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 …

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 …

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 …

Reducing Live Discharges Using A Tiered Protocol In A Rural Hospice: A Quality Improvement Project, Jemma Lowak

Doctor of Nursing Practice Final Project Abstract

Purpose: To reduce 30-day caregiver-driven hospice revocations by implementing a tiered post-admission nursing visit protocol based on caregiver preparedness. Background: Caregiver distress and inadequate support contribute to hospice revocations and interruptions in care. Increased nursing contact during the first week of enrollment may improve caregiver preparedness and reduce crisis-driven hospitalizations. Methodology: An eight-week quality improvement project using the Plan-Do-Study-Act framework was implemented at a rural hospice agency. Caregivers completed a Caregiver Preparedness Survey to assign preparedness tiers and guide additional nursing visits during the first week. Process measures included survey completion and protocol adherence. Outcome measures included caregiver preparedness and …

Improving Cpr Quality In The Emergency Department By Implementing Data Driven Debriefs, Alyssa M. Hughes

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of the quality improvement project was to evaluate the effectiveness of implementing a data driven debrief tool to improve the average compressions in target in adult cardio-pulmonary resuscitation (CPR) events.

Results

In FY23 prior to implementation the average compressions in target was only 1.65%. During the implementation phase of the project the average compressions in target reached 41% (n=3). In addition, the staff provided positive feedback regarding the tool and the integration in the workflow.

Background

The project was completed in a tertiary academic medical center emergency room. All adult CPR events within the emergency department utilizing …

Improving Response To Patient Alarms And Reducing Alarm Fatigue By Implementing An Alarm Fatigue Bundle Protocol In An Intermediate Care Unit At A Small Public Hospital, Christina Galvan

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to reduce alarm fatigue by implementing an alarm fatigue bundle protocol in an Intermediate Medical Unit (IMU) at a mall public hospital in Houston, Texas. The project aimed to achieve 80% compliance with daily electrode changes, improve alarm response times by 10%, reduce telemetry technician calls by 15%, and reduce alarm fatigue levels by 20%.

Background: Frequent non-actionable alarms can lead to desensitization, delayed responses, and missed alarms.

Methodology: The Plan-Do-Study-Act (PDSA) Model guided implementation of the CEASE bundle, focusing on staff education and daily electrode changes. Daily audits assessed skin preparation and …

The Measles Serology Initiative: A Quality Improvement Intervention To Increase Provider Compliance With Rubeola Serology Screening, Erika S. Martinez

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to increase provider adherence to Rubeola IgG serology screening during prenatal visits at an outpatient women’s health clinic by 10% from a baseline adherence rate of 63.3%.

Background

Rubeola remains a highly contagious viral infection that poses health risks for nonimmune pregnant patients and their newborns. With increasing Rubeola cases and the importance of identifying immunity status during pregnancy, consistent prenatal screening practices are essential. Baseline data demonstrated inconsistent adherence to Rubeola IgG screening recommendations, highlighting the need for workflow interventions to improve provider compliance.

Methodology

A pre-post QI design …

Reducing Potentially Preventable Emergency Department Visits (Ppvs) Through A Telehealth Intervention In Children With Asthma Within A Managed Care Organization (Mco), Renee A. Roker

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma …

Reducing The Readmission Rate In Adult Psychiatric Patients With Bipolar Disorder, Jessica Nwokocha

Doctor of Nursing Practice Final Project Abstract

Purpose: 

The goal of this project was to reduce the readmission rate among patients by improving attendance to the post-hospitalization program through phone call reminders.

Background: 

Review of baseline data at the project site showed a 60% increase in the readmission rate among adult patients with bipolar disorder in May 2025. This analysis demonstrates that the readmission rate in psychiatric hospitals continues to be an issue.

Methodology: 

The project utilized the Plan-Do-Study-Act (PDSA) framework to guide implementation over a six-week period, with readmission rates monitored for a 30-day period. Data collected and tracked included patient attendance, completed phone calls, and …

Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

Implementation Of Phq-9 To Improve Depression Identification In Icu, Jenny C. Manoly Bsn, Rn

Doctor of Nursing Practice Final Project Abstract

PURPOSE This quality improvement project aimed to improve depression identification by screening 80% of eligible adults admitted to two heart failure intensive care units (ICU) using the Patient Health Questionnaire-9 (PHQ-9).

RESULTS Screening compliance increased from 42.1% to 85% by Week 13, exceeding the project goal. Of 101 patients screened, 16.8% screened positive for depression. Workflow changes, leadership support, and peer engagement improved compliance, though psychiatric referrals remained inconsistent.

BACKGROUND Depression is common among critically ill patients but is frequently underrecognized because ICU care primarily focuses on physiologic stabilization. Existing admission screening was limited to suicide risk assessment, delaying identification …

Enhancing Heart Failure Transitional Care To Reduce 30-Day Readmission Rate, Thuy Nhu Uyen Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project is to reduce 30-day readmissions for adult patients with heart failure (HF) by implementing a standardized HF pathway beginning in the intensive care unit (ICU) and continuing through discharge.

Background: The project was implemented within a large healthcare organization in Northwest Houston, Texas.

Methodology: This project utilized a pre- and post-implementation design guided by the Plan-Do-Study-Act (PDSA) model. Eligible adult patients (≥18 years) with a primary or secondary HF diagnosis were identified during March 2026. The My Pathway to Wellness HF education pathway was initiated at the time of ICU downgrade …

Improving Adherence To Regulatory Standards In A Medicaid-Funded Intellectual And Developmental Disability Setting Through Evidence-Based Nursing Policy Implementation, Waveney R. Lagrone, Ut Health Houston Cizik School Of Nursing

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to improve adherence to health and safety regulatory requirements by implementing an evidence-based nursing policy framework to strengthen documentation consistency and clinical practice in a Medicaid-funded Home and Community-Based Services (HCS) program serving adults with intellectual and developmental disabilities.

Background: A baseline review (January–June 2025) identified documentation and regulatory compliance gaps, including three falls, eight psychotropic medication changes requiring follow-up, two emergency department visits or hospitalizations, and five late or incomplete Comprehensive Nursing Assessments (CNAs), highlighting the need for standardized nursing policies.

Methodology: Guided by the Model for Improvement using Plan-Do-Study-Act …

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Integrating Music Therapy Into Post-Surgical Care: A Quality Improvement Strategy For Reducing Post-Operative Anxiety, Yosdania Hernandez Benitez

Doctor of Nursing Practice Final Project Abstract

Integrating Music Therapy into Post-Surgical Care: A Quality Improvement Strategy for Reducing Post-Operative Anxiety

Purpose

This quality improvement (QI) project aimed to reduce postoperative anxiety among adult patients after general surgery in the post-anesthesia care unit (PACU) by 30% using nurse-led music therapy in an ambulatory surgical center.

Results

Mean VAS-A scores decreased from 6.9 (SD = 0.5) pre-intervention to 4.0 (SD = 0.5) post-intervention, representing a 2.9-point (41.9%) reduction in anxiety and exceeding the project's target of 30%. Nurse adherence to the intervention protocol was 100%, and the mean patient satisfaction score was 4.6/5.0. All 100 patients completed both …

Standardizing Safe Sleep Education In An Outpatient Pediatric Cardiology Clinic: A Quality Improvement Initiative, Casey Hrbacek

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to increase the reliability of standardized, evidence-based safe sleep education for caregivers of infants aged 0–12 months in an outpatient pediatric cardiology clinic within an academic health system

Background: Sleep-related death is the leading cause of death among infants aged 1-11 months and the third leading cause of infant mortality overall and is closely associated with modifiable unsafe sleep practices. Safe sleep education is delivered inconsistently across settings, particularly during the hospital-to-home transition for infants with complex cardiac disease.

Methodology: A caregiver-completed Safe Sleep Screening Checklist was embedded into clinic workflow. A medical …

Implementation Of A Perioperative Normothermia Bundle To Improve Temperature Maintenance In Adult Colorectal And Hysterectomy Surgical Patients: A Quality Improvement Project, Jessica L. Salisbury

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project evaluated the effectiveness of an evidence based perioperative normothermia bundle in improving maintenance of normothermia among adult colorectal and hysterectomy surgical patients at a community hospital. The project aimed to reduce perioperative hypothermia through standardized warming interventions while improving compliance with evidence based practice.

Background

Preventable perioperative hypothermia increases postoperative complications, prompting implementation of an evidence based warming bundle to maintain intraoperative temperatures 36 Celsius or greater.

Methodology

Using the Iowa Model, an interdisciplinary team implemented an evidence based perioperative normothermia bundle incorporating multimodal warming, temperature monitoring, and staff education. Compliance and temperature outcomes were …

Implementing A Professional Wellness Session To Foster Improvement In Oncology Nurse Retention And Well-Being, Connie Tran

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement chaplain-led professional wellness sessions to improve the well-being of nurses on an oncology pilot unit.  Aims were to increase nurse retention by 5%, decrease staff absenteeism by 3%, and improve Perceived Stress Scale (PSS) scores by 10%, and Professional Quality of Life (ProQOL) scores by 10% from baseline.

Background

The emotionally taxing nature of oncology patient care creates a high-pressure environment, which can lead to turnover. Literature has shown that allowing staff to pray, debrief and engage in peer support groups to discuss work-related stressful encounters reduces stress …

Improving Physiologic Monitoring Adherence During Behavioral Emergencty Sedation In A Prehospital Ems System, Jared Aucoin

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:

This quality improvement (QI) project evaluated whether provider education and standardized documentation improved adherence to evidence-based physiologic monitoring during behavioral emergency sedation in a prehospital EMS setting.

Background:

Behavioral emergencies are common and often require rapid chemical sedation, with risks of hypoxia, hypercapnia, and cardiovascular instability. At baseline, inconsistent adherence to recommended monitoring and documentation of end-tidal carbon dioxide (EtCO₂) and pulse oximetry (SpO₂) presented an opportunity to improve patient safety.

Methodology:

This QI project educated current adult behavioral emergency protocol in a prehospital EMS setting, re-emphasizing standardized documentation and evidence-based monitoring practices. Utilizing Plan-Do-Study-Act (PDSA) through pre- …

Enhancing Care Coordination Between The Same Day Clinic (Sdc) And Primary Care Group (Pcg) By Facilitating Care Establishment With A Primary Care Provider (Pcp), Saba Zabarah

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this Quality Improvement (QI) project was to connect patients to a Primary Care Provider (PCP). The specific aim was to increase by 25% the percentage of patients without a PCP who established care with a PCP within 30 days of visiting the Same Day Clinic (SDC).

BACKGROUND

The SDC provides episodic care for acute illness, making it difficult to coordinate care for patients who do not have a PCP and require follow-up. The project was implemented in an outpatient clinic that is connected to a larger primary care group in Houston, Texas.

METHODOLOGY

The intervention included …

Improving Nursing Compliance With Pressure Injury Prevention In Postoperative Patients In The Cardiovascular Intensive Care Unit, Chingyi Lam

Doctor of Nursing Practice Final Project Abstract

Pressure injuries acquired in the hospital continue to be a major concern in patient safety among critically ill populations. The purpose of the quality improvement project was to improve nursing compliance with pressure injury prevention strategies among postoperative patients in a cardiovascular intensive care unit (CVICU). Patients who undergo cardiovascular surgery are at a high risk of developing pressure injuries due to immobility, sedation, vasopressors, and prolonged positioning on their backs. The quality improvement project was carried out in a 37-bed CVICU using the Institute for Healthcare Improvement (IHI) Model for Improvement and Plan–Do–Study–Act (PDSA) cycles. Data on nursing repositioning …

Fall Prevention In A Medical Intermediate Care Unit (Mimu) Through Use Of A Collaborative Fall Bundle, Sara M. Jose

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This DNP project focused on reducing the fall rate in a medical intermediate care unit by half, from 1.81 falls per 1000 patient days to 0.91 falls per 1000 patient days.

BACKGROUND

The number of patient falls poses a significant concern in a medical intermediate care unit. The fall rate goal is zero.

METHODOLOGY

The Collaborative Fall Bundle includes implementing the Fall TIPS Toolkit, an 11 x 17 bedside poster informing patients and staff of their fall risk factors and interventions to counteract; an alarm buddy system pairing two nurses to answer each other's call lights and assist with …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Emma Jade Mowery, Justin D. Ruiz

Doctor of Nursing Practice Final Project Abstract

Purpose: To investigate the impact of implementing use of the Smiling Mind app (a free and easily accessed mobile application that teaches mindfulness skills) in inpatient psychiatric nurses. The aims: A 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background: Workplace stressors experienced by psychiatric nurses include high patient acuity, emotional strain, environmental factors, and new policies. Unmanaged stress can harm nurse's well being and affect quality of care.

Methodology: Using a pre-post implementation design, 7 dayshift and 10 night-shift nurses used the Smiling Mind app for 10 weeks. Perceived stress (PSS-10) and workplace satisfaction (WPS) …

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …

Improving Postoperative Handoff For Placenta Accreta: Implementing A Structured Handoff Communication Tool, Isabelle L. Gerrard

Doctor of Nursing Practice Final Project Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology …