Population Health Commons^™

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

The Efficacy Of Transversus Abdominis Plane Block As An Adjunct To Spinal Anesthesia For Cesarean Delivery: An Evidence Synthesis And Implementation Toolkit, Alyssa Hebert, Alex Potts, Gabriela Robertson

Graduate Theses, Dissertations, and Capstones

Postoperative pain hinders cesarean delivery recovery and overall patient experience. Although spinal anesthesia with intrathecal opioids remains the standard of practice, associated side effects and concerns regarding opioid exposure highlight the need for effective opioid-sparing strategies. Anesthesia providers play a critical role in advancing postoperative pain management through evidence-based protocol development, provider education, and interdisciplinary collaboration to optimize maternal outcomes. The transversus abdominis plane (TAP) block provides somatic analgesia to the anterior abdominal wall by targeting the thoracolumbar nerves (T6–L1) and has increasingly been incorporated into multimodal postoperative pain management strategies for abdominal surgery. Nevertheless, a gap remains in obstetric …

Addressing Obesity In Rural Health Clinics, Morgan P. Trusley

Student Scholarly Projects

Practice Problem: According to the Centers for Disease Control and Prevention (CDC), more than 2 in 5 adults in the United States are obese (CDC, 2024a). In a rural primary care clinic in South Carolina, approximately 70% of patients are obese and there is no current intervention in place to help educate and guide these patients in weight loss strategies.

PICOT: In obese adults over the age of 18 at a rural health clinic with a Body Mass Index (BMI) greater than or equal to 30, does implementing weekly virtual and in person multicomponent behavioral intervention educational sessions compared to …

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Posters and Presentations

Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Scholarly Projects

Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ekstremitas Bawah Pada Pasien Luka Kaki Diabetik, Jannaim Jannaim, Ridha Dharmajaya, Asrizal Asrizal

Jurnal Keperawatan Indonesia

The Influence of Buerger Allen Exercise on Lower Extremity Circulation in Patients with Diabetic Foot Ulcer. Diabetic footulcer (DFU) is a complication of diabetes caused by impaired venous and arterial blood circulation. Buerger allen exercise is a modality therapy with active postural movement. This study aims to assess the effect of buerge rallen exercise on the circulation of lower extremities in DFU patients. The study design was pre experimental pretest and posttest without control. The sampling technique was consecutive sampling and the large sample of 43DFU patients, analysis data was using Wilcoxon test. Increased circulation is measured using the Ankle …

Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …

Implementing The Walking Impairment Questionnaire For Peripheral Artery Disease Screening And Referral, Lisa Doyle

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Peripheral artery disease (PAD) is a leading cause of cardiovascular morbidity, mortality, and lower extremity amputation. At a Level 1 veterans medical center, the absence of a standardized screening and referral process contributed to delayed identification of symptomatic PAD and underutilization of supervised exercise therapy (SET). Between August 2024 and July 2025, only four veterans completed SET despite a large high-risk population, demonstrating a significant gap in evidence-based recommendations and clinical practice.

Aim of the Project: The aim of this project was to improve patient outcomes by standardizing screening for symptomatic PAD using the Walking Impairment Questionnaire (WIQ) to …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Where Housing And Healthcare Meet: Ed Utilization Through On-Site Nursing And Fmr Collaboration, Bennett Gosiker, Tara Ahmadi, Bessie Liu, Naeemah Munir, Viet Nguyen, Carrie B Rubenstein

All Poster Presentations

No abstract provided.

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

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 Glp-1 Ra Initiation In Primary Care Through A Paper-Based Clinical Decision Support Tool, Carissa R. Bowery, Karen Carver

Epsilon Sigma at-Large Research Conference

Title: Improving GLP-1 RA Initiation in Primary Care Through a Paper-Based Clinical Decision Support Tool

Authors: Carissa R. Bowery, MSN, FNP-C; East Tennessee State University College of Nursing. Karen M. Carver, PhD, APRN, FNP-C; East Tennessee State University College of Nursing

This quality improvement project focuses on improving evidence-based pharmacologic management of adults with type 2 diabetes mellitus (T2DM) and obesity through implementation of a paper-based clinical decision support (CDS) tool in primary care. The aim is to increase initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among eligible patients and improve provider adherence to current clinical guidelines.

Processes: This …

Examining Outcomes Of Client Education Interventions To Reduce Caffeine Intake In The College-Age Population, Mackenzie Leonard, Mikayla Evans

James Madison Undergraduate Research Journal (JMURJ)

This scoping review aimed to explore health interventions that address excessive caffeine consumption in college students aged 18–23 years. Excess caffeine intake is associated with a range of health concerns, including neurological, cardiovascular, and behavioral issues, highlighting the need for effective interventions to mitigate its impact on overall wellness. The literature exploring interventions aimed at modifying health behaviors among the college student population is notably limited. Furthermore, there has been a lack of studies replicating interventions aimed at reducing caffeine intake. These gaps suggested the need for further investigation and exploration of reports pertaining to health promotion. The results of …

A Systematic Review Of Implementing Iot Healthcare Systems: Technological, Organizational, And Ethical Barriers In Rural Settings, Mudzramer A. Hayudini, Angela Joy A. Jimpoy, Jonel T. Alibasa, Aisha A. Carolino, Jenden M. Julkamri, Nagdir B. Muhadja, Al Rajab H. Aming, Hamdoni K. Pangandaman, John Ed Augustus A. Escorial

Jurnal Keperawatan Indonesia

The implementation of Internet of Things (IoT) technologies holds transformative potential for healthcare delivery in rural and underserved regions. This systematic review focuses on technological, organizational, and ethical barriers. A comprehensive literature search across six major academic databases yielded eleven empirical studies published between 2015 and 2025. The review adhered to PRISMA protocols, with data synthesized using the Synthesis Without Meta- Analysis (SWiM) guidelines. Findings revealed that technological challenges—such as unreliable internet connectivity, lack of device interoperability, and power supply issues—are widespread across rural implementations. Organizational limitations included inadequate training, resistance to workflow changes, and financial constraints. Ethical concerns primarily …

Factors Affecting Older Adult Adjustment At A Health Promoting Hospital In Nakhon Phanom, Thailand, Onuma Kaewkerd, Yuttachai Chaiyasit, Phensiri Dumrongpakapakorn, Nuttiya Prommasaka Na Sakonnakhon

Jurnal Keperawatan Indonesia

Elderly adjustment influences quality of life and well-being and informs appropriate health promotion, holistic care, and health services. This study aimed to investigate the factors influencing the adaptation of older adults by focusing on a study conducted at Dong Kwang Health Promoting Hospital in Nakhon Phanom Province, Thailand. A cross-sectional design was used for the study. The sample consisted of 100 older adults and were selected for data collection from March 22, 2023, to April 20, 2023. The research instruments consisted of questionnaires assessing personal information, spiritual well-being, stress, perceived self-care abilities of older adults, quality of life, and older …

The Predictive Ability Of Child Characteristics And Parenting Factors On Four Developmental Domains In Toddlers, Melly Latifah, Dwi Hastuti, Neti Hernawati, Reisi Nurdiani, Raihan Ainun Hasanah

Jurnal Keperawatan Indonesia

Stunting is a chronic condition that has a significant impact on child development. This phenomenon is primarily caused by prolonged nutritional deficiency, especially during the first 1,000 days of life. In addition, as family factors also play a crucial role in children’s development, this study aims to analyze the influence of child and family characteristics, mother–child attachment, parenting practices, and the nutritional status of children (stunted/non-stunted) on children’s gross motor, fine motor, language, and personal–social skills. This study used a quantitative design with an explanatory approach involving 202 mother–child pairs with children aged 12–36 months. The findings show that healthcare …

Transforming Nursing Clinical Education: The Power Of Environment, Student Motivation, And Clinical Instructors, Lia Mulyati, Nur Wulan, Abdal Rohim

Jurnal Keperawatan Indonesia

Clinical learning is an important component in the formation of nursing students’ professional competence. The clinical environment, student motivation, and the role of clinical instructors are factors that influence the achievement of learning outcomes in nursing clinical practice. However, the relationship between these factors is still not fully understood. This study aims to examine the relationship between the clinical environment, student motivation, and the role of clinical instructors, and to determine how these three factors contribute to learning outcomes in nursing clinical practice. A quantitative design with a cross-sectional survey approach was used. The sample consisted of 117 nursing students, …

Association Of Central Obesity And Hypertension In An Urban Area, Chandrayani Simanjorang, Diva Anita Churiana Sudrajat, Ulya Qoulan Karima

Jurnal Keperawatan Indonesia

Hypertension is one of the non-communicable diseases in Indonesia that is closely related to obesity. Therefore, this study aimed to determine the association between central obesity and hypertension in a cohort study group in Bogor City, West Java from 2011 to 2021. A retrospective cohort study design was employed, with multivariate Cox regression analysis performed using secondary data from the Risk Factors for Non-Communicable Diseases (FRPTM) Cohort Study. Among 3,586 samples, 879 incident cases of hypertension were observed by the end of follow-up, accounting for 24.5% of the at-risk population. The incidence rate of hypertension was 28 cases per 1000 …

Prevalence Of Fall Among Elderly In Rural Sabah And Its Associated Factors, Khalid Mokti, Mohd. Yusof Ibrahim, Syed Sharizman Abd Rahim, Mohammad Saffree Jeffree, Mazlinda Musa, Mohd. Rohaizat Hassan, Yugo Shobugawa, Muhammad Aklil Abd Rahim, Ahmad Faizal Roslan, Mervynn Koon Kar-Wai

Jurnal Keperawatan Indonesia

Falls are a leading cause of injury among older adults, often resulting in significant physical, psychological, and social consequences. This study aims to determine the factors that contribute significantly to fall risks among the older adults in rural Sabah. A cross-sectional community study was conducted in the Kudat Division, Sabah, Malaysia from January to June 2021. Using multistage random sampling, 700 adults aged ≥60 years were recruited, excluding those with severe disability, mental illness, or institutionalized. Data were collected through face-to-face interviews with a structured questionnaire adapted from the validated Japanese Gerontological Evaluation Study (JAGES) tool, and anthropometric measures were …

The Effectiveness Of Psychoeducation And Mind Mapping In Preventing Early Marriages In Central Java, Indonesia, Eviyati Aini Muriana, Mardiyono Mardiyono, Lanny Sunarjo, Melyana Nurul Widyawati

Jurnal Keperawatan Indonesia

During the COVID-19 pandemic, the number of early marriages increased. Early marriage causes biological and psychological problems in the mother and her baby. The combination of psychoeducation and mind mapping emerged as a preventive effort against early marriage. The aim of this study was to analyze the effectiveness of this combination in preventing early marriage in Central Java, Indonesia by influencing adolescents’ knowledge and intentions. This study was conducted using a convergent mixed-methods design. For the quantitative phase, the pre-test – post-test control group experimental design was used, while in the qualitative phase, a thematic analysis was performed using focus …

Ventilator Weaning Through Spontaneous Breathing Trials In Children With Tetralogy Of Fallot In The Picu: A Case Report, Megah Fitrian, Kadek Ayu Erika, Muhammad Yunus

Jurnal Keperawatan Indonesia

Tetralogy of Fallot (TOF) is a congenital heart defect that causes chronic low oxygen levels, increased right ventricular workload, and a higher risk of complications. Weaning mechanical ventilation in patients with TOF is particularly challenging due to right ventricular dysfunction, muscle weakness, and the risk of heart failure. This study evaluates the use of a spontaneous breathing trial (SBT) strategy with pressure support ventilation (PSV) mode for mechanical ventilation weaning in pediatric patients with TOF. An observational study was conducted on a six-year-old pediatric patient with TOF and a cerebral abscess who underwent mechanical ventilation weaning using the SBT technique …

The Role Of Health Workers In Interprofessional Collaboration For Cancer Patient Navigators: A Scoping Review, Agung Subakti Nuzulullail, Aulia Diah Rahayu, Rury Nindya Taluphyta, Ika Arif Lidiyana, Mohamad Rusdiyansyah, Petrus Paris Rumsori, Riyati Riyati, Suci Wahyu Hariyanto, Wa Ode Umi Kalsum, Sri Hartini

Jurnal Keperawatan Indonesia

Cancer remains a leading cause of death worldwide. The complexity of cancer care demands strong interprofessional collaboration (IPC), particularly within cancer patient navigator (CPN) programmes. However, research examining IPC in the context of CPN implementation is still limited. This scoping review aims to explore the various roles of healthcare workers in the IPC process within cancer navigator programme interventions. The review was conducted using four databases: PubMed, Clinical Key, EBSCOhost, and ScienceDirect. The Arksey and O'Malley framework was used to address the research question: “What is the role of health workers in interprofessional collaboration within cancer patient navigation?” Study selection …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

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 …

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Nativity And English Language Use In Relation To Undiagnosed And Diagnosed Diabetes In U.S. Adults, Aliya Kuerban Phd, Fnp-Bc, Ms, Ma, Rn

Nursing: Faculty Presentations

Introduction and Objective: Diabetes detection varies across demographic and immigration-related groups. Foreign-born adults and individuals with limited English proficiency may be less likely to have diabetes identified, even when the disease is present. This study examined demographic, socioeconomic, and immigration-related correlates of undiagnosed and diagnosed diabetes among U.S. adults.

Methods: Data from the National Health and Nutrition Examination Survey (NHANES, 2011-2023) were analyzed using survey-weighted multinomial logistic regression. Diabetes status was categorized as no diabetes, undiagnosed diabetes, or diagnosed diabetes based on self-report and laboratory criteria. Models sequentially adjusted for age, sex, race/ethnicity, nativity, English language use, income, and education. …