Nursing Commons^™

Nurses' Perspectives Of Dysphagia Screening Practices In Irish Residential Long-Term Care Settings: A Qualitative Descriptive Study, Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney

Research outputs 2022 to 2026

Objectives To examine nurses’ perspectives on current dysphagia screening practices in Irish residential long-term care settings (RLTCS), and to investigate barriers and facilitators to nursing-led dysphagia screening within this healthcare context. Methods This study employed a qualitative descriptive design and was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Participants were recruited through purposive sampling from RLTCS located in the northeast of the Republic of Ireland. Eleven in-person focus group interviews were conducted with thirty-four nurses working in clinical and managerial roles. A semi-structured interview guide was utilised, and the data were subsequently analysed using reflexive …

Enhancing Tardive Dyskinesia Screening In An Outpatient Psychiatry Training Clinic: A Quality Improvement Initiative, Ariel Davalos

Doctor of Nursing Practice Final Manuscripts

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Moving Toward Standardization Of Breast Cancer Screening: A Scoping Review Comparing Uspstf And Acs Recommendations For Women Aged 40–74, Gerita F. Perry, Krystal D. Hester-Smith, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose 

To compare U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) breast cancer screening guidelines for women aged 40–74, and to recommend adopting one consistent, standardized guideline in practice. Standardization can improve care continuity, patient adherence, reduce anxiety, support early detection, and lower mortality.

Background 

Breast cancer is the second leading cause of cancer-related death amongst women. The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. The ACS recommends an annual mammogram. Differences between the two organizations for screening emphasize the need for a common alignment to reduce breast cancer mortality. As breast …

Quality Improvement Project: Implementation Of A Screening Tool For Postpartum Depression, Yaminah Johnson

Doctor of Nursing Practice Projects

Postpartum depression (PPD) remains underrecognized in clinical practice, with many cases going undiagnosed due to inconsistent or absent screening processes. At the project site, only 60% of postpartum patients reported that their mental health needs were adequately addressed, highlight-ing a critical gap in care. The purpose of this quality improvement project was to implement an evidence-based PPD screening tool and evaluate its impact on provider confidence and patient outcomes. Guided by Lewin’s Theory of Planned Change and Orem’s Self-Care Deficit Theory, the project aimed to improve physician and nursing staff confidence in screening and increase appropriate interventions for patients who …

Effects Of Educational Programs On Reducing Sexually Transmitted Infection Rates, Phierica D. Gardin

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) remain a significant public health concern in the United States, with increasing rates reported in many states, including North Carolina. Limited sexual health education, stigma surrounding sexual health discussions, and lack of awareness regarding prevention and screening contribute to ongoing transmission, delayed diagnosis, and potential long-term complications associated with untreated STIs. The purpose of this Doctor of Nursing Practice (DNP) project was to implement a sexual health education program aimed at increasing knowledge of STI transmission, prevention strategies, and the importance of screening among adults aged 18 years and older. Two educational sessions were completed within …

Evaluating The Implementation And Use Of A Standardized Screening Process To Increase Flu Vaccine Uptake In A Rural Health Primary Care Clinic, Mackenzie L. Pierce

DNP Projects

Background: Research has shown that an annual influenza vaccine is the most effective way to both prevent and reduce the risk of hospitalization and severe health complications of the flu. A yearly influenza vaccination is recommended for everyone age 6 moths and older.

Local Problem: Rural communities have lower rates of influenza vaccination which can be due in part to a lack of screening and education on vaccines and their importance. No process for influenza vaccine status screening existed at the project site prior to this project.

Methods: A quality-improvement project was conducted to evaluate the implementation of a standardized …

Evaluating Healthcare Professionals’ Perceptions Of The Ist Algorithm In Maternal-Fetal Health Clinic: Usability And Satisfaction, Terri Taylor

Doctor of Nursing Practice Projects

Background: Standardizing substance-use screening in perinatal care is essential for optimizing clinical decision-making and promoting equitable patient outcomes. To address gaps, the Integrated Screening Tool (IST) algorithm was introduced in a Maternal–Fetal Medicine (MFM) clinic. However, 2023 data revealed inconsistent utilization. Evaluation Question: This Doctor of Nursing Practice (DNP) project evaluated: (1) How do nurse practitioners, medical doctors, and registered nurses perceive the usability of the IST algorithm for standardized drug screening in pregnancy? (2) How do these providers rate their satisfaction with the IST algorithm in managing patients with positive drug screens? Methodology: A cross-sectional survey was conducted with …

Quality Improvement Project: The Impact Of Staff Education On Utilization Of The Phq-9 Tool And Follow-Up Management Protocol, Shuntak Jerideau

Doctor of Nursing Practice Projects

Depression is a prevalent mental health disorder that affects daily functioning. Timely screening enables the identification of symptoms, monitoring treatment efficacy, and informs additional treatment such as referrals. The practice site reported low screening rates of patient’s post-psychiatric hospitalization, which was attributed to inadequate knowledge of the PHQ-9 tool. The purpose of this quality improvement project was to evaluate the impact of staff education on the utilization of the PHQ-9 tool and follow-up management protocol in a mental health clinic. A quasi-experimental design method was used in an outpatient mental health clinic. Pretest knowledge of the PHQ-9 was obtained from …

Quality Improvement Project Impacting Healthcare Providers’ Knowledge And Self-Efficacy On Peripheral Artery Disease In An Outpatient Cardiovascular Clinic, Nikki Naphaphone Phanyoraj

Doctor of Nursing Practice Projects

Peripheral artery disease (PAD) affects over 200 million people worldwide and contributes to functional limitations, decline in quality of life, and increased risk of cardiovascular morbidity and mortality. Failure to effectively screen patients for PAD can lead to delayed treatment and poorer health outcomes. Early detection and intervention are key to altering the disease progression, reducing complications, and improving health outcomes. The purpose of the quality improvement project is to impact the knowledge and self-efficacy of the healthcare providers working in the outpatient cardiovascular clinic on PAD. A quasi-experimental design with pre- and post-test PAD knowledge exam and a pre- …

Palliative Care Beyond Cancer: The Use Of The P-Cares Tool, Breslin E. Meyer

Dissertations

Emergency Departments (EDs) often lack the necessary resources and protocols to provide comprehensive palliative care, resulting in inadequate pain and symptom management (Stoltenberg et al., 2022). This study investigates the potential transformative impact of a palliative care consultation on patients with advanced disease who screen positive using the validated P-CaRES tool. The PICOT questions: Will patients with end-stage COPD, CHF, and or other chronic conditions benefit from P-CaRES screening in the emergency department over nine weeks and receive more palliative care consultations from their primary care providers?

This project was conducted over 9 weeks, utilizing convenience sampling to select 20 …

National Patient Safety Goals: Reducing Health Care Disparities In Adult Patients With Alcohol Misuse, Jolie M. Carpenter

Doctor of Nursing Practice Projects

Background: An estimated 76 million people worldwide suffer from alcohol use disorder, accounting for almost two million deaths annually. The Joint Commission has made it a requirement to screen all patients admitted to an inpatient facility for health-related social needs, including alcohol use. By doing so, outpatient resources can be provided appropriately.

Purpose: The facility of interest does not currently have a discharge follow-up protocol. The purpose of this project was to implement an evidence-based protocol to follow-up one week after discharge to determine if patients accessed the community resources provided for alcohol use disorder and to determine whether the …

Implementation Of An Education Program For A Ptsd Screening Tool To Increase Knowledge Among Providers Within The Primary Care Setting, Kimberly Inez Schat

Doctoral Dissertations and Projects

Post-Traumatic Stress Disorder (PTSD) is frequently underdiagnosed or misdiagnosed in primary care settings, leading to delays in treatment and poorer patient outcomes. This scholarly project aims to enhance primary care providers' knowledge and application of PTSD screening tools, specifically the PC-PTSD-5, through a structured educational intervention. The project follows a quasi-experimental pre-test/post-test design, assessing providers' baseline knowledge, delivering targeted education, and measuring changes in knowledge and confidence post-intervention.

Data analysis revealed a statistically significant improvement in providers' ability to identify PTSD symptoms, utilize appropriate screening tools, and refer patients for timely treatment. The project highlights the clinical significance of routine …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

Health Equity And Social Determinants Of Health Nurse Education, Jacqueline Arana Clements

Walden Dissertations and Doctoral Studies

The primary care setting provides integrated healthcare services where nurses address many healthcare needs, develop patient relationships, and practice in the context of family and community. To provide comprehensive care, nurses must complete a social determinants of health screening that addresses the social factors that impact clinical outcomes. In 2021, the National Academies of Sciences, Engineering, and Medicine published a nursing education strategy on educating nurses on social determinants of health. This project aimed to develop a staff education program to prepare primary care nurses on the concepts and terminology encompassing social determinants of health, identifying the severity of health …

A Multicomponent Quality Improvement Initiative For The Early Identification, Prevention, And Management Of Delirium In The Medical-Surgical Setting, Sarah K. West

Doctor of Nursing Practice Scholarly Projects

Hospital-acquired delirium affects older adult patients, across the healthcare continuum. The incidence in frail older adults is high, costly, and often deemed preventable. Hospital-acquired delirium is associated with a multitude of short- and long-term complications, resulting in an increased rate of morbidity and mortality. The challenges of early recognition and management are prevalent in healthcare literature. While published guidelines exist, hospital systems continue to struggle with the standardization of geriatric delirium care. Given medical-surgical nursing is the cornerstone of hospital care, it is imperative to establish a standardized delirium prevention and management guideline, at this level of care, to optimize …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Utilizing The Mdq For Bipolar I Screening In The Primary Care Environment, Jamie Strozier

Epsilon Sigma at-Large Research Conference

Abstract- Utilizing the MDQ for Bipolar I Screening in the Primary Care Environment

Bipolar disorder is a chronic mental health condition characterized by episodes of depression, mania, or mixed symptoms, affecting approximately 5.7 million adults in the U.S. and 40 million individuals worldwide. Despite its significant impact, bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD) in primary care settings, leading to inappropriate treatment and worsening patient outcomes. Research indicates that 78% of bipolar patients are initially misdiagnosed, with only 32% of primary care providers (PCPs) screening for the disorder. This quality improvement project aims to enhance bipolar disorder …

Changing Intimate Partner Violence Screening And Intervention: Focus Group Perspectives, Colleen M. Galambos, Teresa Jerofke-Owen, Heidi Paquette, Linda B. Piacentine, Erin C. Schubert, Mychoua Vang, Erica Arrington, Nilanjan Lodh, Kimberly S. Gecsi

College of Nursing Faculty Research and Publications

Background: Many survivors of intimate partner violence (IPV) remain unconnected to professional help. Screenings in health settings may improve connections to support services.

Purpose: The purpose of this study was to gather data to help inform an IPV screening intervention in an obstetrics/gynecology health clinic.

Methods: A qualitative analysis was employed using a summative content analysis approach of the transcripts of 2 focus groups consisting of health care providers, advocates, and survivors of IPV.

Results: Four thematic categories and additional subcategories emerged from the analysis, including (1) current process (what is done); (2) need (what is not done); (3) concerns …

Quality Improvement Project: Improving Tardive Dyskinesia Detection And Management Through Aims Scale Utilization In Outpatient Psychiatry Clinic, Judeline Docteur

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a debilitating movement disorder commonly associated with prolonged antipsychotic medication use. The disorder results in functional impairment and reduced quality of life for those affected. Frequent TD screening using scales such as the Abnormal Involuntary Movement Scale (AIMS) for those on antipsychotic medication is recommended. However, its underutilization due to a lack of awareness, confidence, and knowledge of its applicability contributes to delayed detection and management, resulting in poor patient outcomes. The purpose of this quality improvement project was to improve TD detection and management through healthcare provider training to affect their self-efficacy and knowledge and …

Heart Of An Athlete: Educating On The Importance Of Cardiovascular Screening Of High School Athletes, Tiffany Michelle Haley

Doctor of Nursing Practice Projects

There is a lack of education regarding cardiovascular screening and the incidence of sudden cardiac arrest (SCA) in high school athletes. The target population needing improved education is primarily school faculty, staff, trainers, and coaches. Effective cardiovascular screening and education will aid in the prevention of a catastrophic injury, including SCA and sudden cardiac death (SCD). Educating high school faculty and staff will bring forth awareness of signs and symptoms of SCA and aid in proper care and treatment for high school athletes who are at higher risk. The goal of this project was to educate faculty and staff on …

Evaluating Knowledge, Skills, Attitudes, And Suicide Hotline Referrals In Aprns Screening Children For Depression And Suicide In Primary Care, Brooklyn D. Higginbotham

DNP Projects

Background: Suicide is the 2nd leading cause of death in adolescents across the United States (US). Primary care providers (PCPs) are often the first people an adolescent sees for depression or suicide symptoms; however, evidence shows PCPs may not be comprehensively screening for suicide in the primary care setting by using the Patient Health Questionnaire (PHQ) alone. Screening tool usage for depression and suicide among PCPs is currently at rates as low as 26% due to lack of knowledge and insufficient resources. Evidence-based education on American Academy of Pediatrics (AAP) recommendations can improve PCPs’ knowledge, skills, and attitudes when assessing …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

Improving Timely Palliative Care Consultation In The Micu: A Nurse-Driven Quality Improvement Initiative, Sandy Louise Gray

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Improving Timely Palliative Care Consultation in the MICU: A Nurse-Driven Quality Improvement Initiative

Sandy L Gray

Background: Early palliative care in intensive care units improves outcomes and reduces costs, yet referrals are often delayed. At J.W. Ruby Memorial Hospital’s medical intensive care unit (MICU), baseline median time to consultation was 112 hours (mean=246), exceeding recommended benchmarks and highlighting the need for a standardized process.

Purpose: This quality improvement project evaluated a nurse-driven screening tool to improve timeliness and consistency of palliative care consultations in the MICU.

Intervention: The tool was embedded in the electronic health record (EHR) …

Hpv Self-Sampling Promotion Among African American (Aa) And Sub-Saharan African (Sai) Immigrant Women: Adaptation And Usability Testing, Adebola Adegboyega, Gia Mudd-Martin, Nancy Schoenberg, Mark Dignan

Nursing Faculty Publications

Background: Cervical cancer (CC) rates have declined nationally but rates remain high in Black women with most cases occurring among unscreened and under-screened women. This paper describes the adaptation, acceptability, and useability of an education intervention, “Health is Wealth: A Cervical Health Intervention”, to promote cervical screening and reduce perceived barriers to CC screening among two subgroups of Black women: African American (AA) and sub-Saharan African immigrant (SAI) women.

Methods: In this paper, we describe the process of adapting the Health is Wealth intervention using the Barrera and Castro adaptation framework. The iterative adaptation process included formative focus groups (n …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Identification Of Obstructive Sleep Apnea Symptoms Among Veterans In The Primary Care Setting, John Dominic Rosella Iv

Doctor of Nursing Practice Scholarly Projects

Untreated obstructive sleep apnea (OSA) has long-term cardiovascular and metabolic health implications, impacting quality of life and increasing health expenditures. Veterans have a higher prevalence rate of OSA attributed to an aging population and higher rates of comorbid conditions. The problem of under recognition of OSA symptoms partly relates to clinicians needing to elicit relevant symptoms routinely. At the same time, the lack of primary-care-based screening protocols contributes to the percentage of undiagnosed OSA. The purpose of this evidence-based project was to implement routine screening to identify OSA risk among veterans in primary care settings in South Carolina. The method …

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …