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Implementation Of Visual Bed Indicator Lights To Improve Fall Prevention Processes, Andrea Leffew

Master's Projects and Capstones

Problem: Inpatient falls remain a significant patient safety concern associated with preventable patient harm, prolonged hospitalization, and increased healthcare costs. Routine fall bundle validations identified inconsistent adherence to safe bed configuration practices, such as beds left raised and bed alarms turned off.

Context: A 3-month quality improvement project was implemented on a 20-bed medical-surgical telemetry unit within an integrated healthcare delivery system at a 130-bed community hospital in Northern California, which was experiencing an increase in inpatient falls and fall-related sentinel events.

Interventions: Implementation of bed-monitoring technology with visual indicator lights that provided real-time feedback on bed configuration.

Measures: The …

Sense Of Purpose As The Guiding Light In Nursing Practice: A Grounded Theory Study, Kathleen Casler

Theses & Dissertations

Problem: As a prosocial profession, individuals may enter the practice of nursing because of an interest in helping and caring for others. However, over time, nurses may be challenged with experiences of burnout that can impact both their relationship with the profession and patient outcomes.

Background/Significance: A sense of purpose has been associated with positive physical, behavioral, and psychological outcomes. In a professional context, a sense of purpose may provide support for navigating complex work environments. It is currently not known what nurses’ experience of sense of purpose may be in relation to nursing practice and how their sense of …

Staff Education To Improve Mindfulness Knowledge Among Rns, Nps, And Mas In A Behavioral Health Setting, Barbara Buxton

Walden Dissertations and Doctoral Studies

Burnout is a recurrent problem for healthcare workers and is associated with staff turnover, a decline in the quality of care, emotional fatigue, and risks to patient safety. This Doctor of Nursing Practice (DNP) staff education initiative created a mindfulness-based training program to expand the knowledge of registered nurses, nurse practitioners, and medical assistants on mindfulness practices in a behavioral health setting. Baseline assessment data identified a need for support to address emotional fatigue, absenteeism, and staff disengagement, with a mean pre‑education knowledge score of 66%. A structured, in‑person educational program addressing burnout awareness, stress reactivity, and helpful mindfulness methods …

Improving Adolescent Antidepressant Medication Adherence In An Outpatient Psychiatric Clinic Through Teach-Back And Motivational Interviewing, Sandra Ajao

Walden Dissertations and Doctoral Studies

Antidepressant medication adherence among adolescents is a significant concern in outpatient psychiatric care. Adolescents may miss doses because of stigma, forgetfulness, side effects, limited understanding of medication instructions, or inconsistent caregiver support. The purpose of this Doctor of Nursing Practice project was to improve antidepressant medication adherence and adherence-focused communication among adolescents in an outpatient psychiatric clinic through staff education on teach-back and motivational interviewing. The practice-focused question examined how teach-back combined with motivational interviewing, compared with usual care, affected medication adherence and depressive symptoms during the implementation period. Staff education included use of a previsit questionnaire, structured visit script, …

Standardized Metabolic Monitoring Protocol For Adult Outpatients Who Are Prescribed Antipsychotic Medications, Abel Bueno Gonzalez

Walden Dissertations and Doctoral Studies

This doctoral project was an organization change process evaluation of a quality improvement initiative in a masked outpatient mental health clinic. The practice challenge was poor metabolic monitoring and documentation among adult outpatients taking antipsychotics that were not in line with guidelines. This problem is relevant to nursing practice because use of antipsychotic medications raises risk for weight gain, dyslipidemia, hypertension, and glucose abnormalities, and not monitoring risks may delay referral or management. The practice-focused question was: According to evidence, among adult patients who are prescribed antipsychotic medications in an outpatient mental health clinic, what is the impact of implementing …

Effectiveness Of The Smart Me-De Digital Program On Health Literacy And Glycemic Control In Newly Diagnosed Type 2 Diabetes, Nongnaphat Rungnoei, Siriporn Kruttakart, Natthapan Phianthanyakam, Pakaporn Klinhom, Umaporn Nokpaet, Jintipa Sirikunwiwat, Burong Jaitham

Journal of Health Research

Background: Individuals newly diagnosed with type 2 diabetes often have limited knowledge and self-management skills, leading to poor glycemic control and increased complications. This study evaluated the effectiveness of the Smart ME-DE Digital Program in improving health literacy and glycated hemoglobin levels among newly diagnosed individuals with type 2 diabetes.

Methods: A quasi-experimental study was conducted with seventy participants recruited from diabetes clinics at three hospitals in a central province of Thailand. They were selected using simple random sampling and matched by gender, age, and baseline HbA1c levels, and allocated to an experimental or comparison group. The experimental group received …

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

The Effectiveness Of Treatment Options For Localized Prostate Cancer: A Meta-Analysis Of Cross-Sectional And Cohort Studies, Pius Omolewa, John Bressan, Nassrine Noureddine

All Faculty Scholarship

Background: Prostate cancer is one of the most common malignancies among men worldwide, with incidence rates rising steadily over the past decades. Although the widespread adoption of PSA screening has improved early detection, it has also sparked extensive debate regarding overdiagnosis and overtreatment. Against this backdrop, balancing the avoidance of unnecessary interventions with the need to ensure favorable patient outcomes has become a central challenge in clinical decision-making. Methods: Articles published from 2010 through 2025 were searched in five databases. The cross-sectional and cohort studies examined the effects of treatment options on localized prostate cancer. Results: From the analysis of …

Improving Obesity Management In Primary Care Through Provider Education, Natalie Anderson

Doctor of Nursing Practice Projects

Background: Childhood obesity is a significant public health concern associated with metabolic, cardiovascular, and psychosocial complications. Despite the availability of evidence-based pediatric obesity management guidelines, adherence to these guidelines remains inconsistent in primary care settings. Purpose: This evidence-based quality improvement project aimed to determine whether provider education on the 2023 American Academy of Pediatrics (AAP) Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, combined with implementation of an electronic health record (EHR) clinical decision support prompt, improved provider knowledge and adherence to guideline-recommended obesity management practices. Method: A pre-post quasi-experimental study was …

The Effects Of An Educational Intervention To Enhance Knowledge And Awareness Of The Prevention Of Sexually Transmitted Infections Among College Students, Darcy Yates

Doctor of Nursing Practice Projects

Purpose

The DNP student implemented a single group pretest-postest design underpinned by the Health Belief Model to address the PICOT question: Among a purposive sample of college students at a mid-west college (Population) to what degree does participation in an evidence-based intervention providing information about STIs (Intervention), compared with before that intervention (Comparison), result in to an increase in knowledge and awareness regarding STI infections and associated risks and treatment options (Outcomes) over a six-week period (Time)?

Methods

The pretest and postest scores of 15 students for the 27 items in the Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ) were evaluated. …

Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti

Walden Dissertations and Doctoral Studies

Suicide is a major public health concern, and consistent suicide risk assessment is essential for patient safety in psychiatric settings. This Doctor of Nursing Practice staff education project addressed a knowledge gap in evidence-based suicide risk assessment among psychiatric clinicians in an outpatient mental health setting. The practice-focused question examined whether an evidence-based suicide risk assessment education program would improve clinicians' knowledge from pre- to post-education. The educational intervention consisted of a 60-minute in-person training session on evidence-based suicide risk assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) framework. Ten psychiatric …

Quality Improvement Initiative To Improve Adherence To Ob Hemorrhage Policy And Standardize Pitocin Administration During Cesarean Sections To Reduce Postpartum Hemorrhage Risk, Lauren R. Litz, Monica Blauser

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, …

Enhancing Patient Outcomes In Obstetric Neuraxial Anesthesia: Evaluation Of A Structured Documentation Tool For Post-Dural Puncture Headache Tracking (Pdph), Jacqueline Saldana Tovar, Ahmad Hasaan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

The purpose of this Doctor of Nursing Practice (DNP) project is to evaluate the incidence, management, and practice variation of post-dural puncture headache (PDPH) in an obstetric population using retrospective data from standardized follow-up tools. The project aims to identify inconsistencies in procedural techniques, documentation practices, and adherence to evidence-based guidelines across anesthesia provider levels. By analyzing key clinical variables and patient outcomes, this project seeks to identify gaps in current practice, improve data reliability, and support the development of standardized protocols for PDPH assessment and management. Ultimately, the goal is to enhance quality of care, promote evidence-based decision-making, and …

Enhancing Sbar Documentation And Telecommunication Between Nursing And Anesthesia Teams In The Obstetric And Labor And Delivery Unit, Apollonia C. Anderson, Celeste Meda

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication during obstetric handoffs is essential for promoting maternal and neonatal safety, yet communication failures remain a significant contributor to adverse events due to inconsistent and unstructured handoff practices. This Doctor of Nursing Anesthesia Practice (DNAP) quality improvement project was developed following the recommendations of the 2025 DNAP project, which implemented the OB/L&D-specific SBAR tool. This project evaluated the use of this communication tool in areas of OB interdisciplinary team communication accuracy, efficiency, and collaboration, particularly during obstetric epidural requests within a community-based labor and delivery unit. Guided by the Plan-Do-Study-Act (PDSA) framework (Institute for Healthcare Improvement, 2020). Utilized …

Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

Reducing Falls In The Cardiac Care Unit: An Improvement Project, Andrea Otero, Aryanna Campa, Nia Butac

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

Abstract

Background: Patient falls persist as a leading cause of preventable harm in hospitals, particularly among cardiac care patients who are at increased risk because of medication effects and mobility limitations. Despite existing fall `prevention measures in the Cardiac Care Unit (CCU) at Sutter Medical Center, Sacramento, 43 falls occurred, highlighting the need for improved patient education and consistent staff communication.

Purpose: This quality improvement project evaluated the effectiveness of implementing a standardized fall prevention communication script to reduce the average monthly fall rate in the CCU from 3.583 to fewer than 2 falls per month.

Methods: Using the Plan-Do-Study-Act …

Improving Knowledge Of Obesity-Related Risks And Healthy Lifestyle Behaviors In Adolescents, Tehroop Notra, Samreet Kaur, Karina Heredia

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

This quality improvement project evaluated the effectiveness of a school-based educational intervention aimed at improving ninth-grade students’ knowledge and understanding of obesity prevention, nutrition, and physical activity. Adolescent obesity remains a significant public health concern, showcasing the need for early, evidence-based education. A total of 57 students participated in the two classroom sessions. Of these students, 49 completed the pre-intervention survey, and 48 completed the post-intervention survey. The intervention included an interactive presentation, group discussions, and educational materials. Student knowledge was assessed using a six-item survey administered before and after the session. The results demonstrated improvements across multiple knowledge areas, …

Co-Creation Of Global Public Health Interventions Within The Context Of Limited Resources: A Conceptual Qualitative Framework For Modest Co-Creation, Kahabi Isangula, Constance Constance Shumba

School of Nursing & Midwifery, East Africa

Co-creation is increasingly promoted in global public health as a participatory methodology that centres lived experiences, the preferences, and structural realities of those most affected by health interventions. Within human-centred design (HCD), co-creation is typically operationalised through intensive cycles of qualitative inquiry, in-person workshops, facilitation, and iterative prototyping. While these approaches are methodologically robust, they are often resource-intensive and difficult to implement in low- and middle-income countries (LMICs) and other low resource settings, precisely where context-sensitive and equitable intervention design is most needed. Despite this tension, existing literature offers limited guidance on how co-creation can be meaningfully adapted to such …

Improving Mobility Awareness And Jh-Amp Tool Utilization On A Cardiac Care Unit, Courtney Joe, Clarissa Chaires, Jocelyn Martin, Eunice Sanchez

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

The quality improvement project evaluated the impact of staff education and a unit-wide mobility awareness campaign on the use of the Johns Hopkins Activity and Mobility Promotion tools and patient mobilization in a 48-bed Cardiac Care Unit (CCU). The project involved registered nurses, nursing assistants, unit leaders, and adult cardiac patients represented by aggregate mobility data. A preliminary survey completed by 42 CCU staff members, CCU Partnership Council focus group, meetings with clinical nurse specialists, and a baseline unit audit identified inconsistent mobility practices, uncertainty regarding Johns Hopkins Highest Level of Mobility tool, and limited completion of in-room mobility signs. …

Mind Over Scrubs – A Peer-Led Anxiety Reduction Program, Nhi T. Tran, Angelica Dirige, Adeleke Fashola

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

Nursing students experience elevated anxiety during the transition into accelerated programs, which can negatively affect academic performance, well-being, and retention. This quality improvement project evaluated Mind Over Scrubs, a peer-led anxiety reduction program for incoming Entry-Level Master of Science in Nursing students at the University of the Pacific, consisting of four 45-minute sessions on evidence-based coping strategies. Generalized Anxiety Disorder-7 surveys were administered at baseline, before and after each session, and at two- and four-week follow-ups; Wilcoxon signed-rank tests evaluated matched changes. Thirty-one of 62 enrolled students (50%) attended at least one session. Post-session scores fell below individual baselines for …

​​Hospital-Acquired Pressure Injury Prevention In The Sutter Sacramento Cardiac Care Unit ​Qi Proposal, Angelina Lucido, Amy Roderick, Karly Link

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

Background: Hospital-acquired pressure injuries (HAPIs) remain a significant source of preventable patient harm despite established prevention protocols. In the Cardiac Care Unit (CCU) at Sutter Medical Center Sacramento, inconsistent patient education and limited patient engagement were identified as potential contributors to ongoing HAPI occurrence. This quality improvement (QI) project evaluated whether implementing structured, individualized patient education could strengthen existing pressure injury prevention efforts.

Methods: A seven-week QI project was conducted in the CCU using the Plan-Do-Study-Act (PDSA) framework. The intervention consisted of nurse-led, individualized pressure injury prevention (PIP) education supported by a standardized patient handout tailored to each patient's risk …

From Birth To Better Health: Educating Mothers With Gestational Diabetes On Breastfeeding Benefits And Glucose Management, Jesse A. Soria Jr, Sarah Smith, Audrey Nolan Smith, Keeley Kosier

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

Gestational diabetes mellitus (GDM) increases a mother's risk of developing type 2 diabetes mellitus (T2DM) later in life and can affect an infant's future health. Breastfeeding can help improve a mother's blood sugar control and may lower her future risk of diabetes, but many mothers with GDM do not know about these benefits. This quality improvement (QI) project evaluated a standardized education program on breastfeeding and diabetes prevention for postpartum mothers with GDM at the Family Birthing Center at St. Joseph's Medical Center (SJMC) in Stockton, California. The intervention included a 10- to 15-minute education session and an evidence-based educational …

Improving Clostridioides Difficile Prevention Practices Through Standardized Stool Collection And Hand Hygiene, Dunya Khateeb, Laura Martin, Jessica Zhang

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

Healthcare-associated Clostridioides difficile (C. diff) infections increase patient morbidity, length of stay, and healthcare costs (Simor, 2010). Our quality improvement project seeks to reduce C. diff infection rates and enhance prevention practices on the Med-Acute Unit at Sutter Medical Center Sacramento (SMCS) by utilizing the Plan-Do-Study-Act (PDSA) framework. Interventions will be implemented between March 2026 and July 2026. The project examined whether introducing a standardized stool collection tote and improving hand hygiene compliance would reduce C. diff infection rates. Participants included all nursing staff on the unit. Data is being collected through observational hand hygiene audits, collaboration with the SMCS …

Know Your Birth, Jasmine Mckelvey, Reagan L. Hunt, Michaela M. David

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

Maternal mortality remains a significant public health concern in rural Kenya because of limited healthcare resources, inadequate emergency obstetric training, and barriers to accessing timely, high-quality maternal care. This quality improvement project evaluated the implementation of the Know Your Birth educational intervention, a culturally responsive, simulation-based training program designed to improve healthcare providers' knowledge, confidence, and competency in evidence-based maternal and newborn care. The project was conducted at Sega Dispensary in Sega, Siaya County, Kenya, and included 26 healthcare staff members. Guided by the Plan-Do-Study-Act framework, participants completed a brief educational presentation followed by three interactive skills stations focused on …

Enhanced Communication Is Fundamental In Providing Quality Care, Jacqueline Turcotte Rn, Msn, Ccrn

MaineHealth Maine Medical Center

No abstract provided.

Telling Their Intensive Stories: Black/African American Intensive Care Unit Nurses And Their Perceived Encounters With Icu Workplace Racism, Sharon M. Butler

Theses & Dissertations

The 2022 American Nurses Association (ANA) study on racism and racial inequality within the nursing profession both acknowledges the presence of racism in nursing and provides evidence of the diverse negative social and psychological effects of racism on minority nurses. Although the 2022 ANA study sets a precedent and shows evidence of racism’s effects across the broader professional nursing workforce, there is limited nursing research literature that offers a focused presentation and understanding of the lived experiences of minority nurses and their personal perceptions of workplace racism. There is also limited nursing research on how workplace racism impacts cultural and …

The Future Midwife: A Prisma Scoping Review Of Education, Transition, And Work Readiness Among Midwifery Students, Danielle Gleeson, Tracey Tulleners, Jessica Elliott, Dianne Stratton-Maher, Liz Ryan, Jillian Mcculloch, Geraldine Roderick, Thenuja Jayasinghe, Joanne Buckley, Jamie May Newman, Helen Nutter, Jo Southern, Lisa Beccaria, Georgina Sheridan, Tess Trinder, Haiying Wang, Tao Wang, Sita Sharma, Linda Ng, Jing Yu Tan, Daniel Terry

Research outputs 2022 to 2026

Background: Preparing midwifery graduates to be confident, competent, and resilient is essential for workforce sustainability, yet students report a disconnect between academic preparation and clinical realities. Increasing care complexity, workforce shortages, and variable clinical learning environments globally highlight the need to examine how educational strategies support effective transition to practice. Objective: To map and synthesise the evidence regarding educational approaches, learning experiences, and transition-to-practice factors that influence preparedness for professional practice among midwifery students, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.

Methods: A PRISMA-ScR-guided scoping review was conducted across seven databases. …

The Tension Of Retention And Retirement: A Narrative Study Of Full-Time Nursing Faculty Within Five Years Of Retirement At Public, Four-Year Institutions In Texas, Shelley Hunt

Electronic Theses and Dissertations

This narrative inquiry, qualitative study explored the retirement decision-making process of nursing faculty at public, four-year institutions who were within five years of retirement. Through purposive sampling, 11 participants across eight institutions consented to participate and were interviewed via Zoom. Due to the nursing faculty shortage, the researcher hypothesized that nursing faculty nearing retirement may be retiring not only as a natural progression of their career but also because of factors that lead other early and mid-career faculty members to leave academia. Through thematic analysis, four themes emerged: Finding Meaning and Fulfillment in the Nurse Faculty Role, Institutional Factors Shaping …

A Mindfulness-Based Stop Technique Training To Improve Nurses’ Knowledge And Self-Efficacy In Stress And Burnout Prevention, Rukiat Abolanle Afinni

Walden Dissertations and Doctoral Studies

Nurse burnout and stress are well-documented occupational concerns in outpatient clinical settings, where high patient acuity and chronic staffing shortages leave nurses with little structured support for proactive self-care. To address this gap, a mindfulness-based STOP (stop, take a breath, observe, proceed) training program was developed and evaluated for outpatient nurses. The evidence-based practice question was: Among nurses in an outpatient clinical setting, what is the impact of a mindfulness-based STOP technique training on nurses' knowledge of stress and burnout prevention and self-efficacy in applying the technique? A one-group pretest-posttest design was used with eight participants. A project-developed questionnaire measured …