Investigating The Effects Of Workload Management Strategies On Nurse Practitioner Burnout And Job Satisfaction, Erica G. Smith

Doctoral Projects

Burnout is a critical issue among psychiatric mental health nurse practitioners (PMHNPs), worsened by excessive workloads, productivity demands, and the emotional intensity of patient care (Chi et al., 2024). The negative effects of burnout included diminished job satisfaction, reduced quality of care, and increased turnover (Chi et al., 2024). As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) grew, addressing these challenges was essential for maintaining a sustainable workforce and ensuring quality patient care.

This doctoral project aimed to assess the impact of a workload management strategy on reducing burnout and improving job satisfaction among PMHNPs in a hospital …

Improving Outcomes Of Patients Being Seen In The Emergency Room For Mental Health Crisis, Kimberly Hudson

Doctoral Projects

Mental health is a significant problem, especially in males aged 20 to 50 years old (Omary, 2019). Lack of a primary mental health care provider, lack of proper treatment and follow up appointments for this population, and bottlenecking patients in the emergency room are all factors that contribute to the problem. As a result, these patients experience negative outcomes such as not receiving proper care and/or causing harm to themselves or others. In this doctoral project we will explore the option of patients having better outcomes if seen immediately by a psychiatric health care provider.

Having psychiatric healthcare providers in …

Comparison Of Two Learning Methodologies: Virtual Reality And Osce Simulation, Connor Blackwell, Tabor Mcgee

Doctoral Projects

Anesthesia education has evolved immensely over the past twenty years, and with the new virtual reality (VR) simulations created by SIMVANA, the exponential growth can continue. The anesthesia program at The University of Southern Mississippi (USM) currently utilizes an educational platform known as the Objective Structured Clinical Examination (OSCE) for their students’ clinical curriculum. With the development of technology and education models, the purpose of the doctoral project is to determine if VR simulation can produce more effective learning than the OSCE modules. To determine the effectiveness, pharmacologic lessons for intraoperative hypotension were administered through both platforms and then tested …

Improving Consistency Of Quality-Of-Life-Assessments In Schizophrenia Patients Through Structured Education For Healthcare Providers, Dorothy Stewart

Doctoral Projects

Schizophrenia is a chronic and debilitating mental disorder that significantly impacts patients' quality of life (QoL). Effective management of schizophrenia requires not only symptom control but also a comprehensive assessment of QoL to guide treatment plans. The Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) is a specialized tool designed to evaluate the unique challenges faced by patients with schizophrenia. However, inconsistencies in the administration and interpretation of the SQLS-R4 by healthcare providers have led to variability in patient care. This doctoral project aimed to address this gap by implementing a structured educational intervention for healthcare providers that focused on …

Unlocking Icu Barriers: Investigating The Challenges Of Early Progressive Mobility, Leslie S. Bigler

Doctoral Projects

Approximately 800,000 patients in the United States annually are admitted to the Intensive Care Unit (ICU) due to critical illnesses and prolonged immobility contributes to poor patient outcomes. While existing data demonstrates early and progressive mobility helps improve outcomes, adherence remains inconsistent for a variety of reasons such as safety concerns, staffing, and lack of knowledge and confidence of mobilization techniques. This quality improvement project, conducted in a 20-bed Medical Intensive Care Unit, asked staff to identify barriers to adherence to mobility protocols. Nurse managers and clinical educators play a crucial role in addressing these issues using strategies such as …

The Perceptions Of A Nurse-Led Telehealth Discharge Program On Continuity Of Care For Pediatric Rheumatology Patients, Adrienne Ramirez

Doctoral Projects

When pediatric rheumatology patients are discharged from a hospital, they are given a complex discharge plan which involves responsibilities in self-managing their care at home. This creates an overwhelming time for patients and families who may have questions or concerns during this time. In order to address this care gap and provide continuity of care, this quality improvement project implemented a nurse-led telehealth discharge visit intervention to 15 pediatric rheumatology patients during the transition from hospital discharge to outpatient care. This quality improvement (QI) project also aims to describe the patients’ perceptions of the nurse-led telehealth discharge intervention on continuity …

Utilization Of The Reproductive Justice Framework In Contraceptive Counseling With Black And African American Women: A Comparison Of Patient Satisfaction And Provider Knowledge, Simranjeet K. Tagore

Doctoral Projects

Current practice in contraceptive counseling is characterized by great variation in both content and implementation. The literature indicates that African American women desire contraceptive counseling based in respect, trust, and equity. Conducted over 8 weeks, this quality improvement project compared satisfaction in African American and Black patients receiving contraceptive counseling by a provider trained in the Reproductive Justice Framework (RJF) versus those receiving contraceptive counseling by a provider not trained in the Reproductive Justice Framework. This project also evaluated the effects of Reproductive Justice Framework training on clinician knowledge. Inclusion criteria for the patients included identifying as Black and/or African …

Effects Of Group Visits On Self-Care Management For Veterans With Type 2 Diabetes Mellitus, James Nwaizugbu

Doctoral Projects

Individuals diagnosed with type two diabetes mellitus (DM2) can be overwhelmed by daily choices, leading to self-care neglect. Self-care is vital to DM2 management to avoid chronic complications. This project utilized group visits to increase self-care management and improve outcomes among veterans with poorly controlled DM2.

This evidence-based practice (EBP) project used a single-group quasi-experimental pretest-posttest design to evaluate a self-care management program for US veterans with poorly controlled DM2 who were enrolled a clinic within the Department of Veterans Affairs (VA), Northern California Healthcare System (NCHCS). The study facilitator provided education on DM2, medication, diet, and exercise. Participants (N …

Primary Care Access In San Luis Obispo County- Primary Care Practitioner’S Perspectives, Jessica Peckham

Doctoral Projects

This study investigates healthcare access and utilization among Primary Care Providers (PCPs) in SLO County, utilizing a mixed-methods approach. Survey responses from PCPs when applied to Levesque’s Theoretical Framework reveal variations in provider approachability and acceptability, alongside significant wait times for both new and established patients, indicating barriers in healthcare reaching. Qualitative interviews further illuminated dimensions of healthcare access, including socioeconomic disparities and provider burnout. These underscore the complexities of ensuring equitable access to primary care services. The relationship between provider and consumer dimensions, such as work-life balance, workload, and the role of advanced practice providers, highlight the intricate dynamics …

A Survey Of Nurse Preceptor Preferences Regarding Training Topics: A Descriptive Study, Janice Yao Valadez

Doctoral Projects

Background: The nurse preceptor role can be as challenging and demanding as it is critical in the context of nursing shortages and burnout. The improvement of nurse preceptor training, based on preferences expressed by the nurses fulfilling this role, therefore represents a potentially important part of the solution to these problems.

Methods: A modified version of the +RN Learning Needs Assessment tool was administered to 24 nurse preceptors who precepted in the nurse residency program on two campuses of a not-for-profit Western US hospital, regarding their preferences for topics to be covered in preceptor training, as well as the sequence …

Ultrasound-Guided Erector Spinae Plane Block: An Objective Structured Clinical Examination For First-Year Anesthesia Providers, Andrew Edwards, Jonathan Mardis

Doctoral Projects

The use of ultrasound-guided regional anesthesia (UGRA) in anesthetic practice is an invaluable tool for anesthesia providers to implement into their daily practice. One of these regional techniques is the erector spinae plane block (ESPB) which has anesthetic implications in numerous surgical procedures including cervical spine, thoracolumbar spine, thoracic wall, and chest wall procedures. Because of the novelty of this regional anesthetic technique, it is important to educate first-year anesthesia providers about the implications, skillset, and complications of the ESPB.

To bridge the gap between didactic knowledge and clinical practice in first-year anesthesia providers, an objective structured clinical examination (OSCE) …

Management Of High Spinal, An Objective Structured Clinical Examination, Stephanie Williamson, Darienne Lowery

Doctoral Projects

Certified Registered Nurse Anesthesiologists (CRNAs) are responsible for administering safe anesthesia and prompt intervention throughout the continuum of surgical care. During the surgical experience, many potentially life-threatening complications will require timely treatment to prevent irreversible or even fatal consequences. CRNAs are held accountable for recognizing and addressing a wide range of these complications despite their infrequency in clinical practice. Strategic education and training tools must be employed to ensure student registered nurse anesthesiologists (SRNAs) are equipped with the knowledge and critical thinking skills necessary to mitigate crises in the clinical setting.

This DNP project created an Objective Structured Clinical Examination …

The Effect Of A Neonatal Palliative Care Education Program In Increasing Knowledge And Communication Self-Efficacy Among Nicu Nurses, Shiou-Huei Joy Wang

Doctoral Projects

Background: Neonatal palliative care is crucial to providing comprehensive, high-quality care to neonates with life-limiting or life-threatening health conditions and their families. One significant barrier to the inconsistent provision of neonatal palliative care is the lack of education. This project aimed to deliver an education training program to increase neonatal palliative care knowledge and self-efficacy in NICU nurses. Method: A pre-post-test study design was used to examine the efficacy of an educational training program on NICU nurses’ knowledge and communication self-efficacy in neonatal palliative care. A post-test was administered immediately after the training and again four weeks later to evaluate …

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Preventing Diabetes Through Prediabetes Screening And Treatment In Primary Care, Dewona Beal

Doctoral Projects

Diabetes is an epidemic in the United States. There are three types of diabetes: type 1, 2, and gestational diabetes. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. This type of diabetes can be prevented or delayed. In persons with T2DM, the body cannot use insulin well to keep blood glucose within normal limits. Several factors, including genetics, lifestyle such as poor diet and physical inactivity, obesity, insulin resistance, hormones, and certain medications, can cause it. A precursor to T2DM is prediabetes. Prediabetes is when blood sugar levels are elevated but not elevated enough to be …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Use Of Behavior Management Training To Improve Nurses' Confidence In Managing Patient Aggression, Chasity Long

Doctoral Projects

Workplace aggression and violence toward healthcare workers are documented extensively throughout the literature and unfortunately, this behavior has increased during the COVID-19 pandemic. Challenges brought on by the pandemic, such as visitor restrictions and short staffing, have only exacerbated patient aggression and violence. Workplace aggression and violence can cause not only psychological or physical injury to nurses and nursing staff, but it also impacts patient care, job satisfaction, absenteeism, and nurse retention. Training programs to improve nurses’ assessment skills to predict aggressive behaviors and de-escalate violent situations can help nurses better predict and manage patient aggression. A behavior management training …

Promoting The Adoption Of Double Gloving Among Nurse Anesthetists: An Educational Intervention Based On The Theory Of Planned Behavior, Nguyet Tran

Doctoral Projects

Abstract

Background: The role of anesthetists in the transmission of pathogenic and non-pathogenic organisms from their work station to the patient has been well established in research. The proposed study aims to test the efficacy of an educational intervention in promoting double gloving in an effort to minimize the risk of cross-contamination.

Methods: This pilot study explored if multi-component educational intervention facilitates the adoption of double gloving and the prevention of cross-contamination in the anesthesia workstation. Student Registered Nurse Anesthetists (SRNAs) and Certified Registered Nurse Anesthetists (CRNAs) were followed in three evaluation phases; the first test was done before the …

Promoting Positive Sexual Health Behaviors Among Rural College Students: Results Of A Targeted Sti Prevention Program, Julie Loyke

Doctoral Projects

Sexually transmitted infections (STIs) are a significant public health concern, with 26 million new cases diagnosed annually in the U.S. Emerging adults aged 18 to 25 years, which are included in the age group of Americans who have the highest rates for the three most common STIs: chlamydia, gonorrhea, and HPV (cdc.gov., 2020). Unfortunately, there is a paucity of research on the effects of STI education interventions on the attitudes and knowledge regarding STIs in this age group, especially in rural youth. While STI rates are high among adolescents and young adults nationally, rural youth have different behavioral risk factors …

Supporting Adoption Of Atraumatic Care By Rural Hospital Nursing Staff Through Education, Angie Sowers

Doctoral Projects

Problem Statement: While atraumatic care is often practiced in children's specialty hospitals, it is less likely to be a part of the care provided in rural hospitals (Li et al., 2018). Nurses in this setting may not feel equipped or supported to provide atraumatic care.

Purpose: The purpose of this DNP Project is to support increased knowledge and utilization of atraumatic care by nursing staff providing care for pediatric patients in rural community hospital through a professional development education program. Methods: An educational program development project was created, implemented, and evaluated to support the utilization, awareness, and knowledge of atraumatic …

Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto

Doctoral Projects

For patients with advanced heart failure (HF) ineligible for or awaiting heart transplantation, left ventricular assist device (LVAD) implantation can be considered. LVADs have helped to improve recipients’ survival rates and quality of life. However, LVAD patients are at risk for complications such as stroke, bleeding, infection, and right ventricular failure. Moreover, events such as end-stage malignancy or progression of a neurodegenerative disorder may occur. Such complications and repeated hospitalizations can pose questions about the acceptability of LVAD therapy. As such, both the Centers for Medicare and Medicaid Services and The Joint Commission require that palliative care (PC) be part …

Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor

Doctoral Projects

Background: One of the leading causes of death in the college age population is suicide. While colleges provide opportunities in the acquisition of knowledge and skills for future careers; those same opportunities can also bring about challenges that put students at risk for suicide such as: dealing with their mental health issues, finding and maintaining support system, financial costs, and the pressure from ensuring academic success. One of the ways to help student at risk for suicide is by early intervention by connecting them with mental health support system such as crisis counselors. Question, Persuade, and Refer (QPR) is a …

Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo

Doctoral Projects

Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …

Does The Enhanced Recovery Pathway Decrease Length Of Stay And Readmission Rates In Patients Undergoing Gynecologic Surgery?, Trinh T. Nguyen

Doctoral Projects

The Enhanced Recovery After Surgery (ERAS) pathway promotes an early recovery after surgery using an evidence-based multidisciplinary approach. The ERAS protocol is aimed at standardizing care to improve patient outcomes. There is consistent evidence that ERAS pathways reduce hospital length of stay (LOS) and readmission rates, decrease healthcare costs, and improve patient satisfaction and outcomes. By attenuating the surgical stress response and supporting the return of physiological function, the ERAS pathway achieves its effectiveness. This scholarly project aimed to evaluate how ERAS improves patient outcomes in gynecology patients at a county hospital. A standardized method for improving patient recovery was …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …