Family Practice Nursing Commons^™

Standardizing Cardiac Rehabilitation Referrals In A Rural Primary Care Clinic, Carlie H. Sanders

SACAD: Scholarly Activities

Abstract

Cardiac rehabilitation (CR) is a cost-effective, evidence-based approach for patients with cardiac conditions to improve quality of life and health outcomes. Despite the benefits, it remains a nationally underutilized service, and extensive research has been conducted to identify interventions that most effectively increase referrals and participation in CR programs. Two of the more successful interventions include strengthening provider recommendations and using a standardized referral system (Ades et al., 2022). This quality improvement project aimed to strengthen provider recommendations and increase the frequency of referrals to the existing CR program at a rural primary care clinic by 50%. To do …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

SACAD: Scholarly Activities

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Standardized Home Blood Pressure Log Implementation For Patients With Hypertension To Increase Patient Awareness And Clinical Action, Ashley Alcala

Doctoral Dissertations & Projects

Background: Home blood pressure monitoring (HBPM) is recommended for hypertension management, yet primary care clinics often lack standardized workflows for distributing, collecting, and using home blood pressure (BP) data. Inconsistent reporting and limited patient understanding of their own BP trends, such as whether readings are stable, elevated, or unchanged, reduce providers ability to make timely clinical decisions.

Problem: Despite evidence supporting HBPM, patients rarely brought usable BP logs to follow‑up visits, limiting providers ability to assess BP control, identify trends, and make timely medication or care plan adjustments.

Approach: This project used a Plan‑Do‑Study‑Act (PDSA) model to implement a standardized …

Implementing Hypertension Guidelines Into Clinical Practice, Misti Michele Mays

Electronic Theses and Dissertations

Hypertension is a complex chronic disease process, and it is essential to educate the patient on the disease process, as well as on all aspects of self-management. It is essential that providers choose an evidence-based guideline by which they will manage their hypertensive patients. In addition, providers must schedule regular follow-up appointments with their patients, along with a wide variety of other multifactorial components in regard to the management of patients diagnosed with hypertension. In addition, providers have a responsibility to stay informed on new approaches to blood pressure management by reviewing the professional literature on a regular basis. Much …

Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales

SACAD: Scholarly Activities

Abstract  

This poster presents a theoretically grounded, AI-integrated simulation program design structured across 3-4 semesters of Family Nurse Practitioner (FNP) and Doctor of Nursing Practice (DNP) education. This program is designed to support the development of clinical judgment and diagnostic reasoning among FNP students. Guided by Tanner’s Clinical Judgment Model and Roy's Adaptive Model as Theoretical Framework. The program addresses identified gaps in differential diagnosis and role transition from Registered Nurse (RN) to FNP practice. A needs assessment informed the development of a semester-sequenced curricular framework integrating AI-supported simulation across four semesters. The proposed design illustrates how progressive simulation experiences …

Efficacy And Safety Of Stem Cell-Based Interventions For Burn Wound Healing: A Systematic Review And Meta-Analysis Of Pre-Clinical And Early Clinical Evidence, Prayuth Poowaruttanawiwit, Patsanan Kulla, Naveeya Pakpoomkamonlert

The Thai Journal of Pharmaceutical Sciences

Background: Burn injuries remain a major therapeutic challenge, with conventional treatments often failing to achieve complete functional skin regeneration. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and exosome derivatives, have demonstrated regenerative and immunomodulatory potential, yet their translation to clinical practice remains limited.
Objectives: To systematically evaluate the efficacy and safety of stem cell-based therapies for burn wound healing across pre-clinical and clinical studies.
Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, four databases (PubMed, Embase, Scopus, and Cochrane) were searched through April 2025. Eligible studies included randomized controlled trials and controlled pre-clinical …

Hybrid Diabetes Coaching Model: Integrating In-Person And Telemedicine Strategies To Improve Glycemic Outcomes, Sandis A. Mundackal

Student Scholarly Projects

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or …

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Marital Satisfaction And Social Media Use: A Comparative Study Based On Addiction Levels, Fatma Ayhan, Elif Arık, Merve Gülsüm Saçan, Zehra Sevim, Esme Arguç

Makara Human Behavior Studies in Asia

In recent years, the widespread use of social media platforms has raised questions about their impact on marital relationships. This study examined the relationship between marital satisfaction, social media use, and certain sociodemographic characteristics. This descriptive and cross-sectional study comprised 461 individuals residing in Turkey who had been married for at least one year. Data were collected using the Bergen Social Media Addiction and Marital Satisfaction Scales. Statistical analyses included t-tests, analysis of variance, and multiple linear regression analysis. Social media addiction was high among 16.5% of the participants. Marital satisfaction was higher among males, those who married at age …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

Differences In Comorbidities, Presenting Symptoms, Demographics, And Patient Reported Outcomes In Long Covid By Initial Test Status, Stephanie Georgoudiou

Nursing Dissertations - Archive

Importance Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), remains a major global health concern. Recovery may result in persistent symptoms known as post-acute sequelae of SARS-CoV-2 (PASC), or long COVID. Most studies focus on individuals with laboratory-confirmed infection; however, some patients with COVID-like illness and negative tests also develop persistent symptoms. Testing status should not delay appropriate interventions or specialist referrals. Early, symptom-based care is essential to improve outcomes.

Objective To compare patient-reported outcomes and demographics between long COVID patients who tested positive versus negative during their initial illness.

Design, Setting, and Participants This secondary …

Paternal Involvement And Bonding In Neonatal Intensive Care Unit: Evaluating Daily Caregiving, Emotional Well-Being, And Father-Infant Connection, Ava G. Kinyon

Nursing | Senior Theses

Background: Premature birth and serious neonatal conditions frequently require infants to obtain care in the NICU, producing psychological and emotional obstacles for families. Despite the fact that skin-to-skin contact has been extensively researched for its strengths in encouraging stability and bonding, there persists restricted importance and understanding on paternal participation in routine caregiving tasks such as feeding, diapering, temperature checks, and swaddling. Purpose: This study aims to evaluate paternal participation in daily NICU caregiving tasks to address gaps in comprehending how these experiences impact bonding and emotional well-being among fathers of hospitalized infants. Methods: This study will employ a quasi-experimental …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

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

Doctor of Nursing Practice (DNP) Scholarly Projects

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

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

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

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Poorly Controlled Type 2 Diabetes (T2dm) In A Rural County In Texas: A Diabetes Intervention Bundle, Roxanne Morales

Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) remains a significant public health concern, particularly in rural and underserved communities where patients often face barriers to effective self-management. This quality improvement (QI) project evaluated the impact of a diabetes intervention bundle consisting of individualized diabetes education, biweekly support phone calls, and digital self-monitoring tools on glycemic control, body weight, diabetes knowledge, medication adherence, diet compliance, and physical activity. The project was implemented over an eight-week period in a rural family medicine clinic and included 18 adults with uncontrolled T2DM (HgbA1c >7%). Participant outcomes were evaluated using pre- and post-intervention clinical measures, the Diabetes …

The Impact Of Parental Mental Health On Infant Outcomes In The Neonatal Intensive Care Unit: Length Of Stay, Feeding, Bonding, And Developmental Progress, Andee L. Plaskett

Nursing | Senior Theses

Background: The neonatal intensive care unit (NICU) can be a highly stressful environment for both infants and their parents. Poorer infant outcomes, including longer hospital stays, feeding difficulties, and delayed developmental progress can all be a reflection and outcome of elevated parental distress. Currently, mental health distress and infant screening tools are used in most NICUs but are not seen in all practices, it is also important to provide interventions based on the screening results. Screening tools are used to identify a problem but interventions should be implemented to try to alleviate the problem. Objective: By implementing a standardized screening …

Blister Packaging Versus Bottles: Caregiver Accuracy And Child Safety In Pediatric Medication Gummy Administration, Paolo Olimpiada

Nursing | Senior Theses

The safety of medication in pediatric settings has become an increasing concern as gummy-formulated medications have gained popularity in children’s care. Gummy-formulated medications have a close resemblance to candy, and this may mislead children to ingest additional doses or more than what was prescribed. Children also depend a lot on their caregivers for medications. Therefore, the design of packaging would be impactful in supporting medication dosing accuracy. And studies have evaluated safety features of packaging related to adherence, misuse, and unintended administration. However, limited studies have examined the influence of medication packaging on the dosing accuracy at the time of …

Development Of An Educational Toolkit For Clinical Staff At Little Rivers Health Care To Guide Shared Decision Making For The Expanded Age Range Of The Hpv Vaccine, Maureen B. Boardman

DNP Scholarly Projects

BACKGROUND: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States (CDC, 2024). Unlike other common STI's, persistent infection with HPV increases the risk of cancer. A Human Papillomavirus (HPV) vaccination was approved in the United States in 2006 for girls and women aged 9 to 26 and in 2009 it was approved for boys and men in this same age range. Despite 20 years of data on the efficacy and safety of the HPV vaccine, rates of completed HPV vaccine series remain low. In 2019 the Advisory Committee on Immunization Practices (ACIP) expanded …