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2025 Nursing Annual Report, Children's Health System Of Texas

2025

No abstract provided.

Staff Education Project:  Cultural Competency For Outpatient Nurses Caring For Adult Patients With Suds, Chloe Hylaire

Walden Dissertations and Doctoral Studies

No abstract provided.

Structured Communication Education Program To Improve Interprofessional Communication In An Outpatient Mental Health Organization, Doris Ofodile

Walden Dissertations and Doctoral Studies

No abstract provided.

Evidence-Based Clinical Practice Guidelines For Postspinal Hypotension In Pregnant Women, Grace Mackey

Doctor of Nursing Practice Scholarly Projects

Abstract

Postspinal hypotension (PSH) in pregnant women undergoing a cesarean delivery is a common yet significant problem for the safety of the mother and fetus. The physiological effects of a spinal injection may compromise uteroplacental flow, predisposing the fetus to hypoxia and acidosis. Maternal consequences of prolonged hypotension include unstable hemodynamics, loss of consciousness, and nausea. Historically, healthcare providers have used crystalloid preloads and reactive phenylephrine boluses to correct hypotension. However, recent evidence suggests that these interventions have limited effectiveness. Thorough research led to the development of clinical guidelines that propose providing a 500 mL 6% hydroxyethyl starch preload or …

Evidence-Based Practice Guidelines For The Risk Stratification And Anesthetic Management Of Geriatric Surgery Patients At High Risk For Postoperative Cognitive Dysfunction Undergoing Non-Cardiac Surgery, Patrick M. Garvey

Doctor of Nursing Practice Scholarly Projects

As the global geriatric surgical population rapidly expands, managing complications like postoperative cognitive dysfunction is increasingly essential, given its adverse impacts on recovery, quality of life, and healthcare costs. Postoperative cognitive dysfunction can lead to extended hospital stays, delayed recovery, and significant cognitive decline, particularly among elderly patients exposed to general anesthesia. This quality improvement final scholarly project develops and hypothetically implements evidence-based practice guidelines for anesthetic management in geriatric patients at high risk for postoperative cognitive dysfunction undergoing non-cardiac surgery. This Doctor of Nursing Practice (DNP) project uses preoperative cognitive assessments, such as the Mini-Cog tool, to identify patients …

Practice Considerations For Perioperative Ondansetron Use In Parturients Undergoing Cesarean Sections With Spinal Anesthesia, Mackenzie Glaros

Doctor of Nursing Practice Scholarly Projects

Elective cesarean sections are often performed with spinal anesthesia, a form of neuraxial anesthesia that offers superior pain relief and reduces the risks associated with general anesthesia. However, over 50% of parturients experience side effects from spinal anesthesia, including shivering, hypotension, nausea, and vomiting, which can cause both physiological and psychological issues for the laboring mother and be detrimental to the fetus. Preventing these side effects is vital for improving safety, patient satisfaction, and minimizing complications. While various interventions and medications have been explored to manage these effects, no standardized guidelines exist for their prevention. A review of existing literature …

Evidence-Based Guidelines For Intraoperative Quantitative Neuromuscular Monitoring, Noah Graham

Doctor of Nursing Practice Scholarly Projects

Nondepolarizing neuromuscular blocking agents are routinely used medications vital to anesthetic care. When administering neuromuscular blocking agents, monitoring neuromuscular blockade depth and degree of recovery is a standard of nurse anesthesia practice to facilitate adequate recovery. If not adequately reversed, postoperative residual neuromuscular blockade can cause severe complications. Traditional qualitative neuromuscular monitoring practices largely contribute to the continuing high incidence of postoperative residual neuromuscular blockade, as supported by research that qualitative monitoring methods are insensitive to the depth of blockade and clinical situations, providing unreliable physiologic information. As recommended in practice guidelines by the American Society of Anesthesiologists, quantitative neuromuscular …

Implementation Of Evidenced Based Practice Guidelines For Reducing Emergence Delirium In Elderly Patients Undergoing A Total Hip Replacement, Luke D. Kleinfelder

Doctor of Nursing Practice Scholarly Projects

A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the …

Proposed Evidence-Based Practice Guidelines For Using Esmolol To Blunt The Sympathetic Stress Response To Laryngoscopy And Intubation, Maya Kurdi

Doctor of Nursing Practice Scholarly Projects

Direct laryngoscopy (DL) and endotracheal intubation (ETI) are standard procedures performed during general anesthetic induction, which provoke a sympathetic stress response that can result in intraoperative hemodynamic instability. Traditional agents like lidocaine and fentanyl, commonly used to mitigate the stress response, have limitations and can lead to adverse effects. Recent literature suggests that esmolol, an ultra-short-acting, cardio-selective beta-1 adrenergic receptor antagonist, may be an effective alternative due to its rapid onset, short duration, and minimal side effects. This final scholarly project (FSP) aims to develop evidence-based practice guidelines for using esmolol as an adjunctive induction agent. A systematic literature review …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

Enhancing The Diversity And Number Of Certified Registered Nurse Anesthetists: A Proposed Pipeline Program For Underrepresented Students, Alexis Lamoreaux

Doctor of Nursing Practice Scholarly Projects

The underrepresentation of minority groups in the Certified Registered Nurse Anesthetist (CRNA) profession impacts healthcare providers’ diversity and cultural competence. This Final Scholarly Project (FSP) proposes a pipeline program to increase diversity within the CRNA field by providing academic support, mentorship, and clinical exposure to students from underrepresented backgrounds. Given the shortage of anesthesia providers, especially in underserved areas, improving access to the CRNA profession for minority students is critical for enhancing patient outcomes. This FSP suggests establishing mentorship and skill development concepts through a 12-month structured program that targets minorities, first-generation college students, or those from rural backgrounds. The …

Evaluating The Impact Of A Meaningful Recognition Bundle On The Health Of The Emergency Department Work Environment And Emergency Nurse Burnout, Sean Truesdell

Doctoral Projects

Background: The health of the work environment significantly influences emergency nurse practice. The Emergency Nurses Association and the American Association of Critical-Care Nurses have called for the establishment of a healthy work environment (HWE) to improve outcomes, reduce burnout and turnover, and increase job satisfaction. Meaningful recognition is consistently among the lowest-performing HWE standards. Purpose: To implement a bundle of meaningful recognition elements in the Emergency Department (ED) and evaluate the outcomes. Methods: A quality improvement project was conducted in the ED of a non-profit community health system in Northern California. The Healthy Work Environment Assessment Tool (HWEAT) and Oldenburg …

Evidenced-Based Practice Guideline Development: The Addition Of Adjunctive Dexmedetomidine In Brachial Plexus Blocks For Upper Arthroscopic Surgery, Mylene Louail

Doctor of Nursing Practice Scholarly Projects

Dexmedetomidine (DEX) is an alpha-2 adrenergic agonist increasingly studied as an adjunct in brachial plexus blocks (BPBs) to enhance postoperative pain management. This project examines the efficacy of DEX as an adjunct in BPBs for upper extremity arthroscopic surgeries, focusing on its ability to extend analgesia duration, reduce opioid use, and enhance patient satisfaction. With analgesic and sedative properties, DEX can improve postoperative pain management with minimal side effects, providing shortened hospital stays, decreased costs, and better patient outcomes. Using the Iowa Model for evidence-based practice, baseline data on postoperative pain, analgesia duration, and opioid use will be collected from …

Nurse-Driven Palliative Care Screening Tools In The Icu, Olivia Sarkis Bsn, Rn, Fiona Hill Bsn, Rn, Isak Madden Bsn, Rn

Nurse Residency

PICOT Question: In adult ICU patients, how does implementing a nurse-driven palliative care screening tool, compared to provider-discretion palliative care consultation, affect rates of palliative care consultation in the ICU?

Safety Practices Regarding Oral Nimodipine Administration, Hannah Linsky Bsn, Rn, Nathan Mendoza-Connell Bsn, Rn, Perla Moguel Bsn, Rn, Andrew Vachon Bsn, Rn

Nurse Residency

PICOT Question: In adult patients with subarachnoid hemorrhage who are unable to swallow, does pharmacy prepared nimodipine oral solution administered via EnFit syringes, compared with bedside aspiration of nimodipine capsule solution using a blunt needle into syringes, reduce medication administration errors during hospitalization?

Identifying And Addressing Burnout Among Nurses In Cache Valley And The Surrounding Salt Lake Metropolitan Area, Teegan Alma Martinez

Undergraduate Honors Capstone Projects

Background: Nursing burnout has emerged as a critical issue within modern healthcare systems, with widespread implications for nurse well-being, patient safety, and organizational performance. Characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, burnout affects an estimated 30% to 60% of nurses, particularly in high-acuity settings. The persistence of burnout highlights the need to better understand its contributing factors, consequences, and effective strategies for mitigation.

Purpose: The purpose of this study was to examine the prevalence and contributing factors of nursing burnout, evaluate its impact on nurses and patient care, and identify effective interventions. Additionally, this study aimed …

A Pilot Project On Improving Icu Nurses’ Confidence In Early Defibrillation, Adetutu Obadina

Doctoral Projects

Early recognition of shockable cardiac rhythms and timely defibrillation are critical components of effective resuscitation during in-hospital cardiac arrest. Despite established guidelines from the American Heart Association (AHA), nurses may experience uncertainty or reduced confidence when identifying shockable rhythms and delivering timely defibrillation during cardiac arrest events. The purpose of this project was to examine whether a structured educational intervention incorporating simulation-based training could improve intensive care unit (ICU) nurses’ confidence and knowledge in recognizing shockable rhythms and performing timely defibrillation. A pre-and post-intervention design was implemented among ICU nurses at a large academic medical center between September and October …

Implementing An Online Mental Health Intervention For Educators, Angela Cheney

Doctor of Nursing Practice Scholarly Project

The primary objective of this project was to assess the impact of the New Directions Behavioral Health Employee Assistance Program, an online intervention, on teacher stress and well-being. Teacher participation was recruited through email, flyers, and in-person discussions. The study used a mixed-method design, including pre- and post-project surveys of the Perceived Stress Scale (PSS) to measure changes in stress, and the System Usability Scale (SUS) to evaluate the ease of use of online intervention. The intervention aimed to increase teachers’ self-awareness of stress and anxiety, provide strategies for prevention and early intervention, and support overall mental wellbeing. Paired-samples t …

Volume 17, Christian O’Neill, Kyara Greene, Savva Sidorov, Laura Bisaillon, Luke Clemmer, Hannah Gordon, Kitt Benson, Taylor Blount, Rachel Danzitz, Nicholas Duellman, Chase Gionis, Hima Fernando, Seth Franzyshen, Onyx Gonzalez, Bryan Lin, Samantha Start, Ysabel Wells, Maggie Duncan

Incite: The Journal of Undergraduate Scholarship

Introduction Dr. Amorette Barber, Director, Office of Student Research

From the Editor Dr. Hannah Dudley-Shotwell

Cover Artist’s Statement Maggie Duncan

On Mentoring Dr. Yulia Uryadova

Ukrainian Resistance in the Face of Russification: Nestor Makhno and Anarchism

by Christian O’Neill

Life Vest by Kyara Greene

Isolation and 16S rRNA Identification of Bacteria from Fire Department Connection Pipe by Savva Sidorov

The Effectiveness of Planned Exercise in Reducing ADHD Symptoms in Children by Laura Bisaillon & Luke Clemmer

Linguistic Analysis on Confidence and Communication Strategies with Disparities Between Sign Fluency and Hearing Impairment by Hannah Gordon

Freedmen in Indian Territory by Kitt …

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Poster Presentations

Research on NICU experiences largely focuses on majority-language families; non-English-speaking families are understudied (Cleveland, 2008). The Family Integrated Care model promotes parent-infant connection and shared decision-making to improve outcomes (Wreesmann et al., 2020). Language barriers impede parent-provider communication, increasing miscommunication and parental anxiety (Kynoe et al., 2020; Ardal et al., 2011). The purpose of this research is to explore communication experiences and barriers between English-speaking and bilingual NICU nurses and a Spanish-speaking NICU mother.

Exploring Student Feelings, Knowledge Related To Menstruation And Menstrual Education: A Cross-Sectional Survey, Ella A. Handel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Menstrual, reproductive, and sexual health education in the United States remains inconsistent in both content and delivery. This inconsistency often leaves adolescents underprepared for developmental milestones such as menarche and contributes to ongoing stigma and discomfort surrounding menstruation. This study examined participants’ feelings and perceptions related to menstruation and menstrual education. Using a cross-sectional descriptive survey design, a mixed-methods approach was employed to collect data from 29 college students aged 18 to 19 years at a large public university in Arkansas. Quantitative data from Likert-scale items were analyzed using descriptive statistics, while qualitative open-ended responses were reviewed and organized into …

The Prevalence Of Stress Fractures In Relation To Red-S Syndrome Among Various Sports In Collegiate Female Athletes, Lilianna G. Couch, Marilou D. Shreve

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: RED-S is a risk factor for bone stress injuries in female athletes. Athletes that compete in sports that involve repetitive movements of impact are prone to stress injuries. The treatment of stress fractures requires addressing all potential causes of the injury to accelerate healing and prevent reinjury. Since RED-S is a well-established risk factor for stress injuries, early detection of RED-S is crucial to prevent long term negative health consequences in athletes including the development of stress fractures. It is also confirmed that certain sports have a higher prevalence of reported stress fractures in female athletes such as cross …

Tiny Tusk Internship: Gut Instincts: A Review Of Literature On The Impact Of Breastfeeding On The Infant Gut Microbiome, Rayla Payne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to investigate both the short- and long-term benefits that breastfeeding has on the infant gut microbiome. The PICOT question was: In full-term infants, how does exclusive breastfeeding compared to mixed or formula feeding influence the diversity and composition of the gut microbiome throughout the first 12 months of life? For this research, EBSCOhost, CINAHL, and the National Library of Medicine databases were searched to find relevant studies and systematic reviews. Terms such as “breastfeeding and infant gut microbiome” were used to conduct the search. Other terms used included “breastfeeding OR formula feeding”, “human …

Total Intravenous Anesthesia Versus Inhalation Anesthesia For The Prevention Of Post Operative Nausea And Vomiting: A Comprehensive Literature Review, Francesca A. Diflorio

Nursing Undergraduate

Postoperative nausea and vomiting (PONV) is a common complication defined as the occurrence of nausea and/or vomiting within the first 24–48 hours following surgery. While nausea represents the subjective urge to vomit, vomiting involves the physical expulsion of gastric contents; both remain among the most distressing postoperative complications, strongly associated with the type of anesthesia administered. According to Timerga and Befkadu (2024), the incidence of PONV ranges from 25% to 30% in the general surgical population and may increase to as high as 80% among high-risk patients. Complications resulting from PONV can further prolong recovery and negatively impact patient outcomes, …

Ai Literacy In The Nursing Informatics Community: A Needs Assessment, Jerri Westphal

Doctoral Projects

Nursing informatics professionals are required to lead AI integration in healthcare, yet their baseline AI literacy, competency, and educational needs have not been formally assessed. This descriptive needs assessment examined AI literacy, competency, adoption readiness, and engagement among nursing informatics professionals, concurrently identifying educational priorities and preferred learning modalities. A cross-sectional survey was administered to members of the American Nursing Informatics Association (ANIA) and the broader community (N = 194). The N.U.R.S.E.S. framework (Hoelscher & Pugh, 2025) informed the survey instrument's domain structure. Five composite indices were developed: AI Familiarity, Knowledge, Attitude, Competency, and Use. Descriptive statistics and Pearson correlation …

Fingernail Enhancement Microbiomes Study, Kendall E. Bare

Undergraduate Honors Theses

Policies in healthcare regarding fingernail enhancements have not been supported by current science. This study examined bacterial colony growth on gel nail enhancements, regular nail polish, and bare natural nails to evaluate which condition harbors the least bacterial microbiota. The hypothesis proposed that gel enhancements would demonstrate the lowest bacterial counts compared to regular polish and unpolished nails. This investigation was conducted in the context of a local healthcare system dress code policy permitting only regular nail polish in clinical settings. Six participants volunteered and underwent nail swabbing in a microbiology laboratory using sterile cotton applicators and a neutral solution. …

The Lived Experience Of Nursing Students Sitting With Patients: A Phenomenological Study, Emma L. Dalton

Undergraduate Honors Theses

In an inpatient healthcare setting, patient sitters play a key role in maintaining the safety of patients who are exhibiting acute psychiatric or behavioral issues. These sitters are often nursing students working as nurse technicians. There is a gap in the literature surrounding sitting with patients, also known as specialling, concerning the lived experiences of nursing students assigned to be patient sitters as part of their job. The aim of this phenomenological study is to elucidate their experiences. The research question guiding this study is: what is the lived experience of nursing students working as patient sitters? Student nurses …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

Newly Registered Nurses With Neurodiversities: A Qualitative Study Of Their Experiences During Transition To Professional Practice, Heather Wallace

Dissertations and Theses (Open Access)

Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND …

Exploring Teamwork Between Virtual And Bedside Nurses, Caitlin Weinheimer

Dissertations and Theses (Open Access)

Background: Advancing technologies and the use of telehealth have expanded in hospitals to include telenursing. Telenursing introduces a unique dynamic where virtual and bedside nurses work together as a remote team to provide patient care. Published literature reports that teamwork among nurses and healthcare professionals impacts patient and workforce outcomes. However, there is a gap in exploring teamwork between virtual and bedside nurses. Addressing this knowledge gap is critical to ensure positive patient and nursing workforce outcomes in hospital-based telenursing settings.

Objective: To generate a grounded theory that explains teamwork between virtual and bedside nurses in the hospital setting. A …