Date of Award


Document Type

Restricted Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Deborah Schuhmacher DNP, RN

Second Advisor

Joyce P Miller DNP, RN

Third Advisor

Khaled Shawwa MD


Heparin, a porcine product, is being given to Somalian Muslim patients’ while on dialysis. Healthcare providers in this Midwestern dialysis unit are not disclosing that heparin is a porcine product, thus acting in a paternalistic manner in the provider-patient interaction. Since the attacks on the World Trade Center in New York in 2001, an increase in fear of Muslims (Islamaphobia) has increased the inequities and marginalization of this population. The purpose of this DNP project is to explore the inequity the Somali Muslim population faces, specifically with the use of heparin on dialysis and search for possible alternatives to heparin use. To reduce the inequities, a shared decision-making process was created including a dialysis nursing guideline for saline administration, patient interview questions, a patient informed handout, a patient pilot pre and postsurvey, and a shared decision-making session. The shared decision- making session was preceded by patient interviews to gain insight into the Muslim population, and a piloted pre and postsurvey was given to evaluate the shared decision- making session. The project was guided by Madeleine Leininger’s Theory of Cultural Care Diversity and Universality as well as Leininger’s Sunrise Enabler Model and supported by a literature review. The project was implemented with one Somalian Muslim woman who decided to try saline infusion instead of heparin.


SC 11.DNP.2019.Wellerri.E