Digital Commons Network^™

Implementing Delirium Prevention Strategies To Reduce The Need For 1:1 Observation In A Palliative Care Unit, Natalyn Finley

Doctor of Nursing Practice Projects

Background: Delirium is a common complication within the palliative care community that is preventable. Delirium is a condition characterized by confusion and disturbed thought processes. One to one observation was the facility’s intervention used to prevent delirium. The best intervention is non-pharmacological interventions.

Purpose: This quality improvement (QI) project aimed to reduce 1:1 observation hours without increasing patient safety issues.

Methods: The Doctor of Nursing Practice (DNP) student educated nursing staff about the American Nurses Association’s (ANA) evidence-based interventions to help decrease delirium. The staff received the ANA interventions form and the Confusion Assessment Method (CAM) tool. The DNP student …

Reducing The Incidence Of In-Hospital Cardiac Arrests (Ihca) By Utilizing Infographics, Alexis Morgan Pope

Doctor of Nursing Practice Projects

Background: In-hospital cardiac arrests (IHCA) have negative outcomes on patients and can prolong hospitalization or lead to death. The rate of IHCA has been increasing over the past few years in the United States. A medical intensive-care stepdown unit in a level three trauma center has an incidence of IHCA above the national average and a survival-to-discharge rate less than the national average.

Purpose: The project aimed to improve patient outcomes and reduce the rate of IHCA by placing infographics containing evidence-based practice in the unit with the highest incidence.

Methods: A pre-post implementation quality improvement design was used to …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

Evidence-Based Strategies For Fall Prevention, Angelia Palmer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Patient falls represent the largest category of preventable adverse events in hospitals, with 700,000 to 1,000,000 falls occurring annually in U.S. hospitals and 30-35% resulting in injuries. The cost of fall-related injuries exceeds $50 billion globally, with an average of $14,056 per fall.

The aim of this project was to introduce a standardized fall prevention approach to improve performance and reduce falls in the medical-surgical department.

A comprehensive literature review indicates multifactorial bundled approaches, clinical pathways, purposeful rounding, and patient and family engagement as effective fall prevention strategies.

This quality improvement (QI) project design was based on the Plan, Do, …

A Staff Education Program On The Education Of Nurses On Transgender Health Care, Diana Collins

Walden Dissertations and Doctoral Studies

In nursing education, both preregistration and continuing professional development, there is an absence of information about the specific needs of transgender people. The practicum site observed that education on the needs of the transgender community was lacking, discussing a discrepancy in the information offered and the scant attention paid to the unique requirements of transgender individuals. The goal of this project was to create a program that would raise staff members’ understanding of the exceptional health care requirements of the transgender population by providing them with an evidence-based assessment screening tool and training on transgender health care for nurses. The …

A Staff Education Program On The Education Of Nurses On Transgender Health Care, Diana Collins

Walden Dissertations and Doctoral Studies

In nursing education, both preregistration and continuing professional development, there is an absence of information about the specific needs of transgender people. The practicum site observed that education on the needs of the transgender community was lacking, discussing a discrepancy in the information offered and the scant attention paid to the unique requirements of transgender individuals. The goal of this project was to create a program that would raise staff members’ understanding of the exceptional health care requirements of the transgender population by providing them with an evidence-based assessment screening tool and training on transgender health care for nurses. The …

A Qualitative Study Cultural Components Contributing To Resilience And Its Importance To Trauma-Informed Care Of Veterans, Tineka L. Banks

College of Science and Health Theses and Dissertations

Background: Trauma-informed care (TIC) creates an environment of safety, empowerment, and healing. It provides services in a way that encourages mindfulness and promotes the feeling of well-being. Resilience, described as a protective factor to decrease the risk of suicide, is imperative to the delivery of TIC. However, research also suggests resilience is culturally affected.

Purpose: The purpose of this study was to identify cultural components that contribute to resilience in African American female (AAF) veterans, and its relevance to the delivery of TIC and suicide prevention.

Method: Individual interviews were conducted using a semi-structured questionnaire to identify supporting factors, based …

Protocol: Factors Influencing The Implementation Of Non-Pharmacological Interventions For Behaviours And Psychological Symptoms Of Dementia In Residential Aged Care Homes: A Systematic Review And Qualitative Evidence Synthesis, Hunduma D. Ayeno, Gizat M. M. Kassie, Mustafa Atee, Tuan Nguyen

Research outputs 2022 to 2026

This is a protocol for a Cochrane Review. The objectives are as follows. This paper aims to describe a protocol for a systematic review that will synthesise the qualitative evidence regarding factors influencing the implementation of non-pharmacological interventions (NPIs) for behavioural and psychological symptoms of dementia (BPSD) management in residential aged care homes (RACHs). The planned systematic review aims to answer the research question: ‘What are the factors influencing the implementation of NPIs in the management of BPSD at RACHs?’. Additionally, the planned systematic review also aims to generate recommendations to guide stakeholders (e.g., clinicians and aged care staff) and …

A Review Of Socially Responsible Hrm Practices In The Lebanese Healthcare Sector, Maya Issam Houri, Abdul Rahman Beydoun

BAU Journal - Creative Sustainable Development

This study reviews the existing literature on Socially Responsible Human Resource Management practices on both nurses' performance and their intention to stay which constitute important factors of nurses’ decisions to stay in the healthcare sector in Lebanon. It also focuses on the current knowledge about existing literature in socially responsible HRM. This literature review highlights on the current knowledge about the determinant factor and the importance of socially responsible HRM practices and key outcomes for nurses. It suggests that socially responsible HRM practices, covering initiatives such as training, performance evaluation, compensation, work-family balance and occupational health and safety practices, may …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Fall Reduction In The Home Setting For Older Adults: An Evidenced Based Practice Project, Alison Birnie

Doctor of Nursing Practice Final Manuscripts

Falls in the elderly over the age of 65 are the highest mechanism of injury in a Level II TraumaCenter in the SanGabriel Valley. In reviewing the data from 2021-2022, there were 20,653 patients over the age of 65 that arrived in the EmergencyDepartment, 12.3% of those patients had falls. The Senior Care Network is a service line of Huntington Hospital whose mission is to support the health and well-being of older adults living in and around Pasadena and the San Gabriel Valley. To meet this mission, the Multipurpose Senior Services Program (MSSP) supports community members 65 and older covered …

Education Program To Increase Compliance With Advance Directive Completion In A Primary Care Setting Among Filipino Americans, Genalin Paglingayen

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This evidence-based practice project aimed to provide an education program to Filipino Americans in their preferred language (English or Tagalog) to improve compliance with Advance Directive (AD) completion in a primary care setting. Educating them about AD empowers patients with their decision-making about their health in situations where they are incapacitated and unable to make sound decisions. Moreover, it will eliminate the decision-making problem for family members.

Background: An advance directive is a document that empowers patients to convey their wishes to their healthcare provider when they can no longer decide for themselves. Evidence suggested that …

The Experience Of Nursing Faculty In Uganda Integrating Technology In The Classroom: A Phenomenology Study, Catherine Nankanja

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the lived experiences of nursing faculty in integrating digital technology in the classroom in Uganda. Technology penetration in Uganda, a developing country, is still minimal and as a result little is known about impact of digital technology integration in the nursing education. This study was guided by this central research question: What is the experience of nursing faculty in Uganda in integrating digital technology in the classroom? There were four other sub-questions. The study was founded on the connectivism learning theory, which emphasizes leveraging digital technology in education. However, to …

Using Gerontechnology For Care Transition Conversations In Senior Living, Roschelle L. Fritz, Catherine Van Son, Chris Veloicaza, Stephanie Soriano, Gabrielle Barling

ICHRIE Research Reports

Every day across the United States, thousands of senior living organizations assist with housing transition decisions for older adults experiencing health-related changes. These decisions impact resources for older adults and senior housing corporations, yet these decisions are based primarily on subjective observational data regarding older adults’ changes in function or cognition. Smart homes offering continuous, unobtrusive health monitoring with artificial intelligence capabilities are emerging as solutions offering health maintenance support and objective functional and health information. Such systems are well-positioned to support hospitality staff conversing with residents about transitioning from independent to assisted living. Our interdisciplinary nursing research and hospitality …

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer

Doctor of Nursing Practice Projects: College of Nursing

Purpose

The purpose of this study was to evaluate the knowledge and attitudes of nursing students participating in a high-fidelity transgender patient simulation. The aims were to increase student knowledge and confidence to improve communication and provide more inclusive and equitable care.

Healthcare providers are not adequately prepared to manage the unique health needs of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Nurses are ideally positioned to address gaps in LGBTQ healthcare by providing culturally competent care. Yet, LGBTQ health education is lacking in most undergraduate nursing school curriculums.

Methods

62 undergraduate nursing students participated in a post-surgical …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

A Contextual Analysis Of Life Stories From Older Adults Participating In A Telephone Reminiscence Program, Eliana Likorama

Honors Scholar Theses

Life satisfaction, loneliness, and mental health & well-being are important factors to consider when working with the older adult population. This population is predisposed to many risk factors for mental health problems such as coping with a serious illness, losing a loved one, living alone, cognitive deficits, and more. Reminiscence is one simple, flexible, and cost-effective intervention that can be utilized to promote the mental health and well-being of older adults. Reminiscence is defined as the cognitive process of recalling the past. Numerous studies have shown beneficial effects of reminiscence in older adults: increased self-esteem, enhanced quality of life, increased …

Improving Initial Management Of Acute Musculoskeletal Pain In The Emergency Department, Cynthia Y. Norris

Cohort XII

Background/Problem Statement: Acute musculoskeletal pain is one of the major chief complaints amongst Emergency Department (ED) visits each year. In the United States, approximately 41.9 million annual ED visits are musculoskeletal pain related (Fontánez, et al., 2021). Yet, data statistics demonstrate at least 40% of patients reported their pain remained unchanged during their presentation to an ED (Bussey et al., 2020).

Aims/Methods: At University Medical Center, site of the quality improvement project, a total of 91,455 ED annual visits were reported in the latest data reports (El Paso County Hospital District 2022 Annual Report, 2022). This paper chronicles the implementation …

The Effects Of Mediterranean Diet On The Epileptic Population With Depression, Celina Navarro

Cohort XII

Background: People with epilepsy often develop depression during the course of their disease progression. This condition is multifactorial, often related to the unpredictability of their disease, the lack of control on their symptoms, and the medications they use to treat their seizures. Mental health services continue to be insufficient for our growing border region, and patients with epilepsy, often will lack the proper mental health management due to mental health provider shortage. Multiple medications can be used to successfully treat depression in the general population, however people with epilepsy often will struggle as anti-seizure drugs can interact with antidepressants. Also, …

Reaching Gold: Diagnosing And Individualizing Care Using Gold Abe Guidelines, Martha Flores

Cohort XII

Background: Chronic obstructive pulmonary disease (COPD) remains the fifth leading cause of disease-related deaths worldwide, resulting in an annual cost of $3.5 billion in the United States due to COPD exacerbations. COPD treatment necessitates a multifaceted approach that includes collecting complex, subjective, and objective patient information. A ten-day patient assessment log was completed in an outpatient pulmonary clinic to evaluate any shortcomings in the current practice, revealing that the current evaluation of breathlessness involved gathering subjective reporting with binary yes/no responses, leading to variability in diagnosis and treatment.

Methods/Aims: The binary evaluation fell short of the recommendations of the Global …

Hypertension And Treatment Modalities: What Does The Current Evidence Say?, Luis R. Tellez

Cohort XII

Background/Problem Statement: The significantly elevated rates of cardiovascular (CV) disease observed among individuals with mental health conditions might stem from suboptimal handling of cardiovascular risk factors. In this project, I sought to address one aspect of cardiovascular risk: hypertension in patients 18-74 years of age, marked with a blood pressure >140/90 mmHg in a psychiatric inpatient setting. A tenday review of patient care revealed that hypertension management provided to patients under our service was inadequate and might be improved by adopting and implementing more consistent and systematic protocols for medication administration.

Aims/Methods: At the onset of my project, I undertook …

On Solid Ground: A Quality Improvement For Fall Prevention, Jessica Vergara

Cohort XII

Background/Problem Statement: Falls among older adults are a significant concern, affecting up to 30% of individuals aged 65 and older annually. Multiple risk factors contribute to falls, including age, comorbidities, medications, and environmental hazards. Despite the common belief that falls are inevitable with aging, this project emphasizes the preventability of falls through multidisciplinary management and proactive engagement in fall prevention programs.

Aims/Methods: The initiative focuses on implementing the Matter of Balance (MoB) program within an institutional setting. MoB has shown favorable effects on fall-related concerns. The study employs a comprehensive outreach strategy targeting older adults at risk of falling, those …

Improvement Of Patient Outcomes Through The Use Of Intensivist Nurse Practitioners, Leigha Fish

The Eleanor Mann School of Nursing DNP Capstone Projects

This mixed retrospective and prospective cohort study aimed to compare mortality outcomes and associated factors between two cohorts of patients diagnosed with respiratory failure: on-call physicians and Interventional Nurse Practitioners (INPs). The analysis involved 143 patients, 82 in the on-call physician cohort and 61 in the INP cohort. Contrary to initial expectations, the two cohorts had no significant difference in mortality rates (p = 0.143). However, significant differences were observed in critical variables affecting mortality, including Time from Admit to Procedure Performance (p = 0.029), ICU Length of Stay (p = 0.013), and Ventilator Days (p = 0.048), with INP-managed …

Effectiveness Of A Virtual Simulation Program As A Novel Approach To Improve Clinical Judgment In Prelicensure Nursing Students, Monica Millard

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: Limited clinical placement opportunities for practicing decision-making skills have widened the academic-practice gap. Research shows a disturbing decline in entry-level competency among newly graduated registered nurses. Innovative strategies like virtual patient simulation may foster decision-making skills and prepare prelicensure nursing students for practice. However, research is lacking in examining virtual patient simulation (VPS) as an effective approach for developing clinical judgment in prelicensure nursing students. The American Association for Academic Nursing has determined that clinical judgment is an essential nursing attribute. Moreover, the National Council of State Boards of Nursing developed the Next Generation National Council Licensure Exam based …

Psychiatric Mental Health Nurse Practitioner Perceptions Of How Providing Patient Care During The Covid-19 Pandemic Affected Their Own Mental Health, Linda Cabage

Electronic Theses and Dissertations

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to …

Education And Bingo Exercise: Pressure Injury Reduction In An Assisted Living Facility, Emmalee Holmes, Ashley Jaynes, Annah Khan, Caitlin Thornton, Brooke Waller

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.