Improving Social Drivers Of Health Screening In An Inpatient Setting For Sdoh Data, John P. Lussier

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose

Title of the Project: Improving Social Drivers of Health Screening in an Inpatient Setting for SDoH Data

Purpose: This evidence-based practice project aimed to increase social drivers of health (SDoH) screening compliance by redesigning the workflow to distribute responsibility between nursing and case management, ultimately improving identification and referral of patients with supportive service needs.

Background: Screening for SDoH needs facilitates the provision of appropriate supportive services. The existing workflow required nurses to conduct initial screening in five domains (Housing Stability, Utility Difficulties, Food Insecurity, Interpersonal Safety, and Transportation Needs), with positive responses triggering additional investigative questions. These …

Crisis Without Cops: Trauma-Informed Mental Health Care For Bipoc Communities, Amanda Carson

Doctor of Nursing Practice Final Manuscripts

This policy paper advocates for a structural transformation in mental health crisis response, moving beyond police-led interventions toward trauma-informed, community-rooted models grounded in public health and equity. Drawing on Critical Race Theory (CRT), neuroscience, and program evaluations of models like CAHOOTS, 988, Denver’s STAR, and Durham’s HEART, it examines how systemic racism, institutional mistrust, and implicit bias contribute to disproportionate harm for BIPOC individuals. The paper highlights the effectiveness of peer-led, culturally responsive alternatives that reduce force, hospitalization, and disengagement from care. Using Kingdon’s Multiple Streams Framework, it proposes actionable, scalable policy strategies supported by recent federal momentum, including the …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementation Of A Tracheostomy Discharge Education Class For Nicu Nurses, Todd N. Chamoy

Doctor of Nursing Practice Final Manuscripts

Infants who are ventilator-dependent or have anatomic anomalies of their airway frequently require tracheostomy placement prior to discharge from the hospital in order to be cared for safely at home. At this large quaternary children’s hospital in Southern California, preparing these infants for discharge after tracheostomy placement has not been the role of the NICU nurse. There was no system in place on how to train caregivers, and the NICU staff felt unprepared. Evidence supports use of intensive educational programs to improve nurse knowledge and skills of tracheostomy care, allowing NICU nurses to provide improved care and pre-discharge teaching.

A …

Suprathel Burn Dressing Versus Standard Care: Impact On Hospitalization Duration And Post- Discharge Outpatient Visits, Isaac Awolola

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project is to determine the effectiveness of Suprathel a synthetic, one-time application, wound dressing that acts as a temporary skin substitute, particularly effective for partial-thickness burns and deep dermal burns vs, the standard of either Polysporin or Santyl, Xeroform, gauze on the frequency of outpatient (OP) visits after a patient’s discharge. A secondary aim of this project was to investigate whether Suprathel burn dressing significantly decreases the length of stay (LOS) for patients with second-degree burns involving < 20% total body surface area (TBSA). The results showed that the use of Suprathel dressings resulted in a shorter hospital stay 7.05 vs 9.35 days with a higher number of outpatient visits 5.47 vs 2.69 visits, compared to conventional dressings. The use of Suprathel dressings as a standard practice reduces inpatient hospitalization but increases outpatient visits and resource utilization. The use of Suprathel dressings shortens the length of hospitalization and may augment patient comfort, and decrease overall healthcare costs associated with hospitalization. Due to the reduction in need for painful daily dressing changes, Suprathel dressings constitute a potentially preferred option in burn care and could thereby influence treatment protocols and enhance patient outcomes.

Keywords: Wound care, Suprathel dressing, total body surface area, Outpatient Visits, Second-degree Burn, Length of stay, Gauze

Implementation Of One Key Question® Screening Tool To Increase Reproductive Life Planning At A Community Health Clinic, Laura D. Adams

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.

Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Implementing The Fib-4 Tool For Liver Fibrosis Screening In Diabetic Patients In Primary Care, Robert I. Montillano

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-non-alcoholic fatty liver disease (NAFLD), affects over 1 in 3 adults with type 2 diabetes mellitus (T2DM) and is a leading cause of advanced liver fibrosis. Despite guideline support from the American Diabetes Association (ADA) and American Association for the Study of Liver Diseases (AASLD), screening practices remain inconsistent in primary care. The Fibrosis-4 (FIB-4) index is a validated, low-cost, noninvasive tool for fibrosis risk stratification, yet it remains underutilized despite its availability in many electronic health record (EHR) systems.

Purpose: This Doctor of Nursing Practice (DNP) evidence-based practice (EBP) project …

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …

Nurse-Led Medication Reconciliation Protocol In The Adult Outpatient Mental Health Setting, Grace Gu

Doctor of Nursing Practice Final Project Abstract

This scholarly project implemented a medication reconciliation protocol within the adult outpatient mental health clinic setting. The protocol aimed to increase the medication reconciliation rate from 55% to 60% within three months by May 2025, as well as improve the perception of medication reconciliation among nursing staff. The project was implemented within an outpatient mental health clinic, part of a local community mental health center in Austin, Texas. Patients often see multiple healthcare providers, leading to risks of polypharmacy. This can lead to adverse reactions, medication interactions, and hospitalizations. A flowsheet protocol was created to help guide nursing staff on …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

Electronic Medical Record Clinical Decision Support Across The Ob Continuum Of Care: Enhancing Doula Education And Usage, Jonese D. Randall

Doctor of Nursing Practice Final Manuscripts

Background: The United States is seeing an uptick in maternal deaths by 159% since 2019, with maternal mortality higher with cesarean procedures (Hoyert, 2020; Riches et al., 2024[LC1] ). UC San Diego Health NTSV C-Section rates between September 2024 – October 2024 ranged between 22-54%, well above the benchmark of 23.4% in California (Slone, n.d.). Doulas are trained to care for the mother before, during, and after birth by being an advocate, providing physical and emotional support, and being a continuous support person (Dekker, 2017). Doulas have been shown to improve birthing outcomes by providing these support mechanisms, particularly …

Increase Knowledge And Competency Of Point Of Care Ultrasound (Pocus) Among Emergency Nurse Practitioner Students Incorporating Web-Based Videos And Clinical Benchmarks., Andrew N. Walsh

Doctor of Nursing Practice Final Manuscripts

Background: Point of care ultrasound (POCUS) is a critical skill in Emergency Medicine (EM), and Emergency Nurse Practitioner (ENP) students are increasingly expected to demonstrate proficiency. ENP students often face limited opportunities for hands-on practice compared to EM residents. Research suggests that the didactic component of POCUS training delivered through e-learning is as effective as in-person instruction. The American College of Emergency Physicians (ACEP) supports the flipped classroom model, which maximizes simulation time and focuses on psychomotor skills and clinical application, allowing didactic portions to be delivered online. Additionally, ACEP recommends a benchmark of at least 25 POCUS examinations to …

Parent’S Health Literacy And Stress Level In The Inpatient Pediatric Setting, Tina C. Smith

Dissertations

Purpose: This study examined the relationship between parent health literacy and stress levels during their child’s inpatient hospitalization.

Background: In 2019, over five million pediatric hospitalizations occurred in the United States. Parents are central to their child’s care, but stress and sociodemographic factors may hinder their ability to understand and apply health information. This study explored how stress and other variables impact parent health literacy during hospitalization.

Methods: A cross-sectional design included a demographic survey, the Perceived Stress Scale (PSS-10), and the Newest Vital Sign (NVS). Bivariate analyses (Chi-square, t-tests) and logistic regression were used to assess …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

The Perceived Effectivenss Of Nurses' Suicide Management Training In Correctional Facilities: A Phenomenological Study, Phillis Hopson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the perceived effectiveness of nurses' suicide management training in correctional facilities in the United States. The central research question was: What suicidal educational training do nurses receive, and what is their lived experience of managing suicidal inmates at correctional facilities? The type of research design for this study was hermeneutic phenomenology. This study's geographic setting was two correctional facilities in rural areas in the United States. The settings include the Federal Mental Correctional Facility (FMCF) and the Villian Mental Correctional Facility (VMCF). The Federal Mental Correctional Facility is situated in the …

Evidence Based Orientation And Mentorship: A Solution To Decreased Job Satisfaction And Performance Amongst Healthcare Techs In The Emergency Department, Paige E. Fleming

Doctoral Dissertations and Projects

Healthcare technician support in high-volume emergency departments (EDs) is often inadequate, leading to challenges in job satisfaction, confidence, and competence. This project implemented an evidence-based orientation and mentorship program to enhance these factors among healthcare techs. Using a nonrandomized before-after design, participants underwent structured mentorship and orientation, with outcomes measured through pre- and post-intervention surveys, competency assessments, and feedback forms. Data analysis employed descriptive and inferential statistics to evaluate changes in job satisfaction, confidence, and competence. Results demonstrated measurable improvements in all three areas, supporting the effectiveness of structured mentorship in professional development and retention.

Enhancing Access To Medication-Assisted Treatment (Mat) For Minority Inmates In The San Diego Prison System: A Quality Improvement Through Culturally Competent Approach, Douglas Seangmany

Doctor of Nursing Practice (DNP) Projects

Abstract

Background The opioid crisis disproportionately affects racial and ethnic minority groups, particularly in correctional settings. In San Diego’s prison system, only 20% of incarcerated individuals with Opioid Use Disorder (OUD) receive Medication-Assisted Treatment (MAT), highlighting significant care disparities.

Local Problem Limited access to MAT among minority inmates contributes to poorer health outcomes, higher overdose rates, and increased healthcare costs. Addressing these disparities is crucial for improving health equity within the prison system.

Methods A review of 10 studies emphasized the importance of culturally competent care in improving treatment engagement and outcomes among minority populations. To address disparities, the intervention …

Staff Education On Physical Activity As A Therapeutic Option For Anxiety And Depression, Suja Paul

Walden Dissertations and Doctoral Studies

This project’s aim was to educate staff on physical activity (PA) as a therapeutic option for anxiety and depression to relieve psychotic symptoms, enhancing patients’ quality of life. PA enhances cognitive functioning, reduces anxiety and depression, and decreases the risk of cardiovascular conditions and early death. Patients with severe mental illnesses face barriers to PA and exercise, so providers and policymakers must create an environment that encourages participation. A knowledge gap for staff exists in promoting PA in mental health patients. Healthcare professionals should recommend the right amount of PA for each patient. This initiative aims to increase staff confidence …

Clinical Practice Patient Education Guideline For Patients With Substance Use Disorders, Josephine Nandzo

Walden Dissertations and Doctoral Studies

The Veteran’s hospital for which this DNP clinical practice patient education guideline (CPPEG) was developed has made strides in addressing the needs of patients with substance use disorders (SUDs). However, the problem identified for this project was the need for veterans with SUDs to obtain information about resources available in the hospital, community, or state to manage their recovery. The project question was as follows: Will a CPPEG on resources for patients with SUDs meet the optimal threshold of 7 on the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument? The purpose was to plan, implement, and evaluate …