Nursing Commons^™

Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a quality improvement (QI) initiative. Nephrologists were inconsistent in ordering iron studies and sometimes delayed the initiation of erythropoiesis-stimulating agents (ESAs) on admission to the inpatient site. These delays often led to suboptimal outcomes. The practice-focused question guiding the project asked whether a nurse-driven iron protocol would improve adherence to anemia management guidelines. The project’s purpose was to evaluate the impact of the evidence-based nurse-driven protocol. I used descriptive and inferential statistics for data analysis. Findings demonstrated a statistically significant improvement in the timely completion of iron studies and in intravenous (IV) iron …

Bridging The Gap: Optimizing Outpatient Care Delivery In Rural Kenya Through A Telemedicine Workflow Training Initiative, Elizabeth K. Bennett

Doctoral Dissertations and Projects

Access to timely, high-quality outpatient care in rural Kenya is constrained by workforce shortages, geographic barriers, and inefficiencies in care delivery. This Doctor of Nursing Practice project evaluated the impact of implementing a structured telemedicine workflow and training program for a regional mission hospital in the highlands of Western Kenya and its satellite outpatient clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's Change Theory, and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework, the project employed a quasi-experimental, pre-post design, with eight medical providers participating in structured workshops, interactive telemedicine simulations, and workflow integration exercises. Impacts were …

Nursing Faculty Attitudes Toward Artificial Intelligence: A Quantitative Causal-Comparative Cross-Sectional Study, Micaela Mcspadden

Doctoral Dissertations and Projects

The rapid growth of artificial intelligence (AI) in healthcare has highlighted the importance of understanding how nursing faculty perceive this technology. Although prior studies have explored public views, nurses’ perceptions, and faculty attitudes toward technology and curriculum change, limited research has focused on nursing faculty perspectives toward AI. Through the lens of the Theory of Reasoned Action (TRA) and the Technology Acceptance Model (TAM), this study examined factors that influence nursing faculty attitudes toward AI in nursing education. This study used a quantitative, causal-comparative, cross-sectional design with 263 nursing faculty participants from undergraduate pre-licensure programs in the United States. Participants …

Workplace Violence: A Paradigm Shift, Ann Marie Hutchens

Doctoral Dissertations and Projects

Workplace violence (WPV) has reached epidemic proportions. WPV poses devastating results on the healthcare industry: affecting quality of care and patient outcomes, contribute to the development of physical and psychological conditions for nurses, and reduce the healthcare teams’ level of job satisfaction and organizational commitment. The United States is already facing a nursing shortage due to baby boomers retiring and an increase chronic disease and the elder population. Although strongly prevalent, WPV is significantly underreported. It is believed that the low rate of reporting is a consequence of apathy that violence is an occupational hazard, and that nothing will change. …

Staff Education To Improve Knowledge Of Probiotic Use And Benefits For Best Patient Outcomes, Rebecca M. Hoover

Walden Dissertations and Doctoral Studies

Abstract The staff education project to improve knowledge of probiotic use and benefits with antibiotic use, has shown to improve patient recovery and outcome. The post-implementation impact of the project is increased awareness of probiotic use and their benefits to prevent Antibiotic. Associated Diarrhea at the project site organization. I identified no limitations in the project. Staff education can be used worldwide to prevent digestive diseases with the use of probiotics supplements or probiotic food. Probiotics use is to improve patient outcomes by maintaining gut microbiome and digestive health. The evidence-based practice solution of a staff education on probiotic use …

A Clinical Practice Guideline For Screening For Insomnia In College Students, Ashly Bliss

Walden Dissertations and Doctoral Studies

Insomnia and sleep deprivation are highly prevalent issues among the U.S. college student population, contributing to a significant health care gap due to the inconsistent performance of routine clinical screening. This Doctor of Nursing Practice (DNP) project sought to determine the rigor and applicability of a Clinical Practice Guideline (CPG) designed for the early identification of insomnia in college students using a best-evidence screening tool within a rural health clinic. The primary practice-focused question was: In a rural health clinic, will a CPG for implementation of a screening tool based on best evidence for early identification of insomnia in college …

Impact Of Staff Education To Clinical Documentation Integrity Team, Leyna Belcher

Walden Dissertations and Doctoral Studies

The doctoral project investigates the impact of education on Clinical Documentation Integrity (CDI) nurses in enhancing the accuracy and quality of clinical documentation within healthcare organizations. Clinical documentation plays a crucial role in accurately reflecting patient care and is essential for capturing proper diagnoses, coding, and reimbursement. In contrast, inaccurate or incomplete documentation can lead to misdiagnoses, poor patient outcomes, and financial deficits. Due to frequent updates in clinical guidelines and coding standards, CDI professionals require continuous, specialized training to stay informed with ever-changing medical terminology, disease processes, and coding regulations. By enhancing the CDI education, the aim is to …

Effect Of Implementing Safety Nursing Measures For Maintaining Fluid And Electrolyte Balance Among Critically Ill Patients With Acute Pancreatitis, Marwa Abdo

Nursing

Acute pancreatitis is a severe inflammatory condition that affects the pancreas and causes multiple organ failure. High rates of morbidity and mortality are caused by acute pancreatitis. Early fluid resuscitation, within the first 48 hrs., remains the hallmark for acute pancreatitis management. It lowers the incidence of pancreatic necrosis. Therefore, the foundation of treating acute pancreatitis in its early stages is safe fluid resuscitation. Aim: This study aims to evaluate the effect of implementing safety nursing measures for maintaining fluid and electrolyte balance among patients. Study design: A quasi-experimental research design was utilized in this study. Setting: This study was …

Early Depression Screening In Adults With Opioid Use Disorder, Ekaterina Versace

Walden Dissertations and Doctoral Studies

Abstract This Doctor of Nursing Practice project involved the development and quality appraisal of a clinical practice guideline (CPG) for early depression screening in adults with opioid use disorder (OUD), addressing the absence of standardized, evidence-based screening protocols in addiction treatment settings. Guided by the practice-focused question of whether existing evidence supports the development and evaluation of such a guideline using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, a systematic synthesis of 35 research articles was conducted, with 15 high-level studies informing guideline development. A multidisciplinary panel of four experts evaluated the CPG using the …

Transition-To-Practice Program For Aprn Msn Graduates, Jennifer Nneoma Nwosu

Walden Dissertations and Doctoral Studies

The transition from graduate education to clinical practice marks a pivotal point in the professional journey of advanced practice registered nurses (APRNs). Despite rigorous preparation, many APRN MSN graduates struggle to adapt to the complex expectations of autonomous practice. The lack of structured mentorship, inconsistent orientation processes, and unclear performance expectations contribute to high stress, role confusion, and early turnover. This Doctor of Nursing Practice Executive Leadership project addressed this critical issue by evaluating whether an interprofessional team could achieve consensus on developing a best practice program to guide APRN MSN graduates’ transition to independent clinical practice. This initiative was …

The Relationship Between Religious Attitude And Breastfeeding Attitude: A Cross-Sectional Study From Türkiye, Melike Yavaş Çelik, Cuma Tunçkaşık

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: This study was conducted with 203 mothers with babies aged 0–24 months. Simple random sampling was used in sample selection. The Religious Attitude Scale and Breastfeeding Attitudes of the Evaluation Scale were used in data collection.

Results: A significant relationship was found between religious attitudes and breastfeeding attitudes. Additionally, mothers' negative breastfeeding attitudes and positive breastfeeding attitudes were found to be close to each other. The time it took for mothers to start breastfeeding their …

Climate Change Anxiety Related To Women’S Health Among Health Sciences Students, Derya Kaya Şenol, Semiha Aydın Özkan, Durdu Cennet Omuş

Makara Journal of Health Research

Background: Climate change impacts are unequally distributed globally, with children, women, pregnant women, the elderly, marginalized populations, and refugees bearing a disproportionate burden. This study aims to determine the levels of related anxiety among female students and to examine the relationship between the anxiety and their perceptions, knowledge levels, and health behaviors related to women’s health.

Methods: The study has a descriptive cross-sectional design. The study population included women students enrolled in the fall semester of the 2023–2024 academic year at the Faculty of Health Sciences of a university between October and December 2023. Personal Information Form and …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

The Relationship Between Individual Innovativeness Traits And Medical Artificial Intelligence Readiness Levels Among Nursing Students In Türkiye, Özlem Öztürk, Tülay Sağkal Midilli

Makara Journal of Health Research

Background: This study examined the relationship between nursing students’ individual innovativeness traits and their readiness for medical artificial intelligence, and the influencing factors.

Methods: This study was a descriptive, correlational study. The study was conducted with 606 nursing students enrolled at the Faculty of Health Science, Manisa Celal Bayar University. Data were collected using the Descriptive Information Form, the Individual Innovativeness Scale (IIS), and the Medical Artificial Intelligence Readiness Scale (MAIRS).

Results: The mean IIS score was 64.23 ± 8.47, indicating that most students fell into the skeptical or interrogator categories. The mean MAIRS score was 75.77 …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

Integrating The Five As Framework To Enhance Person-Centered Care For Adults Living With Obesity, Alexandra Charles

Electronic Theses and Dissertations

Obesity has adverse effects on physical health, emotional well-being, and mental functioning. To effectively address this highly prevalent and multifaceted condition, the use of a structured, evidence-informed framework is essential to support providers in delivering consistent, person-centered care for individuals living with obesity. The Five As is a powerful yet not commonly implemented framework in many primary care practices. The Five As framework (Ask, Assess, Advise, Agree, Assist) offers a structured model to guide clinicians in delivering consistent, supportive, and transformative care for individuals with obesity.

The goal of the project was to implement a timely and cost-effective protocol/tool that …

Pediatric Anesthesia And Virtual Reality: Managing Perioperative Pain And Anxiety– A Scoping Review, Moneer Sharafi, Mason Pham, Alec Wiscombe

Doctoral Projects

Pediatric surgery is common, but it often causes considerable anxiety and pain. A staggering percentage of children experience preoperative anxiety, which can heighten pain, delay recovery, and contribute to complications such as emergence delirium and longer-term behavioral issues (Fortier & Kain, 2015). Virtual reality (VR), which immerses users in computer-generated environments, has been proposed as a distraction technique to reduce these challenges. This Doctor of Nursing Practice (DNP) project conducted a scoping review to examine the effectiveness of VR in reducing perioperative pain and anxiety in pediatric patients. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses …

A Program Evaluation Of Universal Screening For Depression In The Primary Care Setting, Samantha W. Burns

Doctoral Projects

Depression is a chronic condition affecting millions of Americans annually and is often associated with poor clinical outcomes, multiple co-morbidities, a negative economic impact, and an increased mortality rate. Many primary care settings have implemented universal depression screening programs following the recommendations of governing healthcare entities such as the United States Preventive Services Task Force (USPSTF) and Center for Medicare and Medicaid Services (CMS). Due to positive benefit, universal depression screenings have now been included as a quality measure in the Merit-based Incentive Payment System (MIPS) to increase organizational reimbursement. The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening …

The Role Of Multimodal Analgesia In Spine Surgery: A Scoping Review Of Its Impact On Opioid Consumption And Surgical Outcomes, Madison Milam, Kristie Mullins, Tatum Trent

Doctoral Projects

The ongoing opioid epidemic emphasizes the need for alternative perioperative pain management strategies, particularly in high-risk surgical populations such as spine surgery patients. This project proposes a scoping review to examine the role of multimodal analgesia (MMA) in reducing opioid consumption and improving surgical outcomes in adult neurosurgical patients. MMA analgesia involves the use of multiple pharmacologic and nonpharmacologic approaches that target different pain pathways in the human body, aiming to enhance patient comfort while minimizing reliance on opioids.

This review synthesizes current literature on MMA strategies used in spinal surgeries, evaluates reported outcomes such as pain control, postoperative complications, …

Nurses' Comfort Toward Caring For The Dying: A Cross-Sectional Descriptive Study, Candies Warren

ATU Theses and Dissertations 2021 - Present

The purpose of this quantitative cross-sectional descriptive research study was to explore nurses’ comfort levels toward caring for dying patients and what factors influence the bedside nurses’ comfort levels in providing end-of-life care in an acute care hospital setting. A convenience sample (N=63) of RNs voluntarily participated in an online survey from January 2025 to March 2025 that provided direct patient care. Data was collected through Question Pro. Data collected included sociodemographic questions, questions about current comfort level, factors that influence nurses’ comfort level, and selected items from the Frommelt Attitude Toward Care of the Dying Patient (FATCOD) scale. Institutional …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Misconceptions About Nursing In High School Students Of Color: Promoting Diversity In Nursing, Veronnica D. Pham

Doctor of Nursing Practice (DNP) Projects

Background: Equitable and culturally competent care can reduce health disparities among underserved populations; yet the nursing shortage the US faces does not allow for better patient outcomes. One barrier is how the profession can be negatively viewed among high school students of color.

Methods: A comprehensive literature search was performed to identify how perception of nursing affects a student’s career choice and what influences these perspectives. Three databases were utilized for this search: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus. Six articles were selected for this review. The following themes have been identified: misconceptions, …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

Effects Of Communication Boards On Improving Communication In Assisted Living Care Facilities, Koleen Beatrice Arribas

Master's Projects and Capstones

Problem: A Residential Care facility utilizes paper charting causing limited access to vital information such as code status, allergies, and/or diet for those caring for the resident.

Context: Exceptional charting only when a resident’s condition changes may not provide enough vital information for the caregiver to administer medication or provide proper support during an emergency, such as the resident’s DNR status.

Interventions: A communication board was placed in a secure space near the nurses’ station with key resident information. Nurses would huddle at the board at before the change of shift and make updates as necessary.

Measures: Staff input in …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

The Pressure Is On: A Quality Improvement Project To Educate Nurses On Hospital Acquired Pressure Injuries, Lance Ward

Master's Projects and Capstones

Objective Hospital acquired pressure injuries (HAPIs) are injuries developed by admitted patients, from treatment interventions that they encounter during their hospital stay. If a patient acquires a HAPI during their stay, the hospital is required to cover all expenses related to the injury. An in-patient trauma unit at a large medical center wishes to improve patient care by educating nursing staff on preventive measures of HAPIs. A review of relevant literature on HAPIs from the past five years was conducted to identify HAPI preventions tools, such as the Braden Scale and SKINS bundle, as well as the best methods to …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the …

Promoting Interprofessional Collaboration By Increasing Visibility Of Volunteer Doula Services, Ciera Rose Zelie

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team developed a standardized doula awareness poster featuring each doula's name, photo, years of experience, and personal interests. Aim: Enhance visibility and promote the integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for four weeks, a post-survey assessed these same domains to determine …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

Staff Education To Impact Staff Knowledge Of Depression Screening In Primary Care, Nkeiruka Chinwendu Unaegbu

Walden Dissertations and Doctoral Studies

Summary This doctoral project was a staff education program designed to improve depression screening among patients in an adult primary care setting. The practice problem addressed was the lack of standardized depression screening that led to inconsistent detection, delayed diagnosis, and fragmented mental health care. A move to address the issue is critical in nursing practice since nurses play a central role in early identification, patient advocacy, and integration of behavioral health into primary care. The practice-focused question guiding the project was, Will implementing a nursing staff education program impact their knowledge of Clinical Practice Guideline (CPG) for depression screening …