Journal of Doctoral Nursing Practice最新文献

{"title":"Innovative Scenario-Based Child Abuse Training for Doctoral Nurse Practitioner Students.","authors":"Pamela G Balogh, Michelle Cathorall, Kelly Ezzell, Lecia Reardon","doi":"10.1891/JDNP-2025-0060","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0060","url":null,"abstract":"<p><p><b>Background:</b> Child maltreatment is a serious public health issue with long-lasting consequences that extend beyond immediate harm to the child. Despite substantial evidence highlighting its profound impact on individuals and society, formal training on recognizing and responding to child abuse remains limited in graduate nursing education, particularly in nurse practitioner (NP) programs. <b>Objective:</b> This study aimed to evaluate the effectiveness of an in-person structured evidence-informed child sexual abuse training session in enhancing NP students' ability to recognize, respond to, and manage suspected cases of maltreatment. <b>Methods:</b> Voluntary presurvey and postsurvey were completed by 34 NP students via Qualtrics after an in-person training session. χ² analysis was used to assess changes in confidence across key domains. <b>Results:</b> Improved NP student self-confidence in identification, documentation, and making appropriate referrals occurred. χ² analysis demonstrated a significant posttest relationship between confidence in recognizing abuse signs and documenting suspected cases. <b>Conclusion:</b> Educational programs that increase NP students' confidence and skills in managing child abuse cases should be integrated into graduate curricula. Further research is warranted. <b>Implications for Nursing:</b> Integrating structured, evidence-informed child maltreatment training into NP programs can strengthen provider competence in early recognition, intervention, and referral, ultimately improving individual and public health outcomes.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Dynamic Education System Improves Critical Care Nurse Practitioner Turnover and Reduces Cost.","authors":"Kathryn S Dippel, Sarah J Rochford","doi":"10.1891/JDNP-2025-0092","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0092","url":null,"abstract":"<p><p><b>Background:</b> Standardized nurse practitioner (NP) orientation programs boost job satisfaction and retention. California Pacific Medical Center Van Ness Campus critical care NPs faced a 63% turnover rate, primarily among senior team members, and the need for robust, standardized NP training was identified. <b>Objective:</b> This project aimed to assess the impact of the dynamic education system (DES) on NP turnover and costs. <b>Methods:</b> The DES included asynchronous didactic education, in-person education, formal evaluations, and an orientation guide. Ten NPs completed the DES from May 2023 to December 2024. Staffing schedules were compiled from October 2021 to March 2025 to analyze turnover rate, staffing trends, and associated expenditures before and after the intervention. <b>Results:</b> NP turnover decreased after the implementation of the DES. Costs decreased through reduced turnover. Staffing expenditures increased immediately following DES implementation due to extensive recruitment and training. <b>Conclusions:</b> The structure, resources, and support provided by the DES increased the resilience and versatility of the critical care NP team while also decreasing turnover and costs. <b>Implications for Nursing:</b> The implementation of the DES demonstrates that standardized NP training reduces turnover and organizational costs. Investing in educational infrastructure fosters clinical competence, job satisfaction, and team cohesion. Prioritizing evidence-based orientation frameworks builds more resilient teams, strengthens professional identity, and improves patient care outcomes.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Provider Awareness and Comfort in Caring for PANDAS in the Outpatient Setting.","authors":"Candice Brunger, Michelle Anderson, Sarah Lemley, Noelle Taylor, Jamie L Russell","doi":"10.1891/JDNP-2025-0003","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0003","url":null,"abstract":"<p><p><b>Background:</b> Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disorder with symptoms of obsessive-compulsive disorder and/or tic disorders associated with group A streptococcal infection. PANDAS is considered a subtype of pediatric acute-onset neuropsychiatric syndrome (PANS), and both can cause disabling symptoms. The influence of PANS/PANDAS on family function is significant, with parents reporting many adaptations and disruptions to the family, including extreme financial, emotional, and social impacts (Dolce et al., 2022; Tang et al., 2021). Despite the publication of evidential literature in 1998, there remains a lack of skilled providers who are confident in diagnosing and treating this disorder. Parents report that finding a skilled provider and confirming a timely diagnosis are significantly difficult. This can cause a treatment delay for years with indeterminate consequences (Tang et al., 2021). <b>Objective:</b> This quality improvement initiative aimed to assess changes in providers' awareness and comfort with diagnosing and treating PANDAS following an educational intervention implemented as part of a quality improvement effort. <b>Methods:</b> Pretest/posttest descriptive survey was used for providers participating in an educational intervention. The educational intervention was a recorded PowerPoint created using the published PANS/PANDAS Diagnostic and Treatment Guidelines. <b>Results:</b> After completing the provider educational intervention, participants' comfort in diagnosing and treating PANDAS improved. <b>Conclusions:</b> Access to a knowledgeable provider is a significant barrier for families of PANDAS patients. An educational intervention on PANDAS improved comfort in providing diagnoses and treatment in a small cohort of providers. <b>Implications for Nursing:</b> PANDAS education for providers may improve the comfort in diagnosing and treating PANDAS in primary care, thus positively impacting the quality of care families receive.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quality Improvement Initiative to Enhance Screening and Referral for Adolescents and Young Adults With Opioid Use Disorder.","authors":"Sydney Salter, Rebecca Sutter","doi":"10.1891/JDNP-2025-0041","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0041","url":null,"abstract":"<p><p><b>Background:</b> Adolescents and young adults (AYAs) face increasing rates of opioid use disorder (OUD) yet remain underserved in access to medications for opioid use disorder (MOUD). Provider stigma, limited training, and inconsistent referral pathways contribute to low treatment uptake in community settings. Northern Virginia reports elevated rates of AYA overdoses and opioid-related emergency department visits, highlighting the need for coordinated, provider-focused interventions. <b>Objective:</b> To evaluate the acceptability, appropriateness, feasibility, and usability of a standardized screening and referral intervention designed to improve identification and referral of AYAs with OUD across suburban jurisdictions in Northern Virginia. <b>Methods:</b> This mixed-methods quality improvement initiative was guided by Lippitt's Change Theory and the Knowledge-to-Action Framework. Providers participated in an intervention consisting of asynchronous educational modules, live webinars, and use of a standardized screening and referral algorithm. Four Plan-Do-Study-Act cycles informed iterative refinements. Quantitative evaluation included the Acceptability of Intervention Measure, Intervention Appropriateness Measure, Feasibility of Intervention Measure, and the System Usability Scale (SUS). Qualitative evaluation included six think-aloud sessions analyzed thematically to identify key usability, feasibility, and implementation themes. <b>Results:</b> Fifteen providers participated in the intervention. Posttraining survey respondents (<i>n</i> = 5) reported high acceptability (<i>M</i> = 4.9), appropriateness (<i>M</i> = 4.75), feasibility (<i>M</i> = 4.6). Usability was rated as excellent (SUS = 82.5). Thematic analysis of six think-aloud sessions supported the algorithm's clarity, structure, and clinical guidance, particularly for providers with less experience, while identifying opportunities for refinement. <b>Conclusions:</b> Standardized screening and referral tools paired with provider education improve identification and referral of AYAs with OUD. <b>Implications for Nursing:</b> Nurses can lead OUD screening and referral efforts to support early intervention, reduce gaps, and enhance coordinated care for AYAs.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Chatbot to Care Team: A Pilot Study of Generative Artificial Intelligence to Support Nurse-Pharmacist Collaboration and Patient Care in Telemedicine.","authors":"Fahim Faruque, Ashley Fenton, Colleen King Goode","doi":"10.1891/JDNP-2025-0084","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0084","url":null,"abstract":"<p><p><b>Background:</b> Collaboration between nurse practitioners (NPs) and pharmacists is essential for comprehensive patient care, especially in telehealth settings where communication is often asynchronous. Generative artificial intelligence (AI) offers a novel tool to enhance interprofessional coordination and improve patient outcomes. <b>Objective:</b> To evaluate the impact of an AI-enabled NP-pharmacist collaboration model on interprofessional collaboration, provider workflow, patient outcomes, and implementation feasibility in a telehealth environment. <b>Methods:</b> This prospective 18-month mixed-methods protocol will evaluate an AI-supported care model using chart reviews, provider and patient surveys, and system usage data. Quantitative and qualitative analyses will explore workflow integration, patient experiences, and care outcomes. <b>Results:</b> Results are pending. Outcomes will include measures of collaboration, patient confidence, access to care, provider satisfaction, and feasibility of sustained implementation. <b>Conclusions:</b> Integrating AI into NP-pharmacist collaborations may enhance virtual care delivery by supporting communication, task sharing, and proactive patient monitoring. <b>Implications for Nursing:</b> This study highlights the potential of AI to strengthen nursing roles in interprofessional care and offers a model for scalable, technology-enhanced nursing practice.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Wellness and Resiliency of Neonatal Nurse Practitioners Through Implementation of MINDBODYSTRONG.","authors":"Katie L Gerbetz, Jacqueline Hoying, Stephanie Sykes, Susan E Thrane","doi":"10.1891/JDNP-2022-0031","DOIUrl":"https://doi.org/10.1891/JDNP-2022-0031","url":null,"abstract":"<p><p><b>Background:</b> Health care providers pride themselves on providing high-quality care to others but often do not prioritize themselves. Cognitive-behavioral skill building has been demonstrated to decrease stress, anxiety, and depression. <b>Objective:</b> The objective of this evidence-based quality improvement project was to implement MINDBODYSTRONG with neonatal nurse practitioners (NNPs) to improve stress, burnout, and well-being. <b>Methods:</b> NNPs completed seven weekly sessions, held virtually, that focused on skills to build resiliency and coping. Participants completed the Perceived Stress Scale-4 (PSS-4), Single Item Burnout Measure (Burnout), and Well-being Index (WBI) prior to and at the completion of the program. <b>Results:</b> Ten NNPs completed all sessions, and 100% were white females. The majority had master's degrees and NNP experience of <2 years to >20 years. When comparing pre- to postintervention, PSS-4 scores and burnout scores showed a nonsignificant decrease (<i>p</i> = 0.509, <i>p</i> = .343) and a small effect size (d = .218, d <i>=</i>316). WBI scores were significant (<i>p</i> = .096, significance was set at <i>p</i> < .10) with a medium effect size (d = 0.588). <b>Conclusion:</b> There were improvements in stress, burnout, and well-being, with an overall shift in positive outlook. <b>Implications for Nursing:</b> The MINDBODYSTRONG program provides an evidence-based intervention to promote mental health and well-being and has positive effects on the NNP participants.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nurse-Led Quality Improvement Project to Examine the Impact of Reduced Plastic Medical Waste Recycling in Health Care Settings.","authors":"Barbara Belanger, Jane Flanagan","doi":"10.1891/JDNP-2025-0010","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0010","url":null,"abstract":"<p><p><b>Background:</b> U.S. health care facilities dispose of over 5 billion tons of waste per year, the majority of which is plastic medical waste (PMW). Recycling efforts for plastic waste slowed dramatically after 2018 in response to global events. PMW disposed of in landfill or incineration can emit toxic emissions, causing air pollution and over 5 million deaths globally. <b>Objective:</b> This quality improvement project aimed to understand current efforts in recycling plastic-based items from U.S. health care facilities. <b>Method:</b> A survey was completed through Practice Greenhealth by Greening the Operating Room members. <b>Results:</b> There was an increased purchase and use of plastic-based single-use-only medical items since 2018 by health care facilities across the United States. A considerable amount of PMW is disposed of in landfill. <b>Conclusion:</b> Findings demonstrated significant interest in circular economy and standardization of PMW disposal from a legislative perspective. <b>Implications for Nursing:</b> Nurses were identified as key advocates in waste reduction efforts and should be included as partners with health care leaders in discussions for PMW recycling efforts that ensure public health.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers to Doctor of Nursing Practice Nurse Practitioner Program Implementation: A Mixed Methods Study.","authors":"Marcy Ainslie, Jaeyeon Lee, Kara Elena Schrader, Mary Beth Bigley, Shannon Idzik, Susan W Buchholz","doi":"10.1891/JDNP-2024-0076","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0076","url":null,"abstract":"<p><p><b>Background:</b> Financial challenges can prevent the Doctor of Nursing Practice (DNP) from being offered to nurse practitioners (NPs). <b>Objective:</b> This study explored financial facilitators and barriers to implementing DNP-NP programs. <b>Methods:</b> An explanatory, sequential, mixed methods design was used. Full inclusion criteria required implementing a DNP-NP program after 2015 and creating a transition budget. <b>Results:</b> Of 119 respondents, 49 schools implemented a DNP-NP program; 70 schools never attempted implementation. Seventeen schools met full inclusion criteria, of which seven met financial projections. Dean's support was the most important contributor to meeting financial projections, while budget concerns were the anticipated primary contributor to schools not implementing a DNP-NP program. Low enrollment was the top-ranking barrier in all schools that implemented a DNP-NP program. Three focus groups and two structured interviews (<i>n</i> = 9) were conducted. Three important themes emerged for DNP-NP program implementation: financial factors, curriculum delivery, and external influences. <b>Conclusions:</b> Facilitators of budget-neutral or income-generating DNP-NP programs include support of administration, faculty and clinical partner collaboration, integrative curricular delivery, and staged transitions from Master of Science in Nursing NP programs. <b>Implications for Nursing:</b> Given the challenging financial environment of higher education, this work informs the successful implementation of DNP-NP programs.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unfinished Nursing Care in General Medical and Surgical Units: A Systematic Review.","authors":"Alexandra Giannarou, Stefania Chiappinotto, Alvisa Palese, Nikos Stefanopoulos, Michael Igoumenidis","doi":"10.1891/JDNP-2025-0016","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0016","url":null,"abstract":"<p><p><b>Background:</b> Unfinished nursing care is a global phenomenon that has been investigated by many researchers in recent years. <b>Objective:</b> The aim of this systematic review is to identify the most frequently omitted aspects of nursing care and the reasons for these omissions in general medical and surgical units. <b>Methods:</b> We conducted a PubMed, Scopus, and Ovid search for all primary quantitative studies investigating unfinished nursing care in general medical and surgical units from 2006 to 2024. The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines for systematic reviews have been followed. <b>Results:</b> Aspects of missed nursing care are categorized differently depending on the measuring instruments used, but it is evident that the most frequently omitted nursing interventions are those related to patients' basic needs. The main reason for these omissions is understaffing. <b>Conclusions:</b> Omissions in medical and surgical units have been recognized as a significant problem, compromising patients' basic care. <b>Implications for Nursing:</b> Quality of nursing care is negatively affected by omissions. Prioritizing basic needs of patients is strongly recommended to reduce the levels of unfinished care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Theory-Driven and Evidence-Based Posthospital Discharge Tobacco Cessation Pilot Program.","authors":"Hiboombe M Haamankuli, Susan J Appel, Christina J Ezemenaka","doi":"10.1891/JDNP-2023-0065","DOIUrl":"https://doi.org/10.1891/JDNP-2023-0065","url":null,"abstract":"<p><p><b>Background:</b> The association of tobacco use and poor health outcomes is well documented. When tobacco users are hospitalized, some temporarily refrain from tobacco use with the aid of nicotine replacement therapy (NRT). However, most are unable to sustain cessation postdischarge. <b>Objective:</b> Investigate whether smoking cessation rates are higher for patients prescribed NRT compared with patients with no NRT (nNRT), 2 months postdischarge. <b>Methods:</b> Participants aged 19-65 years, who smoked ≥1 cigarette/day, were enrolled. Participants were randomly assigned to receive NRT versus nNRT. The primary outcome was self-reported smoking cessation at 2 months. Secondary outcomes were smoking decline and progression in the Transtheoretical Model (TTM) of change. <b>Results:</b> The 2-month cessation rates in the NRT group were 53.8% compared with 57.1% in the nNRT group, <i>p</i> = .86. The NRT group had a 27.7% decline in tobacco use, compared with 8.33% in the nNRT group. Although at 2 months the findings were not statistically significant, they were clinically significant; both groups demonstrated progress toward positive behavior change. <b>Implications for Nursing:</b> Tobacco users should receive NRT on admission and discharge. Additional follow-up intervention strategies based on the TTM stage should be incorporated as a tool to aid cessation.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}