Nursing Commons^™

An Anesthesia Informed Consent Checklist And Ahrq Share Decision-Making Model For Labor And Delivery Patients: A Quality Improvement Project, Katherine C. Burnett

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and Significance: Informed consent is the disclosure of all benefits, risks, and alternatives to patients for a given intervention. Recalling all important details during the consenting process can prove difficult for providers. The process is further complicated for obstetric patients since healthcare decisions also have consequences for the fetus. The American College of Obstetricians and Gynecologists’ Committee (ACOGC) (2021) recommends shared decision-making models (SDMs) for the obstetric patient population. SDMs engage patients in healthcare decisions by reaching a decision through provider expertise, best evidence, and patient values. In addition, surgical informed consent checklists have emerged as useful …

Staff Education Focused On Screening Patients For Depression Using The Phq-9 Tool, Eveline Mankom Gwaabe

Walden Dissertations and Doctoral Studies

The doctor of nursing practice (DNP) project at a community health center (CHC) addressed a performance improvement measure related to the usability of the depression screening tool, Patient Health Questionnaire (PHQ-9), for patients 12 years and older. At CHC, the mental health providers underutilized this tool, leading to missed opportunities in identifying patients 12 years and older with depressive disorders. These missed opportunities may contribute to suboptimal patient treatment outcomes. The purpose of the staff educational program was to increase CHC staffs’ understanding of the PHQ-9 screening tool for routine depression screening. Ten mental health providers participated in the program, …

Staff Education To Nursing Leadership On Implementation Requirements Of A Nurse Residency Program, Sherri Ulfig

Walden Dissertations and Doctoral Studies

Nurse residency programs provide new graduate nurses with a solid foundation to support their transition into practice. The DNP students completed a staff education project to educate nurse leaders on the implementation requirements of a nurse residency program at a not-for-profit hospital in the Midwest. The identified practice problem was that the organization paused its nurse residency program during the COVID-19 pandemic due to critical staffing needs, and the leaders wanted to redesign the program to meet current practice standards. The educational project question addressed whether education for site leaders would increase their knowledge of the implementation requirements of a …

Staff Education On Using The Epworth Sleepiness Scale In Primary Care, Amanda Robyn Jones

Walden Dissertations and Doctoral Studies

Sleep disorders are prevalent in primary care settings and often remain underdiagnosed due to inconsistent assessment practices. This doctoral project was conducted to develop, implement, and evaluate whether an educational intervention for registered nurses would enhance their knowledge on using the Epworth Sleepiness Scale (ESS) for sleep assessment in primary care. Guided by adult learning theories and the analysis, design, development, implementation, and evaluation instructional design model, the aim of the project was to address the practice gap related to inadequate sleep evaluations, ultimately improving patient outcomes and promoting holistic care. Evidence was collected through pre and post intervention assessments, …

Relationship Of Provider-Patient Communication And Health Literacy To Self-Management In Black Adults With Type-2 Diabetes, Linda Walker

Walden Dissertations and Doctoral Studies

Black adults in the United States are nearly twice as likely to receive a diagnosis of type 2 diabetes mellitus (T2DM) and are more susceptible to severe diabetes-related complications. Health literacy and patient-provider communication (PPC) are extremely important for self-management in patients of all ethnicities however, 58% of non-Hispanic Blacks have basic or below-basic health literacy skills compared to 28% of non-Hispanic Whites. The purpose of this descriptive correlational study, with was guided by the interaction model of client behavior, was to determine (a) if there is relationship between PPC during the healthcare encounter to health literacy among Black adults …

Optimizing Workflow And Patient Outcomes: The Impact Of The Modified Adult Difficult Intravenous Access (A-Diva) Scale On Peripheral Iv Access: A Quality Improvement Project, Dakota S. Weaver, Ryan O'Sullivan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Peripheral intravenous cannulation (PIVC) is one of the most performed invasive procedures in hospital settings, yet it is frequently associated with multiple attempts in patients with difficult intravenous access (DIVA). In obstetric (OB) triage settings, where time-sensitive care is critical, failed PIVC attempts can delay treatment and negatively affect patient experience. The Modified Adult Difficult Intravenous Access (A-DIVA) scale is a validated tool designed to identify patients at risk for DIVA and guide early use of advanced techniques such as ultrasound (US) guidance.

A QI initiative was implemented in the OB triage unit of a large academic hospital. The tool …

Change For The Use Of Phenobarbital In Severe Alcohol Withdrawal Syndrome, Rylee J. Studiner

Walden Dissertations and Doctoral Studies

Alcohol withdrawal syndrome (AWS) is a critical condition commonly encountered in hospital settings. If not properly treated, AWS can progress to seizures, delirium tremens, and death. Traditionally, benzodiazepines guided by the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar), have served as a mainstay of treatment. However, emerging evidence supports the use of phenobarbital as a pharmacologic alternative and the Severity of Ethanol Withdrawal Scale (SEWS) as a more objective and clinically practical assessment tool. This doctor of nursing practice (DNP) project aimed to develop an evidence-based clinical practice guideline (CPG) for the use of phenobarbital in managing severe …

Staff Education On Suicidal Screening In Young African American Male Adults With Bipolar Disorders, Tokunbo Ndidi Allen

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice education project aimed to enhance mental health providers’ preparedness in culturally competent suicide screening, specifically for African American males with bipolar disorder in a behavioral health department. The practice issue identified was a lack of documented training, leading to underdiagnosis, missed interventions, and health disparities driven by cultural stigma, provider discomfort, and the absence of standardized guidelines. This represents a serious patient safety concern for African American males with mood disorders, such as bipolar, who are significantly underserved in mental health care. The guiding question was: Does a suicide screening education program improve the knowledge …

Implementation Of Patient-Centered Approaches To Enhance Engagement And Satisfaction In Psychiatric Care Within A Family Mental Health Service, Nnenna Attah

Walden Dissertations and Doctoral Studies

Summary I conducted this evaluation of a quality improvement initiative at a family mental health service center aimed to enhance patient engagement and satisfaction in psychiatric care through patient-centered approaches. The practice problem addressed in this project was the lack of patient engagement and satisfaction. This issue is critical to address within the context of nursing practice because patient-centered care is fundamental to improving clinical outcomes, patient satisfaction, and overall quality of care. The practice-focused question was: How can patient-centered approaches enhance patient engagement and satisfaction in psychiatric care? In the project, I focused on evaluating the impact of patient-centered …

Enhancing Interprofessional Competence Among Speech Pathology, Nursing, Social Work, And Psychology Students Using Simulated Case Presentations, Elizabeth Oommen, Emily Helder, Kayla Johnson, Stacia L. Hoeksema, Laura Schipper

University Faculty Publications and Creative Works

Background: This study assesses the impact of an Interprofessional Education (IPE) program (which included simulated case presentations), on the perceived competence and quality of interprofessional (IP) work products of undergraduate social work, nursing, psychology students, and graduate students in speech-language pathology.

Methods: Participants included 123 students who participated in IP colloquiums through reviewing clinical cases, developing IP assessment and treatment goals, and presenting these to fellow students and faculty. Pre- and post-testing using IPEC Competency Self-Assessment Tool was used for assessment. For each colloquium, the students from all disciplines also submitted a single worksheet for their assigned case, …

Improving Student Success In 2nd Degree Bsn Students, Sharon Radzyminski, Eloisa G. Tamez, Jennifer Brewster, Leslie Kimberling Jones

School of Nursing Faculty Publications

Second Degree Bachelor of Science in Nursing (BSN) programs are designed to leverage a student’s prior academic achievements and professional experience, integrating them into the curriculum for their nursing degree. This allows students to receive credit for previous core courses and move through the nursing program at an accelerated rate. This, however, brings special challenges for both students and faculty. At our university we noticed the attrition rate of students in the second-degree BSN program was significantly higher than the traditional BSN program. Investigation into this issue revealed students in the Second-Degree Program had significant issues with role conflict, poor …

Antidepressant Medication Nonadherence In Adult Patients With A Major Depressive Disorder, Sandrine Djou Kaze

Walden Dissertations and Doctoral Studies

The chosen approach for the Doctor of Nursing Practice (DNP) project was a clinical practice guideline (CPG) on interventions to improve antidepressant medication adherence in adults diagnosed with depression in an outpatient setting. The consequences of medication nonadherence in patients with depression are devastating for individuals and the healthcare system. Therefore, addressing it within nursing practice is essential to improve treatment efficacy and patient outcomes. The practice question related to the DNP project was to determine whether the CPG could improve antidepressant medication compliance in adults diagnosed with a depressive disorder in an outpatient setting. I aimed to develop a …

An Educational Intervention Focused On Identifying Adverse Childhood Experiences, Laconia Bacon

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) refer to traumatic childhood experiences that individuals may have been exposed to during their youth, such as child maltreatment, domestic violence, or interparental violence. Research has demonstrated that experiencing ACEs in childhood may result in physical and mental illnesses that led to dangerous lifestyle patterns in adulthood. In the local organization, several patients with ACEs presented in the emergency department (ED). The nurses, unaware of ACEs, were unable to detect and respond to the consequences of ACEs. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine whether an educational intervention focused …

Conceptual Model And Design Of An Initiative To Build Nurses’ Resilience And Ethical Practice, Cynda Hylton Rushton, Sandra M. Swoboda, Nancy Reller, Laura C. Sarver, Erin M. Wright, Krysia Warren Hudson, Robie Victoria Hughes, Ginger C. Hanson, Rita D’Aoust

College of Nursing Faculty Papers & Presentations

Background: Healthcare faces a nursing crisis with high turnover, burnout, and faculty shortages, which requires innovative educational approaches that bridge the gap between education and practice. Purpose: To present the conceptual model and design of a statewide, trans-institutional academic-practice collaboration that holistically builds nurses' resilience and ethical practice across the education-to-practice continuum. Method: Development of the Renewal, Resilience, and Retention (R³) Initiative based on adaptation of the Mindful Ethical Practice and Resilience Academy (MEPRA), social ecological framework, and stakeholder input across eight schools of nursing and five hospitals in Maryland. Results: The R³ Initiative created a scalable …

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

Using Exercise To Treat Anxiety In Adult Patients With Addiction, Emmanuella N. Nnadozie

Walden Dissertations and Doctoral Studies

Summary In this Doctor of Nursing Practice (DNP) project, I selected a staff education as the best intervention to improve staff knowledge in using exercise to treat anxiety disorders in adult patients at a recovery clinic for addiction. Anxiety disorders are highly prevalent among individuals undergoing substance abuse treatment, often exacerbating withdrawal symptoms and increasing relapse risks; thus, integrating the use of exercise in addition to existing standard care for anxiety treatment in individuals with substance use disorder (SUD) will lead to decreased anxiety, decreased alcohol use and drug cravings, improved quality of life and affect, increased abstinence, and improve …

Enhancing Social Determinants Of Health Education In Home Health Care Including Social Determinants Of Health In Assessments And Care Plans For Home Health Clinicians, Emilia Mbanwite

Walden Dissertations and Doctoral Studies

This staff education-focused doctor of nursing practice (DNP) project addressed the critical practice problem of one southern health care facility staff’s knowledge on the integration of social determinants of health (SDOH) into home health care plans. Despite SDOH screening, clinicians lacked standardized training to effectively assess and intervene on factors such as housing, transportation, and food insecurity, contributing to preventable hospitalizations, particularly in vulnerable populations. The practice-focused question addressed whether an evidence-based education module could improve home health nurses’ knowledge and application of SDOH in assessments and care plans. The project’s purpose was to develop, implement, and evaluate this training …

Targeted Depression Screening For At-Risk High School Students: An Integrated Review, Joseph Calub

DNP Qualifying Manuscripts

Depression in high school students is underrecognized because symptoms can present not only as mood issues but also behavioral or academic problems. This integrated review examined literature from 2010-2015 using PsycInfo, ERIC, CINAHL, and PubMed to evaluate the effectiveness of targeted depression screening for students referred for behavioral, academic, or social concerns. Studies meeting inclusion criteria assessed targeted or clinically referred screening methods, with a focus on validated tools such as the Patient Health Questionnaire modified for Adolescents (PHQ-A). Findings indicate that targeted screening effectively identifies depressive symptoms in at-risk students and is more feasible in resource-limited schools than universal …

Improving Diabetes Management Through Evidence-Based Educational Resources In A Federally Qualified Health Center, Linda F. Dunbar

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to implement updated culturally tailored diabetes education materials, conduct staff training sessions, and promote consistent documentation of hemoglobin A1c values and adherence to evidence-based guidelines, aligned with current American Diabetes Association (ADA) standards of care. These interventions aimed to reduce the percentage of adults with HbA1c levels greater than 9%.

Background

The project was implemented at a Federally Qualified Health Center (FQHC) in a rural community of Tomball, Texas. The patient population is 73% Hispanic/Latino, who primarily speak Spanish, and are disproportionately affected by diabetes.

Methodology

The project was implemented using the …

An Integrated Literature Review Examining Nurse Burnout Interventions, Wislande Joseph

DNP Qualifying Manuscripts

Nurse burnout has detrimental consequences for patients, nurses, and organizations and can negatively impact patient outcomes, nurse quality of life, and organizational costs. This integrated literature review aimed to examine interventions for nurse burnout in order to identify what characterizes effective interventions, whether evidence supports implementing such interventions, and how the most commonly-implemented intervention type (mindfulness-based) in particular impacts signs and symptoms of nurse burnout. A two-part search was conducted of CINAHL, PubMed, Google Scholar, and APA PsychInfo. Part one investigated burnout interventions broadly using the primary search terms nurse burnout and interventions; part two focused specifically on mindfulness-based interventions …