Family Practice Nursing Commons^™

A Pilot Project On Improving Icu Nurses’ Confidence In Early Defibrillation, Adetutu Obadina

Doctoral Projects

Early recognition of shockable cardiac rhythms and timely defibrillation are critical components of effective resuscitation during in-hospital cardiac arrest. Despite established guidelines from the American Heart Association (AHA), nurses may experience uncertainty or reduced confidence when identifying shockable rhythms and delivering timely defibrillation during cardiac arrest events. The purpose of this project was to examine whether a structured educational intervention incorporating simulation-based training could improve intensive care unit (ICU) nurses’ confidence and knowledge in recognizing shockable rhythms and performing timely defibrillation. A pre-and post-intervention design was implemented among ICU nurses at a large academic medical center between September and October …

Implementing The Steadi Fall Risk Screening Initiative Within A Primary Care Setting To Improve Patient Safety, Haleigh Marie Brown

Doctoral Projects

Falls among older adults are a significant public health issue and the leading cause of injury-related illness and death in people aged 65 and older. While evidence-based guidelines exist and awareness of fall risks has increased, many primary care settings do not use standardized fall risk screening protocols. This gap results in missed opportunities for early identification and prevention. To address this need, the Centers for Disease Control and Prevention (CDC, 2019) created the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Toolkit, which offers healthcare providers a structured approach to assess, manage, and reduce fall risk.

This doctoral project aims …

Evaluating The Impact Of Evidence-Based Guidelines On Corticosteroid Prescribing For Acute Upper Respiratory Infections In Outpatient Primary Care, Cody Allen Boyd Hyatt

Doctoral Projects

Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.

The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders …

What Is The Impact Of An Education Program Designed To Remove The Healthcare Professional As A Barrier To Care For The Transgender And Gender Diverse Community?, Richard D. Dansereau

Doctoral Projects

Healthcare disparities disproportionately affect transgender and gender-diverse (TGD) individuals, often due to implicit biases among healthcare providers. This study examines the impact of an educational intervention designed to address these biases and improve care for TGD patients. Using the Biased Care Model as a guiding framework, the intervention targeted three critical phases of bias: pre-visit assumptions, in-visit interactions, and post-visit decisions. Conducted in the intensive care unit of a mid-sized hospital in Northern California, the study employed a pretest-posttest quasi-experimental design involving multidisciplinary healthcare workers. Participants completed a modified Jefferson Scale of Empathy survey to assess changes in cognitive and …

Healthcare Provider Comfort Surrounding Adverse Childhood Events (Aces), Cameo Culcasi

Doctoral Projects

Adverse Childhood Experiences (ACEs) are strongly linked to long-term health outcomes, yet discussions around ACEs in clinical settings remain inconsistent. This study investigates the comfort levels of healthcare providers in addressing ACEs with their patients, identifying barriers and facilitators to such conversations. Using a Quasi-experimental, single group, pretest-post test experimental design, we surveyed a diverse group of physicians, nurse practitioners, and physician assistants working in a primary care setting, providing ACE training, and an opportunity for learning reflection. Preliminary results indicate that while most providers acknowledge the importance of discussing ACEs, many report discomfort due to time constraints, lack of …

Patient Perception Of Nurse Practitioner Care, Nurse Practitioner Scope Of Practice And How That Influences Provider Choice, Naomi Hemp

Doctoral Projects

This project investigates patients' perceptions of nurse practitioner (NP) care versus physician (MD) care, the factors influencing these perceptions, and patients' understanding of NP scope of practice. A cross-sectional design was used, gathering quantitative data through an anonymous one-time survey distributed via Qualtrics, open for three months. Questions were based on The Watson Caritas Patient Score (WCPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). Data were analyzed using Intellectus Statistics software™, with descriptive statistics summarizing the findings. A two-tailed paired samples t-test revealed statistically significant differences in favor of patients' perceptions of NP care versus …

Reducing Congestive Heart Failure Readmissions Through Discharge Planning And Education, Coewonda Burse

Doctoral Projects

Chronic heart failure (CHF) is a widespread problem among individuals, which, at the same time, consumes a considerable share of global healthcare demand. CHF management poses a persistent issue mainly due to the short interval of hospital readmissions four weeks after discharge, which indicates deficiencies in care transitions and patient education. This doctoral project addresses this topic and evaluates whether implementing patient-specific education and discharge planning programs can decrease CHF-associated hospital readmissions. To investigate the phenomenon, the DNP student completed a retrospective chart review, found an intervention, implemented said intervention, and then evaluated the intervention's effectiveness versus interventions already in …

Prescription For Change: Tackling Inappropriate Antibiotic Use In Urgent Care Settings, Lachundra Mosley

Doctoral Projects

A pressing global health issue that significantly contributes to antibiotic resistance is the inappropriate antibiotic prescribing for Upper Respiratory Infections (URI’s) in urgent care settings (World Health Organization [WHO], 2022). The purpose of this doctoral project was to reduce inappropriate antibiotic prescriptions for URI at an urgent care in D’Iberville, Mississippi through the implementation of an educational pamphlet.

A pre-post intervention project was conducted, collecting data on antibiotic prescribing practices via retrospective chart reviews before and after the educational intervention. Data was collected using a researcher developed screening tool based on Evidence based guidelines to distinguish viral vs bacterial infections. …

Utilization Of The Reproductive Justice Framework In Contraceptive Counseling With Black And African American Women: A Comparison Of Patient Satisfaction And Provider Knowledge, Simranjeet K. Tagore

Doctoral Projects

Current practice in contraceptive counseling is characterized by great variation in both content and implementation. The literature indicates that African American women desire contraceptive counseling based in respect, trust, and equity. Conducted over 8 weeks, this quality improvement project compared satisfaction in African American and Black patients receiving contraceptive counseling by a provider trained in the Reproductive Justice Framework (RJF) versus those receiving contraceptive counseling by a provider not trained in the Reproductive Justice Framework. This project also evaluated the effects of Reproductive Justice Framework training on clinician knowledge. Inclusion criteria for the patients included identifying as Black and/or African …

Effects Of Group Visits On Self-Care Management For Veterans With Type 2 Diabetes Mellitus, James Nwaizugbu

Doctoral Projects

Individuals diagnosed with type two diabetes mellitus (DM2) can be overwhelmed by daily choices, leading to self-care neglect. Self-care is vital to DM2 management to avoid chronic complications. This project utilized group visits to increase self-care management and improve outcomes among veterans with poorly controlled DM2.

This evidence-based practice (EBP) project used a single-group quasi-experimental pretest-posttest design to evaluate a self-care management program for US veterans with poorly controlled DM2 who were enrolled a clinic within the Department of Veterans Affairs (VA), Northern California Healthcare System (NCHCS). The study facilitator provided education on DM2, medication, diet, and exercise. Participants (N …

Primary Care Access In San Luis Obispo County- Primary Care Practitioner’S Perspectives, Jessica Peckham

Doctoral Projects

This study investigates healthcare access and utilization among Primary Care Providers (PCPs) in SLO County, utilizing a mixed-methods approach. Survey responses from PCPs when applied to Levesque’s Theoretical Framework reveal variations in provider approachability and acceptability, alongside significant wait times for both new and established patients, indicating barriers in healthcare reaching. Qualitative interviews further illuminated dimensions of healthcare access, including socioeconomic disparities and provider burnout. These underscore the complexities of ensuring equitable access to primary care services. The relationship between provider and consumer dimensions, such as work-life balance, workload, and the role of advanced practice providers, highlight the intricate dynamics …

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Preventing Diabetes Through Prediabetes Screening And Treatment In Primary Care, Dewona Beal

Doctoral Projects

Diabetes is an epidemic in the United States. There are three types of diabetes: type 1, 2, and gestational diabetes. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. This type of diabetes can be prevented or delayed. In persons with T2DM, the body cannot use insulin well to keep blood glucose within normal limits. Several factors, including genetics, lifestyle such as poor diet and physical inactivity, obesity, insulin resistance, hormones, and certain medications, can cause it. A precursor to T2DM is prediabetes. Prediabetes is when blood sugar levels are elevated but not elevated enough to be …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei

Doctoral Projects

Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Understanding The Effectiveness Of Diabetes Self-Management Education On Psychological Distress And Self-Care Activity Measures: A Focus On Latinx Community, Anita Khadka

Doctoral Projects

The psychological distress that people with diabetes experience makes them twice likely to have clinical depression. Diabetes self-management education and support is an effective strategy to improve psychological distress and increase self-care activity measures. However, there has been limited knowledge on the impact of formal diabetes self-management education and support DSME/S on psychological distress among minority populations such as Latinx. The primary objective of this study is to explore the impact of diabetes self-management education on psychological distress and self-care activity measures. This study also explores the impact of demographic variables of the Latinx respondents on psychological distress and self-care …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

Implications Of Educational Counseling On Prep Uptake In Msm At A Community Health Clinic, Thanh T. Dinh

Doctoral Projects

HIV pre-exposure prophylaxis (PrEP) medication is 99% effective at preventing HIV acquisition if used daily (CDC, 2020; FDA, 2019). Despite its effectiveness and wide availability, PrEP uptake and adherence remained low, especially among MSM of color (Bradley et al., 2019; Kuhns et al., 2017). Prior studies have shown that participants exposed to PrEP information, counseling, and education were more likely to show interest in PrEP and uptake of PrEP. Although various studies support the effectiveness of educational interventions in increasing PrEP uptake, it has not been widely implemented in the practice setting in communities that would benefit from it. The …

Full Practice Authority: Determining Readiness Among Nurse Practitioner Students In Mississippi, Betty Hoffman

Doctoral Projects

Full practice authority has been granted to nurse practitioners by many states. These practitioners are educated and trained as full primary providers of health care. Full practice authority for nurse practitioners is not granted in Mississippi, which currently ranks in the lowest positions for health care in the United States. The low ranking can be attributed to a lack of providers and access to services.

This project seeks to explore attitudes and understanding of nurse practitioner students in the State of Mississippi regarding full practice authority. A survey will be electronically distributed to determine what is already known and understood …

Increasing Knowledge Of Fibromyalgia Diagnostic Criteria Using A Screening Tool In Primary Care, Diane Morris

Doctoral Projects

ABSTRACT

Fibromyalgia (FM) is a chronic pain condition that is second only to osteoarthritis. Fibromyalgia dramatically impacts the quality of life, with its many symptoms requiring a multidisciplinary approach to treatment. The recommendation is that patients with fibromyalgia are treated in primary care, as are other chronic diagnoses such as hypertension and diabetes, with referrals to other disciplines as needed. However, some primary care providers may not recognize fibromyalgia as a valid diagnosis, have received inadequate formal training in fibromyalgia, and have limited awareness of diagnostic criteria.

According to the research, as many as 3 out of 4 people with …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Evaluating The Clinical Impact Of Providing Home Blood Pressure Monitors To Patients With Elevated Or High Blood Pressure, Theresa La Guardia Asmus

Doctoral Projects

Many clinicians continue to diagnose hypertension based on office-based readings, despite the 2015 United States Preventive Services Task Force recommendation for the use of home or ambulatory blood pressure monitoring to confirm the diagnosis of hypertension prior to initiating treatment. Without obtaining blood pressure readings outside of the clinic environment, it is impossible to correctly diagnose hypertension, particularly regarding masked hypertension and white coat hypertension.

Stanford Health Care implemented a quality improvement project that provided patients with a home blood pressure device to monitor out of clinic blood pressure readings. The purpose of the project was to improve clinical care …

Nurse Practitioners’ Perceptions Of Telehealth Behaviors, Michelle Austin

Doctoral Projects

Problem: NP’s must be proficient in the behaviors that are required for a successful patient encounter to provide the full benefit of nurse practitioner (NP) telehealth. Consequently, it is imperative for NPs to understand telehealth etiquette behaviors which include the technical and non-technical skills that are necessary for an effective NP-patient patient telehealth encounter (Haney, Kott & Fowler, 2015). Telehealth has been incorporated into healthcare delivery and its use is expanding. In the United States, it is predicted to be used by seven million patients in 2020 (US Department of Health and Human Services, 2018). Appropriate access to health care …

The Mental Health Experience Among Parents Of Children With Autism, Thao Tran

Doctoral Projects

Parents of children diagnosed with autism spectrum disorder (ASD) face challenges, stress, and mental health issues than parents of children without autism. Mental health experience of parents in underserved communities are not adequately studied. This qualitative study used a phenomenological approach to understand the mental health experience of eight parent caregivers residing in San Joaquin Valley, California. All parents reported the journey was stressful but not all parents described the point when they received the diagnosis as being more stressful than before and after the ASD diagnosis. Parents’ responses to the semi-structured interview that assesses for the degree of ambiguous …