communicable Diseases (FRPTM) Cohort Study. Among 3,586 samples, 879 incident cases of hypertension were observed by the end of follow-up, accounting for 24.5% of the at-risk population. The incidence rate of hypertension was 28 cases per 1000 …

Prevalence Of Fall Among Elderly In Rural Sabah And Its Associated Factors, Khalid Mokti, Mohd. Yusof Ibrahim, Syed Sharizman Abd Rahim, Mohammad Saffree Jeffree, Mazlinda Musa, Mohd. Rohaizat Hassan, Yugo Shobugawa, Muhammad Aklil Abd Rahim, Ahmad Faizal Roslan, Mervynn Koon Kar-Wai

Jurnal Keperawatan Indonesia

Falls are a leading cause of injury among older adults, often resulting in significant physical, psychological, and social consequences. This study aims to determine the factors that contribute significantly to fall risks among the older adults in rural Sabah. A cross-sectional community study was conducted in the Kudat Division, Sabah, Malaysia from January to June 2021. Using multistage random sampling, 700 adults aged ≥60 years were recruited, excluding those with severe disability, mental illness, or institutionalized. Data were collected through face-to-face interviews with a structured questionnaire adapted from the validated Japanese Gerontological Evaluation Study (JAGES) tool, and anthropometric measures were …

The Effectiveness Of Psychoeducation And Mind Mapping In Preventing Early Marriages In Central Java, Indonesia, Eviyati Aini Muriana, Mardiyono Mardiyono, Lanny Sunarjo, Melyana Nurul Widyawati

Jurnal Keperawatan Indonesia

During the COVID-19 pandemic, the number of early marriages increased. Early marriage causes biological and psychological problems in the mother and her baby. The combination of psychoeducation and mind mapping emerged as a preventive effort against early marriage. The aim of this study was to analyze the effectiveness of this combination in preventing early marriage in Central Java, Indonesia by influencing adolescents’ knowledge and intentions. This study was conducted using a convergent mixed-methods design. For the quantitative phase, the pre-test – post-test control group experimental design was used, while in the qualitative phase, a thematic analysis was performed using focus …

Ventilator Weaning Through Spontaneous Breathing Trials In Children With Tetralogy Of Fallot In The Picu: A Case Report, Megah Fitrian, Kadek Ayu Erika, Muhammad Yunus

Jurnal Keperawatan Indonesia

Tetralogy of Fallot (TOF) is a congenital heart defect that causes chronic low oxygen levels, increased right ventricular workload, and a higher risk of complications. Weaning mechanical ventilation in patients with TOF is particularly challenging due to right ventricular dysfunction, muscle weakness, and the risk of heart failure. This study evaluates the use of a spontaneous breathing trial (SBT) strategy with pressure support ventilation (PSV) mode for mechanical ventilation weaning in pediatric patients with TOF. An observational study was conducted on a six-year-old pediatric patient with TOF and a cerebral abscess who underwent mechanical ventilation weaning using the SBT technique …

The Role Of Health Workers In Interprofessional Collaboration For Cancer Patient Navigators: A Scoping Review, Agung Subakti Nuzulullail, Aulia Diah Rahayu, Rury Nindya Taluphyta, Ika Arif Lidiyana, Mohamad Rusdiyansyah, Petrus Paris Rumsori, Riyati Riyati, Suci Wahyu Hariyanto, Wa Ode Umi Kalsum, Sri Hartini

Jurnal Keperawatan Indonesia

Cancer remains a leading cause of death worldwide. The complexity of cancer care demands strong interprofessional collaboration (IPC), particularly within cancer patient navigator (CPN) programmes. However, research examining IPC in the context of CPN implementation is still limited. This scoping review aims to explore the various roles of healthcare workers in the IPC process within cancer navigator programme interventions. The review was conducted using four databases: PubMed, Clinical Key, EBSCOhost, and ScienceDirect. The Arksey and O'Malley framework was used to address the research question: “What is the role of health workers in interprofessional collaboration within cancer patient navigation?” Study selection …

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

A Study Of Awareness Of Antiseptics And Disinfectant Use Among Allied Health Sciences Students And Interns Of A Tertiary Care Hospital, Pooja M, Puneeth A, Sharmi Nm

Digital Journal of Clinical Medicine

Background:

Antiseptics and disinfectants are among the most vital tools in infection prevention and control (IPC), especially in healthcare settings where the risk of hospital-acquired infections (HAIs) remains a significant concern. This study aims to assess the awareness and knowledge of antiseptics and disinfectants among Allied Health Sciences (AHS) students and interns, identify knowledge gaps at different stages of training, and recommend educational interventions.

Methods:

This was a cross-sectional, questionnaire-based study conducted among 1st to 3rd-year AHS students and interns at a tertiary care hospital. Data were collected using a validated questionnaire via a Google form after obtaining approval from …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Teamwork Enhanced With Digital Technology To Augment Bedside Shift Report: An Integrative Research Review (Irr), Daniel Everard Hronek

Covenant Nurses Week 2026

No abstract provided.

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Senior Theses

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

How Is The Use Of Ai Impacting Nursing Students Education?, Lorna H. Strain

Honors College Theses

The use of Artificial Intelligence (AI) in education is rapidly increasing and reshaping how nursing students learn and engage with content. This thesis proposal looks at the impact of AI on the education of nursing students and explores students' perceptions of its use in their learning and education. As AI becomes more prevalent, many students are using it for study aids and content personalization, while schools are using it in simulations and textbook platforms. Many recognize its benefits, such as enhanced critical thinking, improved accessibility of materials, and more immersive learning. Concerns persist around ethical use, academic integrity, and the …

Ambient Listening: Using Artificial Intelligence To Transcribe Provider Office Visits, Odia Russette

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Electronic health record (EHR) documentation burdens contribute to increased “pajama time” or after–hours charting, reduced job satisfaction, and provider burnout. Provider burnout leads to provider and critical access point losses. Ambient–listening artificial intelligence (AI) technologies have emerged as a possible tool to reduce charting burdens; however, evidence from outpatient wellness settings remains limited.

Local Problem: At an urban adult wellness clinic in Texas with limited resources for completing tasks, in-clinic and after-hours “pajama time” charting burdens contributed to provider fatigue, job dissatisfaction, and burnout.

Methods: A quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) framework implemented an AI ambient …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Senior Theses

Background: Islam is currently the fastest growing religion in the world and the chances of nurses having a Muslim patient is exceptionally high yet many nurses lack the knowledge and resources on how to accurately provide culturally sensitive care to Muslim patients. Hospitals lack educational sessions/training as well as Epic tools to help nurses provide culturally sensitive care to Muslim patients which leads to a knowledge deficit in cultural sensitivity of Islamic beliefs, values, and practices. Purpose: This thesis paper proposes a research design for a nurse education/training program on Islamic beliefs, values, and practices along with an implementation of …

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 …

Augmenting Large Language Models To Predict Social Determinants Of Mental Health In Opioid Use Disorder Using Patient Clinical Notes, Madhavi Pagare, Deva Sai Kumar Bheesetti, Inyene E. Essien-Aleksi, Mohammad Arif Ul Alam

Health Sciences Faculty Publications

Objective

Identifying social determinants of mental health (SDOMH) in patients with opioid use disorder (OUD) is crucial for estimating risk and enabling early intervention. Extracting such data from unstructured clinical notes is challenging due to annotation complexity and requires advanced natural language processing (NLP) techniques. We propose the Human-in-the-Loop Large Language Model Interaction for Annotation (HLLIA) framework, combined with a Multilevel Hierarchical Clinical-Longformer Embedding (MHCLE) algorithm, to annotate and predict SDOMH variables. Materials and Methods

We utilized 2636 annotated discharge summaries from the Medical Information Mart for Intensive Care (MIMIC-IV) dataset. High-quality annotations were ensured via a human-in-the-loop approach, refined …

Determining Factors For Long Term Use Of Gadget By Preschool Children, Wardatus Sholihah, Allenidekania Allenidekania, Nur Agustini, Rukmini Rukmini, Dwi Yuniar Ramadhani

Jurnal Keperawatan Indonesia

In the digital era, preschoolers spent more time playing on their gadgets than with their peers. The excessive use of gadgets (including laptops, cellphones, tablets, and similar electronic devices) can have negative impacts on preschool-age children. This study analyzes the determining factors that influence the duration of gadget use in preschool children. The study used a correlational design with a cross-sectional approach involving 318 parents who were selected using cluster sampling. The results showed that there was a significant relationship between the duration of gadget use and the gender of the parents (p = 0.001), parental education (p = 0.035), …