Nursing Commons^™

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 …

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 …

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 …

Quality Improvement Project Integrating Educational Program For School Faculty In Childhood Diabetes, Sharon Anna-Marie Hill

Doctor of Nursing Practice Projects

In the United States, diabetes affects approximately 38.4 million individuals, including over 304,000 children and adolescents diagnosed with type 1 diabetes. As the most common chronic condition in children, diabetes management in school settings is critical to ensure health, safety, and academic success. However, a lack of standardized training for school faculty often results in inadequate knowledge and confidence in managing diabetes, exacerbating student health risks. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to develop and implement an educational program for school faculty, focusing on managing and treating childhood diabetes. A paired sample t-test was used …

Quality Improvement Project Integrating Clinical Decision-Making Tools Within An Ehr System For Provider-Enhanced Diagnosis And Treatment Of Depression In Primary Care, Theresa Ojoye

Doctor of Nursing Practice Projects

The inconsistent management of depression in primary care settings persists despite numerous available treatments, which current behavioral health literature frequently addresses.  A review of the project site highlighted the inconsistency in diagnosing and managing depression due to varying levels of provider familiarity with current guidelines and a lack of integrated decision-support tools within the Electronic Health Record (EHR) system. This project aims to evaluate the impact of integrating a clinical decision-making tool and patient outcomes in managing depression. This Quality Improvement (QI) project implemented UpToDate as an evidence-based clinical resource within the EHR system to address inconsistent application of evidence-based …

Assessment Of Faculty Perception Of Flipped Classroom Pedagogy, Jincymol Thomas

Doctor of Nursing Practice Projects

This DNP project assesses the faculty's perception of the flipped classroom (FC) pedagogy, which is an evidence-based teaching strategy to promote active learning and student success. The purpose of this project is to assess faculty members’ perception of implementing FC. The problem identified is the low progression and graduation rates for associate degree nursing (ADN) students at a North Central Texas Community College. This indicates that current teaching strategies need to be revised. As healthcare is constantly evolving and becoming more complex, the traditional methods of teaching nursing students are no longer sufficient. This QI project is aiming to educate …

Dnp Project: Research Study Using Mindfulness Meditation For Stress Reduction In Undergraduate Nursing Students, Jennifer Williams

Doctor of Nursing Practice Projects

Undergraduate nursing students often experience high stress from academic rigor, clinical demands, and personal challenges, contributing to mental health concerns and increased attrition. Unmanaged stress, when met with insufficient coping strategies, may contribute to students failing, leaving, or withdrawing from a nursing program. This research project addressed the need for a structured coping strategy within the curriculum at a State College to promote student resilience and reduce stress. As a quality improvement process change, the project’s purpose was to evaluate the impact of a four-week mindfulness meditation (MM) intervention on perceived stress levels of first-semester Associate Degree in Nursing (ADN) …

Strategies For Sustainable Recruitment, Retention, And Engagement In State Nurse Organization, Carolyn E. Hunter Layne

Doctor of Nursing Practice Projects

Many state nurse organizations are experiencing minimal and stagnant membership, which hinders involvement in policy advocacy, professional development, and workforce stability in healthcare. Policy changes are needed to offer state nurse organization memberships under the umbrella of a single organization that operates multiple medical clinics and employs at least one nurse. This research examined strategic policy interventions designed to increase membership within a state-level nursing organization. The problem is that a minimum number of state-licensed nurses are choosing to join professional nursing organizations, and membership models must be identified. The literature review drew on research from various scholarly sources specific …

Quality Improvement Project Implementing A Structured Communication Program For Academic Clinical Nursing Education, Ashley Daniel

Doctor of Nursing Practice Projects

Effective communication between healthcare professionals is a critical component of safe and high-quality patient care. Structured tools like SBAR (situation, background, assessment, and recommendation) provide a framework to enhance clarity and reduce miscommunication. This quality improvement project implemented SBAR as a structured communication program in debriefing after simulation to improve communication confidence among practical nursing students. The purpose of this project was to evaluate whether the integration of SBAR into debriefing would increase students’ self-reported communication confidence. The problem addressed was the lack of confidence in clinical communication among nursing students, which can impact patient safety and team collaboration. The …

Implementing Education On Music Therapy To Healthcare Professionals In Acute Psychiatric Inpatient Units To Decrease Incidences Of Aggression Among Patients, Judy Murua

Doctor of Nursing Practice Projects

Aggression in psychiatric inpatient units presents a significant barrier to therapeutic care and staff safety, often resulting in the overuse of pharmacological interventions or restraints. Despite strong evidence supporting music therapy as a non-pharmacological option, limited exposure and confidence among healthcare team members hinder its use in practice. This quality improvement project evaluated whether an educational intervention on music therapy could improve staff‘s confidence in utilizing this technique to manage aggression. A quasi-experimental, one-group pre- and post-test design was employed in an adult inpatient psychiatric unit, involving participation from nurses and behavioral health technicians. A structured 30–45-minute educational session was …

Enhancing Clinical Understanding And Management Of Hypertensive Disorders Of Pregnancy Among Ob-Gyn Providers, Jenelle Camino

Walden Dissertations and Doctoral Studies

Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and chronic hypertension, are among the leading causes of maternal and neonatal morbidity and mortality globally, affecting approximately 10% of pregnancies. Despite established clinical guidelines, a significant gap remains in provider knowledge and the consistent application of evidence-based practices, particularly during the postpartum period and among marginalized populations. This Doctor of Nursing Practice (DNP) project addressed this gap by implementing a staff education program using the evidence-based California Maternal Quality Care Collaborative (CMQCC, 2021) toolkit. The intervention consisted of a pretest to assess baseline knowledge, an interactive PowerPoint presentation based on …

Quality Improvement Project The Impact Of Targeted Education And Training On The Use Of Rapid Mood Screener Tool On The Rate Of Mood Disorders Detection Among Psychiatric Providers, Oluwatobi Adeleke

Doctor of Nursing Practice Projects

Optimal mood disorder (MD) management outcomes are associated with accurate and timely diagnosis. Yet, MD misdiagnosis, particularly Bipolar I, is an unfortunately common problem. Rapid assessment or screening tools offer effective diagnostic assessment interventions for faster diagnosis without compromising effectiveness. Still, their administration is constrained by providers’ knowledge and competence limitations. The Rapid Mood Screener (RMS) is a rapid screener for MDs, including Bipolar I, with well-established specificity, accuracy, and reliability. Provider training and education on RMS implementation can be effective in addressing the challenges providers encounter in the tool’s administration. Here, through a pre-post quasi-experimental design, this quality improvement …

Quality Improvement Project Implementing Test Anxiety-Reducing Methods In Senior-Level Nursing Students, Ashley Brooke Gray

Doctor of Nursing Practice Projects

Test anxiety is a common occurrence among university students, particularly nursing students. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address the problem of test anxiety among senior-level nursing students and the lack of faculty intervention in a Bachelor of Science in Nursing (BSN) program. This DNP project aimed to increase awareness of test anxiety among nursing students and provide faculty development training on identifying symptoms, utilizing the Westside Test Anxiety Scale (WTAS), and implementing test anxiety-reducing measures in the classroom. The DNP student provided training to senior-level nursing faculty in integrating relaxation methods, …

Quality Improvement Project Evidence-Based Practice For The Use Of Lower Fio2 Concentration Amongst Pediatric Anesthesia Providers, Brittany Raines

Doctor of Nursing Practice Projects

Hyperoxia during pediatric anesthesia is linked to postoperative pulmonary complications such as atelectasis and oxidative lung injury. Despite strong evidence supporting the use of lower inspired oxygen concentrations (FiO2), many providers habitually administer 100% oxygen during induction and emergence due to tradition and lack of formal guidelines. This quality improvement project aimed to reduce unnecessary hyperoxia by educating pediatric anesthesia providers on evidence-based FiO2 titration strategies. Guided by Kolb’s Experiential Learning Theory and Lewin’s Change Theory, a quasi-experimental one-group pretest/posttest design was employed. Sixteen certified registered nurse anesthetists (CRNAs) and physician anesthesiologists completed baseline surveys, participated in a targeted educational …

Evidence-Based Intervention Proposal For Reducing Intimate Partner Violence Against Jamaican Women, Kimisha K. Campbell

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is a significant public health concern that negatively impacts women’s health, yet gaps in trauma-informed screening and referral processes persist within nursing practice. In Jamaica, DV remains underreported, highlighting the need for enhanced provider competency in identifying and supporting survivors. The doctoral project was used to examine how implementing the trauma-informed care (TIC) model and the Identification and Referral to Improve Safety (IRIS) program could improve healthcare staff’s ability to recognize, assess, and support DV survivors. Guided by the TIC framework and the IRIS program, a mixed-methods approach was used, incorporating pre- and posttraining assessments, staff surveys, …

Impacting Atherosclerotic Cardiovascular Disease Risk Screening In The Primary Care Setting, Rosalyn Primus

Doctor of Nursing Practice Projects

Cardiovascular disease continues to be the leading cause of death worldwide. Despite the availability of evidence-based guidelines recommending routine cardiovascular risk screening, tools such as the atherosclerotic cardiovascular disease (ASCVD) Risk Estimator are underutilized in primary care settings. This quality improvement project implemented an evidence-based educational intervention to enhance healthcare providers' knowledge, self-efficacy, and consistent utilization of the ASCVD Risk Estimator within a primary care setting. The project employed a quasi-experimental design involving four primary care providers. Data was collected through various methods, including a knowledge questionnaire, the Evidence-Based Nursing Practice Self-Efficacy (EBPSE) Scale, a retrospective chart review, and a …

Evaluating The Impact Of Auscultation Task Trainer On Faculty Teaching Health Assessment Course In A Bsn Program, Marie Leonie Tampus

Doctor of Nursing Practice Projects

Simulation-based education continues to transform nursing pedagogy by enhancing instructional effectiveness and clinical competency through experiential learning. In undergraduate Bachelor of Science in Nursing (BSN) programs, faculty often face challenges when teaching complex skills such as respiratory system assessment due to variability in lung sound exposure and reliance on peer-based instruction. The project aimed to evaluate whether the implementation of a high-fidelity auscultation task trainer could improve faculty knowledge and self-confidence in teaching respiratory assessment in a BSN Health Assessment course. Using a pre- and post-intervention quality improvement design, five faculty members teaching the course participated in a six-week intervention. …

Quality Improvement Project Structured Faculty Mentorship Program: A Quality Improvement Project, Nikki R. Pearson

Doctor of Nursing Practice Projects

The increasing issue of untrained faculty stepping into teaching roles poses a challenge in nursing education. This shift often causes stress and a period of disorientation. One evidence-based solution to enhance role clarity involves mentorship, which is defined as a professional relationship whereby a more experienced faculty member aids in the growth of a novice. The purpose of this project was to help novice nursing faculty by offering them structured, consistent mentorship as they moved into academia. The goal was to increase job satisfaction by clarifying roles, building a sense of support, and ultimately helping to retain faculty. The intervention …

Protecting Sleep To Reduce Delirium In Patients 65 Years And Older In The Icu, Jessica L. Thomas

Doctor of Nursing Practice Final Project Abstract

Protecting Sleep to Reduce Delirium in Patients 65 Years and Older in the ICU

PURPOSE

This quality improvement (QI) project aimed to reduce the incidence of delirium by 30% through a nurse-initiated, non-pharmacological sleep improvement protocol in the ICU.

BACKGROUND

This project was implemented in a large healthcare organization in Houston, Texas, in a 16-bed Intensive Care Unit.

METHODOLOGY

A pre- and post-intervention study was conducted in the ICU over a period using Plan-Do-Study-Act (PDSA) cycles. Baseline delirium (CAM-ICU) and sleep quality (RCSQ) assessments were obtained during Phase 1. Environmental adaptations, such as low lighting, noise reduction, staff education, and …

Digital-Based Nutrition Interventions Employing The Dietary Approaches To Stop Hypertension (Dash) Diet: A Systematic Scoping Review, Elizabeth Dodge, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. Methods: A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. Results: The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare …