Quality Improvement Commons^™

Integrating Evidence-Based Practice Into Post-Code Blue Debriefings To Enhance Clinical Practice And Staff Well-Being In The Micu - A Quality Improvement Project, Jeffrey Schall

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction/Background:

Intensive care (ICU) nurses are routinely exposed to traumatic events, such as code blue resuscitations, which contribute to increased stress, burnout, and lower perceived quality of care. A gap analysis of MICU charge nurses and team leaders found that 87% reported that post-code debriefing did not occur and that 40% experienced emotional distress, indicating a need for a brief, structured, emotionally safe reflection process.

Methodology: Using a pre-post design, the CARE tool, adapted from the DISCERN and Post-Code Pause frameworks and validated by three institutional experts, was introduced into practice over six weeks. Nurse champions completed pre-surveys …

Reducing Stress Through Low-Carbohydrate Nutrition Education In Emergency Department Staff – A Quality Improvement Project, Hassan Oman Gomar

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Emergency department staff often face job-related stress, which can lead to burnout, reduced compassion satisfaction, and adverse effects on patient care. Loma Linda University Health (LLUH) offers support programs, including Care for the Caregiver (C4C) and the Living Whole Employee Wellness program, that provide emotional and general wellness resources. While these programs are helpful, they do not offer practical solutions for everyday stress. There is a need for simple, lasting, and food-based ways to help staff manage stress and perform better. Recent research shows that eating patterns, especially high intake of processed carbohydrates, can alter energy and …

Implementation Of A Language-Concordant Follow-Up Protocol To Reduce Percutaneous Nephrostomy Tube Complications: An Evidence-Based Practice Project, Marisol Ornelas

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims: Complications of percutaneous nephrostomy tubes (PCN) are common after discharge. Language barriers place patients at higher risk for misunderstanding discharge instructions. This evidence-based project evaluated whether a bilingual follow-up protocol three days post-discharge reduces PCN complications in patients.

Methodology: This project utilized the Johns Hopkins Nursing Evidence-Based Practice Model. The project leader reviewed the literature, synthesized the evidence, and developed a standardized PCN discharge training and bilingual PCN follow-up protocol.

Implementation: Unit nurses received training to standardize the PCN discharge process. Nurses educated PCN patients using the standardized process at the time of discharge. Three days …

Improving Medication Adherence In Mental Health Patients: A Quality Improvement Project, Ryan Oh

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction / Aims

Medication adherence among patients with mental health conditions is essential for quality of life, health outcomes, and longevity (Stewart et al., 2022). This quality-improvement project investigates whether a medication reminder app, supported by healthcare staff, effectively improves adherence and how it influences patients' perceptions of their health management.

Methods

Adult patients (aged 18-80) diagnosed with mental health disorders were identified at Orange County Health and Psychology Associates (OCHPA) in February 2026. All patients completed a PAM-10 survey both before and after the intervention, a mobile app called MyTherapy. Clinic staff received training on using MyTherapy to assist …

Transforming Obesity Management In Primary Care: Shared Medical Appointments (Smas) – An Evidence-Based Practice Project, Glendy Chen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

The purpose of this DNP project is to implement a 10-week Lifestyle Intervention Shared Medical Appointment (LISMA) program in primary care to improve obesity outcomes. Aims include increasing structured visit frequency, enhancing multidisciplinary engagement, and improving metabolic indicators, mindful eating behaviors, and self-efficacy.

Background of Problem & Description of Current Practice

Obesity affects over 40% of U.S. adults and is associated with cardiometabolic morbidity, reduced quality of life, and rising healthcare costs. Guidelines recommend intensive, multicomponent behavioral interventions with frequent contact. Current practice primarily offers one-on-one visits at insufficient frequency with limited team integration, contributing to suboptimal management. LISMAs …

Educating Nurses On Caring For Patients With Intellectual And Developmental Disabilities – An Evidence-Based Practice Project, Amyela Adarlo

Loma Linda University Electronic Theses, Dissertations & Projects

Intellectual and developmental disabilities (IDD) refer to a range of conditions that begin before age 18 and impact physical, cognitive, and socioemotional development. Patients with IDD often experience poorer health outcomes due to healthcare providers’ limited training in effective communication strategies. This evidence-based project aims to evaluate whether educating nurses on effective communication with IDD patients improves nurse self-efficacy and confidence in communication and enhances caregiver perceptions of nursing care.

Use Of A Structured Rounding Model To Improve Interprofessional Communication And Collaboration Among Mds And Rns In A Medicine Unit – An Evidence-Based Practice Project, Jackie Raygoza,

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

This DNP project aims to improve communication and collaboration between physicians (MDs) and registered nurses (RNs) on medical units by implementing a structured three-step communication-rounding model integrated into the daily workflow and leveraging existing communication tools. As patients’ conditions become more complex and healthcare demands increase, it is crucial to foster an environment where communication among providers and staff is clear, transparent, respectful, and collaborative. By leveraging information technology and evidence-based strategies, the project seeks to strengthen interprofessional collaboration and improve patient satisfaction and the quality of care. The project includes educational sessions for both MDs and RNs to …

Early Mental Health Screening In The Gi Patient Population: A Quality Improvement Project, Jacqueline Sagala

Loma Linda University Electronic Theses, Dissertations & Projects

Aims

This quality improvement project aimed to increase awareness and better integrate mental health screening in a GI clinic by educating staff and providers. The project evaluated changes in depression literacy, attitudes toward mental illness assessment, perceived training effectiveness, use of the training in clinical practice, and referrals to the Resiliency Clinic.

Background

Patients with chronic GI disorders commonly experience anxiety and depression, yet mental health concerns are often overlooked in specialty care. Although annual depression screening was already a part of the standard care at the Digestive Disease Center at Loma Linda University Faculty Medical Clinics, staff education and …

Implementing A Noise Reduction Protocol To Reduce Perceived Noise In The Icu – An Evidence-Based Practice Project, Soh Jeon

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims:

This project aims to reduce perceived noise in the ICU and promote a healing environment through a multi-interventional noise-reduction protocol and nursing staff education.

Rationale/Background:

The World Health Organization (WHO) recommends that hospital noise levels remain below 35 decibels during the day and 30 decibels at night. However, ICU noise often exceeds 50-70 decibels. Increased noise levels are primarily caused by conversations, monitoring alarms, and routine care activities, such as cleaning and procedures. These high noise levels directly affect patients’ sleep, which is essential to recovery. Insufficient rest can lead to immunosuppression, prolonged mechanical ventilation, and elevated stress …

Optimizing Communication In The Periprocedural Area: Implementing Sbar: A Quality Improvement Project, Autumn Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The primary aim of this project is to improve standardized nurse-to-nurse communication at the electrophysiology lab of a large Los Angeles hospital. By providing nursing education on a unit-specific, structured handoff communication framework (SBAR) and incorporating a procedure-specific handoff form for electrophysiology (EP) across pre-, intra-, and post-procedure units, this project aims to improve nurses’ perceptions of the handoff process and the effectiveness of handoff education across the periprocedural units. The project further aims to assess nursing incorporation of the training four weeks post-education and changes in patient satisfaction related to nursing teamwork and communication.

Scrub Up For Success: Transforming Infection Control In Transplant Patients Through Microlearning Video And Poster – A Quality Improvement Project, Wendy Dio

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Healthcare-associated infections (HAIs) threaten patient safety, affecting about 1 in 25 hospitalized patients. Clostridium difficile infection (CDI) is a significant contributor, impacting both high-risk groups and the general population. Proper hand hygiene is crucial for preventing CDI transmission. In the U.S., hospital-acquired CDI costs over $1.5 billion annually and causes nearly 500,000 cases and I15,000 deaths each year. California reported 3,526 CDI cases in acute care hospitals, with Loma Linda University hospitals accounting for 16 cases, or 23% of their health system's infection rate.

Methodology

Nurses in the 6A West-Transplant Unit received a PowerPoint presentation on when …

Skin Injury (Moisture-Associated Skin Damage, Skin Tears, And Pressure Injury) Prevention Education: An Evidence-Based Practice Project, Elizabeth Lopez

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Aims: Skin injuries, particularly pressure injuries, pose significant challenges in hospitals, especially for critically ill patients, leading to discomfort and increased healthcare costs. Such injuries profoundly impact patient outcomes, resulting in increased morbidity and mortality rates. Furthermore, these injuries can severely affect patients' quality of life, impeding their recovery. This project at LLUMC aims to address knowledge gaps among ED nursing staff regarding skin injury prevention through targeted education, thereby enhancing nurses' knowledge and confidence in managing these injuries.

Methodology: To evaluate the effectiveness of the skin injury prevention education initiative, eight tools were utilized, including the …

Optimizing Tbi Care: Brain Oxygen Monitoring In Nursing - An Evidence-Based Practice, Alyssa Grisham

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. …

Telephone Inquiries, Types Of Calls : Are Emergency Service Nurses Qualified To Give Answers?, Constance M. Boskin

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract not included]

Hospital Situations In Which Male Patients Prefer A Male Nurse, Norma Groome White

Loma Linda University Electronic Theses, Dissertations & Projects

This was a study of the preferences of men patients for the sex of the nurse desired to meet their physical, social, spiritual, and emotional needs. The purposes of the study were: (1) to identify the hospital situations in which a male nurse is preferred to give care, (2) to provide information that could be used in the utilization of male personnel, and (3) to provide information that could be used to possibly provide for better fulfillment of the needs of male patients.

The descriptive survey was chosen as the method of study. A questionnaire of thirty-five hospital situations was …

Nursing Care Given To Hemiplegic Patients, Margaret Eugenia Messer

Loma Linda University Electronic Theses, Dissertations & Projects

Statement of the Problem: The purpose of this study was to ascertain whether nursing care currently being given to hemiplegic patients in the area of body mechanics was adequate; to develop a standard from current literature in the field of medicine, physical therapy, and nursing by which nursing care given to hemiplegic patients could be evaluated; and to learn if better prepared nursing personnel were giving better nursing care.

Method: The descriptive survey was the method used in this study. The data were gathered by making actual observations of nursing care given to hemiplegic patients in the area of body …

Incidents Which Threaten Patient Safety Classified For Use In Teaching Operating Room Nursing, Elsie Dorothy Vivian Wendth

Loma Linda University Electronic Theses, Dissertations & Projects

The study was conducted in an attempt to identify incidents threatening the safety of patients in the care of operating room personnel and to classify them for use in teaching safety in operating room nursing.

Literature was reviewed to find concepts of safety and to aid in classification of safety hazards which are applicable to hospital patient safety. Need was shown for safe working conditions and for personnel with attitudes of safety as well as skills and knowledge. Safety included freedom from mechanical, thermal, chemical, bacteriological, and psychological injury.

The descriptive method of research using the critical incident technique was …

An Investigation Into Nursing Students' Awareness Of Emotional Needs Of Patients In A General Hospital, Sadie Sinclair

Loma Linda University Electronic Theses, Dissertations & Projects

Nursing educators consider that awareness of the emotional needs of a patient is a prerequisite to the formulation of a nursing problem. The problem of this study was to discover if the senior student in a specific college program in nursing is aware of the emotional needs of patients. A collection of senior research papers written over a period of sic [sic] years in a specific course assignment was studied. The attention was focused on the portion of the paper which dealt with the personality description of the patient. The direction given by the instructor did not emphasize any particular …