Journal of Doctoral Nursing Practice最新文献

{"title":"Mindfulness-Based Cognitive Therapy Self-Directed Education in Depressive Symptom Remission: A Quality Improvement Study.","authors":"Bethanie Simmons-Becil, Kirsten Pancione","doi":"10.1891/JDNP-2025-0029","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0029","url":null,"abstract":"<p><p><b>Background:</b> Mindfulness-based cognitive therapy (MBCT), a therapeutic method that combines cognitive behavioral therapy (CBT) techniques and mindful meditation teachings, has been highly efficacious in remission maintenance for depressive symptoms and is currently recommended for remission maintenance of depression. <b>Objective:</b> The MBCT quality improvement study sought to implement an evidence-based MBCT-guided self-education program to maintain remission of depressive symptoms, improve quality of life, and reduce disability. <b>Results:</b> Comparing the Patient Health Questionnaire-9 (PHQ-9), Sheehan Disability Scale (SDS), and World Health Organization Well-Being Questionnaire-5 (WHO-5) surveys from both the treatment-as-usual and MBCT groups, there is a notable improvement in scores in the MBCT group. Within 8 weeks, the intervention group mean PHQ-9 scores reflected a 41% decline in depression; the WHO-5 scores reflected a 56.06% increase in quality of life, and the group mean SDS scores reflected a 66.67% improvement in function. <b>Conclusions:</b> This evidence-based MBCT self-education program, through a quality improvement implementation, decreased incidence of relapse in depressive symptoms by maintaining stable mood, maintaining functional ability, and maintaining or improving quality of life of the participants. <b>Implications for Nursing:</b> Combining MBCT techniques with self-education offers evidence-based practice education, autonomy, and self-efficacy for those who struggle with recurrent depression and lack of access to quality mental health care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692965","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":"Optimizing Rehabilitation Referrals to Improve Early Mobility and Discharge.","authors":"Dianne A London, Suzanna Fitzpatrick","doi":"10.1891/JDNP-2025-0071","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0071","url":null,"abstract":"<p><p><b>Background:</b> In a 30-bed medical-surgical unit, only 53% of patients received complete mobility screening versus the 80% national benchmark due to incomplete activity orders and poor communication among providers, nurses, and therapists. <b>Objective:</b> The aim of the study is to enhance mobility management by integrating systematic mobility discussions into daily multidisciplinary rounds and achieving 100% comprehensive mobility screenings. <b>Methods:</b> This 15-week project implemented staff training on the care team rounds flow sheet. Patient mobility was reviewed during daily rounds, with providers completing missing activity orders to enable nursing screenings and rehabilitation referrals. Weekly data were analyzed using Research Electronic Data Capture (REDCap). <b>Results:</b> Among 359 patients, 5.6% (<i>n</i> = 20) lacked activity orders and 7% (<i>n</i> = 24) lacked mobility screenings. During rounds, 100% of patients with missing activity orders received appropriate orders and subsequent screenings. Run-chart analysis showed decreasing trends in missing orders. <b>Conclusions:</b> The intervention achieved 100% compliance in placing missing activity orders and assessing mobility status. Using validated tools within interdisciplinary discussions enhances patient outcomes and hospital efficiency. <b>Implications for Nursing:</b> This approach empowers nurses to conduct comprehensive mobility assessments, improving care coordination and patient safety while establishing clear protocols for mobility management.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692987","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":"Early Prenatal Care Bridges: A Quality Improvement Project to Support Early Care Engagement.","authors":"Josephine S D Arnold, Tammy Walker-Smith, Sarah Guy, Rosie Banda","doi":"10.1891/JDNP-2024-0071","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0071","url":null,"abstract":"<p><p><b>Background:</b> The United States leads the West in maternal mortality, with 18.6 deaths per 100,000 births. Late prenatal care (PNC) entry, a notable problem in the United States, is associated with maternal mortality. The clinic of interest had a 15% prevalence of early PNC entry in 2023. <b>Objective:</b> This quality improvement study sought to assess the relationship between free initial prenatal (IPN) visits with a community nurse practitioner (NP) and early PNC care entry for uninsured pregnant adults. <b>Methods:</b> Guiding frameworks included King's Theory of Goal Attainment and Stevens' Star Model of Knowledge Transformation. Aims included a 2% monthly increase in early PNC appointments and completed early PNC visits. Uninsured pregnant adults (<i>n</i> = 20) were recruited for IPN visits. PNC entry was assessed via follow-up contacts. <b>Results:</b> Sixty-five percent of participants reported early PNC appointments, and 45% completed early PNC visits during the study period. <b>Conclusions:</b> This study supported the efficacy of NP-led IPN visits to improve PNC entry timing. Limitations included a limited sample and study period. <b>Implications for Nursing:</b> NP care for early pregnancies may promote early PNC entry. Future research utilizing larger samples and longitudinal formats is indicated.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693018","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":"The Implementation of a CDC Guideline Using an Evidence-Based Risk Assessment Tool to Increase Colorectal Cancer Screening in Primary Care Patients.","authors":"Jaime L Musone","doi":"10.1891/JDNP-2024-0065","DOIUrl":"https://doi.org/10.1891/JDNP-2024-0065","url":null,"abstract":"<p><p><b>Background:</b> Over the years, colorectal cancer (CRC) has been diagnosed in younger adults less than 50 years of age, most common in those with Lynch syndrome. In turn, CRC has become the fourth leading cause of cancer deaths. According to Sinicrope et al. it is imperative in identifying inherited syndromes, Lynch syndrome being the most recurrent. <b>Objective:</b> This quality improvement project aimed to increase colorectal cancer screening in primary care patients by implementing a CDC guideline and risk assessment tool. The implementation of an evidence-based risk assessment tool during primary care visits will improve the identification of patients who should be referred for CRC screening. <b>Methods:</b> For this quality improvement project, 25 patients were selected at random during their well-visit encounter, between the ages of 45 and 50, male or female, who did not have a current diagnosis or history of CRC. Over a 2-week period, the Centers for Disease Control and Prevention guideline and the evidence-based risk assessment tool were implemented during these patient encounters. Following implementation, there was a vigorous chart review to further determine which of those individuals were at risk for CRC based on the risk assessment tool. If the evidence identified a patient at risk for CRC, a colonoscopy was ordered. <b>Results:</b> The following week after implementation, a chart review was performed on all 25 of these individuals, which further identified who was at risk for CRC. The female patient accounted for only 4% of the total charts reviewed, whereas the remaining 24 male patients were calculated at 96% of the total. The only female patient indeed had CRC risk factors based on the risk assessment tool; in turn, a colonoscopy was ordered. For the remaining 24 male patients, it was identified that 7 of these individuals had CRC risk factors based on the risk assessment tool, and the remaining 17 did not. It was further identified that three out of the seven male patients, or 42.86%, were overdue for a colonoscopy. <b>Conclusion:</b> This means that approximately 29.167% of the male patients were identified as having CRC risk factors, and 70.833% were not. After patient discussion, a colonoscopy was ordered for all seven male individuals. <b>Implications for Nursing:</b> In relation to these project findings, it is imperative that the nursing community continues to have leaders who will educate and promote the health and well-being of patients. As nurses continue to provide effective patient education, this will positively impact the overall patient health care delivery. By using risk assessment tools, such as the tool used for this project, nurses have the ability to prevent cancers and other disease states.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692984","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":"Implementing Prescribing Guidelines for Atypical Antipsychotics to Reduce Metabolic Effects.","authors":"Katrice Lowe, Kelli Whitted","doi":"10.1891/JDNP-2025-0063","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0063","url":null,"abstract":"<p><p><b>Background:</b> Atypical antipsychotics have become the standard prescribing therapy for mental health treatment. Metabolic conditions such as weight gain and increased glucose measures have been a consistent concern with the use of these medications. <b>Objective:</b> An evidence-based practice change was initiated by implementing the Prescribing Guidelines for Atypical Antipsychotics to evaluate the effect of the guidelines on weight, waist circumference, blood pressure, fasting blood glucose, and fasting lipid profile. <b>Methods:</b> Implementation of the prescribing guidelines prompted the provider to assess weight, waist circumference, blood pressure, fasting blood glucose, and fasting lipid profile and monitor changes in these variables. <b>Results:</b> There were 23 patients who completed the 12-week data collection, and data analysis provided statistically significant results. The study revealed that utilization of the interventional tool can reduce metabolic effects by increased monitoring of the measures within the tool. <b>Conclusions:</b> Patients can have decreased long-term metabolic effects of atypical antipsychotics when providers utilize structured guidelines to monitor the side effects of these medications. <b>Implications for Nursing:</b> Providers must complete initial and ongoing assessments of patients initiated on atypical antipsychotic medications and also patients currently taking these medications to assess for side effects as well as ensure treatment response.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692948","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":"Exploring the Role of Embedded Resilience Training in a Doctor of Nursing Practice Program.","authors":"Susan E Young, Sara L Hubbell, Anka Roberto","doi":"10.1891/JDNP-2025-0087","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0087","url":null,"abstract":"<p><p><b>Background:</b> Graduate nursing students face unique challenges balancing the demands of school, work, and personal life, putting both their academic success and individual well-being at risk. <b>Objectives:</b> This study examined the impact of embedding Community Resiliency Model^© training in a Doctor of Nursing Practice (DNP) program at a U.S. public university to determine the utility of and perceived need for resilience training in this population and measure student resilience, burnout, and posttraumatic growth. <b>Methods:</b> A quantitative, pre/post design was used to evaluate outcomes via surveys utilizing open-ended questions and three validated instruments before and following resilience training. <b>Results:</b> Among 98 students who participated, the training was described as good to excellent quality (95%) and most (85%) continued to use the skills learned. All students recommended that resilience training should be included in a DNP program. There were no statistically significant differences in measures of resilience, burnout, or posttraumatic growth. <b>Conclusions:</b> A holistic approach including building resilience is needed to appropriately support graduate nursing students. <b>Implications for Nursing:</b> Resilience training is essential to equip DNP students with the skills needed to navigate demands of personal and professional life while ensuring their own well-being and that of those they serve.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693005","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":"Implications of the 2025 Executive Order on Homelessness and Mental Health for Nursing Practice.","authors":"Elijah Grant","doi":"10.1891/JDNP-2025-0093","DOIUrl":"https://doi.org/10.1891/JDNP-2025-0093","url":null,"abstract":"","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":"147628804","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":"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}