Public Health and Community Nursing Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Promoting Foot Care Health In Individuals Recovering From Addiction: A Collaborative And Community-Based Nursing Intervention, Erika Frahm, Kayla Goodrow, Zoe Hofmaister, Jaycie Inouye, Shuma Katori, Caleb James Maza, Fauzia Tomno

Nursing Leadership in Community Engagement Projects

As housing instability and homelessness increase in King County, many basic needs, including foot care, are often unmet. According to a study on foot health among vulnerable populations, individuals may be unable to perform proper foot care due to prioritization of basic daily needs over preventative care (Razmus, 2023). Research indicates that foot-related complications are highly prevalent among vulnerable populations and may worsen without timely intervention (Haughton et al., 2026). Barriers such as fear of stigmatization and untreated mental health conditions can also limit access to healthcare services (Kimball et al., 2023). These statistics inspired the purpose of this community …

Promoting Mobility And Emotional Well-Being Through Chair Yoga In Women Experiencing Homelessness, Brenna Kiyota, Fahmo Abdi, Naretzni Ponce, Zekiya Sage Mapilisan, Taylor Krueger, Anelcy Lopez

Nursing Leadership in Community Engagement Projects

Promoting Mobility and Emotional Well-Being Through Chair Yoga in Women Experiencing Homelessness

This paper summarizes a project completed by nursing students at a women’s day center and transitional housing program in Washington state that supports women experiencing homelessness as they work toward stability. The center provides daytime services to more than 200 women daily who experience chronic stress, trauma, limited access to healthcare, and environmental barriers. These challenges occur within a broader regional crisis, as the 2024 Point‑in‑Time Count states that 16,868 individuals are experiencing homelessness in King County, a 26% increase from 2022 (King County Regional Homelessness Authority, 2024). …

Parent-Focused Resource And Staff Crisis Tool For Addressing Teen Suicidal Ideation, Maya Ewing, Jasmine Crisan, Delaney Fewel, Brandon Fung, Kaylee Cornejo, Alyssa Arthur, Christine Elayda

Nursing Leadership in Community Engagement Projects

The team of seven Seattle Pacific University nursing students partnered with an agency that functions as a family resource center. The agency provides emergency shelter, mobile outreach, and basic needs to families in King County. The team created an evidence-based solution focused on education for suicide prevention. Additionally, the team identified a gap in available staff clinical resources during emergencies.

Improving Emergency Preparedness: Disaster Response Gap Executive Summary, Yunuen Pamatz Rangel, Angela Reine Palapos, Edward Vladimir Bondarenko, Sarah Marie Wilson, Semhar Misgina Mehari, Benjamin Lee Lucas

Nursing Leadership in Community Engagement Projects

Improving Emergency Preparedness: Disaster Response Gap Executive Summary

Universities in Washington State have a responsibility to maintain both educational continuity and campus safety, particularly because of the region’s vulnerability to major earthquakes. Although many institutions maintain emergency preparedness plans, the accessibility and strategic placement of emergency resources remain critical concerns. At a private university in Seattle, Washington, the project team identified gaps in earthquake preparedness related to the accessibility, visibility, and availability of emergency supplies.

This project aimed to develop a practical and achievable proposal for university leadership to strengthen disaster preparedness efforts. The project focused on improving access to …

Bridging The Vaccine Gap: Multilingual Vaccine Education For Families In Transitional Housing, Isaac Olaes, Alexia Sandoval, Kassandra Solano, Rachael Termure, Sydney Webber, Jordan West, Maya Parman

Nursing Leadership in Community Engagement Projects

As part of a health promotion initiative in the community, our leadership team of seven nursing students is partnering with an agency that supports families experiencing housing instability by providing transitional housing. According to agency staff, some families have limited health literacy regarding vaccinations. Common concerns include illness following a vaccination, perceived risks of autism, and attention deficit hyperactivity disorder. To address these concerns, we have developed a vaccine education binder containing materials in handout form. To accommodate language accessibility, we provided handouts in the four most spoken languages including English, French, Amharic, and Tigrinya. Through this initiative, we aim …

Advocateai: A Human-In-The-Loop Artificial Intelligence Platform To Improve Diagnostic Trajectories And Patient Empowerment In Chronic Pelvic Pain, Gayatri Bhanot, Ashley Kochans

InnovateHER Meeting 2026

Chronic pelvic pain (CPP) affects up to 27% of women globally^1, yet diagnosis takes 4 – 12 years on average² — a crisis driven by healthcare fragmentation, systemic gender bias, and a 62% rate of symptom dismissal by healthcare providers³. AdvocateAI is a human-in-the-loop AI platform designed to empower patients to accelerate their own diagnostic journey. By synthesizing fragmented medical records and patient-reported symptoms, the tool creates structured clinical summaries and personalized advocacy scripts. Here, we present our findings from discovery, including a landscape analysis of available CPP treatments, a prototype co-designed by patients, and custom …

Caregiving Experiences And Challenges Among Caregivers Of Children With Epilepsy In Thailand: A Qualitative Study, Arthittaya Kaenkrai, Pramote Thangkratok, Pawanrat Panjatharakul, Apasri Lusawat, Moritz Tacke

Journal of Health Research

Background: Childhood epilepsy requires long-term management and places substantial responsibilities on caregivers. In Thailand, limited public awareness and persistent stigma surrounding epilepsy may intensify caregivers’ psychosocial and practical burdens. This study aimed to explore the lived experiences of caregivers of children with epilepsy in Thailand.

Methods: A qualitative study using two semi-structured focus group discussions (FGDs; 5 participants per group) and 15 in-depth interviews (IDIs) was conducted with primary caregivers of children with epilepsy receiving care at a neurological referral institute in Thailand. Participants were purposively selected to capture a diverse range of caregiving experiences. Data were audio-recorded, transcribed verbatim, …

Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Improving Appropriate Nephrology Referrals Using Epic Screening Tools And Nurse Practitioner (Np) Education, Diahann M. Volcy

Seton Hall University Dissertations and Theses (ETDs)

Nephrology referral has been recognized as a modifiable factor influencing patient outcomes (Cheng, 2025). This project aims to reduce delayed or missed CKD diagnoses at large suburban hospitals in north New Jersey by improving timely nephrology referrals. I used a mixed-methods approach, retrospective chart review, pre- and post-education surveys, and referral trend analysis to assess how an educational session affects nurse practitioner knowledge and nephrology referral behavior. Enhancing nurse practitioner (NP) awareness and decision tool usage may increase early kidney care for patients, leading to better outcomes (ISN-KDIGO, 2021; Van Mil et al., 2024).

Be Prepared For Your Nurse Practitioner Clinical Readiness Exam, Elizabeth Heavey, Renee Biedlingmaier, Colleen Burgoyne, Carnel C. Jackson

Milne Open Textbooks

This text contains case studies and review questions for nurse practitioner students; focusing on the 3Ps of nurse practitioner education (Pharmacology, Pathophysiology, and Physical (Health) Assessment) to help NP students prepare for their clinical courses and pass their clinical readiness exam.  It includes cases commonly seen in entry-level NP practice.  In addition to the three individual sections of the text that focus on cases applying content from each of the distinct courses (Pathophysiology, Pharmacology, and Physical Assessment), we included summative case studies at the end of the book that connect all three areas in a single case. Because these three …

Building A Road To Mitigate Ambulance Patient Offload Time (Apot), William J. Manguil

Doctoral Projects

Emergency departments (EDs) worldwide are experiencing increased utilization resulting in care delays for patients seeking urgent treatment. Despite critical circumstances that warrant emergency medical services (EMS) response, patients arriving to the ED via ambulance remain vulnerable to delays in care due to prolonged ambulance patient offload times (APOTs). The amount of health care providers and treatment space necessary to initiate care are both limited and often strained resources which dictate the need for innovative interventions to prevent patient harm. The following project outlines the interventions implemented at the project site to improve APOT as a means to enhance patient safety …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Evaluating The Effectiveness Of A Nurse-Initiated Post-Discharge Phone Call In The Prevention Of Hospital Readmissions For Type 2 Diabetes Mellitus, Sierra Kane

Doctoral Projects

Background: Hospital readmissions are widely recognized as a key metric of quality care, reinforced by Centers for Medicare and Medicaid (CMS) incentive programs (U.S. Centers for Medicare & Medicaid Services, 2025). Despite these incentives, achieving a meaningful reduction of readmissions remains a challenge, especially for chronic conditions such as type 2 diabetes mellitus (T2DM), where readmission is fueled by gaps in medication management, patient confidence in symptom management, and access to timely follow-up care. Purpose: Evaluate the impact of a nurse-initiated post-discharge telephone outreach, conducted at 48 hours, by the outpatient endocrinology clinic, on 7- and 30-day readmission rates for …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

A Quality Improvement Project To Strengthen Hospice Spiritual Care Delivery, Patricia Boudreau

Doctoral Projects

Spiritual care is an essential component of holistic end-of-life nursing, yet it is inconsistently provided in home hospice settings. For this Doctor of Nursing Practice (DNP) quality improvement project, we developed and implemented the Compassionate Spiritual Comfort Integration Program (CSCI), a brief, theory-based educational intervention to strengthen hospice nurses' spiritual care practices. Grounded in Kolcaba's Comfort Theory and Jinpa's Compassion Framework, the CSCI was delivered as a prerecorded webinar. A quasi-experimental single–group pretest–posttest design was used to evaluate changes in spiritual care behaviors, measured with the 17-item Nurse Spiritual Care Therapeutics Scale (NSCTS) and a single-item confidence measure. Twenty-two nurses …