Nursing Commons^™

Change For The Use Of Phenobarbital In Severe Alcohol Withdrawal Syndrome, Rylee J. Studiner

Walden Dissertations and Doctoral Studies

Alcohol withdrawal syndrome (AWS) is a critical condition commonly encountered in hospital settings. If not properly treated, AWS can progress to seizures, delirium tremens, and death. Traditionally, benzodiazepines guided by the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar), have served as a mainstay of treatment. However, emerging evidence supports the use of phenobarbital as a pharmacologic alternative and the Severity of Ethanol Withdrawal Scale (SEWS) as a more objective and clinically practical assessment tool. This doctor of nursing practice (DNP) project aimed to develop an evidence-based clinical practice guideline (CPG) for the use of phenobarbital in managing severe …

Staff Education On Suicidal Screening In Young African American Male Adults With Bipolar Disorders, Tokunbo Ndidi Allen

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice education project aimed to enhance mental health providers’ preparedness in culturally competent suicide screening, specifically for African American males with bipolar disorder in a behavioral health department. The practice issue identified was a lack of documented training, leading to underdiagnosis, missed interventions, and health disparities driven by cultural stigma, provider discomfort, and the absence of standardized guidelines. This represents a serious patient safety concern for African American males with mood disorders, such as bipolar, who are significantly underserved in mental health care. The guiding question was: Does a suicide screening education program improve the knowledge …

Implementation Of Patient-Centered Approaches To Enhance Engagement And Satisfaction In Psychiatric Care Within A Family Mental Health Service, Nnenna Attah

Walden Dissertations and Doctoral Studies

Summary I conducted this evaluation of a quality improvement initiative at a family mental health service center aimed to enhance patient engagement and satisfaction in psychiatric care through patient-centered approaches. The practice problem addressed in this project was the lack of patient engagement and satisfaction. This issue is critical to address within the context of nursing practice because patient-centered care is fundamental to improving clinical outcomes, patient satisfaction, and overall quality of care. The practice-focused question was: How can patient-centered approaches enhance patient engagement and satisfaction in psychiatric care? In the project, I focused on evaluating the impact of patient-centered …

Improving Student Success In 2nd Degree Bsn Students, Sharon Radzyminski, Eloisa G. Tamez, Jennifer Brewster, Leslie Kimberling Jones

School of Nursing Faculty Publications

Second Degree Bachelor of Science in Nursing (BSN) programs are designed to leverage a student’s prior academic achievements and professional experience, integrating them into the curriculum for their nursing degree. This allows students to receive credit for previous core courses and move through the nursing program at an accelerated rate. This, however, brings special challenges for both students and faculty. At our university we noticed the attrition rate of students in the second-degree BSN program was significantly higher than the traditional BSN program. Investigation into this issue revealed students in the Second-Degree Program had significant issues with role conflict, poor …

Antidepressant Medication Nonadherence In Adult Patients With A Major Depressive Disorder, Sandrine Djou Kaze

Walden Dissertations and Doctoral Studies

The chosen approach for the Doctor of Nursing Practice (DNP) project was a clinical practice guideline (CPG) on interventions to improve antidepressant medication adherence in adults diagnosed with depression in an outpatient setting. The consequences of medication nonadherence in patients with depression are devastating for individuals and the healthcare system. Therefore, addressing it within nursing practice is essential to improve treatment efficacy and patient outcomes. The practice question related to the DNP project was to determine whether the CPG could improve antidepressant medication compliance in adults diagnosed with a depressive disorder in an outpatient setting. I aimed to develop a …

An Educational Intervention Focused On Identifying Adverse Childhood Experiences, Laconia Bacon

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) refer to traumatic childhood experiences that individuals may have been exposed to during their youth, such as child maltreatment, domestic violence, or interparental violence. Research has demonstrated that experiencing ACEs in childhood may result in physical and mental illnesses that led to dangerous lifestyle patterns in adulthood. In the local organization, several patients with ACEs presented in the emergency department (ED). The nurses, unaware of ACEs, were unable to detect and respond to the consequences of ACEs. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine whether an educational intervention focused …

Conceptual Model And Design Of An Initiative To Build Nurses’ Resilience And Ethical Practice, Cynda Hylton Rushton, Sandra M. Swoboda, Nancy Reller, Laura C. Sarver, Erin M. Wright, Krysia Warren Hudson, Robie Victoria Hughes, Ginger C. Hanson, Rita D’Aoust

College of Nursing Faculty Papers & Presentations

Background: Healthcare faces a nursing crisis with high turnover, burnout, and faculty shortages, which requires innovative educational approaches that bridge the gap between education and practice. Purpose: To present the conceptual model and design of a statewide, trans-institutional academic-practice collaboration that holistically builds nurses' resilience and ethical practice across the education-to-practice continuum. Method: Development of the Renewal, Resilience, and Retention (R³) Initiative based on adaptation of the Mindful Ethical Practice and Resilience Academy (MEPRA), social ecological framework, and stakeholder input across eight schools of nursing and five hospitals in Maryland. Results: The R³ Initiative created a scalable …

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

Using Exercise To Treat Anxiety In Adult Patients With Addiction, Emmanuella N. Nnadozie

Walden Dissertations and Doctoral Studies

Summary In this Doctor of Nursing Practice (DNP) project, I selected a staff education as the best intervention to improve staff knowledge in using exercise to treat anxiety disorders in adult patients at a recovery clinic for addiction. Anxiety disorders are highly prevalent among individuals undergoing substance abuse treatment, often exacerbating withdrawal symptoms and increasing relapse risks; thus, integrating the use of exercise in addition to existing standard care for anxiety treatment in individuals with substance use disorder (SUD) will lead to decreased anxiety, decreased alcohol use and drug cravings, improved quality of life and affect, increased abstinence, and improve …

Enhancing Social Determinants Of Health Education In Home Health Care Including Social Determinants Of Health In Assessments And Care Plans For Home Health Clinicians, Emilia Mbanwite

Walden Dissertations and Doctoral Studies

This staff education-focused doctor of nursing practice (DNP) project addressed the critical practice problem of one southern health care facility staff’s knowledge on the integration of social determinants of health (SDOH) into home health care plans. Despite SDOH screening, clinicians lacked standardized training to effectively assess and intervene on factors such as housing, transportation, and food insecurity, contributing to preventable hospitalizations, particularly in vulnerable populations. The practice-focused question addressed whether an evidence-based education module could improve home health nurses’ knowledge and application of SDOH in assessments and care plans. The project’s purpose was to develop, implement, and evaluate this training …

Targeted Depression Screening For At-Risk High School Students: An Integrated Review, Joseph Calub

DNP Qualifying Manuscripts

Depression in high school students is underrecognized because symptoms can present not only as mood issues but also behavioral or academic problems. This integrated review examined literature from 2010-2015 using PsycInfo, ERIC, CINAHL, and PubMed to evaluate the effectiveness of targeted depression screening for students referred for behavioral, academic, or social concerns. Studies meeting inclusion criteria assessed targeted or clinically referred screening methods, with a focus on validated tools such as the Patient Health Questionnaire modified for Adolescents (PHQ-A). Findings indicate that targeted screening effectively identifies depressive symptoms in at-risk students and is more feasible in resource-limited schools than universal …

Improving Diabetes Management Through Evidence-Based Educational Resources In A Federally Qualified Health Center, Linda F. Dunbar

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to implement updated culturally tailored diabetes education materials, conduct staff training sessions, and promote consistent documentation of hemoglobin A1c values and adherence to evidence-based guidelines, aligned with current American Diabetes Association (ADA) standards of care. These interventions aimed to reduce the percentage of adults with HbA1c levels greater than 9%.

Background

The project was implemented at a Federally Qualified Health Center (FQHC) in a rural community of Tomball, Texas. The patient population is 73% Hispanic/Latino, who primarily speak Spanish, and are disproportionately affected by diabetes.

Methodology

The project was implemented using the …

An Integrated Literature Review Examining Nurse Burnout Interventions, Wislande Joseph

DNP Qualifying Manuscripts

Nurse burnout has detrimental consequences for patients, nurses, and organizations and can negatively impact patient outcomes, nurse quality of life, and organizational costs. This integrated literature review aimed to examine interventions for nurse burnout in order to identify what characterizes effective interventions, whether evidence supports implementing such interventions, and how the most commonly-implemented intervention type (mindfulness-based) in particular impacts signs and symptoms of nurse burnout. A two-part search was conducted of CINAHL, PubMed, Google Scholar, and APA PsychInfo. Part one investigated burnout interventions broadly using the primary search terms nurse burnout and interventions; part two focused specifically on mindfulness-based interventions …

Effectiveness Of Leadership Rounding In Reducing Patient-Related Falls In A Medical-Surgical Unit, Elsie-Solange Mvoueng Nkoi-Mimba

Walden Dissertations and Doctoral Studies

Summary In this Doctor of Nursing Practice (DNP) project, I evaluated whether the project site organization’s implementation of leadership rounding reduced patient falls within a medical-surgical unit. Despite established fall prevention strategies, the unit continued to experience ongoing incidents, prompting the implementation of structured leadership rounding. The practice-focused question assessed changes in fall rates over a 3-month postintervention period compared to the preceding 3 months. A retrospective chart review was conducted from December 2023 to June 2024, excluding March 2024 due to partial implementation. I used descriptive statistics to analyze trends. The average monthly fall rate remained stable at 2.67 …

A Comparative Subnational Policy Analysis Of State Covid-19 Vaccine Policies And Application Of The Political Determinants Of Health Model, Demetrius Cianci Chapman

Nursing ETDs

A COMPARATIVE SUBNATIONAL POLICY ANALYSIS OF STATE COVID-19 VACCINE POLICIES AND APPLICATION OF THE POLITICAL DETERMINANTS OF HEALTH MODEL

By

Demetrius Cianci Chapman

Associate of Science Nursing, Jewish Hospital College of Nursing and Allied Health, 1998

Bachelor of Science of Nursing, Saint Louis University, 2000

Master of Public Health, Saint Louis University, 2004

Master of Science Nursing (Research), Saint Louis University, 2004

Doctor of Philosophy, Nursing, University of New Mexico, 2025

ABSTRACT

This study uses the political determinants of health (PDoH) framework to analyze state-level COVID-19 vaccine policies and their impact on population health. The PDoH model examines how structured …

Optimizing Inventory Management To Reduce Medication Waste At A Low-Resource Clinic, Maqadus A. Khan

Doctor of Nursing Practice Final Project Abstract

Introduction

This project implemented standard operating procedures for inventory management in a low-resource clinic, incorporating First Expired, First Out (FEFO), Just-in-Time (JIT) ordering, and barcode scanning to reduce medication waste and optimize inventory processes. The aim was to reduce medication waste and optimize inventory processes.

Methodology

The Lean Six Sigma framework guided this project. Root causes of waste included inaccurate demand forecasting, lack of expiration tracking, insufficient staff training, poor stock rotation, and absence of standardized procedures. Baseline waste and practices were recorded. Medications were organized with nearing expirations upfront (FEFO), PAR levels were set, and JIT ordering implemented. Waste …

Skin-To-Skin Contact At Birth For Very Preterm Infants And Symptoms Of Depression And Anxiety In Parents During The First Year – A Secondary Outcome Of A Randomized Clinical Trial, Siri Lilliesköld, Karoline Lode-Kolz, Björn Westrup, Nils Bergman, Kimmo Sorjonen, Ulrika Ådén, Evalotte Mörelius, Siren Rettedal, Wibke Jonas

Research outputs 2022 to 2026

Background: Mental health issues are common in parents to preterm infants. In the neonatal intensive care unit (NICU), skin-to-skin contact (SSC) as an avenue for parent-infant closeness may improve parental mental health. Few studies exist regarding its benefits when initiated immediately postbirth. The aim was to determine the effect of SSC for very preterm infants at birth on parents' mental health, by assessing symptoms of depression and anxiety within the first year. Methods: The Immediate Parent-Infant Skin-to-Skin Study was a randomized clinical trial conducted 2018–2021 at three NICUs in Sweden and Norway. Very preterm infants (28–33 weeks of gestation) were …

Temporal Patterns Of Ectopic Pregnancy: Using The Electronic Health Record To Illuminate A Dark Corner In Women's Health, Kirsten Hepburn

Theses & Dissertations

Ectopic pregnancy remains a significant contributor to pregnancy-related morbidity and mortality, yet little is known about whether its occurrence follows discernible temporal patters that could inform prediction and prevention efforts. This dissertation aimed to explore the temporal characteristics of ectopic pregnancy through three interrelated projects: development of a new theoretical framework, a scoping review of the literature on ectopic pregnancy temporal patterns, and an empirical study using electronic health records data from a ten-year period at a single academic medical center. The Nursing Genomic and epigenomic, Environment, and Microbiome (N-GEM) situation-specific theoretical framework was introduced as a novel nursing theory …

Symptom Clusters And Their Association With Health-Related Quality Of Life In Pediatric Cancer Survivors After Treatment Completion, Krishtee Napit

Theses & Dissertations

A critical area of cancer research, symptom management, has evolved from focusing on individual symptoms to recognizing the complexity of co-occurring symptoms, commonly referred to as symptom clusters. However, most studies on pediatric cancer symptom clusters have focused primarily on the treatment phase or long-term survivorship, overlooking the early post-treatment period. This dissertation examines the prevalence of multiple symptoms and symptom clusters in pediatric cancer survivors post-treatment; factors associated with the total number of symptoms and symptom clusters; and the association of the total number of symptoms and symptom clusters with health-related quality of life (HRQoL). We developed and tested …

Integrating Artificial Intelligence And Evidence-Based Guidelines Into Nursing Education, Allyson Kornahrens, Kerriann Latten

International Journal of Transformative Teaching and Learning in Higher Education

Artificial Intelligence (AI) and emerging technologies are transforming the healthcare system and patient care delivery. Due to this, there is an essential need for faculty to incorporate AI into the nursing curriculum to educate students about its use and improve preparation for clinical practice. This practice-based article addresses the integration of AI into nursing education for students using AI-driven academic learning activities. These activities, created in alignment with the American Association of Colleges of Nursing (AACN) Essentials, explore clinical decision-making by comparing AI recommendations to evidence-based guidelines. Students are tasked with reflecting on AI’s accuracy and the ethical implications of …

Living With Disability After Spinal Cord Injury: A Grounded Theory Methodology, Diaa K. Abd Ali

Al-Ameed Journal for Medical Research and Health Sciences

Study Design: A Grounded Theory Methodology is employed to investigate the study phenomenon. the entire study started from Jan. 15^th. 2021 to March, 1^st. 2022.

Aim: The study is conducted to explore the concepts that shape the experience of living with disability among patients with spinal cord injury, and to formulating a grounded theory regarding nursing care for patients with spinal cord injuries.

Setting: The study is conducted in Ibn Alkuf Hospital for Spinal Cord Injuries, Baghdad, Iraq.

Methods: A non-probability purposive sampling technique was used to select (12) patients with chronic (more than 5 years) …

Reducing Icu Delirium Through Implementation Of The Icu Liberation Bundle, Stacey C. Woodard Dnp

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project was to evaluate whether identifying delirium through the Confusion Assessment Method for the ICU (CAM-ICU) assessment followed by treating delirium positive patients with the ICU Liberation Bundle reduced ventilator days or length of ICU stay and increased nursing satisfaction.

Background

ICU delirium is an acute state of confusion that affects up to 80% of ICU patients and increases morbidity and mortality. Decreasing the occurrence of delirium increases patient survivability and improves patient care (Society of Critical Care Medicine, 2023). There is currently no gold standard for managing and treating ICU delirium.

Methodology

This project …

Implementing Interventions To Decrease Readmission Rates In A Behavioral Hospital For People Experiencing Homelessness, Stacy M. Alvarez

Doctor of Nursing Practice Final Project Abstract

PURPOSE This quality improvement (QI) initiative aimed to reduce 30-day psychiatric readmission rates among adults experiencing homelessness by 10% over a 3-month period. Secondary goals included a 15% improvement in medication adherence and completion of follow-up visits.

BACKGROUND Individuals experiencing homelessness and mental illness face higher risks of psychiatric decompensation and hospital readmission. At Houston Behavioral Hospital, 13.34% of psychiatric readmissions involved unhoused individuals, highlighting limitations in standard discharge planning.

METHODOLOGY A pre-post intervention model was used to implement a discharge protocol based on the Transitional Care Model (TCM). The intervention included staff training, the use of a resource guide …

Staff Education To Improve Knowledge And Adherence To Diabetic Foot Ulcer Screening Protocols Using The Brief Diabetic Foot Ulceration Risk Checklist Tool, Sandrine Happi

Walden Dissertations and Doctoral Studies

This doctoral project implemented a structured nurse education module on the Brief Diabetic Foot Ulceration Risk Checklist to improve knowledge and adherence to diabetic foot ulcer screening, supporting preventive care, clinical consistency, and equitable patient outcomes in primary care. The practice-focused question guiding the project was whether providing structured education on the BDFURC would improve nurses’ knowledge and adherence to DFU screening protocols within 12 weeks. The goal was to equip nurses with standardized screening tools to support the early identification of high-risk patients and reduce the burden of DFU-related outcomes. The project involved 12 nursing staff and used a …

Addressing And Recognizing Secondary Traumatic Stress In Hospice And Palliative Care Clinicians, Laquisha La Chelle Jackson

Walden Dissertations and Doctoral Studies

In the emotionally demanding field of hospice and palliative care, the well-being of clinicians is critical. This Doctor of Nursing Practice (DNP) project focused on implementing a staffing education initiative to address secondary traumatic stress (STS). I designed this staffing education project to enhance clinician awareness, resilience, and coping strategies while informing organizational leadership on how improved staffing models and support systems can mitigate STS. Hospice and palliative care clinicians are uniquely vulnerable to STS due to constant exposure to trauma, death, and grieving families. The guiding question for this project was: In hospice and palliative care clinicians, how does …

Implementing A Delirium Risk Assessment Protocol For Older Adults To Reduce Post-Operative Delirium, Toni-Ann Thompson

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to reduce post-operative delirium (POD) in patients aged 65 years and older in a post-anesthesia care unit (PACU) through the implementation of the Confusion Assessment Method (CAM) tool.

BACKGROUND

POD is a significant issue in the PACU, especially among older adults. POD can increase the length of stay in the PACU and hospital, and also increase rates of morbidity and mortality. Prior to this QI project, there was no standardized test being used to screen patients.

METHOLOGY

The Plan-Do-Study-Act (PDSA) cycle was used throughout the implementation of the confusion assessment tool to guide quality …

Staff Education Program On Medication Reconciliation In Primary Care, Virginia Ann Bloomer

Walden Dissertations and Doctoral Studies

Medication errors represent a persistent threat to patient safety, particularly during transitions of care in outpatient settings. Despite recognition of the problem, standardized medication reconciliation practices among primary care physicians and nurse practitioners (NPs) remain inconsistent, hindered by varied workflows, unclear responsibilities, and knowledge gaps. To address these issues, a staff education program focusing on medication reconciliation was introduced to seven NPs and three physicians in a primary care clinic. Pre- and post-intervention surveys measured participants’ knowledge and confidence in conducting medication reconciliation and documenting medications in electronic medical records. The average test score improved from 68% to 92%, demonstrating …

Senior Living: Filling The Gap, Katy J. Johnson

The Interactive Journal of Global Leadership and Learning

This white paper explores how colleges and universities can help address the housing crisis for Americans aged 65 and older by integrating seniors into college campuses. This approach not only helps to fill dormitories but also provides students with valuable work experience. The paper examines three key issues: the Silver Tsunami (the growing senior population), declining enrollment leading to campus housing vacancies, and the financial burden of higher education. By advocating for intergenerational living, the proposal offers an innovative solution that benefits seniors, students, and universities.

Implementing Age-Appropriate, School-Based Comprehensive Sexuality Education, Emira Romero

DNP Qualifying Manuscripts

Background: Sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion. Yet, there are no federal education requirements for sexuality education in the United States, leading to inconsistent and inadequate instruction.

Methods: In an effort to better understand the barriers beyond policy variability that affect successful implementation of SRH education, a literature search was conducted on CINAHL and ERIC with the following search terms and Boolean operators: (sex* education OR reproductive educat*) AND (elementary school OR school based) AND (United States OR California). The years of publication were limited to the past five …

Effect Of Whole-Food Plant-Based Diet On Ldl Cholesterol: A Scoping Literature Review, Joel Gregory Mueller

Nursing Capstones

Background: The whole-food, plant-based (WFPB) diet includes whole grains, whole plants, unrefined sugars, beans, and legumes. The diet excludes meat, dairy, and added fats. The diet has been popularized by documentaries .The diet claims to lower total and LDL cholesterol to a safe level as both a primary and secondary mode of prevention.

Purpose: Review existing studies to see whether the WFPB diet will lower LDL cholesterol in adult males over a 14 day or more duration.

Methods: A scoping literature review was completed of the University of North Dakota’s library system for keyword combinations. The returned 102 studies were …