Nursing Commons^™

Exploring The Barriers To The Implementation Of Acute Care Nurse Practitioner Roles, Madeline Wd Mcnulty

2025 Fall Honors Capstones Projects - Archive

Acute care nurse practitioners (ACNPs) are associated with improved patient outcomes and are among the fastest-growing professions in healthcare. However, this growth is accompanied by barriers to the ACNP role. Despite this expansion, limited research has examined these barriers or identified strategies to reduce them in acute care settings. Therefore, this study aimed to identify the obstacles to ACNP practice and to describe approaches to overcoming them. A qualitative descriptive design was employed. Twenty-one pioneering ACNPs participated in semi-structured interviews. Data were analyzed using the “Sort and Sift, Think and Shift” method. We identified nine themes in the study: four …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

The Influence Of Social Support On The Stress Levels Of Pre-Nursing Students, Michelle Chinwendu Nicole Izuwah

2025 Fall Honors Capstones Projects - Archive

Introduction/Background: The nursing shortage in the United States continues to pose a significant challenge due to the widening gap between the supply of and demand for qualified nurses. The COVID-19 pandemic demonstrated the importance and vitality of nurses to society. Thus, it is important to support students throughout their nursing journey, even from the earliest stages. Pre-nursing students are college students who have not yet begun taking upper-division classes and are enrolled in nursing programs, and face a unique set of struggles due to the pressure of prerequisite classes, as well as fears of not being accepted into the nursing …

Burnout Among Nurses In The United States, Faheem Ohri

Social Work Dissertations - Archive

Burnout is an exhausted state of the body, mind, and emotions, characterized by feelings of “depersonalization and reduced personal accomplishment” resulting from prolonged and continuous occupational stress. Burnout among nurses in the United States (U.S.) is a growing concern with significant implications for healthcare professionals and patient outcomes. Nurse burnout compromises patient safety and workforce stability, but pre-pandemic national correlates remain understudied. This dissertation examined employment settings and demographic correlates of burnout among U.S. nurses using the National Sample Survey of Registered Nurses (NSSRN) secondary datasets. Compared inpatient burnout odds pre-/post-pandemic using national twin surveys. Jackknife complex survey logistic regression …

Perioperative Surgical Site Infection Reduction Bundle In Colorectal Patients, Flatasha A. Roland

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Surgical site infections (SSIs) are a common and preventable complication after colorectal procedures, significantly impacting patient morbidity and increasing healthcare costs. This quality improvement (QI) project aimed to lower SSIs in adult colorectal surgery patients by implementing a perioperative SSI reduction bundle at a large acute care facility in North Texas. The intervention targeted three modifiable risk factors: perioperative hypothermia, hyperglycemia, and incorrect antibiotic timing. Despite established protocols, institutional data revealed subpar compliance with active warming (46%), blood glucose control (52%), and antibiotic stewardship (75%), all of which fell below national benchmarks. A gap analysis and literature review guided the …

Regionality In Heart Failure Self-Care Behaviors Using The Medical Expenditure Panel Survey, Gretchen K. Wendt

Nursing Dissertations - Archive

Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.

The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. …

Nurse's Satisfaction With The Implementation Of A Standardized Physical Assessment Template In Home Based Medical Care, Nicole Silvestri

Doctor of Nursing Practice Scholarly Projects

Background and Literature Review:
Home based medical care (HBMC), part of Optum’s UnitedHealth division, delivers in-home urgent care to medically complex patients at high risk for hospitalization. A nurse is dispatched to the home and a provider connects via telemedicine to conduct the visit. Currently, there is no standardized documentation tool to communicate physical assessment findings between the in-home nurse and the telemedicine provider. A literature review was conducted using PubMed and CINAHL with search terms including nursing satisfaction, physical assessment, EMR, template, standardized tool, and documentation. This revealed challenges in nursing documentation, communication, and physical assessment, particularly regarding …

2025-2026 Graduate Msn-Fnp Handbook, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2025-2026 Graduate Student Handbook for the Department of Nursing at Morehead State University.

Perceptions Of Influence And Collaboration Amongst Healthcare Providers, Nurses And Allied Health Professionals, Barbara Harrison

Dissertations

Problem

While attention to interprofessional collaboration is increasingly present in academic settings and in clinical practice, there is little understanding of the role power, specifically the scope of influence, plays in interprofessional collaboration.

Method

Targeted cross-sectional sampling was used to select possible candidates to participate in this quantitative study. An email invitation was sent to healthcare providers, nurses and allied healthcare professionals in a multi-hospital healthcare system in the mid-western United States of America. Willing participants proceeded to the Microsoft Forms survey via an embedded link which was available to them for eight days. The survey sought demographic information, and …

Relationship Between Ehealth Literacy And Use Of Patient Portals Among Older Adults: An Integrative Review, Lore Oluwatominiyi

Senior Honors Theses and Projects

The rapid advancement of healthcare technologies, including patient portals, has the potential to improve patient engagement and health outcomes, particularly among older adults. However, the adoption of patient portals among this demographic remains relatively low, primarily due to varying levels of eHealth literacy. The aim of this integrative review, guided by the Whittemore and Knafl’s (2005) framework, was to investigate the experience of eHealth literacy and patient portal use among older adults. The databases of PubMed, CINAHL, and PsycINFO were searched for articles published between 2017 and 2023. Keywords used included: eHealth literacy, patient portals, and older adults. Thirty records …

Enhancing Nursing Education To Improve Care For Patients With Substance Use Disorder: A Literature Review, Allma Swier

Senior Honors Theses and Projects

Background. As nursing students attend undergraduate school and prepare to enter the workforce, clinical experience and classroom training shape who they will become as caregivers. There is a lack of education built into the standard curriculum on how to care for people with substance use disorders empathetically and professionally. Aim. The purpose of this literature review is to determine if nursing students feel adequately prepared to care for patients with substance use disorder, and how implementation of educational curricula can increase students' knowledge of caring for individuals with substance use disorder, leading to an increase in confidence when caring for …

Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] We read with interest the recent study by Rosenfeld et al.¹ However, we have several clinical and methodological concerns about this study.¹

First, this study's propensity score matching (PSM) lacked key clinical confounders, including perinatal risk factors and the highest systolic/diastolic blood pressures. Smoking, alcohol use, and multifetal gestation, which influence blood pressure during pregnancy,²,³ potentially affect both primary and secondary outcomes. Additionally, the authors did not report standardized mean differences before and after PSM, which are essential for assessing balance.⁴

Nursing Assessment Of Mental Health Issues In The General Clinical Environment: A Descriptive Study, Irene Ngune, Beverley Ewens, Sharlene Bell, Brendon Burns, Claire Sutton, Craig Creswell, Yvonne Middlewick

Research outputs 2022 to 2026

Aims: To evaluate the effectiveness of a mental health screening form for early identification and care escalation of mental health issues in general settings. A secondary aim was to explore general nurses' use of the form and their confidence to discuss mental health issues with patients. Methods: A cross-sectional design comprising a review of clinical records to determine use of the form, instances of missed care and escalation to the mental health team. The survey focused on nurses' confidence in general settings to engage in discussions with patients about mental health. Data were collected from April to December 2022. The …

Implementation Of A Code Sepsis Response Protocol In A Large Emergency Department Increases Rate Of Timely Antibiotic Administration In Patients With Suspected Sepsis, Leah Shults, Kailey Cox, Destiny Kramer, Grace Mariano, Amy Pinkos, Jordan Sanders, Kimberly Patterson

Articles, Abstracts, and Reports

No abstract provided.

Make It Your Hobby, To Check On The Lobby, Kenda Bishop, Berlyn Davis, Daveena Maple

Articles, Abstracts, and Reports

No abstract provided.

Zoll® Immediate Pad Placement (Zipp) Pilot: Optimizing Aed Pad Placement And Reducing Time To Defibrillation, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

No abstract provided.

Sirs Alert In Emergency Department Triage, Reilly Gardner, Alaine Schauer

Articles, Abstracts, and Reports

No abstract provided.

Increasing Special Pathogen Preparedness At A Frontline Hospital: A Quality Improvement Project, Mckenna Freed, Christa Arguinchona, Barbara Bennett-Wolcott

Articles, Abstracts, and Reports

No abstract provided.

Nurse Education For Perinatal Substance Use Disorder And Mental Health, Michelle Simpson

Articles, Abstracts, and Reports

No abstract provided.

Providing Skilled Mentorship For A Newly Forming Research And Evidence-Based Practice (Ebp) & Education Council, Bedane Geleta, Gale Springer, So Young Pak

Articles, Abstracts, and Reports

No abstract provided.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Impact Of Nurse-Led Environmental Controls On Insomnia In Elderly Acute Care Inpatients, Tyler G. Van Note, Lindsay V. Garay, Ava R. Eisenhart

SPARK Symposium Presentations

The Impact of Nurse-Led Environmental Controls on Insomnia in Elderly Acute Care Inpatients

Research Question: Does teaching nurses to control the patient environment (I) in acute care in-patients aged 65+ (P) reduce insomnia compared to current practice (Q1H rounding) (C) from 67.4% to less than 30% as measured by the Insomnia Severity Index (ISI) (O)?

Background and Significance: 67.4% of hospitalized patients report experiencing insomnia from sleep disturbances, which can significantly impact their recovery and overall health outcomes. Nurses can address these disruptions by monitoring noise, light exposure, and staff interruptions.

Sample methods: The literature review search keywords were sleep …

Quality Improvement Initiative To Decrease Excessive Testing For Streptococcal Pharyngitis In Adults In An Outpatient Clinic Setting, Hana Roussey, Jennifer Sternberg, David Phillippi

SPARK Symposium Presentations

Project Title: Quality Improvement Initiative to Decrease Excessive Testing for Streptococcal Pharyngitis in Adults in an Outpatient Clinic Setting

Background and Rationale: Current guidelines recommend utilization of a clinical decision-making tool, like the Centor score, in conjunction with confirmatory diagnostic methods, such as a throat culture or rapid test, rather than either method alone. The existing practice at the clinic site was to test most adults with upper respiratory infection symptoms (e.g., sore throat, cough, fever, sinus congestion) with little discretion. With the reported prevalence of streptococcal pharyngitis or “strep throat” in adults being 5-15%, universally testing adult patients could …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino

SPARK Symposium Presentations

Project Title: The Impact of High Deductible Health Plans on Mental Health Treatment

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact …

Bibliography, Mary P. Bennett

Faculty/Staff Personal Papers

Bibliography of publications by Mary Bennett.

Exploring Factors Influencing Posttraumatic Growth Among Nurses: A Path Analysis, Shinhi Han, Hee Sun Kang, Koun Eum, Kathleen Karsten, Faith Armstrong

Publications and Research

Introduction: Persistent exposure to the COVID-19 pandemic has subjected frontline nurses to heightened levels of collective traumatic syndromes, including stress, burnout, and emotional distress. Resilience and self-compassion may serve as protective factors in mitigating stress and burnout stemming from the pandemic. Moreover, these factors may contribute to posttraumatic growth (PTG), which has been recognized as a potential outcome for nurses caring for patients. This study aimed to investigate the factors contributing to PTG among registered nurses, with perceived stress, burnout, resilience, and self-compassion.

Methods: This cross-sectional observational survey used convenience sampling with 228 registered nurses from New York. Data were …

Reducing Unnecessary Antibiotics For The Treatment Of Urinary Tract Infections, Megan A. Carullo

West Chester University Doctoral Projects

Urinary tract infections (UTIs) are among the most common infections in women and are often a reason for prescribing antibiotics. Appropriately treating these infections is vital to prevent significant health concerns such as pyelonephritis or sepsis. Providers commonly prescribe antibiotics as a preventive measure, but incorrect usage can lead to unnecessary use of antibiotics. This is a large concern for the medical community, given the increased rates of antibiotic resistance. This quality improvement project aimed to answer the following research question: In women with recurrent UTIs (rUTIs), does presumptive treatment compared to standard treatment upon confirmed infection increase the number …

Assessing The Effect Of Increasing The Frequency Of Copd Assessment Test Utilization On Rehospitalization Rates For Home Health Patients, Rebecca Goldberg

West Chester University Doctoral Projects

Abstract

This evidence-based practice Process Improvement (PI) project involves using the COPD Assessment Test (CAT) to decrease rehospitalization rates for home health patients with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The project includes having therapy clinicians complete the CAT during their in-home skilled visits, between home health nursing visits to increase the frequency of completion. The goal is to recognize symptoms of exacerbation early, engage patients in their own care, encourage communication with providers, initiate early intervention at home, and prevent rehospitalization. Patients with COPD experience frequent symptom exacerbations leading to anxiety, poor quality of life, and challenges …

The Impact Of Health Promotion Home Visits On Loneliness In An Older Adult Population, Jean M. Herb

West Chester University Doctoral Projects

Loneliness among older adults is a significant public health concern associated with adverse physical, emotional, and cognitive outcomes. Despite widespread recognition of the issue, effective interventions remain limited in clinical practice. This Doctor of Nursing Practice (DNP) project implemented and evaluated a Health Promotion Home Visit (HPHV) intervention designed to reduce loneliness in community-dwelling adults aged 65 and older. A quality improvement initiative using a pre-post design was conducted at a community outreach division of a home health agency. Patients received HPHV every other week over an eight-week period. The UCLA Loneliness Scale (Version 3) was used to assess loneliness …

Cus+E: Creating A Culture Of Safety Through Improved Communication Within Perioperative Services, Sunilka Thompson

West Chester University Doctoral Projects

The Department of Perioperative Services identified ongoing communication and cultural challenges that compromised team dynamics, psychological safety, and patient care. A culture of safety survey revealed a significant disconnect: while many staff felt comfortable raising safety concerns, nurses and ancillary support staff reported widespread experiences of disrespectful behavior—perceptions not shared by providers. In response, the department implemented the CUS+E (I’m concerned, I’m uncomfortable, this is a safety issue + Explanation) communication tool to enhance the real-time escalation of safety concerns. Project goals included increasing safety reporting, reducing adverse events, and improving staff confidence in raising concerns. Post-implementation surveys indicated that …