Nursing Commons^™

Executive Summary: Quality Improvement Initiative Retrospective Program Evaluation Of Sms Reminder System In Decreasing Outpatient Mental Health Clinic No-Show Rates, Jordan Rogers

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project presents an organizational quality improvement initiative implementing a text message reminder system to decrease appointment no-show rates in the outpatient mental health clinic. The project was developed based on the high rate of appointment no-shows at the DNP project site. Appointment no-shows are costly to both clinics and patients. Clinics experience decreased revenue and efficiency, and patient outcomes can be compromised. The project evaluated whether text message reminders sent 24 hours before a scheduled appointment time decreased no-show rates by at least 10%. Preimplementation data were collected for months October, November, and December, …

The Impact Of Marijuana Edibles On Fetal Development In Pregnant Adolescents And Young Mothers, Rachel Doyle

Honors Theses

With the growing prevalence of marijuana use for both recreational and medicinal purposes, this study explores the impact of edible cannabis consumption on fetal development in pregnant adolescents and young mothers. While most existing research focuses on smoked cannabis in adult populations, this review highlights a significant gap regarding the unique risks of edibles among younger, vulnerable users who may perceive them as safer. Through a comprehensive literature review, the study examines the physiological effects of THC in edible form, as well as the social, economic, and healthcare factors influencing its use. Key areas of focus include maternal health, placental …

Enhancing Provider Knowledge With Phq-9 Education, Laurette Abunaw

Walden Dissertations and Doctoral Studies

Depression represents a significant public health concern that often remains undiagnosed or untreated, primarily due to insufficient systematic screening in primary care settings. The lack of standardized screening tools such as the Patient Health Questionnaire-9 (PHQ-9) elevates patient risks, increasing symptom severity, increasing suicide rates, and delaying interventions. Research studies show that a significant number of individuals with depression go untreated for long durations, with primary care settings recognizing only a small percentage of cases. The PHQ-9 is an effective tool for assessing and monitoring depression in a primary care setting, leading to early detection of symptom severity. Clinical practice …

Implementing A Standardized Colorectal Cancer Screening Protocol To Enhance Screening Rates In A Primary Care Setting, Sam Terranova

Doctoral Dissertations & Projects

Colorectal cancer (CRC) is a significant health concern in the United States, ranking third in incidence and mortality among all cancers. Despite established screening guidelines, adherence often falls short in primary care settings. This quality improvement project aimed to enhance CRC screening rates in a Midwest primary care practice through implementation of a standardized screening protocol. The intervention was two-fold and consisted of the routine ordering of fecal immunochemical test (FIT) kits to eligible patients and the use of electronic health record (EHR)-based patient reminders. Screening completion rates were monitored over a four-month period and compared to pre-intervention rates from …

Milk Is Medicine: Early Exposure To Mother's Milk With Oral Immune Therapy, Kristina N. Tucker

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to improve early Oral Immune Therapy (OIT) initiation by implementing a nursing intervention bundle for infants weighing less than 1500 grams at birth.

BACKGROUND Premature infants face nutritional challenges due to immature digestive systems and delayed oral feeding. Drops of maternal breast milk in the buccal mucosa as OIT expose infants to immune factors, positively impacting their microbiome, supports immune function and enhances health outcomes for very low birth weight (VLBW) infants.

METHODOLOGY Using the Institute for Healthcare Improvement (IHI) Model for Improvement with a multi-disciplinary team, interventions included provision of a colostrum …

Patient Satisfaction With Telehealth To Access Psychiatric Health Services In Rural Outpatient Psychiatric Health Settings: A Project Proposal, Chimezie C. Onuchukwu

Doctor of Nursing Practice Scholarly Projects

Abstract

Telehealth competencies of the National Organization of Nurse Practitioner Faculties for Advanced Practice Registered Nurses (APRN) are fundamental in psychiatric health management. This project examined patient satisfaction with telehealth services through surveys and interviews, focusing on factors such as quality of care and provider-patient relationships, comparing satisfaction levels between in-person visits and telehealth services while evaluating how telehealth impacts overall service utilization.

Methodology: The project applied a mixed-methods approach. In structured interviews and surveys, patients were surveyed on satisfaction scores based on convenience, usability, provider-patient communication, and perceived care effectiveness. A comparative analysis was done between telehealth and …

Quality Improvement Project New And Novice Nurse Faculty: Orientation Bootcamp, Megan Titus

Doctor of Nursing Practice Projects

The ongoing shortage of nurse educators across the United States has led to a critical need among nursing programs, particularly in rural areas. A quality improvement project was developed in response to literature regarding the need for new and novice nurse educator orientation programs and limited structured onboarding at the implementation site. The quality improvement project implemented an orientation boot camp for new and novice nurse educators. Guided by Benner’s Novice to Expert Theory (Benner, 2023) and Lippitt’s Phases of Change Theory (Barrow, 2022), the project aimed to enhance faculty preparedness through educational support related to seventeen key nursing education …

Nursing Faculty Perspectives On Students With Learning Disabilities: A Transcendental Phenomenological Study, Marlies Aanensen Hébert

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to record the lived experiences of nursing faculty perspectives of students with learning disabilities in all learning environments. The theories that provide the framework for the study are John Dewey’s theory of education and Malcolm Knowles’ theory of adult learning. Both theories establish a foundation for understanding the challenges faced by adult learners with learning disabilities and how to offer effective support. The research question is: What are the lived experiences of nurse educators working with students with learning disabilities in all learning environments? The study employed a snowball sampling method to …

The Ability Of Algebra Final Grades And Teas Scores To Predict Undergraduate Nursing Student Grade Point Averages: A Quantitative, Non-Experimental, Predictive Correlational Study, Jeanna L. Kerchner

Doctoral Dissertations and Projects

A major concern for many nursing programs is student completion rates. This is due in large part to the demands and rigor of curriculum in accredited nursing programs. The purpose of this quantitative, non-experimental, predictive correlational study was to determine if final nursing program GPA can be predicted by the linear combination of college algebra final grades and TEAS scores in an undergraduate nursing program at a private university. A quantitative, non-experimental research design was used to address the proposed study’s purpose. The study’s sample of participants was purposive and convenient in nature, and was accessed using an existing, archival …

Palliative And End-Of-Life Care Education In Undergraduate, Pre-Licensure Nursing Program Curriculums: The Lived Experience Of Students, Whitney Hicks

Doctoral Dissertations and Projects

The purpose of this qualitative study with a transcendental phenomenological approach is to investigate and describe nursing students’ experience with palliative and end-of-life care education within their undergraduate, pre-licensure nursing program curriculum. The study utilizes Kolb’s Experiential Learning Theory as its theoretical framework to answer the central research question and three sub-questions. The central research question is: what are nursing students' lived experiences with palliative and end-of-life care education within their undergraduate, pre-licensure nursing program curriculum? Twelve senior level nursing students participated in the study. The data collection methods included one-on-one interviews, observations, and journal entries. Data was analyzed using …

Pharmacogenomics-Guided Treatment Of Depression Evidence-Based Practice Scholarly Project, Richard A. Sonnier

Doctoral Dissertations and Projects

Pharmacogenomics is a popular topic in psychiatry today that is poised to replace the outdated trial-and-error paradigm of prescribing psychotropic medications. For patients suffering from a myriad of psychiatric disorders, it has been a frustrating period for those who have struggled with multiple failed trials of medications before finding relief from debilitating depression, anxiety, and many other mood-dysregulating disorders. Often, patients are forced to endure several weeks or months of trying psychotropic agents with poor responses and intolerable side effects before finally finding a medication that yields a desired outcome. In some cases, no therapeutic response is ever achieved. With …

Improving Access To Same-Day Insertion Of Subdermal Implantable Long-Acting Reversible Contraception In Primary Care, Katherine Alwes

Doctoral Dissertations and Projects

Unplanned pregnancies are a significant public health problem in the United States. Timely access to reliable contraception can decrease the incidence of unplanned pregnancies and their detrimental health impacts. This evidence-based practice project aimed to improve access to subdermal implantable long-acting reversible contraceptives (LARCs) in the primary care setting by implementing a technology platform that enables in-office stocking of LARC devices, allowing for same-day access to LARC options. Data were collected over a 12-week period before and after implementation. The results revealed that in-office LARC stocking increased subdermal implantable LARC placements, reduced patient wait times, improved patient satisfaction, and optimized …

Investigating The Effectiveness Of Implicit Bias Teaching Using High-Fidelity Simulation, Eva Wangia

Doctoral Dissertations and Projects

Nursing education lacks explicit, effective teaching methods for recognizing and managing student biases, which could potentially impact patient outcomes and perpetuate health disparities. This study may influence changes in the associate degree nursing program curricula to include implicit bias teaching, which in turn helps nurses understand the concepts associated with health equity, such as health disparities. This quasi-quantitative experimental study aimed to investigate the effectiveness of implicit bias teaching using high-fidelity simulation to nursing students at a community college in the Pacific Northwest. A convenience sample of first-year nursing students was utilized in the study. Participants completed demographic surveys and …

Meanings And Understandings Of Racial-Ethnic Minority Prelicensure Associate Degree In Nursing And Bachelor Of Science In Nursing Students Who Experience Uncivil Faculty Behaviors In United States Nursing Programs: A Transcendental Phenomenological Inquiry, Lenora Valdez

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological qualitative study was to explore the meanings and understandings of racial-ethnic minority (REM) prelicensure Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) students who experience uncivil faculty behaviors in United States nursing programs. The literature points to a wide range of faculty behaviors that nursing students experience as incivility. However, little data was found in the literature regarding REM prelicensure ADN or BSN students’ experiences with nurse faculty incivility. Purposive snowball sampling was used to recruit 10 REM currently enrolled junior and senior prelicensure ADN and BSN students who experience …

Effect Of Multiple Simulation Exposures On Nursing Students' Critical Thinking In First Direct Patient Care Practice, Dawn Veltre

Doctoral Dissertations and Projects

Critical thinking is a core competency essential for nursing practice, and nursing students must develop these skills to become competent nurses. The purpose of this quantitative quasi-experimental pretest-posttest design is to determine the effect of multiple simulation exposures on nursing students' critical thinking during their first direct patient care practice. A convenience sample of 39 first-year nursing students enrolled in an associate degree nursing program in the western United States participated in this study. Participants completed a demographic survey and the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills before multiple simulation exposures, two exposures, or four exposures …

Optimizing Ehr Utilization: Implementing An Educational Program To Improve Template Use, Knowledge, And Satisfaction Among Primary Care Providers And Staff, Danielle Alley Lewis

Doctoral Dissertations and Projects

Electronic health record utilization is essential for improving clinical documentation, enhancing patient care, and ensuring regulatory compliance. Despite the benefits, provider reluctance and inconsistent utilization of electronic health records remain significant challenges in many primary care settings. This scholarly project aimed to implement an educational program to increase provider and staff knowledge, satisfaction, and utilization of electronic health record tools and templates within a small primary care office. The project addressed an identified gap in electronic health record adoption where providers continued to rely on paper documentation despite the availability of a fully functional electronic health record system. This inefficiency …

English As A Second Language Nurse Experiences With Collaborative Learning During Pre-Licensure, Baccalaureate Nursing Education: A Phenomenological Study, Candice Tart Phillips

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to understand how ESL nurses experienced collaborative learning with their native English-speaking peers in traditional baccalaureate-accredited nursing programs across the United States. The theories guiding this study were the Social Learning Theory (SLT) of Academic Self-Efficacy (ASE) by Albert Bandura and the Sociocultural Theory of Zone of Proximal Development (ZPD) by Lev Vygotsky. The central investigative research question was: What are the lived experiences of novice ESL nurses who participated in collaborative learning with their native English-speaking peers during baccalaureate nursing education? Sampling methods used included a purposive and a snowball sample …

Scoping Review Of Algorithms For Electronic Fetal Monitoring, Katherine Sabatier, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to review the use of an algorithm in evaluating continuous external fetal heart rate (FHR) monitoring in labor as opposed to clinician judgment for improved fetal outcomes, including earlier recognition of abnormal tracings (Clark et al., 2017). FHR monitoring was created to evaluate for fetal hypoxia in labor and has become standard practice (Gyllencreutz et al., 2018). One of the goals of the use of cardiotocography is to decrease hypoxia-induced fetal metabolic acidemia and neurologic injury. There are multiple options for individual or computer-based algorithms in evaluating FHR to reduce fetal acidemia …

Improving No-Show Rates At A Federally Qualified Health Center (Fqhc), Christelle M. Hernandez

Doctor of Nursing Practice Final Project Abstract

The purpose of this quality improvement project was to improve no-show and missed appointments among adult patients at a federally qualified health center (FQHC) located in greater Houston, TX in the adult medicine department. This intervention aimed to decrease no-show and missed appointment rates to 20% or below to improve productivity, yield less staff burnout, and improve patient healthcare outcomes. A 4-week initiative was completed to identity top reasons and to reduce no-shows. A no-show outreach initiative was developed and used in the electronic health record (EHR) and targeted to patients identified as most likely to not show cancel an …

Surgical Smoke Evacuation Quality Improvement Project, Angela Howell

Graduate Theses, Dissertations, and Capstones

Abstract

Background: Surgical smoke is a byproduct produced during surgical procedures when high-energy producing devices are used to vaporize tissue. This smoke poses health risk to anyone present in the operating room.

Purpose: The purpose of this quality improvement (QI) project was to educate and minimize the exposure of both staff and patients to the hazardous toxic fumes and vapors produced by energy-generating electrocautery devices.

Methods: The intervention based on the Kim Ball Smoke Evacuation Compliance Model was implemented in a large military hospital with 20 operating rooms and three labor and delivery suites. Implementation included formal education strategies, equipment …