Nursing Commons^™

Empowering Psychiatric Nurse Practitioners To Address Nutritional Deficits: An Educational Quality Improvement Study, Beatrice Joan Richards

Doctoral Dissertations and Projects

Psychiatry is a complex and multifaceted discipline, and treatment approaches often vary based on provider preference and philosophy. Some focus heavily on pharmacotherapies, while others use psychotherapeutic methods, and still others take a more holistic approach involving full-body wellness. All three strategies are beneficial, and providing psychiatric care with a combination of them all can address the full spectrum of factors that influence one’s mental health. Much research, education, and clinical focus have been put on pharmacotherapy and psychotherapeutics. However, there is a marked lack of understanding regarding the holistic realm of psychiatric care, specifically the role of nutrition, amongst …

Pilot Study: Integrating The Epic Stroke Narrator Into Inpatient Code Stroke Protocols To Improve Symptom Onset Identification And Reduce Intervention Times, Stacy L. Carter

Doctoral Dissertations and Projects

In-hospital strokes are often underrecognized, leading to treatment delays and poorer outcomes compared to community-onset strokes. This scholarly project evaluated whether integrating the Epic Stroke Narrator into inpatient code stroke protocols could improve documentation of last known well time (LKWT) and reduce time to intervention. A 6-week quasi-experimental pilot study guided by the Iowa Model of Evidence-Based Practice and Rogers’ diffusion of innovations theory was conducted on a neuroscience telemetry step-down unit at a comprehensive stroke center in Richmond, Virginia. Education on the Stroke Narrator was provided to bedside nurses and was followed by implementation and evaluation of narrator use …

The Relationship Between Nursing Faculty Sense Of Belonging And Faculty Intent To Stay, Heather M. Bowers

Doctoral Dissertations and Projects

The purpose of this quantitative causal-comparative and correlational study was to evaluate the relationship between workplace sense of belonging and intent to stay in the current nursing faculty role among full-time nursing faculty. The shortage of nursing faculty impacts the ability to prepare the next generation of nurses needed to meet worldwide nursing demands. Strategies to effectively recruit and retain nursing faculty are important considering the current shortage and increasing retirements of nursing faculty. While sense of belonging has been studied for student retention and studies are beginning to explore the importance of workplace belonging, the impact of organizational sense …

The Lived Experiences Of Micu Nurses During The Covid-19 Pandemic: A Qualitative Study, Thomas Hopkins

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the lived experiences of MICU nurses during the COVID-19 pandemic and how these experiences may inform disaster preparedness in the nursing curriculum. This research is guided by Watson’s (1979) theory of human caring. The theory emphasizes the importance of interpersonal relationships and emotional support in nursing practice, and how these elements can be integrated into disaster preparedness training. Using interpretive phenomenological analysis, data were collected through semi-structured interviews, field notes, and guided journaling. The interviews were conducted via digital conferencing software over the internet. Field notes were recorded during the interviews. …

Increasing Patient Satisfaction And Engagement By Improving Patient Intake Process In An Outpatient Mental Health Clinic, Hotenesia Njoroge

Doctoral Dissertations and Projects

This scholarly project aimed to enhance patient satisfaction and engagement by improving the intake process in an outpatient mental health clinic. Inefficient intake procedures, characterized by long wait times, communication gaps, and misreferrals, contribute to patient disengagement and dissatisfaction. A quasi-experimental pretest-posttest design evaluated a patient-centered intervention involving communication training, streamlined workflows, and real-time updates. Data were collected from 52 participants using Patient-Reported Experience Measures (PREMs) and qualitative feedback. Quantitative results revealed high satisfaction with staff respect (M = 4.19), communication clarity (M = 4.06), and facility comfort (M = 4.13). Wait time satisfaction scored slightly lower (M = 3.96), …

Self-Efficacy And Burnout Of Nursing Faculty: The Mediating Role Of Fear Of Negative Evaluation, Sarah Murray Kelly

Doctoral Dissertations and Projects

The contents of this manuscript include a dissertation of a survey research study using the theoretical models of self-efficacy and burnout. The quantitative study used mediation analysis to explore the relationship between self-efficacy and burnout, with fear of negative evaluation as a mediator. Fear of negative evaluation was measured using the Brief Fear of Negative Evaluation Scale-Revised; self-efficacy was calculated using the General Self-Efficacy Scale; and burnout was measured using the Oldenburg Burnout Inventory. The study drew a sample of 98 academic nurse educators (N = 98) who were evaluated by student evaluations of teaching. The sample included educators who …

Enhancing Parental Knowledge Of Functional Medicine Interventions For Adhd: An Educational Initiative To Improve Caregiver Competency, Julie Gammer

Doctoral Dissertations and Projects

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent pediatric psychiatric condition often managed with stimulant medications that carry potential side effects and may not address underlying causes. Research findings indicate a significant gap in caregiver knowledge and confidence in treating their child's ADHD with functional medicine strategies. This project develops an evidence-based educational initiative designed to enhance caregiver knowledge and confidence in applying functional medicine interventions—such as dietary modifications, targeted supplementation, and gut health restoration—as natural, root-cause approaches to managing ADHD symptoms. The project utilized a 30-minute audiovisual presentation and was evaluated using pre- and post-intervention competency tests, as well as a …

Decreasing The Incidence Of Healthcare Associated Presure Injuries In The Acute Care Setting, Amanda R. Nichols

Doctoral Dissertations and Projects

Healthcare-associated pressure injuries (HAPIs) can cause great harm to vulnerable patients. Acquiring a HAPI during hospitalization can result in delayed wound treatment, prolonged hospitalization, risk for infection, reimbursement issues for the facility, and delayed patient discharge. Avoiding these injuries is essential to improve patient outcomes. Research reveals that the implementation of nurse education and two registered nurse skin assessments on admission, instead of one nurse skin assessment, can decrease the incidence of healthcare-associated pressure injuries. Using the Iowa model, the goal of this scholarly project is to implement evidence-based research to change the current process and decrease the incidence of …

Experiences Of First-Generation Nursing Students After Their First Year At An Hbcu: A Transcendental Phenomenological Study, Ari L. Cuffee

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore the lived experiences of first-generation nursing students (FGNS) after their first year at a Historically Black College or University (HBCU). The central research question asked, “What are the lived experiences of first-generation nursing students who have completed one year at a Historically Black University?” The theoretical framework that guided this study was Banks’ theory of multicultural education. This theory demonstrated how educators taught FGNS using the multicultural education paradigm with strategies and procedures to make provisions for culturally, racially, and ethnically diverse students. Data were analyzed using Moustakas’ interpretive phenomenological …

Passing The Torch: Evaluating Documentation Quality And Its Impact On Nurses’ Perceptions Of Communication Across Va Care Transitions, Shannon Collier Baker

Doctoral Dissertations and Projects

Effective communication during transitions of care is crucial to ensuring patient safety and optimizing outcomes. However, current practices may fall short in supporting clear and comprehensive communication among healthcare providers, particularly during complex care transitions involving Veterans who have received targeted care coordination intervention outside of their primary Patient Aligned Care Team. The absence of standardized tools for handoff documentation exacerbates fragmented communication and ambiguity about the transfer of care management responsibilities, potentially leading to avoidable errors and care coordination failures. This project aimed to investigate nurses' perceptions of the adequacy of communication during the transition of moderate to complex …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray-Johnson

Doctoral Dissertations and Projects

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to teenagers aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was used as a framework for implementing this study. The quasi-experimental …

Mental Health Provider Education On The Benefits Of Telepsychiatry To Increase Knowledge And Promote Adoption To Improve Organizational Efficiency, Standards Of Care, And Revenue Generation., Jada Eugene

Doctoral Dissertations and Projects

The study implemented an educational intervention on the benefits of telehealth among mental health providers to improve their level of knowledge and promote technology adoption to improve organizational efficiency, revenue generation, and standards of care. The clinical question was: Among mental health providers, does an educational intervention on the benefits of telehealth, compared to no education, enhance knowledge of telepsychiatry consultations and promote adoption to improve organizational efficiency, standards of care, and revenue generation? Utilizing the Iowa Model of EBP, the researcher implemented a pilot study using the quasi-experimental design. Knowledge, telehealth usability, revenue generation, and standards of care were …

Improving The Medication Communication Domain Of The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey In A Pediatric Hospital, Bailey N. Godwin

Doctoral Dissertations and Projects

Patient education is a key responsibility of nurses. Providing education is the most effective when the teach-back method is used in combination with tangible education materials. Patient satisfaction in the pediatric setting is measured using the Child Hospital Consumer Assessment of Healthcare Providers and Systems survey (Child-HCAHPS). This evidence-based practice project aimed to improve patient/caregiver satisfaction scores for medication education on the Child-HCAHPS survey through comprehensive medication education and improved usage of patient education materials at discharge. Three pediatric units within an academic health institution in central North Carolina were identified for participation in the intervention by their managers and …

Providing Evidenced Based Practice Interventions To Direct Care Providers In Long-Term Facilities To Increase Knowledge Of Mental Health Care In Older Adults: An Educational Toolkit, Chelisa Ann Crabtree

Doctoral Dissertations and Projects

The purpose of this scholarly project is to increase the knowledge of mental health (MH) care among direct care providers in long-term facilities by developing an educational toolkit focused on evidence-based education and training, with the goal of enhancing staff competencies in MH care, improving the management of residents’ MH needs, and ultimately optimizing care and quality of life. With the increasing number of younger and sicker individuals, particularly those with MH issues, residing in long-term facilities and lack of specialized training for direct care providers which leads to inadequate/complicated care and poor patient outcomes, there is a pressing need …

Enhancing Hypertension Management In Correctional Facilities: Educating Advanced Practice Providers On Effective Strategies, Kimbreya E. Otey

Doctoral Dissertations and Projects

Hypertension is a leading risk factor for cardiovascular disease and remains a significant public health concern, particularly within correctional facilities where access to consistent guideline-based care is often limited. Incarcerated individuals experience higher rates of chronic conditions, including hypertension, yet standardized approaches to management are frequently lacking. To address this gap, an evidence-based educational program was developed for nurse practitioners (NPs) and physician assistants (PAs) working in the correctional setting. Grounded in the International Society of Hypertension (ISH) guidelines, the program was developed to enhance awareness and knowledge among NPs and PAs regarding evidence-based hypertension management practices using the International …

The Effect Of An Educational Intervention On Pre-Licensure Nursing Students Using The Theory Of Cultural Humility, Margaret Curry

Doctoral Dissertations and Projects

The American population has become more racially and ethnically diverse. Pre-licensure nursing students must have the knowledge, skill, and attitude to meet the needs of this diverse patient population. The purpose of this study was to educate pre-licensure nursing students on the concept of cultural humility using standardized patients from diverse cultural backgrounds in simulation experiences. The 27 students in this study were enrolled in a traditional nursing program in the southern U.S. This one-group quasi-experimental pretest–posttest design used Foronda’s Cultural Humility Scale. These students completed this scale (pretest), participated in simulation experiences with standardized patients from diverse cultural backgrounds, …

The Impact Of Trauma-Informed Care Education On Healthcare Providers And Staff In An Outpatient Clinic: A Holistic Approach To Diversity, Equity, And Inclusion, Ngozi Azu

Doctoral Dissertations and Projects

Trauma is an emotional response that an individual may experience due to exposure to an event beyond their ability to manage. Trauma-informed care (TIC) is essential in health care for creating a supportive and safe atmosphere for individuals with a trauma history, but many health providers and staff lack proper training in TIC. The purpose of this project was to design, implement, and evaluate a comprehensive education program focused on TIC for health care providers and staff in an outpatient clinic setting. A quasi-experimental methodology and the Iowa Model of Evidence-Based Practice were used. Quantitative and qualitative data were collected …

Nurse Preceptors' Perceptions Of Effectiveness Precepting Senior Baccalaureate Nursing Students: A Transcendental Phenomenological Study, Kelly Anne Arraf

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore how clinical nurse preceptors perceive their effectiveness when working with senior baccalaureate nursing students in East Texas. The study was guided by two theories: Invitational Education Theory, introduced by Purkey and Novak, used to understand how preceptors teach, and Bandura’s Social Learning Theory, used to understand how preceptees learn. The central research question was: What is the lived experience of being a nurse preceptor to senior baccalaureate nursing students in East Texas? Data were collected from semistructured virtual interviews, field and journal notes, and a demographic survey. Braun and Clarke’s …

Implementation Of An Education Program For A Ptsd Screening Tool To Increase Knowledge Among Providers Within The Primary Care Setting, Kimberly Inez Schat

Doctoral Dissertations and Projects

Post-Traumatic Stress Disorder (PTSD) is frequently underdiagnosed or misdiagnosed in primary care settings, leading to delays in treatment and poorer patient outcomes. This scholarly project aims to enhance primary care providers' knowledge and application of PTSD screening tools, specifically the PC-PTSD-5, through a structured educational intervention. The project follows a quasi-experimental pre-test/post-test design, assessing providers' baseline knowledge, delivering targeted education, and measuring changes in knowledge and confidence post-intervention.

Data analysis revealed a statistically significant improvement in providers' ability to identify PTSD symptoms, utilize appropriate screening tools, and refer patients for timely treatment. The project highlights the clinical significance of routine …

Decreasing Medication Errors Among Unlicensed Assistive Personnel, Tamara J. Carroll

Doctoral Dissertations and Projects

Unlicensed assistive personnel, although their role is controversial, are present in many different settings and have many varying roles and job responsibilities. Yet, removing this type of healthcare worker from the job pool may lead to increased labor costs, which could be stifling to some organizations and facilities. Digging deeper, data suggests errors are due to lack of a defined scope of practice, a lack of understanding of job roles and responsibilities and decreased confidence when working in the healthcare setting. The purpose of this project utilizes a setting specific educational intervention and skills check off to increase job self-efficacy …

Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli

Doctoral Dissertations and Projects

Communication between nursing staff and providers is essential for supporting optimum patient outcomes. Each component of the communication process needs to be clearly defined to create an environment of safety for both patients and caregivers. The SBAR (situation, background, assessment, recommendation) is a nurse-driven protocol that is widely used as a communication and documentation template in health care organizations. This format is currently not being used effectively on the mental health units where the evidence-based project was implemented. Recognizing and reiterating the value of SBAR as a communication tool is necessary when communication deficits are noted. The purpose and scope …

Implementation Of An Educational Intervention To Improve Antibiotic Stewardship In An Urgent Care Setting, Evelyn Jane Clinton

Doctoral Dissertations and Projects

Antimicrobial resistance is a leading threat to global health. Resistance to antibiotics in the United States continues to increase contributing to rising numbers of resistant infections and subsequent deaths. This highlights the critical need for increased focus on antibiotic stewardship efforts. Urinary tract infections are one of the leading indications for antibiotic prescription in the outpatient setting and research suggests that there is an opportunity for improvement in antibiotic stewardship efforts in this area. The PICOT question for this project is as follows: In an urgent care setting, does provider education on the current evidence for urinary tract infection diagnosis …

Improving New Graduate Nurse Clinical Judgment By Training Preceptors On The Use Of The Tanner Model, Denise E. Carr

Doctoral Dissertations and Projects

New graduate nurses (NGNs) often enter the workforce with deficits in clinical judgment, which has been further exacerbated by pandemic-related limitations in clinical education. This project aimed to improve NGN clinical judgment by training preceptors to use the Tanner Clinical Judgment Model (TCJM) and Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental evaluation design was used to compare outcomes between two groups of preceptor–preceptee pairs. Half of the preceptor participants received training on the TCJM and LCJR, while the other half did not. Clinical judgment development was measured using the LCJR pre- and post-orientation. Additional preceptor feedback regarding the implementation and …

Do Perceived Social Support And Positive Religious Coping Moderate Any Relationship Between Post-Intensive Care Syndrome–Family Symptoms And Quality Of Life In Informal Caregivers Of Intensive Care Unit Survivors?, Carol R. Hirschkorn

Doctoral Dissertations and Projects

Family members and close friends often act as informal caregivers (CGs) for survivors of critical illness, assisting with activities of daily living, ongoing care needs, and adjustment to life after critical illness. These CGs simultaneously cope with their own mental, physical, and social sequelae, including significant changes (to roles and responsibilities) in everyday life. Qualitative researchers have examined this constellation of CG symptoms, which constitute post-intensive care syndrome–family (PICS-F), to understand the experiences, needs, and coping of CGs of intensive care unit (ICU) survivors. None have looked at the impact of religious coping and perceived social support on PICS-F and …

The Perceived Effectivenss Of Nurses' Suicide Management Training In Correctional Facilities: A Phenomenological Study, Phillis Hopson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the perceived effectiveness of nurses' suicide management training in correctional facilities in the United States. The central research question was: What suicidal educational training do nurses receive, and what is their lived experience of managing suicidal inmates at correctional facilities? The type of research design for this study was hermeneutic phenomenology. This study's geographic setting was two correctional facilities in rural areas in the United States. The settings include the Federal Mental Correctional Facility (FMCF) and the Villian Mental Correctional Facility (VMCF). The Federal Mental Correctional Facility is situated in the …

Ageism From The Perspectives Of Diploma Program Nursing Students After An Aging Simulation: A Phenomenological Reflection, Melissa Suzanne Jones

Doctoral Dissertations and Projects

Ageism in the healthcare system creates a challenge for nurses and their patients. Knowledge is needed regarding sensory changes that occur with normal aging. This knowledge gap leads to stereotyping and missed opportunities for age-appropriate care. Nurses must recognize that hearing loss and naturally occurring vision changes can lead to poor outcomes and social isolation in older adults. In addition, caring for older adults becomes less desirable to nurses entering practice because of negative perceptions about older adults. However, nursing programs can address ageism by augmenting the curriculum with a geriatric sensitivity simulation. Through a series of exercises that simulate …

Implementation Of Social Support Assessment In Patients Aged 65 And Older With Type 2 Diabetes Mellitus To Improve Treatment Adherence In A Primary Care Setting, Angela Allen-Blaine

Doctoral Dissertations and Projects

Background: There is a growing number of adults aged 65 years and older living with type 2 diabetes. Research shows this population is at a higher risk of losing independence due to diabetic complications. Social support is a key component to help assist patients with taking medications properly, preparing diabetic meals and monitoring blood glucose. Adequate social support may improve the quality of health and well-being in older adults. Social support is not routinely assessed in primary care, but it is routinely treated. This evidence-based practice project aimed to educate clinicians about social support assessment and facilitate implementation of a …

A Qualitative Study Of Registered Nurses’ Perceptions Of The Impact Communication Modalities Have On Patient Care Outcomes In Primary Care, Eleanor M. Chapital

Doctoral Dissertations and Projects

Communication plays a vital role in the provision of patient care and directly impacts patient care outcomes across the care continuum. The purpose of this qualitative study was to explore and determine registered nurses’ perceptions of the communication modalities that facilitate optimum patient care outcomes in the primary care setting. Registered nurses play a critical role in the provision and coordination of patient care. Therefore, it is imperative to study their experiences and perceptions to facilitate communication within primary care teams. The central research question for this study was the following: How do registered nurses describe their use of communication …

Evidence Based Orientation And Mentorship: A Solution To Decreased Job Satisfaction And Performance Amongst Healthcare Techs In The Emergency Department, Paige E. Fleming

Doctoral Dissertations and Projects

Healthcare technician support in high-volume emergency departments (EDs) is often inadequate, leading to challenges in job satisfaction, confidence, and competence. This project implemented an evidence-based orientation and mentorship program to enhance these factors among healthcare techs. Using a nonrandomized before-after design, participants underwent structured mentorship and orientation, with outcomes measured through pre- and post-intervention surveys, competency assessments, and feedback forms. Data analysis employed descriptive and inferential statistics to evaluate changes in job satisfaction, confidence, and competence. Results demonstrated measurable improvements in all three areas, supporting the effectiveness of structured mentorship in professional development and retention.

From Awareness To Action: Enhancing Medication Safety Culture To Improve Outcomes, Joseph A. Mensah

Doctoral Dissertations and Projects

The purpose of this project was to evaluate how a culture of medication safety can improve healthcare outcomes. Medication errors persist and remain the leading cause of preventable injury, highlighting the necessity to enhance the culture of medication safety in healthcare. The population for this project included clinical staff within a military healthcare setting. A quantitative survey assessed perceptions of medication safety, confidence levels, and obstacles to error reporting within the organization. The survey results revealed that 28% of clinical staff had not received medication safety training in the past year, 55% were not confident in medication administration, and 25% …