Nursing Commons^™

Reducing Catheter-Associated Urinary Tract Infections In The Intensive Care Unit, Rosa Shiffman

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Despite established prevention guidelines, inconsistent practices in catheter removal and gaps in daily necessity reviews persist. At the project site’s 24-bed ICU, the CAUTI rate was 1.9 per 1000 catheter days, which exceeds the national benchmark of 1.0. Gaps in consistent assessment of necessity and delays in removal contributed to an elevated infection risk.

Aim of the Project: This project aimed to reduce CAUTI rates in the ICU through evidence-based interventions …

The Effects Of A Triaging Educational Training Program On Triaging Knowledge, Self-Efficacy And Accuracy In Emergency Department Nurses In A Private Hospital In Saudi Arabia, Sawsan Falatah, Janice Hawkins, Craig Cunningham

Graduate Student Government Association Research Conference

Inaccurate triage decisions can lead to increased length of patient stays in the emergency department, increased rehospitalizations, and increased risk of mortality, all of which are quality of care indicators (Srinivas et al., 2021). The triaging decisions in the emergency department at our facility are conducted by relatively new and inexperienced nurses. Anecdotal evidence from the emergency department leadership suggests that inaccurate triaging decisions are being made. In addition, 60 percent of a limited sample of 30 charts that were recently reviewed contained inaccurate triaging decisions. The accuracy of these triaging decisions has not been systematically evaluated at our facility. …

Exploring The Relationship Between Burnout, Professional Fulfillment, And Individual And Organizational Factors In Nurse Managers Across Ambulatory And Inpatient Settings, Yulia Romazanova Lopez

MUSC Theses and Dissertations

Nurse managers play a vital role in the functioning and stability of healthcare systems, yet their well-being remains an underexplored area of research. The COVID-19 pandemic brought renewed attention to occupational burnout, including in nursing leadership, where nurse managers reported high levels of stress, emotional exhaustion, and organizational strain. While the literature on burnout has grown rapidly in recent years, there is limited research that addresses what comes next, what sustains nurse managers in their roles and how organizations might foster their long-term well-being and engagement. This dissertation compendium explores professional fulfillment (PF) as a proactive and constructive lens for …

2024 Nursing Annual Report, System Of Texas Children's Health

2024

No abstract provided.

Evidence Based Pilot Project To Reduce Nurse Documentation Time In The Electronic Health Record, Herbert Rolito C. Ortiz

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was the reduction of electronic health record (EHR) documentation time and improve nurse satisfaction in an Intermediate Care Unit (IMU).

Introduction: Nursing documentation supports patient safety, interdisciplinary communication, and regulatory compliance. However, excessive documentation requirements may reduce the time nurses spend with patients, increase the risk of errors, and contribute to job dissatisfaction and burnout. At a large, academic hospital, nurses in the target unit were averaging 155 minutes of documentation per 12-hour shift, ranking in the 90th percentile for documentation time among peer institutions.

Methodology: The project, conducted between March 1 …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

Cross Cultural Mentoring: Including Diversity Awareness Strategies Into Healthcare Leadership Mentor Curriculum To Support Career Advancement Of Underrepresented Racial And Ethnic Groups, Deidra R. Burris

Doctoral Projects

Background: Mentoring programs in healthcare organizations can establish clear pathways for advancement through various management and leadership levels to senior-level positions. While mentoring develops leaders, many healthcare organizations do not offer mentoring programs that address unique issues experienced by members of racially and ethnically underrepresented groups. A study was conducted using a single-group, repeated-measures design to assess the impact of an intervention aimed at improving mentor attitudes, behaviors, and confidence regarding cultural awareness in the mentoring relationships of healthcare leaders. Methods: The study was conducted in a large California healthcare organization. The Cultural Diversity Awareness related to Race/Ethnicity (CDA-R/E) subscales …

Healthcare Provider Comfort Surrounding Adverse Childhood Events (Aces), Cameo Culcasi

Doctoral Projects

Adverse Childhood Experiences (ACEs) are strongly linked to long-term health outcomes, yet discussions around ACEs in clinical settings remain inconsistent. This study investigates the comfort levels of healthcare providers in addressing ACEs with their patients, identifying barriers and facilitators to such conversations. Using a Quasi-experimental, single group, pretest-post test experimental design, we surveyed a diverse group of physicians, nurse practitioners, and physician assistants working in a primary care setting, providing ACE training, and an opportunity for learning reflection. Preliminary results indicate that while most providers acknowledge the importance of discussing ACEs, many report discomfort due to time constraints, lack of …

Sugammadex For Reversal Of Neuromuscular Blocking Agents Versus Neostigmine - Safety Comparison, Amanda K. Butler, Daniel Belu, Bailey Accardo, Courtney Ayana Bullard, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Sugammadex and neostigmine are two common drugs used to reverse neuromuscular blockade in anesthesia, but they differ in mechanism of action, side effects, and cost.

Sugammadex provides rapid reversal, has fewer side effects, and has a lower risk of bradycardia than neostigmine. This scoping review examines the frequency of bradycardia in adult surgical patients receiving sugammadex versus neostigmine.

Methods

A scoping review was completed of peer-reviewed articles comparing the incidence of bradycardia in adult surgical patients after the administration of sugammadex and neostigmine for neuromuscular blockade reversal. Findings indicate that sugammadex resulted in fewer adverse events, including bradycardia, than …

Patient Perception Of Nurse Practitioner Care, Nurse Practitioner Scope Of Practice And How That Influences Provider Choice, Naomi Hemp

Doctoral Projects

This project investigates patients' perceptions of nurse practitioner (NP) care versus physician (MD) care, the factors influencing these perceptions, and patients' understanding of NP scope of practice. A cross-sectional design was used, gathering quantitative data through an anonymous one-time survey distributed via Qualtrics, open for three months. Questions were based on The Watson Caritas Patient Score (WCPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). Data were analyzed using Intellectus Statistics software™, with descriptive statistics summarizing the findings. A two-tailed paired samples t-test revealed statistically significant differences in favor of patients' perceptions of NP care versus …

Development Of An Evidence Based Orientation Model For The Newly Graduated Nurse, Sandra L. Takach

Doctor of Nursing Practice Scholarly Projects

Healthcare in the acute hospital setting experienced a significant increase in highly acute patients with multiple comorbidities requiring competent, experienced clinicians who can provide high quality, safe care. The nursing shortage paired with the post pandemic hospital environment has altered the landscape of nurses entering the workforce and created a gap in competency of the bedside nurse. A loss of tenured nurses who typically onboard and mentor the novice nurse coupled with less than adequate clinical preparation of those graduating college led to elevated levels of stress and staggering turnover rates for the newly graduated nurse. Research validates efficient orientation …

Pulmonary Embolism Response Team In Acute Care Settings: A Scoping Review Of The Evidence, Tia Glover Bsn, Rn, Leslie Asplund Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Pulmonary embolism (PE) is a critical cardiovascular emergency associated with high morbidity and mortality. Despite its prevalence, traditional PE management often lacks cohesion, leading to suboptimal outcomes. Pulmonary Embolism Response Teams (PERTs) offer a multidisciplinary approach aimed at improving patient outcomes by streamlining diagnosis, facilitating timely interventions, and promoting evidence-based treatment. This scoping review evaluates the evidence supporting PERT efficacy across various clinical and resource-related outcomes with the aim to decrease mortality rates, shorten inpatient length of stay, improve cost efficacy, and minimize adverse events from treatment modalities.

Methods

A comprehensive literature search was conducted using PRISMA guidelines across …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Improving Communication And Job Satisfaction: Utilizing Team Strategies And Tools To Enhance Performance And Patient Safety (Teamstepps) For Interventional Service Areas, Sukhbinder Kaur Sangha

Doctoral Projects

Purpose: Improved communication and job satisfaction among staff are essential for those working in high-stress critical care environments like the cardiac catheterization laboratory (Cath Lab). The purpose of this investigation was to utilize the quality improvement initiative Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve attitudes and job satisfaction in the Cath Lab. Method: A total of 30 subjects participated in a TeamSTEPPS educational intervention. After obtaining informed consent, a demographic survey, a pre- and post-test TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Job Satisfaction Survey (JSS) were administered. The post-test included open-ended questions for feedback …

Smoking Cessation Education In Caregivers Of Pediatric Patients Hospitalized With Asthma Exacerbation, Maya Emptage, Kaitlynn Lineberry, Suzanne Kayali, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Michelle Rickard Dnp, Pnpac-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Pediatric asthma is rising globally, currently affecting over 300 million individuals and projected to reach 400 million by 2025. This scoping review aims to summarize existing evidence on the impact of providing smoking education to caregivers during hospitalization on reducing pediatric asthma exacerbations, with the goal of encouraging further research.

Methods

The search spanned from August 2022 to November 2024, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria focused on studies involving human participants and caregivers of children receiving smoking cessation education in relation to asthma exacerbation and hospital admission. Databases searched included …

Dexmedetomidine As An Adjunct To Local Anesthetics In Neuraxial Anesthesia: A Scoping Review, Meaghan Elrod, Jacob Flake, Sarah Eggers, Kieraney Coston, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Neuraxial anesthesia is key for pain management and comfort during surgery. While local anesthetics and opioids have notable side effects, Dexmedetomidine (DEX) offers a promising alternative. Early studies suggest DEX improves pain control, prolongs anesthesia duration, and reduces opioid-related side effects. This review explores the benefits of incorporating DEX into neuraxial anesthesia for better patient safety and comfort

Methods

This scoping literature review took place from August 2023 to April 2024, utilizing PubMed, CINAHL, Cochrane Library, and Google Scholar for sources. After reviewing over 2,000 abstracts, 25 articles met the inclusion criteria, with nine selected as most relevant. Four …

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …

Ultrasound-Guided Epidural Placement Vs. Conventional Technique - Evaluating Effectiveness: A Scoping Review, Skylar R. Kuehn, Bsn, Rn, Ccrn-Cmc, Jacob B. Morphis, Bsn, Rn, Sarah D. Price, Bsn, Rn, Katherine E. Pritchard, Msn, Rn, Jordan Isaac Dnp, Crna, Sharon Little Dnp, Aprn, Fnp-Bc, Tracy Mcclinton

Doctor of Nursing Practice Projects

Purpose/Background

Epidural anesthesia is a cornerstone of perioperative pain management, offering effective analgesia and reduced opioid dependency. However, traditional landmark-based epidural placement (EP) techniques often result in variable first-pass success rates (FPSR) and increased risks of complications. Ultrasound-guided (USG) EP has emerged as an alternative, providing real-time anatomical visualization to improve accuracy and safety. This scoping review synthesizes evidence on the comparative efficacy of USG EP and conventional techniques in adult patients undergoing perioperative epidural anesthesia.

Methods

This review commenced September 2023 and included full-access, peer-reviewed journal articles published in English between 2014-2023. Databases searched included PubMed, CINAHL, Cochrane Library, …

Design And Implementation Of A Notification System For The Purpose Of Improving Communication Between Nurses And Patients, Aindrila Bhattacharya

2025 Spring Honors Capstone Projects - Archive

Communication is an important part of how nurses administer treatment to their patients. Without proper communication, it is difficult for the nurses to connect with their patients and vice versa. This paper will be going into some previous literature about communication between patients and nurses in general, communication with respect to pediatric patients and how notification systems have been implemented in the past. It will then discuss the methodology and implementation of a notification system for a medical app. The medical app is meant to facilitate communication from the side of the patient to the nurse, while the notification system …

Postpartum Depression Screening At First Year Well-Child Visits: Evaluating The Rate Of Maternal Ppd Detection, Chidera A. Speight, Bsn, Rn, Katherine Scarbrough, Bsn, Rn, Camille Jones, Bsn, Rn, Laura Reed, Dnp Fnp-C

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum Depression (PPD) is a concerning mental health condition characterized by feelings of extreme sadness, exhaustion, and challenges with maternal-infant bonding. PPD effects mothers’ ability to adequately care for themselves and their newborns. Current research suggests that one in seven women experience symptoms of PPD as late as 12 months postpartum. Despite screening guidelines set forth by the American Academy of Pediatrics, 50% of mothers with PPD will not receive a diagnosis.

This study aims to evaluate the rate of PPD detection at well-child visits occurring within the first 12 months postpartum by administering the Edinburgh Postnatal Depression Scale …

Assessing The Efficacy Of Remimazolam Vs. Midazolam In Short-Duration Gastrointestinal Endoscopy Procedures And How They Affect Patient Recovery Time: A Scoping Review, Kelsey Gray, Bsn, Rn, Ccrn, Shannon Guthrie, Bsn, Rn, Ana Grace Holder, Bsn, Rn, Will Howard, Bsn, Rn, Dwayne Accardo Dnp, Crna, Faana, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose

The purpose of this scoping review is to evaluate and compare the efficacy of Remimazolam and Midazolam as sedatives in short-duration gastrointestinal endoscopy procedures.

Efficacy Of Aprepitant And Ondansetron In Managing Postoperative Nausea And Vomiting In Perioperative Obese Patients, Jada Stewart, Reagan Revon, Samantha Castellaw, Ashlee Roberts, Dwayne Accardo Dnp, Crna, Faana, Bobby Belflower Dnsc, Nnp-Bc, Faanp, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Postoperative nausea and vomiting (PONV) is a common adverse event that occurs during the recovery period following anesthesia. PONV has been reported to affect nearly 80% of patients, leading to prolonged hospitalization, increases in cost of care, patient dissatisfaction, dehydration, electrolyte imbalances, acute kidney injury, and pulmonary aspiration. Certain risk factors, including obese patients, female gender, and nonsmoker status, increase the risk of PONV. Traditionally, for all patients going under anesthesia, a prophylactic antiemetic regimen is administered; however, since obese and other high-risk patients are at increased risk of experiencing PONV despite traditional regimens, anesthesia providers should administer multiple …

Social Determinants Of Health Screening – Evaluating Its Influence On Glycated Hemoglobin Levels In The Pediatric Population: A Scoping Review, Lindsay Gibson, Victoria Hutchison, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Social determinants of health (SDOH) have a significant impact on health outcomes. Pediatric patients with type one diabetes mellitus (T1DM) with adverse SDOH have inferior glycemic control, higher healthcare utilization, and increased risks of complications. SDOH screenings are not standard practice in pediatric T1DM care despite literature demonstrating that screening can improve outcomes. This scoping review aims to summarize existing evidence surrounding SDOH screenings and their impact on pediatric T1DM outcomes.

Methods

A scoping literature review was conducted from August 2022 to November 2024 via CINAHL, Cochrane, EBSCO, Elsevier, and PubMed. Inclusion criteria included peer-reviewed articles, English language, publication …

Improving Nurse Confidence Around Communication With Physician Partners Through The Caritas Processes, Deborah M. Yracheta

Doctoral Projects

Nurses are the eyes and ears at the bedside during a patient’s hospital stay. They are responsible for communicating significant changes in a patient’s health status, mainly to their physician partners. Unfortunately, good communication between nurses and doctors is a shortcoming of the nursing profession. Seven thousand reviewed malpractice lawsuits were directly related to poor provider communication, resulting in $1.7 billion in malpractice cases and 2,000 preventable deaths. These communication errors also lead to prolonged hospital delays in care, underscoring the need for improved communication. These poor outcomes compromise patients’ lives, safety, and well-being and decrease patient satisfaction scores, ultimately …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Assessing The Efficacy Of Tranexamic Acid In Adjunct To Oxytocin In Reducing Blood Loss During Cesarean Deliveries: A Scoping Review, Hilary Clair Ray Bsn, Rn, Shelbie Freeman Hendrix Bsn, Rn, Lauren Elizabeth Hubbard Bsn, Rn, Helen Maisen Conley Bsn, Rn, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using …

Evaluation Of Depression Screening Tools For Utilization In Adolescents: A Scoping Review, Helen Whitaker Bsn, Rn, Jade Bray Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Anxiety and depression are prevalent mood disorders among the adolescent population with significant impacts on academic performance, social interactions, and mental well-being. With depression rates continuing to rise and suicide among the leading causes of death in adolescents, there is an urgent need for effective screening and intervention. While depression screening is recommended in the primary care setting, many adolescents do not have regular access to healthcare, complicating early identification and treatment. The purpose of this scoping review is to compare the effectiveness of two depression screening tools, the Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), …

Improving Handoffs Between Outpatient Clinics And Acute Cancer Care Centers At A Tertiary Oncology Hospital Using A Quality Improvement Methodology, Mini George, Mohamed Ait Aiss, Gabriele Urschel, Maria Franco Vega, Susan Gaeta, Diane Bodurka

Advances in Cancer Education and Quality Improvement

Accrediting agencies recommend safe and accurate transfer of clinical information during care transitions. At our institution, a tertiary care cancer hospital, ambulatory clinic providers use multiple methods for communicating essential information to emergency care providers. Therefore, we initiated a quality improvement project using a standardized electronic handoff during the transfer of care between providers at outpatient clinics and acute cancer care centers. The project was launched in May 2023 and aimed to achieve electronic handoff for 70% or more of ambulatory care patients transferred to emergency care by October 2023. A multidisciplinary team developed an electronic handoff, provided training, and …

Enhancing Schizophrenia Treatment Outcomes: Integrating Cbt With Medication Therapy To Reduce Hospital Readmission, Kamauri Fleming Msn, Rn, Grace Adeniji-Ilesanmi Fnp-Bc, Zillah Anagho Tah Fnp-C, Alex Cook Msn, Rn, Margaret Harvey Phd, Acnp-Bc, Chfn, Sharon Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn, Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Schizophrenia is a chronic mental illness that disrupts cognition, emotion, and social functioning, imposing significant personal and societal burdens. While antipsychotic medications are effective in alleviating psychotic symptoms, they are often associated with side effects, poor adherence, and relapse risk. Cognitive behavioral therapy (CBT) has shown promise as an adjunct to medication, addressing persistent symptoms and improving outcomes. This scoping review examines the integration of CBT with medication therapy to reduce hospital readmissions and improve quality of life for adult patients hospitalized with schizophrenia.

Methods A systematic search of databases, including PubMed, PsycINFO, Embase, and Cochrane Library, was conducted …