Nursing Commons^™

The Incidence Of Hospital-Acquired Pressure Injuries In The Setting Of The Changing Nursing Workforce Throughout The Covid-19 Pandemic, Jacqueline H. Jacobs

MUSC Theses and Dissertations

Background: This study examines how the experience level of Registered Nurses (RNs) has declined while the incidence of hospital-acquired pressure injuries (HAPIs) has increased from 2018 to 2022. Purpose: To evaluate the association between nurses’ experience level and patient outcomes, specifically HAPIs, on a state-by-state basis. Methods: Retrospective, observational study of Medicare patients hospitalized in 41 states using the Medicare 5% Limited Dataset. Nurse experience was measured by the date of first licensure using the Nursing Sample Survey of Registered Nurses (NSSRN). Outcomes include a comparison of the percent increase in HAPIs and change in RN experience level by state. …

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Central-Line Dressing Protocols: The Effectiveness Of A Standardized Dressing Change Protocol In Reducing Central-Line Associated Bloodstream Infections (Clabsi) In Critically Ill Patients Requiring Central Lines, Cody Jones, Melissa Marino, Ryan Mcfarland, Asia White, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

In the Intensive Care Units (ICU), central lines are an essential way of life. However, central lines have risks such as central line-associated bloodstream infections (CLABSI), which increase hospital stays and mortality. CLABSI significantly impacts patient outcomes in critical care, increases mortality and morbidity, increases medical costs, increases hospital-acquired infections, and reduces hospital reimbursements. Typically, antimicrobial dressing has been associated with decreased mortality and improved CLABSI rates. The scoping review will evaluate the literature and examine the effectiveness of various antimicrobial dressing strategies on CLABSI rates. This study aims to synthesize these findings to develop improved CLABSI prevention protocols …

Responsible Pain Management For Postpartum Patients, Anna Beth Wyatt, Isabella B. Conwell, Kaley E. Edelbrock, Missy M. Sterkel

SPARK Symposium Presentations

At Vanderbilt University Medical Center’s postpartum unit on 4 East, uncontrolled pain is a leading cause of decreased patient satisfaction and increased risk for complications. Effective, timely, and conscientious pain management plays a crucial role in improving patient satisfaction and promoting safer recoveries. Given the wide range of pain management needs due to varied birth experiences and complications, nursing judgment and clear patient communication are essential in ensuring both comfort and long-term safety. This makes 4 East an ideal unit to explore standardizing communication strategies to optimize patient care. The primary goal of our intervention is to enhance patient satisfaction …

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

Impact Of Cde Referral On A1c Control In Adult Type 2 Dm Patients., Alivia Watts Bsn, Rn, Yesica Sanchez Bsn, Rn, Morgan Hilliard Bsn, Rn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Type II Diabetes Mellitus is a chronic health condition impacting many adults in Tennessee. Certified Diabetic Educators (CDEs) are specifically trained in educating and addressing the health care needs of patients with diagnoses of Type I or Type II Diabetes. Research has shown that education conducted by CDEs leads to improved outcomes and self- care in those with diabetes (Bowen, et al., 2016, King et al., 2019). Not only are CDEs cost effective services leading to a decrease in healthcare costs, but they also aid in the improvement of hemoglobin A1C (Hgb A1C) levels and decrease complications associated with Type …

Evaluating The Effectiveness Of A Non-Pharmacological Sleep Bundle For The Prevention Of Delirium In Geriatric Patients In The Intensive Care Unit: A Scoping Review, Morgan Wilkins Bsn, Rn, Vanessa D'Amico Bsn, Rn, Alyssa Goyda Bsn, Rn, Seema Janga Bsn, Rn, Kaylin Story Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is an acute disorder yielding cognitive deficits, such as disruption in attention and awareness. It impacts approximately 50% of individuals over the age of 65 who are admitted to the hospital and is prevalent with patients in the intensive care unit (ICU). ICU delirium is associated with adverse outcomes, including higher morbidity, prolonged hospital stays, and chronic neurocognitive deficits. Research demonstrates that implementation of a non-pharmacological sleep bundle can reduce the overall occurrence of delirium. The purpose of this scoping review is to examine the efficacy of a non-pharmacological sleep bundle on the incidence of ICU delirium in …

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

Addressing Organizational Factors Contributing To The Underreporting Of Workplace Violence In Nursing, Jason K. Blomquist

Doctor of Nursing Practice Projects

Background: Nurses routinely face threats, verbal abuse, and physical violence, yet widespread underreporting obscures the full scale of the problem, hindering efforts to address workplace culture and protect nurses.

Aim: Through leadership engagement and targeted staff education, this quality improvement project sought to increase workplace violence reporting rates on a 35-bed medical/surgical unit.

Methods: Over eight weeks, a three-phase intervention was implemented. Phase one equipped charge nurses with uniquely designed training (DIVER framework) to strengthen leadership support. In phase two, staff received micro-education through established communication channels. Phase three reinforced learning via interactive staff meetings. Pre- and post-intervention surveys assessed …

“I’Ll Be There For You”: F·R·I·E·N·D·S And Spirituality May Impact Intent To Stay, Danell Stengem, Alison Smock, Ashley Doherty, Dana Kopp, Karen Colorafi, Teresa Rangel

Social Work

No abstract provided.

Navigating Excellence: A Comprehensive Program Evaluation Of An Academic Clinical Nurse Educator Pilot Course, Rachel Marquart, Jennifer Sternberg, Kathryn Dambrino, David Phillippi, Jessica Savage, Tammy Legge

SPARK Symposium Presentations

Project title: Navigating Excellence: A Comprehensive Program Evaluation of an Academic Clinical Nurse Educator Pilot Course

Background and Rationale: Clinical instructors play a key role in nursing education, yet clinical instructors have varying degrees of formal preparation for the role. These inconsistencies affect student outcomes and instructors’ ability to effectively teach, mentor, and evaluate students. To address this, Belmont University developed the Academic Clinical Nurse Educator Program online course. This project conducted a comprehensive program evaluation to assess its effectiveness.

Aim: This project evaluated the effectiveness, success, and sustainability of an online Clinical Nurse Educator and Preceptor course designed to …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Ebp Implementing Telehealth In Outpatient Settings, Kylee Scott, Ellianna Grammer

Scholars Week

This evidence based practice project is researching if the implementation in outpatient settings would be beneficial. Specifically in the emergency department for areas such as triage and collaboration with other physicians.

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …

Nurse Retention Through Mentorship, Leah Lodato, Campbell Wroblewski, Sarah Endre, Annika Eldred

SPARK Symposium Presentations

High turnover rates contribute to staff shortages, increased workload, burnout, and a decline in patient care quality. Nurse retention can be incredibly costly, and it is estimated to cost $56,300 per every RN who leaves their job. For the average hospital, this can equate to roughly $3.9 to $5.8 million in losses per year.” (2024 NSI National Healthcare Retention and RN Staffing Report). Our initiative focuses on implementing a structured mentorship program for new graduate nurses at Vanderbilt’s 6 East Med-Surg unit. By pairing new nurses with experienced mentors, the program aims to improve job satisfaction, provide professional …

Navigating Excellence: A Comprehensive Program Evaluation Of An Academic Clinical Nurse Educator Pilot Course, Rachel D. Marquart

DNP Projects

Background and Rationale: Clinical instructors play a key role in nursing education, yet clinical instructors have varying degrees of formal preparation for the role. These inconsistencies affect student outcomes and instructors’ ability to effectively teach, mentor, and evaluate students. To address this, Belmont University developed the Academic Clinical Nurse Educator Program online course. This project conducted a comprehensive program evaluation to assess its effectiveness.

Aim: This project evaluated the effectiveness, success, and sustainability of an online Clinical Nurse Educator and Preceptor course designed to prepare registered nurses to teach undergraduate students and new nurses in clinical settings.

Design …

Written Reminders For Mammogram Compliance, Kristine Cholly, Marcus Barksdale, Rachel Gates, Mabel Olaya, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Breast cancer remains the second leading cause of cancer death among women in the United States, with a median age of mortality at 68 years old. Mammography has been shown to improve early detection and reduce mortality rates. Current United States Preventive Services Task Force (USPSTF) recommends biennial mammograms for women aged 50-74. However, compliance with biennial mammogram screenings remains inconsistent. This project aims to evaluate the effectiveness of written reminder letters in improving mammogram compliance among women aged 50-74 years old. The study focuses on comparing mammogram adherence rates among patients who received reminder letters compared to those …

The Impact Of Adopting Unicef Growth And Development Modules In Enhancing Nursing Students' Knowledge: A Qualitative Study, Yousef Eljeesh, Mahmoud Ayash

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Background: The growth and development phase are an essential and critical period of human life, especially in the early stages. It was defined by most professionals as the interval from conception to eight years of age. This interval is vital for brain growth. In addition, these developmental years have a significant and lifelong impact on children. Thus, almost all children in these years need to be well cared. Aim: The study aimed to assess the impact of adopting UNICEF modules on nursing students' knowledge about growth and development concepts. Design: A qualitative study design was used to conduct the study. …

Caring For Native American Elders: Developing Cultural Knowledge And Comfort Levels Of Senior Nursing Students In Northern California, Ireland Odonnell

Nursing | Senior Theses

Providing appropriate care to patients in the healthcare setting includes being aware of their culture. Nurses play an important role in caring for patients and need to know how to be culturally sensitive toward their patients. Various research articles highlight the lack of knowledge and comfort that current nurses and nurse educators have when caring for culturally diverse patients. Research also shows that a lack of overall knowledge about how to be culturally competent, knowing how to care for patients from different backgrounds, and understanding the effect cultural beliefs have on modern-day medicine poses a challenge when trying to provide …

The Impact Of Standardized Leadership Rounding On Nursing Satisfaction, Amber N. Vaughn

Regis University Student Publications (comprehensive collection)

This quality improvement project aimed to address the lack of standardized communication between staff and management within the behavioral health service line, as this contributed to a negative culture. This project explored if implementing standardized leadership rounds would increase nursing staff satisfaction compared non-standardized rounds. This project utilized a pre- and post- intervention survey design, with a survey consisting of 15 questions. Eleven (N=11) nurses participated in the study, completing both the pre- and post- intervention surveys. There was an eight-week period of intervention between the pre- and post- intervention surveys. The pre-intervention survey mean score was 6.4848, while the …

Chalkboards To Chatbots: Helping Faculty Harness Ai For The Future Of Higher Education, Justin C. Grace

Regis University Student Publications (comprehensive collection)

Integrating artificial intelligence (AI) into nursing education presented significant opportunities yet posed challenges due to varied faculty readiness. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated an educational intervention aimed at enhancing nursing faculty's AI proficiency and confidence at Regis University’s Rueckert-Hartman College for Health Professions. Using a mixed-methods, pre- and post-intervention design, validated surveys assessed changes in faculty perceptions, knowledge, and skills related to AI. The intervention included a digital toolkit with nine instructional videos demonstrating practical AI applications using FreedAI’s large language model, ChatGPT, supported by voiceover narration and closed captioning. Data analysis involved descriptive …

Nursing Workplace Rituals: Communication Before, During, And After Covid-19, Angel Infante

Nursing Dissertations - Archive

ABSTRACT

NURSING WORKPLACE RITUALS: COMMUNICATION BEFORE, DURING, AND AFTER COVID-19

Angel Infante, PhD

The University of Texas at Arlington, 2025

Professors: Dr. Deborah Behan (Committee Chair), Dr. Yungfei Kao (Committee Member), and Dr. Jessica Grace Smith (Committee Member)

Background: According to Griner et al. (2021) many disruptions caused confusion for healthcare workers during the pandemic. Communication is imperative when dealing with everyday disruptions in a hospital setting. However, it is even more important to learn about the different types of communication and what is communicated during a past pandemic to know how and what to communicate in a future pandemic. …

Decreasing Hospital-Acquired Clostridium Difficile Infections, Angel S. Louder

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Clostridium Difficle Infection (CDI) is a significant healthcare threat due to its ability to be transmitted rapidly in healthcare settings. Patient engagement and participation in infection prevention initiatives at admission will lead to early implementation of isolation precautions, diagnosis of infectious pathogens, and treatment. A quality improvement project was implemented at a south-central Texas acute care hospital to engage alert and oriented adult patients, using a bundled approach to screen for the early detection of CDI within 48 hours of hospital admission, thereby reaching the goal of reducing hospital-acquired CDIs. This initiative improved patient engagement with CDI screening, reducing confirmed …

Enhancing Patient-Centered Efficiency: Reducing Cardiology Clinic No-Shows Using Technology, Pre-Visit Planning & Patient Resources, Pat Shirey

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Cardiovascular disease (CVD) affects 48% of U.S. adults, requiring regular cardiology visits to manage risk factors and the early detection of complications (American Heart Association, 2019). No-shows disrupt continuity of care, worsen health outcomes (Choi et al., 2020), and decrease clinic efficiency (Goossens et al., 2022). A North Texas cardiology clinic reported a 31.9% overall no-show rate and a 42.1% no-show rate for new patients, costing $1.3 million annually.

Purpose: This quality improvement project aimed to reduce no-show rates through a patient-centered cardiology appointment bundle to improve continuity, patient outcomes, and efficiency.

Methods: This eight-week project utilized the Plan-Do-Study-Act …