Nursing Commons^™

Heart Failure And The Need For Better Patient Education, Amber Ball

Doctor of Nursing Practice Scholarly Project

Heart failure is becoming a more prevalent condition, evidenced by the fact that 25% of patients who are diagnosed with heart failure are readmitted within 30 days of being discharged due to exacerbation of this disease process. Heart failure symptoms can worsen due to inadequate patient education and other issues with patient self-management of the disease process leading to readmissions and increased hospital stays—adding to an already burdened healthcare system.

The aim of this project was to address the gap in nurse led patient education early on during hospitalization of patients admitted with a new diagnosis of heart failure or …

The Influence Of Perioperative Education On Postoperative Digestive Restoration, Christian Cedeno

Doctor of Nursing Practice Scholarly Project

The human body often needs encouragement to return to its natural state of functioning following intraoperative and postoperative drug therapy. Anesthesia can sedate the gastrointestinal tract and frequently requires medical and physical interventions to allow the body to return to full functionality. There are several methods thought to be beneficial in overcoming of this condition, and some have proven their significance more so than other methods. This project seeks to measure the power-of-knowledge methodology via a chart review of individuals specifically educated on what they can expect in the postoperative phase of care compared to those that receive routine education. …

Enhancing Care For Psychiatric Patients Boarding In The Emergency Department, Abby Ford

Doctor of Nursing Practice Scholarly Project

Psychiatric boarding in the emergency department has become a common phenomenon in emergency departments throughout the United States. The purpose of this DNP Scholarly Project was to create a quality improvement project to enhance the care that psychiatric patients receive while they are boarding in the emergency department (ED). This quality improvement project consisted of an educational PowerPoint module for ED nursing staff and the dissemination of a care plan that nursing staff utilized while caring for psychiatric patients in this specific ED. The target population for this scholarly project was emergency department nursing personnel in a 40-bed metropolitan ED. …

Enhancing Outpatient Referrals To Heart Failure Clinics, Charla Furing

Doctor of Nursing Practice Scholarly Project

Heart failure patients require complex and specialized treatment that can be provided for in a heart failure clinic. Heart failure is extremely complex and the recommendations for management require observation and diligence. Lindberg et al. (2022), recommends patients with heart failure receive specialized care from providers trained in optimizing therapy, especially patients with new onset heart failure, worsening heart failure, or those unable to tolerate first-line treatments in optimal doses. Patients require referrals to the providers specializing in heart failure management. This study created a comprehensive outpatient referral form for outpatient providers utilizing published heart failure referral forms, heart failure …

Cultural Competence Among Nursing Faculty And Staff Utilizing An Educational Course To Promote Diversity, Equity, And Inclusion Individually And Within The Baccalaureate Nursing Program, Jessica Shippee

Doctor of Nursing Practice Scholarly Project

Nurse educators play a pivotal role in fostering cultural competence among nursing students. The purpose of this quasi-experimental project was to provide an educational course to help nursing faculty and staff identify implicit bias, develop cultural competence, and recognize the importance of incorporating diversity, equity, and inclusion into practice. A pretest-posttest design collecting demographic data and the Healthcare Provider Cultural Competence Instrument (HPCCI) was given to 21 participants, the course was six-hours and delivered over two days. Participants were asked the day of, before the intervention, to complete the instrument and immediately after the intervention on the second day. Varying …

Implementing A Provider Education Program For Opioid Medication Management, Mitra A. Taylor

Doctor of Nursing Practice Final Manuscripts

Implementing a Provider Education Program for Opioid Medication Management

Mitra Akhavan Taylor, BSN, RN

Joseph F. Burkard, DNSc, CRNA, EBP-C, AACN Health Policy Fellow

Introduction: Continuing health provider education is an important intervention supported by health policy to counter the opioid epidemic. The purpose of this evidence-based project was to create and implement an opioid prescribing program in line with California and Federal regulations in response to the opioid epidemic. The purpose of this project was to evaluate the effect of the program and EMR template and guidelines on opioid prescribing practices. The motivation behind this evidence-based practice (EBP) project …

Staff Education To Enhance Nurse Knowledge Of Depression And Screening Tool Using Patient Health Questionnaire-9, Oluwakemi Omotayo Aregbesola

Walden Dissertations and Doctoral Studies

Summary This staff education program focused on addressing a practice deficit regarding nonstandard depression assessment and substandard nurse knowledge of evidence-based screening tools, mainly the Patient Health Questionnaire-9 (PHQ-9), a nine-item, self-reporting test used to screen for depression and assess severity of the condition based on the Diagnostic and Statistical Manual of Mental Illnesses, 5th Edition. Depression exists as a familiar yet unidentified disorder among psychiatric inpatients, resulting in delayed treatment inferior outcomes. The staff education project targeted the nurses’ knowledge of depression identification while also teaching them to administer the PHQ-9 for prompt screening and intervention. I used an …

Standardizing Icu-To-Ward Transitions: Implementing Icu-Pause In The Process Of Medical Intensive Care Unit Downgrade, Edwin Perez, Md, Benjamin Tasevac, Md, Timothy J. Kuchera, Md, Erika J. Yoo, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• The ICU-to-ward transition is a high-risk process in which unstandardized communication can increase the risk for adverse events.
• Variability exists in documentation content, quality, and even authorship.
• Aims:
  • Institute the standardized ICU-PAUSE framework for ICU downgrades
  • Reassign documentation responsibility to the sending rather than receiving team
  • Evaluate the impact of these interventions on provider satisfaction & understanding of patient care

Community-Based Toolkit For Parents And Their Children With Severe Mental Illness, Adam Thai, Jo Loomis, Alicia Kletter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Many adult children with severe mental illness (SMI) reside with their aging parents, who not only provide financial and housing support but often serve as the caretakers and care coordinators. Circumstances can change in an instant for this population with the loss of their parents.

Local Problem: Persons with SMI in San Mateo County that have been reliant on their parents throughout their lives would suddenly be unhoused, vulnerable and without support in the community, which can adversely affect health outcomes.

Methods: A Doctor of Nursing Practice (DNP) student-led pilot online community-based toolkit was designed …

Trauma-Informed Care: A Therapeutic Communication - Executive Summary, Nicole Anne Leonce

Doctor of Nursing Practice (DNP) Projects

Background Effective therapeutic communication is essential for building strong patient relationships, yet bias, stigma, and judgment can exacerbate trauma and widen health disparities. Trauma-Informed Care (TIC) emphasizes respect, compassion, and empathy to mitigate these issues. Problem Although TIC is extensively studied in high-income regions such as the United States, Europe, and Australia, its application in developing countries remains limited. This gap impedes culturally sensitive healthcare practices that address unique social, cultural, and economic challenges, potentially deepening disparities. Methods A comprehensive literature review was conducted to assess current TIC training research among healthcare workers. The review aimed to underscore TIC's importance …

“Invisible Populations”: A Policy Brief Approach To Address Housing Data Needs In Vulnerable Communities, Kristin E. Moser

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Dependent adult children with severe mental illness (ASMI) living with aging parents have been an increasing population over decades due to lack of supportive housing and services in the community. ASMI living with aging parents is a high-risk group for housing instability and future homelessness. Local Problem: A limited amount of literature and data exist to determine the size and needs of the population of ASMI living with aging parents. A collaboration with University of San Francisco (USF) and non-profit, Solutions for Supportive Homes (S4SH) of San Mateo County (SMC) formed to disseminate information and quantify the “invisible …

Trauma-Informed Family-Centered Care Training For Neonatal Intensive Care Nurses, Sonja A. Alli-Casella

Doctor of Nursing Practice (DNP) Projects

Background The neonatal intensive care unit (NICU) is a high-stress environment that can cause or exacerbate emotional trauma for parents of critically ill infants. While NICU nurses are trained in neonatal care and basic family-centered principles, they often receive limited education on supporting adults in acute emotional distress, leaving them unprepared to manage dysregulated behaviors. Local Problem At a Level IV NICU in a Southern California pediatric hospital, nurses may underestimate their influence on parental stress levels due to a lack of formal training in supporting emotionally distressed adults. Methods A comprehensive literature review informed an evidence-based practice (EBP) initiative …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Increasing Formation Of Advance Directives In Acute Care Through Staff Education, Piper E. Parres

Doctor of Nursing Practice Scholarly Project

In the acute care setting, the condition and stability of patients can change in an instant. Oftentimes, patients that were ambulatory, independent, and high functioning may be rendered critically ill and unable to communicate due to the rapid onset of an illness. When this happens, the care team must act quickly to stabilize the patient by any means necessary. With the wealth of medical knowledge and technology available in modern healthcare, life may be sustained indefinitely with the help of machinery such as ventilators, continuous renal replacement therapy, or extracorporeal membrane oxygenation. While some patients may welcome these interventions, others …

A Theory-Based Examination Of Factors Influencing Caregivers’ Intentions To Disclose Sickle Cell Trait Status To Their Children, Christine A. Chaba

WUSM Theses and Dissertations – All Programs

Sickle cell trait (SCT), the heterozygous form of sickle cell disease, has significant implications for health and reproductive decision-making. Timely disclosure of SCT status to children by their caregivers is critical for promoting genetic awareness and supporting informed reproductive choices. However, many caregivers delay or avoid this conversation. This study examined the psychosocial and behavioral factors influencing caregivers’ intentions to disclose SCT status to their children, guided by the Theory of Planned Behavior and the Theory of Regret Regulation. A descriptive, cross-sectional study was conducted with 78 caregivers of Children with SCT, who completed an online survey. The study addressed …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Bridging The Gap: Enhancing Medical Interpreter Utilization For Patients With Limited English Proficiency In Healthcare Settings, Rocio J. Tapia-Nuss

Doctor of Nursing Practice (DNP) Projects

The Impact of Utilizing Medical Interpreters and Associated Patient Outcomes

Abstract

Background: In the United States, approximately 21% of households speak a language other than English, emphasizing the need for accessible language services for patients with limited English proficiency (LEP).

Problem: Despite legal mandates, medical interpreters remain underutilized, leading to adverse health outcomes, such as misunderstanding discharge instructions, medication use, and disease processes.

Methods: This DNP student-led evidence-based project explored barriers to medical interpreter utilization among healthcare professionals.

Intervention: A continuing education module was implemented by a DNP student at the University of San Francisco’s School of Nursing and Health …

Saving Lives: Naloxone Education And Training For Mental Health Re-Entry Program Providers, Remigus C. Nwaokoro

Doctor of Nursing Practice (DNP) Projects

Background Opioid overdose fatalities are a major public health concern with significant cost implications. Naloxone effectively reverses opioid overdose symptoms and prevents fatalities, yet many healthcare professionals lack the confidence and knowledge to administer it. This knowledge gap delays efforts to combat opioid overdose. Local Problem Opioid-related fatalities are among the leading causes of preventable deaths. In a northern California county, opioid overdose deaths increased by 20% from 2018 to 2021, with 48 fatalities in 2021. A needs assessment revealed that healthcare providers at a reentry program in that county had limited knowledge and confidence in using naloxone. Methods A …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

Doctor of Nursing Practice (DNP) Projects

Background: Suicide among adolescents and youth is a serious public health issue that requires immediate intervention to reduce ideation and death. The increasing rate of suicide among children and adolescents has a profound effect on families, friends, and the community.

Problem: Suicide among school aged children and adolescents can create significant challenges for school nurses, who are often the first contact for students who recognize suicidal ideation and mental health crises. This issue is particularly significant for the Alameda school nurses in California, as they play a significant role in identifying and supporting students in a crisis.

Methods: A …

Trauma-Informed Care: A Therapeutic Communication, Nicole Anne Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Educating Community Health Workers: To Improve Maternal And Infant Health In Rural Areas, Katerina Markova Shikhvarg

Doctor of Nursing Practice (DNP) Projects

Background

Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.

Local Problem

Despite the benefits of CHW involvement, they lack standardized training that could improve their services.

Methods

A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Amir Rashid

Doctor of Nursing Practice (DNP) Projects

Background Schizophrenia cases and their associated healthcare costs have drastically increased over time in the United States. Antipsychotic nonadherence is a primary contributor to the high rates of relapse and rehospitalization among adult patients with schizophrenia. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underutilized in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses hold a unique position to potentially change practice and address some of the barriers to LAI usage. Local Problem A Mental Health Rehabilitation Center in California …

Leading The School Team: A Professional Development Training On Eating Disorders For School Nurses, Michelle Samaniego Concepcion

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The COVID-19 pandemic sharply increased the prevalence of eating disorders (EDs) among youth. These conditions are associated with high treatment costs and have the second-highest mortality rate among mental illnesses, surpassed only by opioid overdose, making them a critical concern for school communities.

Local Problem: A learning needs assessment conducted by the Alameda County School Nurses Network identified gaps in school nurses’ knowledge and confidence regarding ED identification, referral, and care coordination. Methods: In response, a Doctor of Nursing Practice (DNP) student scholar developed and implemented an evidence-based, virtual professional development training focused on EDs. The module was …

Staff Education Program Utilizing A Workflow Template To Streamline Care In Occupational Health, Alicia Vogleson

Walden Dissertations and Doctoral Studies

This DNP Project is one designed to educate Occupational Health Staff. As there are varying levels of skills and education of staff working with patients, it is important to identify staff that who can play a large role in helping gather important information to help in treatment decisions early on in the process of patient care. The practice-focused question and the purpose of the project was to answer the following question: will a staff education program for Medical Assistants and Front Desk Staff in an Occupational Health clinic on the utilization of a template to streamline workflow improve their knowledge? …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Exploring The Public Health Agency Of Canada’S And The Ontario Government’S Vaccine-Related Crisis Communication On X During The Covid-19 Pandemic, Sheraza Burney, Lori Donelle Phd, Rn, Fcan, Anita Kothari

Publications

Crisis communication strategies must be tailored to the unique nature of social media. In response to the COVID-19 pandemic, public health agencies have widely used social media to address vaccine hesitancy and misinformation. This research utilized the social media pandemic communication model to describe the key themes disseminated through the Ontario government and the Public Health Agency of Canada's vaccine-related crisis communication on X (formerly Twitter). Between 27 January 2020 and 6 April 2021, 1271 posts related to COVID-19 vaccination were collected from three official government X accounts—two from the province of Ontario and one from Canada. Posts were analyzed …

Secondary Educators’ Knowledge And Perceptions Of Their Own Self-Efficacy As It Relates To 504 Plan Accommodations For Students Diagnosed With Adhd, Anne Richardson

Seton Hall University Dissertations and Theses (ETDs)

This study investigated the role of Section 504 accommodations in meeting the needs of secondary students with attention-deficit/hyperactivity disorder (ADHD) in the United States. While legislation requires equitable education for students with disabilities, gaps remain in understanding how educators perceive their own abilities in implementing Section 504 plans for students with ADHD. The study used a qualitative research design to explore the academic and organizational challenges faced by secondary school students with ADHD, specifically examining the knowledge, perceptions, and self-efficacy of secondary educators regarding ADHD strategies and 504 plan accommodations. Semi-structured interviews were conducted via Zoom with 11 educators from …