Medicine and Health Sciences Commons^™

Improving Nursing Deployment Readiness, George Mcenroe

Doctor of Nursing Practice (DNP) Projects

Improving Air Force Nursing Deployment Readiness

Abstract

Background. Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, mass casualty care, and military-specific skills.

Problem. Air Force nurses are required to maintain an annual Comprehensive Medical Readiness Program (CMRP) checklist, a list of clinical skills based on their nursing specialty. Assessing and maintaining deployment readiness is an ongoing challenge. The Air Force does not currently use any …

Evaluation Of Implementing Clinical Partnerships For Fourth Semester Bachelor Of Science In Nursing (Bsn) Students And Employers On Perception Of Readiness To Practice, Gwendolyn Kay Chrisenbery

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Gwendolyn K Chrisenbery MSN, APRN, FNP-C

Abstract

Today’s new graduate nurses are entering a complex and constantly evolving healthcare environment. Nursing education has not kept up with the changing environment, resulting in graduate nurses not being ready to practice at graduation. To better prepare graduate nurses for practice, education methods must evolve with the changing demands of healthcare (National Academies of Sciences, Engineering, and Medicine, 2021). Utilizing clinical partnerships between universities and healthcare facilities to provide clinical experience to Bachelor of Science in Nursing (BSN) students could provide opportunities for learning that better …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Stress Management Education Module For Nursing Students, Valentina Loreto-Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background. Stress refers to a state of mental tension caused by a difficult situation. Research indicates that stress negatively affects university students.

Problem. Researchers have found that 30% of undergraduate nursing students have symptoms of burnout resulting from an overaccumulation of stressors and 97.8% were at moderate risk for developing burnout.

Approach. An educational module consisting of a 15-minute YouTube videos was designed, developed, and implemented to increase awareness about stress, reduce feelings of anxiety, and identify integration potential of such a module in nursing education to promote student well-being. Participants completed an online survey before …

Improving Compliance In Missed Visits Documentation, Ma Rosalie Felix

Master's Projects and Capstones

Problem: Within the South Bay Hospice Agency, documentation compliance for missed visits was 68% in the first quarter of 2024, when the national standard should be 100% according to the Centers for Medicare & Medicaid Services.

Context: Inadequate nurse documentation and communication between health professionals can lead to medical errors, poor team communication and suboptimal patient outcomes (Tasew et al., 2019). Therefore, the importance of documentation compliance is imperative. Hospice staff perform scheduled visits for terminally ill patients 1-2 times a week; however, a missed visit can occur when a patient declines it for a variety of reasons.

Interventions: The …

Implementation Of A Daily Engagement System Board (Desb) To Improve Hospital Staff Communication, Catherine Villanueva

Master's Projects and Capstones

Implementation of a Quality Improvement (QI) project to help improve staff communication between shifts at an Inpatient Acute Psychiatric Unit was determined to be of immense need. This unit is part of a large acute medical hospital. Currently, the end of shift report consists of a verbal report along with a robust printed end of shift report consisting of shift related information. This printed end of shift report can have as many as seven to nine pages thus causing information overload and decreases prioritized patient information. Furthermore, missed information or too much information can be provided in the verbal shift …

Adolescent Suicide Prevention Techniques, Kaitlyn R. O’Malley

Honors Capstones

The purpose of this paper is to understand prevention techniques for adolescent suicide. Suicide is defined as death caused by injuring oneself with the intent to die. Suicide is the fourth leading cause of death among 15–29-year-olds (WHO). From 2021 to 2022, the number of suiciderelated deaths increased by 2.6%. 48,123 people died from suicide in 2021 alone. (CDC) From 2011-2021, 13% of high school girls tried to commit suicide, and 30% of them considered trying (Youth Risk Behavior Survey Data Summary and Trends Report: 2011–2021). Suicide is very preventable in society, which is why, with how many people try …

Implementation Of Peer Mentorship Process Within A Nurse Fellowship Program, Julie Edwards

Doctor of Nursing Practice Final Project Abstract

PURPOSE: The purpose of this scholarly project was to implement a peer mentorship program within an inpatient labor and delivery nurse fellowship program. This program was intended to increase the job satisfaction of experienced nurses transitioning into an inpatient labor and delivery unit.

BACKGROUND: The project was implemented within a large healthcare organization in Houston, Texas, in an established nursing fellowship program in the Labor & Delivery inpatient practice area.

METHODOLOGY: A nursing workplace satisfaction questionnaire was administered to access job satisfaction using the Microsoft Forms platform. This method was chosen as it allowed for easy access, at any time, …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients, Alexandra Violeta Theodosopoulos

Master's Projects and Capstones

Objective: Cytotoxic chemotherapy places oncology patients at risk of complications such as mucosal barrier injuries (MBI) and aspiration pneumonia. Current literature supports the use of high-quality oral hygiene protocols to reduce the frequency and severity of these complications.

Aim: By end of fiscal year 2025, we will achieve a 0.2% reduction in incidences of aspiration pneumonia, from 1.5% to 1.3% of total patient discharges, among adult cancer patients in the oncology units. Methods: A survey was used to gather baseline oral hygiene compliance data on six acute care oncology units. Based on the results of the survey and discussions with …

Chronic Disease Management In A Nurse Practitioner-Led Clinic: An Interpretive Description Study, Natalie Floriancic, Anna Garnett, Lorie Donelle Phd, Rn, Fcan

Publications

Introduction

Objective

Journey To Baby-Friendly: Standardizing Patient Breastfeeding Education In The Postpartum Microsystem, Emily Korwin

Master's Projects and Capstones

Problem Low breastfeeding rates remain a global challenge and a cause of adverse infant health outcomes despite the benefits of exclusive breastfeeding. In response, UNICEF and the WHO developed the Baby-Friendly Hospital Initiative (BFHI) to promote, protect, and support breastfeeding for infant growth and development. Context Hospital A is a mid-size hospital in Northern California. It has 24 labor, 13 antepartum, and 33 postpartum beds and serves a diverse population of patients. Intervention After a literature review, microsystem assessment, stakeholder survey, and root cause analysis, a standardized infant feeding nurse patient education checklist was developed and aligned with Baby-Friendly teaching …

Practicing Responses To Acute Clinical Troubles: Initiative Through Clinical Education (P.R.A.C.T.I.C.E.) To Improve Medical Emergency Response Increasing Nurse Confidence And Preparedness Through Low-Stakes Clinical Education, Lauren Castelblanco Rn, Viviana Lopez Rn, Nosa Odiase Rn, Everly Pompa Rn

Master's Projects and Capstones

A newly established pediatric outpatient infusion center in Los Angeles does not have immediate access to a Code Blue Team or a Rapid Response Team, and instead relies on the Staff Assist protocol to manage medical emergencies. Via direct interviews, registered nurses at the infusion center report feeling underprepared and lacking confidence to respond to medical emergencies that must be escalated to code blue. Microsystem assessment tools determined the root cause to be limited clinical exposure and limited opportunities for skills development. To address the nurses' concerns, Practicing Responses to Acute Clinical Troubles: Initiative through Clinical Education (P.R.A.C.T.I.C.E.) was implemented …

Journey To Baby-Friendly Designation: Standardizing Infant Feeding Education, Jasmine Geronimo Ibay

Master's Projects and Capstones

Problem The influence of formula companies in hospitals has caused a decrease in national breastfeeding rates, increasing risks of adverse health outcomes among infants. In response, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) in 1991 to support breastfeeding practices for infant development and eliminate commercial interests of formula companies from hospitals. Context The quality improvement (QI) project was conducted at Hospital A’s Birth Center, serving a diverse population of patients in the greater East Bay of Northern California. The microsystem has 24 labor beds, 13 antepartum beds, and 33 …

Chronic Disease Screening And Detection In Vulnerable Populations, Courtney J. Seman, Hussein Hadid, Tania Jaimes, Robert Walls

Master's Projects and Capstones

This quality improvement project aims to address gaps in chronic disease screening by implementing standardized protocols for diabetes, hypertension, vision impairment, and scoliosis within the University of San Francisco (USF) Nurse-Led Clinic in Orange County. Problem: The clinic identified a lack of screening practices, which limited early detection and intervention for two specific vulnerable populations. Context: The clinic serves two high-risk groups: older adults, including formerly homeless individuals, and children in two local grade schools. These populations face significant healthcare disparities, making early detection of chronic conditions critical. Interventions: Guided by Kotter’s Change Theory, the project developed and implemented evidence-based …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

Improving Performance And Documentation Of The Bedside Mobility Assessment Tool, Joseph P. Chellew

Master's Projects and Capstones

Objectives: Decreased patient mobility is associated with negative health outcomes including decreased functional capacity, pressure injuries, deep vein thrombosis, and bloodstream infections (Yasmeen et al., 2020). Early and increased mobilization mitigates these complications and is associated with positive outcomes (Wang et al., 2020). The Bedside Mobility Assessment Tool 2.0 (BMAT) is a mobility assessment that guides the selection of equipment to safely mobilize patients (Boynton et al., 2020). Aim: This quality improvement project aims to increase BMAT documentation compliance by 10% in three medical-surgical units at Hospital A where only 31.3% of patients were assessed per day using the BMAT. …

Increasing Access To Fresh Fruits And Vegetables At An Urban Clinic: A Quality Improvement Project, Jordan Michael Leahy

Master's Projects and Capstones

The microsystem setting for this quality improvement project is an adult health unit at one of five safety net clinics housed within a macrosystem in a large urban setting in Northern California serving a low-income, predominantly Hispanic population. Professionals involved in the delivery of the food security program include patient support services, medical assistants, case managers, health promoters, registered nurses, and providers. With enrollment in clinic’s food security program significantly lower than program goals, clinical site stakeholders sought to identify and address gaps in delivery. This quality improvement aimed to improve the screening process to increase the percentage of eligible …

Improving Mood Scores With Social Robot Dog ‘Pupper’ In Pediatric Cardiovascular Patients, Alyssa Lopez

Master's Projects and Capstones

Objective Pediatric hospitalization has been shown to increase the risk of developmental delays, social isolation, and mental health disorders. Consequently, decreased happiness also results from hospitalization, leading to reduced motivation and less engagement in their care. Aim The aim of this project is to improve the mood of pediatric patients aged 3-25 years by 50% from the patient’s baseline level within one month, from October 16, 2024 to November 13, 2024, on a pediatric cardiac step down unit by utilizing a social robot dog to motivate patients in engaging in their care. Methods Twelve participants between the ages 4-18 years …

Sleep To Heal: Creating A Quiet At Night Environment, Victor Marie V. Blardony

Master's Projects and Capstones

Problem: Noise in hospitals disrupts patient well-being, recovery, and satisfaction. A 120-bed community hospital in South San Francisco consistently scored below the national average for nighttime quietness (Medicare, 2023).

Context: Over six months, a multidisciplinary committee launched the Quiet at Night (QAN) Program, focusing on the high-acuity telemetry unit. The program utilized Kotter’s 8 Steps Model and the Institute for Healthcare Improvement Model for Improvement (MFI) to tackle nighttime noise issues.

Interventions: Quiet hours were established from 8:30 p.m. to 6:00 a.m. Patients were provided an “Enhanced Sleep Menu” that included a sleep sound machine and “sleep kits” (eye masks …

Integrating The Bedside Mobility Assessment Tool (Bmat): Increasing Compliance With Assessments And Charting In Medical Surgical Units, Khaterah Sayed

Master's Projects and Capstones

Objective: Decreased patient mobilization is associated with poor patient recovery and increased hospital costs. Complications include decreased functional capacity, pressure injuries, deep vein thrombosis, and infections. Aim: The Bedside Mobility Assessment Tool (BMAT) is a mobility assessment tool designed to help healthcare providers safely mobilize patients (Boynton et al., 2020). In a 244-bed California hospital, preliminary data from three medical-surgical units indicate an average daily patient census of 23.7 of which only 31.3% were assessed using the BMAT. This quality improvement intervention aims to increase compliance with the BMAT by 10%. Interventions: Over a six-week period, staff received …

Patient-Centered Language During Peripartum Bedside Reports, Krystal H. Nguyen

Master's Projects and Capstones

Problem Using complex medical language that excludes the patient can result in lower patient satisfaction, increased miscommunication, and heightened anxiety for patients. Hospital A’s peripartum mesosystem currently does not have a training on the use of patient-centered language during labor and delivery (L&D) patient transfers to postpartum (PP). Context Hospital A is an urban tertiary care medical center located in the Bay Area, with its peripartum mesosystem consisting of 35 L&D and postpartum beds distributed across two floors. Intervention Through analysis of stakeholder engagement, an ongoing literature review and a mesosystem needs assessment, potential barriers to implement patient-centered language in …

Reducing Healthcare-Acquired Pneumonia In A Geriatric Long-Term Care Facility, Jacob R. Magsalin

Master's Projects and Capstones

Problem: Healthcare-acquired pneumonia (HAP) is a nosocomial infection that poses a serious threat in geriatric long-term care facilities due to its high morbidity and mortality.

Context: This evidence-based quality improvement project seeks to reduce the incidence of HAP in a geriatric long-term care facility in the San Francisco Bay Area by utilizing findings

from existing literature.

Interventions: Key interventions include improving and standardizing oral care techniques and promoting education on HAP prevention to allow patients and their families to be more proactive in preventing this complication.

Measures: Outcome measures include HAP diagnosis rates after implementation, any costs saved for the …

Enhancing Communication And Reducing Near Misses Through Comprehensive Handoff Tools At A Residential Nursing Facility, Sabrina Guralnik, Sophia Nguyen, Gabriela Benelyahu, Giselle Peyus

Master's Projects and Capstones

Our quality improvement project at Regina House addresses communication gaps during patient handoffs, which have led to missed or delayed care. The research underscores the critical role of effective communication in patient safety, particularly for vulnerable populations in nursing homes. Current handoff practices at Regina House are inconsistent, especially among Certified Nursing Assistants, resulting in frequent reporting errors and communication disparities.

To enhance patient safety and care continuity, this project introduces a standardized handoff tool and an incident reporting system, aligning with Regina House’s goal of improving care quality. Over three months, CNAs will receive training on the tool, with …

Improving Documentation Compliance And Patient Mobility Using The Bedside Mobility Assessment Tool, Hayley M. Bernard

Master's Projects and Capstones

Objective: Patient immobility during hospitalization contributes to avoidable complications including increased length of stay, pressure injuries, thromboembolic events, reduced functional capacity, and increased rates of discharge to rehabilitation facilities. The Bedside Mobility Assessment Tool (BMAT) was developed to empower Registered Nurses to safely assess and mobilize patients without a physical therapy evaluation. Aim: This quality improvement projects aims to enhance nurse compliance with BMAT documentation by 10% in three medical-surgical units of a 244-bed Northern California Hospital. Preliminary findings indicate an average daily patient census of 23.7 of which only 31.3% are assessed using the BMAT. Methods: Across a six-week …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Implementing The Donna Wright Competency Model In Pediatric Perioperative Units For Nursing Professional Development, Benjamin Amezcua

Master's Projects and Capstones

Background Each year, preventable adverse events in hospitals lead to numerous deaths. Research consistently indicates a strong correlation between nurse competency and improved patient outcomes, emphasizing the importance of healthcare organizations prioritizing the continuous development of their staff's skills. Bay Area Children’s Hospital A is taking a proactive step by adopting the Donna Wright Competency Model (DWCM), changing from the traditional approach competencies to a collaborative, shared governance model that incorporates the input and perspectives of the nursing staff. Objectives The project aims to utilize the DWCM to enhance the competencies of 90 nurses in the pediatric perioperative units at …

Implementing The Brief Confusion Assessment Method (Bcam) Delirium Screening Tool In An Emergency Department, Carolina Van Dalen

Master's Projects and Capstones

Problem: Persons with delirium have an elevated risk of falls. Thus, falls and delirium are inextricably linked. Both should be routinely screened for older adults.

Context: A 40-bed Emergency Department (ED) in the East San Francisco Bay area of Northern California and the first site among all acute care hospitals in the organization to implement the Brief Confusion Assessment Method (bCAM) delirium scoring tool within the Electronic Health Record (EHR).

Interventions: An EHR toolkit for delirium screening using bCAM was developed, tested, and implemented in the ED.

Measures: The outcome measure was the percentage of patients with a reported fall …

Baby-Friendly Hospital Initiative: Becoming Baby-Friendly Designated, Krystal Angelique Mora

Master's Projects and Capstones

Section I: Abstract

Problem Despite efforts to increase breastfeeding rates, the influence of formula companies has contributed to the decrease in rates, affecting the health outcomes of infants. In response, the Baby-Friendly Hospital Initiative (BFHI) introduced standardized education for nursing staff to support infant growth and development. Context Hospital A Birth Center is a 33-bed culturally diverse unit that provides care to mothers in Northern California, delivering approximately 7,400 babies each year and helping patients transition into motherhood. Aim The quality improvement project aims to enhance the retention of BFHI-aligned education provided during hospitalization by 26.2%, raising retention rates among …

Impact Of Supply Organizational Culture Within A Surgical Unit, Irene T. Peng

Master's Projects and Capstones

Objective: This quality improvement project aims to propose an intervention that helps anesthesia technicians improve communication efforts, reduce delays in care, and reduce medical waste. Aim: At least 80% of the anesthesia technicians are educated on properly stocking the pediatric anesthesia medical lockers utilizing the standardized checklist and handoff report tool to reduce waste and increase timely patient care after three months of implementation. Methods: Assessment surveys were used to identify the surgical unit’s current issues and Hospital A’s staff's opinions of pediatric medical anesthesia C-lockers. Resources such as the GANTT Chart, Fishbone Analysis, Budget Analysis, SWOT Analysis, and PDSA …

The Donna Wright Competency Model In Pediatric Perioperative Nursing Development, Nadia Hamid

Master's Projects and Capstones

Abstract

Background Preventable adverse patient events occur daily in hospitals across the United States which can be significantly decreased by effective nurse competency assessment. Bay Area Children’s Hospital X has adopted the Donna Wright Competency Model (DWCM) to support their institutional goal of Magnet status for excellent nursing care. With the goal of changing the traditional approach of competency achievements by engaging nurses through shared governance. Objective The project seeks to attain a higher level of performance for 90 nurses employed on the perioperative unit (PPU) to provide a safer environment to support patient centered care. Aim By December 1, …