Nursing Commons^™

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 …

Implementation Of Mindfulness-Based Interventions And Weekly Visits To Reduce Loneliness In Older Adults, Victoria E. Cobb

Dissertations

Implementation of Mindfulness-Based Interventions and Weekly Visits to Reduce Loneliness in Older Adults

Abstract:

Problem: Social isolation and loneliness have emerged as a significant public health issue for the older adult population. Loneliness has been linked to both physical and mental health effects. According to current literature, there is no standard intervention to treat loneliness in the older adult population.

Methods: This quality improvement (QI) project utilized a descriptive cohort design and the Visit-A-Bit screening assessment instrument. Undergraduate nursing students implemented mindfulness interventions during weekly visits over an eight-week period at an independent living facility located in the Midwest. Descriptive …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Race-Neutral Pft: Implementing Patient Activation Measure Following Race- Neutral Pulmonary Function Testing, Ann M. Way

Dissertations

Abstract

Background

The introduction of a race-neutral equation to predict normal values on pulmonary function testing (PFT) has led to changes in the diagnosis of pulmonary diseases previously diagnosed using a race specific equation. Minority patients appear to be most likely impacted by this change, potentially impacting how they self-manage their pulmonary health. Patient self-management can be measured and assessed by using the Patient Activation Measure (PAM) tool.

Purpose

The purpose of this project is to assess patient activation levels amongst minority patients with a new or changed pulmonary diagnosis to identify a possible need for interventions to improve patient …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

The Psychological Impact Of Parenting Child Victims Of Trauma, Stephanie Faulkingham

Dissertations

Abstract

Research indicates that non-offending caregivers of traumatized children (NOC) is a population with an elevated risk for increased levels of depression and anxiety and are an underserved population for mental health services. The purpose of this quality improvement project was to determine if screening caregivers of traumatized children using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) improves identification of depression and anxiety. Participants of this investigation were individuals enrolled in the Children’s Advocacy Services of Greater St. Louis’ 12-week parenting group, TASK (Trauma, Assessment, Skills, and Knowledge). Each participant was asked to complete the PHQ-8 and …

Depression Screening In The Adult Inpatient Oncology Population, Erica Bizub

Dissertations

Routinely screening oncology patients for depression is recommended due to the higher rates of depression in this population as well as the negative impact of untreated depression. The goal of this QI project is to implement a standard depression screening protocol for patients admitted to this hospital, where there is currently no standard screening protocol. There were 110 patients included in this study, and 67 (60.91%) of patients received a PHQ-9 screening. Of the patients who completed the PHQ-9, 21 (19.09%) had a positive screening, which was a score of seven or higher. While there were high rates of provider …

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …

Screen Foundations: How Pediatric Nurse Practitioners Can Implement ‘Family Media Use Plans’ In Primary Care To Reduce Pediatric Behavior Concerns, Katie Anderson

Dissertations

Abstract for:

Screen Foundations: How Pediatric Nurse Practitioners Can Implement ‘Family Media Use Plans’ in Primary Care to Reduce Pediatric Behavior Concerns

Problem: Parents of children 2-5 years-old increasingly reach out to PCPs for escalating behavior concerns, including when the child doesn’t listen well, is inattentive, having tantrums, meltdowns, hitting, yelling, etc. Referrals to psychiatry and/or play therapy result in long waits, or referrals not accepted. Coincidingly, toddler and preschool aged children continue to exceed daily screen time recommendations. This results in a gap of care for families with young children and externalizing behavior.

Methods: This quality improvement project addressed …

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …

Promoting Pre-Exposure Prophylaxis (Prep) Regimen Adherence Through A Multifaceted Approach To Increase Adherence: A Quality Improvement Project, Queen C. Ezenwome

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to implement the use of daily text message reminders to promote PrEP medication regimen adherence, thereby reducing the risk of HIV acquisition in an at-risk population. Patient interviews and surveys were also conducted to obtain valuable information regarding barriers and facilitators to PrEP regimen adherence.

Background

The project was implemented at a homeless shelter in Harris County, Houston, Texas, that houses homeless youth ages 18-24 while also providing medical, educational, and financial services or assistance. Due to risky behaviors prevalent in this population, coupled with living in the Houston area, these patients …

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

Impact Of Primary Care Healthcare Providers Patient Electronic Medical Records Completion Rates Using Speech Recognition Dictation, Pepper Losely

Student Scholarly Projects

Practice Problem: Completion of electronic medical records (EMRs) is an ongoing problem for providers, facilities, and insurance reimbursement. Current completion of EMRs lack standardized processes to make EMRs completion easier for providers with their busy workday and allow optimal time for patient care.

PICOT: For healthcare providers at primary clinics (P) will implementing speech recognition dictation (SRD) for data entry into the electronic medical records (EMRs) (I) compared to the current practice of manually typing all data causing long medical record turnaround times (c) improve medical record completion within 30 days (O) over 10-weeks (T).

Evidence: Evidence that was …

Cultural Humility, Holistic Admission Review, And Multicultural Experiences Among Newly Admitted Nursing Students, Janna Michelle Hackett

Nursing ETDs

This study explored the impact of Holistic Admissions Review (HAR) on demographic characteristics, multicultural experiences, and cultural humility (CH) levels among newly admitted pre-licensure nursing students. Fostering CH and diversity among healthcare providers may help reduce health disparities. Traditional admissions methods may not identify candidates with traits supporting CH development, whereas HAR considers diverse backgrounds and experiences. Two groups were surveyed: one admitted through HAR and the other through traditional methods. No significant differences in CH scores were found, but significant differences were found in age, living abroad, and volunteering with diverse populations. Students admitted through HAR were younger and …

The Healthcare Workforce In Nevada, 2024, Olivia K. Cheche, William E. Brown Jr., Caitlin J. Saladino

Health

This fact sheet presents data on the healthcare workforce in Nevada. The U.S. Bureau of Labor Statistics’ Occupational Employment and Wage Statistics Query System provides data on the amount of employment in all job sectors at the state and metropolitan statistical area (MSA) levels. This fact sheet focuses on employment and wage data for the State of Nevada, the Las Vegas-Henderson-Paradise, NV MSA, and the Reno, NV MSA as of May 2024.

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 …

Nurse Leader Onboarding, Jennifer Dawn Mcinerney

Walden Dissertations and Doctoral Studies

he objective of this Doctor of Nursing Practice project was to investigate the impact of a structured 30-60-90-day onboarding program, incorporating a competency-based checklist aligned with the American Organization for Nursing Leadership (AONL) nurse leader competencies, on nurse leader satisfaction. Nurse leaders, often promoted for their clinical skills, frequently lack the necessary support and training for their new roles, leading to high turnover rates. This project aimed to address this gap by developing and implementing a nurse leader education module, which was introduced to 23 nurse leaders over four sessions. A pre-/posttest survey was used to measure changes in satisfaction …

Impact Of A Mentorship Program On School Nurse Confidence, Shanna Groom

Doctor of Nursing Practice Projects

The prevalence of chronic health conditions in children has risen in recent years. As a result, school nurses are now expected to manage medically fragile students while also responding to acute and emergent health issues. This increasing complexity adds extra demands to school nurses, emphasizing the need for strong clinical decision-making skills and confidence. Mentorship programs have been proven to increase the confidence of nurses and are a core essential of the national standards and framework for school nurses. The problems addressed by this project were the lack of a mentorship program in a large school district for newly hired …

Use Of An Electronic Medication Management Application To Support Pharmacists Review To Optimise Medicines In Residential Aged Care (Prompt-Rc): A Study Protocol For A Parallel Cluster Randomised Controlled Trial, Amy Theresa Page, Dee Mangin, Hend Almutairi, Esa Y.H. Chen, Kenneth Lee, Nagham Ailabouni, Jacinta Johnson, Kathleen Potter, Nahal Mavaddat, Rhonda Marise Clifford, Elton Lobo, Loretta Baldassar, Liza Seubert, Dennis Petrie, Kate Wang, Sarah Hosking, Jenny Tasker, Christopher Etherton-Beer

Research outputs 2022 to 2026

Introduction Most older adults living in residential aged care facilities (RACFs) have at least one marker of potentially suboptimal prescribing. Pharmacists play a crucial role in medication management, with their effectiveness enhanced by using computerised decision support tools. The Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC) study aims to optimise medicine use by providing pharmacists in RACFs with an electronic medicine management app with integrated decision support (AusTAPER App/Pathway) to use as part of medication reviews they undertake. Methods and analysis The PROMPT-RC study is a parallel cluster randomised controlled trial design involving Australian RACFs. It will …