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Psychological Safety Is Everyone’S Work: A Call To Practice, Education, And Leadership In Nursing, Gina Rivera

HCA Healthcare Journal of Medicine

Psychological safety is essential to nursing practice, education, and leadership because it enables individuals to speak up, ask questions, report concerns, and learn from mistakes without fear of humiliation or blame. In health care settings, psychological safety supports patient safety by encouraging error reporting, timely escalation, and interprofessional collaboration. For nurses, it strengthens teamwork, accountability, well-being, and retention in complex, high-pressure environments. In nursing education, psychological safety allows students to admit uncertainty, engage in feedback, and develop clinical judgment across simulation, clinical, didactic, and online learning spaces. This article argues that psychological safety is often discussed separately across practice, academia, …

Safer Together: A Special Nursing Issue Focusing On Safety In Health Care, Tracy A. Ortelli, Lori M. Brodie

HCA Healthcare Journal of Medicine

Safety is a shared responsibility dependent upon the collective efforts of health care professionals, educators, leaders, organizations, and systems. This special nurse-led issue of the HCA Healthcare Journal of Medicine highlights scholarly works addressing education, clinical practice, and health care workforces. We are informed about safety through research, clinical reviews, case-based learning, and education. This issue was created to inspire the entire health care workforce to pursue continuous improvement to make health care safer together.

Sedation Minimization And Early Mobility To Prevent Intensive Care Unit Delirium, Alana M. Kugelard

Lynchburg Journal of Medical Science

The purpose of this paper is to synthesize current evidence on sedation minimization, early mobility, and multicomponent care bundles for the prevention of intensive care unit (ICU) delirium in critically ill adults. ICU delirium is a common and serious complication associated with increased mortality, prolonged mechanical ventilation, extended ICU and hospital length of stay, and long-term cognitive impairment, making it a significant safety and quality-of-care concern. A literature review was conducted using PubMed and the Cochrane Library, with search terms including “ICU delirium,” “sedation minimization,” “light sedation,” “early mobilization,” and “ABCDEF bundle.” Filters included adult populations, peer-reviewed studies, randomized controlled …

Use Of The Well-Star Model And Well-Star Graphic In Healthcare, Fidan Korkut-Owen, Zubeyde Akpakir, Dean W. Owen

Journal of Wellness

No abstract provided.

Synthesizing Evidence Of Stress, Anxiety, Burnout, And Health Habits In Nursing Students Compared To Non-Nursing Students, Brooklyn Watson, Julie Harrison, Mariah Leopold, Nantz Kerry Fleurant

Best Integrated Writing

Nursing school is widely recognized as a demanding and stressful academic program, characterized by rigorous clinical and academic expectations. Elevated levels of stress among nursing students can contribute to negative academic, emotional, and professional outcomes. Through this project, the student team conducted an in-depth examination of nursing student stress and burnout to better understand its prevalence, contributing factors, and potential interventions. The team employed comprehensive search strategies to identify and evaluate relevant evidence. Multiple Johns Hopkins Evidence-Based Practice appraisal tools were used to critically assess the literature, synthesize findings, and determine the significance of the evidence in relation to the …

Best Integrated Writing Fall 2026 - Complete Edition, Wright State University School Of Humanities And Cultural Studies, Kristie Mckiernan

Best Integrated Writing

Best Integrated Writing includes excellent student writing from Integrated Writing courses taught at Wright State University.

How Does Nurse-To-Patient Ratio Impact Patient Satisfaction?, Kathryn G. Courtney, Alexa Nicholson

Scholars Week

This evidence-based practice project examined the relationship between nurse-to-patient ratios and patient satisfaction. A review of current literature, guided by Jean Watson's Theory of Human Caring and the Plan-Do-Study-Act (PDSA) quality improvement framework, found that lower nurse-to-patient ratios are associated with improved communication, higher patient satisfaction, better patient outcomes, and increased patient safety. Based on these findings, recommendations and a Safe Nurse-to-Patient Staffing Policy were proposed to support acuity-based staffing, enhance quality of care, and improve both patient and nursing outcomes.

Implementation Of A Standardized, Multimodal Safe Sleep Education Policy For Newborns, Emma C. Cook, Anisa E. Toliver

Scholars Week

This evidence-based practice project proposes updating a regional hospital’s infant sleep policy to include standardized, multimodal safe sleep education. The goal is to improve adherence to safe sleep practices and reduce the risk of sleep-related infant death using interventions such as multiple forms of standardized parent education, consistent staff modeling of safe sleep practices, environmental modifications, and routine bassinet audits. This project uses Dorothea Orem’s Self-Care Deficit Nursing Theory to strengthen parental understanding and promote safe sleep environments during hospitalization and at home.

Developing An Emergency Department-Specific C. Difficile Infection-Prevention Policy, Katelyn M. Wuest, Chris Bray

Scholars Week

Our evidence-based practice project focuses on the need for an Emergency Department (ED)- specific Clostridioides difficile (C. difficile) infection-prevention policy that adapts the existing facility-wide guidelines to the unique workflow and environment of the ED. Using infection-prevention literature and environmental disinfection recommendations as a foundation, the project proposes the need for clearer guidance regarding applying precautions, managing shared equipment, and maintaining environmental cleanliness. Implementation and evaluation using a Plan-Do-Study-Act approach can help assess staff adherence and identify opportunities to improve consistency in infection-prevention practices.

Trust But Verify: Testing A Framework For Ai Interrogation In Nursing Education, Michael Chamberlain

AI in the Classroom: A Virtual Summit

Generative AI produces fluent, confident output that is sometimes fabricated. Nursing students increasingly submit work built on sources that do not exist, or that exist and do not support the claims drawn from them. This session reports two semesters of classroom observation testing whether prompt design can address that problem.   The hypothesis was that structuring student prompts to require the AI to validate its own sources would improve detection of hallucinated citations. It did not. Across two sections, students who used the structured format caught fabricated citations at the same rate as students given an open prompt. Structure did change …

Pre-Procedural State Anxiety In Patients Scheduled For Colonoscopy, Zahraa Kareem Mansoor Al-Saady, Mohammed Hakim Shamran Al-Hchaim

Maaen Journal for Medical Sciences

Background: Anxiety is a common issue among patients undergoing invasive medical procedures such as colonoscopy because of concerns regarding the procedure itself and its possible results. High levels of anxiety can negatively affect patient readiness and cooperation during the examination, thereby influencing the quality and outcome of the procedure.

Study objective: To assess the prevalence and severity of pre-procedural anxiety among patients scheduled for colonoscopy and examine the association between socio-demographic and clinical characteristics and anxiety levels.

Methodology: A descriptive cross-sectional study design was employed to collect data from patients undergoing colonoscopy. A validated and comprehensive questionnaire tailored for individuals …

Impact Of A Head-To-Toe Assessment Simulation On The Self-Efficacy Of First Semester Nursing Students, Martin Dole

Nursing Faculty Publications

The transition into clinical practice presents significant challenges for first-semester nursing students, particularly related to self-efficacy and the ability to perform comprehensive patient assessments. Low self-efficacy may negatively influence clinical judgment, skill performance, and patient safety. The purpose of this Doctor of Nursing Practice project was to examine whether participation in a head-to-toe assessment simulation impacted general self-efficacy among first-semester nursing students. Guided by Bandura’s theory of self-efficacy, a quantitative, quasi-experimental, one-group pretest–posttest design was used to evaluate changes in self-efficacy following a high-fidelity simulation experience. A convenience sample of 42 first-semester Bachelor of Science in Nursing students participated in …

Implementation Of A Standardized Protocol To Improve Provider Documentation And Initiation Of Guideline-Concordant Hypertension Follow-Up Within 14 Days In Primary Care, Stella Williams

Doctor of Nursing Practice Projects

Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality, yet timely follow-up after elevated blood pressure (BP) readings is not consistently documented in primary care. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a standardized hypertension screening follow-up protocol improved provider initiation or documentation of guideline-concordant follow-up within 14 days. The faculty-approved PICOT population was primary care providers in a primary care clinic; we used eligible electronic health record (EHR) encounters as the analytic records to observe provider performance. We used a quantitative pre/post design and retrospectively reviewed 30 eligible EHR encounters: 15 pre-implementation …

Navigating Study Demands In First-Year Midwifery Education: Mixed-Methods Insights From Students, University Lecturers And Clinical Mentor Midwives, Chantal Soyka, Julia Berger, Dorothee Herrmann, Ruth Martis, Claudia Plappert, Niclas Schaper, Martina Schlüter-Cruse, Dorothea Tegethoff, Marina Weckend, Mechthild M. Gross

Research outputs 2022 to 2026

Aim: To examine:(1) study-related demands faced by first-year midwifery students; and (2) support provided to help them cope with demands.

Background: The recent national transition from vocational training into tertiary midwifery education in Germany resulted in a new teaching environment and adjusted clinical placement settings. Capacity building at tertiary level enabled innovative services to foster supportive learning environments for midwifery students, including processes for onboarding. However, little is known about students’ perceived challenges during this time.

Design: Convergent mixed-methods study.

Methods: An online survey of 304 first-year direct-entry midwifery students from 31 German higher-education institutions and semi-structured interviews with lecturers …

Implementing A Fall-Prevention Bundle To Reduce Falls In A Skilled Nursing Facility, Ginette Lubin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are a persistent patient-safety concern in skilled nursing facilities (SNFs), contributing to injury, functional decline, reduced quality of life, healthcare utilization, and costs. At the project site, a short-term rehabilitation unit in an urban SNF, 13 resident falls occurred during the baseline period, with 23% resulting in injury, and prevention relied on routine risk assessments, environmental checks, and post-fall reporting rather than proactive strategies.

Aim: To decrease the overall fall rate by 20%, reduce fall-associated injuries from 23% to 15% or less, and raise staff adherence to evidence-based fall-prevention interventions to 90% or higher within 12 weeks.

Evidence: …

Implementing An Evidence-Based Checklist To Improve Hypertension Clinical Performance, Angelica Wilson

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hypertension is a significant chronic disease management challenge at an urban Federally Qualified Health Center (FQHC), where about 26% of adults aged 18 to 85 years have uncontrolled blood pressure (BP). Despite the organization achieving a hypertension control rate of 74%, which exceeds the national FQHC average of 57.6% and approaches the goal of 80%, there remains inconsistent implementation of evidence-based hypertension management. The lack of standardized workflow has led to variances in BP reassessment, treatment management, lifestyle counseling, documentation, and follow-up, resulting in missed opportunities for guideline-directed care.

Aim of the Project: The quality improvement (QI) project aimed …

Enhancing Care Coordination: Nurse-Physician Bedside Communication To Improve Outcomes, Harriet Chinakwe

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inconsistent nurse-physician bedside communication on a 28-bed hybrid intermediate stepdown unit contributed to gaps in care coordination, patient engagement, and discharge readiness. Baseline Centers for Medicare & Medicaid Services (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) (2026), Press Ganey (2022) communication scores were below the national 90th-percentile benchmark; nurse communication at 58% and doctor communication at 46%, indicating the need for a structured communication process.

Aim of the Project: The quality improvement project aimed to improve nurse-physician communication during daily bedside rounds by implementing a TeamSTEPPS-informed, structured bedside rounding process using the PATIENT tool over 12 …

Midwifery Student Attrition In Australia: A Scoping Review, Terri Downer, Tanya Capper, Olav Muurlink

Research outputs 2022 to 2026

Problem: Global literature suggests that attrition rates from entry-to-practice midwifery programs are increasing. However, little is known about student attrition in the Australian context.

Background: Australia faces a growing midwifery shortage, prompting calls to increase program enrolments. Evidence from the United Kingdom shows high and rising attrition in entry-to-practice programs. In Australia, the scale of midwifery student attrition and the factors influencing it remain largely underexplored.

Aim: To identify and synthesise existing Australian literature on factors influencing midwifery student attrition.

Methods: A search of PubMed, Medline, CINAHL Ultimate, Embase, MIDIRS, EBSCO, and Google Scholar databases was conducted with key data …

Strengthening Post-Fall Huddle Practices In Long-Term Care, Janette Perry

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: High resident fall rates and repeat falls caused by an unreliable nurse-only post-fall huddle (PFH) process that lacked structure, interdisciplinary participation, and timely root-cause analysis.

Aim of the Project: To reduce falls and fall-related injuries in long-term care units by implementing a standardized, evidence-based PFH workflow that strengthens root-cause analysis, improves interdisciplinary communication, and increases PFH reliability.

Review of the Evidence: Evidence from fourteen high-quality, peer-reviewed studies demonstrates that structured, interdisciplinary post-fall huddles are more effective than informal, nurse-only approaches in improving fall analysis and reducing repeat falls in long-term care settings. Structured PFHs strengthen root-cause analysis; interdisciplinary participation …

Analysis Of The Deborah Sampson Act Of 2020: Improving Women Veterans’ Care, Jessica N. Shipp

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Women Veterans are one of the fastest-growing populations served by the Veterans Health Administration (VHA), yet gaps persist in access to gender-responsive, trauma-informed care. Despite requirements established by the Deborah Sampson Act (DSA) of 2020, implementation remains inconsistent in Women's Health Primary Care Provider (WH-PCP) access, women's mental health (MH) services, military sexual trauma (MST) care, workforce capacity, care coordination, and accountability.

Aim of the Project: The aim was to evaluate the effectiveness, feasibility, equity, and implementation fidelity of the DSA using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework (POLARIS) and identify evidence-based recommendations to …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …

Impact Of Cannabis Use Screening And Early Intervention In Outpatient Psychiatric Settings, Theresa Chibuoke

Doctor of Nursing Practice Projects

Cannabis use can complicate psychiatric assessment, treatment planning, and clinical outcomes, yet standardized cannabis-use screening remains inconsistently implemented in behavioral health practice. This quality improvement (QI) project addressed inconsistent cannabis screening and referral practices in an outpatient psychiatric clinic by implementing a standardized workflow to improve screening documentation to at least 80% and timely referral completion to at least 75%. A quantitative, quasi-experimental pretest-posttest design included 10 outpatient psychiatric providers over six weeks. Lewin’s Unfreeze-Change-Refreeze model guided change, the Plan-Do-Study-Act framework supported implementation, and Donabedian’s Structure-Process-Outcome model guided the project. The evidence-based intervention incorporated provider education, the valid and reliable …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: Providing Evidence-Based Practice Education On Administering The Edinburgh Postnatal Depression Screening During Visits Once Per Trimester And Postpartum, Megan Keeney

Doctor of Nursing Practice Projects

Perinatal depression (PND) is prevalent worldwide and frequently remains undetected and untreated due to inconsistent screening. At the project site, the Edinburgh Postnatal Depression Scale (EPDS) was administered postpartum only, without standardization. This quality improvement project implemented evidence-based provider education and a revised EPDS protocol, screening once per trimester and postpartum, to increase PND identification, provider self-confidence, self-efficacy, and behavioral health referral rates. This project was guided by Lewin’s Change Theory and the Donabedian framework. A quantitative pre-post design was used with nine providers in an outpatient women’s health clinic, alongside a retrospective and post-implementation electronic health record (EHR) review. …

Quality Improvement Project: Improving Nurse Discharge Competency Through Standardized Education And Discharge Tools In An Inpatient Behavioral Health Hospital, Valina Williams

Doctor of Nursing Practice Projects

Inconsistent discharge education and variable use of structured discharge tools can affect the consistency of transitions from inpatient behavioral health care. The purpose of this Doctor of Nursing Practice quality improvement project was to improve nurse discharge competency by implementing standardized discharge education and reinforcing use of a structured discharge tool in a rural inpatient behavioral health hospital. A quantitative, quasi-experimental one-group pretest-posttest design was used over 12 weeks with 16 eligible registered and licensed practical nurses. Organizational readiness was assessed at baseline, and nurse self-efficacy was measured before and after implementation. Discharge-tool adherence and 30-day readmissions were also evaluated. …

Determining Impact On Provider Adherence To Current Diabetes Guidelines: A Quality Improvement Project, Rashemia Suber

Doctor of Nursing Practice Projects

The delivery and documentation of evidence-based adult lifestyle counseling for patients with type 2 diabetes mellitus (T2DM) were found to be inconsistent in a clinic that serves an underserved population. This quality improvement (QI) project assessed whether a provider education program based on the 2025 American College of Lifestyle Medicine (ACLM) Diabetes Guidelines would improve provider confidence and documentation of lifestyle recommendations. A quasi-experimental, pretest-posttest design was guided by both Pender's Health Promotion Model as the theoretical framework and Lewin's Change Theory as the change theory. The Plan Do Study Act (PDSA) cycle guided this project as the implementation framework. …

The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu

Doctor of Nursing Practice Projects

Aging causes frailty and multiple comorbidities, necessitating polypharmacy. Complicated drug regimens predispose patients to adverse drug events and hospital readmissions. The practice problem was high rates of medication-related readmissions due to inadequate provider knowledge of medication reconciliation and the lack of a standardized tool. This project aimed at evaluating the impact of provider medication reconciliation education on hospital readmissions in a skilled nursing facility. A pretest-posttest study design was utilized. The Donabedian Model of Healthcare Quality guided the translation of evidence into practice, whereas Lewin’s Change Model and Plan-Do-Study-Act models guided implementation. Eight providers were educated on medication reconciliation using …

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …

Quality Improvement Project: The Impact Of Self-Assessed Quality Of Sleep On Illness Experience And Job Satisfaction Among Night Shift Nurses, Eunice Ikpekpe

Doctor of Nursing Practice Projects

Compromised sleep quality, illness experience, and job satisfaction are important concerns among registered nurses working night shifts. The purpose of this quality-improvement project was to evaluate changes in self-assessed sleep quality, illness experience, and job satisfaction following participation in the six-week Sleep Hygiene and Recovery Program (SHRP) among night-shift registered nurses at a large, urban, Level I trauma academic teaching medical center. The project used a quantitative, quasi-experimental, single-group pretest–posttest design guided by the Plan-Do-Study-Act framework and Lewin’s Change Management Theory, with the Neuman Systems Model and Pender’s Health Promotion Model providing the theoretical foundation. SHRP was a structured, evidence-informed …