Improving Equity In Women's Stroke Outcomes, Lindsay M. Warner

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project is to review research-based evidence evaluating the inequities in women’s stroke research and treatments and how this effects women’s stroke outcomes. This paper sought to identify current recommendations for improving sex equity for women’s stroke research and identify further areas of policy change to ensure that women’s health outcomes are prioritized in this historically underrepresented population.

Background: An area of critical importance to society is the significant cause of gender-based inequity in healthcare and research. Historically medical research has primarily involved males and the findings have been …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

Why Throughput Is Group-Put, Edward Sales

Doctor of Nursing Practice Final Manuscripts

Introduction: University of California San Francisco (UCSF) Saint Mary’s Health, has two hundred forty licensed beds to utilize for patient care, ninety one that can be used for inpatient medical surgical patients. Throughput is a challenging issue, especially at Unit seven west which houses thirty beds. Post op surgical orthopedic patients, medical surgical patients from the emergency department (ED), intensive care unit (ICU), and telemetry downgrades are waiting for inpatient beds, which causes delays in care and increases length of stay.

Background: Unit seven west is a surgical ortho floor with a high admission census consisting of three to ten …

Improving Social Drivers Of Health Screening In An Inpatient Setting For Sdoh Data, John P. Lussier

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose

Title of the Project: Improving Social Drivers of Health Screening in an Inpatient Setting for SDoH Data

Purpose: This evidence-based practice project aimed to increase social drivers of health (SDoH) screening compliance by redesigning the workflow to distribute responsibility between nursing and case management, ultimately improving identification and referral of patients with supportive service needs.

Background: Screening for SDoH needs facilitates the provision of appropriate supportive services. The existing workflow required nurses to conduct initial screening in five domains (Housing Stability, Utility Difficulties, Food Insecurity, Interpersonal Safety, and Transportation Needs), with positive responses triggering additional investigative questions. These …

Crisis Without Cops: Trauma-Informed Mental Health Care For Bipoc Communities, Amanda Carson

Doctor of Nursing Practice Final Manuscripts

This policy paper advocates for a structural transformation in mental health crisis response, moving beyond police-led interventions toward trauma-informed, community-rooted models grounded in public health and equity. Drawing on Critical Race Theory (CRT), neuroscience, and program evaluations of models like CAHOOTS, 988, Denver’s STAR, and Durham’s HEART, it examines how systemic racism, institutional mistrust, and implicit bias contribute to disproportionate harm for BIPOC individuals. The paper highlights the effectiveness of peer-led, culturally responsive alternatives that reduce force, hospitalization, and disengagement from care. Using Kingdon’s Multiple Streams Framework, it proposes actionable, scalable policy strategies supported by recent federal momentum, including the …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementation Of A Tracheostomy Discharge Education Class For Nicu Nurses, Todd N. Chamoy

Doctor of Nursing Practice Final Manuscripts

Infants who are ventilator-dependent or have anatomic anomalies of their airway frequently require tracheostomy placement prior to discharge from the hospital in order to be cared for safely at home. At this large quaternary children’s hospital in Southern California, preparing these infants for discharge after tracheostomy placement has not been the role of the NICU nurse. There was no system in place on how to train caregivers, and the NICU staff felt unprepared. Evidence supports use of intensive educational programs to improve nurse knowledge and skills of tracheostomy care, allowing NICU nurses to provide improved care and pre-discharge teaching.

A …

Suprathel Burn Dressing Versus Standard Care: Impact On Hospitalization Duration And Post- Discharge Outpatient Visits, Isaac Awolola

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project is to determine the effectiveness of Suprathel a synthetic, one-time application, wound dressing that acts as a temporary skin substitute, particularly effective for partial-thickness burns and deep dermal burns vs, the standard of either Polysporin or Santyl, Xeroform, gauze on the frequency of outpatient (OP) visits after a patient’s discharge. A secondary aim of this project was to investigate whether Suprathel burn dressing significantly decreases the length of stay (LOS) for patients with second-degree burns involving < 20% total body surface area (TBSA). The results showed that the use of Suprathel dressings resulted in a shorter hospital stay 7.05 vs 9.35 days with a higher number of outpatient visits 5.47 vs 2.69 visits, compared to conventional dressings. The use of Suprathel dressings as a standard practice reduces inpatient hospitalization but increases outpatient visits and resource utilization. The use of Suprathel dressings shortens the length of hospitalization and may augment patient comfort, and decrease overall healthcare costs associated with hospitalization. Due to the reduction in need for painful daily dressing changes, Suprathel dressings constitute a potentially preferred option in burn care and could thereby influence treatment protocols and enhance patient outcomes.

Keywords: Wound care, Suprathel dressing, total body surface area, Outpatient Visits, Second-degree Burn, Length of stay, Gauze

Electronic Medical Record Clinical Decision Support Across The Ob Continuum Of Care: Enhancing Doula Education And Usage, Jonese D. Randall

Doctor of Nursing Practice Final Manuscripts

Background: The United States is seeing an uptick in maternal deaths by 159% since 2019, with maternal mortality higher with cesarean procedures (Hoyert, 2020; Riches et al., 2024[LC1] ). UC San Diego Health NTSV C-Section rates between September 2024 – October 2024 ranged between 22-54%, well above the benchmark of 23.4% in California (Slone, n.d.). Doulas are trained to care for the mother before, during, and after birth by being an advocate, providing physical and emotional support, and being a continuous support person (Dekker, 2017). Doulas have been shown to improve birthing outcomes by providing these support mechanisms, particularly …

Implementation Of One Key Question® Screening Tool To Increase Reproductive Life Planning At A Community Health Clinic, Laura D. Adams

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.

Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is …

Increase Knowledge And Competency Of Point Of Care Ultrasound (Pocus) Among Emergency Nurse Practitioner Students Incorporating Web-Based Videos And Clinical Benchmarks., Andrew N. Walsh

Doctor of Nursing Practice Final Manuscripts

Background: Point of care ultrasound (POCUS) is a critical skill in Emergency Medicine (EM), and Emergency Nurse Practitioner (ENP) students are increasingly expected to demonstrate proficiency. ENP students often face limited opportunities for hands-on practice compared to EM residents. Research suggests that the didactic component of POCUS training delivered through e-learning is as effective as in-person instruction. The American College of Emergency Physicians (ACEP) supports the flipped classroom model, which maximizes simulation time and focuses on psychomotor skills and clinical application, allowing didactic portions to be delivered online. Additionally, ACEP recommends a benchmark of at least 25 POCUS examinations to …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Implementing The Fib-4 Tool For Liver Fibrosis Screening In Diabetic Patients In Primary Care, Robert I. Montillano

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-non-alcoholic fatty liver disease (NAFLD), affects over 1 in 3 adults with type 2 diabetes mellitus (T2DM) and is a leading cause of advanced liver fibrosis. Despite guideline support from the American Diabetes Association (ADA) and American Association for the Study of Liver Diseases (AASLD), screening practices remain inconsistent in primary care. The Fibrosis-4 (FIB-4) index is a validated, low-cost, noninvasive tool for fibrosis risk stratification, yet it remains underutilized despite its availability in many electronic health record (EHR) systems.

Purpose: This Doctor of Nursing Practice (DNP) evidence-based practice (EBP) project …

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …

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 …

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 …

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.

Enhancing Access To Medication-Assisted Treatment (Mat) For Minority Inmates In The San Diego Prison System: A Quality Improvement Through Culturally Competent Approach, Douglas Seangmany

Doctor of Nursing Practice (DNP) Projects

Abstract

Background The opioid crisis disproportionately affects racial and ethnic minority groups, particularly in correctional settings. In San Diego’s prison system, only 20% of incarcerated individuals with Opioid Use Disorder (OUD) receive Medication-Assisted Treatment (MAT), highlighting significant care disparities.

Local Problem Limited access to MAT among minority inmates contributes to poorer health outcomes, higher overdose rates, and increased healthcare costs. Addressing these disparities is crucial for improving health equity within the prison system.

Methods A review of 10 studies emphasized the importance of culturally competent care in improving treatment engagement and outcomes among minority populations. To address disparities, the intervention …

Staff Education On Physical Activity As A Therapeutic Option For Anxiety And Depression, Suja Paul

Walden Dissertations and Doctoral Studies

This project’s aim was to educate staff on physical activity (PA) as a therapeutic option for anxiety and depression to relieve psychotic symptoms, enhancing patients’ quality of life. PA enhances cognitive functioning, reduces anxiety and depression, and decreases the risk of cardiovascular conditions and early death. Patients with severe mental illnesses face barriers to PA and exercise, so providers and policymakers must create an environment that encourages participation. A knowledge gap for staff exists in promoting PA in mental health patients. Healthcare professionals should recommend the right amount of PA for each patient. This initiative aims to increase staff confidence …

Clinical Practice Patient Education Guideline For Patients With Substance Use Disorders, Josephine Nandzo

Walden Dissertations and Doctoral Studies

The Veteran’s hospital for which this DNP clinical practice patient education guideline (CPPEG) was developed has made strides in addressing the needs of patients with substance use disorders (SUDs). However, the problem identified for this project was the need for veterans with SUDs to obtain information about resources available in the hospital, community, or state to manage their recovery. The project question was as follows: Will a CPPEG on resources for patients with SUDs meet the optimal threshold of 7 on the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument? The purpose was to plan, implement, and evaluate …

Influence Of Nurse’S Knowledge And Attitudes On Caring Behaviors For People With Opioid Use Disorder, Inyene E. Essien-Aleksi, Don Roosan, Tracie Mcpadden, Leslie Rideout, Michael Martin, Paula-Jo Beniers, Amy Lund, Danielle Leone-Sheehan, Alysse Wurcel

Health Sciences Faculty Publications

Background: Opioid use disorder (OUD) remains the leading cause of preventable substance use-related deaths in the U.S. Each year, more than 1 million Americans seek hospital care for OUD-related issues. However, they often receive inadequate treatment and face barriers such as limited overdose prevention education, delays in medication initiation, and insufficient post-discharge follow-up. Nurses are well-positioned to improve inpatient OUD treatment, yet qualitative research suggests they often have limited knowledge and negative attitudes toward OUD, which can decrease the level of compassion and empathy nurses have toward people with OUD. Validated instruments, such as the Care Behavior Index (CBI-6) and …

Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer

Doctoral Dissertations and Projects

Burnout is an international occupational phenomenon that can negatively impact one’s physical, emotional, and psychological well-being. Although burnout affects all occupations, professionals working in the healthcare field are known to be at high risk for occupational burnout secondary to factors such as high-stress environments, critically ill patients, increased patient care requirements, frequent exposure to mortality, and shiftwork with long hours, among other factors. Of the subgroup of healthcare providers, it is also widely known that nurses who have a high exposure to death, such as hospice nurses, are at an even higher risk for occupational burnout. At a hospice care …

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 …

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% …

Undergraduate Nursing Students' Perceptions Of Faculty Mentorship For Student Success In Persevering Toward Program Completion: A Qualitative Study, Shirley C. Callihan

Doctoral Dissertations and Projects

The purpose of this qualitative exploratory single case study is to explore the undergraduate nursing students' perceptions of faculty mentorship for student success in persevering toward program completion. The theory guiding this study is the Roy Adaptation Model (RAM) by Callista Roy, as it relates to nursing students' adaptation to the challenges in their environment through faculty mentorship. The central question is: What are undergraduate nursing students' perceptions concerning faculty mentorship for student academic success in persevering toward program completion? Convenience sampling was used to recruit ten participants who were undergraduate nursing students from a Registered Nursing program in the …

Pain Management Educational Module For Nursing Staff, Kathyrina Lucy Pham

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in pain management among nursing staff in the rehabilitation unit. Frequent pain-related patient calls contributed to inconsistent clinical practices. This project aimed to evaluate whether a brief, evidence-based educational intervention could enhance nurses’ knowledge of pain management. 47 registered nurses participated in an educational module delivered during both day and night shifts. Pre- and post-test scores were collected and analyzed to assess knowledge acquisition. T-test results indicated a statistically significant improvement in nurses’ pain management knowledge. The findings support the effectiveness of brief, targeted education in promoting clinical outcomes …

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …