Nursing Commons^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Implementing A Nurse-Led, Family Caregiver–Integrated Delirium Prevention Protocol To Improve Bcam Screening Compliance And Caregiver Confidence Among Hospitalized Older Adults, Geraldine K. Ijezie

Doctor of Nursing Practice Final Project Abstract

Purpose:  To evaluate the effectiveness of a nurse-led, family caregiver–integrated delirium prevention protocol in improving bCAM screening compliance and caregiver confidence among hospitalized older adults in an Acute Care for the Elderly (ACE) unit.

Background; Delirium is a common but preventable complication in hospitalized older adults. Baseline assessments on the ACE Unit identified inconsistent bCAM screening and limited caregiver involvement. This quality improvement (QI) project aimed to improve early recognition through routine nurse screening and caregiver education to improve early delirium recognition and prevention.

Methodology: 12-week QI project using three PDSA cycles implemented nurse bCAM education, caregiver education, visual reminders, …

Implementing An Icu-Specific Pressure Injury Prevention Bundle (Skin Safe)To Reduce The Incidence Of Hospital-Acquired Pressure Injuries In Adult Surgical Intensive Care Unit., Komal Ali

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this project was to evaluate the effectiveness of implementing an ICU-specific pressure injury prevention bundle (SKIN SAFE) Sto reduce hospital-acquired pressure injuries (HAPIs) in an adult Surgical ICU.

BACKGROUND

HAPIs remain a major safety concern in critically ill patients. Standardized prevention bundles improve adherence and reduce incidence.

METHODOLOGY

This QI project in a 20-bed Surgical ICU used the PDSA framework to implement the eight-component SKINSAFE bundle. Strategies included staff education, champions, and weekly audits. Data were collected through EMR review, monthly PIP audits for HAPI incidence, and weekly compliance audits.

RESULTS

Pre-intervention data showed two HAPIs …

Evaluating The Effectiveness Of A Mindfulness-Based App To Reduce Stress Among Psychiatric Nurses At A Children’S Hospital, Miracle U. Izevbekhai

Doctor of Nursing Practice Final Project Abstract

The purpose of this quality improvement project was to evaluate the effectiveness and feasibility of a mindfulness-based mobile application (Smiling Mind) to reduce perceived stress and emotional exhaustion among psychiatric nurses on an adolescent inpatient unit at a children’s hospital.

Psychiatric nurses experience high levels of stress and burnout, which threaten staff well-being, retention, and patient safety. Brief, app-based mindfulness practices may offer a low-burden strategy to support nurse wellness in high-acuity environments, but real-world uptake and impact are not well described.

Using a pre–post quality improvement design, a convenience sample of 11 nurses enrolled in a 12-week intervention. Nurses …

Promoting Sleep Hygiene In The Intensive Care Unit- Implementation Of A Sleep Bundle, Emma J. Harris

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project’s purpose was implementation of a sleep bundle for at least 25% of an 18-bed cardiac intensive care unit (ICU) and reduce noise level by 20% (decibels) through education of at least 75% of the patient-care staff 3 months post-implementation.

Background: This quality improvement (QI) project’s purpose was implementation of a sleep bundle for at least 25% of an 18-bed cardiac intensive care unit (ICU) and reduce noise level by 20% (decibels) through education of at least 75% of the patient-care staff 3 months post-implementation.

Methodology: Patients were assessed using the Richard Campbell Sleep Questionnaire …

The Prevention Of Mouth Sores In Breast Cancer Patients Receiving Doxorubicin Using Oral Cryotherapy, Imani Wright

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of the evidence-based project is to implement and evaluate oral cryotherapy to reduce and prevent incidence and severity of chemotherapy-induced mucositis in breast cancer patients receiving Doxorubicin at a large cancer hospital in Southeast Texas.

BACKGROUND

Chemotherapy-induced oral mucositis is a common and painful complication among breast cancer patients receiving Doxorubicin leading to difficulty eating, treatment delays and a decrease in patient satisfaction and adherence to treatment regimen. Despite strong evidence supporting oral cryotherapy, its use is seldomly used in many oncology settings.

METHODOLOGY

A pre- and post- intervention quality improvement design guided by the Plan-Do-Study-Act (PDSA) …

Implementation Of The Pressure Injury Prevention Care Bundle At A Home Based Hospice Program: A Quality Improvement Project, Adaeze U. Amechi-Fannin

Doctor of Nursing Practice Final Project Abstract

Purpose: This Doctor of Nursing Practice project was created to improve the prevention of pressure injuries in hospice patients receiving care through a Home-based Hospice and Palliative program. The project focused on introducing a standard set of care steps (a care bundle), enhancing caregiver education, and tailoring interventions to meet each patient’s unique needs, with the goal of improving overall patient outcomes.

Background: Pressure injuries remain a common and serious problem in hospice care, especially among patients who are immobile or confined to bed. Although effective prevention methods are known, inconsistent use of these methods, limited caregiver training, and poor …

Exploring The Relationships Between Emotional Intelligence, Perceived Organizational Support, Job Satisfaction, And Intent To Stay Among Minnesota School Nurses, Kristin K. Coudron

Dissertations, Theses, and Projects

School nurses face escalating job demands driven by increasing student health complexity, chronic condition management, and expanding public health responsibilities. Often serving as the sole healthcare professional within a school or district, they work in settings characterized by high autonomy, variable organizational support, and growing concerns about job satisfaction and retention. Limited empirical research has examined how personal and organizational resources jointly relate to school nurses’ intent to remain in practice. Guided by the Job Demands–Resources (JD–R) theory and the National Association of School Nurses School Nursing Practice Framework, this quantitative, correlational, cross-sectional study explored relationships among emotional intelligence, …

Crc Station: Improving Colorectal Cancer Screening Rates In Primary Care, Kathryn Nanji

Doctor of Nursing Practice Final Project Abstract

Purpose: To improve colorectal cancer (CRC) screening completion rates among eligible patients at a primary care clinic, located in Houston, Texas, by optimizing the medical assistant (MA) workflow and addressing systemic and patient-level barriers.

Background: The project site is a Federally Qualified Health Center that provides comprehensive and inclusive care to diverse and underserved populations, including those with low income, living with HIV/AIDS, experiencing homelessness, and uninsured. Despite the availability of non-invasive screening methods like the fecal immunochemical test (FIT), CRC screening rates remain suboptimal due to workflow inefficiencies, patient barriers, and inconsistent follow-up.

Methodology: A multifactorial intervention was implemented …

The Impact Of Virtual Discharge Interventions Compared To Traditional Methods On Adult Patient Population Readmission Rates: An Integrative Review, Tiffany Providence, Carrie Brooks, Nannono Kayondo, Courteney Lovell, Alice Smith

Master's Projects

Hospital readmissions are a persistent quality and cost burden to the healthcare system, prompting evaluation of modern strategies to strengthen transitional care. This integrative review synthesized findings from thirteen studies published between 2011 and 2025 to assess the effectiveness of virtual discharge interventions in reducing readmission rates among adult patients. Virtual discharge interventions included programs utilizing technology, such as phone calls, video visits, apps, or remote monitoring, to help patients understand their care and improve positive outcomes. Many of these studies showed that virtual support can reduce hospital readmissions, especially for people with heart failure. Some programs also improved patients’ …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Standardizing Ascitic Fluid Panel To Improve Outcomes In A Large State Hospital, Yimei Zhang

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase provider compliance with evidence-based, hepatology-recommended ascitic fluid studies among inpatient providers from a baseline of 50% to 60% within five months through electronic health record (EHR) standardization.

Background: Delayed or incomplete ascitic fluid analysis can increase the risk of preventable complications. Workflow variability and non-standardized ordering practices contributed to inconsistent adherence to evidence-based recommendations.

Methodology: Using the Institute for Healthcare Improvement (IHI) Model for Improvement with Plan–Do–Study–Act (PDSA) cycles, two paracentesis workflows were redesigned. For the Mobile Procedure Team, a standardized ascitic fluid panel with six defaulted, evidence-based tests …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

The Unacknowledged Challenge Of Moral Distress For Nurse Academics, Adam Burston, Glenna Mae Guiriba, Meena Gupta, Sara Bayes

Research outputs 2022 to 2026

The pluralistic nature of healthcare presents nurses with situations challenging their moral values which nurses must navigate. Challenges to moral values can result in the experience of moral distress, a problem that is common within the clinical nursing context. Moral distress is a known and well-researched phenomenon within nursing and has long contributed to detrimental effects such as frustration, anger, anxiety, decreased job satisfaction, burnout and ultimately attrition. However, despite extensive research in clinical environments, minimal research exists detailing this concept within the context of nursing academics and educators. Nurses can experience moral distress if they are in or exposed …

Facilitating Timely Hospice Referrals Using A Screening Toolkit In A Rural Hospital: A Quality Improvement Initiative, Jessica Muse

Doctoral Projects

End of life care is often a difficult time for patients, families, and caregivers. Hospice is a valuable resource for individuals who are considered terminally ill and have a life expectancy of six months or less. Many patients who are near the end present to acute care settings for treatment needs. While there are several clinical indicators that may suggest hospice care is the best plan of care for a patient, identifying hospice appropriate patients can be difficult in an acute care setting and there are currently no numerical assessment tools available in the literature that provides a quick reference …

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Implementation Of Asynchronous Mentor Education Modules To Improve Mentoring Competency, Elvira Sayfutdinova

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Structured mentorship supports new CRNAs as they transition to practice, fostering confidence, job satisfaction, and professional growth. The WashU Medicine Department of Anesthesiology (WUDA) launched a CRNA Mentorship Program in 2022, but it lacked standardized mentor education, leading to inconsistent mentor preparation and variable mentoring practices.

Review of Literature Findings: Structured mentor education improves mentoring competency across healthcare settings, yet the literature specific to CRNAs remains limited. Asynchronous, self-paced formats reduce barriers to participation for busy clinicians, but no prior study has evaluated a fully asynchronous, prerecorded mentor-education format for CRNAs.

Methods: This pre-/post quality improvement (QI) …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …

Implementation Of A Learning Module To Reduce Advanced Practice Provider Preceptor Burden, Michelle Bloom

Doctor of Nursing Practice (DNP) Student Projects

The transition of advanced practice providers (APPs) from student to provider, or from an experienced provider to a new organization or location, has been identified as a high-stress period with potential turnover for new-hire APPs. APP preceptors play a key role in this transition. Limited time to teach during the clinical day and a limited knowledge base among new hires were two of many factors associated with increased preceptor burden. A brief online educational module that provided pre-clinical, organization-specific education was proposed to improve new-hire APPs’ knowledge base and reduce preceptor burden, among APP preceptors working in a 36-bed surgical/burn/trauma …

Reimagining Clinical Education: Interprofessional Simulation And Clinical Skill Readiness In Nursing And Occupational Therapy Curricula, Gretchen Johnson, Linda Barnett, Lori Aaron-Brija, Emily Berkowitz

Internet Journal of Allied Health Sciences and Practice

Purpose: As the healthcare landscape evolves, education for health professionals must prepare future practitioners to meet emerging challenges and navigate diverse care settings. Integrating interprofessional education (IPE) opportunities within healthcare curricula supports the development of essential clinical skill competencies and collaboration across multiple disciplines. The Clinical Skill Readiness interprofessional model prepares students for successful clinical rotations by integrating assessment and skill development. Students develop vital interprofessional skills, with specific emphasis on communication, professionalism, and role clarity, all of which are essential for effective practice in a collaborative clinical setting. Methods: Nursing and occupational therapy students participated in timed treatment sessions …