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Nursing Theses and Dissertations

Theses/dissertations from 2023 2023.

Psychological Distress, Resilience, and the Impact on Quality of Life in Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy , Lauren Schwab

Theses/Dissertations from 2022 2022

Medication-Assisted Treatment Versus 12-Step Group Therapy: A Comparative Analysis of Adherence and Abstinence In Patients With Opioid Use Disorder , Derrick C. Glymph

Theses/Dissertations from 2021 2021

Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy: A Mixed Methods Study , Tina M. Mason

Theses/Dissertations from 2020 2020

In Post-Extubated Patients What are the Preferred Methods of Communication During Their Experience of Endotracheal Intubation with Mechanical Ventilation , Lanette Dumas

The Effect of Hope on the Relationship between Personal and Disease Characteristics and Anxiety and Depression in Adolescents and Young Adults with Cancer , Sharon B. McNeil

Predictors of Nonadherence to Radiation Therapy Schedules Among Head and Neck Cancer Patients , Jennifer Lynn Miller

Theses/Dissertations from 2019 2019

Perceived Discrimination and Cardiovascular Outcomes in Blacks: A Secondary Data Analysis of the Heart SCORE Study , Marilyn Aluoch

Exploration of Gratitude in Cardiovascular Health: Mediators, Medication Adherence and Psychometrics , Lakeshia A. Cousin

Theses/Dissertations from 2018 2018

Fatigue-related Symptom Clusters and their Relationship with Depression, and Functional Status in Older Adults Hospice Patients with Cancer. , Suzan Fouad Abduljawad

Genetic Moderation of Pain and Fatigue Symptoms Resulting from the Mindfulness-Based Stress Reduction for Breast Cancer Program , Carissa Bea Alinat

The Moderating Effect of Religion on Death Distress and Quality of Life between Christian Cancer patients in the United States with Muslim cancer patients in Saudi Arabia , Doaa Almostadi

Prevention of Post Intensive Care Syndrome-Family with Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study , Paula L. Cairns

Assessing Abstinence in Infants Greater Than 28 Days Old , Genieveve J. Cline

The Relationship Between Sleep Quality and Motor Function in Hospitalized Older Adult Survivors of Critical Illness , Maya N. Elías

The Role of Migration-Related Stress in Depression Among Haitian Immigrants in Florida: A Mixed Method Sequential Explanatory Approach , Dany Amanda C. Fanfan

The Effect of Depression, Inflammation and Sleep Quality on Risk for Cardiovascular Disease , Catherine L. O'Neil

Adapting SafeMedicate (Medication Dosage Calculation Skills software) For Use In Brazil , Samia Valeria Ozorio Dutra

Theses/Dissertations from 2017 2017

The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function. , Ashraf Abulhaija

Validation of the Electronic Kids Dietary Index (E-KINDEX) Screening Tool for Early Identification of Risk for Overweight/Obesity (OW/OB) in a Pediatric Population: Associations with Quality of Life Perceptions , Patricia A. Hall

Theses/Dissertations from 2016 2016

The Effectiveness of an Intervention Designed to Improve Chlorhexidine (CHG) Bathing Technique in Adults Hospitalized in Medical Surgical Units , Janette Echemendia Denny

Levels of Distress Among Women Veterans Attending a Women’s Health Specialty Clinic in the VA Healthcare System , Debbie T. Devine

Examination of the Use of Accelerated Resolution Therapy (ART) in the Treatment of Symptoms of PTSD and Sleep Dysfunction in Veterans and Civilians , Marian Jevone Hardwick

Investigating the Mutual Effects of Depression and Spiritual Well-being on Quality of Life in Hospice Patients with Cancer and Family Caregivers Using the Actor-Partner Interdependence Model , Li-Ting Huang

The Change in Nutritional Status in Traumatic Brain Injury Patients: A Retrospective Descriptive A Retrospective Descriptive Study , Dina A. Masha'al

Exploring the Relationship Between Severity of Illness and Human Milk Volume in Very Low Birth Weight and Extremely Low Birth Weight Infants Over Six Weeks , Shannon Leigh Morse

Cardiovascular Disease Risk Scores and Novel Risk Factors in Relation to Race and Gender , Johanna Wilson

Theses/Dissertations from 2015 2015

A Comparative Evaluation of the Learner Centered Grading Debriefing Method in Nursing Education , Marisa J. Belote

Sleep, Depressive Symptoms and Cognition in Older Adults and Caregivers of Persons with Dementia , Glenna Shemida Brewster

The Relationship between Hearing Status and Cognitive Performance and the Influence of Depressive Symptoms in the Older Adult , Julie A. Daugherty

Basal Salivary Oxytocin and Skin to Skin Contact among Lactating Mothers of Premature Infants , Jessica Marie Gordon

The Relationship Between Nurses' Emotional Intelligence and Patient Outcomes , Mary Kutash

Sexual Functioning and Body Image in Younger Breast Cancer Survivors , Carly Lynn Paterson

Cognitive Load of Registered Nurses During Medication Administration , Sarah Faith Perron

A Comparison of Quality of Life between Intense and Non-Intense Treatment for Patients with Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome , Sara Marie Tinsley

Theses/Dissertations from 2014 2014

Acculturation, Self-Efficacy and Breastfeeding Behavior in a Sample of Hispanic Women , Ivonne F. Hernandez

Knowledge and Acceptance of HPV and the HPV Vaccine in Young Men and Their Intention to be Vaccinated , Brenda Renee Jasper

The Relationships Between Sleep Disturbances, Depression, Inflammatory Markers, and Sexual Trauma in Female Veterans , Ellen Marcolongo

Examination of Possible Protective Effect of Rhesus D Positive Blood Factor on Toxoplasma-related Depressive Symptoms in Pregnancy , Lisa Lynn Parnell

Knowledge, Attitudes, and Practice of Primary Care Nurse Practitioners Regarding Skin Cancer Assessmnets: Validity and Reliability of a New Instrument , Debra Michelle Shelby

Theses/Dissertations from 2013 2013

Knowledge and Practice of Reproductive Health among Mothers and their Impact on Fetal Birth Outcomes: A Case of Eritrea , Winta Negusse Araya

Race/Ethnicity, Subjective and Objective Sleep Quality, Physical and Psychological Symptoms in Breast Cancer Survivors , Pinky H. Budhrani

Factors Predicting Pap Smear Adherence in HIV-infected Women: Using the Health Belief Model , Crystal L. Chapman Lambert

The Relationship Between Socioeconomic Status and Body Mass Index on Vitamin D Levels in African American Women with and without Diabetes Living in Areas with Abundant Sunshine , Shani Vann Davis

Predictors of Quality of Life in Patients with Cutaneous T cell Lymphoma , Darcie Marie Deaver

Relationship between dysphoric moods, risk-taking behaviors, and Toxoplasma gondii antibody titers in female veterans , Allyson Radford Duffy

Prenatal Stress, Depression, and Herpes Viral Titers , Pao-Chu Hsu

Factors Associated with Fear of Breast Cancer Recurrence Among Survivors , Jean Marie Lucas

Sickle Cell Disease: The Role of Self-Care Management , Nadine Matthie

Factors Influencing Vaccination Decisions in African American Mothers of Preschool Age Children , Chauntel Mckenzie Mcnair

The Strong Black Woman, Depression, and Emotional Eating , Michelle Renee Offutt

Development of an Investigator-designed Questionnaire Concerning Childbirth Delivery Options based on the Theory of Planned Behavior , Chun-Yi Tai

Theses/Dissertations from 2012 2012

The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer. , Abdel Alkhalouf

Testing a Model of Bacterial Vaginosis among Black Women , Jessica Brumley

The Effect of Tight Glycemic Control on Surgical Site Infection Rates in Patients Undergoing Open Heart Surgery , Sierra Gower

Development of a Tool for Pressure Ulcer Risk Assessment and Preventive Interventions in Ancillary Services Patients , Monica Shutts Messer

Hospice Nurses- Attitudes and Knowledge about Pain Management , Amie Jacqueline Miller

Theses/Dissertations from 2011 2011

Literacy and Hazard Communication Comprehension of Employees Presenting to an Occupational Health Clinic , Christine Bouchard

A Meta-Analysis of Cultural Competence Education in Professional Nurses and Nursing Students , Ruth Wilmer Gallagher

Relationship Between Cancer-Related Fatigue and Depression: A Pilot Study , Gloria Michelle Guess

A Comparison of Oncology and Non-Oncology Nurses in Their Knowledge of Cancer Pain Management , Nicole Houle

Evaluating Knowledge and Attitudes of Graduate Nursing Students Regarding Pain , Eric Bartholomew Jackson

Bone Marrow Transplant Nurses' Attitudes about Caring for Patients Who are Near the End of Life: A Quality Improvement Project , Leslie Lauersdorf

Translation and Adaptation of the Center for Epidemiologic Studies-Depression (CES-D) Scale Into Tigrigna Language for Tigrigna Speaking Eritrean Immigrants in the United States , Mulubrhan Fisseha Mogos

Nurse Manager Emotional Intelligence as a Predictor to Registered Nurse Job Satisfaction and RN Perceptions of the Practice Environment and the Relationship to Patient, Nursing and Hospital Outcomes , Jacqueline Cecilia Munro

The Relationship of Mid-Pregnancy Levels of Cytokines, Stress, and Depression with Gestational Age at Delivery , Melissa Molinari Shelton

Prophylactic, Risk-Reducing Surgery in Unaffected BRCA-Positive Women: Quality Of Life, Sexual Functioning and Psychological Well-Being , Sharon Tollin

Theses/Dissertations from 2010 2010

The Relationship Between FAM5C SNP (rs10920501) Variability, Metabolic Syndrome, and Inflammation, in Women with Coronary Heart Disease , Jennifer L. Cline

Women’s Perceptions of Postpartum Stress: A Narrative Analysis , Nancy Gilbert Crist

Lived Experience: Near-Fatal Adolescent Suicide Attempt , Phyllis Ann Dougherty

Exploring the Relationships among Work-Related Stress, Quality of Life, Job Satisfaction, and Anticipated Turnover on Nursing Units with Clinical Nurse Leaders , Mary Kohler

A Comparative Study of Knowledge of Pain Management in Certified and Non-Certified Oncology Nurses , Sherrie A. LaLande

Evaluating Knowledge and Attitudes of Undergraduate Nursing Students Regarding Pain Management , Jessica Latchman

Evaluation of Oncology Nurses' Knowledge, Practice Behaviors, and Confidence Specific to Chemotherapy Induced Peripheral Neuropathy , Rebecca Denise McAllister

Moderating the Effectiveness of Messages to Promote Physical Activity in Type 2 Diabetes , Rachel E. Myers

Factors Affecting the Process of Clinical Decision-Making in Pediatric Pain Management by Emergency Department Nurses , Teresa A. Russo

The Correlation Between Neuropathy Limitations and Depression in Chemotherapy Patients , Melissa Thebeau

Theses/Dissertations from 2009 2009

Fatigue Symptom Distress and Its Relationship with Quality Of Life in Adult Stem Cell Transplant Survivors , Suzan Fouad Abduljawad R.N., B.S.N.

Nursing Advocacy and the Accuracy of Intravenous to Oral Opioid Conversion at Discharge in the Cancer Patient , Maria L. Gallo R.N., O.C.N.

Transitional Care for Adolescents with HIV: Characteristics and Current Practices of the Adolescent Trials Network Systems of Care , Patricia Gilliam

The Effect of Ethical Ideology and Professional Values on Registered Nurses’ Intentions to Act Accountably , Susan R. Hartranft

Falls in Bone Marrow Transplant Patients: A Retrospective Study , Lura Henderson R.N., B.S.N.

Predictors of cancer caregiver depression symptomatology , Henry R. Rivera

Psychosocial outcomes of weight stigma among college students , Sabrina Joann Robinson

The Experience of Fatigue and Quality of Life in Patients with Advanced Lung Cancer , Andrea Shaffer

The Relationship Between Uncertainty in Illness and Anxiety in Patients With Cancer , Naima Vera

Shifting Paradigms: The Development of Nursing Identity in Foreign-Educated Physicians Retrained as Nurses Practicing in the United States , Liwliwa Reyes Villagomeza

Theses/Dissertations from 2008 2008

Prostate Cancer Screening Intention Among African American Men: An Instrument Development Study , Susan Anita Baker

The Geriatric Cancer Experience in End of Life: Model Adaptation and Testing , Harleah G. Buck

Communication Systems and HIV/AIDS Sexual Decision Making in Older Adolescent and Young Adult Females , Rasheeta D. Chandler MS, ARNP, FNP-BC

Relationship of Anger Trait and Anger Expression to C-Reactive Protein in Post-Menopausal Women , Rosalyn Gross

Identifying Patients with Cancer at Risk of Experiencing a Fall While Hospitalized , Joann M. Heaton

Modulation of Monocyte-Derived Dendritic Cell Maturation and Function by Cigarette Smoke Condensate in a Bronchial Epithelial Cell Co-Culture Model , Alison J. Montpetit

Cancer Patients with Pain: Examination of the Role of the Spouse/Partner Relationship In Mediating Quality of Life Outcomes for the Couple , Mary Ann Morgan

Development of an Ecological Model to Predict Risk for Acquisition of Clostridium difficile -Associated Diarrhea During Acute Care Hospitalization , Susan Elaine Steele

Development and Psychometric Evaluation of the Chemotherapy Induced Peripheral Neuropathy Assessment Tool , Cindy S. Tofthagen

Health Decision Behaviors: Appropriateness of Dietary Choice , Daryle Hermelin Wane

Theses/Dissertations from 2007 2007

The Relationship Between Sleep-Wake Disturbance and Pain in Cancer Patients Admitted to Hospice Home Care , Marjorie Acierno

Wheelchair Positioning and Pulmonary Function in Children with Cerebral Palsy , Lee Barks

Structural Equation Model of Exercise in Women Utilizing the Theory of Unpleasant Symptoms and Social Cognitive Variables , Sarah Elizabeth Cobb

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Writing a Thesis for Nursing School

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Writing a thesis presents an opportunity for graduate students to conduct scholarly inquiry, with the potential of publishing their finished paper. A thesis requires nursing students to identify a problem in nursing, and review academic literature while developing advanced research skills. Thesis advisors and committees guide students from the proposal phase to the final oral defense, a process that spans about two semesters.

Not every nursing student is required to complete a thesis. Some nursing programs offer a non-thesis option, in which candidates complete a final capstone project or oral examination on topics such as nursing theories and clinical practices.

The thesis process and requirements vary by school. Ohio State University’s master of science in nursing program’s final examination includes oral and written portions.

Want to know what to expect during the thesis process? Read on to learn how you can choose a thesis topic and orally defend your paper.

Choosing Your Nursing Thesis Topic

Nursing students must choose a thesis topic before they begin the research and writing process, typically within the first two terms of nursing school. A solid thesis must present an original argument, manageable research scope, and worthy academic pursuit. A thesis advisor or research professor will help to guide each student through the process of choosing a topic.

In the conceptual phase, candidates research potential thesis topics based on their interests within their nursing specialty. Students may start with a broad topic such as obesity and weight management, depression, or cardiovascular disease. To narrow their thesis argument, graduate students might focus on racial or ethnic groups, socio-economic issues, or current events.

After settling on a topic, students draft and submit a thesis proposal to an advisor or committee chair. Once this proposal has been approved, students can begin the formal work on his or her approved thesis topic.

While graduate students must complete a thesis to fulfill the requirements of a master’s degree in nursing, the thesis process also offers a chance for future nurses to immerse themselves in current academic literature and collaborate with fellow graduate students, faculty, and professors. A thesis can also serve as the foundation for doctoral studies. A thesis at the doctoral (PhD) level is called a dissertation.

Completing Your Nursing Thesis

Brainstorming a thesis topic begins as early as the first semester of a master’s in nursing program. The formal thesis process, which typically spans multiple terms, does not take place until the student’s final year, usually during the last term.

Thesis requirements vary by school, and students must meet specific deadlines and take prerequisite courses beforehand. At the University of Texas-Houston’s School of Nursing , candidates take a public health class before they submit a thesis proposal.

Future nurses work under the guidance of a thesis committee and advisor. The experience of writing a thesis trains students in original investigation, data collection, implementing research design, and public speaking. Candidates also learn to flex their analytical thinking skills and master a specific area of nursing as they develop the ability to analyze and draw conclusions through data.

At a program’s conclusion, students submit their thesis as a bound manuscript or electronic file. In addition to submitting a written report, students orally defend their final thesis in front of the committee. Many graduates also submit their manuscripts for publication.

Presenting Your Nursing Thesis

Graduate students generally orally defend their proposal and present their completed thesis in front of their committee. This committee also includes the thesis mentor, a faculty member specializing in the nursing discipline of their scholarly inquiry. There are generally 3 total committee members on a thesis committee.

Fellow graduate students or consultants outside of the college may attend presentations, if the process is open to the public. Otherwise, the thesis defense remains a private session, with students presenting their findings. The oral examination of the thesis takes up to one hour, but can last longer depending on how many questions the committee has for the student.

During that time, the committee evaluates the thesis based on how the research experience has shaped the student’s graduate education and the findings’ significance to the nursing field. When the exam concludes, the committee either accepts or rejects the thesis defense.

How is a Nursing Thesis Graded?

Nursing schools rely on each committee to formally grade each product in the thesis process. Some graduate nursing students may receive a letter grade, while other nursing schools adhere to a “pass” or “fail” policy.

To determine a grade, the committee assesses the thesis based on set criteria. Committee members look at the project’s key components, including the statement of purpose, literature review, research methodology, analysis, findings, and implications. The process and grading criteria for the thesis process can be found in the school’s graduate handbook. Most of these handbooks are published online for student review.

The thesis must identify significant issues or service gaps in nursing and present them in a concise and coherent fashion. Candidates must support all findings and analysis by research and explain the implications for healthcare.

The oral defense also factors into the grade. The committee grades the defense based on the quality of the student’s presentation, taking into consideration if the student spoke clearly and presented a logical and well-organized argument.

What is the Difference Between a Nursing Thesis and a Capstone?

A nursing thesis and a capstone demonstrate the student’s comprehensive knowledge and educational journey. Graduate students in a non-research track may have the choice of completing a clinical project. Doctoral of Nursing ( DNP ) students complete a capstone project.

Graduate-level nursing students work on an original scholarly inquiry during their thesis, while undergraduates recap their cumulative learning experience. The thesis process, which includes completing nursing courses and writing a proposal, takes place over the entire program.

Learn more about the difference between a thesis and capstone project on this page .

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• v.3; 2021 Nov
• PMC11080477

The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review

a Advanced Nurse Practitioner, Hampshire Hospitals Foundation Trust, Hampshire, United Kingdom

Dean Whitehead

b College of Health and Medicine, School of Nursing, University of Tasmania, Launceston TASMANIA 7250

To evaluate the effectiveness of the role of advanced nurse practitioners compared to physicians-led/ usual care (care managed by medical doctors or non-advanced nurse practitioners)

Advanced nurse practitioners contribute to the improvement of quality patient care and have substantial potential to optimise the health of people globally. Since the formal recognition of advanced nurse practitioners by the International Council of Nurses, among others, the role has been adopted across most departments and clinical specialties, particularly in high-income countries.

Systematic review of primary research evidence

Data Source

MEDLINE, EMBASE, CINAHL, Cochrane registry, Cochrane trials, and Cochrane EPOC (PDQ Evidence) were searched for randomised controlled trials (RCTs) of patient care and health resource utilisation outcomes associated with advanced nurse practitioners.

Review Methods

The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The chosen articles were restricted to full-text English language trials published in the last 20 years, incorporating comparators of usual care. Search terms were limited to variations of advanced nurse practitioner role and practice. The eligible studies were bias risk assessed and quality assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Clinical and service outcomes were analysed using narrative synthesis as the marked heterogeneity between studies precluded meta-analysis.

Thirteen RCTs were reviewed. All of them were conducted across high-income countries within primary care and hospital settings involving paediatric and adult patients. Five trials were assessed as high quality, and eight were of low to moderate quality. Positive effects were demonstrated for the impact of advanced nurse practitioners on usual care; for indigestion, mean difference [MD] 2.3: 95% CI 1.4, 3.1]), perceptions of health status [ (MD –140.6; 95% CI –184.8, –96.5)], satisfaction levels [ (MD ranged from –8.79; 95% CI –13.59, –3.98 to 0.61; 95% CI –4.84, 6.05)], physical function (1.58 [SD 0.76] v. 1.81 [SD 0.90]), and blood pressure control (systolic [133 [SD 21] v. 135 [SD 19] mmHg p  = 0.04] and diastolic [77 [SD 10] v. 80 [SD 11] mmHg p  = 0.007]) were looked at. Positive effects related to service provision included improved patient satisfaction and reductions in waiting times and costs, which significantly favored advanced nurse practitioners (all p  < 0.05).

The evidence of this review supports the positive impact of advanced nurse practitioners on clinical and service-related outcomes: patient satisfaction, waiting times, control of chronic disease, and cost-effectiveness especially when directly compared to medical practitioner-led care and usual care practices - in primary, secondary and specialist care settings involving both adult and pediatric populations.

• • What is already known about this topic?
• • Previous randomized control trials and systematic reviews identify that nurse-led care (as a substitute for physician-led care) can improve overall patient care and service outcomes delivery.
• • Consistently reported positive outcomes include greater patient satisfaction, improved access to health advice, and better chronic disease self-management.
• • Previous reviews, of this nature, have focused on evaluating the impact of nurses working as substitutes for doctors in the primary care setting. This review differs in that it explores the role and capacity of Advanced Nurse Practitioners (ANPs) - in primary, secondary and specialist care settings involving both adult and pediatric populations.
• • Previous reviews focus on the study outcomes of specific nurse-led care interventions. This review evaluates studies that explore the comparable effect of advanced nurse practitioners-led care programes as they directly compare to physician-led/usual care programes.
• • This paper highlights the need for more high-quality randomized control trials design studies to further explore this clinical concept - given the notable existence of methodological flaws in the current research literature.

What this review paper adds?

Alt-text: Unlabelled box

Introduction

Advanced Nurse Practitioners (advanced nurse practitioners) are now a well-recognized subset of nurses who have acquired expert knowledge and advanced clinical skills. Since the formal acceptance and recognition of advanced nurse practitioners by the International Council of Nurses and other formal regulatory bodies and organizations, the role has been adopted by most departments and clinical specialties; particularly in high-income countries (81 countries classed as high-income countries [World Bank, 2019]) such as the United States, United Kingdom, Australia, New Zealand, and the Netherlands ( Scanlon et al., 2020 ). Advanced nurse practitioners have been perceived to benefit patient care and experiences while. At the same time reducing the workload of medical staff, and subsequently optimizing the cost-effectiveness and efficiency of health care services and improving overall patient satisfaction. Emerging evidence has revealed that advanced nurse practitioners can provide comparable levels of care and achieve similar outcomes as physicians (both junior and senior clinicians / medical doctors) and, in some cases, attain superior outcomes with regards to patient satisfaction, waiting times, control of chronic disease, and cost-effectiveness. Although this position has been supported by the International Council of Nurses, Carney (2014) highlights that defining the distinctive nature of advanced nursing practice, recognizing the key competencies and capabilities of advanced nurse practitioners, and exploring facilitative strategies in maintaining, implementing. and supporting the role of advanced nurse practitioners worldwide, is still incrementally developing and on-going studies are needed to map and monitor ANP progression. Given this context, this review aims to explore the impact of advanced nurse practitioners’ role and practice on nurse-led care – especially when aligned with other key health professional groups who have traditionally previously led this care.

An advanced nurse practitioner has been formally defined by the International Council of Nurses as a nurse with professional registration, who has acquired additional expert or specialist knowledge, clinical skills, and complex decision-making capabilities and whose role varies in accordance with the contextual demand (ICN, 2002 ). In the UK, the Royal College of Nursing (RCN) has outlined the minimum standards for advanced nurse practitioners, which encompass a masters-level education in one of several core clinical or research areas through to the capacity of being able to independently prescribe medication ( RCN, 2018 ) – competencies that are required of most advanced nurse practitioners at an international level. The role development of advanced nurse practitioners is usually congruent with the four defining pillars of advanced practice, which are clinical practice, leadership, education, and research, and reflect the level at which advanced nurse practitioners are able to operate ( RCN, 2010 ).

Over recent years, up to 13 different titles have been used to denote advanced nursing practice: clinical nurse specialists (CNS), advanced practice nurse (APN), Advanced Practice Registered Nurse (APRN), nurse consultant (NC), nurse endoscopist, nurse anaesthetist etc ( Cooper et al., 2019 ). This has led to confusion related to role definition and structure – and exactly where such roles fit within the role of the medical disciplines ( King et al. , 2017 ). While CNS, APN, and NCs continue to play fundamental supportive roles in various medical disciplines, it is only in the last two decades that countries have observed an increasing utilisation of these advanced nurse practitioners ( Delamaire and Lafortune, 2010 ).Notably, global health care services are currently experiencing unprecedented pressure, through the growing demands rising of rising population numbers, a rapidly ageing demographic, an increasing prevalence of chronic diseases, shortage of staffing among frontline health professionals, and financial austerity ( Ham, 2017 ). Efforts to address these issues have included considerations around the advanced nurse practitioners’ role in adapting to and coping with such adversity and generating new initiatives to maintain and improve patient care practice (Baileff, 2015). Indeed, ANPs are now considered essential in meeting the complex care needs of patients and generating overall improvements in patient care quality and safety ( Brook and Rushforth, 2011 ). Advanced nurse practitioners are also considered crucial in improving the cost effectiveness and efficiency of healthcare delivery and waste reduction, which may help achieve various government's efficiency savings target. For instance, such saving has been valued at £10 billion ( NHS England, 2014 ). However, conducting research that can directly measure the impact (financial and otherwise) of advanced nurse practitioners in the healthcare arena as the variable that independently benefits patient outcomes is a methodological challenge. In a previous systematic review, Carter and Chochinov (2007) evaluated the impact of nurse practitioners (NP) on four key Emergency Department outcomes: cost, quality of care, satisfaction, and waiting times. After reviewing the primary evidence, the authors suggested that nurse practitioners reduced waiting times, promoted high patient satisfaction levels with care, and provided care that was equivalent to that of a senior medical doctor. No positive effect on cost was demonstrated, but this was compounded by insufficient data regarding the hiring of medical practitioners. In a later systematic review, Wilson et al. (2009) explored the clinical effectiveness of advanced nurse practitioners’ management of minor injuries among adults in the Emergency Department and found that there was no statistically significant difference demonstrated in comparison with the management provided by junior doctors. This review seeks to extend these previous review studies through adding further information related to the expansive roles and capacity of ANPs in both primary and secondary care settings between ANP- led care and physician led care and/or usual care.

The efficiency and impact of the greater utilization of the advanced nursing practice is recognized on an international scale, with advanced nurse practitioners being reported to exist in approximately 70% of all health care systems worldwide (Parker and Hill, 2017; Sheer and Wong, 2008 ). Given the international prevalence of advanced nurse practitioners, it has been observed that such nurses are contributing to current patient care and outcomes, driving improvements in hospital admission and readmission rates, and playing an instrumental role in reducing healthcare costs and improving efficiency within primary and secondary care settings (Parker and Hill, 2017). Table 6 identifies the current international advanced nursing practice context, set criteria, capabilities, and regulations by country of origin.

Existence of advanced nursing practice, set criteria, capabilities and its regulations by country of origin

Research aim

Given the above background and the increases in the number of published studies pertaining to the effectiveness of widely implemented advanced nurse practitioner roles in preliminary literature search, it was deemed appropriate to systematically review the most recent primary research evidence, particularly since this could be used to inform current advanced nursing practice, which does and will continue to play a critical role in meeting increasing population demands and managing rising patient complexity both nationally and internationally ( Christensen et al. , 2009 ). The uniqueness of this review is that it adds expansive roles and capacity of ANPs in both primary and secondary care settings between ANP- led care and physician led care and/or usual care. The care settings, in this review, were expanded to include further specialized disciplines/settings, such as intensive care, whereas studies such as the Laurant and colleagues (2018) Cochrane review focused specifically on primary care and was not exclusively ANP-specific. Furthermore, their study focused on nurse-led care outcomes alone (whilst discussing them against physician-led care) – whereas this review focuses on studies that directly compare ANP-led care to physician-led care. Therefore, this review sought to evaluate the effectiveness of advanced nursing practice on patient outcomes in comparison with other relevant healthcare practitioner providers. The main aim, of this review then, was:

• • To summarize and critically evaluate the evidence of how advanced nurse practitioners can best be utilized to help meet the growing complexity and demands of service-user populations in high-income nations, to further inform current advanced nursing practice by way of how and in what context the role of advanced nurse practitioners can maximally benefit patient care – related to ANPs in both primary and secondary care settings between ANP-led care and physician led care and/or usual care.

This review of the primary literature pertaining to patient outcomes associated with the effectiveness of advanced nurse practitioners was performed against the Cochrane Collaborations criteria for producing credible reviews ( Higgins and Thomas, 2018 ).

Search methods

A search for relevant primary studies was conducted using a series of bibliographic databases, including MEDLINE, EMBASE, CINAHL, Cochrane registry, Cochrane trials, and Cochrane EPOC (PDQ Evidence) in April 2019. Studies were restricted to publication in the last two decades (2000–2019), which were subjected to peer-review and available in English. However, no restrictions were placed on the age of the research subjects, as this would allow for a broader capturing of the impact of advanced nurse practitioners. The final search terms were truncated where necessary and combined using Boolean logic. Grey literature was searched using key and unique terms: Advanced nursing practice, advanced nurse practitioner, clinical impact, resource utilisation outcomes, care quality, patient satisfaction, international and adherence in the research question was searched. Moreover, EThoS British Library and GreyNet were visited. The outcomes were based on an exploratory range of patient- and service-related measures of quality of care, in accordance with the fundamental standards of care of the Care Quality Commission (CQC) and the indicators of care quality defined by the National Institute for Clinical Excellence ( Care Quality Commission, 2019 ; NICE, 2019 ). Restricting the review to just RCT design studies was deemed necessary to facilitate the derivation of causal inferences between exposure to advanced nurse practitioners and reported outcomes, since RCTs represent the agreed standard for evaluating the effect of interventions by being able to control for a range of biases ( Spieth et al. , 2016 ; Whitehead, 2020 ). Exclusion criteria included studies of non-RCT design, studies published in a non-English language, and studies reporting data irrelevant to the ‘PICO’ framework (see Table 1 ).

PICO/ Inclusion and Exclusion Criteria

Search outcomes

Following the acquisition of articles through database searching, the eligibility of the studies was determined by the development and application of the inclusion and exclusion criteria (see Table 1 ) and complemented by the ‘PICO’ framework ( Whitehead, 2020 ).

A total of 456 studies were identified through electronic database searching and, after the removal of duplicates, 402 were subjected to title and abstract screening. At this stage, the application of the inclusion and exclusion criteria led to the exclusion of a further 377 studies, leaving 25 key sources for full-text review and appraisal. The appraisal process resulted in the identification of 12 more studies for exclusion. The reasons included the reporting of incongruent data , insufficient operational definition of an advanced nurse practitioner ( N = 4 ), lack of effective comparison ( N = 1) , and insufficient training of nurses to meet the requirements of advanced nurse practitioners ( N = 7). Consequently, 13 studies were deemed eligible for the final synthesis of results (see Fig. 1 ).

PRISMA chart showing the process leading to study eligibility.

Quality appraisal

In order to assess the risk of different biases in the included RCTs, Cochrane Collaboration's Risk of Assessment Bias Tool for EPOC Reviews was used (Cochrane Effective Practice and Organization of Care, 2017) (see Table 2 ). Risk of bias was expressed in terms of internal and external validity. Internal validity included information on the reliability and completeness of the measurement as well as the ability of the study to control for potential confounding factors (Griffiths et al ., 2018 ) (e.g., binding of outcomes assessment, incomplete outcomes data, and selective reporting). External validity was assessed primarily by considering the representative sampling of a center for a large region/country (Griffiths et al., 2018 ) (e.g., random sample of hospitals/countries) and reported sampling power. The complete quality appraisal checklist used in this literature review is available for access (see Appendix 1 ).

Synthesis of Risk Assessment of Included Studies

Data extraction

Data from eligible studies were extracted using proformas developed by the Cochrane Collaboration (2019), which provide a systematic structure for extracting data. The extracted data were then evaluated for amenability to meta-analysis and, if the degree of inter-study heterogeneity permitted, these were presented using standard Forest plots ( Campbell, Machin, and Walters, 2007 ). However, marked heterogeneity was anticipated, and the review, therefore, contingently analyzed data using a descriptive or narrative-type approach, which could provide meaningful and information-rich findings to inform nursing practice ( Thomas and Harden, 2008 ).

The majority of the studies were at a low or unclear risk of selection, confounding, and ascertainment biases, although a number of studies were deemed to be at high risk of attrition ( Krichbaum, 2007 ; Mundinger et al. , 2000 ; Ryden et al. , 2000 ; Venning et al. , 2000 ). This was where the rates of dropouts or loss to follow-up exceeded 15–20%. Two RCTs ( Krichbaum, 2007 ; Mundinger et al. , 2000 ) were also deemed at a high risk of contamination, as the advanced nurse practitioners’ intervention group also received input from the comparator of physician care. Finally, a number of studies were of high or unclear risk of bias resulting from insufficient statistical power ( Dierick-van Daele et al. , 2009 ; Kamps et al. , 2003 ; Krichbaum, 2007 ; Ryden et al. , 2000 ; van Zuilen et al. , 2011 ; Venning et al. , 2000 ), in turn, increasing the possibility of type II or false-positive errors ( Kim, 2015 ) (see Table 2 for details).

Included studies

A total of 13 international RCTs were included in this review (see Table 3 ). The countries of study origin were the United Kingdom ( Chan et al. , 2009 ; Kinnersley et al. , 2000 ; Ndosi et al. , 2014 ; Stables et al. , 2004 ; Venning et al. , 2000 ; Williams et al. , 2005 ), the United States ( Krichbaum, 2007 ; Mundinger et al. , 2000 ; Ryden et al. , 2000 ), and the Netherlands ( Dierick-van Daele et al. , 2009 ; Kamps et al. , 2003 ; Kuethe et al. , 2011 ; van Zuilen et al. , 2011 ). The NPs as the intervention or exposure of interest were situated in a number of different care settings. These were primary care/general practices ( Dierick-van Daele et al. , 2009 ; Kinnersley et al. , 2000 ; Venning et al. , 2000 ), a cardiothoracic day-unit in a hospital setting ( Stables et al. , 2004 ), out-patient hospital clinics ( Chan et al. , 2009 ; Ndosi et al. , 2014 ; Kamps et al. , 2003 ; Kuethe et al. , 2011 ; Mundinger et al. , 2000 ; van Zuilen et al. , 2011 ), and community-based care involving home-visits, nursing homes, and rehabilitation centres ( Krichbaum, 2007 ; Ryden et al. , 2000 ; Williams et al. , 2005 ).

Included Studies, Study Characteristics, and Main Findings

Participants and nursing intervention

Two studies included paediatric patients requiring management of asthma ( Kamps et al. , 2003 ; Kuethe et al. , 2011 ), whilst the majority included adults aged more than 18 years. Three studies restricted the population to older persons aged 60 years and above, with problems related to urinary incontinence ( Williams et al. , 2005 ), management following a hip fracture ( Krichbaum, 2007 ), and multiple comorbidities or complex problems necessitating nursing home admissions ( Ryden et al. , 2000 ). In three studies, the NP acted as the first contact of care and managed the ongoing care ( Mundinger et al. , 2000 ; Kamps et al. , 2003 ; Ryden et al. , 2000 ). In four studies, the NP was the principal contact for patients seeking same-day or urgent consultations ( Dierick-van Daele et al. , 2009 ; Venning et al. , 2000 ; Kinnersley et al. , 2000 ; Stables et al. , 2004 ). Five studies identified that the NP was responsible for the management or follow-up of patients with chronic disease ( Chan et al. , 2009 ; Ndosi et al. , 2014 ; Kuethe et al. , 2011 ; van Zuilen et al. , 2011 ; Williams et al. , 2005 ), while one study confirmed that the NP was responsible for co-ordinating and supporting post-acute care ( Krichbaum, 2007 ).

Quality assessment of included studies

Use of grade criteria.

Following the methodological quality assessment of the included studies, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria, which is the most widely used and validated transparency framework, was applied for quality assessment of reproducibility, applicability, and generalzability of the included study findings. The GRADE criteria assisted by developing and presenting summaries of evidence in order to determine the methodological quality of the included studies ( Guyatt et al. , 2011 ). The rating of quality, using the GRADE criteria, is based on study design and the presence and/or degree of different biases and other factors, where the overall quality is subjectively determined to be very low, low, moderate, or high ( Guyatt et al. , 2011 ). In addition to the risk of bias, the downgrading of research quality is informed by other factors such as imprecision in confidence intervals, inconsistency in comparison with other reports and influence of heterogeneity, indirectness in applicability of outcomes to the target population, and publication bias regarding inferences about missing data. Alternatively, the quality of research can be upgraded in the presence of large effects, dose-response effects, and reduction of the effect when accounting for residual confounders ( Siemieniuk and Guyatt, 2019 ).

Based on the GRADE criteria, five studies ( Chan et al. , 2009 ; Kinnersley et al. , 2000 ; Kuethe et al. , 2011 ; Stables et al. , 2004 ; Williams et al. , 2005 ) were considered to be of high quality, with minimal risk of bias, imprecision, inconsistency, and indirectness. Three of these studies were upgraded due to the reporting of large effect sizes ( Chan et al. , 2009 ; Kuethe et al. , 2011 ; Williams et al. , 2005 ). The remaining studies were of moderate quality ( Dierick-van Daele et al. , 2009 ; Ndosi et al. , 2014 ; Ryden et al. , 2000 ; van Zuilen et al. , 2011 ) and low quality ( Kamps et al. , 2003 ; Mundinger et al. , 2000 ; Venning et al. , 2000 ). One study ( Krichbaum, 2007 ) was deemed to be very low in its methodological quality due to the high number of biases and evidence of indirectness (see Table 4 ).

GRADE Evidence Profile of Included Studies

Excluded studies

A total of 12 studies were excluded from this review after full-text scrutiny (see Table 5 ). They did not meet the inclusion criteria for the study selection: either poorly defined the level of training of the nurses and their role or additional education and training carried out by the nurse but to a degree that was inconsistent with formal or operational definition of an advanced nurse practitioner.

Excluded Studies

The studies, included in this review reported a diverse range of outcomes associated with the utilization of advanced nursing practice, with positive benefits observed in relation to the management of dyspepsia ( Chan et al. , 2009 ), medication costs and requirements ( Chan et al. , 2009 ; Kamps et al. , 2003 ), health status ( Chan et al. , 2009 ), patient satisfaction levels ( Stables et al. , 2004 ; Venning et al. , 2000 ; Kinnersley et al. , 2000 ), duration of time spent in outpatient clinics ( Stables et al. , 2004 ), physical functioning ( Krichbaum, 2007 ), blood pressure levels ( van Zuilen et al. , 2011 ; Mundinger et al. , 2000 ), frequency of urinary symptoms ( Williams et al. , 2005 ), severity of rheumatoid arthritis symptoms and related costs ( Ndosi et al. , 2014 ), frequency of incontinence, pressure ulceration, and aggressive behavior ( Ryden et al. , 2000 ).

Advanced nurse practitioners demonstrated greater adherence to recommended targets and practical guidelines. The central themes reported are reflective of the number of diverse ways in which advanced nurse practitioners are currently employed in clinical practice, in settings that vary from long-term nursing home facilities to inpatient clinics. Overall, 13 RCTs were eligible for this review, with almost all trials reporting that care from advanced nurse practitioners led to positive effects on patient care and service outcomes, including symptom severity ( Chan et al. , 2009 ; van Zuilen et al. , 2011 ; Mundinger et al. , 2000 ; Williams et al. , 2005 ; Ndosi et al. , 2014 ; Ryden et al. , 2000 ), physical function ( Krichbaum, 2007 ), satisfaction ( Stables et al. , 2004 ; Venning et al. , 2000 ; Kinnersley et al. , 2000 ), waiting times ( Stables et al. , 2004 ), and costs ( Chan et al. , 2009 ; Kamps et al. , 2003 ; Ndosi et al. , 2014 ). No studies were found that explored the impact of advanced nurse practitioner/NP on staff experiences and job satisfaction, although Krichbaum et al . (2007) acknowledged that gerontological APRNs have effective links between current scientific knowledge and nursing home staff. A small number of studies support the positive impacts of collaborative care by advanced nurse practitioners and medical doctors. These studies were mostly conducted within critical care settings where the technical skills of advanced nurse practitioners are similar to those of their medical counterparts, i.e., performing blood gas sampling via the arterial line and analysing its result.

Several other studies were also found to have investigated the impact of nurse-led care on similar outcomes, with most being conducted in primary care settings. For example, in a multi-centered randomized controlled trial, Shum et al. (2000) assessed the acceptability and safety of a minor ailment service in general practice between trained nurses and physicians. They found that patients were more satisfied with the care received from nurses compared to that provided by doctors ( p  < 0.05). In another primary care-based trial, Moher et al. (2001) evaluated the effectiveness of a nurse-led service compared to general practitioner-led service in promoting secondary prevention of cardiovascular disease in a cohort of older adults. The results demonstrated that the assessment of blood pressure, cholesterol, and smoking status was more frequent in patients assigned to the nurse group, although clinical outcomes related to these measures were comparable between groups at the study conclusion. Furthermore, Sanne et al. (2010) explored the impact of ‘nurse versus doctor-led’ management of anti-retroviral therapy care for patients with human immunodeficiency virus. Their results identified that both groups observed comparable outcomes related to treatment failure (48% v. 44%), mortality (10% v. 11%), virological failure (44% v. 39%), adverse effect failure (68% v. 66%), and program losses (70% v. 63%), which were all significantly non-inferior. Notably, these trials were excluded from their review, as the definition of the nurse intervention was not congruent with that of advanced nurse practitioners. A range of previous studies also assessed the effect of nurse-led care. They found that their input could provide safe care, markedly reduced the workload of general practitioners, and promoted a more rapid access to clinical advice and clinical care ( Lattimer et al. , 1998 ; Lewis and Resnik, 1967 ; Chambers and West, 1978 ).

The results of this systematic review are also congruent with a relatively recent Cochrane review, where Laurant et al. (2018) investigated the impact of nurses as substitutes for primary care physicians on patient outcomes, care processes, and resource utilization. Their study evaluated a total of 18 RCTs, including several studies in this review; however, they also analyzed outcomes from interventions comprising across a range of advanced and non-advanced practice nurses – rather than a focus on just advanced nurse practitioners. The results demonstrated a moderate quality evidence to suggest that nurses positively improved patient satisfaction levels and clinical or health status indicators, such as blood pressure. However other outcomes, such as patient satisfaction and mortality, highlighted a lower degree of certainty and evidence compared to this study. The authors could only conclude that there is some evidence that nurses probably provide equal or even superior care to that of doctors for a range of minor and urgent illnesses and chronic conditions. In a preceding systematic review, Laurant et al. (2005) confirmed that trained nurses could safely deliver care and achieve outcomes that were non-inferior to that of doctors, although the review included studies with a range of methodological flaws and a limited duration of patient follow-up. Numerous other reviews have supported and considered advanced nurse practitioners as professionals who can deliver equal and even, at times, superior care than physicians. For example, Swan et al. (2015) conducted a systematic review of 10 randomized trials comprising over 10,000 patients, in order to investigate the safety and efficacy of advanced nurse practitioners in the provision of acute care. The follow-up period ranged from one to two years and, notably, advanced nurse practitioners conferred an equal or improved outcome benefit upon a range of physiological measures, service costs, and patient satisfaction levels in contrast to patients receiving physician-only care. In another systematic review of advanced practice nurses, outcomes, among studies published within an 18-year period, Newhouse et al. (2011) found that, in acute clinical settings, advanced nurse practitioners were associated with reductions in length of hospital stay and healthcare costs. However, in a systematic review of the effect of nurse-led and physician-led care for patients with chronic diseases, Martinez-Gonzalez et al. (2015) discovered that there were no significant or meaningful differences between the intervention groups and only 40% of patients preferred nurse-led care. Indeed, this finding is congruent with this review, where a number of studies ( Dierick-van Daele et al. , 2009 ; Kamps et al. , 2003 ; Kinnersley et al. , 2000 ; Mundinger et al. , 2000 ) reported non-significant outcomes related to clinical and service-related measures of care quality.

With regard to specific settings, in a systematic review of 15 studies comprising 23681 participants, Woo et al. (2017) evaluated the impact of advanced nurse practitioners on quality of care, clinical outcomes, satisfaction, and cost within emergency and critical care environments. In the Emergency Department setting, the authors found mixed results with regards to the duration of stay, waiting time, patient satisfaction, mortality, cost, and greater adherence of advanced nurse practitioners to the recommended targets of administering analgesia. Two out of the fifteen studies reported a significant reduction in waiting time in the Emergency Departments, but this was confounded by doctors being responsible for patients with greater acuity and complexity of illness, whilst other studies demonstrated no difference between nurses’ and physicians’ associated length of stay and waiting time for treatment. The positive impact of advanced nurse practitioners on waiting times was less marked, with only the study by Colligan et al. (2011) demonstrating that patients with minor injuries endured a 14 min median shorter waiting time compared to the time that would have been taken on being managed by an emergency medical doctor. Meanwhile, other studies demonstrated that waiting times were equal between groups of advanced nurse practitioners and physicians working in the same setting. With regards to the critical care setting, 7 out of the 15 studies used comparative designs, with one evaluating direct management of patient care delivered by advanced nurse practitioners and others analyzing the impact of collaborative advanced nurse practitioner and physician-led care. The length of stay was found to be largely similar between direct care by advanced nurse practitioners and usual/physician-led care. Although one study (Landsperger et al. , 2016) showed that patients had significantly lower odds (13%) of a longer stay, this was associated with a higher patient-to-nurse ratio. Nonetheless, it may imply that directed care provided by advanced nurse practitioners may be more efficient than conventional physician-managed care. Interestingly, the time of stroke treatment was found to be significantly lower when on-site care was provided by advanced nurse practitioners and when these nurses were available 24/7 ( p  < 0.001) as compared to the usual service model that was managed by physicians (Moran et al. , 2016). However, this merely reflects better availability of stroke intervention measures such as thrombolysis rather than highlighting advanced nurse practitioners as the independent beneficial factor for this service outcome measure (Moran et al., 2016).

The collaboration of advanced nurse practitioners and physicians was also found to have positive effects on mortality in intensive care units, with significantly lower mortality rates compared to physician-only care (6.3% v. 11.6%, p  = 0.01). However, general in-hospital mortality was comparable between groups ( p =  0.11) ( Skinner et al. , 2013 ; Scherzer et al. , 2016). However, the findings of the identified studies, which relied on propensity scoring, are likely to have missed important confounders, thus limiting the reliability of the results. Patient satisfaction levels were comparable between advanced nurse practitioners and physicians, with cost-effective analyses being generally similar between the advanced nurse practitioners–physician collaborative and physician-only models. However, only two studies ( Skinner et al ., 2013 ; Hiza et al ., 2015 ) identified results that demonstrated cost saving comparison between NP-physician groups and physician-only groups. Skinner et al . (2013) suggested that annual staffing costs of more than £170,000 could be saved if advanced nurse practitioners were employed to manage intensive care unit patients.

While this review and previous studies have reported a variety of beneficial effects from the widespread utilization of advanced nursing practice, the findings are limited by the challenges associated with conducting comparative studies among different health professionals and the inability to account for non-interventional factors and extraneous influences such as physical activity, dietary habits, and the occupational stress of these professionals. This could clearly have confounded the outcome effects ( Laurant et al. , 2018 ). Considering the findings, a number of implications and recommendations have been identified for nursing practice and future research. These need to be interpreted in light of the study's limitations.

Limitations

Firstly, the limitations of this systematic review mostly involve the inclusion and exclusion criteria that have been used to define study eligibility. In this regard, while efforts were sought to reduce the risk of reporting-type bias (that is, the avoidance of excluding relevant studies for addressing the research question), there is always a risk that important studies may be missed from the database indexing processes. Second, studies had to be restricted to the English language due to limited investigator resources, which may have excluded important and relevant studies conducted in non-English speaking countries as well as some other high-income countries and low-to-middle income countries. Indeed, the exclusion of grey literature and non-English studies could have excluded pertinent articles from collective evaluation, although this was not deemed overall a negatively impactful risk – as this is commonplace with systematic reviews. Thirdly, the credibility of the findings in this review are inherently linked to and limited by the methodological quality of informing RCTs, which was on average moderate at best, with some trials comprising a high number of biases and having detectable inconsistencies and statistical imprecision.

Implications for practice

As the majority of studies have supported advanced nurse practitioners as providers of non-inferior care and outcomes compared to physicians/ doctors-led care and usual care, they pose several implications for practice. These include: the incorporation of advanced nurse practitioners into various clinical settings is both feasible and required to help alleviate the burden placed upon physicians and reduce waiting times for patients; the study findings also extend to implications related to the cost of healthcare and service provisions, as it appears that advanced nurse practitioners may help reduce costs and improve efficiency in the health care system; wider benefit for patient flow, with advantages in terms of higher patient throughput among acute admitting departments and more timely discharge of patients from general medical/surgical wards; and subsequently, inclusion of advanced nurse practitioners can lead to reducing diagnosis and treatment delays and alleviating the risks associated with protracted hospital stays, such as nosocomial infections and venous thromboembolism.

In the interim, since the current literature is predominately of moderate quality, additional RCTs are required to further evaluate the clinical impact of extensive utilization of advanced nurse practitioner role. However, this may prove challenging as a number of biased studies from the past already exist. Future research should not only re-explore the clinical impact of advanced nurse practitioners using RCT design, but also attempt to enhance the methodological quality of the trials by accounting for residual confounders and minimizing the risk of other biases that were identified in this review.

This systematic review has found that advanced nurse practitioners enhance patient care, service cost-effectiveness, efficiency, and general patient satisfaction with the overall quality of care provided. Studies evaluating the impact of advanced nurse practitioners on clinical and service outcomes appear to be generalizable to all health settings, supporting the diverse capability of this professional discipline in addressing current and future health care needs of patients and their families. Despite that the findings are somewhat limited by methodological issues informing trials, it is apparent that advanced nurse practitioners offer a promising solution for addressing the rising complexity and demand of health service users worldwide. Undeniably, the continued delivery of high-quality patient care during times of unprecedented complexity and pressure is fundamental to the present and future safety of patients. Although most of the studies included in this review were conducted in high-income countries, they provide strong evidence that the positive, comparable effectiveness of advanced nurse practitioners, can be explored and exported into low to middle-income countries. Utilizing advanced nurse practitioners to facilitate effective healthcare should be considered an international healthcare imperative at the policy level.

Declaration of Competing Interest

The authors of this review declare no known conflicts of interest.

Acknowledgements

The authors would like to acknowledge Natalie Gabe (NB) as an expert librarian of the Hampshire Hospitals Foundation Trusts in refining the search strategy used for this review.

This review received no funding.

Authors’ contributions

MH conducted the preliminary literature search and final literature search, completed the study selection, critically appraised the studies, extracted data, analyzed, interpreted data, and drafted the manuscript. DW participated in the data analysis, interpreted data, and drafted the manuscript .

file:///C:/Users/Maung/Downloads/suggested_risk_of_bias_criteria_for_epoc_reviews.pdf

Key search terms used for ANP outcomes/ effects

Cochrane Registry looking into SR database for ANP.text – 545, but looking for ANP and variations .txt- 175 Trials & Cochrane SR database looking at ANP and variations .txt- 1

Among the first search, only a few studies were conducted related to the cost associated with ANP involvement. Therefore, search continued using original key terms combined with (cost* OR economic* OR expenditure*).ti,ab,

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Home > USC Columbia > Nursing, College of > Nursing Theses and Dissertations

Nursing Theses and Dissertations

Theses/dissertations from 2023 2023.

Is There a Relationship Between Direct Patient Care Registered Nurses Emotional Intelligence and Patient Satisfaction? , James J. Leach

The Impact of Shift Work on Women’s Neurological Health , Kathy Nelson

Nurse Perceptions of Caring and Professional Governance , Lan Angela Nguyen

Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease (UPSTREAM CVD): African American Emerging Adults , Shannon Bright Smith

Substance Use Disorder Treatment Among African American Men Living in the Rural South of the United States , Serge Raoul Wandji

Theses/Dissertations from 2022 2022

Unintended Consequences of the Electronic Health Record And Cognitive Load in Emergency Department Nurses , Carolyn S. Harmon

Physical Activity and Breast Cancer Prevention Among Asian American Women , Jingxi Sheng

Theses/Dissertations from 2021 2021

Early Premature Infant Physiologic and Behavioral Indicators of ANS Instability , Karen Popp Becker

Nurses’ and Patients’ Perceptions of the Availability of Post-hospital Instrumental Support as a Predictor of 30- And 60-Day Acute Care Utilization , Beth E. Schultz

Race Is Not a Risk Factor: Examining the Influence of Models Of Care, Race, and Discrimination on Racial Disparities in Maternal Outcomes , Curisa Mae Tucker

Advancing Knowledge of Exercise as a Therapeutic Management Strategy for Women with Polycystic Ovary Syndrome , Pamela J. Wright

Theses/Dissertations from 2019 2019

Examining Caregiver Vigilance for Child Sexual Abuse , Kate K. Chappell

Exploring Turnover Among Nurse Managers, Directors, and Executives in Acute Care Hospitals , Deborah Hughes Warden

Psychometric Evaluation of Lung Cancer Stigma Among Lung Cancer Survivors in South Carolina , Lisa A. Webb

Theses/Dissertations from 2018 2018

Utilization Of The USDA Supertracker System In High Schools: A Quality Improvement Project , Twanda D. Addison

Online Risks, Sexual Behaviors, And Mobile Technology Use In Early Adolescent Children: Parental Awareness, Protective Practices, And Mediation , Kendra Allison

Implementation of a Depression Screening Tool for Cardiovascular Patients in the Primary Care Setting , Amber Nicole Ballentine

Forensic Patient Flow: An Imbalance Between Capacity And Demand , Versie J. Bellamy

An Evidence-Based Evaluation Tool To Assist Healthcare Providers In Their Assessment Of Effective mhealth Applications For The Management Of Chronic Health Conditions , Sara Belle Donevant

The Effect of a Compassion Fatigue Awareness and Self-Care Skills Educational Program on Retention Among Certified Nursing Assistants Working in a Veterans Nursing Home , Michele M. Dreher

Efficiency Of Ambulatory Blood Pressure Monitoring Vs. 5-Day Serial Monitoring In A Military Treatment Facility , Kadijatu Kakay

Initiating the Loeb Criteria in Long-term Care , Janice Khauslender

High Fidelity Simulation Experience and Development of Clinical Judgment: Recent Graduate Nurses’ Reflections , Martha Kay Lawrence

Implementing a Surgical Pathway to Reduce Operating Room Cancellation Rates , Demerise Ott Minor

Home Exercise Therapy For The Treatment Of Knee Osteoarthritis , Kezia Nixon

Assessment Of An Educational Intervention To Increase Knowledge And Intention To Take HPV Vaccine And Cervical Cancer Screening In Nigeria , Chigozie Anastacia Nkwonta

Chemotherapy Knowledge And Health Literacy Among Women With Breast Cancer , Pearman deTreville Parker

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients , Courtney Prince

Initiating a Peer Support Program for Parents of Children With Autism Spectrum Disorder in Richland and Lexington Counties , Danielle P. Simmons

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury , Regina Thompson

Theses/Dissertations from 2017 2017

Best Practice for Screening Adult Patients with Psoriasis for Polyautoimmunity: Celiac Disease, Rheumatoid Arthritis and Crohn’s Disease , Susan Danielle Ashbaugh

Adherence of Nurse Practitioners to JNC 8 Guidelines , Stephanie E. Averette

Losing Weight with Five A’s (5 A’s): Assess, Advise, Agree, Assist, Arrange framework and Motivational Interviewing (MI) for health behavior change counseling , Jacqueline Baer

A Quality Improvement Project to Reduce the Incidence of Clostridium difficile Infection through Implementation of Evidence-Based Terminal Clean Procedures , Tamara Cook

Tuberculosis Screening in New Healthcare Employees: A Comparison of QuantiFERON®-TB Gold In-Tube Test and Tuberculin Skin Test , Mary C. Giovannetti

Utility of the Modified Early Warning System Score in Early Sepsis Identification , Lisa E. Hart

Picturing Rest: A Photovoice Study Of African American Women’s Perceptions And Practices Of Rest , Eboni T. Herbert Harris

Developing And Implementing A Quality Assurance Strategy For Electroconvulsive Therapy , Jessa Hollingsworth

Improving Leadership Communication In Nurse-Physician Dyad Teams , Lisa James

Assessment of Providers’ Perception and Knowledge of Overactive Bladder in Women: A Quality Improvement Project , Helen Wambui Ngigi

Simulation-Based Interprofessional Education in a Rural Setting , Ann D. Scott

An Evidence-Based Process Change to Improve Mammography Adherence , Tara E. Smalls

Evaluation, Treatment, and Education In The Hospice Setting By Initiating a Formalized Pain Card , Alyssa M. Soprano

Scribes Impact On Patient And Provider Experience In The Outpatient Setting , Kimberly A. Taylor

Barriers to the Use of Guardrails On IV Smart Pumps , Ivory Williams

Theses/Dissertations from 2016 2016

Nursing Attitudes towards Suicidal Patients in the Emergency Department: Assessment Interview Training , Belinda Beaver

MySleep101©: An Educational Mobile Medical Application for Sleep Health in Primary Care , Sonya Cook

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis , Monika U. Mróz

Multi-Symptom Management in Hospice Patients during End-of-Life Transition , Ashley N. B. Sirianni

Theses/Dissertations from 2015 2015

Best Practice for a Standardized and Safe Registered Nurse Shift Handoff , Nancy Rankin Ewing

An Evidence-Based Approach to Prepare Interdisciplinary Team Members for Implementation of the ABCDE Bundle , Jessica Murner Hamilton

Nurses Utilizing the V.O.I.C.E.S. HIV Prevention Intervention in the Black Church Community , Jason Richard

Unexpected and Interrupted Transitions Among Newly Licensed Registered Nurses: Perspectives of Nurse Managers and Preceptors , Sheri S. Webster

Theses/Dissertations from 2014 2014

Best Practice for Antipsychotic Medication Management in Community Dwelling Older Adults with Schizophrenia , Estelle Marie Brown

The Effects of Multiple Gratitude Interventions Among Informal Caregivers of Persons with Dementia and Alzheimer's Disease , Cristy DeGregory

An Analysis of Interpreter-Mediated Healthcare Interactions , Robin Dawson Estrada

Quality Improvement Project: A Comparison of Daily Routine Chest Radiography Versus Clinically-Indicated Chest Radiography in Preventing Ventilator-Associated Pneumonia in Adult ICU Patients on Ventilators: An Evidenced Based Practice Project , Kimberly McKenney

Best Practices in High Fidelity Patient Simulation to Enhance Higher Order Thinking Skills , Kathryn S. Mock

Best Practices in the Management of Pediatric Obesity in Primary Care Clinics , Lori Moseley

Early Screening and Identification of Preschool Children Affected by Serious Emotional Disorders , Cathy Renee Robey-Williams

Theses/Dissertations from 2013 2013

Improving the Diagnostic Accuracy of Failure-to-Rescue , Amelia Marie Joseph

Best Practice Guideline For Managing Interstitial Cystitis In Adult Women , Amanda Thomas Langford

The Use of Ultrasound as an Adjunct to X-Ray For the Localization and Removal of Soft Tissue Foreign Bodies in an Urgent Care Setting , Stacy Lane Merritt

Prevention of Skin Breakdown In the Pediatric Intensive Care Unit , Lydia H. Palmer

A Pilot Intervention To Engage Nurses To Lead Transformation of The Workplace , Molly Patton

Foot Assessment In the Dialysis Unit , Karen Robertson

Emergency Department Triage Acuity Ratings: Embedding Esi Into the Electronic Medical Record , Candace Whitfield

Theses/Dissertations from 2012 2012

Best Practice to Promote Bone Health in Post-menopausal Women through Adequate Intake of Calcium and Vitamin D , Ellen Soley Adkins

Developing A Facilitated Pathway For Associate Degree Nursing Graduates to Enroll In An Rn-Bsn Program , Christy Vansant Cimineri

Pursuing Improved Quality of Life In the Atrial Fibrillation Population: Evidence-Based Practice , Jamie Hayes Cunningham

Continuous Subcutaneous Insulin Infusion in Comparison to Subcutaneous Insulin Injections in the Preschooler with Type 1 Diabetes Mellitus , Meredith D'Agostino

Transition to Motherhood-A Qualitative Study of Low Income Women's First Term Pregnancy Experiences , Lisa Bennett Duggan

Vitamin D and Calcium Supplementation For Prevention of Falls and Fractures In Older Adults , Cynthia Hartman

The Best Practice Guideline for Early Detection and Treatment of Heart Disease In Asymptomatic Adults with a Family History of Premature Coronary Artery Disease , Stephanie Brooke Huston

Best Practice Protocol for Patients with Schizophrenia and Co-Occurring Substance Use Disorders , Shauna Rae Jones

Transcultural Nursing Clinical Education: A Systematic Review of the Literature Since 2005 With Recommendations for International Immersion Clinical Courses , Deborah J. McQuilkin

Using a Consensus Process to Develop an Evidence-Based Practice Guideline for School Exclusion For Head Lice (Pediculosis Capitis) , Michelle Lorraine Myer

Using Therapeutic Writing to Deconstruct Recovery from Posttraumatic Stress Disorder (PTSD) , Pamela Phillips

Improving Outcomes by Improving Practice: Evidence-Based Assessment, Prevention and Documentation of Pressure Ulcers In the ICU. , Kristy Fry Speronis

Increasing Awareness of Fertility Preservation Options in Cancer Patients & Survivors , Norma Sweet

Identification, Prevention and Treatment of Children with Decreased Bone Density , Laura Lee Szadek

Assessment and Strategic Planning to Determine the Growth Feasibility of a Distance-Based Rural Baccalaureate Nursing Program , Amber Proctor Williams

Theses/Dissertations from 2011 2011

A Research Utilization Project: Implementation of an Evidence-Based Behavioral Treatment for Students At-Risk of Dropout at Richland Northeast High School , Kathrene Carter Berger

The Impact of the Patient Protection and Affordable Care Act of 2010 On the Evidence Based Practice of Distributive Justice Via Comfort Care In Elderly Burn Trauma Victims , Christina Pacileo Blottner

Parenting Interventions For Children Exposed to Intimate Partner Violence , Christie Michelle Furr-Roeske

Nurse State Legislators: The Journey to State Capitols , Debbie Whitman Herman

Autonomous Nurse Practitioner Practice: A Position Paper and Action Plan for Change , Patricia Susan Noser

Best Practices in The Use of Vena Cava Filters oo Prevent Pulmonary Emboli in Trauma Patients , Dennis Absher Taylor

Theses/Dissertations from 2010 2010

Assessment and Identification of Deliberate Self-Harm in the Adolescent and Young Adult Patient in the Primary Care Population , Courtney Brooks Catledge

A Best Practice Guideline for Screening and Treating Vitamin D Deficiency in a Primary Care Setting: Moving Beyond the Bones , Amy Jeanette Clark

Best Faculty Practice Plan Model for a Small College of Nursing , Sharyn Neiman Conrad

Impact of A Primary Care-Based Organ Donation Practice Initiative On Individual Willingness to Donate , Cyndi B. Faudree

Substance Abuse Treatment Avoidance, Length of Stay, and Criminal Justice Referral For Women of Reproductive Age In South Carolina Prior to and After theWhitner Decision (1993 to 2007) , Sarah J. Gareau

Childhood Obesity and School-Based Interventions: An Evidence-Based Best Practice Guideline , Jessica Guyton

The Best Practice Guideline For theTreatment of Pediatric Diaper Dermatitis , Kate Hansson Mack

A Church-Based Health Promotion Program for Older Adults: Impacts on Participants' Religiosity, Spirituality, and Social Support , Katherine Holland Pope

Dedicated Education Units: Dothey Improve Student Satisfaction? , Eileene Elizabeth Shake

Recommendation For A Best Practice Model of Hiv Management by Advanced Practice Registered Nurses In Primary Care Settings , Sabra Smith

Exploration of the Evidence to Support Clinical Practice to Decrease Hospital Readmission Rates For Patients With Chronic Pancreatitis , Shannon Bright Smith

Best Practices: Retaining Registered Nurses , Jessica Epps Wilkes

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Home > ETDs > DNP Projects

Doctor of Nursing Practice (DNP) Projects

Dnp projects from 2021 2021.

Implementation of an Agitation Scale in Three Emergency Departments in an Urban Area of Northern California , Adam Pelzl

Targeting Pre-Operative Booking Processes to Decrease Risks of "Never Events" , Rebecca Lynn Poths and Rebecca Lynn Poths

Building Excellence through Shared Governance and Continuous Process Improvement , Deborah Reitter

Streamlining Care for Children with Autism Spectrum Disorder , Siavash Rostami Jafarabad

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model , Miranda Saint-Louis and Miranda Saint Louis

Use of Simulation to Improve Nurse's Response to COVID-19 Code Blue: A Literature Review , Charity Shelton

Using Simulation to Improve COVID-19 Code Blue Outcomes , Charity Shelton

Utilizing Group Prenatal Care to Support Underserved Pregnant Women , Kathleen Shrader

Utilizing Tracer Methodology to Evaluate the Effectiveness of a Hospital Antimicrobial Stewardship Program , Christine Smyth

Patient Placement Matters: The Impact of Unnecessary Lateral Movement on Patients , Jacqueline Strinden

The Effects of Naloxone Education Among Adults in Alameda County , Patricia Ronnica Tinglin

Prevention of Abusive Head Trauma Using an Educational Program for Parents/Caregivers , camile williams

Utilizing a Stress and Coping Model into a Preventive Abusive Head Trauma Parent/Caregiver Educational Program , Camile Williams

Successfully Spreading Improvement Work Using a Proven Framework , Rachel Lynn Wyatt

DNP Projects from 2020 2020

Ultrasound-Guided Peripheral Intravenous Catheter Insertion for Nurse Practitioners , Alvin Joseph Abad

Preconception Screening for Family Planning , Nnenna Abaeze

Pre-conception Screening Tool , Nnenna Abaeze

Healthcare Provider Education: Adult Jamaicans with Type 2 Diabetes , PATRICIA ANDERSON

Bisphenol-A (BPA) and Breast Cancer: Utilizing Risk Assessment and Education to Improve Preventative Care , Ashley Catherine Babcock

Continuous Glucose Monitoring and Diabetes Management During Pregnancy , Nicole Beamish

Workplace Violence: An Urgent Call for Integrated Staff Education in Acute Care Hospitals , Nicole Bellisario

Valley Fever: Education for Primary Care Providers and Allied Health Care Professionals , Michelle Elizabeth Bergen

Improving Clinicians’ Access to Patient Education and VA Resource Information , Ella Bermudez

Reducing Frustration with Wait Times Utilizing Technology and Education: A Patient Satisfaction Improvement Model , Tiffany Brown

Identification of Victims of Human Trafficking: Leading Change through a Global Pandemic , Connie Clemmons-Brown

Earlier Palliative Care Referrals for Nephrology Patients , Jerold Cohen

Implementation and Evaluation of Whole Health Opioid Safety Shared Medical Appointments in a Veteran Population: A Quality Improvement Study , Sherry Cox

Chief Nurse Executive Work Engagement: System Leadership Through a Natural Disaster, Strike, and Pandemic , Ryan Fuller

Program Implementation for New Graduate Nurses to go from Moral Distress to Moral Courage and Beyond , Melinda Furrer

Wound and Stoma Care Education for Primary Care Providers , Deanna Garza

Transformational Leadership for Frontline Leaders , Marta L. Hudson

USP Compliance: A Hazardous Drug Safe Handling PPE Toolkit for Infusion Nurses , Cynthia Huff

USP Compliance: A Hazardous Drug Safe-Handling Quality Improvement Project for Ambulatory Care Infusion Nurses , Cynthia Huff

Preceptor as Frontline Leader Utilizing Emotional Intelligence , Dwanette Judkins

Technology-Based End-of-Life Planning for an Underserved Population , Haley Kirkpatrick

Increasing Access to Medicare Annual Wellness Visits in Primary Care; Utilizing Registered Nurses as part of an Interdisciplinary Team Based Approach , Iyo Kubota

An Online Self-Directed Learning Module for Regional Stroke Survey Success , Winchell Rodriguez Kuttner

Application of Sustainability Framework for Quality Improvement in an Integrated Health System , Cristine Lacerna

Using Simulation for Oncology Nursing Competency Evaluation in Hospitals , DANA N. LITTLEPAGE

Using Simulation for Oncology Nursing Competency Evaluation in Hospitals , DANA LITTLEPGE

Optimizing Screening Mammography: Educating Underserved Individuals with Limited English Proficiency , Yao Luo

Improving Clinical Communication and Collaboration Through Technology , Michelle Machon

Initiating PrEP in Primary Care: Addressing the Adolescent and Young Adult High Risk Populations , Igor G. Mocorro

Fall Reduction Project in a Skilled Nursing Facility , Jalpa Patel

Implementing Virtual Sitters to Reduce Falls and Sitter Costs , Asia QuoVadis Williams Plahar

Implementation of Artificial Intelligence Initiated Rapid Responses to Reduce In-Hospital Cardiac Arrest , Alicia Potolsky

A Performance Improvement Nursing Fellowship to Enhance Timely Access to Care , Cheryl Reinking

Competency-Based Practicum Evaluation Tools for Family Nurse Practitioner Programs , Angelica Renteria

#Leadershipaccelerated: A Coach Mindset Focused Leadership Development Program , Diane Rindlisbacher

Illicit Substance Use in Acute Care Hospitals: Creating a Safe Environment , Christina Sanford

Improving Nurse Engagement through Unit Practice Councils , Pavna Sloan

Improving Nurse Engagement Through Unit Practice Councils: A Literature Review , Pavna Sloan

Unaddressed Challenges for the “Most Honest and Ethical Profession:” A Pilot Study of Web-Based Learning Strategies to Prevent Moral Distress , Kelly Straight

Wound Care Education for Primary Care Providers at a Regional Medical Center , Zaira Torres

An Education Program for Novice Nurses to Increase Case Management Knowledge , Emily Trefethen

Creating a Thriving Informatics Culture , Nicholas Webb

Reducing the Second Victim Phenomenon: Promoting Healing with Caritas Coaching , Shanda N. Whittle

Eliminating Barriers to Chinese American Diabetic Patients: Implementation of Diabetic Cantonese Group Visits , Sabrina Wong

Development of a Disaster Preparation Toolkit to Improve Community Resilience , Tiffany Wong

Evidence-based Suicide Screening and Prevention Protocol for Licensed Nursing Staff , Rose Zhang

Evidence-based Suicide Assessment and Prevention Training for Licensed Nursing Staff , Rose Waithira Zhang DNP(c), MSN-FNP-BC, BSN, RN

DNP Projects from 2019 2019

Caring Science Education: The Essence of Professional Practice for the Registered Nurse , Linda C. Ackerman

Collaborative Care in College Health: Care Team Training to Support Improved Integration , Elizabeth Adams

Implementing Foot Care Program in a Rural Clinic , Maliheh Bakhshi

Coaching Nurse Leaders in Conflict Management and Team Building to Improve Retention , Jeanette Black

Improving Nurse-Physician Collaboration: Building an Infrastructure of Support , Marshall Blue

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention and Quality Improvement Project in a School-Based Setting , Stephanie Calabrese

Implementation of a Mentor Program to Support Nurse Retention: A Pilot Project , Lucy Camarena

Clinical Pathway Adoption to Aid in Medication Calendar Procurement in a Pediatric Oncology Clinic , Cinnamon R. Chavez

A Toolkit for Administration of Antipsychotic Medications in Nursing Homes , Nino Dantes Flores

Applying the Model of Interrelationship Environments and Outcomes to Simulation for Nurse Leaders to Enhance the Professional Practice Work Environment: Creating a Mile One Nurse Leadership Simulation Toolkit , Alicia Garcia-Cisneros

Expanding Magnetic Resonance Imaging Access for Patients with Cardiovascular Implantable Electronic Devices , Rosalie Geronimo

School-Based Mental Health Screening: Improving Outcomes Through Interprofessional Communication and Collaboration , Tiffany Gishizky

Standardizing Mammogram Screening in Primary Care: Integrating an Evidence Based Approach , Lacrisha Go

Improving Access to Youth-Friendly Health Services in a Rural California Community , Elena Higley

Increasing Nursing Policy and Advocacy Engagement , Marketa Houskova

LARC Method Appropriateness in Substance Use Treatment: A Quality Improvement Project for Integrated Care , Malia Johnson DNP, FNP; Alexa Curtis PhD, FNP-BC; and Neda Afshar DNP, FNP-C, MSN, CGRN

Nursing Leadership Beyond 2020: A Succession Plan , Janet Jule

DNP Project: Development of a Nurse-Led Pop-Up Clinic Model in San Diego , Jennifer King

The Development and Implementation of Nurse-Managed Community-Based Medication Assisted Treatment Services for an Underserved Non-Metropolitan Northern California Community , Lauren Knapp

Strengthening the Advanced Practice Clinician Workforce Pipeline Through Preceptor Education and Support , Tarina Levitt-Trujillo

Developing a Culturally Tailored Support Program for Chinese Cancer Patients , Yan Li

A Quality Improvement Project to Implement Shared Medical Appointments for the Management of Type 2 Diabetes in Latino Patients , Denisse Maldonado

Enhancing Health Literacy Using Teach Back Method to Increase Patient Adherence to , Tram Mendoza

Nursing Practice Meets Theory , Debra J. Morton

Operationalizing a Theoretical Framework to Improve Patient Perception of Care , Debra J. Morton

Implementation of a Simulation-based Interprofessional Patient Safety Program , Mariko Nowicki

Hepatitis C Treatment in High Risk Patients: Implementation of a Successful Community Focused Program , Annie Pedlar and Jodie Sandhu DNP, FNP-C

Increasing Long Acting Reversible Contraception Use in Primary Care: Removing the Barriers , Jessamyn Phillips

Enhancing Nutrition Education for School Aged Children; a Preventive Health Measure and Quality Improvement Project , Fanny M. Powell

Increasing Utilization of Motivational Interviewing to Promote Pediatric Oral Health , Ulyses Reamico

Burnout, Depression and Suicide Prevention for Nurses in High-Intensity Settings , April Ritchie

Burnout, Depression and Suicide Prevention for Nursing Staff in High-Intensity Settings , April Ritchie

Reducing Critical Care Nurse Distress During End-of-Life Care: Change of Practice Intervention , Alexis S. Roschitsch-Preszlowski

Adopting Complex Case Management Competencies , Phyllis Stark

Nurse Manager Succession Planning: Building a Leadership Pipeline for the Future , Katie Stephens

The Impact of a Nurse Engagement Model Implementation on Patient Outcomes , Karen Strauman

Improving Chronic Hepatitis B Virus Screening at a Safety-Net Primary Care Clinic , Uwaezu J. Umeh

Addressing Childhood Obesity in a Rural Community Using Motivational Interviewing , Chituru Uwaoma

DNP Projects from 2018 2018

Promoting Transgender Cultural Awareness and Sensitivity through Education: It Starts with a Pronoun , Jacob Adkison

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Home > College of Nursing > Nursing Student Scholarship and Creative Works > Nursing Graduate Theses and Dissertations

Nursing Graduate Theses and Dissertations

A collection of Nursing Masters Theses and Doctoral Dissertations.

Theses/Dissertations from 2023 2023

Racial Discrimination, Social Support and Psychological Distress among Black Pregnant Women , Camilla Carey

The Associations Among Racial Discrimination, Perceived Stress and Birth Satisfaction Among Black Women , Amanda de la Serna

Exploring Mindfulness in Simulation-Based Learning: Promoting Self Care in Nursing Education , Marci Dial

Evaluating Relationships Between Clinical Judgment and Emotional Intelligence in Undergraduate Nursing Students , Helen Mills

Usability of a Video-Based Virtual Simulation Program for Hands-On Skill Building in Undergrduate Nursing Students , Heidi L. Penney

A Digitally Enhanced Virtual Cognitive Behavior Skill Building Intervention to Reduce Parent Stress and Family Obesogenic Behaviors , Sharlene Smith

Mother-Father Relationship and Perceived Stress among Black Pregnant Women: A Mixed Methods Approach , Jenna Wheeler

Theses/Dissertations from 2022 2022

Nurse Managers' Patient Safety Communication , Christine Deatrick

Exploration of the Oral Microbiome in Non-Ventilated Hospitalized Patients , Kimberly Emery

Social Support and Empowerment Among Caregivers of Children with Asthma , Lauren Lebo

Theses/Dissertations from 2021 2021

Factors Associated with Resilience and Sense of Coherence in Adult Transgender Persons: Identifying Predictors to Reduce Health Disparities in a Vulnerable Population , Jake Bush

Cognitive Rehearsal, Self-efficacy, and Workplace Incivility Among Baccalaureate Nursing Students , Alina Diaz-Cruz

Survivors of Human Trafficking: Reintegration into the Community and Society , Charrita Ernewein

Remembering to Resume: Using Simulation-based Education to Teach Nursing Students to Manage Interruptions , Peggy Hill

First Impressions of the Bedside Nurse From the Patient Perspective , Sharon Imes

The Influences of Generational Membership and Practice Environment on Nurse Manager Job Satisfaction , Angela Keith

Knowledge and Attitudes of Nurse Practitioner's Assessment of Adults with Signs and Symptoms of Posttraumatic Stress Disorder , Kelli Lipscomb

Ethical Decision Making Among Nurses Participating in Social Media , Melissa Lynn

Hospital Readmission After Major Abdominal/Colorectal Surgeries: A Mixed-Methods Study , Ansu Sebastian

The Effect of the Medilepsy Mobile App on Medication Adherence and Transition Readiness in Adolescents and Young Adults with Epilepsy , Michelle Tall

Theses/Dissertations from 2020 2020

Access and Utilization of Prenatal Care in Florida and its Effects on Preterm Birth , Corinne Audette

Nurse-Physician Collaboration during Bedside Rounding: What is the Impact on the Nurse? , Martha Decesere

The Relationship of Cognitive Load and Different Participant Roles on Knowledge Retention in Simulation-based Learning Among Undergraduate Nursing Students , Amanda Houston

Undergraduate Nursing Students' Depth of Reflection and Perceptions of Self-Debriefing Following Virtual Simulation: A Multi-method Descriptive Study , Valorie MacKenna

Patients with a Left Ventricular Device and Factors Affecting Readmission , Diana Pitcher

Geographic Access to Community Mental Healthcare and Adherence to Treatment Among Patients with Schizophrenia Spectrum Disorders , Marie Smith-East

The Effect of Acuity-based Nurse Staffing on Nursing Medication Errors , Egidius Maria Eugene Waterval

Theses/Dissertations from 2019 2019

Persistence of Physical Activity Among Veterans , Jean Davis

Factors Influencing Nurse Practitioners' Weight Management Practices in Primary Care , Suzanne Hyer

Evaluation of Postoperative Air Leak and Chest Tube Drainage Systems after Pulmonary Resection , Kristina Jacobsen

Stress, Coping, and Quality of Life Among Parental Caregivers of Children with Autism Spectrum Disorder , Dawn Turnage

Theses/Dissertations from 2018 2018

Understanding the Perceived Experiences of Goal Setting of Mothers of Preschool Children: A Narrative Analysis , Dawn Eckhoff

Theses/Dissertations from 2017 2017

The Influences of Mindfulness and Neuromotor Exercise Mode on Balance in Healthy Older Adults , Maxine Hicks

Theses/Dissertations from 2016 2016

An Evaluation of Anxiety Following Substance Abuse Withdrawal and Assessment of Somatic Treatments presently Available with a Focus on Cranial Electrotherapy Stimulation , Janet Hutchison

Perceived readiness to transition to adult health care for youth with cystic fibrosis and congruence with their caregivers' views , Valerie Lapp

Evaluating Moral Distress, Moral Distress Residue and Moral Courage in Oncology Nurses , Lolita Melhado

Preschool Attendance: A Parental and Teacher Perspective of Barriers and Behaviors using Grounded Theory Research , Anne Meoli

Prehabilitation (Prehab): Prevention in Motion , Billie Russell

Theses/Dissertations from 2015 2015

Impact of Interruption Frequency on Nurses' Performance, Satisfaction, and Cognition During Patient-Controlled Analgesia Use in the Simulated Setting , Kristi Campoe

Perceived Social Support and Self-care in Patients Hospitalized with Heart Failure , Lyne Chamberlain

Rapid Response Teams versus Critical Care Outreach Teams: Unplanned Escalations in Care and Associated Outcomes , Valerie Danesh

The Impact of Relational Coordination and the Nurse on Patient Outcomes , Fanya DeJesus

Family Care Giver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults with Cancer , Patricia Geddie

Helping Mothers Defend their Decision to Breastfeed , Kandis Natoli

Nurse Managers, Work Environment Factors and Workplace Bullying , Joy Parchment

A Faith-Based Primary Diabetes Prevention Intervention for At-Risk Puerto Rican Adults: A Feasibility Study , Sylvia Torres-Thomas

Pre and Post Implementation Evaluation of an Emergency Department Severe Sepsis Alert and Practice Protocol , Darleen Williams

Theses/Dissertations from 2014 2014

Factors Associated With Information Literacy Competencies Of The Traditional Baccalaureate Nursing Student , Patricia Lafferty

Mobile Phone Short Message Service (SMS) to Improve Malaria Pharmacoadherence in Zambia , Elinda Steury

Theses/Dissertations from 2013 2013

Evaluation Of A Mind-body Website By Women With Breast Cancer , Laura Beck

Nutrition Literacy And Demographic Variables As Predictors Of Adolescent Weight Status In A Florida County , Leslee D'Amato-Kubiet

Ventilator-associated Complications In The Mechanically Ventilated Veteran , Joan Grano

The Early Postpartum Experience Of Previously Infertile Mothers , Sigrid Ladores

Early And Intermediate Hospital-to-home Transition Outcomes Of Older Adults Diagnosed With Diabetes , Jacqueline Lamanna

Improving Chronic Kidney Disease Care With Group Visits , Vicki Montoya

Theses/Dissertations from 2012 2012

An Exploratory Study Of Physiologic Responses To A Passive Exercise Intervention In Mechanically-ventilated Critically Ill Adults , Christina M. Amidei

The Self-described Experience Of Coping And Adaptation Associated With Workplace Stress Of Registered Nurses In The Acute Care Setting In Florida: An Ethnographic Study , Joyce Burr

Predictors Of Immunosuppressant Adherence In Long-term Renal Transplant Recipients , Sandra J. Galura

Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study , Stephen D. Heglund

Noncardiac Chest Pain: The Use Of High Resolution Manometry As A Diagnostic Tool , Iman Hilal

Infection Control And Health Care Associated Infection (hcai) In The Nursing Home: A Study To Determine The Impact Of An Educational Video And Pamphlet About Infection Control On Knowledge And Perception Of Hand Hygiene In Certified Nurse Assistants , Kathe Hypes

Barriers To Timely Administration Of Thrombolytics In Acute Ischemic Stroke Patients , Elizabeth Joseph

Development And Evaluation Of An Instrument To Measure Mother-infant Togetherness After Childbirth , Carol Lawrence

Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity , Susan Quelly

Front-line Registered Nurse Job Satisfaction And Predictors: A Meta-analysis From 1980 - 2009 , Deborah Anne Saber

Impact Of Cancer-specific Advance Care Planning On Anxiety, Decisional Conflict, And Surrogate Understanding Of Patient Treatment Preferences , Lynn Waser

Theses/Dissertations from 2011 2011

Duplicated Laboratory Tests : A Hospital Audit And Evaluation Of A Computerized Alert Intervention , Sharon Bridges

Exploring Women's Life Course Experiences With Weight Using Story Theory , Poff Allison Edmonds

Adherence Practices Of Caucasian Women With Hypertension Residing In Rural Florida An Exploratory Study , Jeanne M. Hopple

The Lived Experience Of Young-onset Dementia , Debra A. Hunt

Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Health Care : Can Obesity In Combination With Other High-risk Diagnoses Be Used For Screening Purposes? , Clelia Lima

Clopidogrel Provision For Indigent Patients With St-elevation Myocardial Infarction , Sita S. Price

Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients , Amma Serwaah-Bonsu

Spirituality And Expectations Of Care Providers Of Older Patients With Chronic Illnes In North Central Florida , Myra Sherman

Factors Related To Birth Transition Success Of Late-preterm Infants , Karen L. Wright

Theses/Dissertations from 2010 2010

The Experiences Of Health Care Providers Providing Comfort For Nursing Home Patients At The End Of Life , Herma Baker

Comparison Of Arnp And Physician Malpractice In States With And Without Controlled Substance Prescribing Authority , Deborah Chandler

A New Measure Of Parental Self-efficacy For Enacting Healthy Lifestyles In Their Children , Jonathan W. Decker

Effectiveness Of Probiotics In Preventing Antibiotic Associated Diarrhea And Clostridium Difficile In Long Term Care , Marva Edwards-Marshall

The Effect Of Combat Exercises On Cardiovascular Response: An Exploratory Study , MeLisa Gantt

The Impact Of Pre-operative Mupirocin Prophylaxis On Surgical Site Infections In Same-day Admission Open Heart Patients , Joanna Gerry

Evaluation Of A Simulation-enhanced Obstetric Clinical Experience On Learning Outcomes For Knowledge, Self-efficacy, And Transfer , Mary Elizabeth Guimond

The Incidence And Epidemiologic Factors Of Community-acquired Methicillin-resistant Staphylococcus Aureus Skin And Soft Tissue I , Ivonne Johnson

The Impact Of An Interdependent Conferencing Activity In An Online Rn-bsn Practicum Clinical Conference On Psychologocial Sense Of Community , Barbara Lange

Advanced Practice Nursing In The Faith Community Setting: A Case Study , Chianta Lindsey

Prevalence Of And Risk Factors For Intraoperative Non-euglycemia Events In Premature Neonates >2500 Grams , Zulay Ritrosky

Retrospective Analysis Of Screening Patterns In Cirrhotic Patients With Heptocellular Carcinoma , Shelly-Ann Scott-Castell

A Phenomenological Description Of The Lived Experience Of Creating Art For Women With Breast Cancer , Laurie Stark

Assessing Adult Attitudes Toward End-of-life Issues And Advanced Directives After Implementing An Educational Intervention In A , Marchina Tolbert-Jones

Theses/Dissertations from 2009 2009

Cohort Study Of Pain Behaviors In The Elderly Residing In Skilled Nursing Care , Allison Burfield

Effects Of An Evidence-based Intervention On Stress And Coping Of Families Of Critically Ill Trauma Patients , Sandra Knapp

Awareness Of Increased Risk For Heart Disease And Cardiovascular Risk Factors In Women With Systemic Lupus Erythematosus , Patricia Weinstein

Consumer Perspectives Of Health During Prenatal Care In The Usa And Iceland: An Exploratory Study , Claudia Wiseman

Theses/Dissertations from 2008 2008

A Comparison Of Computer And Traditional Face-to-face Classroom Orientation For Beginning Critical Care Nurses , Patricia Anzalone

Health-care Seeking Behaviors Of Puerto Ricans With Diabetes Mellitus Who Live In South Florida: An Exploratory Study , Laura Gonzalez

Evaluation Of The Antecedents Of Cultural Competence , Mary Harper

The Impact Of A Nurse-driven Evidence-based Discharge Planning Protocol On Organizational Efficiency And Patient Satisfaction In , Tracey King

Theses/Dissertations from 2007 2007

Resiliency In Adolescent College Students , Nancy Ahern

The Impact Of Music On Postoperative Pain And Anxiety , Kelly Dixon Allred

Evaluation Of An Education Intervention For The Staff On The Head Of The Bed Elevation In The Pediatric Intensive Care Unit , Randall Johnson

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EliScholar > Nursing > Yale School of Nursing Digital Theses

Yale School of Nursing Digital Theses

Theses/dissertations from 2024 2024.

Reducing 30-Day Hospital Readmission In The Older Homebound Population: Using An Interprofessional Communication Protocol Within A Multidisciplinary Hospital At Home Program , Pamela Ann Alvey

Improving Outpatient Medication Reconciliation And Reducing Adverse Drug Events: Development Of A New Process , Marisa Kristine Blake-Raut

My Identi T: Improving Mental Health Outcomes Through Group Support In Pre-Treatment Transgender Teens , Jill Day

Relationship-Centered Communication In Breast Cancer Screening: An Interdisciplinary Training Model , Patricia Aideen Ducharme

Establishing An Infrastructure For Nursing Innovation In A Large Urban Magnet®hospital , Gregory Parsons Eichelzer

Virtual Care Navigation To Reduce Disparities And Improve Quality: A Pilot Program For Colorectal Cancer Screening , Robert Freeman

Implementation Of A Transition Shock Prevention Workshop To Promote Satisfaction And Confidence Among New To Practice Nurse Practitioners , Denis L. Hawkins

Implementation And Evaluation Of Perinatal Educational Video Series – Postpartum Hemorrhage , Daileann Lamara Hemmings

Nonfatal Strangulation And Intimate Partner Violence Decision Tree Protocol , Joy Martin

Retaining New Graduate Nurses: Creating A Model Inpatient Transition To Practice Program In A Large Healthcare System , Amanda Jane Richards

Moral Distress: The Importance Of Support For Black And Brown Nurses After Encountering Racism From Patients And Peers In The Acute Care Setting , Marsha Sinanan

The California Bridge Model For Emergency Department-Initiated Medication-Assisted Treatment For Opioid Use Disorder: Adaptations For Perinatal Hospital Services , Devin C. Thomas

Theses/Dissertations from 2023 2023

Reduction Of Unnecessary Emergency Department Visits Through An Ed-Initiated Advanced Care Program For Vulnerable Patients , Dr. M. Dustin Bass

Implementing Prediabetes Screening During Hospitalization In An Internal Medicine Unit , Roxana Bustamante

Harnessing Family Empowerment To Promote Healthcare Transition For Youth With Special Healthcare Needs: The F.a.m.e. Project , Vanessa Coppola

Implementing A Workload Tool To Increase Float Nurses' Job Satisfaction And Reduce Intent To Leave The Workplace , Lisa Czaplinski

Shifting The Paradigm Toward Intent To Stay: Creating A Nurse Career Crafting Program To Increase Nurse Engagement In An Urban Teaching Hospital , Jaclyn Davis

Achieving Success[ion] In Healthcare Leadership: Building An Immersive Nurse Manager Residency Program , Natalie Marie Fucito

Enhancing Self-Efficacy Of Novice And Emerging Nurse Leaders Through A Virtual Emotional Intelligence Education Program , Josephine C. C. Garcesa-Duque

A Project To Improve Advanced Practice Provider Financial Metrics Through A Practice Management Program , Stefanie Anne Generao

Increasing Transplant Medication Knowledge Through Implementation Of A Medication Education Intervention Algorithm , Colleen Chime Karkhang

Multimodal Opioid-Sparing Analgesia: Increasing Regimen Adherence In Minimally Invasive Abdominal Surgery , Panicha F. Kittipha

Evaluating The Use Of Reflective Practice Principles To Support Nurse Manager Well-Being During A Period Of Chronic Distress , Amy A. Martone

Implementing A Prediabetes Screening Algorithm To Improve Identification And Referrals In Primary Care , Katherine Masoud

Addressing Social Needs And Creating Community Linkage Pathways For Vulnerable Populations In Primary Care Practice Settings , Mindy Marie Matthews

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Nursing School Theses, Dissertations, and Doctoral Papers

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COMPLETED PHD DISSERTATIONS

• Aric Bunch : High Versus Low-Fidelity Ultrasound Phantoms in the Acquisition of Needle to Vascular Target Contact Skill During Simulated Central Venous Line Placement
• Jessie Reich : Medical-surgical Nurses’ and Nursing Assistants’ Attitudes and Beliefs towards Young Adult Patients with Sickle Cell Disease and their Perceptions of Barriers to Providing Quality Care to this Population
• Megan Moyer : Early Patient Mobilization in the Neurological Intensive Care Unit.
• Caroline Ortiz : Decia mi Mama: Traditional Medicine from Mexico Among Mexican Women American in the Texas Rio Grande Valley
• Gwen Hamid : The Association of Functioning, Relationship Quality and Community Reintegration to Depressive Symptoms in Miliary Veterans with Traumatic Brain Injury
• Kathleen Williams : An Examination of the Relationship of Mandated Reporting to Pediatric Up-to-Date Immunization Status
• Marcia Gamaly : Comparing the effectiveness of self-directed and interactive online educational interventions to reduce obesity bias in nurses in the hospital setting
• Carol Devlin : The Relationship Between Preoperative Smoking Status and Postoperative Surgical Site Infections: A Secondary Analysis of the American College of Surgeons’ 2019 National Surgical Quality Improvement Program Data
• Kimberly Hampton : Survey of Baccalaureate Nursing Faculty About Non-Clinical Transition-to-Practice Courses and Their Perceived Effectiveness
• Tanya Carmichael : Effect of an Educational Intervention on Nursing Students’ Knowledge of and Attitudes toward Caring for Transgender and Gender Nonconforming People
• Waad Ali : The Influence of Undergraduate Informatics Education on Information and Communication Technologies (ICT) Use
• Marin Jacobwitz : Predictors of Poor Oral Feeding in Infants with a Congenital Heart Defect (CHD) Following Surgical Intervention with Cardiopulmonary Bypass
• Patricia Griffith : The Effect of Structured Reflection on Diagnostic Reasoning Competency and Accuracy of Nurse Practitioner Students Who Experience Cognitive Bias: A Mixed Methods Experimental Study
• Mary Ann Zimmer : Enhancing Communication Skills of Pre-Licensure Baccalaureate Nursing Students Through the Use of Standardized Patients in Clinical Simulation
• Melissa Bourne : Clinical Nursing Faculty Perceptions about Teaching Pre-Licensure BSN Students to Provide Care for Adults with Developmental Disability in the Clinical Setting
• Melissa Leisen : Exploration of the Learning Experiences of Undergraduate Nursing Students in Relation to the Care of Children with Special Health Care Needs in Home-Based Respite Care
• Jodi Erickson : How Older Adults Perceive the Terminology “Allow Natural Death”: A Qualitative Dissertation
• Meg Kloster : Measuring Knowledge and Behavior after an Educational Program on Air Pollution as a Health Risk Reduction Strategy
• Emily Sheff : Factors Associated with Work Engagement among Doctorally Prepared Nursing Faculty
• Joseph Vena : The Lived Experience of Young Adults with Lymphoma During Acute Survivorship
• Megan M. Walsh : The Emotional Experience of Women with Multiple Sclerosis in the Postpartum Period
• Lyn Starrs-Zorn : The Lived Experience of Civilian, Female Spouse Caregivers of Community-Dwelling U.S. Veterans Who Sustained Polytrauma Injuries in Iraq and Afghanistan
• Heiddy DiGregorio : Organizational Skill Development Using Simultaneous Multiple Patient Simulation
• Laura Klenke-Borgmann : The Effect of Interprofessional Simulations in the Classroom on Pre-Licensure, Baccalaureate Nursing Students’ Clinical Judgment Development
• Sister Jackline Mayaka : Risk Factors Associated with Low-Birth-Weight Infants Among HIV-Positive Women and Related Outcomes of HIV-Exposed Low Birth Weight Infants at 18 Months Follow-up in Western Kenya
• Claire McKinley-Yoder : The Relationships Among Individual and School Characteristics and Long-Term Educational Outcomes for Students with Disabilities
• Ginger Schroers : Interruptions During Simulated Medication Administration: An Examination of Errors and Interruption Management Strategies
• Caitlin Yeager : The Role of Nurses in Surveillance of New and Emerging Infectious Disease to Enhance Global Health Security: A Delphi Study
• Cynthia Hambach : Using Standardized Patients in Simulated Learning Experiences to Develop Clinical Judgment and Clinical Competence of Sophomore Baccalaureate Nursing Students in a Foundations in Nursing Course
• Amal Alqahtani : Workplace Incivility and Work Ethic Across Three Generations of Saudi Nurses
• Zainab Al-Maqbali : Pre-gestational Diabetes Mellitus (Type 1 & Type 2), Gestational-Diabetes, and Pre-eclampsia with Preterm Birth Among Omani Women
• Susan Moyer : Fruit and Vegetable Intake of Young Adult Millennials
• Serah Nthenge : Perinatal Experiences of Women with Physical Disabilities
• Christine Pariseault : Nurse Practitioners Experiences of Polypharmacy in Older Adults in the Primary Care Setting
• Tara Sacco : The Relationship of the Work Environment to Compassion Satisfaction and Compassion Fatigue in Critical Care Nurses  
• Mia Waldron : Relationship of Parental Health Literacy (PHL) and Perceptions of Home Discharge Readiness in NICU Parents of Black Preterm Infants 
• Lisa Aiello : Assessment of Genomic Knowledge among Nurses in an Online RN to BSN Completion Program
• Zaina Al Harmali : Nurse characteristics and perceptions about safety and error reporting in Omani hospitals
• Abdullah I. Al Salmi : Self-Management Behaviors & Quality of Life of Patents with Sickle Cell Disease
• Al Cadavero : Nurse Graduates’ Perceived Educational Needs after Experiencing the Death of a Patient
• Mandy Kirkpatrick : Development of Palliative Care Competence in Nursing Students Using Simulation
• Brittany Koons : Factors Related to Travel for Transplantation Among U.S. Kidney Transplant Candidates
• Michelle McKay : The Relationship of Frailty, Fear of Falling, and Depression with the Risk for Falls and Health-Related Quality of Life in Community-Dwelling Older Adults
• Susan Myers : Postpartum Nurses’ Perceptions of Identifying and Providing Care for Mothers at Risk for Postpartum Depression
• Jennie Ryan : Parents’ Experience Using Medical Marijuana
• Cathy Sargent : The examination of nursing students’ attitudes towards chronic pain in the older adult.
• Saira Al-Bulushi : A Pilot Study of Standardized Patient Simulation Teaching Strategies and Instruments to Assess Knowledge, Skills, and Attitude of Primary Care Nurses in Cardiovascular Risk Assessment
• Khamis Al-Mamari : Omani Nurses’ Attitudes Towards Clients with Mental Illness in General and Psychiatric Hospitals in Oman
• Faith Atte : Factors Related to Caregiver Burden in Family Members of Military Veterans with Traumatic Brain Injury
• Adaorah Azotam : The Intention of Advanced Practice Registered Nurses to Report Child Maltreatment
• Susan Birkhoff : Examining the Usability and Acceptability of a Patient-Centered Mobile Health Tracking App for Patients Undergoing Radiation Therapy for Cancer Treatment
• Deborah Byrne : Evaluating the Level of Cultural Competence in Undergraduate Nursing Students Using Standardized Patients in Simulation
• Michael Cont i: A Descriptive Study Exploring the Perceptions of Certified Registered Nurse Anesthetists about Collaboration with Physician Anesthesiologists
• Becky Coyle-Mueller : Family Nurse Practitioners’ Use of mHealth Apps for Health Promotion with Patients
• Patricia Gellasch : The Developmental Screening Behaviors, Skills, Facilitators and Constraints of Family Nurse Practitioners in Primary Care
• Stacy Hohenleitner : New Nursing Graduates’ Perceptions of Support
• Amanda Jenkinson : The Relationships Among Inner Strength, Depression, and Time Since Diagnosis to Quality of Life and Health Promoting Behaviors in Female Cancer Survivors
• Sue Lynch : The Lived Experience of Newly Qualified Registered Nurse First Assistant (RNFA) Who Have Transitioned to the Hospital Operating Room Surgical Setting: A Phenomenological Perspective
• Carlene McLaughlin : The Effect of Debriefing with Good Judgment on Nurse Anesthesia Students’ Critical Event Recognition, Response, and Treatment
• Jacquelyn McMillion-Bohler : Nurse Educators’ Perceptions of the Characteristics and Behaviors of Master Teachers in Nursing
• Kathleen Monforto : A Comparison of Outcomes in Patients with Common Pediatric Diagnoses Admitted on Weekends to Those Admitted on Weekdays
• Hanan Saca-Hazboun : Knowledge and Health Beliefs about Breast Cancer Screening among Rural Palestinian Women: A Pilot Study
• Jenna Thate : Leveraging Documentation in the Electronic Health Record to Support Interprofessional Communication: A Delphi Study 
• Susan Vacca : Patient Delivered and Expedited Partner Therapy for Chlamydia Trachomatis among Adolescent Females Using School Based Health Centers  
• Eilleen Feehan Choi : Development and Analysis of the Sodium Knowledge and Skills Index for Heart Failure (SKASI-HF)
• Katie Hooven : Development and Testing of the Collaboration in the Clinical Learning Environment (CCLE) Tool
• Christina Lam : Nurse Faculty Members' Experiences Teaching Chronic Illness Self-Management Concepts: An Exploration Study
• Patricia Ann Oertwich : Emotional Intelligence as a Component of Leadership Development in Traditional Undergraduate BSN Students
• Kelly Reilly : The Use of Simulation in Transformational Leadership Development in the Nurse Manager Role
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A thesis statement is a sentence (or sentences) that expresses the main ideas of your paper and answers the question or questions posed by your paper. It offers your readers a quick and easy to follow summary of what the paper will be discussing and what you as a writer are setting out to tell them. The kind of thesis that your paper will have will depend on the purpose of your writing. This handout will cover general thesis statement tips, explain some of the different types of thesis statements, and provide some links to other resources about writing thesis statements.

General Thesis Statement Tips

A thesis statement generally consists of two parts: your topic, and then the analysis, explanation(s), or assertion(s) that you're making about the topic. The kind of thesis statement you write will depend on what kind of paper you're writing.

In some kinds of writing, such as narratives or descriptions, a thesis statement is less important, but you may still want to provide some kind of statement in your first paragraph that helps to guide your reader through your paper.

A thesis statement is a very  specific  statement -- it should cover only what you want to discuss in your paper, and be supported with specific evidence. The scope of your paper will be determined by the length of your paper and any other requirements that might be in place.

Generally, a thesis statement appears at the end of the first paragraph of an essay, so that readers will have a clear idea of what to expect as they read.

You can think of your thesis as a map or a guide both for yourself and your audience, so it might be helpful to draw a chart or picture of your ideas and how they're connected to help you get started.

As you write and revise your paper, it's okay to change your thesis statement -- sometimes you don't discover what you really want to say about a topic until you've started (or finished) writing! Just make sure that your "final" thesis statement accurately shows what will happen in your paper.

Analytical Thesis Statements

In an analytical paper, you are breaking down an issue or an idea into its component parts, evaluating the issue or idea, and presenting this breakdown and evaluation to your audience. An analytical thesis statement will explain:

what you are analyzing

the parts of your analysis

the order in which you will be presenting your analysis

Example: An analysis of barn owl flight behavior reveals two kinds of flight patterns: patterns related to hunting prey and patterns related to courtship.

A reader who encountered that thesis in a paper would expect an explanation of the analysis of barn owl flight behavior, and then an explanation of the two kinds of flight patterns.

Questions to ask yourself when writing an analytical thesis statement:

What did I analyze?

What did I discover in my analysis?

How can I categorize my discoveries?

In what order should I present my discoveries?

Expository (Explanatory) Thesis Statements

In an expository paper, you are explaining something to your audience. An expository thesis statement will tell your audience:

what you are going to explain to them

the categories you are using to organize your explanation

the order in which you will be presenting your categories

Example: The lifestyles of barn owls include hunting for insects and animals, building nests, and raising their young.

A reader who encountered that thesis would expect the paper to explain how barn owls hunt for insects, build nests, and raise young.

Questions to ask yourself when writing an expository thesis statement:

What am I trying to explain?

How can I categorize my explanation into different parts?

In what order should I present the different parts of my explanation?

Argumentative Thesis Statements

In an argumentative paper, you are making a claim about a topic and justifying this claim with reasons and evidence. This claim could be an opinion, a policy proposal, an evaluation, a cause-and-effect statement, or an interpretation. However, this claim must be a statement that people could possibly disagree with, because the goal of your paper is to convince your audience that your claim is true based on your presentation of your reasons and evidence. An argumentative thesis statement will tell your audience:

your claim or assertion

the reasons/evidence that support this claim

the order in which you will be presenting your reasons and evidence

Example: Barn owls' nests should not be eliminated from barns because barn owls help farmers by eliminating insect and rodent pests.

A reader who encountered this thesis would expect to be presented with an argument and evidence that farmers should not get rid of barn owls when they find them nesting in their barns.

Questions to ask yourself when writing an argumentative thesis statement:

What is my claim or assertion?

What are the reasons I have to support my claim or assertion?

In what order should I present my reasons?

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Family nurse practitioner, msn, master of science in nursing, family nurse practitioner degree requirements.

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Enablers and barriers to nurse practitioners working in Australian aged care: A scoping review

Affiliations.

• 1 University of South Australia, UniSA Clinical and Health Sciences, Rosemary Bryant AO Research Centre, Adelaide, South Australia, Australia; Australian Nursing and Midwifery Federation (Federal Office), Melbourne, Victoria, Australia; University of Adelaide, School of Public Health, Health Evidence Synthesis, Recommendations and Impact (HESRI), Adelaide, South Australia, Australia; University of Adelaide, Faculty of Health and Medical Sciences, Adelaide Nursing School, Adelaide, South Australia, Australia; The Danish Centre of Systematic Reviews: a Joanna Briggs Institute Centre of Excellence, Department of Clinical Medicine, Aalborg University, Denmark. Electronic address: [email protected].
• 2 University of South Australia, UniSA Clinical and Health Sciences, Rosemary Bryant AO Research Centre, Adelaide, South Australia, Australia; Australian Nursing and Midwifery Federation (Federal Office), Melbourne, Victoria, Australia.
• 3 Charles Darwin University, Faculty of Health, School of Nursing, Australia.
• PMID: 39121578
• DOI: 10.1016/j.ijnurstu.2024.104861

Objective: To identify evidence reporting on nurse practitioners working in aged care in Australia and to categorise the reported factors found to be barriers or facilitators to operation in terms of establishment, sustainability, and expansion.

Introduction: Nurse practitioners work in a variety of aged care contexts throughout Australia but are underutilised and uncommon. Despite evidence for their effectiveness, it is unclear what barriers or enabling factors contribute to the successful and sustainable implementation of nurse practitioners working in this sector.

Methods: Based on an a-priori protocol the JBI methodology for scoping reviews was used and the review reported against the PRISMA extension for scoping reviews (PRISMA-ScR). Databases searched included MEDLINE, Embase, Emcare, Web of Science, and Scopus. Peer reviewed and grey literature describing the role of Australian nurse practitioners in aged care were included.

Results: Of 2968 retrieved sources, 18 were included representing studies of a variety of designs from all Australian states and territories. Residential care and in-home care contexts as well as metropolitan, regional, and remote locations were represented. Overall, 123 individual barriers and facilitators were identified across seven inductively derived categories: staff/individual, organisational, system, operational, resource, data, and consumers/clients/residents. In many cases, factors appeared across both positive (facilitators) and negative (barriers) categories.

Conclusions: Nurse practitioners can improve the quality of care being provided to older people accessing aged care in Australia. When establishing or maintaining nurse practitioner roles in aged care knowledge users should have a comprehensive understanding of the range of factors potentially contributing to or limiting success or sustainability. As implementation is highly contextual, various types of organisational and sectoral factors as well as individual and overarching factors related to the regulation of nurse practitioners practice should be considered.

Keywords: Australia; Health Services for the Aged; Home care services; Nurse practitioners; Nursing homes; PRISMA-ScR.

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Conflict of interest statement

Declaration of Competing Interest Micah Peters declares that he is an Associate Editor for the International Journal of Nursing Studies. Authors Micah Peters and Casey Marnie declare that their roles at UniSA are funded by the Australian Nursing and Midwifery Federation (ANMF) however no funding was received in relation to the work underpinning this manuscript or in relation to the preparation of the manuscript.

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Master Thesis

Specialties NP

Published Jul 19, 2006

I have a question about the master thesis paper. What were some of the difficulties that you came upon? Exactly how long did it take you to write it? What are some things that you would have done differently? If I could get anyone's thoughts about the master thesis, I would greatly appreciate it. Thanks in advance.

• + Add a Comment

14,633 Posts

In my graduate program (I'm sure every school does it a little differently), we had a required course the second semester of the first year in which we met in small groups (

The best advice I can give about a thesis is to remember that you don't have to set the world on fire, or change the face of nursing as we know it -- you have the rest of your career to do that. You just have to meet the requirements for graduation. Many of my classmates had very ambitious and grandiose ideas for research projects, and bit off quite a bit more than they ended up actually wanting to chew! Remember that the point of a Master's thesis isn't the final result of the study -- it is for you to go through the process of designing, conducting, and writing up a study.

My other "best advice" for a thesis is to choose a topic which hasn't been researched much and doesn't have a lot of literature. It makes a big difference in how much research and writing you have to do. It was just (happy) coincidence that my topic was one that had v. little literature out there, but my lit review ended up being only 13 pages. Classmates who chose more popular topics that had lots of previous research ended up writing lit reviews the size of a good-sized telephone directory ...

The primary general advice that faculty gave us at the time was this -- writer's block is the big downfall of many people, and your brain finds all kinds of excuses to not focus on working. As soon as you sit down to write, your brain becomes preoccupied with how you really need to mop the kitchen floor, or reorganize your closet, or change the oil in your car. Instead of sitting in front of the computer agonizing about it, just get up and do , first, whatever it is you need to do (mopping, reorganizing, etc.) and get it out of the way in order to be able to sit down and focus on writing. Do whatever you need to do in order to be able to write, even if it seems silly or weird.

Your school will (should ...) have v. specific requirements for theses about format, margins, etc. -- take those v. seriously, and follow them exactly! At our school, theses occasionally got rejected (despite the content being just fine) because the margins or something else about the format of the final, bound copy didn't meet the school's requirements (it didn't mean those students didn't graduate -- but they had a terrible time at the last minute, running around frantically to reformat, reprint and get the new version rebound in time to meet the final deadline. No point in putting yourself through that if you can avoid it in the first place. :) )

Best wishes for your studies.

Hello WannabFNP:

Some schools are no longer requiring either a thesis or a master's project. I guess they feel like it is a lot of energy devoted to something that will just "sit on a shelf and gather dust" (as one nursing dean I spoke with said).

There is also another thread on this topic somewhere here. It refers to the problems many have had with thesis papers, and how it has delayed their graduation for a lengthy time, in some cases.

I know a few NP's that had nightmarish stories to tell me about their own thesis experience.

Needless to say, I have chosen a school that does not require a thesis!

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Precipitation amounts

The precipitation diagram for Novorossiysk shows on how many days per month, certain precipitation amounts are reached. In tropical and monsoon climates, the amounts may be underestimated.

The diagram for Novorossiysk shows the days per month, during which the wind reaches a certain speed. An interesting example is the Tibetan Plateau , where the monsoon creates steady strong winds from December to April, and calm winds from June to October.

Wind speed units can be changed in the settings (top right).

The wind rose for Novorossiysk shows how many hours per year the wind blows from the indicated direction. Example SW: Wind is blowing from South-West (SW) to North-East (NE). Cape Horn , the southernmost land point of South America, has a characteristic strong west-wind, which makes crossings from East to West very difficult especially for sailing boats.

General information

Since 2007, meteoblue has been archiving weather model data. In 2014 we started to calculate weather models with historical data from 1985 onwards and generated a continuous 30-year global history with hourly weather data. The climate diagrams are the first simulated climate data-set made public on the net. Our weather history covers any place on earth at any given time regardless of availability of weather stations.

The data is derived from our global NEMS weather model at approximately 30km resolution and cannot reproduce detail local weather effects, such as heat islands, cold air flows, thunderstorms or tornadoes. For locations and events which require very high precision (such as energy generation, insurance, town planning, etc.), we offer high resolution simulations with hourly data through point+ , history+ and our API.

This data can be used under the Creative Commons license "Attribution + Non-commercial (BY-NC)". Any commercial use is illegal.

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We offer competitive rates for container transportation and high-quality service connecting ports of Sfax, Novorossiysk and Istanbul. Our solutions are also devised for Ro-Ro/breakbulk  connections of major Black Sea ports with ports of Persian Gulf, Africa and Southeast Asia.