Family Practice Nursing Commons^™

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 …

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 …

Standardizing Cardiac Rehabilitation Referrals In A Rural Primary Care Clinic, Carlie H. Sanders

SACAD: Scholarly Activities

Abstract

Cardiac rehabilitation (CR) is a cost-effective, evidence-based approach for patients with cardiac conditions to improve quality of life and health outcomes. Despite the benefits, it remains a nationally underutilized service, and extensive research has been conducted to identify interventions that most effectively increase referrals and participation in CR programs. Two of the more successful interventions include strengthening provider recommendations and using a standardized referral system (Ades et al., 2022). This quality improvement project aimed to strengthen provider recommendations and increase the frequency of referrals to the existing CR program at a rural primary care clinic by 50%. To do …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

SACAD: Scholarly Activities

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales

SACAD: Scholarly Activities

Abstract  

This poster presents a theoretically grounded, AI-integrated simulation program design structured across 3-4 semesters of Family Nurse Practitioner (FNP) and Doctor of Nursing Practice (DNP) education. This program is designed to support the development of clinical judgment and diagnostic reasoning among FNP students. Guided by Tanner’s Clinical Judgment Model and Roy's Adaptive Model as Theoretical Framework. The program addresses identified gaps in differential diagnosis and role transition from Registered Nurse (RN) to FNP practice. A needs assessment informed the development of a semester-sequenced curricular framework integrating AI-supported simulation across four semesters. The proposed design illustrates how progressive simulation experiences …

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. …

Screening For Bullying In A Middle School Setting, Paige Bernau

Dissertations

Problem: Bullied youth are two and a half times more likely to experience depression and three times more likely to experience anxiety and suicidal ideation than their peers (Li et al., 2024). Schools represent a key access point for mental health support and treatment for youth (Duong et al., 2020). Despite this, schools typically do not have formal bullying screening integrated into student support services.

Methods: This program evaluation used a descriptive, observational design to evaluate a bullying screening program in a suburban middle-school. This program used the California Bullying Victimization Scale (CBVS) to assess for bullying victimization (BV) followed …

Defining Sexual Assault, Consent, And Resources To Empower Students: A Dnp Project, Sarah Powers

SACAD: Scholarly Activities

Abstract

Sexual assault (SA) remains a pervasive issue on college campuses in the United States, often compounded by underreporting and a lack of knowledge about available resources. This Doctor of Nursing Practice (DNP) project aims to educate first-year college students about SA, sexual consent, and available resources to empower students in preventing assaults and seeking help when needed. The intervention, which was integrated into mandatory freshman seminars at a four-year university, was guided by Knowles' Adult Learning Theory. A presentation provided critical information, and knowledge gains were assessed through pre- and post-presentation surveys. Initial findings indicated significant increases in understanding …

Paternal Negative Lifestyle Choices Affect On Maternal Pregnancy And Birth Outcomes: Bmi, Smoking, Drinking, Domestic Violence, Partner Involvement, Estrella Lopez

Nursing | Senior Theses

Paternal lifestyle choices are often overlooked yet are a crucial factor in maternal pregnancy and fetal outcomes. While maternal health behaviors have been the primary focus that determines a healthy pregnancy and child outcomes, this thesis explores how a paternal's (father's) harmful behaviors such as high body mass index (BMI), smoking habits, alcohol consumption, exposure to domestic violence, and lack of partner involvement, can contribute to diminishing the health of both mother and baby. After analyzing six research articles, this thesis revealed how a father's negative lifestyle choices affect maternal pregnancy and fetal outcomes. Using a quantitative, non-experimental descriptive design, …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Improving Diabetes Self-Management Skills Among Adults With Type 2 Diabetes Through Weekly Education, Carthia Joachim

Dissertations

Type 2 Diabetes Mellitus is one of the major health issues worldwide, which has led to many health complications, such as cardiovascular disease, nerve damage that leads to limb amputation, kidney damage, and even death (Sameer et al., 2020). Lack of self-care management is one of the reasons diabetes is becoming such an issue in society. Studies have shown that T2DM outcomes can be improved by implementing diabetes self-management education (DSME) (Hailu et al., 2019). The study evaluated the effectiveness of DSME intervention in adult patients with T2DM over 12 weeks in Orlando, Florida. Using a structured education program, the …

Naloxone Prescribing For High-Risk Opioid Patients In Primary Care, Theresa Turk

SACAD: Scholarly Activities

Objective: Primary care providers have an integral role in combating the opioid epidemic and preventing opioid-related deaths. One method of prevention is prescribing naloxone to patients at high risk for overdose. Naloxone is a medication that bystanders may administer during an overdose situation that can reverse the life-threatening side effects of opioids. The purpose of this quality improvement project was to increase the number of naloxone prescriptions written by primary care providers to patients on opioids considered at high risk for overdose. High-risk patients were considered those prescribed opioids over 50 morphine equivalents (MME) and those who had co-prescribed benzodiazepines. …

What Are The Key Factors Influencing The Successful Integration Of Ai In Healthcare?, Gabe Herman

Graduate Research Projects

No abstract provided.

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Improving Blood Pressure In Adults 65 Years And Older Via Weekly Telehealth Coaching, Janet Bathini

Student Scholarly Projects

Practice Problem: Hypertension is a significant modifiable risk factor for CVD and is on the rise with advancing age. The management at the VA hospital's GEC clinic acknowledged the importance of managing HTN in veterans to lower their CVD risk and were open to implementing EBP to enhance HTN management.

PICOT: The PICOT question that guided this project was: In the primary care setting, in older adults > 65 years with BP > 140/90 (P), does weekly telehealth coaching (I) compared to no telehealth coaching (C), decrease their BP (O) over a 6-week period (T)?

Evidence: The evidence that guided this project …

Improving Postoperative Breast Augmentation Patient Education Delivery., Madison Callery

Doctor of Nursing Practice Papers

Background: Effective patient education promotes successful postoperative outcomes. Nurses in an outpatient surgery center lacked consistent patient education practices and materials.

Purpose: The purpose of the project was to implement an evidence-based multimodal educational strategy for patients who undergo breast implant surgeries.

Methods: At an outpatient plastic surgery center, pre- and post-intervention phone calls were tracked; post-intervention education, documentation, and patient satisfaction data were recorded. Nurses were educated on the new materials, delivery procedures, and electronic health record (EHR) documentation. All patients undergoing breast implant surgery received multimodal education at each postoperative appointment. Outcomes included (1) the number of patient …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Reducing 30-Day Heart Failure Hospital Readmissions Through The Implementation Of A Telehealth Education And Screening Program, Madison Geib, Jo Loomis, Maria (Dupi) Gomez Cogan

Doctor of Nursing Practice (DNP) Projects

Heart Failure (HF) is a difficult disease to manage. It requires knowledge on weight monitoring, diet, exercise, medications, and symptom management. With this difficulty, there is a high incidence of HF patient readmissions into the hospital, especially in the first 30-days after discharge, showing that patients are not well equipped to manage their HF on their own at home. A review of the available literature found that some of the most common reasons for readmission include poor discharge planning, a lack of continuation of care, as well as a lack of education and adherence to their medications (Mathew & Thukha, …

Fantastic Four, Jaden Zumbahlen, Andrea Palmer

Doctor of Nursing Practice Projects

Clinical Issue
Heart failure claims one in four lives of those diagnosed each year. The term Guideline Directed Medication Therapy (GDMT) represents optimal medication therapy as defined by the American College of Cardiology Foundation and American Heart Association. Appropriate quadruple therapy results in an estimated 73% relative reduction in mortality over a two-year time span (Greene & Khan, 2021). However, there is a gap in proper GDMT stemming from suboptimal initiation and/or titration in the outpatient setting.

Project Implementation
Nursing staff in a rural midwestern cardiology clinic were provided with an in-service presentation discussing current guidelines and recommendations of GDMT …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Hypertension, Bethany Stemen

Masters Theses/Capstone Projects

Hypertension is dangerous and known as the silent killer. It can be managed with proper healthy life choices.

Lung Cancer Screening In Primary Care, Ellen Macdonald

Masters Theses/Capstone Projects

A chart audit was completed in a central Ohio primary care office to evaluate the compliance of lung cancer screening according to guidelines set forth by the USPSTF.

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

An Interprofessional Prediabetes And Diabetes Self--Management Education Quality Improvement Project Among Vulnerable Populations At A Tuberculosis Hospital, Robert Saul Castro Natal

Doctor of Nursing Practice

Background. Patients greatly benefit from diabetes self-management education (DSME) as it boosts knowledge and self-efficacy, decreases body weight, fasting blood sugar, and hemoglobin A₁C levels, and improves overall health outcomes in a cost-effective manner. Unfortunately, many individuals with prediabetes and diabetes who qualify for DSMEs do not attend these classes nor receive sufficient prediabetes and diabetes support elsewhere to attain guideline recommended metrics. However, individuals from vulnerable populations and without DSME education experience disproportionate diabetes-related complications worsening health outcomes. Aims: Increase general prediabetes and diabetes knowledge, facilitate behavior change, improve glycemic, metabolic, and lipid values, and increase …

Addressing Obstacles In Following Prescribed Medication Regimens In Patients With Type 2 Diabetes Mellitus, Cristina Sarro

Doctor of Nursing Practice

Background. Type 2 diabetes is the ninth leading cause of death in the United States. Micro/macro vascular complications are common in diabetes. Purpose. To implement an evidence-based protocol addressing obstacles for patients with type 2 diabetes in following their prescribed medication regimens to reduce glycosylated hemoglobin levels. Evidence. Failure to follow treatment plans increases diabetes complications. Perceptions and complexities of treatment plans, side effects of therapies, and cost contribute to patients not taking their medications as prescribed. Goals. To increase the number of patients with type 2 diabetes who follow their prescribed medication regimen and reach their targeted glycosylated hemoglobin. …