Public Health and Community Nursing Commons^™

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).

Transforming Obesity Management In Primary Care: Shared Medical Appointments (Smas) – An Evidence-Based Practice Project, Glendy Chen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

The purpose of this DNP project is to implement a 10-week Lifestyle Intervention Shared Medical Appointment (LISMA) program in primary care to improve obesity outcomes. Aims include increasing structured visit frequency, enhancing multidisciplinary engagement, and improving metabolic indicators, mindful eating behaviors, and self-efficacy.

Background of Problem & Description of Current Practice

Obesity affects over 40% of U.S. adults and is associated with cardiometabolic morbidity, reduced quality of life, and rising healthcare costs. Guidelines recommend intensive, multicomponent behavioral interventions with frequent contact. Current practice primarily offers one-on-one visits at insufficient frequency with limited team integration, contributing to suboptimal management. LISMAs …

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 …

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 …

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 …

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Poster Presentations

Research on NICU experiences largely focuses on majority-language families; non-English-speaking families are understudied (Cleveland, 2008). The Family Integrated Care model promotes parent-infant connection and shared decision-making to improve outcomes (Wreesmann et al., 2020). Language barriers impede parent-provider communication, increasing miscommunication and parental anxiety (Kynoe et al., 2020; Ardal et al., 2011). The purpose of this research is to explore communication experiences and barriers between English-speaking and bilingual NICU nurses and a Spanish-speaking NICU mother.

Exploring Student Feelings, Knowledge Related To Menstruation And Menstrual Education: A Cross-Sectional Survey, Ella A. Handel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Menstrual, reproductive, and sexual health education in the United States remains inconsistent in both content and delivery. This inconsistency often leaves adolescents underprepared for developmental milestones such as menarche and contributes to ongoing stigma and discomfort surrounding menstruation. This study examined participants’ feelings and perceptions related to menstruation and menstrual education. Using a cross-sectional descriptive survey design, a mixed-methods approach was employed to collect data from 29 college students aged 18 to 19 years at a large public university in Arkansas. Quantitative data from Likert-scale items were analyzed using descriptive statistics, while qualitative open-ended responses were reviewed and organized into …

Exploring Perceived Structural Barriers And Access Related To Menstruation And Menstruation Education, Rylie Sisengrath

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Menstrual health is an important component of women’s health. However, many adolescents in the United States report feeling unprepared for menarche due to limited menstruation education. Menstruation education is limited, exclusively taught in schools with sex education courses, limiting the scope of female developmental education. Period poverty, limited access to menstrual education and hygiene products, continues to affect a large group of women. This study aimed to understand adolescents’ experiences with menstrual education, identify gaps in menstruation education, and explore structural and policy barriers affecting access to menstrual health resources. Using a cross-sectional survey with Likert-scale and open-response questions, quantitative …

Tiny Tusk Internship: Gut Instincts: A Review Of Literature On The Impact Of Breastfeeding On The Infant Gut Microbiome, Rayla Payne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to investigate both the short- and long-term benefits that breastfeeding has on the infant gut microbiome. The PICOT question was: In full-term infants, how does exclusive breastfeeding compared to mixed or formula feeding influence the diversity and composition of the gut microbiome throughout the first 12 months of life? For this research, EBSCOhost, CINAHL, and the National Library of Medicine databases were searched to find relevant studies and systematic reviews. Terms such as “breastfeeding and infant gut microbiome” were used to conduct the search. Other terms used included “breastfeeding OR formula feeding”, “human …

Healthy Living For Unhoused Women, Aliya K. Jatoi

Undergraduate Honors Theses

This capstone thesis details the importance of healthcare for unhoused women. Unhoused women do not have the ability to receive women’s healthcare nor receive proper education surrounding the topic of women’s healthcare. After participating in several events with unhoused women throughout Johnson City, a lack of attention to improving the quality of women’s healthcare was noticed. To address this issue, I began by surveying unhoused women, talking with unhoused women, and collecting online data and statistics regarding homelessness, prevelant diseases, and infection rates among unhoused women. After collecting data, educational materials, such as flyers with information about local resources and …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Disease (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Posters and Presentations

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …