Digital Commons Network^™

Nursing Professional Liability: Bridging Rn & Aprn Perspectives On Risk, Coverage & Evolving Practice Authority, Michelle Hileman Msm, Rn, Cnm, Parkview Health

Nursing Publications, Posters, & Presentations

Presented at the 2025 Parkview Nursing Research Symposium.

The purpose of this literature review is to explore professional liability for RNs and APRNs. Specific objectives include:

• Identify patterns in malpractice claims for RNs and APRNs

• Compare employer-provided and personal malpractice coverage

• Examine the impact of scope-of-practice laws on APRN liability

• Clarify principles of vicarious liability

• Recommend lifelong strategies for education, risk management, and professional practice

Provider Perspectives On Produce Prescription Programs In A Rural Community, Heather Ward Dnp,Fnp-Bc, Sarah Giaquinta Md, Mph, Susan Storey Phd, Rn, Aocns

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium.

Purpose:

• To evaluate healthcare provider perspectives on PPPs in a rural community
• To identify barriers and facilitators to implementing a PPP
• To lay the groundwork for the successful implementation of a PPP in the Count

Pairing Vashe And Cavilon Advanced Skin Protectant For An Innovative Approach To Neonatal Diaper Dermatitis Treatment, Jennifer Thieman Msn, Rn, Accns-P, Rnc-Nic, C-Elbw, Cls

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium.

Objective: To implement a new process that allows Vashe and Cavilon Advanced Skin Protectant to be used together in order to improve healing time of diaper dermatitis.

Tiered Skills Acquisition Model Implementation Parkview Health Centers For Wound Healing, Harlee Heller Bsn, Rn,Csmrn, Ariel Custer Bsn, Rn

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Parkview Nursing Research Symposium.

Implement TSAM at Parkview Centers for Wound Healing to:

• Ensure consistent delivery of high-quality nursing care
• Establish standardization to equip nurses to float between outpatient wound clinic locations, promoting flexibility and operational efficiency
• Support preceptor flexibility to continue an orientee’s training, regardless of the availability of the primary preceptor, expediting orientation
• Increase confidence of outpatient wound care nurses for independent practice following orientation
• Increase nursing retention rates

Three Wishes Project: Individualizing End Of Life Care, Sarah Seddon Rn

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium. •We used the journal article to create tangible ways to individualize the dying process •A binder ways created with the different “wishes” nurses can provide.

Optimizing Defibrillation Response: A Quality Improvement Initiative In The Cath Lab, Sara Cullis Bsn, Rn

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Parkview Nursing Research Symposium.

Patients undergoing diagnostic or emergent procedures in the Cardiac Cath Lab are at risk of developing lethal arrhythmias, which require immediate defibrillation to prevent adverse outcomes. Currently, the use of paddles and the absence of pre-applied defibrillator pads delay response time during critical events, increasing the risk of morbidity and mortality. Additionally, there is a liability when staff assume which patients are “high risk” versus “diagnostic,” as even seemingly low-risk cases can rapidly deteriorate without warning. This quality improvement initiative aims to address this gap by ensuring defibrillator pads …

Best Practice In Geriatric Fracture Care: Impact Of Early Urinary Catheter Removal On Cauti Incidence, Samantha Tiede Bsn, Rn, Onc, Heather Kegerreis Msn, Rn, Cmsrn

Nursing Publications, Posters, & Presentations

Poster presented at the 2025 Parkview Nursing Research Symposium.

Objective: Evaluate the effectiveness of urinary catheter removal by POD1 on CAUTI incidence in GFPs.

Use Of Machine Learning Models To Predict Microaspiration Measured By Tracheal Pepsin A., Annette Bourgault, Ilana Logvinov, Chang Liu, Rui Xie, Jan Powers Phd, Rn, Ccrn, Mary Lou Sole

Nursing Publications, Posters, & Presentations

BACKGROUND: Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator of microaspiration, was found in 39% of patients within 24 hours of enteral feeding. Tracheal pepsin A is a potential biomarker of enteral feeding intolerance.

OBJECTIVE: To identify predictors of microaspiration (tracheal or oral pepsin A). It was hypothesized that variables predicting the presence of tracheal pepsin A might be similar to predictors of enteral feeding intolerance.

METHODS: In this secondary analysis, machine learning models were fit for 283 adults receiving mechanical ventilation who had tracheal and …

A Nurse-Led Transitional Care Intervention To Prevent Readmissions In A Low-Income-Serving Urban U.S. Hospital, Melissa Scollan-Koliopoulos

Nursing Faculty Publications

Background: Diabetes-related hospital readmissions within 30-days are costly and an indicator of suboptimal care resolution. Nurse-led transitional care interventions may improve glucose control and reduce emergency department recidivism following hospital discharge in very low-income populations.

Methods: An intention-to-treat design with randomization of participants (n = 108) compared conventional care to transitional care coordination that included diabetes specialty appointments, monthly support tele-phone calls, medication management, and tailored diabetes self-management education. Both the control and intervention group received a diabetes specialist and primary care appointment.

Results: There was a significant difference between the control and intervention groups (P = 0.018) from base-line …

Understanding Emergency Department Utilization By African Americans For Routine Diabetes Care: Are We Asking The Right Cultural Questions?, Melissa Scollan-Koliopoulos

Nursing Faculty Publications

Introduction: The emergency department is a source of routine care for many African Americans. Afrocentric cultural characteristics may serve as a better proxy than race for understanding preferences for emergency department use over primary care for diabetes management. Methods: A literature review was conducted including key terms related to transitional healthcare, emergency department recidivism, Afrocentric cultural characteristics, racism and health disparities, and diabetes in African Americans. An example of tailoring talking points using Afrocentric cultural characteristics is proposed using Jone’s TRIOS Model, a Afrocentric Self-enhancing and Protective Theory. Results: The literature includes evidence to support a complex explanation for emergency …

Librarian Partnerships In Dnp Education, Kerry A. Milner, Roy Brown, Janene Batten, Tami A. Hartzell, Ellen Fineout-Overholt

Nursing Faculty Publications

This is the sixth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series—Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes, and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario …

Letter To The Editor, Julee Waldrop, Kerry A. Milner, Jayne Jennings Dunlap, Staci Reynolds, Anne Derouin

Nursing Faculty Publications

No abstract provided.

Accessing Facility Electronic Health Record For Payer Utilization Review Review, Betsey Denton

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to improve the prior authorization process for payer, provider, and patients by reducing the number of medical necessity denials, peer-to-peer calls, appeals, and increasing payer and provider satisfaction.

BACKGROUND A literature review indicated opportunities for improvement in prior authorization processes. Medical necessity denials are issued by payer if clinical documentation is not available for review. Implementation setting was a large academic medical center. Studied populations included patients who are members of a large Medicaid HMO health plan, payer utilization review registered nurses (RN), and hospital utilization review staff. METHODOLOGY Payer RNs began utilizing …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Still Faces, Different Places: An Assessment Of The Literature On The Face-To-Face Still Face Procedure For Cultural Congruence, Merilyn Arikkat, Leslie B. Lantz, Patricia Kinser

UROP Posters

Cultural understanding is a factor that impacts reliability of research results for observational studies. It is important to include participants of minority groups in research, as many people of color face disproportionate challenges in terms of healthcare access and resources. Within the context of mother-infant attachment, a technique known as the Face-to-Face Still Face procedure can be utilized to observe attachment styles and the bond between a parent and their infant. In order to combat subjectivity within the coding process for this Face-to-Face Still Face procedure, cultural congruence between the participants being observed in the study and the coding researchers …

Impact Of Bundled Care: Optimizing Pain Management Outcomes In Acute Care, Mary Kelly, Denise Danna, Marsha Bennett, Karen Rice, Helen Calmes, Paige Fisher, Mary Dioise Ramos

School of Nursing Faculty Publications

Purpose: Despite therapeutic advances, inadequate pain management in hospitalized patients often leads to chronic pain and opioid dependency. Nonpharmacologic strategies offer potential benefits, especially when integrated into a bundled care approach that enhances pain management and patient engagement. This research aimed to test the effect of a standardized bundle of evidence-based pain care strategies on medical-surgical patients' perceived pain quality outcomes. Design & Methods: This study employed a 2-group, quasi-experimental design to assess the impact of a unit-based intervention, PAIN-X Therapy, on pain care quality outcomes compared to usual pain care. Results: There were 365 participants included in the study …

Application Of Root Cause Analysis For Fall Prevention: A Quality Improvement Initiative For Older Adults In A Skilled Nursing And Long-Term Care Facility, Terrence Ranjo

Doctoral Projects

Falls in older adults are common and often have severe outcomes. They are the leading cause of fatal and non-fatal injuries among people aged 65 and older and continue to increase. Half of residents in nursing facilities fall annually, and one in every ten falls will lead to a severe injury. Federal regulations like the Centers for Medicare and Medicaid Services require long-term care (LTC) facilities to incorporate quality assurance performance improvement initiatives to address identified quality concerns in LTC facilities. Root cause analysis (RCA) can help clinicians identify several root causes of falls and guide clinicians in developing personalized …

Exploring Gaps In Hiv Prevention: Hiv Pre-Exposure Prophylaxis Awareness, Attitudes, Utilization, Coverage, Hiv Testing And Risk Perception Among Sub-Saharan African College Students In The United States, Ikenna Obasi Odii

All ETDs from UAB

This dissertation focuses on increasing HIV awareness and contributing to efforts at reducing new HIV infections among Sub-Saharan African (SSA) college students. It begins with an introductory chapter one and ends in the concluding chapter five. Chapter two presents a systematic review identifying key gaps in HIV Pre-Exposure Prophylaxis (PrEP) knowledge, attitudes, and utilization among Black college students in the United States (U.S). The review synthesizes findings from four studies, revealing that a third of participants demonstrated adequate PrEP knowledge, while PrEP utilization remained under-utilized at three percent. Key barriers to PrEP uptake included fear, low self-perceived HIV risk, infrequent …

Nursing Simulation For Pediatric Communication: An Integrative Literature Review, Jayla R. Call

Honors Undergraduate Theses

The aim of this thesis is to explore literature focused on enhancing nursing students' communication skills with pediatric patients through simulation. Effective communication is key to building rapport and trust, which are essential for improving patient outcomes. However, nursing students may experience anxiety when interacting with pediatric patients due to limited training in communication techniques. Simulation offers a valuable opportunity for students to practice and refine their skills in a risk-free environment, allowing them to build confidence and competence. An integrative literature review was conducted, utilizing three databases and PRISMA guidelines (Page et al., 2021) to gather relevant studies for …

Improving The Emotional Wellbeing Of Healthcare Workers In A Homecare Agency, Crystal U. Okafor

Doctor of Nursing Practice Projects

Healthcare workers (HCWs) often have traumatic experiences in the course of care delivery, and these experiences negatively impact their well-being, affecting them emotionally, psychologically, and physically. With the COVID-19 pandemic, healthcare workers have had indelible experiences questioning their choice of profession. This project aimed to teach the factors affecting the emotional well-being of healthcare workers and develop strategies to improve emotional distress in a home care agency. The implementation site was Carolina Homecare Solutions, with 21 participants, including nursing assistants and registered nurses. Sample selection was via a convenient strategy, selecting the most conveniently available participants. The project leader used …

Enhancing Sleep Quality: The Interrelationship Between Sleep Hygiene And Comprehensive Well-Being, Marissa Strenkert

Doctor of Nursing Practice Projects

In North Carolina, many adults face sleep loss, negatively impacting cognitive functioning, mental health, and physical well-being. This project aimed to educate the public about sleep hygiene techniques and their benefits. An informational session was conducted on sleep hygiene. The informational session included 31 participants, who then completed a voluntary survey to assess their likelihood of adopting the techniques and their satisfaction with the session. Out of 31 participants, 18 completed the survey. The survey consisted of 10 questions, scored on a scale from 1 (strongly disagree) to 5 (strongly agree), allowing for total scores between 0 and 50. Higher …

Sleep Promotion In Neonatal Intensive Care Units, Maelyn G. Cranford

Doctor of Nursing Practice Projects

Sleep is a fundamental requirement for the human body to achieve and sustain overall health and well-being. In Neonatal Intensive Care Units (NICU), sleep is a vital step in an infant’s routine to allow for proper neurodevelopment and growth. Parents of infants in the NICU may be unaware of the critical role sleep plays in their child’s health. Without realizing it, they can unintentionally disrupt their infant’s sleep by speaking loudly, using bright lights, or playing loud sounds from their phone. This DNP project was created to increase NICU parent education on the importance of sleep promotion and involve them …

Recognizing Opioid Withdrawal: An Educational Intervention To Increase Nurses' Knowledge And Improve Quality Of Patient Care, Keyannah L. Glover

Doctor of Nursing Practice Projects

Opioid abuse, prescription and illicit use, remain a problem in the United States. Recognizing signs and symptoms is important because lack of recognition can lead to misdiagnosis and mismanagement. The target population for this study was nurses in the emergency department. This quality improvement project was developed to provide education to the nurses in the emergency department to recognize opioid withdrawal signs and symptoms. This project evaluated the baseline knowledge of nurses working in the emergency department. The project was implemented over a 3-week time frame. The pre-test was sent out to participants via email to test their baseline knowledge. …

Pantry To Plate: Using Local Food Pantries To Improve Diabetes Self-Care Deficits, Rachelle Zielazienski

Doctor of Nursing Practice Projects

This project aimed to improve food pantry participants’ diabetes self-management and understanding of diabetes nutrition education through a collaborative approach. Over the course of 2 months, the project provided educational resources on diabetes nutrition at a food pantry. The target population included individuals with diabetes, pre-diabetes, and those responsible for preparing meals for diabetic individuals. A certified diabetes specialist was enlisted to ensure the delivery of culturally sensitive, evidence-based educational support tailored to participants’ diabetes health goals. Orem’s Self-Care Deficit Theory served as a framework for this project. A mixed-methods approach was utilized through pre-and post-test design to gather qualitative …

Complementary And Alternative Therapies To Improve Quality Of Life For People With Chronic Pain And Addictions, Nicole K. Smith

Doctor of Nursing Practice Projects

There is a known opiate crisis prevalent in the United States. There is similarly an addiction crisis in the United States that saw a marked increase during the COVID-19 pandemic. Interestingly, there are many Americans who experience a connection between chronic pain and the onset of addiction. This project sought to introduce the idea of complementary therapies such as square breathing, mindfulness, and essential oil (EO) aromatherapy that could improve the quality of life for people who have chronic pain and/or addiction. The project consisted of a pre-test prior to education about square breathing, mindfulness, and EO aromatherapy, followed by …

Increasing The Knowledge And Access To Naloxone (Narcan) For High-Risk Populations, Jessica E. Jones

Doctor of Nursing Practice Projects

This study investigated the knowledge and access to Naloxone (Narcan) in high-risk populations in Robeson County, NC. In order to mitigate the rate of overdose in tribal members who are part of the Lumbee Tribe of North Carolina. Indigenous populations have had the highest overdose rate of increase since 2019. In collaboration with CORE Pathways, a quality improvement project was implemented at the Harvest Moon Fall Powwow. Opioid overdose education was provided to voluntary participants, free Naloxone was provided to individuals, along with a created video presentation of Naloxone education. Pre- and post-surveys were utilized to gauge participants' knowledge before …

Homelessness: An Emergency For Many, Casey Almond

Doctor of Nursing Practice Projects

This DNP project implemented nursing staff education on the importance of recognizing homeless individuals early during the initial triage process within the emergency department. Nursing staff were educated on community resources available for homeless individuals. This DNP project helped to promote the collaboration of care by nursing staff with the case management team to help provide resources, which can result in a safer and more effective discharge of homeless patients within the emergency department. Participation consisted of 125 nursing staff who reviewed the online training module and attended one of the 15-minute in-person poster educational sessions. About 53 nursing staff …

Increasing Awareness And Support For Women With Anxiety Disorders In Rural Communities, Candice C. Jones

Doctor of Nursing Practice Projects

Anxiety disorders are among the most common mental health conditions, disproportionately affecting women, particularly those in rural communities with limited access to care. Many women experience perinatal, postpartum, or generalized anxiety, often suffering in silence due to stigma, lack of awareness, and inadequate mental health education. This project focused on increasing awareness and understanding of anxiety disorders among women in rural Randolph County, North Carolina. A comprehensive literature review was conducted to assess the scope of anxiety disorders in women, identify community education needs, and explore evidence-based interventions. Ten relevant studies were analyzed, including randomized controlled trials, cross-sectional studies, and …

Human Trafficking In The Er: Will You Recognize The Signs?, Lauren Neff

Doctor of Nursing Practice Projects

Current data reveals that 88% of human trafficking (HT) victims seek some form of health care while being trafficked. More specifically, 63% seek care in the emergency department setting (McAmis et al., 2022). A recent literature review indicates that regarding human trafficking and healthcare, there is a lack of awareness and knowledge on the issue. Healthcare team members often have little to no education or knowledge of potential signs and symptoms of a victim in a trafficking situation. The purpose of this DNP project was to increase healthcare staff knowledge of human trafficking (HT) and, more specifically, nurses in an …