Family Practice Nursing Commons^™

Implementing A Nurse-Led, Family Caregiver–Integrated Delirium Prevention Protocol To Improve Bcam Screening Compliance And Caregiver Confidence Among Hospitalized Older Adults, Geraldine K. Ijezie

Doctor of Nursing Practice Final Project Abstract

Purpose:  To evaluate the effectiveness of a nurse-led, family caregiver–integrated delirium prevention protocol in improving bCAM screening compliance and caregiver confidence among hospitalized older adults in an Acute Care for the Elderly (ACE) unit.

Background; Delirium is a common but preventable complication in hospitalized older adults. Baseline assessments on the ACE Unit identified inconsistent bCAM screening and limited caregiver involvement. This quality improvement (QI) project aimed to improve early recognition through routine nurse screening and caregiver education to improve early delirium recognition and prevention.

Methodology: 12-week QI project using three PDSA cycles implemented nurse bCAM education, caregiver education, visual reminders, …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Standardizing Ascitic Fluid Panel To Improve Outcomes In A Large State Hospital, Yimei Zhang

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase provider compliance with evidence-based, hepatology-recommended ascitic fluid studies among inpatient providers from a baseline of 50% to 60% within five months through electronic health record (EHR) standardization.

Background: Delayed or incomplete ascitic fluid analysis can increase the risk of preventable complications. Workflow variability and non-standardized ordering practices contributed to inconsistent adherence to evidence-based recommendations.

Methodology: Using the Institute for Healthcare Improvement (IHI) Model for Improvement with Plan–Do–Study–Act (PDSA) cycles, two paracentesis workflows were redesigned. For the Mobile Procedure Team, a standardized ascitic fluid panel with six defaulted, evidence-based tests …

Frailty And Activities Of Daily Living In Older Adults In Primary Care: A Cross-Sectional Study, Öznur Adadıoğlu, Ahmet Seven, Esin Danç

Makara Journal of Health Research

Background: This study aimed to examine frailty status and activities of daily living among older adults.

Methods: This descriptive and cross-sectional study was conducted with 306 voluntary participants aged 65 years and older who were registered at a primary healthcare center in a city in Türkiye. Data were collected using the Participant Information Form, the FRAIL Scale, and the Katz Index of Activities of Daily Living.

Results: Among the participants, 36.9% were non-frail, 42.2% were pre-frail, and 20.9% were frail. The mean Katz Index score was 5.42 ± 1.35. The mean scores of activities of daily living …

Cultivating Civility: A Multicomponent Approach To Reducing Workplace Incivility In An Assisted Living Facility, Sanam Bral, Kaylyn Chang, Catherine Dinh, Sanjil Kumar, Truc Mai Moon

Master's Projects and Capstones

Workplace incivility remains a common challenge in healthcare, negatively affecting communication, staff well-being, and the quality and safety of resident care. Baseline survey findings from a faith-based assisted living facility in Southern California identified concerns related to workplace incivility, psychological safety, and gaps in staff knowledge of available reporting resources. This project aimed to reduce workplace incivility by improving staff knowledge and recognition of uncivil behaviors, with a target of at least 90% staff training attendance among nursing, assistive nursing, and medical technicians, and 80% attendee-reported high confidence level (agree or strongly agree) in recognizing incivility and understanding reporting options. …

Breaking The Silence: Standardizing Routine Intimate Partner Violence Screening At A Community Clinic Serving The Latinx Community, Victoria M. Hall

Master's Projects and Capstones

Intimate partner violence (IPV) affects the Latinx population disproportionately due to socioeconomic status, cultural stigma, and language barriers. However, routine screening remains inconsistent and unstandardized at a local community clinic in San Francisco’s Mission District, despite evidence-based practices recommending it. The gap in IPV screenings across the Adult, Teens, and Women’s clinics resulted in only 1.6% of patients being screened in July 2025 and 4.1% in June 2026. This quality improvement project aimed to address low screening rates by standardizing IPV screening through a printed bilingual screener, a 60-minute staff in-service on IPV and the new screening protocol, and by …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …

The Measles Serology Initiative: A Quality Improvement Intervention To Increase Provider Compliance With Rubeola Serology Screening, Erika S. Martinez

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to increase provider adherence to Rubeola IgG serology screening during prenatal visits at an outpatient women’s health clinic by 10% from a baseline adherence rate of 63.3%.

Background

Rubeola remains a highly contagious viral infection that poses health risks for nonimmune pregnant patients and their newborns. With increasing Rubeola cases and the importance of identifying immunity status during pregnancy, consistent prenatal screening practices are essential. Baseline data demonstrated inconsistent adherence to Rubeola IgG screening recommendations, highlighting the need for workflow interventions to improve provider compliance.

Methodology

A pre-post QI design …

Addressing Obesity In Rural Health Clinics, Morgan P. Trusley

Student Scholarly Projects

Practice Problem: According to the Centers for Disease Control and Prevention (CDC), more than 2 in 5 adults in the United States are obese (CDC, 2024a). In a rural primary care clinic in South Carolina, approximately 70% of patients are obese and there is no current intervention in place to help educate and guide these patients in weight loss strategies.

PICOT: In obese adults over the age of 18 at a rural health clinic with a Body Mass Index (BMI) greater than or equal to 30, does implementing weekly virtual and in person multicomponent behavioral intervention educational sessions compared to …

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Integrating Music Therapy Into Post-Surgical Care: A Quality Improvement Strategy For Reducing Post-Operative Anxiety, Yosdania Hernandez Benitez

Doctor of Nursing Practice Final Project Abstract

Integrating Music Therapy into Post-Surgical Care: A Quality Improvement Strategy for Reducing Post-Operative Anxiety

Purpose

This quality improvement (QI) project aimed to reduce postoperative anxiety among adult patients after general surgery in the post-anesthesia care unit (PACU) by 30% using nurse-led music therapy in an ambulatory surgical center.

Results

Mean VAS-A scores decreased from 6.9 (SD = 0.5) pre-intervention to 4.0 (SD = 0.5) post-intervention, representing a 2.9-point (41.9%) reduction in anxiety and exceeding the project's target of 30%. Nurse adherence to the intervention protocol was 100%, and the mean patient satisfaction score was 4.6/5.0. All 100 patients completed both …

Standardizing Safe Sleep Education In An Outpatient Pediatric Cardiology Clinic: A Quality Improvement Initiative, Casey Hrbacek

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to increase the reliability of standardized, evidence-based safe sleep education for caregivers of infants aged 0–12 months in an outpatient pediatric cardiology clinic within an academic health system

Background: Sleep-related death is the leading cause of death among infants aged 1-11 months and the third leading cause of infant mortality overall and is closely associated with modifiable unsafe sleep practices. Safe sleep education is delivered inconsistently across settings, particularly during the hospital-to-home transition for infants with complex cardiac disease.

Methodology: A caregiver-completed Safe Sleep Screening Checklist was embedded into clinic workflow. A medical …

Dnp Final Report: Community-Based Advance Care Planning Education For Older Adults: A Quality Improvement Project, Teresa Hill

DNP Final Reports

Background: Advance care planning (ACP) supports patient autonomy and promotes care aligned with individual values and preferences. Despite these benefits, fewer than half of adults aged 50–80 have completed formal ACP documentation, and community-dwelling older adults rarely engage in ACP before serious illness, representing a persistent gap in early engagement.

Purpose: This quality improvement (QI) project evaluated the effectiveness of a community-based ACP educational intervention in improving ACP knowledge, confidence, and engagement among older adults.

Methods: A nurse facilitator trained in the Five Wishes framework delivered a structured, 60-minute ACP workshop at a senior center in North Texas. A pre–post …

Tailoring Interventions For Patient Safety Protocol: A Strategy To Prevent Inpatient Falls, Yashu Adhikari

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: Inpatient falls were a significant safety issue at the project site, substantially affecting patient outcomes and organizational resources. The identified gap was the lack of individualized, patient-centered fall-prevention strategies despite the presence of standard fall-prevention bundles. The baseline fall rate of 6.04 was 20% higher than the national benchmark of three to five falls per 1,000 patient days, indicating a clear need for improvement.

Aim of the Project: The quality improvement (QI) project aimed to improve patient safety by reducing inpatient falls through implementation of the AHRQ Fall Tailoring Interventions for Patient Safety (TIPS) protocol on a …

Improving The Accuracy Of Medication Reconciliations For Medicare Advantage Patients At A Primary Care Clinic Using An Interdisciplinary Team, Sallie Mann

Doctor of Nursing Practice Projects

Background: Medication-related problems (MRPs) are a significant and often preventable cause of patient harm, particularly among older adults with complex medication regimens. In primary care settings, inaccurate or incomplete medication reconciliations contribute to adverse drug events, avoidable hospitalizations, increased healthcare costs, and reduced patient satisfaction.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether implementing an interdisciplinary medication reconciliation process using the Medications at Transitions and Clinical Handoffs (MATCH) Toolkit would improve reconciliation accuracy in Medicare Advantage patients aged 65 and older in a primary care clinic.

Project Design: This DNP project used the …

Enhancing Care Coordination Between The Same Day Clinic (Sdc) And Primary Care Group (Pcg) By Facilitating Care Establishment With A Primary Care Provider (Pcp), Saba Zabarah

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this Quality Improvement (QI) project was to connect patients to a Primary Care Provider (PCP). The specific aim was to increase by 25% the percentage of patients without a PCP who established care with a PCP within 30 days of visiting the Same Day Clinic (SDC).

BACKGROUND

The SDC provides episodic care for acute illness, making it difficult to coordinate care for patients who do not have a PCP and require follow-up. The project was implemented in an outpatient clinic that is connected to a larger primary care group in Houston, Texas.

METHODOLOGY

The intervention included …

Implementation Of A Standardized Adverse Childhood Experiences Screening Process In A Primary Care Clinic, Tanya M. Wonnacott

Doctoral Dissertations & Projects

Adverse Childhood Experiences (ACEs) are associated with increased risks of chronic disease, mental health disorders, substance use disorders, and premature mortality. Despite growing evidence supporting ACE screening, it remains inconsistent in many primary care settings, particularly among underserved populations. The purpose of this quality improvement project was to evaluate whether implementation of a standardized ACE screening workflow increased ACE screening completion and behavioral health referral within a nonprofit primary care clinic serving uninsured, underinsured, and refugee populations.

This project utilized a pre–post quality improvement design guided by Lewin’s Change Management Model and the Chronic Care Model. Interventions included standardized ACE …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Supporting Nurse Practitioner Autonomy: A Policy Proposal To Advance Hospice Np Scope, Lauren Hochart

Doctor of Nursing Practice Final Manuscripts

The Nurse Practitioner (NP) profession has achieved many advancements in its autonomy and scope of practice in the last 61 years since becoming a recognized advanced practice registered nursing role. However, some areas of healthcare still limit the NPs ability to practice autonomously even though it is within their scope of practice. This is notable in the subspecialty of hospice care with regards to certifying a terminal diagnosis as part of eligibility determination for a Medicare beneficiary to be able to receive covered hospice services. This health policy paper reviews current hospice regulations and provides evidence to support the benefits …

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Implementation Of A Provider-Focused Multimodal Educational Initiative To Address Polypharmacy And High-Risk Medication Use In A Home And Community Medicare Advantage Setting, Jennifer Butler-Rickard, Kellie Olsen, Eileen Stuart-Shor, Craig Drew

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Community-dwelling adults are at risk for adverse drug events such as falls, hospitalizations, cognitive decline, drug-to-drug interactions, and mortality related to high-risk medication use and polypharmacy, often defined as concurrent use of five or more different medications. Lack of provider knowledge of polypharmacy and high-risk medication use as well as suboptimal communication with primary care providers can lead to gaps in medication management in this vulnerable population.

LOCAL PROBLEM: Patients seen by the Comprehensive Annual Health Assessment Program advanced practice clinicians (APCs) at the project Medicare Advantage insurer organization often experience polypharmacy. Given the lack of provider knowledge of …

Pain Management In Opioid Users, Dawn Starbinski

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Chronic pain remains a significant public health concern in the United States, contributing to disability, reduced quality of life, and over-reliance on traditional opioids. Amid the opioid epidemic, healthcare systems are increasingly seeking safer alternatives to conventional opioid prescribing. (NIDA, 2023).This Doctor of Nursing Practice (DNP) project aimed to evaluate nursing knowledge on the implementation of buprenorphine/naloxone (Suboxone) as a pain management strategy in adult patients with chronic opioid use. The project was conducted in an inner-city Subacute Nursing facility with a population of adult patients experiencing long-term pain who were either opioid-tolerant or at high risk for opioid-related …

Improving Appropriate Nephrology Referrals Using Epic Screening Tools And Nurse Practitioner (Np) Education, Diahann M. Volcy

Seton Hall University Dissertations and Theses (ETDs)

Nephrology referral has been recognized as a modifiable factor influencing patient outcomes (Cheng, 2025). This project aims to reduce delayed or missed CKD diagnoses at large suburban hospitals in north New Jersey by improving timely nephrology referrals. I used a mixed-methods approach, retrospective chart review, pre- and post-education surveys, and referral trend analysis to assess how an educational session affects nurse practitioner knowledge and nephrology referral behavior. Enhancing nurse practitioner (NP) awareness and decision tool usage may increase early kidney care for patients, leading to better outcomes (ISN-KDIGO, 2021; Van Mil et al., 2024).

Be Prepared For Your Nurse Practitioner Clinical Readiness Exam, Elizabeth Heavey, Renee Biedlingmaier, Colleen Burgoyne, Carnel C. Jackson

Milne Open Textbooks

This text contains case studies and review questions for nurse practitioner students; focusing on the 3Ps of nurse practitioner education (Pharmacology, Pathophysiology, and Physical (Health) Assessment) to help NP students prepare for their clinical courses and pass their clinical readiness exam.  It includes cases commonly seen in entry-level NP practice.  In addition to the three individual sections of the text that focus on cases applying content from each of the distinct courses (Pathophysiology, Pharmacology, and Physical Assessment), we included summative case studies at the end of the book that connect all three areas in a single case. Because these three …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Colorectal Cancer Screening: Implementation And Evaluation Of A Screening Algorithm In A Rural Family Practice Clinic, Mollie M. Tate, Whitney Dubas

Doctor of Nursing Practice Projects: College of Nursing

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States and disproportionately affects rural populations. Although more than 90% of cases occur in adults older than 50 years, increasing incidence among younger adults prompted an update to national guidelines recommending screening beginning at age 45. Rural residents face multiple barriers to colorectal cancer screening (CRCS), including limited access to care, transportation challenges, lack of insurance, and absence of standardized screening processes in primary care. These barriers contribute to lower screening rates, delayed diagnosis, and poorer outcomes. Evidence demonstrates that CRCS reduces CRC morbidity and …

Measuring Effectiveness Of A Mobility Aide On A Medical-Surgical Unit, Jamie L. Granatowicz, Laura N. Rogers, Leeza A. Struwe

Doctor of Nursing Practice Projects: College of Nursing

Purpose: To evaluate the effectiveness of a mobility aide on a medical-surgical inpatient unit to improve patients’ surgical outcomes, decrease hospital length of stay, and decrease the number of falls.

Design: A retrospective review was conducted to determine the effects of a mobility aide implemented on a medical-surgical unit. The intent was to ensure the utilization of the Enhanced Recovery After Surgery (ERAS) protocol for early mobilization before and after implementation. Two-month periods were analyzed before and after implementation.

Findings: The results demonstrated clinical significance for patients when implementing a mobility aide. The mean length of stay was 1.044 days …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …