Nursing Commons^™

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Quality Improvement Project The Impact Of Weekly Reminders On Clinician Adherence To Standardized Order Sets, Blair Robillard

Doctor of Nursing Practice Projects

Clinical decision support tools are commonly utilized in clinical practice to assist with decision making and encourage use of evidence-based practices. This quality improvement (QI) project addressed the problem of inconsistent use of CDS tools in clinical practice. Specifically, this QI project addressed suboptimal adherence to standardized order sets (SOS) for congestive heart failure (CHF) treatment by hospitalist providers in an inpatient setting. The purpose of this QI project was to evaluate the impact of weekly educational reminder emails, known as nudges, on CHF SOS utilization over six weeks. A pre- and post-intervention design compared SOS usage rates before and …

Impact Of Nursing Burnout On Preceptors During The Transition Phase Of New Graduates Into The Workforce, Janessa Truss

Doctor of Nursing Practice Projects

There is a massive threat to healthcare systems posed by the growing burnout of inexperienced RNs working in practice transition to new graduate preceptors. Currently, this "Doctor of Nursing Practice (DNP) project" examines the role of the nurse in burnout within Long Term Acute Care (LTAC) facilities through the preceptorship. In the project, burnout factors and their effects on patient care and nursing workforce retention will be investigated, and interventions for burnout and its effects will develop. A mixed methods project involving qualitative and survey and interview analyses of five-year and older patients was performed. Burnout and job satisfaction were …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

Men’S Preconception Health: Impact On Pregnancy And Awareness Strategies., Kara I. Carr

Honors Capstones

Men’s preconception health plays a critical role in pregnancy outcomes, but it continues to be overlooked in healthcare education. While women are routinely counseled by OBGYN providers on how nutrition, lifestyle, and chronic conditions can affect fertility, men often receive little to no guidance from their primary care providers. This project uses a literature review to look deeper into how limited awareness and involvement in men’s preconception health may impact pregnancy and infant health outcomes. The gap is linked to cultural norms, healthcare practices, and the lack of clear resources for men. This research aims to develop strategies that promote …

Unlicensed Assistive Personnel’S Attitudes, Knowledge, And Perceptions Of Alternatives To The Application Of Physical Restraints, Gale Marie Knight

Walden Dissertations and Doctoral Studies

The use of physical restraints in mental health care settings is a common practice, yet it poses significant risks to patients’ physical and psychological well-being. The issue of excessive restraint use was addressed through this doctoral project by designing an educational program aimed at promoting alternative strategies. The practice-focused question was: How can an educational program for unlicensed assistive personnel (UAP) impact their knowledge and attitudes towards alternatives to physical restraints? The purpose of the project was to develop and evaluate an education program to improve UAP knowledge and attitudes to reduce reliance on physical restraints. The project was informed …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

An Educational Intervention Focused On The Importance Of Nurse Leader Rounds, Shantelle Mobley

Walden Dissertations and Doctoral Studies

Nurse leader rounding (NLR) is essential in most healthcare organizations as NLR has been associated with improved nurse recruitment and retention, increased patient satisfaction, and increased quality of care. In the local organization, leadership identified that there was a lack of knowledge and awareness of NLR among nurse managers and charge nurses. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an education intervention focused on structured NLR increased knowledge and awareness among charge nurses and nurse managers. Thirty-seven individuals were invited to participate in the educational intervention. With the support of leadership, 34 …

Enhancing Dermatologic Education In A Family Nurse Practitioner Program: A Quality Improvement Project That Promotes Skin Assessment Competency In Diverse Populations, Solonge Schiavone

DNP Projects

Background: Dermatologic education in Nurse Practitioner (NP) programs often lacks adequate representation of skin conditions in patients with darker skin tones, contributing to diagnostic disparities and delayed treatment. This quality improvement (QI) project aimed to integrate culturally competent dermatologic content into the Primary Care I course at Sacred Heart University to enhance diagnostic accuracy and student confidence.

Purpose: The primary goals were to improve NP students’ knowledge and confidence in diagnosing dermatologic conditions across diverse skin tones and to evaluate the effectiveness of an educational intervention using pre- and post-intervention assessments.

Methods: The project utilized the Six Sigma DMAIC framework. …

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie R. Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Policy Brief: The Nurse Practitioner Modernization Act, Ryleigh Hancock

Fisher Showcase 2025

This is a Policy Brief on why The Nurse Practitioner Modernization Act should be implemented and what actions need to be taken. This was a course assignment in my Healthcare Systems, Policy, and Law class but the primary audience would theoretically be policymakers.

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

The Psychological Effects Of Domestic Violence And Nurse's Role, Cindy Tran

Honors Capstones

This research highlights the significance of domestic violence and how the detrimental effects on psychological health can lead to negative coping mechanisms and severe injuries that lead to death if unaddressed. Healthcare professionals and healthcare facilities have a significant role in treating and identifying domestic violence victims. This research seeks to answer the question,“Do individuals who experience domestic violence abuse have an increased risk of developing negative psychological health concerns and what is the nurse’s role in the care for these victims?” Through a review of literature accessed through databases such as EBSCO and PubMed, there is evidence that domestic …

Clinical Practice Guideline For Patient Education On Indwelling Catheters In The Home, Lyndsy Bolstad

Walden Dissertations and Doctoral Studies

Home healthcare agencies transition patients from the hospital to the home where caregivers may assist in providing care for indwelling Foley catheters. About half of urinary tract infections are in the presence of an indwelling catheter. The agency for which this Doctor of Nursing Practice project was developed does not have an evidence-based clinical practice patient education guideline (CPPEG) for the care of the indwelling catheter to prevent infection. The practice-focused questions were: (a) What evidence-based literature supports the development of a CPPEG for patient education on the care of the Foley catheter in the home and (b) Will the …

Organization Change Process Initiative Recurrent Emergency Room Visits By Mental Health And Substance Use Patients, Julie Marie Tucker

Walden Dissertations and Doctoral Studies

The rising rates of patients diagnosed with mental health and substance use disorders (MHSUD) signify a critical national crisis, worsened by the COVID-19 pandemic, as reported by the United States Department of Health and Human Services. This increase has reduced access to essential resources and treatment options, resulting in overcrowded emergency rooms (ER) and extended wait times. Addressing these issues is vital for nursing practice, as they significantly influence patient care and health outcomes, especially for vulnerable populations. This doctoral project explores whether an organizational change designed to raise awareness of updated community resources impacts MHSUD patient visits to the …

Factors Associated With Quality Of Intrapartum Care In Kenya: A Complex Samples Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Earnest Amwiine, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Angella Namulema, Ahmed Sarki, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background

The provision of quality intrapartum care increases women’s utilization of skilled birth attendants in health facilities and improves maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS).

Methods

Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Based on literature and the availability of indicators within the 2022 KDHS, the quality of intrapartum care was operationalized as receiving all the three clinical components of intrapartum care including a mother having a facility-based …