Improving End-Of-Life Care: A Nursing Education Initiative, Spring C. Kingsley

DNP Projects

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: …

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

Nursing Dissertations - Archive

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

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

Management Of Obesity In Adults 18 And Older, Donna Callicoat

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Obesity is a significant public health concern in the United States, with increasing prevalence and substantial healthcare costs. Despite evidence-based guidelines for obesity management, primary care clinics often fail to implement them effectively, leading to missed opportunities in preventing obesity-related comorbidities such as cardiovascular disease, type 2 diabetes, and certain cancers.

Purpose: This evidence-based project aimed to implement the American Heart Association/American College of Cardiology/Obesity Society (AHA/ACC/TOS) obesity guidelines in a rural Texas primary care clinic. The goal was to assess the effectiveness of these guidelines in reducing weight, body mass index (BMI), and waist circumference among adults with …

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

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

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

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Improving Transitions In Care: The Post-Discharge Follow-Up Process For Va Hospitalizations, Kristina Huntoon

DNP Scholarly Projects

BACKGROUND: Transitions in care from hospitalization to home are a high-risk period for patients. Without care coordination during these transitions in care, patients are left trying to manage their care without any support. The VA has a mandated two-day post-discharge contact process that requires a member of the patient’s primary care team to contact the patient within two business days of a VA discharge.

METHODS: The Plan-Do-Study-Act method of quality improvement was used for this project. Baseline assessment included review of patient medical records for 15 months before the intervention, which included 27 discharges from unit 78C. The patient medical …

An Evidence-Based Practice Initiative To Improve Blood Pressure Control, Teresa D. Hines

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this …

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Examining The Best Dietary And Lifestyle Interventions To Prevent Hyperinsulinemia And Insulin Resistance In Women With Polycystic Ovarian Syndrome, Erica C. Morman

Honors Undergraduate Theses

Polycystic Ovarian Syndrome (PCOS) is a complex reproductive and metabolic disorder that affects up to 15% of women, contributing to insulin resistance, hyperinsulinemia, risk for developing type 2 diabetes. The interconnected hormonal and metabolic disruptions in PCOS create a feedback loop that exacerbates symptoms, making dietary and exercise interventions critical in its management. This literature review evaluates the efficacy of various dietary interventions including the ketogenic diet, high-protein diet, low-carbohydrate diet, and high-fiber diet, as well as exercise interventions such as high-intensity interval training (HIIT), resistance training, and moderate-intensity aerobic exercise. Results found that modifying carbohydrate intake, and increasing fiber …

The Potential Of Vitamin D As An Adjunct Therapy For Eczema, Kimberly Hill

Graduate Research Projects

No abstract provided.

Implementation And Evaluation Of Diet And Physical Activity Screening Tools For Adults With Type 2 Diabetes Mellitus In Primary Care, Ashley O. Dalton

DNP Projects

Background: Only half of individuals with type 2 diabetes mellitus (T2DM) have a hemoglobin A1C (HbA1c) of less than 7%, indicating poor glycemic control and contributing to a global diabetes epidemic. Diabetes is considered a diet-sensitive disease and an individual’s diabetes-related nutrition knowledge is one of the most challenging aspects of the treatment plan. Empirical evidence supports that a combination of dietary and physical activity interventions is more effective than nutrition education alone. Performing a dietary evaluation is fundamental to establishing nutrition goals. The use of the Starting the Conversation (STC) tool, which assesses an individual’s dietary practices, and Physical …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

Utilization Of Organ Inventories In The Primary Care Setting: Two Questions To Increase Usage, Siobhan A. Lister

DNP Projects

Background: The Transgender and Gender Diverse (TGD) population experiences significant health disparities in accessing preventative care when compared to their cisgender counterparts. These disparities often occur with organ-specific screenings and lead to poorer health outcomes, due to patients having organs that do not match their sex assigned at birth. The evidence recommends a two-question method of gender identification to identify those patients whose gender does not match their sex assigned at birth. Using the 2-question method can help identify patients who need an organ inventory completed, which will lead to appropriate preventative health screenings being done.

Purpose: The purpose was …

Evaluating The Outcomes Of An Educational Intervention For Providers And Two-Week Home Blood Pressure Monitoring In Adults, Michelle Ann Schuler

DNP Projects

Abstract

Background: Approximately 1.28 billion adults worldwide have hypertension (HTN), which greatly increases the risk of morbidity and premature death. Home blood pressure monitoring (HBPM) has been shown to increase efficacy of treatment decisions, but is underused in primary care. About 46% of adults are unaware that they have hypertension and only about 21% of those who have been diagnosed have it controlled.

Purpose: The purpose of this project is to evaluate a previous practice improvement project and improve the HBPM process for sustainability.

Methods This HBPM study utilized a retrospective study design combined with a practice improvement project …

Understanding Avoidant Restrictive Food Intake Disorder (Arfid) In Autistic Children Through Parent’S Lens, Lisette Oviedo

Nursing | Senior Theses

This research reviews and proposes a study to assess parents' knowledge about their children with a dual diagnosis of autism and Avoidant-Restrictive Food Intake Disorder (ARFID) with the intent to develop future care strategies that are both person-centered and family-centered.

Preparing For Loss: The Impact Of Hospital-Based Parental Death On Sibling Relationships, Elyssa Thea Cajilig

Nursing | Senior Theses

The death of a parent is a profound and life-altering experience, especially for children and adolescents, who no longer have a parental figure to guide them through the struggles of processing grief and adjusting to life. Objective: The purpose of this study is to examine the impact of hospital-based parental death preparations on sibling relationships after the loss of a parent. Methods: This quasi-experimental, mixed method longitudinal study will explore the impact of structured hospital-based bereavement support on the quality of sibling relationships after parental loss. Quantitative surveys will assess relationship dynamics at three time points: immediately post-loss, 2 years …

Paternal Negative Lifestyle Choices Affect On Maternal Pregnancy And Birth Outcomes: Bmi, Smoking, Drinking, Domestic Violence, Partner Involvement, Estrella Lopez

Nursing | Senior Theses

Paternal lifestyle choices are often overlooked yet are a crucial factor in maternal pregnancy and fetal outcomes. While maternal health behaviors have been the primary focus that determines a healthy pregnancy and child outcomes, this thesis explores how a paternal's (father's) harmful behaviors such as high body mass index (BMI), smoking habits, alcohol consumption, exposure to domestic violence, and lack of partner involvement, can contribute to diminishing the health of both mother and baby. After analyzing six research articles, this thesis revealed how a father's negative lifestyle choices affect maternal pregnancy and fetal outcomes. Using a quantitative, non-experimental descriptive design, …

Reducing Appointment No-Shows In An Occupational Medicine Clinic: A Quality Improvement Project, Diana S. Torres, Cynthia D. Linkes

Nursing Faculty Publications

Abstract

Background: Appointment no-shows in occupational medicine delay recovery, disrupt workers’ compensation processes, and undermine employer trust. A South Texas clinic reported an average 11% no-show rate over 16 months—above the ≤8% benchmark—resulting in an estimated $379,406 in lost revenue. Contributing factors included inconsistent reminder practices, unverified contact information, and language barriers within a predominantly Spanish-speaking population.

Objective/Project Aim: This project aimed to reduce no-shows to ≤8% by implementing a structured, bilingual, multimodal reminder system that improved patient adherence and operational efficiency without increasing staff workload.

Methods: Guided by the “Getting To Outcomes” 10-Step framework, interventions included …

Promoting Confidence And Evidence-Based Practices For Attention-Deficit/Hyperactivity Disorder Among Integrated Primary Care Providers: A Qualitive Improvement Education Initiative, Omar Samateh, Margaret Emerson, Kayla Meisinger, Taylor Wilson, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Primary Care Providers (PCPs) are seeing growing number of patients presenting for adult attention-deficit/hyperactivity disorder (ADHD) evaluations as a result of social media influences highlighting ADHD. Yet, PCPs report lacking confidence and education with adult ADHD. The purpose of this quality improvement study was to develop educational materials to promote confidence, competence, and adherence to ADHD evidence-based recommendations among integrated care PCPs. Methods: A literature review and retrospective chart review of 19 patients were used to create 1) Baseline ADHD Provider Education (PE) tool, 2) Standardized ADHD Diagnosis (SAD) referral process, 3) ADHD Assessment, Treatment, and Monitoring …