Digital Commons Network^™

Building Confidence And Team Communication: Implementation Of A Rapid Response In Situ Simulation Program In The Neonatal Intensive Care Unit, Janell F. Hacker

DNP Projects

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Background: Neonatal code events are high-risk, low-frequency occurrences in the neonatal intensive care unit (NICU). Simulation-based training is used to support skill development, maintain competencies, and enhance team performance.

Purpose: The purpose was to determine if a multidisciplinary, high-fidelity, rapid response in situ simulation program would impact confidence and communication among frontline healthcare providers during neonatal code events.

Methods: A quasi-experimental, pretest-posttest study was conducted in a 90-bed Level IV NICU. A multidisciplinary, high-fidelity in situ rapid response simulation program was implemented over a 3-month period for frontline NICU healthcare providers. Pre- and post-surveys assessed perceptions of role clarity, …

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Implementation Of A Cardiomems Screening Tool To Increase Provider Awareness And Referrals In Eligible Patients, Monica Rios

DNP Projects

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Background: Heart failure affects over 6 million Americans and causes more than one million hospitalizations annually. CardioMEMS, a remote pulmonary artery pressure monitoring device, effectively reduces hospitalizations, yet its use remains limited due to provider and system barriers. The purpose was to increase CardioMEMS referrals for eligible heart failure patients through targeted provider education and a standardized screening tool.

Local Problem: Kentucky experiences higher heart failure hospitalization rates than the national average, contributing to prolonged hospital stays and rising healthcare costs.

Methods: A pre—post quasi-experimental study was conducted at an academic medical center. Baseline chart review of 47 patients evaluated …

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Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

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Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

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Factors Influencing Senior Practicum Readiness For Nursing Practice: A Descriptive Correlational Study, Beth Nease Phd, Dnp, Rn, Ne-Bc, Cynthia F. Corbett Phd, Rn, Faan, Stephanie Armstrong Phd, Msn, Rn, Kesheng Wang Phd, Ma, Bs, Kathy Casey, Kong Chen

Faculty Publications

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Background:

This study investigated the influence of belongingness, self-efficacy, and clinical learning support on readiness for nursing practice and explored the role of demographic factors and nursing program differences.

Method:

A quantitative, descriptive approach was used to explore undergraduate prelicensure senior nursing students' perceptions across the United States.

Results:

Descriptive statistics, Pearson correlation, and multiple linear regression demonstrated students in traditional Bachelor of Science in Nursing programs reported significantly higher scores across all domains compared with those in associate degree programs (p < .01). Similarly, students in programs with ≤400 clinical hours and those assigned only one preceptor scored significantly higher on all measures (p < .01 and p < .05, respectively). Regression analysis indicated self-efficacy and learning support explained 47.9% of the variance in practice readiness (p < .05).

Conclusion:

These findings share how clinical experiences shape students' readiness for nursing practice. Recommendations …

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Improving Nursing Compliance With Pain Reassessment Documentation After Analgesic Administration, Dorcas Okunola

Doctor of Nursing Practice Final Project Abstract

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Improving Nursing Compliance with Pain Reassessment Documentation After Analgesic Administration

PURPOSE: This quality improvement project aimed to increase registered nurse (RN) compliance with documenting pain reassessment within 30–60 minutes after analgesic administration in an adult medical–surgical trauma unit at a large academic medical center.

BACKGROUND: Timely pain reassessment is essential for evaluating treatment effectiveness and ensuring safe, patient-centered care. Baseline audits showed inconsistent documentation and compliance below institutional expectations. Evidence supports the use of electronic health record (EHR) prompts combined with targeted nursing education to improve adherence.

METHODOLOGY: A 12-week quality improvement initiative was conducted to reinforce adherence to the …

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Implementing An Evidence-Based Wound Care Protocol For Inpatient End-Of-Life Residents That Aligns With Hospice Comfort Care Goals, Oge C. Okeke

Doctor of Nursing Practice Final Project Abstract

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Implementing an evidence-based wound care protocol for inpatient end-of-life residents that aligns with hospice comfort care goals.

Purpose

This quality improvement (QI) project aimed to adopt a patient-centered, comfort-focused approach to wound care at the DNP project site and improve patient outcomes by increasing nursing staff's knowledge of evidence-based wound treatment strategies by 20%.

Background

Curative treatments involving aggressive methods do not align with hospice principles. Residents at the project site experience increased suffering at the end of life because of limited nursing knowledge of evidence-based, atraumatic wound care practices for end-of-life patients.

Results

Pre-intervention nursing knowledge survey scores ranged …

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Improving Handoff Communication Among Uaps In A Group Home By Implementing Standardized Sbar Tool And Evaluating Its Impact On Communication Quality And Resident Safety, Ola Iweala

Doctor of Nursing Practice Final Project Abstract

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Purpose

Improving handoff communication among unlicensed assistive personnel (UAPs) in a group home through Situation, Background, Assessment, Recommendation (SBAR) tool implementation.

Background

Communication failures during shift handoffs among unlicensed assistive personnel (UAPs) in a group home contributed to missed information, inconsistent care, and resident safety events. Baseline observations showed that only 37.5% of handoffs met criteria for high-quality communication, and approximately 75% of safety incidents were related to communication breakdowns.

Methodology

This project was conducted in a group home serving adults with intellectual and developmental disabilities and included 19 UAPs. The Plan-Do-Study-Act (PDSA) model and Adult Learning Theory guided implementation. …

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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

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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 …

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Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

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Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

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Improving Clinic Workflow To Enhance Rubeola Immunity Screening In Pregnant Patients, Courtney Mcduffie

Doctor of Nursing Practice Final Project Abstract

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Purpose: The purpose of this quality improvement (QI) project was to improve provider adherence to Rubeola IgG serum order entry for prenatal care visits by implementing a standardized workflow and an electronic medical record (EMR)-based order-entry process in a high-risk maternal outpatient clinic.

Background: Rubeola infection during pregnancy is associated with significant maternal and fetal complications. Despite recommendations from the American College of Obstetricians and Gynecologists (ACOG) to use serologic testing to determine immunity status, inconsistent provider ordering practices and workflow gaps contribute to missed opportunities for identifying non-immune patients and planning post-partum vaccination.

Methodology: A ten-week intervention period utilized …

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Mid-Shift Huddle To Improve Icu Nurse Well-Being And Reduce Burnout, Jesse Cannizzo

Doctor of Nursing Practice Final Project Abstract

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Mid-Shift Huddle to Improve ICU Nurse Well-Being and Reduce Burnout

Purpose

Burnout among ICU nurses negatively affects well-being, job

satisfaction, and retention. This quality improvement project

evaluated a mid-shift support huddle to identify staff stressors

and improve nurse well-being.

Results

The mid-shift support huddle identified high-stress events during 44% of

completed huddles, with workload and unsafe assignments as the

primary concerns. ProQOL scores improved, while employee

engagement findings were mixed, with unchanged well-being and lower

perceived stress manageability.

Background

ICU nurses provide high-acuity care, manage heavy workloads, and

experience emotional fatigue. Brief team huddles and leadership

engagement may improve …

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Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

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Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

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A Survey Of Nurses’ Knowledge Of Evidence-Based Guidelines For Indwelling Urinary Catheter Care, Linda Coventry, Michelle Gay, Amineh Rashidi, Anke Ebeling, Roshnika Fernando, Christine Hallauer, Manjari Jayarathna, Rashmi Shrestha, Blake Smith, Paige Watkins, Rosemary Saunders

Research outputs 2022 to 2026

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Background: Urinary tract infections are one of the most common healthcare-associated infections, with catheter-associated urinary tract infections being a significant burden on healthcare systems globally. Aim: To assess nurses’ knowledge of evidence-based indwelling urinary catheter care and explore the barriers and facilitators of evidence-based indwelling catheter care. Design: A cross-sectional survey-based study of nurses in an acute private hospital in Western Australia was conducted from March 2021 to April 2021. Methods: Respondents were recruited using a convenience sampling method. The questionnaire included (1) demographics, knowledge of: (2) indications, (3) catheter care, (4) catheter-associated urinary tract infections prevention, and two open-ended …

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Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

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Background

Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.

Purpose

This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).

Methods

In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they …

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Impact Of Fast Track On Emergency Department Length Of Stay, Kayce Carrick Bsn, Rn, Kelsey Richmond Rn, Stacy Duncan Rn

Nurse Residency Posters

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Facilitator: Melissa Harper, BSN, RN

OhioHealth O'Bleness Hospital

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Impact Of Exercise And Cognitive Behavioral Therapy On Anxiety And Depression, Ranjita Subedi, Rachel Affeldt, Abigail Bentley, Gavin Gump, Madison Mitchell, Taylor Rodgers, Bayley Mullins, Libbie Woodland, Sophia Rubenkoenig

Nurse Residency Posters

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OhioHealth Grant Medical Center

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Hands-Free Tech For Fall Prevention, Sierra Dixon Rn, Jessica Gillam Rn, Bryan Hatheway Rn, Taightam Hicks Bsn, Rn, Kelsey Tignor Bsn, Rn, Hailie Tomsik Rn, Jeremiah Waworoendeng Rn

Nurse Residency Posters

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Facilitator: Kasey Gillen, MHA, BSN, RN, NPD-BC

OhioHealth Mansfield Hospital

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Impact Of Intentional Leadership Styles On Staff Nurse Satisfaction And Retention, Monica Patrick Rn, Camie Mitchell Rn, Amelia Kennedy Rn, Rachel Geiger Rn, Zachary Foster Rn, Katherine Leahy Rn

Nurse Residency Posters

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Facilitator: Tess Wagner, BSN, RN

OhioHealth Riverside Methodist Hospital

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Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

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ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

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Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

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Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

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Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

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This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

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Preventing G-J Tube Dislodgement - A Device And Communication Innovation, Sarah Clark

2026

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Abstract

The Problem: G/J tube dislodgement is a frequent complication in pediatric patients.

Leads to:

• Emergency department visits
• Hospital admissions
• Delays in nutrition/medication

Impact on Patients & Families:

• IV placement (traumatic)
• Radiation exposure
• Overnight hospital stays

Impact on Nurses & System:

• Increased workload (admissions, coordination)
• Occupied inpatient beds for stable patients
• Inefficient care processes

Aims/Objectives Aim: Reduce unplanned G/J tube dislodgements and related hospital utilization.

Objectives: Develop a breakaway connector prototype

Implementation and Evaluation:
Setting: Pediatric inpatient & outpatient system
Participants: Nurses (bedside, GI, IR), caregiver, innovation team
Process: Roundtable discussions → identified workflow gaps Communication/workflow audit Developed …

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Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

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Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

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Recruitment Agency-Mediated Onboarding, Acculturation, And Contract Completion Among Internationally Educated Nurses In The United States: A Questionnaire Survey, Jasper Erwin Tolarba, Jennifer Orbeso, Reynaldo R. Rivera

Nursing Faculty Publications

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Background

Internationally educated nurses play a vital role in addressing global nursing workforce shortages and supporting healthcare systems across many high-income countries. As international nurse migration continues to increase worldwide, effective transition, onboarding, and acculturation practices have become important determinants of workforce integration and retention. In the United States, internationally educated nurses comprise a growing segment of the nursing workforce; however, variability in onboarding practices may affect successful integration and retention.

Aim

To examine recruitment agency–mediated onboarding and acculturation practices and their association with contract completion among internationally educated nurses in the United States.

Design

Cross-sectional descriptive correlational study.

Methods …

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Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

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Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

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Implementation Of An Acute Critical Event Debriefing To Enhance The Quality Of Cardiopulmonary Arrest Resuscitation In The Cardiovascular Intensive Care Unit At A Safety-Net Hospital, Shara Baker

Doctor of Nursing Practice Final Project Abstract

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Purpose

This scholarly project aimed to implement an Acute Critical Event Debriefing (ACED) program in an intensive care unit to improve resuscitation quality by increasing post–cardiopulmonary arrest debriefing completion rates and enhancing documentation of airway confirmation during resuscitation events. The project took place in a 12-bed intensive care unit at a large academic safety-net hospital in Dallas, Texas.

Background

Structured debriefing after cardiopulmonary arrest events was recommended to enhance team performance, clinical education, and resuscitation quality. However, debriefing following code events was inconsistently conducted across many intensive care units, limiting opportunities for team reflection and quality improvement.

Methodology

The Plan-Do-Study-Act …

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Treatment Manual For Sequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

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This is the Treatment for Sequential Format Two Part Program for Symptom Self Management of Auditory Hallucinations (12-Session Course & Support for Booster Dose of Course).

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Treatment Manual For Nonsequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

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This is the Treatment Manual for NonSequential Format: Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

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Postpartum Depression Screening Among Hispanic Women: Insights From Epds Literature, Gabriella A. Irizarry Negron, Sara Moyer

UROP Posters

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Postpartum depression screening among Hispanic women remains an important but complicated issue, as differences in how the EPDS is used and current barriers to care may affect early identification and treatment. This poster, Postpartum Depression Screening Among Hispanic Women: Insights from EPDS Literature, explores how the Edinburgh Postnatal Depression Scale (EPDS) has been evaluated across studies involving Hispanic populations. Using a literature review approach, eight peer-reviewed articles were organized into an annotated bibliography and matrix to identify key trends in screening practices and outcomes.

Findings revealed three major themes: (1) EPDS cut-off scores for postpartum depression vary widely across …

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Building Self-Perceived Confidence Through Occupational Therapy And Nursing Student Peer Teaching, Jennifer A. Tokash, Melissa Nolan, Jamie Bittiger, Jessica Wagoner, John Damiao, Michelle Lopez

Journal of Occupational Therapy Education

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Peer teaching, which is student-to-student instruction, has emerged as a promising pedagogical strategy in higher education, yet it remains underexplored in health professions curricula. While traditional professor-led instruction remains the predominant model, peer teaching may offer comparable or enhanced outcomes, particularly in fostering students’ self-perceived confidence and active learning. This study examined the impact of peer teaching on nursing students’ self-perceived confidence in applying ergonomic principles and performing safe patient handling techniques, as instructed by occupational therapy students. Additionally, the study assessed occupational therapy students’ self-perceived confidence in measuring vital signs following instruction provided by nursing students. Using a quasi-experimental …

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