A Descriptive Study Of Cancer Care Experiences And Burden Of Rural South Dakotans, Sarah Mollman, Teddi Dowling, Patricia Woolridge, Jamie Hillmer, James Odom, Marie Bakitas, Hossein Moradi Rekabdarkolaee, Brandon Varilek

Journal Articles: College of Nursing

BACKGROUND: American Indian (AI) persons with advanced cancer (PwAC) in South Dakota have seen increased rates of cancer incidence and mortality compared to national rates. These inequities are driven by social determinants of health. Providing early palliative care is highly important for rural PwAC but is sparsely available in rural South Dakota.

OBJECTIVE: To explore cancer care experiences and patient symptoms and caregiver burden among AI and rural PwAC, and their family caregivers (FCGs), to understand the barriers and opportunities for adapting an early palliative care intervention.

DESIGN: Descriptive study design reporting on the qualitative and quantitative data collected.

METHODS: …

The Association Of Social Determinants Of Health On Mortality Among Adults With End-Stage Kidney Disease: A Systematic Review And Meta-Analysis, Prince Agyapong, Lauren Longacre, Patti Brooks, Hossein Moradi Rekabdarkolaee, Surachat Ngorsuraches, Aine O'Connor, Semhar Michael, Brandon Varilek

Journal Articles: College of Nursing

RATIONALE/OBJECTIVE:: Synthesize evidence from published studies on end-stage kidney disease (ESKD) mortality and determine associations between social determinants of health (SDOH) and ESKD mortality.

STUDY DESIGN:: This PRISMA-guided study examined all published research across four electronic databases.

STUDY POPULATIONS:: Adults with ESKD living in the United States.

SELECTION CRITERIA FOR STUDIES:: Clinical trials, observational, cross-sectional, and prospective/retrospective cohort studies were considered if one or more of the five domains of SDOH were present in the analysis.

EXTRACTION/ANALYSIS:: Extraction was performed independently by two reviewers using a standardized form that captured study purpose and design, outcomes, SDOH domain, setting, participant characteristics, …

Trauma And The Brain: Foundations To Trauma-Informed Care In Nursing, David Wolff

OER Materials

The goal of this presentation was to educated nursing students about what traumatic events are and how they impact a patient, thus informing their approach to nursing care that is trauma-informed.

Chronic Dislocations And Pain In A College Athlete, Rachel Joseph, Trina Walker, University Of Wisconsin - Madison, Rebecca Kronk, Karen J. Whitt, Deborah O. Himes

Faculty Publications and Presentations

This diagnostic case study describes an 18-year-old woman and competitive gymnast who presents with recurrent joint dislocations, chronic musculoskeletal pain, and dermatologic findings suggestive of a heritable connective tissue disorder. Early recognition of connective tissue disorders is essential for accurate diagnosis, genetic evaluation, injury prevention, and long-term management planning.

Treatment Manual For Nonsequential Format Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course), Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment Manual and 5 Appendices for NonSequential Format.  Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

An Introduction For Nursing Research: An Open Educational Resource For The Undergraduate Nursing Student, Ellen Benjamin

OER Textbooks

The purpose of this text is not to prepare you to independently conduct research, but to help you become an informed and critical consumer of research. The ability to systematically evaluate the strengths, limitations, and applicability of research findings is known as critical appraisal. Critical appraisal is an expected competency of baccalaureate-prepared nurses [5] and requires a foundational understanding of research principles and methods. This book will introduce the research process, including common research methodologies, data collection and analysis approaches, ethical considerations, and strategies for translating research evidence into nursing practice.

Changes In Telehealth Usage Among Medicaid Beneficiaries With Mental Illnesses In A Rural State: An Analysis Of Kentucky Medicaid Dataset Over 5 Years (2018–2022), Chizimuzo T.C. Okoli, Tianyi Wang, Bassema Abufarsakh, Sarret Seng, Zainab Almogheer, Jarrah Al-Kayed, Pooja Bhattarai, Holly Stith, Andrew Makowski

Nursing Faculty Publications

Introduction: Accessing mental health care remains challenging for Medicaid beneficiaries with mental illnesses (MI) in rural settings. The COVID-19 pandemic prompted telehealth service expansion through temporary policy changes and shifts in health care delivery. Despite the increased availability of telehealth as a modality to address disparities in health care access, telehealth adoption and associated use are inadequately explored among Medicaid beneficiaries with MI in Kentucky.

Objective: To examine trends and factors associated with telehealth use by residence status among Kentucky Medicaid beneficiaries with MI.

Design: A retrospective analysis of Kentucky Medicaid claims data obtained from 174,354 beneficiaries aged 18 years …

Estimating Short-Term And Long-Term Survival For Patients With Kidney Failure Using A Mixture Survival Model, Nathan Meyer, Maxwell Donelan, Hossein Moradi Rekabdarkolaee, Brandon Varilek, Surachat Ngorsuraches, Patti Brooks, Jerry Schrier, Semhar Michael

Journal Articles: College of Nursing

Rationale & Objective

Study Design

Setting & Participants …

Video Instructions For Pre And Post Procedure Care: Evidence-Based Quality Improvement Project, Lynn V. Wojton

DNP Projects

Background: Patient adherence to pre- and post-procedure instructions is essential to ensuring optimal outcomes and patient satisfaction in cosmetic dermatology. However, patients frequently overlook or misunderstand written instructions, leading to suboptimal preparation and recovery experiences.

Project Purpose: The purpose of this quality improvement initiative was to evaluate whether the implementation of short, accessible video-based instructions could improve patient understanding, adherence, and satisfaction compared to standard written instructions alone.

Methods: The project was conducted in a high-volume cosmetic dermatology practice in the Northeastern United States. A HIPAA-compliant platform using a video-based educational intervention was developed and implemented to supplement or replace …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Reducing Live Discharges In Hospice Care Through A Bundled Intervention, Fiona P. White

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction

 Among Medicare fee-for-service hospice beneficiaries, the national live discharge rate increased from 16.9% in FY2021 to 19.1% in FY2025. At a Medicare-certified hospice agency in a southern state, the pre-intervention live discharge rate of 35.3% substantially exceeded national norms, with 68.7% of events representing patient-initiated revocations.

Methods

 A pre-post quality improvement design guided by the Plan-Do-Study-Act framework was implemented over 8 weeks at a single site with 106 newly admitted hospice patients and 15 clinical staff. The four-component bundled intervention comprised Revocation Risk Assessment administration within 24 hours of admission, structured patient and caregiver education within 72 hours of …

Toolkit To Prevent Venous Thromboembolism Among Surgical Patients, Carine Wawa

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: According to the Centers for Disease Control and Prevention, approximately 900,000 people in the United States are affected annually by venous thromboembolism (VTE) (CDC, 2025). The surgical patient population is vulnerable to VTE due to factors such as immobility, tissue injuries, and inflammatory responses. The lack of standardized protocols for surgical patients causes practice variability among healthcare providers and potentially increases the risk for preventable VTE events.

Methods: A toolkit to prevent VTE was developed utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC). A literature review was conducted, reviewed, and graded using the …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

Early Pressure Injury Identification And Intervention In Emergency Department Older Adults Who Are Admitted Into A Community Hospital Intensive Care Unit, Lisa M. Britt

Doctor of Nursing Practice (DNP) Scholarly Projects

A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Evaluating The Effectiveness Of Scenario-Based Virtual Escape Rooms To Improve Student Confidence In Dosage Calculations, Jennifer A. Cuevas

Theses

Abstract

Background: Accurate dosage calculations (DCs) are critical for patient safety, as medication errors contribute to approximately 7,000-9,000 preventable deaths annually. Nearly 30% of nursing students exhibit weakness in foundational mathematical skills, and a significant confidence gap exists: 70% feel confident in mathematical abilities, yet only 45% feel confident in clinical application, necessitating innovative educational interventions.

Purpose: The purpose of this project was to implement and evaluate a scenario-based virtual escape room intervention to enhance undergraduate nursing students' confidence in DCs.

Methods: Grounded in Kolb’s experiential learning theory, this online asynchronous intervention engaged students through concrete experience, reflective observation, abstract …

Dnp Final Report: Poverty Stigma: The Effects Of A Poverty Simulation On Undergraduate Nursing Students And Their Attitudes Toward Caring For Impoverished Patients, Jessica P. Bowen

DNP Final Reports

Background: Current evidence demonstrates that stigma toward individuals living in poverty persists among undergraduate nursing students and negatively influences patient outcomes. Evidence-based educational strategies addressing social determinants of health have been shown to improve nursing students’ perceptions of vulnerable populations.

Purpose: This quality improvement project intended to evaluate the feasibility of integrating an interactive Community Action Poverty Simulation© (CAPS) activity into an undergraduate nursing (BSN) program at an academic health system university in East Texas.

Methods: Guided by the Plan Do Study Act (PDSA) quality improvement framework and The Johns Hopkins Evidence-Based Practice (JHEBP) Model, Missouri's Community Action Poverty Simulation …

Dnp Final Report: Reducing 30-Day Readmissions Through Follow-Up Appointments In An Acute Care Setting, Sukhnandan Kaur

DNP Final Reports

Thirty-day hospital readmissions remain a persistent quality and financial concern for acute care organizations. Poorly coordinated discharge processes, inconsistent follow-up appointment scheduling, and gaps in care transitions may increase the risk of avoidable readmissions among adult medical-surgical patients. The purpose of this quality improvement project was to implement a standardized follow-up appointment scheduling workflow prior to hospital discharge and evaluate its effect on follow-up scheduling compliance and 30-day readmission trends in a 93-bed acute care hospital. The intervention was implemented over 12 weeks on an adult medical-surgical unit from September through December 2025. The standardized workflow included electronic health record …

Enhancing Postoperative Esophagectomy Outcomes With Preoperative Education: A Quality Improvement Project, Gaelyn Kattman

DNP Projects

Title

Enhancing Postoperative Outcomes with Preoperative Education for Esophagectomy Patients

Background/Significance

Esophageal cancer is an aggressive disease and the fourth most common gastrointestinal cancer. A surgical treatment for a patient with esophageal cancer who is a surgical candidate is an esophagectomy. Immediate postoperative complications may include pneumonia, arrhythmias or anastomotic leaks, all of which can potentially increase the patient’s length of stay. Delayed discharges can lead to a backup throughout the hospital, limiting the amount of available inpatient beds for patient care.

Purpose 

The DNP project purpose was to implement an additional preoperative telehealth visit in order to provide  patient …

Improving Awareness And Use Of The First-Responder Alerting Application, Pulsepoint Respond, In The Nursing Profession, Maclaine Matties

DNP Projects

Background/Significance

Out-of-hospital cardiac arrest (OHCA) is a sudden, life-threatening emergency that can occur anywhere and to anyone. In 2023, the American Heart Association identified OHCA as a public health crisis, with survival rates around 10%. Outcomes depend heavily on rapid intervention, as each minute without cardiopulmonary resuscitation (CPR) significantly reduces survival. Mobile phone–based alert systems help bridge the gap between collapse and emergency medical services (EMS) arrival by notifying nearby trained responders. In a county in the Northeast, PulsePoint Respond serves this role. However, despite 1,302 registered responders as of November 2025, only 7 registered nurses were enrolled, highlighting an …

Implementation Of An Updated Opioid Overdose Response Policy To Address Xylazine-Involved Overdoses In A Federally Qualified Health Center, Dana Umbro

DNP Projects

The increasing prevalence of non-opioid adulterants like xylazine, a veterinary tranquilizer, has introduced significant challenges in overdose recognition and management. Non-opioid adulterants cause central nervous system depression, respiratory compromise, and severe soft tissue injury that is not reversed by naloxone. Many healthcare organizations lack standardized clinical guidance for managing overdoses involving non-opioid adulterants, resulting in variability in care and increased risk for adverse outcomes. The purpose of this Doctor of Nursing Practice project was to update and implement an opioid overdose response policy incorporating evidence-based guidance for the recognition and management of overdoses potentially involving non-opioid adulterants. This was conducted …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer

DNP Projects

Background/Significance

Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of morbidity, mortality, and increased healthcare costs. Alcohol-based nasal decolonization is an evidence-based strategy to reduce MRSA transmission; however, staff compliance with decolonization protocols is often suboptimal, limiting effectiveness in inpatient medical-surgical settings.

Purpose

The purpose of this evidence-based quality improvement (EBQI) project was to evaluate whether implementing a structured, evidence-based nasal decolonization protocol improved staff compliance and reduced missed administrations and patient refusals among eligible medical-surgical inpatients.

Methods

This EBQI project was implemented on five inpatient medical-surgical units at a large academic medical center. Interventions included standardized staff education, …

Leveraging Technology To Improve Throughput: A Qi Project Utilizing Electronic Sbar, Suzy Candito

DNP Projects

The DNP practice site, a high-acuity Level I trauma center and regional referral hub, experiences persistent emergency department (ED) crowding and prolonged admission throughput times. Regional data show average ED wait-times near 252 minutes, underscoring the urgency of reducing delays between bed assignment and bed occupancy (assigned-to-occupied time). Inefficient or varied written handoffs contribute to calls for clarification, omissions, and transition delays, where structured, electronic SBAR tools are associated with improved completeness, standardization, and workflow efficiency. At the systems level, prolonged ED boarding is linked to higher daily hospital costs and safety risks, making communication optimization an operational and patient-safety …

Enhancing Postoperative Outcomes: The Impact Of Instruction Format On Patient Satisfaction In Ambulatory Surgery An Evidence-Based Quality Improvement Project, Gillian Shelby

DNP Projects

Background

Effective postoperative discharge communication is essential in ambulatory surgery centers, where short recovery periods and rapid patient turnover increase the risk of misunderstanding postoperative care instructions. Inconsistent delivery of discharge education may contribute to decreased patient satisfaction and reduced adherence to postoperative plans. Project Goals

The goals of this DNP quality improvement project were to: (1) implement standardized dual-format postoperative instructions using written and verbal education reinforced with the teach-back method, and (2) improve patient satisfaction and confidence in understanding postoperative care instructions. Methods

Following IRB exempt approval on September 10, 2025, implementation occurred from November 20,2025 to February …

Acuity-Based Staffing Tool: Improving Patient Outcomes And Nurse Wellbeing In A Local Critical Care Unit, Grace Watson, Rachel Nazha, Madeline Ruffin, Evvy Lewis

SPARK Symposium Presentations

This change project proposes implementation of the CAMEO (Complexity Assessment and Monitoring to Ensure Optimal Outcomes) acuity-based staffing tool in a local critical care unit to improve patient safety, nurse wellbeing, and organizational outcomes (Hurtig et al., 2021). Current staffing practices rely on floating nurses from other units during census fluctuations, creating skill mismatches, increased burnout, and risk for adverse events. Evidence links inadequate staffing with increased mortality, infections, length of stay, and nurse turnover, revealing the need for a more systematic approach (Elmdni, 2025). The CAMEO tool quantifies cognitive workload across 18 domains of care and aligns nurse expertise …

Bias In Nursing Students: How Student Exposure Impacts Patient Interactions, Claire Roy

Honors Theses and Capstones

Bias is a pervasive issue in healthcare. It affects all aspects of the healthcare system and affects patients primarily through their interactions with healthcare providers. This study aimed to identify if exposure to various patient populations reduced bias among participants and increased their understanding of the way bias impacts patients. Two participants were recruited from a baccalaureate nursing program course titled “Living with Mental Illness” to participate in a series of two-semi structured interviews to identify bias, perceptions of community-based care, and the growth from the beginning to the end of their clinical experiences. Results showed skill development, increased understanding …

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …