Nursing Commons^™

Improving Patient Health Portal Enrollment In The Primary Care Setting, Erika L. Bell

Doctoral Dissertations & Projects

In today’s increasingly digital healthcare environment, patient health portals have become critical tools for enhancing communication, improving care coordination, and empowering patients to actively participate in their health management. These secure, web-based platforms allow patients to access medical records, request prescription refills, view lab results, and message providers. Although patient health portals are offered by a vast majority of U.S. health systems, they remain underutilized, with only 15-30% of patients engaging with these platforms despite their potential to improve patient engagement, health status awareness, and care quality. Enhancing patient health portal use not only empowers patients but also supports broader …

Ai’S Role In Searching For Evidence: Friend And Foe, Barbara (Basia) Delawska-Elliott, Brandon Wilkinson

Publications 2026-present

No abstract provided.

Nursing Migration And The Global Workforce: How The U.S. Nurse Shortage Impacts Developing Countries, Mololuwa Faithful Lasekan

Honors Thesis

As United States (U.S.) healthcare organizations face persistent staffing gaps driven by an aging population, burnout, and limited educational capacity, many institutions increasingly rely on internationally educated nurses (IENs) to stabilize their workforce. This reliance intersects with longstanding structural challenges in low- and middle-income countries (LMICs), where inadequate compensation and limited professional opportunities contribute to high migration intentions among nurses. Using a systematic literature review guided by PRISMA principles, this study synthesized evidence and five major themes emerged: (1) push factors driving nurse emigration from LMICs, (2) pull factors attracting nurses to the U.S., (3) digital globalization and post-COVID recruitment …

Breaking Barriers: Advancement Toward Practical Nursing Licensure For Certified Medication Assistants In Long-Term Care--A Descriptive Study, Aleshia L. Maxwell

ATU Theses and Dissertations 2021 - Present

The persistent nursing shortage across the United States, particularly in Long-Term Care (LTC) settings, has complicated the healthcare system’s ability to meet the needs of an aging population. While existing research often examines progression from Licensed Practical Nurse (LPN) to Registered Nurse (RN), limited research explores factors influencing progression from entry-level LTC healthcare workers to Practical Nursing (PN) licensure. This quantitative descriptive study examined the barriers and supporting factors influencing advancement toward PN licensure for Medication Assistants-Certified (MA-Cs) in Arkansas LTC facilities. A convenience sample of N=100 participated in the study. Results indicated that financial and structural barriers often …

Dexmedetomidine (Precedex) Versus Propofol: In Patients Requiring Sedation While Mechanically Ventilated,, How Does The Use Of Dexmedetomidine (Precedex) Compared To Propofol, Affect Reintubation Within 48 Hours Post Extubation?, Kimberly Barbee, Markela Albright, Malak Amro, Evelyn Caty-Pletcher, Margaret Havey Phd, Aprn, Acnp-Bc, Chfn, Fhrs, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within …

Diva Difficult Intravenous Access Assessment, Aileen M. Romero, Mary Jo Sarver

Articles, Abstracts, and Reports

No abstract provided.

Free Money And Safer Patients, Kaitlyn R. Livingston, Kennedy G. Crites, Jazmine Razo, Erin Radigan, Kennedy Crites

SPARK Symposium Presentations

This quality improvement project aims to improve consistency of nurse compliance with daily chlorhexidine gluconate (CHG) bathing in a local oncology unit to reduce the risk of central line-associated bloodstream infections (CLABSI’s). CLABSI’s remain a preventable source of patient morbidity, prolonged hospitalization, delayed cancer treatment, and increased healthcare costs, particularly among immunocompromised oncology patients who frequently require central venous access. Evidence supports daily CHG bathing as an effective infection prevention intervention; however, inconsistent completion and documentation across day and night shifts limit reliability in practice. This project addresses both documentation accuracy and actual bathing completion to ensure care consistency. Implementation …

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

Decreasing Wound Healing Times By Decreasing Stress Levels, Bayleigh S. Kraus, Colson Burnett, Kelsey Spann

Scholars Week

The relationship between stress levels and delayed wound healing needs to be further investigated, particularly in hospitalized and chronically ill patients. Research shows that psychological stress can impair immune function, reduce tissue regeneration, and prolong inflammation, all of which slow the healing process. It is important to explore how both acute and chronic stress affect different types of wounds, such as surgical incisions, pressure injuries, and diabetic ulcers. Additionally, identifying which stress-reduction interventions are most effective in improving healing outcomes is essential. Understanding these factors can help nurses implement targeted, evidence-based interventions to promote faster recovery.

Utilizing Proactive Rounding With Nursing Leadership To Improve Patient Satisfaction Scores In An Adult Medical-Surgical Unit, Lily A. Bogyah

Student Scholarly Projects

Practice Problem: Patient satisfaction is a key quality indicator that reflects patients’ perceptions of care and the healthcare system’s performance. Patient satisfaction scores at the project site were significantly lower than the national benchmark, particularly on the adult medical-surgical unit.

PICOT: The PICOT question that guided this project was: In patients on an adult medical-surgical unit (P), how does the use of proactive patient rounding conducted by nurse leaders (I) versus current practices alone without such rounding (C) affect patient satisfaction scores over an eight-week period (T)?

Evidence: A literature review of multiple studies found that implementing daily nurse leader …

Hybrid Diabetes Coaching Model: Integrating In-Person And Telemedicine Strategies To Improve Glycemic Outcomes, Sandis A. Mundackal

Student Scholarly Projects

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or …

Synchronizing Success: Interprofessional Teamwork In Optimizing Throughput Management, Deborah Nimick, Eran Wilkerson

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Evaluating The Impact Of A Nurse-Driven Oxygen Titration & Weaning Guidelines On Length Of Stay And Costs Of Care: Qi, Stephanie Zarate

Providence Nursing Research Conference 2023 – Present

No abstract provided.

A Qi: Implementing Pawss And Ciwa Adherence Challenge In The Psychiatric Emergency Department, Bailey Poler

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Creating A Culture Change Around Stroke: Integrating Process Improvement To Reduce Door-To-Needle Time, Shayna Brewer, Benedict Pereira, Rose Bisellach, Jason Greenspan

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

Dexmedetomidine Versus Propofol For Reducing Emergence Delirium In Pediatric Anesthesia: A Scoping Review, Hannah Laxton Bsn, Rn, Hannah Mclain Bsn, Rn, Robert Mohr Bsn, Rn, Sarah Rocha Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Dwanye Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched …

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Teamwork Enhanced With Digital Technology To Augment Bedside Shift Report: An Integrative Research Review (Irr), Daniel Everard Hronek

Covenant Nurses Week 2026

No abstract provided.

Don't Let Them Fall, Let Ai Call, Ella Mills, Sara Barker, Andreea Ifrim, Yvette Uwase

SPARK Symposium Presentations

This project proposes a nurse-led pilot of AI-supported predictive mobility monitoring on a cardiac medical-surgical unit, to improve early identification of high-risk mobility behaviors and enhance patient safety. Current fall-prevention strategies, such as bed alarms and virtual sitters, often alert staff after unsafe movement has begun, creating a reactive cycle that contributes to alarm fatigue and delayed intervention (Abbe & O’Keeffe, 2020). This initiative uses monitors with contactless infrared sensors to identify movement before patients exit the bed, an alert system that goes straight to the nurse and PCT phones, and a central console for floor management and care coordination. …

Ambient Listening: Using Artificial Intelligence To Transcribe Provider Office Visits, Odia Russette

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Electronic health record (EHR) documentation burdens contribute to increased “pajama time” or after–hours charting, reduced job satisfaction, and provider burnout. Provider burnout leads to provider and critical access point losses. Ambient–listening artificial intelligence (AI) technologies have emerged as a possible tool to reduce charting burdens; however, evidence from outpatient wellness settings remains limited.

Local Problem: At an urban adult wellness clinic in Texas with limited resources for completing tasks, in-clinic and after-hours “pajama time” charting burdens contributed to provider fatigue, job dissatisfaction, and burnout.

Methods: A quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) framework implemented an AI ambient …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …