Journal of Doctoral Nursing Practice最新文献

{"title":"Improving Postpartum Outcomes: A Quality Improvement Initiative to Reduce Hypertension and Preeclampsia Readmissions.","authors":"Beleda Saziru, Manal Alatrash, Laura Sarff","doi":"10.1891/JDNP-2025-0037","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0037","url":null,"abstract":"<p><p><b>Background:</b> Postpartum hypertension and preeclampsia are leading causes of maternal morbidity and mortality, significantly contributing to hospital readmissions. Although early detection is key to improving outcomes, it remains underutilized in postpartum care. <b>Objective:</b> This project aimed to evaluate the effectiveness of a nurse education intervention and develop a standardized patient education protocol to reduce postpartum hypertension and preeclampsia readmissions. <b>Methods:</b> Hospital readmission data were analyzed for 12 weeks before and after implementing the intervention. Postpartum nurses completed pre- and postintervention surveys assessing knowledge of postpartum assessment and The Joint Commission's (JC) new perinatal standards, as well as self-efficacy in applying evidence-based care. <b>Results:</b> Postintervention, nurse overall knowledge increased by 25% (<i>α</i> ≤ .01). There were significant improvements in recognition of pregnancy-related deaths, awareness of postpartum mortality, and identification of top mortality causes (<i>p</i> < .001). Self-efficacy scores rose from 73.5 to 84.4 (<i>p</i> < .001), and readmissions declined from 3 to 4 to 1 per month. All patients reported receiving the education and understanding when to seek care. <b>Conclusions:</b> Standardized nurse education and patient protocols significantly improved clinical knowledge, patient safety, and reduced readmissions. Sustained integration of these practices is essential for long-term impact. <b>Implications for Nursing:</b> Ongoing training and standardized education empower nurses to improve maternal outcomes through early detection and timely intervention, supporting JC standards, reducing health disparities, and driving sustainable policy in maternal health care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116182","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 Holistic Patient-Centered Lifestyle Intervention for Health Promotion in Southern Peru.","authors":"Brian C Marlia-Larsen, Victor J Villasante, Lori Jo Marlia-Larsen, Diana R Jolles","doi":"10.1891/JDNP-2024-0043","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0043","url":null,"abstract":"<p><p><b>Background:</b> Comprehensive lifestyle interventions (CLIs) support health promotion and management of health conditions. In Peru, health screenings and referral to CLI programs are lacking. <b>Objectives:</b> To implement an evidence-based SBIRT (screening, brief intervention, and referral to treatment) process to detect and respond to obesity among community members of Jerusalén Nueva Esperanza and achieve measurable health behavior change among CLI program participants. <b>Methods:</b> Movimiento Nueva Esperanza (MNE) was an 8-week data-driven implementation of four PDSA (Plan-Do-Study-Act) cycles of rapid improvement informed by run charts, field notes, and aggregate data. MNE's aim was a 30% improvement in participants' Nueva Esperanza Score (NES), a holistic health measure. Process and outcome measures included tool utilization, behavior changes, and team self-efficacy. <b>Results:</b> Obesity screening increased from 20% to 67%. In-person enrollment reached 56%, and cumulative attendance among active enrollees was 46%. Team self-efficacy improved by 21%. Postintervention NES assessment revealed a 25% improvement. <b>Conclusions:</b> MNE's holistic patient-centered processes resulted in meaningful behavior changes and improved team self-efficacy. MNE's successes validate holistic health screenings, patient-centered shared decision-making, and asset-based team management. <b>Implications for Nursing:</b> As community health advocates and leaders of interdisciplinary teams, nurses are uniquely positioned to support holistic patient-centered lifestyle changes in diverse settings by implementing interventions like MNE.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116124","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 Nursing Knowledge in the Care of Patients Undergoing Pituitary Surgery: A Quality Improvement Project.","authors":"Shayla Barrett, Kenya Snowden, Patricia Larrieu-Jimenez, Cynthia L Foronda, Karina A Gattamorta, Irene Collado Tam, Cathy Rosenberg, Ricardo J Komotar","doi":"10.1891/JDNP-2026-0002","DOIUrl":"https://doi.org/10.1891/JDNP-2026-0002","url":null,"abstract":"<p><p><b>Background:</b> Surgical treatment of pituitary adenomas places patients at substantial risk for life-threatening postoperative complications due to the pituitary gland's unique anatomical position and endocrine function. When preoperative patient education is insufficient, early signs of complications such as excessive bleeding, cerebrospinal fluid leaks, and diabetes insipidus may go unrecognized, resulting in delayed intervention. <b>Objective:</b> To support consistent and high-quality preoperative education across the continuum of care, this quality improvement project aimed to increase perioperative nurses' knowledge and competence in preoperatively preparing patients for pituitary surgery and postoperative care. <b>Methods:</b> A pretest and posttest design was used to implement an educational program for nurses. A knowledge test and the Nurse Professional Competence Scale were used. <b>Results:</b> Nurses' knowledge increased by 33.3%. Nurses (92%) reported a \"relatively high\" to \"very high\" competence level with regard to provision of patient education related to preoperative pituitary surgery. <b>Conclusions:</b> Consistent, evidence-based nurse education may improve nurses' knowledge and competence to better prepare their patients for pituitary surgery. <b>Implications for Nursing:</b> Providing nurses with targeted education on best practices in patient teaching supports their role as key educators in the preoperative setting. Effective nursing-led preoperative education may enhance patient understanding of their care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116194","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":"Guiding Doctoral Students in the Appropriate and Ethical Use of Artificial Intelligence for the Doctor of Nursing Practice Proposal Development.","authors":"Lynne Palma, Andre Williams","doi":"10.1891/JDNP-2025-0065","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0065","url":null,"abstract":"<p><p><b>Background:</b> Developing a Doctor of Nursing Practice (DNP) project proposal is challenging as students balance clinical skill development and certification preparation. Many proposals lack coherence, alignment, or measurable value. Generative artificial intelligence (AI) tools, such as ChatGPT, present both opportunities and risks in addressing these barriers. <b>Objective:</b> This article advocates for the responsible use of AI to support DNP students in proposal development and implementation while maintaining scholarly rigor and professional standards. <b>Methods:</b> A narrative review of literature on AI in health care and higher education, with emphasis on large language models, was conducted to examine opportunities, threats, and strategies for ethical academic use. <b>Results:</b> AI can enhance idea generation, alignment, and organization of DNP proposals, but risks such as inaccuracy, bias, privacy, and plagiarism remain. Prompt engineering and faculty oversight are essential for appropriate use. Mitigation strategies are presented. <b>Conclusion:</b> AI should augment, not replace, critical thinking and scholarly inquiry. <b>Implications for Nursing:</b> Nurse educators must lead efforts to integrate AI ethically into curricula, fostering innovation while preserving academic integrity and nursing's humanistic values.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867319","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":"Assessing Nurses' Knowledge and Attitudes Toward Pediatric Pain in a Free-Standing Emergency Department.","authors":"Randy Hamm","doi":"10.1891/JDNP-2025-0079","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0079","url":null,"abstract":"<p><p><b>Background:</b> Pediatric pain-related complaints remain a common reason for emergency department visits. Despite advances in pediatric care, barriers to effective pain assessment and management persist, including gaps in nurses' knowledge and attitudes regarding pediatric pain management. <b>Objective:</b> The purpose of this study was to assess free-standing emergency department (FSED) nurses' knowledge and attitudes regarding pediatric pain management in a rural North Carolina setting. <b>Methods:</b> A descriptive cross-sectional study was conducted among staff nurses employed at an FSED in rural North Carolina. Participants completed the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS). Descriptive statistical analyses were performed using Statistical Package for the Social Sciences version 25. <b>Results:</b> The mean PNKAS score was 29.2 ± 11.1, with scores ranging from 18 (42.8%) to 37 (88.1%). Participants demonstrated strong knowledge in areas including appropriate pain assessment, benefits of nonopioid medications, and opioid administration practices. Lower performance was observed in understanding pediatric pain perception and accurate opioid dosage calculations. No statistically significant differences were identified among varying nursing experience groups. <b>Conclusion:</b> Knowledge gaps continue to exist in critical areas of pediatric pain management among FSED nurses, particularly related to pediatric pain perception and opioid dosage calculations. <b>Implications for Nursing:</b> Findings support the need for ongoing pediatric pain management education and competency-based training for emergency nurses. Strengthening knowledge in pain assessment and safe medication administration may improve the quality and safety of pediatric emergency care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867265","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":"Moving PhD and DNP Collaboration Forward in Clinical Settings: A Literature Review.","authors":"Susan B Fowler, Charlene Pope, Julius Kehinde","doi":"10.1891/JDNP-2025-0109","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0109","url":null,"abstract":"<p><p><b>Background:</b> PhD-prepared nurses generate new evidence, while Doctor of Nursing Practice (DNP)-prepared nurses translate evidence into practice. While doctoral-prepared nurses have different foci, they can use their skills together to advance the art and science of nursing. <b>Objective:</b> The purpose of this project was to review the recent literature on PhD and DNP collaboration and suggest recommendations for partnerships in clinical settings. <b>Methods:</b> A literature search was conducted using two databases and keywords, which resulted in 20 pertinent articles reviewed for focus and findings. <b>Results:</b> Literature supports PhD and DNP collaboration with clear benefits in positive clinical outcomes, enhanced use of theory and methods, teamwork, increased project completion, and shared learning. Despite these benefits, barriers continue with role ambiguity, limited opportunities for collaboration, and hierarchical philosophies. <b>Conclusion:</b> There is strong support for PhD and DNP collaboration but challenges impact operationalizing it in practice. <b>Implications for Nursing:</b> Collaboration between PhD- and DNP-prepared nurses presents a compelling model for advancing clinical practice, research translation, and professional development but requires targeted efforts to support and enhance professional opportunities.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867283","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 Standardized Acute Care Plan for Complex Care Medicine Service Patients: A Quality Improvement Initiative.","authors":"Tracy Markwell, Ellen Benjamin, Lisa Ann Heard, Ryan Thompson, Joanne Roman Jones","doi":"10.1891/JDNP-2025-0046","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0046","url":null,"abstract":"<p><p><b>Background:</b> Care transition plans, or acute care plans (ACPs), are created specifically for frequent health care utilizers of the Complex Care Medicine Service (CCMS) at a large urban hospital emergency department (ED). <b>Objective:</b> The aims of the project were to develop, implement, and evaluate a standardized CCMS ACP using a multidisciplinary approach to facilitate the transitions-of-care process in the ED. <b>Methods:</b> A quality improvement project, utilizing a before-and-after approach, evaluated the implementation of standardized ACPs among CCMS patients in the ED, including number of standardized ACPs successfully implemented; level of education participation among CCMS providers; ED and CCMS provider feedback from huddles to inform implementation; and final perceptions of CCMS providers regarding project barriers and successes. <b>Results:</b> Prior to implementation, 40 out of 65 CCMS patients' (62%) electronic medical records (EMRs) maintained an existing ACP. Post implementation, all 65 (100%) CCMS patients' EMRs maintained a completed and standardized ACP. All CCMS providers attended project education sessions and huddles and perceived improved patient care as a result. <b>Conclusions:</b> Targeted education huddles can be used to support and improve newly standardized ACPs. <b>Implications for Nursing:</b> Future work should consider whether standardization and improvement in use also suggest better patient outcomes and provider satisfaction.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457117","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":"Strategic Delegation in Doctor of Nursing Practice Project Implementation: Advancing Evidence-Based Practice Through Team Empowerment.","authors":"Kirk Bradford, Gina M Nickels-Nelson","doi":"10.1891/JDNP-2025-0069","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0069","url":null,"abstract":"<p><p><b>Background:</b> Delegation is a critical yet underutilized leadership strategy in Doctor of Nursing Practice (DNP) education and its implementation. While DNP curricula emphasize systems thinking, formal training in strategic delegation is limited, leaving nurse leaders without structured guidance to ensure project sustainability and scalabiliy. <b>Objective:</b> The purpose of this quality improvment initiative was to evaluate the impact of a structured delegation framework on the implementation of Morse Fall Scale (MFS) education within a Level 1 trauma center. <b>Methods:</b> A quality improvement initiative at a level 1 trauma center utilized structured delegation to implement Morse Fall Scale (MFS) education for nurses. Nurse residents were trained and assigned roles in the delivery of educational content, survey administration, and staff coaching. <b>Intervention:</b> A five-step delegation framework (assessment, assignment, training, oversight, and outcome) was used to align responsibilities with the team's competencies. <b>Results:</b> Staff MFS knowledge scores improved significantly after the intervention (<i>F </i>[2, 38] = 16.41, <i>p</i> < .001). Delegation enabled a broader reach, enhanced learner engagement, and fostered leadership development among nurse residents. <b>Conclusions:</b> Strategic delegation strengthens DNP project implementation by optimizing team contributions and fostering sustainability. This case illustrates the importance of integrating delegation into DNP leadership competency and curriculum design. <b>Implications for Nursing:</b> Strategic delegation is a critical DNP leadership competency that ensures project sustainability and scalability. By utilizing a structured delegation framework, DNP leaders can optimize team contributions, foster leadership development in emerging nurses, and drive significant improvements in clinical knowledge and patient safety outcomes. Integrating formal delegation training into DNP curricula is essential for preparing leaders to manage complex health system transformations.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457120","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":"Older LGBT+ Adults and Cultural Competence Among Residential Staff.","authors":"Brian K Eggen","doi":"10.1891/JDNP-2025-0066","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0066","url":null,"abstract":"<p><p><b>Background:</b> The population of older LGBT+ adults is increasing, yet many face fear, isolation, and homophobia in care facilities. A lack of LGBT+-specific training among health care staff perpetuates heteronormative practices in care settings. <b>Objective:</b> This project evaluated whether a 2-hour, in-person training could enhance residential care staff's knowledge, skills, and awareness of social oppression faced by LGBT+ individuals. <b>Methods:</b> A literature review identified the best practices for staff education. Eleven staff members from an urban southwestern residential community participated after providing written consent. Participants completed the Ally Identity Measure survey pre- and posttraining, assessing knowledge and skills, openness and support, and awareness of oppression (<i>r</i> = .73; α = .88). <b>Results:</b> Descriptive statistics and paired <i>t</i> tests showed statistically significant improvement in overall scores (<i>p</i> < .001). Results are limited by small sample size and the pilot nature of the project. <b>Conclusions:</b> These findings support that brief cultural competency training enhances staff understanding of LGBT+ aging issues, with a focus on creating safe environments for residents. It is a call to action to continue inclusive efforts for older LGBT+ adults and provide staff with tools to engage with residents more fully aware of societal stressors and historical oppression. <b>Implications for Nursing:</b> Understanding the discrepancy between staff knowledge and understanding of LGBT+ older adults invites the opportunity to apply the underpinnings of nursing training and philosophical foundations. Nursing embodies holistic, whole-person care, and cultural competence aligns with caring for the person in their entirety.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457132","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":"Doctor of Nursing Practice-Led Family Planning Services at a Rural Health Department.","authors":"Pamela Miller","doi":"10.1891/JDNP-2025-0044","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0044","url":null,"abstract":"<p><p><b>Background:</b> In 1995, a rural health department initiated a Title X-funded family planning program serving three Midwestern counties. The program was discontinued in 2017 due to the lack of a nurse practitioner (NP), leading to limited access to family planning services and increased teen births and low-birth-weight infants. <b>Objective:</b> To describe the impact of a Doctor of Nursing Practice (DNP)-led initiative to restart family planning services in the underserved rural area. <b>Methods:</b> In 2022, a DNP-prepared NP led the project to reinstate the clinic. The project committee secured funding, designated clinic space, ordered supplies, contracted a provider, and developed staff assignments, billing methods, and community outreach strategies. <b>Results:</b> The clinic reopened in June 2023, offering comprehensive family planning services and education. By the third quarter of 2024, total utilization reached 308 patients. Over 85% of eligible patients initiated contraception. Sexually transmitted infection testing totaled 289 tests, and 31 identified positive cases were treated. Sixty-seven cervical cancer screenings were completed. <b>Conclusions:</b> The DNP-led initiative successfully reinstated family planning services that produced immediate measurable improvements in access to reproductive health care. The model demonstrates the significant population-level impact of DNP-led initiatives on rural health systems. <b>Implications for Nursing:</b> Utilizing DNP-prepared NPs in leadership roles can enhance health care delivery in underserved areas, improving public health outcomes and addressing disparities in underserved rural areas, demonstrating the value of advanced nursing practice in community health initiatives.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875945","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}