Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

Incomplete (A3) Versus Complete (A4) Thoracolumbar Burst Fractures: Results From A Prospective International Multicenter Cohort Study, Jin W. Tee, Barry T. S. Kweh, Alex R. Vaccaro, Klaus J. Schnake, Mohammad El-Sharkawi, Eugen C. Popescu, Shanmuganathan Rajasekaran, Lorin M. Benneker, Sebastian F. Bigdon, John France, Jerome Paquet, R. Todd Allen, William F. Lavelle, Miguel Hirschfeld, Spyridon Pneumaticos, Richard J. Bransford, Andrei F. Joaquim, Harvinder S. Chhabra, Ulrich Spiegl, Hauri Dimitri, F. Cumhur Oner, Marcel Dvorak, Gregory D. Schroeder, Charlotte Dandurand

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: The objective was to compare incomplete (A3) versus complete (A4) thoracolumbar burst fractures managed nonoperatively or operatively with respect to reaching minimal clinically important difference (MCID) in Oswestry Disability Index (ODI) score.

METHODS: A prospective observational international multicenter cohort study was conducted. After stratification using the AO Spine Thoracolumbar Injury Classification System, A3 and A4 outcomes were analyzed separately within nonoperative and operative management groups. Outcomes included absolute and relative improvement in ODI scores between discharge and 12-month follow-up. Kaplan-Meier curves were generated and compared with the log-rank test. Multivariable Cox regression models were constructed. The Cox regression models …

The Cytotoxicity And Anti-Inflammatory Properties Of 1’S-1’-Acetoxychavicol Acetate (Aca) On Oral Cells, Nur Umairah Atiqah Sabri, Nor Syazwani Muhammad Zahidan, Zulfahmi Said, Siti Noor Adnalizawati Adnan, Normaliza Ab Malik

Journal of Dentistry Indonesia

Objective: Mouthwash is widely used to maintain oral health by reducing the prevalence of pathogenic microbiomes. Nonetheless, chlorhexidine, a common active ingredient, is associated with side effects including teeth staining, mucosal peeling, mouth and tongue numbness. This has prompted interest in natural alternatives. This study aimed to identify the cytotoxicity and anti-inflammatory properties of 1’S-1’-acetoxychavicol acetate (ACA) isolated from Alpinia conchigera rhizome against human primary gingival fibroblast and keratinocyte (HPGF and HPGK). Methods: Cytotoxicity of ACA (1.57 mg/mL) against HPGF and HPGK was assessed using the MTT assay. Meanwhile, the anti-inflammatory property of ACA was analyzed based on …

Factors Affecting Interest In Orthodontic Treatment Among Adults In Jakarta, Joko Kusnoto, Lia Hapsari Andayani, Budi Kusnoto

Journal of Dentistry Indonesia

Objectives: The misalignment of teeth and/or jaws caused by abnormalities in the dynamic process of craniofacial growth and development is known as malocclusion. Over half of children and adolescents worldwide experience some form of malocclusion. Orthodontic treatment is the process of adjusting the position of teeth and jaws to achieve optimal occlusion. In recent decades, there has been a global surge in the need for orthodontic treatment among adults. This study aims to evaluate the factors affecting interest in orthodontic treatment among adults in Jakarta. Methods: This cross-sectional study was conducted from October to December 2023. A total …

Prevalence Of Bruxism And Its Association With Stress Among Dental Students: A Questionnaire-Based Cross-Sectional Study, Ketavatu Durga Prasad Naik, Prasanthi Gortha, Madhu Varma, Mohan Kumar, Rama Laxmi Koruprolu, Mounika Rameswarapu

Journal of Dentistry Indonesia

Objective: Bruxism has been described as a parafunction associated with a multifactorial etiology, but primarily as a psychological factor. This study determined the prevalence of bruxism among dental students and explored the potential contributing factors. Methods: A cross-sectional self-administered questionnaire survey was conducted among dental students across various academic years. The prevalence of bruxism (awake and during sleep) was assessed along with stress levels, lifestyle factors, and demographic variables. Statistical analyses were performed using the chi-square test and multivariate logistic regression. Results: The prevalence of bruxism was significantly associated with stress and academic workload. Most participants exhibited moderate to severe …

Dental Students’ Preferences In Selecting Artificial Teeth For Older Adults' Dentures, Muhammad Afif Sapie, Nur Hanim Farhana Mohamad Hilmi, Aiemeeza Rajali, Nik Rahayyu Nik Zulkifeli, Nor Wati Nur Atikah Mustafa, Hazem Mofreh Dakhilallah Al Tarawneh

Journal of Dentistry Indonesia

Objective: Selecting and arranging acrylic resin teeth for dentures is essential to achieve a natural appearance; however, limited understanding and older adults’ aesthetic expectations may result in inconsistencies and increased patient visits. This study aimed to explore the methods and factors dental students prefer when selecting artificial teeth for dentures for older adults. Method: A validated questionnaire, including consent, demographics, and six domains of the methods with related factors for selecting acrylic teeth, was distributed to dental students of the Universiti Teknologi MARA (UiTM). The participants responded using a five-point Likert scale and closed-ended questions. Result: 161 dental students participated …

Evaluation Of Maxillary Posterior Teeth Proximity To The Adjacent Sinuses In A Turkish Subpopulation: Implications For Dental Education And Clinical Practice, Damla Yiğit, Gizem Dolaşir, Sabri Çelik, Rüya Sessiz, Raif Alan

Journal of Dentistry Indonesia

Objectives: This study aimed to evaluate the proximity of upper posterior tooth roots to adjacent sinus borders using cone-beam computed tomography (CBCT) in a Turkish subpopulation and to assess dental students’ competence in identifying this anatomical relationship. Methods: CBCT scans of 171 patients were analyzed. The vertical relationship between premolars and molar roots, and the maxillary sinus (MS) border was categorized into four types (Type 0–3). Interrater agreement between three final-year dental students and an experienced radiologist was measured. Results: Type 0 was the most frequent classification, except for first molars, where Type 2 and Type 3 predominated. MS-root distances …

Musculoskeletal Disorders In Dentistry: An Insight Into Dental Techniques And Practices, Mehwash Kashif, Aman Ashar, Amna Rehman, Abdul Aleem, Sidra-Tul-Muntaha Hashmi, Muhammad Yousuf Ali

Journal of Dentistry Indonesia

Objective: Musculoskeletal disorders (MSDs) are common workplace hazards in dentistry resulting from poor ergonomics and static postures, which lead to back, neck, and upper limb (shoulder, elbow, wrist, and hand) problems among dentists, resulting in harm to their health, productivity, and career. This study aimed to assess the frequency of MSDs, risk factors related to MSDs, and awareness of ergonomics among clinicians. Methods: Data were collected from 400 dental professionals, including house officers, postgraduate trainees, general dentists, and teachers/consultants, each with at least 12 months of practice. Data were collected using a structured, closed-ended questionnaire. Before data collection, ethical approval …

Matrix Metalloproteinase-9 (Mmp-9) Levels In Dentinal Fluid As A Diagnostic Biomarker For Irreversible Pulpitis, Aryo Megantoro, Valeria Widita Wairooy, Ratna Meidyawati, Endang Winiati Bachtiar

Journal of Dentistry Indonesia

Objective: Pulpitis is an inflammatory condition of the dental pulp. The inflammatory status can be accurately assessed by histological examination. Biomarkers, such as matrix metalloproteinases (MMPs), are effective indicators of inflammation severity. Among these, matrix metalloproteinase-9 (MMP-9) has emerged as a key mediator of inflammatory processes associated with pulpitis. However, its clinical application as a biomarker remains limited owing to challenges in its extraction. This study aimed to evaluate the effectiveness of MMP-9 extracted from the dentinal fluid as a biomarker for pulpitis. Methods: Dentinal fluid was collected using the blunt tip of a sterile paper point, following clean …

Individualized Oral Care Using Photobiomodulation And Tailored Brushing Method In A Patient With Maxillofacial Trauma – A Case Report, Shruthi Reghunath, Roshni Ramesh, S Santhosh Kumar, Anoop Sasi, Shahana C. Mohamed, Bilha Joy, Aswathy Jayasree

Journal of Dentistry Indonesia

Patients who report to the dental outpatient department following maxillofacial trauma often exhibit suboptimal oral hygiene, which is frequently attributed to challenges in sustaining oral care stemming from pain and restricted mouth opening after the injury. This case report aims to provide an individualized protocol of oral care and pain management for patients with maxillofacial trauma. Case report: A treatment protocol combining the Tailored Brushing Method (TBM), a personalized approach for at-home oral hygiene, and photobiomodulation using low-level laser was performed on a 24-year-old patient with maxillofacial trauma and poor oral hygiene. Results: The TBM is successful in achieving good …

Concurrent Tb And Hiv Therapies Control Tb Reactivation During Co-Infection But Not Chronic Immune Activation, Riti Sharan, Yi Zou, Bindu Singh, Vinay Shivanna, Edward J Dick, Shannan Hall-Ursone, Xi Luo, Guanlin Guo, Shabaana A Khader, Xavier Alvarez, Jyothi Rengarajan, Zhao Lai, Smriti Mehra, Hulin Wu, Deepak Kaushal

Faculty, Staff and Student Publications

Most HIV-negative individuals exposed to Mycobacterium tuberculosis (Mtb) control infection as latent TB infection (LTBI), but HIV co-infection greatly increases progression to tuberculosis (TB), the leading cause of death in people living with HIV (PLHIV). Although combination antiretroviral therapy (cART) reduces LTBI reactivation, immune control of Mtb is not fully restored, as shown by persistent TB incidence in PLHIV on cART. In macaques, skewed pulmonary effector memory CD4⁺ T-cell (TEM) responses and new TB lesions persist despite cART. We hypothesize that concurrent anti-TB therapy with cART would improve bacterial control and immune restoration compared to cART alone. Using …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Improving Interdisciplinary Communication And Collaboration With The Standardization Of Doula Care Through An Informatics Tool, Shela Le

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for a month, a post-survey assessed these …

Enhancing Flu Vaccination Rates Through Improved Electronic Health Record User Workflow Training, Grace Sayre

Master's Projects and Capstones

A quality improvement project was implemented at an urban community health clinic primarily serving low-income, underinsured, and Latinx individuals. The site had a history of poorly organized flu vaccine rollout and low vaccination rates among the patient population. Seasonal influenza infects millions of people across the US each year, resulting in hundreds of thousands of deaths (Garza et al., 2023), and vaccination is the best prevention. Electronic health record training has been shown to reduce user burnout and improve efficiency (Gordon et al., 2022). The QI project aims to increase medical assistant satisfaction with the flu vaccine rollout by 15%, …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Improving Chemotherapy Patients' Confidence And Preparedness Through Dual-Format Teaching, Jasmine Esther Aminpour, Harshpreet Kaur, Ana Ruvalcaba, Sarah Muwanas

Master's Projects and Capstones

Section I: Abstract

Objective

Chemotherapy initiation is widely recognized as a period of heightened anxiety and cognitive overload for oncology patients, often limiting their ability to retain essential information during traditional one-time, nurse-led education sessions (Gucuyener & Karabacak, 2025; Howell et al., 2020). This quality improvement (QI) project sought to address gaps in comprehension, preparedness, and digital engagement within an outpatient oncology infusion microsystem by integrating evidence-based digital chemotherapy education with structured follow-up support.

Aim

The project aimed to determine whether a nurse-guided walkthrough of a digital chemotherapy education platform, paired with standardized follow-up calls, would improve patient comprehension, confidence …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Enhancing Patient Safety In A Skilled Nursing Facility With A Post-Fall Huddle Protocol: A Quality Improvement Initiative, Evelin Yajaira Dominguez Dominguez

Master's Projects and Capstones

Objective To implement a post-fall huddle guide at a San Francisco Bay Area skilled nursing facility to address the 75 resident falls that occurred over an eight-month period. The literature emphasized the positive impact of huddles on staff communication, awareness, and collaboration which ultimately created a safe environment. Aim By November 4, 2025, the overall fall rates among patients in a San Francisco Bay Area SNF will decrease by 25%, from 4.8 falls per 1,000 patient days to 3.6 falls per 1,000 patient days. Methods Pre-implementation and post-implementation surveys were completed by LVNs and CNAs to assess knowledge of post-fall …

From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Antibacterial Analysis Of Human Amniotic Membrane Against Streptococcus Mutants, Streptococcus Sobrinus, And Enterococcus Faecalis, Mohamad Ezany Yusoff, Ruhil Hayati Hamdan, Haslina Taib, Tan Li Peng, Maizan Mohamed, Rumaizi Shaari, Mohamad Arif Awang Nawi

Journal of Dentistry Indonesia

Objectives: The human amniotic membrane (HAM) is a promising scaffold for oral applications due to its antimicrobial properties, which help protect against bacterial degradation. However, evidence of its activity against oral bacteria remains limited. Thus, this study aimed to evaluate the antibacterial activity of the HAM against selected Gram-positive oral bacteria, namely, Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), and Enterococcus faecalis (E. faecalis). Methods: HAM in 1 cm²-pieces was inoculated with bacterial suspensions and incubated at 37 °C in 5% carbon dioxide (CO₂) for 48 hours to evaluate …

Association Between Gonial Angle And Mandibular Residual Ridge Resorption In Implant-Overdenture Patients, Pl Ranganayakidevi S Palaniappan, Norsiah Yunus, Norliza Ibrahim, Siti Fauzza Ahmad, Anitha Krishnan

Journal of Dentistry Indonesia

Objectives: The gonial angle could be one of the contributing factors for the continuous bone resorption in edentulous persons. This study aimed to examine the association between the gonial angle and RRR in edentulous patients receiving mandibular implant-supported overdenture (ISOD) and to compare different gonial angle measuring techniques. Methods: Twenty-three individuals with opposing mandibular ISOD and maxillary full dentures were recruited. The proportional area index was used to calculate the posterior RRR. Orthopantomographs (OPGs) pre- and four years post-implant insertion were compared. Comparison of the gonial angle measurements was made on 5 patients using four measurement methods: (i) Two different …

Factors Influencing The Re-Emergence Of Vaccine-Preventable Diseases Using The Social Ecological Model: A Scoping Review, Glenda Dorina Rodriguez Lenarduzzi

Master's Projects and Capstones

Abstract

Background.

Several factors contribute to the resurgence of vaccine-preventable diseases, affecting coverage rates and vaccine uptake during recent outbreaks. The pandemic has underscored how crucial it is to comprehend vaccine literacy, as this understanding influences people's perspectives and behaviors toward vaccination, particularly in their approaches to problem-solving and decision-making.

Objective.

The present study conducts a scoping review of research on the impact of vaccine literacy and vaccine uptake on the re-emergence of vaccine-preventable diseases in the United States, framed by the social ecological model (SEM).

Design.

PubMed and Google Scholar were utilized as online databases to identify papers published …

Prevalence Of Abuse-Specific Injuries In Infants With Prior Injury Evaluated For Abuse., Nara Cho, Kristin G. Crichton, Sara Helwig, Krista K. Wheeler, Rachel M. Stanley, Megan M. Letson, Kristine A. Campbell, Angela N. Bachim, Colleen J. Bressler, Carmen M. Coombs, Lori Frasier, Nicole Johnson, Sara Kilbride, Jan Leonard, Daniel M. Lindberg, Noelle Tran, Joanne N. Wood, Farah W. Brink

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Physical abuse is a common cause of morbidity in infants but is often missed in those with medically minor injuries, increasing the risk for escalating violence. Our objective was to compare the prevalence of abuse-specific injuries among infants with and without prior injuries.

METHODS: This is a retrospective, multicenter study of infants (aged < 12 months) undergoing child abuse pediatrics provider (CAP) consultation for suspected physical abuse between 2/2021 and 12/2022 at 10 participating US centers. Encounters were dichotomized into those with and without history of prior injury. The groups were compared for rates of diagnostic screening and prevalence of abuse-specific injuries. The association of prior injuries with identification of abuse-specific injury was assessed using logistic regression controlling for demographics and presence of prior injury.

RESULTS: We identified 2352 eligible encounters (median age: 4.2 months), of which 13% had a history of prior injury. In infants who underwent diagnostic testing, injury identification was significantly higher in those with prior injury (45% vs 22%,

CONCLUSION: Infants with prior injury undergoing …

Improving Pressure Injury Prevention With Educational Programs For Caregivers And Nurses, Michella B. Kahanding

Master's Projects and Capstones

Problem: Pressure injuries are preventable with adequate interventions and knowledge by healthcare staff; however, skilled nursing facilities struggle with pressure ulcer prevention (PUP). Patient suffering and associated costs with treating these injuries are considerable.

Context: Staff education in knowledge regarding PUP is lacking, and annual PUP education is ineffective in reducing the number of pressure injuries in these facilities.

Interventions: Staff education on prevention strategies includes education, pre- and post-knowledge assessments, return demonstration and product use will be implemented

Measures: Results from the baseline knowledge of appropriate PUP in caregivers, pre- and post-test for knowledge retention, teach back techniques to …

Food, Fitness, And Filipino Culture: Evaluating And Reimagining Chronic Disease Interventions For Filipino Americans Through The Pen-3 Framework, Juliana Mastro

Master's Projects and Capstones

Filipino Americans experience high rates of chronic diseases such as diabetes and hypertension. This paper reviews nutrition and exercise interventions targeting this population through the strengths-based PEN-3 cultural framework, focusing on cultural identity, relationships and expectations, and cultural values. It identifies effective strategies that engage these cultural components, and highlights gaps such as limited research on Filipino-American health outcomes. Recommendations include family-centered approaches, culturally relevant activities like tinikling dance, and community-driven online healthy recipe archives to promote positive health behaviors. These culturally informed strategies aim to improve self-efficacy, support lasting health behavior change and reduce chronic disease prevalence nationwide.

Improving Doula Visibility And Integration In The Labor & Delivery Unit Through The Implementation Of Creative Standardized Visual Strategies, Ninna Alessandra Arcena Acebedo

Master's Projects and Capstones

Objective: The 22-bed, Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post- implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for four weeks, …

Increasing Nursing Staff Confidence And Documentation Compliance For Psychotropic Medication Use, Ei Chit Paing

Master's Projects and Capstones

Objective: Psychotropic medications place a high risk for side effects such as confusion, dizziness, falls, and death in older adults above age 65 (Seifert et al., 2024). Educational training on appropriate psychotropic drug use to nursing staff is linked to a decrease in penalties (Jung et al., 2021), side effects, and an increase in staff knowledge in caring for patients with behavioral and psychological symptoms (Pinazo-Clapés et al, 2020). Aim: Facility A in Northern California is currently non-compliant with the Centers for Medicare and Medicaid Services (CMS) guidelines for appropriate psychotropic use due to limited staff understanding of regulations and …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …