Public Health and Community Nursing Commons^™

Analyzing The Impact Of Interactive Home Monitoring On Congestive Heart Failure Readmissions: A Program Evaluation, Josh C. Riggs

Doctor of Nursing Practice (DNP) Manuscripts

Hospital readmissions are described as a situation in which a patient is admitted to a hospital within 30-days of being discharged from an earlier inpatient stay and is a critical indicator of care, contributing heavily to the rising healthcare costs in the United States. Heart failure is one of the leading contributors to 30-day hospital readmissions, prompting healthcare organizations to develop and implement policies aimed at reducing these occurrences. This program evaluation examined the effectiveness of the University of Virginia’s (UVA) Interactive Home Monitoring (IHM) program at reducing 30-day hospital readmission rates among patients diagnosed with heart failure (HF). Utilizing …

The Impact Of Mindfulness Therapy To Reduce Disruptive Behavior In High School, Wendy Nell Peters

Electronic Theses and Dissertations

The aim of this project was to determine the impact and effectiveness of Gina Biegel’s mindfulness techniques for stressed teens method on adolescent anxiety and the disruptive symptoms that lead to high school adolescents being assigned to detention. This project described a quantitative correlational design research project that investigated a small adolescent sample size, with a goal of decreasing the number of local high school adolescent students who are repeat detention offenders, by implementing Gina Biegel’s mindfulness techniques for stressed teens method on those high school adolescents who were assigned to detention. This was achieved by collecting demographic data from …

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 & …

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 …

Screening For Bullying In A Middle School Setting, Paige Bernau

Dissertations

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

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

Implementation Of A Human Papillomavirus Vaccination Toolkit Postpartum, Emily R. Leone

Dissertations

Problem: Human papillomavirus (HPV) is the most common sexually acquired infection in the world (DeCherney et al., 2018). Even a single dose of the HPV vaccine can provide up to 97% protection against HPV 16 and 18, which are the strains that cause 70% of all cervical cancers (Barnabas et al., 2022). Missouri ranks 35th in the country for HPV vaccination (Office of Disease Prevention and Health Promotion, 2020).

Methods: This quality improvement project implemented an HPV toolkit consisting of: 1) staff nurse education in the form of a written presentation 2) patient and provider education in the form of …

Motivational Interviewing For Weight Loss: A Review Of Evidence-Based Outcomes In Overweight And Obese Adults, Marian Dover

Dissertations

Obesity is a significant clinical problem affecting 41.9% of adults in the United States, with profound implications for individual health and healthcare economics. Standard weight loss interventions, often limited to pharmacological treatments and dietary guidance, frequently fail to achieve sustained adherence and meaningful longterm outcomes. This quality improvement (QI) project evaluated the integration of motivational interviewing (MI), a patient-centered counseling strategy, into routine clinical practice at Innovafusion, a medically supervised weight loss clinic in Aubrey, Texas. The aim was to enhance adherence to lifestyle modifications, promote intrinsic motivation, and improve weight loss outcomes among adults aged 18–65. Using a retrospective …

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 …

Community Health Workers: Key To Decreasing Food Insecurity In Pregnant Individuals, Linda Waggener Dnp

Doctor of Nursing Practice Scholarly Projects

Objectives: Food insecurity (FI) in pregnant individuals (PI)s is a global threat to birthing individuals and fetuses with potential immediate and intergenerational impacts on family and community. Community Health Workers (CHWs) facilitate support including food resources for FIPIs. The Family Fresh Rx (FFRx) program, within Food as Medicine (FaM) model provides fresh fruits and vegetables, optimize nutrition, and mitigates threats to health. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project’s two objectives were CHWs’ FFRx program and referral process satisfaction evaluation through a pre, post, and four-week post refresher presentation (RP) modified System Usability Scale (mSUS) …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

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 …

Influenza And Chronic Obstructive Pulmonary Disease: Correlating Adult Immunization With Exacerbation Reduction After Implementation Of The Global Initiative For Obstructive Lung Disease Recommendations In A Rural Clinic, Jessica Semyonova

Doctor of Nursing Practice Projects

Background: Patients with chronic obstructive pulmonary disease (COPD) may experience exacerbations of the disease, leading to disease progression, decreased lung function, increased mortality, and decreased quality of life. However, one of the clinician’s best tools in preventing exacerbations may be the distribution of annual influenza immunizations.

Purpose: This project aimed to determine whether implementing an influenza vaccination protocol would increase influenza vaccination uptake and decrease COPD exacerbation rates.

Project Design: An influenza vaccination protocol was implemented over an eight-week period. During that time, data was gathered and compared to data from the previous year when a vaccination …

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 …

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 …

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 …

Enhancing Health Literacy In Adolescents At A Homeless Shelter, Raymond Don N. Razon, Lauren Snedeker, Janice Ou, Chau V. Nguyen, Makenna Johnston, Ruweyda Salim, Garett W. Walters

Nursing Leadership in Community Engagement Projects

Enhancing Health Literacy in Adolescents at a Homeless Shelter

Over the past two months, our group of seven Seattle Pacific Nursing Students collaborated with a local nonprofit homeless shelter for families. After meeting with the agency’s health services coordinator, we decided to focus on the teen population and enhance their health literacy. This choice was due to our population primarily not being exposed to the American healthcare system. Our team gathered information from the teens and found that nutrition, sleep, and mental health were of particular interest. Based on this, we planned and implemented a health literacy intervention tailored to …

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 …

Opioid Use Disorder Within The Emergency Department: Not All Skin Infections Are Equal, Jennifer E. Pletcher

Graduate Doctoral Dissertations

The emergency department (ED) is where two health crises commonly converge, the opioid crisis and cellulitic infections while simultaneously being the front door to the healthcare system at large. The aim of this dissertation is to fill the gap in knowledge about specific skin and soft tissue injury and severe infection (SSTI) with comorbidity of opioid use disorder (OUD) (OUD SSTI) population and demonstrate inequities as compared to the SSTI and severe infection without OUD comorbidity (non-OUD SSTI) through the lens of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy. The Nationwide Emergency …

Reducing Stress Through Music And Meditation: A Low-Barrier Mental Health Intervention For Unhoused Women In Shelter Settings, Joan Katumo, Fiona Johnson, Jenny Tanner, Jamilah Salazar, Malica Richards, Hanna Sheikh, My Nguyen

Nursing Leadership in Community Engagement Projects

Reducing Stress Through Music and Meditation: A Low-Barrier Mental Health Intervention for Unhoused Women in Shelter Settings

Seven nursing students from Seattle Pacific University partnered with a women’s day center in downtown Seattle to support unhoused women experiencing chronic stress and systemic inequalities. The center serves as a safe and welcoming space where women can access essential services including hot meals, hygiene facilities, healthcare connections, and case management, all while fostering a sense of dignity, community, and personal agency. Many clients faced significant trauma and housing insecurity, which contributed to ongoing stress and health challenges, conditions often compounded by social …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

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 …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

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 …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Perceptions Of Perinatal Depression Among Immigrant Mothers: Screening Practices In Nurse Home Visitation, Silvia E. Arabia

Doctoral Projects

Screening for perinatal depression is a recommended strategy aimed at prevention and timely management of mood disruption in pregnancy and the postpartum (ACOG, 2024). Screening for perinatal depression is often integrated in evidence-based home visitation curriculums. The aim of this qualitative descriptive quality improvement project was to explore perceptions of perinatal depression among immigrant mothers engaged in nurse home visitation to identify barriers, if any, to disclosure and treatment of perinatal depression among a group at increased risk of developing perinatal depression (Gennaro, S., et al, 2016). Immigrant mothers residing in a large urban county in the San Francisco Bay …

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 …

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 …

Psychoeducational Training For Community Health Workers To Improve Confidence In Providing Mental Health Services To Migrants, Nimota M. Akintoye

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

There is a higher prevalence of mental health illnesses among migrants. This minority group is faced with challenges in accessing healthcare due to poverty, stigmatization, and fear of discrimination. Research has shown that community health workers (CHWs) bridge the gap between the health and social service sectors and the patients by improving patient access to care and healthcare outcomes. A translational project was implemented to evaluate how psychoeducational training improved the CHWs’ confidence and knowledge level in providing mental health support to the patients and community members. Sister Calista Roy’s Adaptation Model was used to guide the study by incorporating …