Digital Commons Network^™

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

Increasing Referrals To The Lung Cancer Screening Program, Megan Randall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Lung cancer is the leading cause of cancer-related deaths worldwide and is frequently diagnosed at advanced stages when treatment options are limited. A Veterans Administration (VA) primary care clinic demonstrated lower referral rates to the lung cancer screening (LCS) program than a comparable VA clinic despite having a higher prevalence of tobacco users. Existing electronic health record reminders focused on smoking cessation and did not systematically assess eligibility for LCS, contributing to underutilization of the screening program.

Aim of the Project: The aim of this quality improvement project was to increase referrals to the LCS program by improving identification …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

Poor Adherence To Established Clinical Guidelines In Outpatient Bladder Cancer Management, Melanie Boren

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The outpatient urology practice encountered challenges with adherence to Clinical Practice Guidelines (CPGs), primarily due to unfamiliarity and lack of operational accountability. This led to a low adherence rate of only 40% among patients with bladder cancer. Key issues included inadequate training and knowledge gaps regarding CPGs.

Aim of the Project: The project aimed to improve patient care and outcomes in bladder cancer treatment by enhancing patient retention and adherence to treatment protocols. Evidence-based interventions were implemented to optimize care delivery and support adherence to prescribed treatments.

Review of Evidence: A literature review highlights the effectiveness of nurse navigator …

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …

Implementing The Walking Impairment Questionnaire For Peripheral Artery Disease Screening And Referral, Lisa Doyle

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Peripheral artery disease (PAD) is a leading cause of cardiovascular morbidity, mortality, and lower extremity amputation. At a Level 1 veterans medical center, the absence of a standardized screening and referral process contributed to delayed identification of symptomatic PAD and underutilization of supervised exercise therapy (SET). Between August 2024 and July 2025, only four veterans completed SET despite a large high-risk population, demonstrating a significant gap in evidence-based recommendations and clinical practice.

Aim of the Project: The aim of this project was to improve patient outcomes by standardizing screening for symptomatic PAD using the Walking Impairment Questionnaire (WIQ) to …

Improving Medication Reconciliation Compliance In Home Health Admissions, Paula A. Petrie-Rivas

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Clinician compliance with medication reconciliation at a home health agency was below regulatory expectations, with agency performance significantly lower than state and national averages. Workflow inefficiencies, inconsistent clinician practices, and limited training contributed to noncompliance, increasing the risk of medication discrepancies, preventable rehospitalizations, and Medicare reimbursement penalties.

Aim: This quality improvement project implemented a standardized medication reconciliation workflow using the Agency for Healthcare Research and Quality’s MATCH toolkit to improve clinician compliance during admission to home health.

Evidence: Literature supports structured medication reconciliation as an effective strategy to improve safety during transitions of care. The MATCH toolkit provides a …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Enhancing Medication Timeliness Through Structured Handoff In A Mental Health Facility, Belinda Zinhu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Delayed medication administration in an adult inpatient mental health facility exceeded organizational benchmarks and posed risks to patient safety, treatment effectiveness, and continuity of care. Baseline electronic health record (EHR) audits showed that about 30% of scheduled medications were administered outside the organization's acceptable timeframe, and inconsistent nurse shift handoffs contributed to the delays.

Aim of the Project: The aim of the quality improvement project was to improve patient outcomes by implementing the I-PASS standardized handoff communication tool to reduce late medication administration from 30% to 15% within 12 weeks.

Review of the Evidence: Evidence supports structured handoff frameworks …

Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls with injury rates had increased for over two years at the project hospital until nurse leaders implemented a new fall-prevention intervention. Patient falls are the most common preventable adverse event in acute care hospitals, with approximately 700,000 to 1 million occurring annually in the United States. Before implementing the Fall Tailoring Interventions for Patient Safety (TIPS) toolkit, the hospital’s program lacked an evidence-based approach and a fall communication board to alert staff, patients, and families about the individual fall risk status, leaving a significant gap in patient-centered care.

Aim of the Project: The aim of the project was …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

The Effect Of Mindfulness-Based Interventions On Stress Resilience And Wellbeing Among Graduate-Level Nursing Students: An Integrative Review Across Disciplines, Delia Linch

Loma Linda University Electronic Theses, Dissertations & Projects

Background

Graduate nursing students frequently experience significant academic, clinical, professional, and personal demands that contribute to stress, burnout, and psychological distress. Mindfulness-based interventions have emerged as a potential strategy for promoting well-being and resilience among healthcare learners.

Purpose

The purpose of this integrative review was to examine the effects of mindfulness-based interventions on stress, burnout, resilience, and emotional regulation among graduate nursing students.

Methods

An integrative review was conducted using the Whittemore and Knafl methodology. Literature searches were performed in CINAHL, PsycINFO, and PubMed for studies published between 2000 and 2025. Primary research studies examining mindfulness-based interventions among graduate nursing …

Effects Of Targeted Interventions On Hiv Testing, Knowledge And Sexual Risk Behaviours Among Long-Distance Truck Drivers: A Systematic Review And Meta-Analysis, Cyrus Mutie, Berrick Otieno, Kawira Kithuci, John Gachohi, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Objectives We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally.

Design A systematic review and meta-analysis.

Data sources We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator, Electronic (J-STAGE) and China National Knowledge Infrastructure (CNKI) up to 15th May 2026.

Eligibility criteria We included original peer-reviewed interventional studies involving LDTDs of either gender …

Climate Change Education For Environmental Sustainability In Health Professions Education: A Modified Delphi, Moses Mutua, Mirriam Kivuva

School of Nursing & Midwifery, East Africa

No abstract provided.

Enhancing Colonoscopy Effectiveness: The Impact Of Split Dose Bowel Preparation, Samantha Balestrieri Bsn, Rn

Nurse Residency

In patients undergoing screening colonoscopies, does a split-dose bowel preparation regimen, compared with a standard single-dose regimen, result in improved colonic visualization and adenoma detection?

Optimizing Nursing Management Of Alcohol Withdrawal In The Emergency Department: A Comparison Of Benzodiazepines And Phenobarbital, Brook Kulis Bsn, Rn

Nurse Residency

In adult patients presenting to the emergency department with alcohol withdrawal syndrome, how does phenobarbital treatment compared with benzodiazepine-based treatment protocols affect emergency department and hospital length of stay, medication requirements, rates of hospital readmission, and overall patient outcomes?

Improving Patient Outcomes Through Nurse-Led Care Coordination, Anna Berry Rn

Nurse Residency

In patients admitted to the hospital, how does nurse-led care coordination compared to none, or patient reliance alone, impact better patient outcomes, better medication management and reduce hospital readmissions?

The Impact Of Emergency Nurse Experience On Triage Accuracy During High-Volume Emergency Department Shifts, Grace Littlefield Rn, Mia Cianchette Rn, Benjamin Drummey Rn, Charles Stever Rn

Nurse Residency

PICOT Question: In adult emergency department patients, how does assigning an experienced emergency room nurse to the triage role compared to assigning a less experienced nurse improve triage accuracy rates during high-volume shifts?

Manual Blood Pressure Readings Versus Automatic Blood Pressure Readings, Logan Delano Rn, Rae Hebert Rn, Hannah Rogers Rn

Nurse Residency

In patients under 60, how does manual blood pressure readings compared to automatic blood pressure readings affect the treatments received in a single hospital admission?

Reducing Missed Opportunities For Crc Screening Via Provider Reminder System In A Primary Care Setting, Komfort Cofield

Doctor of Nursing Practice Projects

Background: Although highly preventable with screening, colorectal cancer (CRC) continues to be a major source of illness and mortality in the United States. Healthcare providers at the Doctor of Nursing Practice (DNP) project site inconsistently ordered CRC screening for eligible patients due to deficiencies in the point-of-care reminder system. These system failures created missed opportunities for CRC prevention and reduced compliance with established practice guidelines.

Purpose: This DNP project aimed to implement and evaluate a CRC screening checklist given to patients at appointment check-in, serving as a reminder for providers to order appropriate screening tests.

Project Design: Using the National …

Addressing Hypertension Medication Non-Adherence Through The Use Of Reminders And Morisky Medication Adherence Scale In Adults Diagnosed Within The Past Year In A Rural Primary Care Clinic, Amanda M. Weaver

Doctor of Nursing Practice Projects

Background: Adherence to antihypertensive medications is essential for decreasing long-term consequences of uncontrolled hypertension, including stroke, kidney failure, and cardiovascular diseases. However, nonadherence is a widespread problem among patients diagnosed with hypertension. In patients who have been diagnosed with hypertension in the past year, more than half stop taking their medications. Mobile health interventions, such as text message or telephone reminders, are a low-cost way to improve medication adherence.

Purpose: The purpose of this Doctor of Nursing Practice project is to examine how a weekly text message or telephone reminder impacts medication adherence among patients taking antihypertensives in a rural …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Reducing Asthma-Associated Absenteeism At A School-Based Health Center Using Asthma Control Test (Act) Scoring, Concetta Terry

Doctor of Nursing Practice Projects

Background: Asthma is a common chronic condition that can lead to increased school absences and lower academic performance. A needs assessment at a rural school-based health clinic identified gaps in care for students with asthma and high absenteeism rates.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce asthma-related absences by personalizing care using Asthma Control Test (ACT) scoring.

Project Design: Using a pre- and post-intervention design, this DNP quality improvement project followed the Plan-Do-Study-Act (PDSA) framework to evaluate the impact of implementing the ACT on asthma-related absenteeism in a rural school-based health center. The project …

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Improving The Accuracy Of Medication Reconciliations For Medicare Advantage Patients At A Primary Care Clinic Using An Interdisciplinary Team, Sallie Mann

Doctor of Nursing Practice Projects

Background: Medication-related problems (MRPs) are a significant and often preventable cause of patient harm, particularly among older adults with complex medication regimens. In primary care settings, inaccurate or incomplete medication reconciliations contribute to adverse drug events, avoidable hospitalizations, increased healthcare costs, and reduced patient satisfaction.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether implementing an interdisciplinary medication reconciliation process using the Medications at Transitions and Clinical Handoffs (MATCH) Toolkit would improve reconciliation accuracy in Medicare Advantage patients aged 65 and older in a primary care clinic.

Project Design: This DNP project used the …

Optimizing Workflow In Advanced Gastroenterology: An Initiative To Improve Turnaround Times, Aundrea Prewitt

Doctor of Nursing Practice Projects

Background: Procedure room turnaround time in advanced gastroenterology is defined as the interval between one patient exiting the procedure room and the subsequent patient entering. Prolonged turnaround times contribute to decreased operational efficiency, delays in care delivery, and suboptimal resource utilization. Current facility turnaround time is 39 minutes, and there is no standardized policy to guide the turnaround process.

Purpose: The purpose of this quality improvement project was to develop a standardized operating procedure that guides policy change in advanced gastroenterology through implementing a sustainable turnaround process that reduces procedure room turnaround time.

Project Design: The quality improvement initiative used …

Efficacy Of Volume-Based Enteral Feeding Compared With Standard Rate-Based Enteral Feeding, Tashia Stevens Rn, Kelly St Jean Rn, Darah Thomas Rn

Nurse Residency

Is volume-based enteral feeding more effective than standard rate-based enteral feeding in achieving nutritional goals and improving clinical outcomes in critically ill patients?

Fall Prevention, Alicia Frasier Rn, Paige Sperry Rn, Heather Tozier Rn

Nurse Residency

In elderly patients (P), does education of fall prevention (I) compared to bed/chair alarms (C) reduce falls.

The Implementation Of Q2 Turns Compared To Air Mattresses For Hapi Prevention In Adult Medical Surgical Patients Over The Course Of Their Stay, Elizabeth Mchugo Rn, Lily Fifield Rn

Nurse Residency

How does the implementation of q 2 turns compare to air mattresses for preventing HAPIs in adult medical surgical patients over the course of their stay?