Public Health and Community Nursing Commons^™

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

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 …

Evaluation Of A Nicotine Prevention Program In A Third Grade Classroom, Jennifer A. Pile

DNP Projects

Purpose: The purpose of this project was to increase knowledge of nicotine products and promote negative perceptions of nicotine use among third-grade students through early prevention education.

Background: Prevention is key and to prevent nicotine use, there must be an educational program with that aim in a much younger population. Third grade encompasses 8-, 9-, and 10-year-olds. This group is in the middle childhood stage and begin more complex thinking and problem-solving skills. There is physical and emotional development among this group.

Methods: This is a quasi-experimental study among third grade students in Breckinridge County Kentucky with pretest and …

Hypertension Prevention Program And Its Effects On Blood Pressure Levels Among Young Adults In A Christian Community In Southwest Michigan, Cindel Hollancid

Doctor of Nursing Practice Projects

Background

Although the majority of patients who present are adults over the age of 40 years old; with blood pressures ranging from 140/88 – 190/110 and many times higher readings, it was intriguing and important to assess whether a direct intervention, teaching young adults ages 18 – 39 years the benefits of lifestyle choices would be beneficial as a preventative measure to implement for hypertension reduction patterns as one ages. According to Hinton et al. (2019), hypertension affects 1 in 8 adults between the ages of 20 and 40 years old and is thus common among young people; with the …

Improving Self-Reported Hydration Using Refillable Bottles And Clean Water Access, Erica Short, Adam Dill, Ali Bradley, Kaito Gao, Jennifer Hanks, Hayat Muhammad, Mai Ngo

Nursing Leadership in Community Engagement Projects

In Washington State, around 18.5% of individuals aged 12 and older, about 1.4 million people, struggle with substance use each year (Substance Abuse and Mental Health Services Administration, 2023). Many also face housing instability and limited access to basic health needs like clean drinking water. Our agency supports Seattle residents in recovery, and during our initial assessment, we identified inadequate hydration as a common concern. As a team of seven nursing students, we developed a community health project to improve self-reported hydration among this population. This paper outlines our process from assessment to intervention and our efforts to support healthier …

Hazing Prevention Education, Elianna Mielbrecht, Sky Agpawa, Ceirra Dean, Joseph Arinaza, Moses Hart, Lily Speakman, Hana Maow

Nursing Leadership in Community Engagement Projects

Hazing Prevention Education

Hazing in higher education is often hidden behind a culture of secrecy, tradition, or team-building. It includes any unwanted physical, emotional, or psychological activities that a person undergoes before joining a group that has clear lasting impacts on the person’s health, regardless of willingness to participate (H.R.5646 - Stop Campus Hazing Act, 2024; Boyer, A., n.d.). Seven nursing students partnered with a university’s campus security office in Seattle, Washington. This department is responsible for maintaining a safe and respectful campus environment, making it a key stakeholder in hazing prevention efforts.

Guided by the Stop Campus Hazing Act …

Integrating Health Education And Scabies Prevention In Correctional Facilities: A Path To Safer Inmate Populations, Bhavandeep Singh

Nursing | Senior Theses

Scabies is a highly transmissible skin infestation that represents a significant public health issue in correctional institutions. Inmates are particularly susceptible to scabies outbreaks due to factors such as high population density, cramped living conditions, limited access to healthcare, and frequent turnover of inmates. Addressing scabies in correctional facilities is vital for protecting inmate well-being, making it essential to explore the most effective ways to tackle this issue. This research aims to determine whether nurse-led educational training sessions for inmates can enhance their knowledge of scabies and effectively reduce its manifestations. This research proposal will use a quantitative-quasi research approach …

Optimizing Pelvic Health: Evaluating The Efficacy Of Prenatal Strength And Resistance Training Combined With Pelvic Floor Muscle Exercises In Reducing Pelvic Organ Prolapse Risk, Samantha Requilman

Nursing | Senior Theses

While postnatal recovery is focused on the newborn, the mother’s health is equally important – particularly in preventing pelvic organ prolapse (POP), a condition that results in pelvic discomfort, incontinence, and a reduced quality of life. Although clinicians encourage pelvic floor muscle exercises (PFME) throughout pregnancy, POP is still prevalent among women, especially those who deliver vaginally. There are limited research studies on the effectiveness of prenatal resistance training in the prevention of pelvic dysfunctions and this study aims to address the gaps in the literature. So the question to address this study is: Does combining prenatal resistance training with …

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Senior Theses

Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child within …

Scabies Prevention In Correctional Facilities: A Path To Safer Inmate Populations, Bhavandeep Singh

Nursing | Student Research Posters

Scabies is a contagious skin condition caused by the Sarcoptes scabiei var. hominis mite, which burrows into the skin to lay eggs and feces, causing intense itching and a rash. These symptoms can take up to 4-6 weeks for a first time infection and it can occur as early as 1-4 days for a person who previously had scabies (National Park Service, 2023). Scabies is often transmitted through prolonged and direct skin to skin contact with an infected person, through sharing clothing, or due to overcrowded environments. This intense itching and rash can cause poor sleep, social ostracization, and affect …

Youth Shelter Bed Bugs & Lice Education, Madeline Mary Rettenmier, Elvina S. Kuzubov, Quoc H. Phan, Megan Myra Joseph, Allie Mechtel

Nursing Leadership in Community Engagement Projects

Youth Shelter Bed Bugs & Lice Education
Allie Mechtel, Maddy Rettenmier, Elvina Kuzubov, Megan Joseph, Kevin Phan
School of Health Sciences, Seattle Pacific University
NUR 4153: Nursing Leadership in Community Engagement
Leah Ngoche DNP, MPH, ARNP-BC
8 November 2023

Youth Shelter Bed Bugs & Lice Education

Introduction

Seattle Pacific University Nursing students were assigned a fifth quarter leadership project in the greater Seattle area. Our group was assigned to a youth shelter located in Belltown, Seattle Washington. It is a thirty-bed, animal friendly shelter for young individuals looking for a safe place to stay. They offer long-term housing for those …

Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio

Nursing Leadership in Community Engagement Projects

Introduction

The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …

Reducing Risk Factors Of Diabetes Mellitus Type Ii Development In Veterans Post Military Discharge Through The Patient Aligned Care Team Model And The Utilization Of Preventive Programs Involving Lifestyle Changes., Jeni Grundy

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Diabetes Prevention Program, Ashley L. Stine

MSN Capstone Projects

The prevalence of diabetes in Texas has increased 40 percent over the last decade and will continue to rise as of 2019. New onset diabetes, chronic, and children with diabetes has significant rise in hospitalization rates. COVID and its restraints of limiting physical activity, restrictions of gyms and sedentary lifestyles. Chronic diabetics who were frequent flyer hospitalizations rates increase due to poor social support, mental health and stressors increased during COVID also. This diabetes prevention program that consists of 16wks for new and current diabetics would decrease complications of diabetes such as DKA, retinopathy, nerve pain, chronic pain, AMS, amputations, …

Improving Mammography Rates Among The Hispanic Population: An Evidence-Based Project Utilizing A Promotora Intervention, Dawn Mirowski

Student Scholarly Projects

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population.

PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)?

Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography …

Prevention Of Abusive Head Trauma Using An Educational Program For Parents/Caregivers, Camile Williams

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The National Center on Shaken Baby Syndrome reports that 1,300 abusive head trauma (AHT) cases occur in the USA each year, a quarter of which are fatal. Injuries are caused by impact, shaking, or both and result in intracranial and spinal damage, retinal hemorrhages, fractures of the ribs and other bones. AHT case rates in the community involved in this project had a 22% increase of AHT from 2018 to 2019.

Context: A practice improvement project involved the implementation of an AHT educational program targeted at parents/caregiversreceiving care services at a children’s hospital pediatric well-child clinic located in …

Community Health Nursing In Ghana: Dental Hygiene, Alexis Llewellyn

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Dental hygiene is an important contributor to our overall health. Poor dental hygiene practices can lead to plaque buildup, cavities formation, tooth decay, and infection. Infection that began as a result of poor oral hygiene can spread to other parts of the body and cause more serious conditions to develop. Dental health is not a priority among Ghanaian residents and there is a need for updated, evidence based research about this topic. This literature review focuses on community health nursing in Ghana, Africa regarding dental hygiene of the pediatric population in this country. The primary focus is to compare the …

Global Impact Of Physical Inactivity And Implications For Public Health Nursing, Elizabeth A. Moxley, Kashica Webber-Ritchey, Laura Hayman

Faculty Articles, Papers, and Other Scholarship

Physical inactivity has been a public health problem worldwide for more than a decade. Of those who are physically active, a substantial percentage engage solely in low or very low physical activity (PA) levels. In the last 3 decades, the prevalence of PA in the United States has decreased with approximately 80% of adults not meeting the recommended guidelines for aerobic and muscle strengthening PA. The PA levels of youth have dramatically decreasedwith 85% of adolescents reporting no PA. Regular PA participation can aid in preventing chronic diseases. A strong inverse dose-response relationship exists between PA and the incidence of …

Prevention Of Pediatric Mortality Associated With Malaria: An Exhaustive Literature Review, Taylor Mosley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Malaria, a disease that is preventable yet frequently fatal, disproportionately affects pediatric African populations at a rate that results in a child under the age of 5 dying every two minutes. Since 1955, the World Health Organization has contributed to a significant reduction in the morbidity and mortality of malaria; however, progress has stalled in recent years. In some countries, particularly those in sub-Saharan Africa, cases have increased since 2015. This literature review seeks to identify factors associated with this incline, as well as what interventions can have the greatest impact to prevent pediatric mortality in areas with the largest …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

Prevent The Preventable: Children With Hypertension Due To High-Sodium Diets., Shana M. Cobb

MSN Capstone Projects

Heart disease in the United States is the number one cause of death and costs $317 billion annually (Centers for Disease Control, [CDCa], 2018). Heart disease is usually considered an adult disease, but today we are finding that more children are developing symptoms of high blood pressure and sodium consumption is the link (Webb, 2017). Health care spending for hypertension is at an all-time high and is expected to triple over the next 20 years (Bussenius, Zeck, Williams, & Haynes-Ferere, 2018). The American Heart Association (AHA) states if sodium consumption was decreased to around 1,500 milligrams (mg) a day, blood …

Managing Childhood Obesity In A Primary Care Clinic, Linda Nnajiofor

Doctor of Nursing Practice

Background: Childhood obesity and overweight have increased health burdens on health care systems, and contribute to chronic diseases such as diabetes, heart disease, asthma, and cancer. Childhood obesity is very complex for healthcare providers to manage in primary care settings.

Purpose: To improve childhood overweight and obesity approach and management in a selected primary care practice (Clinic A) in a large east Texas urban community.

Objectives: 1. Increase the percentage of children and adolescents ages 2 to 19 years seen in Clinic A, who received adequate weight management and obesity counseling, to 75%. 2. Increase the number of referrals to …

Getting To Zero: Creating An Infrastructure To Support Fall Prevention In A Medical–Surgical Unit, Krys Elgarico

Master's Projects and Capstones

Problem: Hospital falls are a growing national patient safety concern that cause anxiety, pain, distress, serious injuries, and increased health care utilization. Despite the presence of a well-developed falls prevention protocol since 2017. Internal data from an inpatient medical-surgical telemetry (MST) unit indicate the largest number of fall-related events among the hospital’s departments.

Context: Practice improvement project was initiated in a 217-bed community hospital to determine barriers and potential success factors. This MST is a dynamic, 48-bed unit providing care to mainly geriatric patients who require continuous telemetry monitoring and complex medical, trauma, and surgical services. Senior leaders in the …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …