Geriatric Nursing Commons^™

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 …

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.

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 …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

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

Doctor of Nursing Practice (DNP) Scholarly Projects

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

Poorly Controlled Type 2 Diabetes (T2dm) In A Rural County In Texas: A Diabetes Intervention Bundle, Roxanne Morales

Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) remains a significant public health concern, particularly in rural and underserved communities where patients often face barriers to effective self-management. This quality improvement (QI) project evaluated the impact of a diabetes intervention bundle consisting of individualized diabetes education, biweekly support phone calls, and digital self-monitoring tools on glycemic control, body weight, diabetes knowledge, medication adherence, diet compliance, and physical activity. The project was implemented over an eight-week period in a rural family medicine clinic and included 18 adults with uncontrolled T2DM (HgbA1c >7%). Participant outcomes were evaluated using pre- and post-intervention clinical measures, the Diabetes …

Implementation Of A Pressure Injury Prevention Bundle To Reduce Hospital-Acquired Pressure Injuries In The Intensive Care Unit, Xibo Lan

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement project was to utilize the SKINSAFE pressure injury prevention bundle during 12 weeks of implementation to increase evidence-based pressure injury prevention practices adherence and decrease risk of hospital-acquired pressure injury (HAPI) in the intensive care units (ICU).

Background

ICU patients experience high risk for hospital acquired pressure injuries (HAPIs) secondary to immobility and device related pressure. Initial adherence to SKINSAFE bundle was 55-56%. There was inconsistent use of heel offloading devices, wound photography and documentation. Prevention bundles were affected by staffing fluctuations and leadership turnovers.

Methodology

The Plan-Do-Study-Act cycle for this project included …

Dementia In Downs Syndrome – A Case Report, Clarita Shynal Martis Ms, Elsa Sanatombi Devi Dr, Panambur Venkataraya Bhandary Dr

Manipal Journal of Nursing and Health Sciences

Down syndrome, is a chromosome 21-related genetic condition, frequently manifests as intellectual difficulty, growth retardation, and distinctive facial traits. People with Down’s Syndrome usually develop Dementia, a major cause of cognitive impairment, impaired judgment memory loss in their midlife. The present report describes a case study of a female diagnosed with dementia in Down’s Syndrome. The report explores the challenges her parents faced in securing appropriate care when diagnosed with dementia and Down's syndrome. It aims to inform caregivers about the best practices for home care in such cases. It follows the woman's history from birth until her dementia was …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Mental Wellness: Breaking Down Barriers To Mental Health Treatment For Veterans, Merita Dallta

Capstones

No abstract provided.

Antibiotic Stewardship And The Prevention Of Healthcare-Associated C.Diff, Nevaeh Tyson, Angel Pearson

Scholars Week

Healthcare-associated Clostridium difficile (C.difficile) infections remain a significant burden to many healthcare facilities across North America. This infection is often linked to long-term antibiotic use and ineffective infection control methods. This presentation addresses current evidence-based practice protocols on the prevention of C.difficile, emphasizing the need for increased monitoring of antibiotic therapy and improved infection control strategies.

Implementation Of A Pre-Discharge Screening Program For Fracture Prevention, Sarah J. Russell

Master's Projects and Capstones

Problem Osteoporotic fractures are a major public health concern in the United States; 1 in 2 women and 1 in 4 -5 men will experience a fracture due to low bone density. Despite established clinical guidelines, many patients in this managed care health system do not receive timely osteoporosis screening or treatment, placing them at increased risk for costly readmissions averaging $50,000 per hospitalization especially among those discharged to skilled nursing facilities.

Context The improvement project targeted patients admitted with fractures and integrated DEXA scanning during the acute care stay to avoid delays in diagnosis and bisphosphonate therapy. Barriers included …

Scoping Review: Faktor – Faktor Yang Mempengaruhi Keputusan Lansia Memilih Senior Living, Nia Murniati, Badra Al Aufa, Mochamad Iqbal Nurmansyah

Jurnal Administrasi Bisnis Terapan

Abstract Senior living has emerged as an alternative solution to public health and social policy challenges amid the global acceleration of aging. Traditionally perceived as a last resort, life in senior living facilities is shaped by evolving dynamics in health, family, and society. This scoping review explores the key factors influencing older adults' decisions to reside in senior living communities during their later years. Utilizing Andersen’s Behavioral Model of Health Service Use as a theoretical framework, the review was conducted following PRISMA-ScR guidelines. Articles published between 2019 and 2024 were identified through searches in PubMed, Scopus, ProQuest, and Taylor & …

Enhancing Medication Adherence In The Older Adult By Implementing A Medication Program, Cathylee Nair

Doctor of Nursing Practice Final Project Abstract

PURPOSE The medication adherence program was a collaborative effort to develop, implement, and evaluate a medication adherence program that aims to reduce health utilization and disease exacerbation by improving medication adherence in older adults. The primary goal was to improve medication adherence by 10% within eight weeks.

BACKGROUND The medication adherence program was based out of a home health agency in Katy, Texas. Medicare utilizes home health agencies as patient support programs for providing services like medication management to reduce older adult’s health utilization and improve health outcomes at home.

METHODOLOGY The Plan Do Study Act (PDSA) model for improvement …

Enhancing Patient Outcomes: Improving Hcahps Scores Via Implementing Pressure Injury Prevention Care Bundle Education In Acute Care Setting, Jasmeen Kaur

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) have a powerful effect on patient outcomes, satisfaction, and health costs. In the face of multiple interventions, nurse-patient communication failures and decreased HCAHPS scores reveal patient safety hazards. Aim: The purpose of this quality improvement effort was to enhance HCAHPS nurse communication scores by instituting a Pressure Injury Prevention Care Bundle (PIPCB) on a 93-bed medical-surgical/telemetry unit. Methods: The intervention was nurse-implemented education through educational posters and education cards distributed at admission and shift report. Nurse participation and education delivery were measured through pre- and post-intervention questionnaires and observations. The change in the HCAHPS nurse …

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 …

Environmental Concerns Of Women In Appalachia, Kristen Montgomery, Adebayo Adeeko, Jessica Binns, Sarah Hall, Paula Hawkins, Allyson Newer, Michaela Outlaw, Karenna Turley

Epsilon Sigma at-Large Research Conference

Purpose: Environmental contamination is rampant in the United States and other parts of the world. There are potential health implications related to environmental contamination.
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Aims: The purpose of this study was to investigate how concerned women in Appalachia are regarding the environment. The following research question was addressed: What concerns do women have regarding the environment? The objective of this study was to understand how women perceive their environment and to evaluate what concerns they have regarding the environment. We also evaluated demographic factors to see if any demographics contributed to particular concerns related …

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Awareness Of The Physiological Changes Occurring In Older Adults Can Reduce Dehydration And Electrolyte Imbalances, Lisa Isley

Nursing | Senior Theses

Background: Individuals over 65 years are at an increased risk of dehydration. The physiological changes that occur with age and medication consumption can cause fluid and electrolyte imbalances that can physically and mentally impair individuals over 65 years old. Objective: By providing education to individuals 65 years and older regarding the significance of drinking water and consuming electrolytes daily, older adults can reduce their dehydration symptoms and improve their quality of life. Method: The proposed research is a quasi experimental study geared towards individuals 65 years and older. The quasi-experimental study will include two pre-surveys and then two post-surveys. The …

Awareness Of The Physiological Changes Occurring In Older Adults Can Reduce Dehydration And Electrolyte Imbalances, Lisa Isley

Nursing | Student Research Posters

Background: Individuals over 65 years are at an increased risk of dehydration. The physiological changes that occur with age and medication consumption can cause fluid and electrolyte imbalances that can physically and mentally impair individuals over 65 years old. Objective: By providing education to individuals 65 years and older regarding the significance of drinking water and consuming electrolytes daily, older adults can reduce their dehydration symptoms and improve their quality of life. Method: The proposed research is a quasi-experimental study geared towards individuals 65 years and older. The quasi-experimental study will include two pre-surveys and then two post-surveys. The survey …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Reducing Caregiver Burden For The Caregivers Of Heart Failure Patients, Joyce W. Kimani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Family members and friends of heart failure patients serve as informal caregivers for many heart failure patients, helping with the management of day-to-day heart failure care. Many caregivers of heart failure patients experience stressors associated with caregiving, including social, psychological, financial, emotional, and physical stress. Reducing caregiver burden is important in improving both patient and caregiver well-being. Healthcare systems can improve caregiver outcomes and encourage the long-term sustainability of informal caregivers by addressing caregiver needs through focused support strategies. The Agency for Healthcare Research and Quality framework was used to develop an evidence-based guideline that healthcare professionals can follow in …

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 …

Improving Performance And Documentation Of The Bedside Mobility Assessment Tool, Joseph P. Chellew

Master's Projects and Capstones

Objectives: Decreased patient mobility is associated with negative health outcomes including decreased functional capacity, pressure injuries, deep vein thrombosis, and bloodstream infections (Yasmeen et al., 2020). Early and increased mobilization mitigates these complications and is associated with positive outcomes (Wang et al., 2020). The Bedside Mobility Assessment Tool 2.0 (BMAT) is a mobility assessment that guides the selection of equipment to safely mobilize patients (Boynton et al., 2020). Aim: This quality improvement project aims to increase BMAT documentation compliance by 10% in three medical-surgical units at Hospital A where only 31.3% of patients were assessed per day using the BMAT. …