Bridging Evidence With Community: Five Routes To Diabetes Prevention In Latino Adults, Ann M. Maliackal

Doctor of Nursing Practice Final Project Abstract

Bridging Evidence with Community: Five Routes to Diabetes Prevention in Latino Adults

Background: This project used the Eightfold Path policy analysis approach to identify and recommend an evidence-based diabetes prevention program (DPP) for Latino adults in the Rio Grande Valley (RGV). The aim was to reduce diabetes prevalence by selecting an intervention that is culturally appropriate and effective for this population.

Methodology: The Eightfold Path policy analysis approach guided this project. A comprehensive literature review identified diabetes prevention programs (DPPs) tailored for Latino adults, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Five DPPs were …

Improving Influenza Vaccination Rates In A Teen/School-Based Clinic, Alina Leigh

Doctor of Nursing Practice Final Project Abstract

Purpose: The Centers for Disease Control and Prevention (CDC) states the best way to prevent the flu is through vaccination recommended for everyone 6 months and older. Clinic flu vaccination rates are low, and effective strategies are needed to improve rates and promote knowledge on the benefits of the vaccine. This can be achieved by educational intervention, provider recommendation, improved screening, and obtaining consents for teens and young adults in the teen clinic.

Background: Every year, the influenza virus is responsible for thousands of deaths and billions of dollars in spending in the United States, however immunization rates remain below …

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 …

Nursing Education Leadership Succession Planning: Utilization Of Career Mapping For Professional Development, Reba L. Carethers

Doctor of Nursing Practice Final Project Abstract

PURPOSE The focus of this quality improvement project was to identify potential future leaders in the Nursing Professional Development (NPD) department at a large hospital system using a succession planning model, strategy organizations use to cultivate individuals with the potential to assume future leadership roles.

BACKGROUND A gap existed in deliberate career planning within the NPD department. A quality improvement project was developed utilizing evidence-based interventions including development of professional objectives, professional development opportunities, and identification of aspiring leaders in nursing education.

METHODOLOGY Participants developed a career map to outline career goals, created an action plan for their professional development …

Reclaiming Teen Recovery: Tailored Therapeutic Recreation To Boost Engagement, Satisfaction, And Participation, Kabresha R. Potts

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project evaluated the impact of four tailored group therapeutic recreation modules on six recovery outcomes: satisfaction, engagement belief, participation likelihood, motivation to seek help, perceived usefulness, and perceived importance, among adolescents at a residential treatment facility in Houston, TX, targeting ≥ 20% improvement in each domain.

Background: Adolescents in short-term, often court-mandated, treatment lack personalized leisure activities that promote emotional expression and resilience. Structured leisure engagement is linked to positive affect and treatment motivation, yet interest-based programs for court-involved youth remain underexplored.

Methodology: Using Plan-Do-Study-Act cycles and Self-Determination Theory, weekly 90-minute modules (mindfulness trivia, art Jeopardy, music …

Implementing A Multi-Faceted Approach To Reduce Falls And Enhance Safety In Psychiatric Patients While Improving Nurses Perception While Improving Nurses Perception Of Fall Risk Identification, Shanika King

Doctor of Nursing Practice Final Project Abstract

Purpose: The goal of this quality improvement project was to decrease falls in inpatient psychiatric units by at least 5% within six months, utilizing a multifaceted approach while increasing nurses' ability to identify patients at risk for falls. This project incorporated fall risk assessment, staff education, visual identifiers, and debriefings. Nurse confidence was measured post-intervention using a Likert scale survey.

Background: Psychiatric fall rates range from 13 to 25 per 1,000 hospital days, compared to 3 to 4 in general hospitals. These rates highlight the importance of tailored interventions. This project was completed in an inpatient psychiatric facility in …

Heart Failure And Home Health Care Referral Utilization, Tatiana Le

Doctor of Nursing Practice Final Project Abstract

Heart Failure and Home Health Care Referral Utilization

Purpose

The purpose was to increase provider awareness of the benefits of home health care (HHC) referrals for heart failure patients. It aimed to increase HHC referral utilization intention to maintain compliance with the American Heart Association’s (AHA) recommendation for early follow-up within seven days post-discharge.

Background

Heart failure is a major cause of readmissions in older adults. HHC has been shown to reduce readmissions and improve outcomes post-discharge. HHC referrals remain underused despite its benefits, due to limited provider awareness. This project addressed the gap at a Southeast Texas suburban hospital …

Improving Medication Adherence In Patients With Uncontrolled Hypertension, Suzanne Cockrell

Doctor of Nursing Practice Final Project Abstract

The project’s purpose was to improve medication adherence and blood pressure with an educational packet. The project was necessary due to patient’s elevated blood pressure readings during visit encounters. Implementation occurred at a clinic in Central Texas and included established patients ages 18 or older with uncontrolled hypertension and employed staff members. The Health Belief Model provided a framework to form a hypertension educational packet. The packet was provided at varying locations within the clinic and via staff handouts. Visual aids were intentionally selected to depict the damaging effects of hypertension, hypertension monitoring, and guidance on medication reminder apps. The …

Implementation Of A Standardized Onboarding Program, Sarah J. Wall

Doctor of Nursing Practice Final Project Abstract

Purpose: To evaluate the impact of a standardized onboarding program on Advanced Practice Provider (APP) retention and productivity within an academic department.

Background: High APP turnover in specialized settings disrupts care and leads to financial losses. Previously, onboarding lacked structure, leading to early attrition and delayed productivity. A 24-week phased, competency-based orientation program was developed to improve retention, job satisfaction, and clinical performance.

Methods: The program, implemented in April 2024, included clinical precepting, didactic modules, and mentorship. Retention and Relative Value Units (RVUs) were measured before and after implementation. Qualitative data was collected through mentorship surveys and APP focus groups. …

Decreasing Emergency Department (Ed) Revisits: Providing Resources That Address Overutilization For Patients With Substance Use Disorder, Amber May

Doctor of Nursing Practice Final Project Abstract

Date of Doctor of Nursing Practice Project Completion

Summer 8-5-2025

Faculty Advisor

Rebecca Tsusaki PhD, APRN-CNP, WHNP-BC, IBCLC

ABSTRACT

PURPOSE This quality improvement project was intended to decrease emergency department (ED) revisits by 10%, from high-utilizer patients (those with more than 10 ED visits in the past year), by implementing community health worker–led follow-up phone calls within one week of discharge, over a 30-day period. The project was conducted at a large metropolitan hospital in Houston, Texas.

BACKGROUND Non-urgent revisits and overutilization affect ED wait times, are associated with overcrowding, contribute to unnecessary care delays, impact patient satisfaction scores, and …

Abstract Prevention Of Hospital-Acquired Pressure Injuries In Older Adults In Acute Care Settings, Evelyn Yegella

Doctor of Nursing Practice Final Project Abstract

INTRODUCTION:

Hospital-acquired pressure injuries (HAPIs) are a significant risk for older people in acute care, leading to increased morbidity,

Healthcare costs and fragility in senior patients result in higher HAPI rates. This quality improvement (QI) project aimed to reduce HAPI incidence by 40% within four months, utilizing evidence-based nursing interventions tailored to this vulnerable population.

METHODOLOGY:

The project followed the Plan-Do-Study-Act (PDSA) methodology, implementing staff training, periodical skin assessments, and repositioning schedules. Data were collected monthly using skin evaluation checklists and HAPI incidence reports from 30 patient days, and chi-square tests and control charts were used to examine the results. …

Evaluating What Works: A Comparison Of Five Diabetes Prevention Programs For Latino Children, Ruchi Patel

Doctor of Nursing Practice Final Project Abstract

Background: Children in the Rio Grande Valley (RGV) are at increased risk of diabetes due to limited access to effective, culturally appropriate prevention programs. Existing programs are often time-intensive, require transportation, and lack cultural relevance, reducing participation and impacting outcomes. This project aimed to evaluate diabetes prevention programs (DPPs) in the literature and identify five that may benefit children in the RGV by reducing diabetes risk.

Methodology: The Eightfold Path policy analysis approach guided this project. A literature review identified DPPs for children, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Limitations included difficulty finding …

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

Titer-First Vaccination Protocol In An Employee Health Clinic, Obehi Dickson

Doctor of Nursing Practice Final Project Abstract

Purpose:

The purpose of this project was to evaluate the clinical and financial outcomes of implementing a titer-first vaccination protocol for new employees at an Employee Health Clinic. This project sought to improve cost-effectiveness and reduce unnecessary vaccinations.

Background:

This project was conducted at a large healthcare organization in Houston, Texas, to address the cost burden of traditional vaccination protocols. Pre-vaccination serologic testing helps identify existing immunity, reducing unnecessary vaccinations and overall clinic costs.

Methodology:

The titer-first vaccination protocol includes serologic testing for measles, mumps, rubella (MMR), varicella, and hepatitis B, followed by vaccine administration for those without immunity. Data …

Culturally Centered, Primary Care Interventions For Effective Weight Management Goals In Hispanic/Latino Children, Remigio Acevedo

Doctor of Nursing Practice Final Project Abstract

PURPOSE To implement and evaluate the effectiveness of a clinic-based childhood obesity intervention program for Hispanic/Latino children.

BACKGROUND From 1975 to 2016, childhood obesity rates have more than quadrupled, affecting Hispanic/Latino families the most. Growing evidence suggests that incorporating the family unit and utilizing culturally centered weight management interventions can be cost-effective and pragmatic compared to a standard, generic approach.

METHODOOLOGY A quality improvement project was initiated to provide information on the degree of success of a clinic-based childhood obesity program for Hispanic/Latino children and their parents. The intervention focused on delivering a culturally centered health promotion message based on …

A Pilot Structured Mentorship Program To Increase Pediatric Advanced Practice Provider Engagement At An Academic Institution, Erica Annotti, Dnp, Aprn, Pnp

Doctor of Nursing Practice Final Project Abstract

Introduction/Purpose: Advanced Practice Providers (APPs) transitioning into academic healthcare often face challenges related to role clarity, professional identity, and emotional support, which can hinder their engagement and retention. This quality improvement project aimed to design, implement, and evaluate a structured mentorship pilot program for pediatric APPs to increase work engagement by 10%.

Methods: Grounded in the Strong Model for Advanced Practice and Wagner’s Caring Mentorship Framework, the project employed a mixed-methods QI design. Four pediatric APPs (n=4) participated in an 8-week structured mentorship program. Interventions included the intentional pairing of mentors and mentees, biweekly one-on-one sessions, and targeted professional development …

Implementation Of A Zen Room To Decrease Perceived Stress: A Quality Improvement Project, Michelle Tat

Doctor of Nursing Practice Final Project Abstract

Introduction: This quality improvement project addresses a lack of quiet space for staff to de-stress. The goal was to create a Zen room at a substance abuse treatment facility to decrease self-perceived stress in staff by 15% within three months.

Methodology: The PDSA cycle was applied to the creation of a Zen room. Stress was measured with questions from the Perceived Stress Scale at baseline, entry, and exit. 23 participants recorded Zen room entry. Limitations included small sample size and exit survey attrition. Implementation challenges included budget issues and low response rates. Stress levels were compared at baseline, room entry, …

Implementation Of A Discharge Process For Pediatric Patients Hospitalized With Asthma Exacerbations To Improve Post-Discharge Follow-Up, Emiko N. Dudley

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to improve pediatric pulmonary outpatient follow-up after hospital discharge for pediatric patients hospitalized with asthma exacerbations through the implementation of a standardized discharge process designed to improve communication, education, and care coordination.

Background

The project was completed in acute care and intermediate care units within a women's and children’s hospital in San Antonio, Texas.

Methodology

Following the IHI Improvement Model, serial PDSA cycles were completed over a 10-week period. An interprofessional team developed a standardized process map and interventions, including a discharge checklist, communication board, patient/family education, medications in hand at discharge, community asthma …

Promoting Pre-Exposure Prophylaxis (Prep) Regimen Adherence Through A Multifaceted Approach To Increase Adherence: A Quality Improvement Project, Queen C. Ezenwome

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to implement the use of daily text message reminders to promote PrEP medication regimen adherence, thereby reducing the risk of HIV acquisition in an at-risk population. Patient interviews and surveys were also conducted to obtain valuable information regarding barriers and facilitators to PrEP regimen adherence.

Background

The project was implemented at a homeless shelter in Harris County, Houston, Texas, that houses homeless youth ages 18-24 while also providing medical, educational, and financial services or assistance. Due to risky behaviors prevalent in this population, coupled with living in the Houston area, these patients …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

Implementation Of A Zen Room And Mindfulness Techniques To Decrease Perceived Burnout, Danika Scott

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a Zen room and mindfulness techniques, aiming to improve job satisfaction by 65% and reduce perceived burnout by 10% among behavioral health staff. The project was conducted at a substance abuse center in Deer Park, TX.

Background: Behavioral health staff face high levels of emotional exhaustion and job-related stress, leading to increased burnout.

Methodology: The Plan-Do-Study-Act model guided the QI methodology using a sample of 23 behavioral health staff. Interventions included an equipped Zen space and wellness resources. Data collection utilized the Maslach Burnout Inventory and a …

Reporting And Tracking Of Occupational Bloodborne Pathogen Exposures, Olivia Smith

Doctor of Nursing Practice Final Project Abstract

Purpose/Background: Underreporting of occupational bloodborne pathogen (BBP) exposures remains a significant patient and employee safety issue. At UT Health, outdated paper-based systems hindered accurate tracking, timely follow-up, and reporting compliance. The aim of this quality improvement (QI) project was to achieve a 30% increase in quarterly BBP exposure reports, from 30 to 39, by implementing an electronic reporting system between January 1 and March 31, 2025.

Methodology: Guided by the Health Belief Model and using the Implementation and Improvement Science (IIS) Framework, the project replaced the existing paper form with an external, user-friendly digital system. Staff received structured training, and …

Enhancing Medication Adherence In The Older Adult By Implementing A Medication Program, Cathylee Nair

Doctor of Nursing Practice Final Project Abstract

PURPOSE The medication adherence program was a collaborative effort to develop, implement, and evaluate a medication adherence program that aims to reduce health utilization and disease exacerbation by improving medication adherence in older adults. The primary goal was to improve medication adherence by 10% within eight weeks.

BACKGROUND The medication adherence program was based out of a home health agency in Katy, Texas. Medicare utilizes home health agencies as patient support programs for providing services like medication management to reduce older adult’s health utilization and improve health outcomes at home.

METHODOLOGY The Plan Do Study Act (PDSA) model for improvement …

Evidence Based Pilot Project To Reduce Nurse Documentation Time In The Electronic Health Record, Herbert Rolito C. Ortiz

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was the reduction of electronic health record (EHR) documentation time and improve nurse satisfaction in an Intermediate Care Unit (IMU).

Introduction: Nursing documentation supports patient safety, interdisciplinary communication, and regulatory compliance. However, excessive documentation requirements may reduce the time nurses spend with patients, increase the risk of errors, and contribute to job dissatisfaction and burnout. At a large, academic hospital, nurses in the target unit were averaging 155 minutes of documentation per 12-hour shift, ranking in the 90th percentile for documentation time among peer institutions.

Methodology: The project, conducted between March 1 …

Nurse-Led Medication Reconciliation Protocol In The Adult Outpatient Mental Health Setting, Grace Gu

Doctor of Nursing Practice Final Project Abstract

This scholarly project implemented a medication reconciliation protocol within the adult outpatient mental health clinic setting. The protocol aimed to increase the medication reconciliation rate from 55% to 60% within three months by May 2025, as well as improve the perception of medication reconciliation among nursing staff. The project was implemented within an outpatient mental health clinic, part of a local community mental health center in Austin, Texas. Patients often see multiple healthcare providers, leading to risks of polypharmacy. This can lead to adverse reactions, medication interactions, and hospitalizations. A flowsheet protocol was created to help guide nursing staff on …

Implementing Sacred Pause After Patient Death To Reduce Burnout In Icu Nurses, Kimberly Lee

Doctor of Nursing Practice Final Project Abstract

This quality improvement project aimed to implement the Sacred Pause in a hospital Intensive Care Unit (ICU) and evaluate its impact on nurse burnout using the Maslach Burnout Inventory (MBI). Background ICU nurses are at high risk for burnout due to frequent exposure to trauma, highacuity care, and patient death. Burnout can negatively affect nurse well-being, staff retention, and quality of care delivery. The Sacred Pause is a brief, intentional moment of silence observed by staff following a patient’s death. This practice honors the life lost and acknowledges the contributions of the healthcare Methodology team, offering a potential source of …

Implementation Of Safety Restraint Chair Algorithm With De-Escalation Techniques To Decrease Restraint Time In Acute Psychiatric Unit, Chiamaka Nwadike

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aims to (1) decrease time in restraint use on the inpatient psychiatric unit through implementing the restraint chair protocol, and (2) improve staff satisfaction in using safety restraint.

Background: In acute psychiatric care, restraints are used to ensure safety, but they pose physical and psychological risks. There is an increasing recognition of the need for patient safety, including the use of de-escalation techniques that prioritize restraint chairs over bed restraints to ensure safety.

Methodology: The project follows the Plan-Do-Study-Act (PDSA) model, which supports a continuous improvement approach to implementing the restraint chair …

Policy To Decrease Attrition Rates Amongst Mental Health Nurses, Ashley E. Burnett

Doctor of Nursing Practice Final Project Abstract

The high attrition rate among mental health nurses in the United States presents a critical challenge, leading to increased operational costs, workforce shortages, and compromised patient care. This policy proposal seeks to address the issue of mental health nurse turnover by offering a structured approach to enhancing job contentment and dealing with stress factors within the workplace. In line with the purpose of the study, quantitative and qualitative data from workforce surveys, peer-reviewed literature, and policy evaluations are combined to determine common retention strategies. Findings indicate that mentorship programs, competitive salaries, flexible scheduling, and workplace support systems significantly reduce burnout …

Decreasing Incidence Of Intramuscular Emergency Psychiatry Medications In Psychiatric Adult Patients Through The Acute Violent Assessment Tool (Avat), Edidiong G. Ebong

Doctor of Nursing Practice Final Project Abstract

Purpose The purpose of this QI project was to reduce emergency IM psychiatric medication usage by implementing the Acute Violent Assessment Tool (AVAT) to improve early aggression management. Background The frequent use of emergency intramuscular (IM) psychiatric medications in inpatient psychiatric settings raises concerns regarding patient safety, autonomy, and staff burden. This quality improvement (QI) project aimed to reduce emergency IM medication administration by 20% over three months by implementing the AVAT to improve early identification, prediction, and management of aggression and violence. Methodology A Plan-Do-Study-Act (PDSA) framework guided the AVAT implementation in an adult psychiatric unit. Three weeks of …

A Quality Improvement Project On Implementing A Nurse-Driven Foley Catheter Removal Protocol Using Modified Houdini Criteria For Oncology Patients To Reduce The Catheter-Associated Urinary Tract Infection (Cauti) And Catheter Days In The Intensive Care Unit (Icu), Rittu K. Justin

Doctor of Nursing Practice Final Project Abstract

Purpose: This scholarly project aimed to develop modified criteria for oncology patients regarding Foley catheter removal guidance and implement a nurse initiative in the ICU to reduce CAUTI and catheter days.

Background: CAUTIs are considered preventable nosocomial infections; hence, a nurse-driven Foley catheter removal protocol has become an essential strategy in healthcare to reduce CAUTIs. The project was implemented in a 43-bed ICU in an academic hospital at the Texas Medical Center. The 12-week pilot project included adult patients with a primary diagnosis of cancer.

Methodology: A quantitative design with a PDSA framework was employed. The institutional infection control trend …