Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Improving Therapeutic Communication Between Patients And Nurses Using The Commit To Sit Method In The Obgyn/Postpartum/Mother-Baby Unit, Simisola A. Shodunke

Doctor of Nursing Practice Final Project Abstract

Purpose

To improve patients’ perceptions of nurses by listening to their needs, helping nurses to engage with their patients therapeutically in the OBGYN/Postpartum/Mother-Baby unit. Aiming to increase patient satisfaction scores from 62.5% to 70% by December 2024 using the "Commit to Sit" method.

Background

The project was implemented in an OBGYN/Postpartum/Mother-Baby Unit, addressing the concerns of the patient’s perception of nurses not listening and addressing their needs which has contributed to a decline in patient satisfaction scores.

Methodology

The Plan-Do-Study-Act (PDSA) model was used. Nurses were trained to sit at eye level with patients for 3–5 minutes per shift. Data …

Implementing Lean Methodology To Decrease Wait Times In A Psychiatric Emergency Department, Kristina S. Baxter

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to implement Lean strategies to optimize the intake process in a psychiatric emergency department, thereby reducing patient wait times, minimizing left-without-being-seen (LWBS) occurrences, and improving access to timely psychiatric care.

Background

The project was conducted in a hospital-based psychiatric emergency department in Southeast Texas, serving adults and children six years and older.

Methodology

Lean methodology and PDSA cycles were employed to refine the intake process and eliminate inefficiencies. Key interventions included patient transport by technicians to minimize delays, using tele-clinicians for assessments to reduce staff burden, and restructuring nursing assessments to prioritize telehealth consultations …

Implementation Of Nurse-Driven Oral Care For Inpatient Oncology Patients Receiving Chemotherapy To Reduce Mucosal Barrier Injury Associated Bloodstream Infections, Ariana Av Allen

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this project was to reduce unit CLABSI rates by targeting mucosal barrier injury associated bloodstream infections through implementation of nurse-driven diligent oral care for all inpatient oncology patients receiving chemotherapy.

BACKGROUND

The project was implemented on a 23-bed inpatient oncology unit in a county, safety-net hospital in north Texas.

METHODOLOGY

The project utilized the PDSA framework for implementing nurse-driven oral care for all inpatient oncology patients receiving chemotherapy. Staff and patients were educated on the ideal frequency and methods of performing oral care during the project. Patients were provided unit-supplied oral hygiene items on admission. Nursing …

Improving The Patient Care Experience In Residential Eating Disorder Treatment: A Quality Improvement Project, Paige H. Nguyen

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project was to implement structured biweekly patient check-ins at a residential treatment facility for eating disorders. This project was intended to increase the patient care satisfaction scores on patient discharge surveys from under 80% to over 90%.

Background

The project was implemented at a 12-bed residential treatment facility for adolescents and adults diagnosed with eating disorders located in Cypress, Texas.

Methodology

The Baird 2007 concept of scripting during rounds was utilized as well as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) patient care experience survey questions when creating the script used during …

Qi Charter: A Risk Assessment Protocol To Improve The Management Of Aggression And Violence In A Psychiatric Setting, Juliette N. Bateki

Doctor of Nursing Practice Final Project Abstract

Background: Patient care and staff safety are considered when determining aggressiveness and violence in psychiatric settings. However, structured violence risk assessment tools like the Broset Violence Checklist (BVC) are difficult to integrate into clinical practice when utilizing the prediction of violent behavior that allows healthcare professionals to intervene proactively. The BVC has been promising at predicting violence, but implementation needs to be done correctly, with proper training and integration into the routine workflow.

Purpose: This project aims to implement the BVC as a violence and aggression predictive tool within a psychiatric intensive care unit. It aims to increase violence prediction …

Reducing Falls In The Emergency Department By Implementing A Virtual Tele Sitter, Danette Riherd

Doctor of Nursing Practice Final Project Abstract

Purpose: This Quality Improvement project focused on evaluating the effectiveness of a portable tele-sitter device in reducing fall rates in the emergency department from February 10, 2025 to May 1, 2025. Background: This project was implemented in a 20-bed emergency department within a hospital system located within the suburbs of a major United States city. Methodology: Baseline data was collected prior to project implementation. Data collected during the implementation period was then collected and compared to baseline data to evaluate whether the intervention effectively reduced falls in the emergency department. Results: Post implementation descriptive statistics indicated a 43% reduction in …

Produce Prescription Policy Project For The Securement Of A Grant To Address Food Insecurity For Low-Income Type Ii Diabetic Patients, Isabel D. Garcia-Gallegos

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This policy-focused Doctor of Nursing Practice (DNP) quality improvement (QI) project aims to secure grant funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) to implement a produce prescription program at a community clinic in Texas. The program targets low-income adults (18-65 years) with type II diabetes who experience food insecurity and are affected by Medicaid non-expansion.

BACKGROUND

Texas’ decision not to expand Medicaid has exacerbated food insecurity among low-income residents, particularly those managing type II diabetes. This decision creates a healthcare policy gap that this project aims to address with a food-as-medicine program.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) …

Improving Scheduling Accuracy Through A Standardized Dermatology Consult Order, Deion Whitehead

Doctor of Nursing Practice Final Project Abstract

Improving Scheduling Accuracy through a Standardized Dermatology Consult Order

PURPOSE

This quality improvement (QI) project aimed to improve scheduling accuracy and reduce referral errors in a dermatology department by implementing a standardized consult order form within the electronic health record (EHR).

BACKGROUND

Inaccurate dermatology referrals led to misdirected consultations, increased reconsultation rates, and treatment delays. A lack of standardization contributed to inefficiencies, impacting patient outcomes and workflow. Implementing a structured referral form aimed to enhance triaging accuracy and improve timely dermatologic care.

METHODOLOGY

A pre- and post-intervention design was used. An eight-week baseline data collection period (n=288) assessed existing referral …

Managing Cardiovascular Health In The Hispanic Community: Implementing The Share Approach At A Primary Care Clinic, Jacqueline Molina

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this project was to determine the effectiveness of the Seek, Help, Assess, Reach, and Evaluate (SHARE) approach in the management of cardiovascular disease (CVD) risk factors in the Hispanic population at a primary care clinic while improving health literacy. The aim was that by February 2025, Hispanic patients at the clinic would achieve a 10% reduction in CVD risk factors.

Background: The project was implemented at a small private primary care clinic in Texas. CVD risk factors prevalent include hypertension, mixed hyperlipidemia, and diabetes mellitus.

Methodology: Before implementation provider and staff were educated on the SHARE …

Improving Glycemic Management Of The Inpatient Adult With Diabetes Mellitus Through The Development Of A Bedside Decision Support Tool For The Medical-Surgical Floor Nurse, Robin Deville Guidry

Doctor of Nursing Practice Final Project Abstract

Background: Uncontrolled blood sugar can lead to adverse events in the adult perioperative inpatient population. Hyperglycemia can lead to diabetic ketoacidosis (DKA), infection, delayed wound healing, increased hospital lengths of stay (LOS), and even mortality. Uncontrolled hypoglycemia can result in confusion, seizures, and even coma.

Purpose: This single-PDSA-cycle quality improvement project aimed to prevent and/or minimize the duration of uncontrolled blood sugar in the peri-operative adult inpatient. The primary objective was to reduce the incidence of hyperglycemia defined as >180 mg/dL by at least 10% from baseline with a goal rate of less than 25%, while also reducing the incidence …

Surgical Specimen Management Protocols In The Pre-Analytical Phase, Jordan L. Hall

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to decrease surgical specimen errors during the pre-analytical phase at the target institution by 50% by January 2025 by developing best practices for specimen labeling and documentation.

Background

The QI project was implemented within a level two trauma center with a 24-suite operating room (OR) in The Woodlands, Texas, which provides care across all surgical specialties except ophthalmology.

Methodology

The target institution changed from nurse-hand-written specimen labels and requisition sheets to electronic medical record (EMR) generated specimen labels and requisition sheets. The change was congruent with the target institution’s shift to a new …

Reducing Hapis In The Icu With A Turn Team, Taylor Guadiz

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose: The purpose of this quality improvement (QI) project was to decrease hospital-acquired pressure injury (HAPI) rates within an Intensive Care Unit (ICU) by implementing a two-nurse turning and repositioning schedule.

Background: The QI project was implemented in a 24-bed Medical-Surgical ICU at a for-profit community hospital in Northwest Houston, Texas, in the United States of America. The project was developed and initiated at the project site because there was an increase in the HAPI rate above the organization’s target rate of zero.

Methodology: Baseline HAPI rates and turning charting compliance were obtained. A baseline Likert scale survey was …

Improving Nursing Processes To Reduce Hospital-Acquired Venous Thromboembolism In Adult Surgical Patients, Stephanie Masson

Doctor of Nursing Practice Final Project Abstract

INTRODUCTION Hospital-acquired venous thromboembolism (VTE) is a preventable outcome that can increase morbidity and mortality. This quality improvement (QI) project aimed to evaluate and improve the nursing prophylaxis processes to reduce the VTE outcome. The project was implemented in a Level I Trauma Center in the Texas Medical Center, Houston, Texas.

METHODOLOGY The QI project was structured using the Lean Six Sigma methodology. Data was collected and analyzed from reports built within the electronic medical record (EMR). A multidisciplinary team evaluated the current state of clinical practice and the electronic workflow for mechanical VTE prophylaxis. The team worked to redesign …

Milk Is Medicine: Early Exposure To Mother's Milk With Oral Immune Therapy, Kristina N. Tucker

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to improve early Oral Immune Therapy (OIT) initiation by implementing a nursing intervention bundle for infants weighing less than 1500 grams at birth.

BACKGROUND Premature infants face nutritional challenges due to immature digestive systems and delayed oral feeding. Drops of maternal breast milk in the buccal mucosa as OIT expose infants to immune factors, positively impacting their microbiome, supports immune function and enhances health outcomes for very low birth weight (VLBW) infants.

METHODOLOGY Using the Institute for Healthcare Improvement (IHI) Model for Improvement with a multi-disciplinary team, interventions included provision of a colostrum …

Improving No-Show Rates At A Federally Qualified Health Center (Fqhc), Christelle M. Hernandez

Doctor of Nursing Practice Final Project Abstract

The purpose of this quality improvement project was to improve no-show and missed appointments among adult patients at a federally qualified health center (FQHC) located in greater Houston, TX in the adult medicine department. This intervention aimed to decrease no-show and missed appointment rates to 20% or below to improve productivity, yield less staff burnout, and improve patient healthcare outcomes. A 4-week initiative was completed to identity top reasons and to reduce no-shows. A no-show outreach initiative was developed and used in the electronic health record (EHR) and targeted to patients identified as most likely to not show cancel an …

Implementing A Social Determinants Of Health Screening Tool To Improve Appointment Attendance In Primary Care Practice, Phuong Truong

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement a screening tool to identify the social determinants of health (SDoH) that may prevent patients from attending their scheduled appointment and to improve patient’s attendance adherence. The project was conducted at a primary care clinic in La Grange, Texas

Background

Missed appointments negatively impact a person’s health status. Missed appointments have been associated with a variety of social factors such as transportation access, socioeconomic status, health literacy, and insurance status.

Methodology

The Logic Model and PDSA model for improvement were used to guide this project. The project utilized …

Improving Bone Density Screening Rates In Patients At Risk For Falls Using Chart Screening And Protocol Orders, Lona Winnegan

Doctor of Nursing Practice Final Project Abstract

PURPOSE: This quality improvement project’s purpose was to identify those at risk for low bone density from a clinic’s population of positive fall risk screenings, to encourage bone density screening and identify those who would benefit from bone health optimization.

BACKGROUND: Spine fractures result in serious morbidity and mortality. The type of treatment options available for spine fractures and the timing of intervention is affected by the patient’s bone density.

METHODOLOGY: The aim was for patients diagnosed with spine fractures and degenerative spine conditions to be screened for osteoporosis/osteopenia according to screening recommendation standards. The goals were to maintain …

Using Musical Interventions As A Non-Pharmacological Strategy To Improve Chronic Pain Levels And Satisfaction Among Patients With Sickle Cell Disease, Fredeline Metellus

Doctor of Nursing Practice Final Project Abstract

Background

Sickle Cell Disease (SCD) is a chronic, inherited blood disorder characterized by severe pain episodes that are often poorly managed with standard pharmacological treatments. In response to patient dissatisfaction with pain control and the desire for holistic alternatives, this quality improvement project explored music therapy as a non-pharmacological pain management strategy.

Purpose

The primary aim was to reduce chronic pain by at least 20% and improve patient satisfaction with pain management among adults with SCD using a structured musical intervention.

Methodology

This project was implemented at a comprehensive outpatient SCD clinic using the Plan-Do-Study-Act (PDSA) model. Five adult patients …

Strategies To Improve Nurse Documentation Compliance And Confidence In The Delivery Of Preprocedural Education, Danielle A. Burris

Doctor of Nursing Practice Final Project Abstract

Strategies to Improve Nurse Documentation Compliance and Confidence in the Delivery of Preprocedural Education:

Abstract

Introduction:This project aimed to implement tools to improve preprocedural education compliance between nurses and patients in an interventional radiology department. The secondary aim was increasing staff confidence in providing education, reducing the potential for avoidable harm and adverse procedural-related outcomes. The project was implemented within an interventional radiology department of a healthcare system in the Texas Medical Center, Houston, Texas.

Methodology: The project utilized the Model for Improvement and followed the steps of the Plan-Do-Study-Act cycle to implement change. Strategies included checklists, reminder tools, …

Improving Medication Adherence For Post-Operative Pediatric Patients With Spanish-Speaking Caregivers Using A Written Medication Action Plan, Carissa Vicente

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aims to improve written discharge education, medication adherence for pediatric patients, and medication education retention for Spanish-speaking caregivers.

BACKGROUND

The project was implemented in a children’s hospital in the Pediatric Post-Anesthesia Care Unit. The discharge process for post-operative pediatric patients lacked appropriate written medication education for Spanish-speaking families, placing patients at an increased risk for improper medication use.

METHODOLOGY

A quality improvement method utilizing Plan-Do-Study-Act (PDSA) cycles was used for implementation, with three cycles completed. A written Spanish-translation medication action plan (MAP) was implemented during discharge for Spanish-speaking caregivers, including adaptions to an electronic health record version …

Integrating Mental Health And Substance Use Treatment Using The Integrated Care Model: Policy Analysis, Victoria Reis

Doctor of Nursing Practice Final Project Abstract

Purpose of Statement

Policy analysis evaluates the integration of mental health services into substance use treatment, particularly for co-occurring disorders. It identifies gaps in existing policies and offers recommendations to enhance access, coordination, and effectiveness of integrated care.

Background

Integrating mental health services is crucial due to the high prevalence of co-occurring disorders. However, the fragmented treatment landscape leads to poor patient outcomes and rising healthcare costs. Policies such as the 21st Century Cures Act and Texas House Bill 4 provide a framework for improvement, but significant gaps hinder effective integrated care.

Methodology

Using the Bardach Policy Analysis Framework, this …

The Prevalence Of Suicide And Suicidal Ideation In Adult Oncology Patients, Mutiat Bamiloshin

Doctor of Nursing Practice Final Project Abstract

Objective

The aim of this quality improvement initiative is to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) to enhance the early detection of suicide risk among adult oncology patients and to facilitate timely referrals for mental health support.

Background

Adult cancer patients experience substantial psychological distress due to the challenges related to their diagnoses and treatments, significantly increasing their suicide risk. The lack of routine suicide screenings in oncology settings impedes the early identification of at-risk patients, necessitating evidence-based approaches.

Methodology

The project involved 50 adult oncology patients and was conducted at a hospital in Texas over eight weeks. Weekly …

Standardizing Warming Measures For Surgical Patients, Brachelle Williams, Bsn, Rn

Doctor of Nursing Practice Final Project Abstract

Purpose

The quality improvement project aimed to address the risk of perioperative hypothermia in surgical patients by standardizing warming measures at a Houston, Texas boutique hospitals surgical department. The focus was to achieve normothermia (≥ 96.8°F) within 10 minutes of PACU arrival and increase patient satisfaction by at least 50% through the implementation of a forced air warming system.

Background

Maintaining normothermia is crucial for surgical patients, as hypothermia can lead to delayed recovery and increased postoperative discomfort. The Houston’s boutique hospital previously solely relied on warm blankets, resulting in inconsistent temperature management.

Methodology

The Plan-Do-Study-Act (PDSA) model guided the …

Student Expectations And Outcomes In Virtual Vs In-Person Interprofessional Simulations: A Qualitative Analysis, Padmavathy Ramaswamy, Abbey M Bachmann, Tiffany Champagne-Langabeer, Chasisty L Gilder, Samuel E Neher, Jennifer L Swails

Faculty, Staff and Student Publications

Background: Health-related programs frequently integrate interprofessional education (IPE) into their training. The COVID-19 pandemic transitioned many IPE programs online, making it essential to assess student expectations and perceived learning outcomes across virtual simulations and in-person settings.

Methods: This qualitative study compared student expectations and self-reported outcomes across in-person and virtual case scenarios at a Texas health science center. Responses to open-ended questions from two data collection periods were analyzed using inductive coding and thematic analysis.

Results: Students from nursing, medicine, dentistry, public health, and informatics participated in each group. Three major themes emerged from this study: communication, teamwork, and …

Mindfulness-Based Interventions And Stress, Jacqueline Parker

Doctor of Nursing Practice Final Project Abstract

Purpose: Stress within the nursing profession is a substantial issue. Staff shortages, poor leadership, and even COVID-19 have contributed to an increase in nursing stress. Stress can negatively impact a nurse’s ability to perform at an optimal level while at work. The purpose of this project is to reduce perceived stress by implementing mindfulness-based interventions (MBI).

Background: The project was implemented in a twenty-three-bed unit that cares for the post operative pediatric population in Houston, Texas.

Methodology: A series of in-person and virtual educational lessons (eight total) on MBIs (with flyers) were implemented throughout this project. The Perceived Stress Scale …

Dietary Program For The Reduction Of Type 2 Diabetes Prevalence In A South Texas Border Region, Siddiqua Noor

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to create a culturally sensitive dietary program template to serve as a guide to offer healthier food alternatives to reduce the incidence of type 2 diabetes while not compromising on their Hispanic heritage.

BACKGROUND This project was implemented in a South Texas border community which has nearly twice the national average of Type 2 Diabetes Mellitus, which presents a significant public health challenge.

METHODOLOGY The project followed the Plan-Do-Study-Act cycle and incorporated the Health Belief Model. A dietary pamphlet featuring local culturally relevant food options was developed. The material was presented at two …

Enhancing Medication Storage Protocols For Safety Optimization In Cardiac Care Unit Inpatients, Baothu Nguyen

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to enhance medication security in the cardiac care unit by implementing a standardized storage protocol to reduce unsecured medications by 20% by December 6, 2024, following a 93-day implementation period. Additionally, the project sought to achieve 100% staff competency in the protocol by September 30, 2024.

Background: Unsecured medications pose significant patient safety risks, including unauthorized access, incorrect administration, and treatment delays. This project aligned with the Patient-Centered Caritas Model and addressed compliance deficiencies identified by the Joint Commission and the hospital’s quality control team.

Methodology: A Plan-Do-Study-Act (PDSA) framework guided the project, integrating …

Improving Pituitary Lab Evaluation Following Radiation Therapy For Sinonasal/Nasopharyngeal Malignancies, Brandon M. Mcanulty, Msn, Aprn, Agacnp-Bc, Rnfa

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this QI project was to create a standardized order set aiming to increase consistency in lab work completion for improved monitoring of pituitary dysfunction in patients diagnosed with sinonasal and nasopharyngeal malignancies. Background: Radiation therapy is important in the treatment plan for this population. The hypothalamic-pituitary axis is frequently included within the radiation field, contributing to radiation induced pituitary dysfunction. There is no established order set for outpatient pituitary lab monitoring at the organization. Methods: Established order sets were modified to include pituitary labs to create a centralized ordering workflow among providers from all three departments …

Iimproving Discharges Within The Monitored Pod Units Of A Regional Health Center In Bryan, Tx, Paul R. Russell Iii

Doctor of Nursing Practice Final Project Abstract

IMPROVING DISCHARGE RATES WITHIN THE MONITORED POD UNITS OF A REGIONAL HEALTH CENTER IN BRYAN, TX

Purpose

The purpose of this scholarly project was to improve discharges by 11:00 a.m. within the Monitored Pod Units located in a regional hospital in Bryan, Texas.

Background

The current discharge rate by 1100 for the monitored pod units at the regional health center was below the health system goal of 50%. The impacts of delayed discharges are broad and can be seen throughout the regional health center. Delayed discharges have a direct effect on staff satisfaction, patient satisfaction, and decreased revenue.

Methodology

This …