Public Health and Community Nursing Commons^™

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Preventive Interventions Targeting Social Determinants Of Health: Implications For Healthcare Utilization And Cost, Audrey Wrinkle

NEXUS: The Liberty Journal of Interdisciplinary Studies

Preventive interventions targeting social determinants of health could reduce avoidable healthcare utilization and positively impact long-term cost outcomes within healthcare systems. Evidence indicates that financial and social barriers to preventive care lead to delayed treatment and increased use of high-cost healthcare services in the long term. Preventive interventions focusing on upstream social factors, like home-based care and digital health programs, could improve patient outcomes and reduce avoidable service utilization. Also, incorporating social needs data into policy creation could promote better allocation of healthcare resources. This research highlights the role of prevention-focused strategies in promoting cost-effective, sustainable healthcare delivery.

Standardizing Gestational Diabetes Mellitus Education To Improve Patient Knowledge And Care Consistency In A Prenatal Clinic Setting, Wynn Zara

Master's Projects and Capstones

The gestational diabetes mellitus (GDM) group visit framework aims to improve consistency of GDM education by standardizing referral processes, educational materials, staff workflows, and patient communication. Although evidence-based GDM education supports patient self-management and improved maternal-fetal outcomes, variability in education delivery contributed to inconsistent care within the outpatient maternal-fetal medicine setting. This quality improvement project was conducted in an outpatient maternal-fetal medicine clinic in Santa Clara County serving pregnant patients diagnosed with GDM. To address this gap, a standardized GDM group visit framework was developed and implemented using structured educational resources, referral criteria, and communication workflows. The intervention was evaluated …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Enhancing Sleep Quality Through Sleep Hygiene Education Among Adults In A Faith-Based Community, Denielle Earle-Thompson

Doctor of Nursing Practice Projects

Background

Adults between 18 and 64 years of age require at least seven hours of sleep per night; however, many adults do not meet this recommendation, contributing to increased risks for chronic disease, impaired functioning, mood disturbances, and reduced quality of life. Poor sleep quality has been associated with weakened immunity, cardiovascular disease, diabetes, obesity, anxiety, depression, and decreased daytime performance. Obtaining adequate, good-quality sleep is essential for maintaining overall health and well-being. In faith-based communities, combining health education with spiritual support may provide a holistic approach that addresses both physical and emotional contributors to poor sleep.

Purpose

The purpose …

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.

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Improving Identification And Referral Of Xylazine‑Associated Wounds In Homeless Healthcare, Ramon A. Gambino

Doctor of Nursing Practice Scholarly Projects

Background: Xylazine-adulterated fentanyl is linked to distinctive necrotic wounds and complex care needs in unsheltered populations. This quality improvement (QI) project implemented a brief survey and referral log at Albuquerque Health Care for the Homeless (AHCH) to track suspected xylazine-associated wounds and referrals to advanced care. Methods: Final data were exported from Qualtrics, cleaned to retain finished responses, standardized categories, and de-identified. The analytic sample included 18 encounters. Results: Results showed that 55.6% (n = 10) documented suspected xylazine-associated wounds; 5.6% (n = 1) reported no suspicion; 38.9% (n = 7) were uncertain. Referrals were rarely documented overall at AHCH …

Optimizing Continuous Renal Replacement Therapy (Crrt) In The Icu: A Qsen-Based Framework For Nursing Decision-Making Support, Leslie Okhirkhian

Knowledge and Creativity Expo

Nurses in critical care environments must exercise precise clinical judgement to recognize patient destabilization cues while managing the complex biomedical technologies that support failing physiological systems. Continuous Renal Replacement Therapy (CRRT) is a modality for hemodynamically unstable patients requiring fluid overload management and waste removal; however, it is a complex technology that demands nurses navigate a “tightrope” between renal perfusion and hemodynamic stability. Despite its prevalence, there is no concise decision-making support for nursing care in the current literature based on the Quality and Safety Education for Nurses (QSEN) strategies. This presentation addresses this gap by proposing a QSEN-based, standardized …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

Student Nurse-Led Hypertension Management In A Rural Free Clinic, Leslie Okhirkhian

Cardiovascular Research Symposium

This pilot project seeks to evaluate the effect of nurse-led assessments and education on blood pressure control among adult patients with prehypertension and hypertension who attend a free health clinic located inside of a rural community in Southeastern Virginia. A leading, modifiable risk factor for cardiovascular disease is hypertension, yet disparities in consistent healthcare access and education disproportionately affect rural populations. Nurse-led interventions are a promising strategy for improving hypertension control through personalized education, blood pressure monitoring, and follow-up.

Methods: Participants with a diagnosis of prehypertension or hypertension were recruited from a free rural health clinic (n=20). Over a 7-week …

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

Bridging Evidence With Community: Five Routes To Diabetes Prevention In Latino Adults, Ann M. Maliackal

Doctor of Nursing Practice Final Project Abstract

Bridging Evidence with Community: Five Routes to Diabetes Prevention in Latino Adults

Background: This project used the Eightfold Path policy analysis approach to identify and recommend an evidence-based diabetes prevention program (DPP) for Latino adults in the Rio Grande Valley (RGV). The aim was to reduce diabetes prevalence by selecting an intervention that is culturally appropriate and effective for this population.

Methodology: The Eightfold Path policy analysis approach guided this project. A comprehensive literature review identified diabetes prevention programs (DPPs) tailored for Latino adults, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Five DPPs were …

Living In Fear: Be Empathetic (Life)-Tool Kit, Desiree A. Díaz, Heather Peralta, Samantha Stephenson, Danny Hernandez, Geraldine Luzincourt, Syretta Spears, Ann Marie Parker, Trysten Altamirano

Nursing Handouts, Tools, and Other Documents

Open source materials to immerse learners in rural and public health experiences are needed to ensure the new work force is equipped to care for a variety of people in differing circumstances. Public health remains a vital yet underemphasized component within healthcare education, specifically nursing education. This often limits opportunities for students to develop the skills necessary to become strong advocates for equity and systemic change. A

This project emerged from a commitment to provide experiential opportunities replicating the communities we serve. A Empathy Walk and LIFE Clinic (Díaz et al., 2025) was created as a strategy designed to engage …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Improving Colorectal Cancer Screening Referrals In A Rural Health Clinic, Kysha Mcbee

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Colorectal cancer is the second leading cause of cancer death in the United States. Preventive screening for colorectal cancer has been associated with early detection and improved 5-year survival rates. The referral rates for colorectal cancer screening at the practicum site were 17.7%, well below the national benchmarks of 71.8%.

Aim of the Project: The aim of this project was to increase the screening referral rates in adults aged 45 to 75 years by 50% over a ten-week period by implementing an evidence-based toolkit.

Review of the Evidence: Literature review highlighted barriers to colorectal cancer screening, such as knowledge …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

The Effect Of An Audio-Recorded Intervention Program On The Knowledge And Self-Reported Practices Of Menstruation And Hygiene Among Visually Impaired Young Girls In Rwanda: A Mixed Method Study, Justine Bagirisano, Marie Laetitia Ishimwe Bazakare, Aimable Nkurunziza, Jean Bosco Henri Hitayezu, Godfrey Katende

School of Nursing & Midwifery, East Africa

Background Menstrual hygiene practices among visually impaired young girls are a significant public health concern in Rwanda. Limited knowledge about menstruation leads to inadequate hygiene practices, increasing the risk of cervical cancer, urinary tract infections, and reduced quality of life. The menstrual hygiene needs of visually impaired girls who depend on daily assistance for personal hygiene have not been adequately addressed in previous studies. Objectives To assess the effect of an audio-recorded program on the knowledge and self-reported practices of menstruation hygiene among visually impaired young girls in Rwanda. Methodology A pre-post mixed intervention study was conducted involving 93 visually …