Factors Influencing Clinician Escalation Practices For Deteriorating Patients In An Australian Emergency Department, Na Wang, Ruth Endacott, Simon Cooper, Clifford J. Connell

Research outputs 2022 to 2026

Background: Physiological deterioration is typically identified through clinical signs and symptoms. There is a growing adoption of emergency department-specific responses to patient deterioration. Although the effectiveness of ward-based Rapid Response Systems is well-documented in the ‘failure-to-rescue’ literature and widely used in acute medical and surgical wards, their implementation and factors influencing failure-to-rescue in emergency department settings are less well understood.

Aim: To explore emergency nurses’ and doctors’ perceptions and experiences of escalation practices for deteriorating patients, including the factors influencing these practices, in an Australian ED.

Methods: A qualitative descriptive study using semi-structured interviews and Framework Analysis. Interviews were conducted …

Infant Formula Introduced Within 24 Hours Of Birth Increases Egg Allergy Risk, Jennie K. Nilsson, Summer V.M. Walker, Susan L. Prescott, Demelza J. Ireland, Sharon L. Perrella, Debra J. Palmer

Research outputs 2022 to 2026

Background: Breast secretions of colostrum precede milk production in the first few days after birth, providing nutrition and playing a critical role in shaping the newborn's gut microbiome and immune system development. Infants fed commercial milk formula in the first few days consume less colostrum, and previous studies have found an associated increased risk of food allergy.

Objective: To determine the risk of food allergen sensitization and IgE-mediated food allergy development in infants who received any formula during their first 3 days of life.

Methods: In a high-risk (defined by family history) cohort of 563 infants, born at 37 weeks’ …

Joint Cancer Nurses Society Of Australia–Clinical Oncology Society Of Australia Position Statement On The Contribution Of Nurses To Cancer Survivorship Care In Australia, Raymond J. Chan, Gemma Mcerlean, Fiona Crawford-Williams, Carla Thamm, Carmel O'Kane, Nicolas H. Hart, Gillian Blanchard, Anne Mellon, Justin Hargreaves, Mei Krishnasamy, Michael Jefford

Research outputs 2022 to 2026

Aim: To describe the development, consultation, and endorsement process for a joint position statement from the Cancer Nurses Society of Australia (CNSA) and the Clinical Oncology Society of Australia (COSA) regarding the contribution of nurses to cancer survivorship care in Australia. Methods: A development team of nursing and oncology experts (n = 11) was convened in September 2025. The draft position statement was informed by key literature, including the COSA Model of Survivorship Care, Australian Cancer Plan, a modified Delphi study defining nurse capabilities in survivorship care, and an overview of systematic reviews on nurse-led care models. A consultation survey …

Beyond Coding: Balancing Interpretive Depth And Rigour In Ethnographic Data Analysis, Thi Ngoc Minh Nguyen, Gordana Dermody, Rosemary Saunders, Lisa Whitehead

Research outputs 2022 to 2026

Aim: To present a refined approach to analysing ethnographic data that preserves the distinctiveness of ethnography while ensuring it meets contemporary expectations of methodological rigour.

Design: Methodological discussion paper.

Data Sources: The approach draws on established ethnographic scholarship and is guided by Wolcott's framework for transforming qualitative data through three interrelated stages: description, analysis and interpretation. A practical application is illustrated through a focused ethnography exploring how older Vietnam-born Australians understand and manage chronic disease.

Implications for Nursing Practice: Focused ethnography has become increasingly popular in nursing research as it reflects the dual nature of the profession: striving to generate …

Nurses' Perceptions Of Their Non-Technical Skills In Recognising And Responding To Clinical Deterioration In Hospital Settings: A Systematic Review, Darlene Archer, Amineh Rashidi, Rajbeer Kaur, Allison Roderick, Olivia Gallagher

Research outputs 2022 to 2026

Aim: To understand nurses' perceptions of non-technical skills in recognising and responding to clinical deterioration in hospital settings.

Design: A mixed methods systematic review was undertaken, guided by the Joanna Briggs Institute Manual for Evidence Synthesis.

Methods: A systematic search of the primary research literature published between 2012 and October 2025 was undertaken. A convergent integrated approach to synthesis, without meta-analysis, was undertaken.

Data Sources: The MEDLINE, CINAHL, Scopus, PsychInfo and Embase electronic databases were searched. Reference lists of full-text articles retrieved were reviewed for additional data sources.

Results: Twenty-four primary studies were included. Narrative synthesis resulted in six main …

Scope Of Nursing Work And Models Of Service Delivery In Australian Primary And Secondary Schools: A Scoping Review, Anita Moyes, Chelsey Williams, Elizabeth Rankin, Imelda Hoodcamp, Eliza Jane Potter, Brent A. Hayward

Research outputs 2022 to 2026

Aim: To map the scope of nursing work and models of service delivery in Australian primary and secondary schools for children aged 3–18 years. Design: Scoping Review. Data Sources: A search of CINAHL, Medline, PsycINFO, ERIC, Informit and Google was conducted in August 2024 for peer reviewed, non-peer reviewed and grey literature giving insight into nursing work in primary and secondary Australian schools in urban, regional and remote areas of all Australian states and territories. Methods: The review employed Johanna Briggs Institute methodology for scoping reviews and reported the findings in line with the Preferred Reporting Items for Systematic Reviews …

Application Of Generative Artificial Intelligence By Nurse Academics In Higher Education: A Scoping Review, Jennifer Hamilton, Martina Costello, Lesley Barr, Simon Cooper, Martin Jones

Research outputs 2022 to 2026

Aim: To systematically map existing research on nurse academics incorporation of generative artificial intelligence when developing teaching and learning resources in higher education and to identify knowledge gaps and future research. Background: Generative artificial intelligence technology is rapidly evolving in healthcare and it's use in nursing higher education is developing. However, concerns regarding its adoption in higher education relate to academic integrity and ethical considerations, including privacy, confidentiality, bias and critical thinking development. Generative artificial intelligence tools present new pedagogy possibilities in nursing higher education; however, the scope and impact of its adoption is unclear. Methods: The Joanna Briggs Institute …

Effectiveness Of Prophylactic Foam Dressings In The Prevention Of Sacral Pressure Injuries In At-Risk Hospitalised Patients (Eepoc): A Randomised Control Trial, Rachel M. Walker, Wendy Chaboyer, Lukman Thalib, Sharon Latimer, Haitham Tuffaha, Marie Cooke, Brigid M. Gillespie

Research outputs 2022 to 2026

Background: Hospital-acquired pressure injuries are a serious patient safety issue with the sacrum the most common location. Silicone foam border dressings are increasingly used in hospitalised patients, yet their clinical and cost-effectiveness in preventing pressure injuries is unclear in some patient cohorts. Objective: To determine the clinical and cost-effectiveness of a silicone foam border dressing in preventing sacral hospital acquired pressure injuries in at-risk medical-surgical patients. Methods: A prospective, multi-site, parallel group, pragmatic, superiority randomised controlled trial was conducted in Southeast Queensland, Australia. Medical-surgical adult patients (≥ 18 years) at-risk of pressure injury were recruited and randomly allocated to either …

Research Publication Performance Of The Australian And New Zealand Nursing And Midwifery Professoriate, Lisa Mckenna, Fiona Bogossian, Simon Cooper, Tracy Levett-Jones, Philippa Seaton

Research outputs 2022 to 2026

Aim: To analyse research publication performance of Australian and New Zealand professors and associate professors of nursing and midwifery, and compare with 2016 data. Methods: A search of university websites was conducted to identify all nursing and midwifery professoriate in Australia and New Zealand. Each individual was then searched in the Scopus database to identify individual total citations, h-index, number of publications, first author Field Weighted Citation Impact (FWCI) and overall FWCI. Comparisons with 2016 data were also undertaken. Results: A total of 304 academics were included, comprising 270 from Australia and 34 from New Zealand, and 169 full professors …

Estimating Short-Term And Long-Term Survival For Patients With Kidney Failure Using A Mixture Survival Model, Nathan Meyer, Maxwell Donelan, Hossein Moradi Rekabdarkolaee, Brandon Varilek, Surachat Ngorsuraches, Patti Brooks, Jerry Schrier, Semhar Michael

Journal Articles: College of Nursing

Rationale & Objective

Study Design

Setting & Participants …

Video Instructions For Pre And Post Procedure Care: Evidence-Based Quality Improvement Project, Lynn V. Wojton

DNP Projects

Background: Patient adherence to pre- and post-procedure instructions is essential to ensuring optimal outcomes and patient satisfaction in cosmetic dermatology. However, patients frequently overlook or misunderstand written instructions, leading to suboptimal preparation and recovery experiences.

Project Purpose: The purpose of this quality improvement initiative was to evaluate whether the implementation of short, accessible video-based instructions could improve patient understanding, adherence, and satisfaction compared to standard written instructions alone.

Methods: The project was conducted in a high-volume cosmetic dermatology practice in the Northeastern United States. A HIPAA-compliant platform using a video-based educational intervention was developed and implemented to supplement or replace …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Toolkit To Prevent Venous Thromboembolism Among Surgical Patients, Carine Wawa

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: According to the Centers for Disease Control and Prevention, approximately 900,000 people in the United States are affected annually by venous thromboembolism (VTE) (CDC, 2025). The surgical patient population is vulnerable to VTE due to factors such as immobility, tissue injuries, and inflammatory responses. The lack of standardized protocols for surgical patients causes practice variability among healthcare providers and potentially increases the risk for preventable VTE events.

Methods: A toolkit to prevent VTE was developed utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC). A literature review was conducted, reviewed, and graded using the …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

Early Pressure Injury Identification And Intervention In Emergency Department Older Adults Who Are Admitted Into A Community Hospital Intensive Care Unit, Lisa M. Britt

Doctor of Nursing Practice (DNP) Scholarly Projects

A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

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 …

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

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 …

Evaluating The Effectiveness Of Scenario-Based Virtual Escape Rooms To Improve Student Confidence In Dosage Calculations, Jennifer A. Cuevas

Theses

Abstract

Background: Accurate dosage calculations (DCs) are critical for patient safety, as medication errors contribute to approximately 7,000-9,000 preventable deaths annually. Nearly 30% of nursing students exhibit weakness in foundational mathematical skills, and a significant confidence gap exists: 70% feel confident in mathematical abilities, yet only 45% feel confident in clinical application, necessitating innovative educational interventions.

Purpose: The purpose of this project was to implement and evaluate a scenario-based virtual escape room intervention to enhance undergraduate nursing students' confidence in DCs.

Methods: Grounded in Kolb’s experiential learning theory, this online asynchronous intervention engaged students through concrete experience, reflective observation, abstract …

Enhancing Postoperative Esophagectomy Outcomes With Preoperative Education: A Quality Improvement Project, Gaelyn Kattman

DNP Projects

Title

Enhancing Postoperative Outcomes with Preoperative Education for Esophagectomy Patients

Background/Significance

Esophageal cancer is an aggressive disease and the fourth most common gastrointestinal cancer. A surgical treatment for a patient with esophageal cancer who is a surgical candidate is an esophagectomy. Immediate postoperative complications may include pneumonia, arrhythmias or anastomotic leaks, all of which can potentially increase the patient’s length of stay. Delayed discharges can lead to a backup throughout the hospital, limiting the amount of available inpatient beds for patient care.

Purpose 

The DNP project purpose was to implement an additional preoperative telehealth visit in order to provide  patient …

Implementation Of An Updated Opioid Overdose Response Policy To Address Xylazine-Involved Overdoses In A Federally Qualified Health Center, Dana Umbro

DNP Projects

The increasing prevalence of non-opioid adulterants like xylazine, a veterinary tranquilizer, has introduced significant challenges in overdose recognition and management. Non-opioid adulterants cause central nervous system depression, respiratory compromise, and severe soft tissue injury that is not reversed by naloxone. Many healthcare organizations lack standardized clinical guidance for managing overdoses involving non-opioid adulterants, resulting in variability in care and increased risk for adverse outcomes. The purpose of this Doctor of Nursing Practice project was to update and implement an opioid overdose response policy incorporating evidence-based guidance for the recognition and management of overdoses potentially involving non-opioid adulterants. This was conducted …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer

DNP Projects

Background/Significance

Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of morbidity, mortality, and increased healthcare costs. Alcohol-based nasal decolonization is an evidence-based strategy to reduce MRSA transmission; however, staff compliance with decolonization protocols is often suboptimal, limiting effectiveness in inpatient medical-surgical settings.

Purpose

The purpose of this evidence-based quality improvement (EBQI) project was to evaluate whether implementing a structured, evidence-based nasal decolonization protocol improved staff compliance and reduced missed administrations and patient refusals among eligible medical-surgical inpatients.

Methods

This EBQI project was implemented on five inpatient medical-surgical units at a large academic medical center. Interventions included standardized staff education, …

Leveraging Technology To Improve Throughput: A Qi Project Utilizing Electronic Sbar, Suzy Candito

DNP Projects

The DNP practice site, a high-acuity Level I trauma center and regional referral hub, experiences persistent emergency department (ED) crowding and prolonged admission throughput times. Regional data show average ED wait-times near 252 minutes, underscoring the urgency of reducing delays between bed assignment and bed occupancy (assigned-to-occupied time). Inefficient or varied written handoffs contribute to calls for clarification, omissions, and transition delays, where structured, electronic SBAR tools are associated with improved completeness, standardization, and workflow efficiency. At the systems level, prolonged ED boarding is linked to higher daily hospital costs and safety risks, making communication optimization an operational and patient-safety …

Enhancing Postoperative Outcomes: The Impact Of Instruction Format On Patient Satisfaction In Ambulatory Surgery An Evidence-Based Quality Improvement Project, Gillian Shelby

DNP Projects

Background

Effective postoperative discharge communication is essential in ambulatory surgery centers, where short recovery periods and rapid patient turnover increase the risk of misunderstanding postoperative care instructions. Inconsistent delivery of discharge education may contribute to decreased patient satisfaction and reduced adherence to postoperative plans. Project Goals

The goals of this DNP quality improvement project were to: (1) implement standardized dual-format postoperative instructions using written and verbal education reinforced with the teach-back method, and (2) improve patient satisfaction and confidence in understanding postoperative care instructions. Methods

Following IRB exempt approval on September 10, 2025, implementation occurred from November 20,2025 to February …

Methods To Reduce Recurrent Pregnancy Loss: An Integrative Review, Jolene J. Davis

All Electronic Theses and Dissertations

This integrative review explores interventions that may improve live birth rates or pregnancy outcomes for individuals experiencing recurrent pregnancy loss (RPL). Approximately 5% of couples experience RPL, and limited evidence contributes to inconsistent clinical recommendations for this population. A literature search was conducted using CINAHL, PubMed, and Nursing and Allied Health Collection. Inclusion criteria consisted of primary research studies published in English from 2016 to 2026 that evaluated preventative interventions aimed at improving live birth rates or pregnancy outcomes in individuals with RPL. Exclusion criteria included infertility unrelated to RPL, single miscarriage, animal subjects, in vitro fertilization-related studies, or studies …

Poorly Controlled Type 2 Diabetes (T2dm) In A Rural County In Texas: A Diabetes Intervention Bundle, Roxanne Morales

Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) remains a significant public health concern, particularly in rural and underserved communities where patients often face barriers to effective self-management. This quality improvement (QI) project evaluated the impact of a diabetes intervention bundle consisting of individualized diabetes education, biweekly support phone calls, and digital self-monitoring tools on glycemic control, body weight, diabetes knowledge, medication adherence, diet compliance, and physical activity. The project was implemented over an eight-week period in a rural family medicine clinic and included 18 adults with uncontrolled T2DM (HgbA1c >7%). Participant outcomes were evaluated using pre- and post-intervention clinical measures, the Diabetes …

The Effects Of Strong Parental Support And Societal Support Compared To Low Or Absent Support In Lgbtqia+ Youth, Kassandra Bautista

Nursing | Senior Theses

Background: LGBTQIA+ youth with unsupportive backgrounds face negative outcomes in their mental health. Past studies share that LGBTQIA+ youth have increased symptoms of mental illness including depression, anxiety, and suicidal thoughts and behaviors related to unsupportive environments among parents, peers, and society. Objective: By advocating for this minority group through education and culturally competent care, healthcare providers can reduce negative outcomes in the mental and physical well-being of the youth. Purpose: The purpose of this study is to address the impact of parental and societal support in LGBTQIA+ mental health, and to implement interventions and increase awareness of this issue. …

Comparing Nurse-Led Holistic Pain Relief Strategies And Sole Pharmacological Use In Enhancing Maternal Satisfaction, Reducing Pain, And Lowering Obstetric Interventions During Childbirth, Jessica C. Moore

Nursing | Senior Theses

Background: Childbirth has become heavily reliant on pharmacological management and obstetric interventions such as epidural use, labor induction, and cesarean deliveries (C-sections) even among low-risk pregnancies. While necessary in some cases, excessive reliance on pharmacological interventions can negatively impact the experience of birthing as a whole. Non-pharmacological interventions (NPIs) such as breathing techniques, positioning, hydrotherapy, massage, aromatherapy and continuous support have shown to be effective in reducing pain and supporting physiologic labor. The gaps in education and lack of standard implementation result in inconsistent application in practice. Purpose: This research proposal aims to evaluate the effectiveness of nurse-led NPIs compared …

How Social Media And Cyberbullying Correlate To Eating Disorders In Adolescents, Nicoli A. Panelo

Nursing | Senior Theses

Background: Social media is very prevalent in today’s society, particularly in adolescents. This time period is crucial for this age group in terms of developing a sense of purpose and identity. Although social media may keep many of our children entertained, they also can create negative impacts on them and ultimately hinder their overall development both mentally and physically through negative body image and unrealistic self-expectations. Purpose: The purpose of this study is to find the correlation between social media use and the rise of eating disorders in adolescents. Doing so would allow us to find ways to lower the …