Medicine and Health Sciences Commons^™

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Exploring The Public Health Agency Of Canada’S And The Ontario Government’S Vaccine-Related Crisis Communication On X During The Covid-19 Pandemic, Sheraza Burney, Lori Donelle Phd, Rn, Fcan, Anita Kothari

Publications

Crisis communication strategies must be tailored to the unique nature of social media. In response to the COVID-19 pandemic, public health agencies have widely used social media to address vaccine hesitancy and misinformation. This research utilized the social media pandemic communication model to describe the key themes disseminated through the Ontario government and the Public Health Agency of Canada's vaccine-related crisis communication on X (formerly Twitter). Between 27 January 2020 and 6 April 2021, 1271 posts related to COVID-19 vaccination were collected from three official government X accounts—two from the province of Ontario and one from Canada. Posts were analyzed …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

Effect Of Clean Closing Tray Use On Surgical Site Infection Following Colorectal Surgeries, Elizabeth Carlson, Nora Laban, Shelli Bergeron, Diana Lee, Donna Kayal, Kristin Lemarbe, Scarlett Hao, Jacob Mesiti, Bradley Krasnick, Harry Wasvary

Conference Presentation Abstracts

Introduction:  Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and postoperative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs are shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.  Methods:  A retrospective cohort study was conducted at a single tertiary care center of all intraabdominal colorectal surgeries performed between 2016 and 2021. Patients with documented infection present at the …

The Wright Way: Advancing Pediatric Perianesthetia Nursing Competencies, Marisela E. Acevedo-Padilla

Master's Projects and Capstones

Objective Implementing the Donna Wright Competency Model at a Bay Area Children’s Hospital in its peri-anesthesia units. Throughout available literature it was possible to observe the positive effects of implementing a competency model such as the DWCM has on the confidence of nursing staff and patient outcomes. An important point shown by literature was addressing more than technical skills and incorporating critical thinking and ethical considerations regarding patient care. Aim We aim to improve nurse competency in pediatric peri-anesthesia units at a Bay Area Children's Hospital by implementing Donna Wright’s Competency Model. Data obtained in August 2024 from a series …

Implementing A Mindfulness Program To Reduce Burnout Rates, Nadine G. Kakanou

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Nadine Kakanou has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Mary Bemker Houghtaling, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Summary Burnout rates among mental healthcare workers remain a concern affected by the increasing demands of the profession and the COVID-19 pandemic. The identified practice gap among mental healthcare staff members at the northern …

Staff Education Program On The Vanderbilt Adhd Diagnostic Rating Scale, Rabiatu Bangura

Walden Dissertations and Doctoral Studies

This DNP project evaluated the effectiveness of a structured staff education program designed to enhance healthcare professionals’ knowledge and utilization of the Vanderbilt ADHD Assessment Scale (VAS) in children aged ≥2 to ≤18 years. The practice problem addressed in this project was the inconsistent use and limited knowledge of the VAS among healthcare staff, which can lead to underdiagnosis or delayed diagnosis. The practice-focused question was: Will a staff education program specifically designed to instruct healthcare professionals on using the Vanderbilt ADHD Assessment Scale in children ≥2 years to ≤18 years increase their knowledge? Targeted educational sessions were implemented, and …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Ehealth For Older Adults: Building Digital Confidence For Better Health, Alejandra M. Fernandez

Master's Projects and Capstones

Abstract

Problem The healthcare field is becoming more technologically advanced than ever before, the older adults are often left behind due to decreased technology literacy. The quality improvement project revolves around enhancing the digital health literacy of older adults at Facility A a low income independent living facility in the greater San Francisco Bay Area. The technology workshops are imperative to improve the digital divide that older adults are experiencing. Aim The goal of the workshops is to improve the confidence of older adults through weekly workshops that were conducted over a six week period where they were instructed on …

Secondary Educators’ Knowledge And Perceptions Of Their Own Self-Efficacy As It Relates To 504 Plan Accommodations For Students Diagnosed With Adhd, Anne Richardson

Seton Hall University Dissertations and Theses (ETDs)

This study investigated the role of Section 504 accommodations in meeting the needs of secondary students with attention-deficit/hyperactivity disorder (ADHD) in the United States. While legislation requires equitable education for students with disabilities, gaps remain in understanding how educators perceive their own abilities in implementing Section 504 plans for students with ADHD. The study used a qualitative research design to explore the academic and organizational challenges faced by secondary school students with ADHD, specifically examining the knowledge, perceptions, and self-efficacy of secondary educators regarding ADHD strategies and 504 plan accommodations. Semi-structured interviews were conducted via Zoom with 11 educators from …

Accelerating Initial Cardiac Arrest Response In Medical-Surgical Nurses Through Virtual Reality Training, Carissa A. Hernandez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Through their limited exposure, non-critical care nurses may feel unprepared to respond when faced with a sudden emergency such as cardiac arrest. This Quality Improvement (QI) project employed virtual reality (VR) technology to improve nurse confidence, adherence to the American Heart Association (AHA) basic life support (BLS) algorithm, and documentation accuracy among medical-surgical nurses in a Veterans Affairs hospital in Nevada. The project addressed their ability to react promptly and effectively during these high-stakes emergencies. Methods: Following a scoping literature review from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed databases, this Evidence Based …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Enhancing Bedside Mobility Assessment Tool (Bmat 2.0) Competency To Promote Early Mobilization, Ensure Patient Safety, And Maximize Health Outcomes, Shaun C. Cunanan

Master's Projects and Capstones

Objective: Immobility among hospitalized patients is linked to serious complications, including muscle deconditioning, increased risk of falls, and functional decline, particularly in older adults (Boynton et al., 2020). Early mobility interventions can help mitigate these risks and improve patient outcomes (Gabele et al., 2023). Context: The Bedside Mobility Assessment Tool (BMAT 2.0) is a standardized tool designed to assess patient mobility and guide safe mobilization practices. In two medical-surgical units (endocrine and stroke) of a 200+ bed general acute care hospital in Northern California, only 31.4% of staff reported being knowledgeable about BMAT 2.0. This quality improvement project aimed to …

Bridging The Gap In Early Mobilization: Implementing The Bmat 2.0 To Enhance Patient Care And Outcomes, Elyas Gul

Master's Projects and Capstones

Objective: Early mobilization of patients is correlated to enhanced functional recovery (Zhang et al., 2019), decreased hospital stays (Zhang et al., 2019), and a reduction in healthcare costs (Liu et al., 2019). Unfortunately, inconsistency in hospital staff training and an absence of mobility assessment standardization have served as barriers to successful implementation. Aim: This quality improvement project aims to increase the percentage of RNs and CNAs who effectively use the BMAT 2.0 to promote early mobilization of medical-surgical endocrine and stroke patients by 20%, from 31.4% to 51.4% by April 22, 2025. The project will occur during a 12-week …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Will Zhu

Master's Projects and Capstones

The objective of this Quality Improvement (QI) project was to increase patient ambulation rate and improve documentation compliance with Patient-reported Level of Function (PLOF) and Clinician-assessed Level of Function (CLOF) on cardiac units at a hospital in San Francisco. Literature highlights that early ambulation reduces hospital-acquired complications, length of stay, and functional decline, yet inconsistent mobility practices and documentation were identified as barriers within this microsystem. The aim of this project was to increase patient ambulation rates by 20% and achieve at least 80% of documentation compliance within four weeks. The interventions included the development and distribution of an educational …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Enhancing Patient Outcomes: Improving Hcahps Scores Via Implementing Pressure Injury Prevention Care Bundle Education In Acute Care Setting, Jasmeen Kaur

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) have a powerful effect on patient outcomes, satisfaction, and health costs. In the face of multiple interventions, nurse-patient communication failures and decreased HCAHPS scores reveal patient safety hazards. Aim: The purpose of this quality improvement effort was to enhance HCAHPS nurse communication scores by instituting a Pressure Injury Prevention Care Bundle (PIPCB) on a 93-bed medical-surgical/telemetry unit. Methods: The intervention was nurse-implemented education through educational posters and education cards distributed at admission and shift report. Nurse participation and education delivery were measured through pre- and post-intervention questionnaires and observations. The change in the HCAHPS nurse …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Strengthening The Birthing Bridge: Educating Labor And Delivery Nurses On Scope And Impact Of Volunteer Doulas, Catherine H. De La Torre

Master's Projects and Capstones

The objective of this quality improvement project was to address the lack of collaboration between the Labor and Delivery (L&D) nurses and the volunteer doulas on a L&D unit at a Bay Area hospital. There were reports of not understanding the role of the volunteer doula, which may have led to a lack of collaboration between both teams. The aim of this project was to improve the L&D nursing staff's understanding of the scope of practice of the volunteer doula to increase positive perception and collaboration between both professions by 25%, from 63% to 88%, following an educational intervention at …

Quality Improvement Project Promotion Of Policy Adherence Through Education On Shared Governance, Chelsea Baker

Doctor of Nursing Practice Projects

The quality improvement project aimed to enhance compliance with the project site’s policy on participation in shared governance by providing an educational session on the importance of shared governance to faculty roles. Literature reviews revealed that shared governance increases faculty voice and satisfaction with their roles. By educating faculty about the role of shared governance and how to engage in institutional shared governance policies, both the institution and the faculty can benefit from more effective participation, leading to the continuous improvement of the program and incorporation of evidence-based practices into the curriculum. Using a quasi-experimental pre-post design, the principal investigator …

The Use Of Systemic Inflammatory Response Syndrome (Sirs) Criteria By Nurses In The Nursing Home Setting To Identify Sepsis, Edwin Tobbee Y. Arceo Jr

Doctor of Nursing Practice Final Manuscripts

Background: Sepsis is a life-threatening organ dysfunction caused by an infection. In the United States, treating sepsis costs approximately $23 billion annually, making it the most expensive condition treated in hospitals. Severe infections in nursing homes are estimated to occur in one to three million cases annually. Infections in nursing homes are on the rise, and the cost of hospitalization due to sepsis is increasing dramatically. Diagnosing sepsis is often delayed in nursing homes.

Purpose of the Project: This project aims to train nursing home nurses to use the SIRS screening tool to identify potential sepsis cases early and administer …

Decreasing Dermal Filler Adverse Events Using Qsen And Benner Theoretical Frameworks To Assess Competency, Stacey D. Stephens Ross

Doctor of Nursing Practice Final Manuscripts

Background: Aesthetic nursing is a new branch of nursing practice. Formal nursing education and standards are lacking, making it challenging to assess competency of an aesthetic nurse. Adverse events (AEs) range from minor (bruising) to severe (vascular compromise and blindness) and can be associated with poor technique or lack of knowledge. Standardized practice using evidence-based (EB) protocols is necessary to provide safe, high-quality care. The Institute of Medicine (IOM) and the Joint Commission support the use of the Quality and Safety in Nursing (QSEN) programs to improve outcomes and promote safety. Due to varied training, “experienced” aesthetic nurses may or …

Implementing Sacred Pause After Patient Death To Reduce Burnout In Icu Nurses, Kimberly Lee

Doctor of Nursing Practice Final Project Abstract

This quality improvement project aimed to implement the Sacred Pause in a hospital Intensive Care Unit (ICU) and evaluate its impact on nurse burnout using the Maslach Burnout Inventory (MBI). Background ICU nurses are at high risk for burnout due to frequent exposure to trauma, highacuity care, and patient death. Burnout can negatively affect nurse well-being, staff retention, and quality of care delivery. The Sacred Pause is a brief, intentional moment of silence observed by staff following a patient’s death. This practice honors the life lost and acknowledges the contributions of the healthcare Methodology team, offering a potential source of …

Staff Education For Nursing Teach-Back Facilitation To Reduce Frequent Readmission, Chikamunario Joy Ekeke

Walden Dissertations and Doctoral Studies

Background: Teach-Back method of education is a simple technique that can be used to check, and correct inaccurate recall of patients’ instructions. It has a great impact on patients’ recall and understanding of discharged information in a healthcare setting and to help minimize hazards such as non-medication adherence, frequent re-hospitalization, and poor self-care/home care (Talevski et al., 2020). Gap in Practice/Problem: “Frequent readmission (30 days Return) of patients in a Rural Psychiatric Center.” The Practice Focus Question: “Does staff education on “teach-back” facilitate the knowledge and confidence level of staff in providing discharged patient education and subsequently minimize frequent rehospitalization?” …

Strategic Policy Development To Reduce Same-Day Cancellations: A Nurse-Led Preoperative Approach, Amanda Kuelz

Doctor of Nursing Practice Final Manuscripts

Background: Same-day surgical cancellations are a persistent and costly issue within outpatient surgery centers, accounting for approximately 5% of elective cases. These disruptions result in inefficient utilization of operating room (OR) time, increased staffing burdens, lost reimbursement, and diminished patient satisfaction. Unanticipated cancellations undermine scheduling reliability and workflow efficiency, contributing to care fragmentation and increased financial strain on health systems. A growing body of evidence suggests that nurse-led, structured preoperative screening has the potential to mitigate these challenges by identifying risk factors in advance and facilitating timely interventions. Nurses' clinical acumen and communication expertise uniquely position them to lead such …

Teaming Up For Better Health: An Interprofessional Collaborative Approach To Older Adult Oral Care, Deborah Dowd, Jodie Lopez, Jennifer Goodman

Utah Conference on Community Engagement

Oral health is a critical component of overall health, significantly influencing systemic diseases and the quality of life in older adults. Conditions such as xerostomia, swallowing difficulties, and poor oral self-care are associated with aspiration pneumonia. Integrating oral health into healthcare in long-term care facilities (LTCFs) is essential for preventing various conditions and improving quality of life. Effective oral hygiene is crucial in avoiding non-ventilator hospital-associated pneumonia by reducing oral biofilm and lowering the risk of pneumonia. Nurses' knowledge and care in oral health across healthcare settings are vital for positive health outcomes. Revising nursing curricula to incorporate oral health …

Staff Education To Improve Patient Follow Through And Continuity Of Care, Aitenobhan Cynthia Ofeinmun

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project was conducted in the adult inpatient psychiatric unit of a behavioral health facility in Texas over 4 weeks. The project involved addressing the absence of standardized staff practices related to patient follow through after discharge. This practice gap contributed to fragmented continuity of care and inconsistent discharge planning. The project’s practice-focused question was: How does staff education on patient follow through impact staff knowledge? The goal was to determine whether an evidence-based staff education program could improve staff knowledge and promote efficiency in terms of discharge practices. Education was delivered through …