Promoting The Use Of Smoke Evacuation Systems In The Operating Room: A Quality Improvement Initiative, Andrea Leigh Drayer

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Surgical smoke produced during procedures poses serious health risks to operating

room (OR) staff and patients, yet many hospitals, including an academic medical center in

northern West Virginia, have underutilized smoke evacuation systems. The imminent

enforcement of West Virginia House Bill 4376, mandating smoke evacuation use, provided both

urgency and opportunity for an intervention.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project

was to increase timely compliance with the use of smoke evacuation systems during all smoke-

producing procedures, ensuring alignment with safety standards and legislative requirements.

Methods: A systematic evidence review of academic …

An Evidence-Based Practice Initiative To Promote Debriefing Within The Obstetrics Surgical Team, Rachel Lynn Runatz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Operating room debriefing is an evidence-based strategy shown to improve communication, efficiency, patient safety, and safety culture; however, debriefing is inconsistently performed in obstetric operating rooms due to workflow, cultural, and time-related barriers.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to increase the frequency of debriefings in the Birthing Center operating rooms at WVU Medicine Children’s Hospital through implementation of a nurse-driven, evidence-based debriefing initiative.

Intervention: A nurse-driven debriefing protocol was implemented using the Iowa Implementation for Sustainability Framework. Interventions included staff education, accessible laminated debriefing documents, identification of nurse champions, leadership support, and …

Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Urinary tract infections (UTIs) are one of the most common infections that require antibiotic therapy. Providers working in three urgent care clinics located in Eastern West Virginia diagnosis and treat UTIs based on their clinical judgement. Variability in clinical judgement results in inappropriate antibiotic use which has implications on antibiotic resistance and the financial burden of the patients as well as the entire organization.

Evidence Review: A total of 10 articles were evaluated to support the implementation of antibiotic stewardship initiatives that provide guidance in caring for this population. Interventions include electronic health record enhancements, provider education, and tracking …

The Effects Of Music Therapy On Anxiety And Sedation Requirements For Total Knee Arthroplasty Patients Undergoing Regional Anesthesia: An Evidence-Based Practice Pilot Initiative, Kyra Marie Savrese

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Excessive noise in the operating room negatively impacts patient comfort and outcomes, particularly in patients undergoing spinal anesthesia who have the potential for awareness.

Background: Research demonstrates that music therapy is a low-cost, low-risk intervention that reduces perioperative anxiety and sedative requirements. Literature supports the use of music as an adjunct to anesthesia care, especially in orthopedic populations.

Purpose: At J.W. Ruby Memorial Hospital, orthopedic procedures with regional anesthesia expose patients to high noise levels, often leading to increased anxiety, sedation use, and longer recovery times. Addressing this problem aligns with institution goals for safe, patient-centered care.

Methods: Using …

A Quality Improvement Initiative To Decrease The Length Of Stay In The Post-Anesthesia Care Unit For Children Undergoing Iv Anesthetic Inductions For Gastrointestinal Procedures, Kaylee Bahret Bangs

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pediatric patients at WVU Medicine Children’s (WVU-CH) are emerging slowly from anesthetics during diagnostic gastrointestinal procedures which delays discharge from the post-anesthesia care unit. The cumulative effect is an increased length of hospital stay and the associated increases in costs. This project explores a novel method to reduce the amount of medication pediatric patients receive by using virtual reality goggles as a nonpharmacologic intervention to reduce preprocedural anxiety.

Purpose: This quality improvement project seeks to reduce time spent in PACU for children undergoing IV induction GI procedures by using preoperative virtual reality (VR) headsets during IV placement …

Empowered Choices: A Quality Improvement Women’S Health Initiative In Faith-Based Nursing For Women Recovering From Substance Use Disorder, Jennifer Mewshaw

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Women with substance use disorder (SUD) face higher rates of unplanned pregnancy, reproductive infections, and delayed prenatal care. Faith community nurses (FCNs) often already serve within this community and have a long history of promoting public health interventions. However, they lack the knowledge and confidence in sexual and reproductive health (SRH) education.

Evidence Review: A literature review identified barriers to SRH care for women with SUD and the role of FCNs in community and public health interventions. Evidence supports providing FCNs with the knowledge and skills to deliver SRH education and support for women with SUD using trauma-informed and …

Improving Access To Care And Utilization Of Telehealth In Pediatric Inflammatory Bowel Disease Patients Through Scheduling Interventions: A Quality Improvement Project, Sarah R. Bergstrom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Improving Access to Care and Utilization of Telehealth in Pediatric Inflammatory Bowel Disease Patients Through Scheduling Interventions: A Quality Improvement Project

Sarah Bergstrom

Introduction/Background. Inflammatory bowel disease (IBD) tends to affect pediatric patients with a more severe, aggressive phenotype as compared to adults. Following closely with a pediatric gastroenterologist (GI) is best practice to manage pediatric IBD. However, pediatric subspecialty clinics are generally located within academic institutions in urban areas. Patients in rural areas often have limited access to pediatric GI care, and poor access to care is associated with increased risk of poor disease control. Telehealth subspecialty …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

A Quality Improvement Initiative To Reduce Pressure Ulcers In Spinal Cord Injury Patients, Nicholas Post

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pressure ulcers are a significant concern for hospitalized patients, leading to various complications and increased medical costs. Despite common preventative interventions, pressure ulcer rates remain elevated. The prevalence of pressure ulcers contributes to patient suffering, extended hospital stays, increased healthcare expenses, and even fatalities. This emphasizes the critical need for additional prevention strategies. The reported increase in pressure ulcer injuries among spinal cord injury patients in the Surgical Intensive Care Unit (SICU), along with 7E and 8NE step-down units, at a large academic hospital highlights the pressing issue.

Purpose: The purpose of this project was to develop and …

Beat By Beat: Empowering Communities With Lifesaving Cpr Skills, Allyssa Mb Hutchins

Doctor of Nursing Practice Projects

Introduction: This doctoral project was created to increase bystanders' willingness and ability to perform CPR by building their confidence in performing it effectively. A total of 13 participants participated in this project to increase knowledge and confidence in CPR interventions.

Background: Cardiac arrests remain a leading cause of death, yet research indicates that rural communities have lower rates of bystanders trained and willing to assist. Increasing CPR awareness and eliminating barriers to care for classes can improve CPR confidence and have a positive community impact.

Methods: Three 4-hour CPR classes were held in Zirconia, NC, at no …

Spreading Awareness To College Athletes About Skin Cancer And Improving Sun Protection Habits, Baylee B. Whiteside

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to provide education on improving awareness of skin cancer to potentially improve sun protection habits. A total of 100 college athletes participated in this project. The goal was to increase educational knowledge and practice intentional sun protection habits.

Background: One in 5 people will develop a type of skin cancer by age 70 (Skin Cancer Foundation, 2024). Several studies have proven that young adults, ages 15-25, are at an increased risk of sun exposure due to decreased knowledge about skin cancer. Teaching and improving the knowledge in this …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

Improving First Case-On-Time Starts In The Operating Room By Implementing A Visual Patient Readiness Assessment Tool: A Pilot Quality Improvement Project, Xochitl I. Miranda-Khayat

Doctor of Nursing Practice Final Project Abstract

Purpose

Delays in first case on-time starts (FCOTS) impact operating room (OR) efficiency, causing compounding schedule delays. This quality improvement (QI) project implemented a visual readiness tool to standardize communication and increase FCOTS rates.

Background

The project was implemented in a 5-room OR in an academic teaching hospital in the Texas Medical Center.

Methodology

Plan-Do-Study-Act (PDSA) cycles and the Consolidated Framework for Implementation Research (CFIR) guided continuous improvement and contextual factors evaluation. Following multidisciplinary education, the visual tool was implemented. De-identified FCOTS data was extracted from the electronic health record (EHR). Qualitative feedback was gathered via Qualtrics (n=17 pre-implementation) and …

Enhancing Uncontrolled Hypertension Compliance And Self-Management In A Senior Center, Kimberly D. Strickland

Doctor of Nursing Practice Projects

Hypertension is a complicated, chronic condition that affects individuals worldwide. The prevalence of this condition has increased nearly 48% in the last decade in America. This project served to determine if participants in a targeted area/community would show increased knowledge and awareness of hypertension after implementation of educational sessions. A post-session survey was provided to determine if the educational sessions were effective. Data was collected and analyzed that showed an increase in awareness and knowledge regarding the prevalence of hypertension, diet modification, lifestyle, and compliance.

Increasing Teens' Knowledge On The Health-Related Effects Of Vaping, Anteja Gore

Doctor of Nursing Practice Projects

Vaping in teens has become an increasing public health issue related to the growth in the number of teens who are using vapes. Many teens are not aware of the potential associated risk of using vapes, as they perceive them to be a safer alternative to smoking cigarettes. The purpose of this project was to increase the middle school teens’ knowledge of the potential health risks associated with vaping through an educational awareness session. This project was implemented in the middle school setting, targeting students aged 12-14 years. The students who participated completed anonymous pre- and post- questionnaires that evaluated …

Preparation Of Australian Nurses For Contemporary Disability Care: A Desktop Review, Lesley Andrew, Martina Costello

Research outputs 2022 to 2026

Approximately 18% of Australians experience disability, with significant health inequities documented in this population. Despite nursing’s crucial role in addressing these inequities, questions remain about nurses’ preparedness to work effectively with people with disability. The review assessed Australian nursing education’s approach to prepare its graduate nurses for disability care in today’s Australia. Using a rigorous desktop analysis methodology, the review evaluated the publicly available undergraduate nursing degree curricula materials from all 32 Australian public universities that offered a preregistration nursing degree in 2024. The review found 50% of nursing degree curricula course materials omitted to mention disability in their publicly …

Delirium In The Acute Care Setting From The Families Perspective: A Scoping Review, Amber Mclean, Beverley Ewens, Amanda Towell-Barnard

Research outputs 2022 to 2026

Aim: To explore the existing literature on delirium within the acute care setting from the family members' perspective and summarise key findings. Design: A scoping review guided by Arksey and O'Malley's methodological framework and refined by the Joanna Briggs Institute. Review Methods: The Population, Concept, and Context framework recommended by the Joanna Briggs Institute's scoping review protocol identified the main concepts in the primary review question. The inclusion criteria focused on primary research studies from any chronological date that explored the family members' experience of delirium within the acute care setting. Following screening by two independent reviewers, data extraction was …

Personal Family-Centred Care For Lgbtq+ Individuals In Acute Hospital Settings: A Scoping Review, Gideon U. Johnson, Bianca Ysabelle Esmeralda, Stephen Pearson, Beverley Ewens, Louise Rose

Research outputs 2022 to 2026

Aim: To identify and synthesise existing evidence on family-centred care for Lesbian, Gay, Bisexual, Transgender, Queer and other diverse identities (LGBTQ+) people in acute hospital settings, including hospital-based palliative care, oncology, general in-patient and intensive care. Design: A scoping review guided by the JBI methodology. Methods: Nine databases and grey literature sources were searched. Inclusion criteria focused on LGBTQ+ adults and family-related care experiences in hospital-based acute settings. After screening, qualitative, quantitative, and narrative data were extracted. Thematic analysis synthesised findings, with quantitative data narratively integrated. Data Sources: Searches were conducted across nine databases and grey literature up to April …

A Case For Qualitatively Driven Mixed Methods In Nursing Research: A Methodological Discussion, Jennifer Hamilton, Cooper, Irene Ngune, Amanda Cole, Richard Bostwick, Debbie Louise Massey

Research outputs 2022 to 2026

Mixed methodology continues to grow as a rigorous and respected research design. However, the value of qualitatively driven mixed methods research within nursing is underrepresented. Qualitatively driven mixed methods, where qualitative data dominate meaning-making, have the potential to capture critical experiential elements pertinent to nursing research while supporting empirical rigour. This methodology paper argues for the importance of qualitatively driven mixed methods approaches within nursing research to enable greater understanding of complex phenomenon. Through discussion and case example the role of qualitatively driven mixed methods, including within a sequential explanatory design, are presented. Nurses and midwives are well placed to …

Opioid Abuse: Community Education, Meggan N. Wolff-Jackson

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has persisted for over two decades and has become one of the leading causes of accidental deaths nationwide (Robert et al., 2022). The opioid crisis represents a widespread public health emergency that extends beyond individual and community boundaries, imposing burdens on both the national economy and the healthcare system (Kyei et al., 2024). Although the opioid epidemic is a global concern, it is particularly concerning in the target community located in the western part of North Carolina. This region has some of the highest rates of opioid overdoses within the state, with 118 …

Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …

Musical Measures: Nurse Education On Music-Based Interventions To Reduce Patient Restraints, Crystal D. Tucker

Doctor of Nursing Practice Projects

The use of physical restraints in acute psychiatric settings poses significant risks to patient safety, including physical injury and psychological distress. Evidence supports the need for alternative, non-pharmacologic interventions to reduce reliance on restraints. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of an educational intervention on nurses’ knowledge and confidence in implementing music-based interventions, specifically binaural beats, to manage patient anxiety and agitation.

The project was conducted on a medical observation and behavioral health holding unit and utilized a pre- and post-intervention design. Registered nurses participated in educational sessions on music-based interventions and were …

Combating Pressure Injuries In Critical Care: A Dnp Project On Nursing Education And Prevention Strategies In The Icu, Tijuana M. Johnson

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) are preventable complications that significantly increase patient morbidity, mortality, length of stay, and healthcare costs, particularly in intensive care units (ICUs). At a rural 146-bed hospital, the ICU pressure injury rate of 1.17 per 1,000 discharges exceeded the national benchmark of 0.58 per 1.000 discharges, identifying a critical gap in prevention practices. This Doctor of Nursing Practice (DNP) project aimed to improve ICU nurses' knowledge of pressure injury prevention and reduce unit-based educational intervention grounded in Patricia Benner’s Novice to Expert Theory and implemented using the Plan-Do-Study-Act (PDSA) quality improvement framework.

A pre-and post-intervention design was …

Improving Timeliness Of Extubation Post-Cabg: An Educational Intervention Utilizing A Nurse-Driven Checklist, Christy Scott

Doctor of Nursing Practice Projects

Background: Timely extubation following coronary artery bypass graft (CABG) surgery is associated with improved patient outcomes. In a rural six-bed cardiovascular intensive care unit (CVICU) in North Carolina, extubation times were previously reported at approximately 15 hours. A lack of a standardized nurse-driven process and inconsistent familiarity with extubation readiness criteria contributed to variation in practice.

Purpose: The purpose of this DNP project was to implement and evaluate an educational intervention using a nurse-driven extubation checklist to improve nurses' knowledge, confidence, communication, and role clarity related to post-CABG extubation readiness in the CVICU.

Methods: The staff education …

Building Clinical Competency In Central Line Care: A Nurse-Focused Initiative To Prevent Clabsis, Glenda A. Robbins

Doctor of Nursing Practice Projects

Central line-associated bloodstream infections (CLABSIs) are a significant yet preventable source of increased morbidity, mortality, and healthcare costs in acute care settings. Despite established evidence-based prevention bundles, inconsistent nursing adherence remains a primary contributor to elevated CLABSI rates. A 241-bed acute care hospital reported CLABSI rates above the national benchmark. This Doctor of Nursing Practice (DNP) project utilized Neuman’s Systems Model. The intervention consisted of a structured educational module on central line care and maintenance, including pre- and post- knowledge assessments. Additionally, standardized daily central line visual audits were reinforced by the Vascular Access Team. A total of 363 bedside …

Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

Spreading Awareness To Adults About Cardiovascular Disease And Improving Healthy Lifestyle Habits, Madison L. Eldridge

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to evaluate if providing education to the target community would increase awareness and knowledge of cardiovascular disease and healthy lifestyle habits. The goal was to increase educational knowledge and promote awareness of cardiovascular disease and healthy lifestyle habits.

Background: Cardiovascular disease (CVD) is a critical health issue that prevails across the state of North Carolina, while continuing to remain one of the leading causes of death across the south-center Piedmont area of North Carolina. Several studies have proven that increasing knowledge on cardiovascular risks, promoting healthy exercise, and …

Enhancing Mass Casualty Incident Preparedness: Bridging The Gap Between Education And Practice, Emily M. Coggins

Doctor of Nursing Practice Projects

The increasing amount of mass casualty incidents (MCIs), such as natural disasters, large-scale emergencies, and active shooter events, has emphasized the need for healthcare professionals to respond effectively. Traditional undergraduate nursing curriculum often offers limited opportunities for students to practice disaster preparedness through simulated experiences. This DNP project was created to evaluate the effectiveness of implementing an MCI training simulation to increase the confidence and competence of senior pre-licensure nursing students when responding to a mass casualty event. The project implemented a 1-day, simulation-based MCI event for senior nursing students enrolled in an Adult Health II course. The event included …

Enhancing Clinical Judgement In Pre-Licensure Nursing Students Through Active Learning Strategies Of Unfolding Case Studies And Simulations For Postpartum Hemorrhage, Lisa M. Alley

Doctor of Nursing Practice Projects

New graduate nurses lack the appropriate clinical judgement to provide optimal, safe, quality care, as evidenced by the report of errors in health care (Rodziewicz et al., 2024). The purpose of this project was to provide an evidence-based intervention that used an unfolding case study and simulation to further develop clinical judgement among undergraduate nursing students in a rural ADN program. The project used a pre-test and post-test to measure students' improvement prior to versus after the learning experience and debrief. This project also introduced a DASH tool, which is a debriefing assessment for simulations in healthcare, to help students …

Nurse Leaders’ Perceptions Of Organisational Policies, Guidelines, And Practices That Enact Children And Young People’S Involvement In Hospitals, Mandie Jane Foster, Julie Blamires, Virginia Jones, Smita Keshoor, Chris Moir, Annette Dickinson

Research outputs 2022 to 2026

There is limited literature on nurse leaders’ perceptions of organisational policies, guidelines, and practices that enact children and young people’s (CYP) involvement in hospitals. Nurse leaders within what were the four District Health Board providers of children’s tertiary health services in New Zealand (Auckland, Counties Manukau, Wellington, and Canterbury) were invited to respond to an online survey during November 2022 through to January 2023. The survey was developed by the researchers in accordance with the literature and included 11 open-ended questions. The open-ended questions were analysed iteratively through inductive thematic analysis. Eight out of 24 invited nurse leaders responded to …