Nursing Commons^™

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

Doctor of Nursing Practice Projects

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

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

Streamlining A Faculty Simulation Educational Program To Improve Faculty Confidence And Proficiency, Megan Lannom

Doctor of Nursing Practice Projects

Simulation-based education is essential to clinical preparedness in nursing. This quality improvement project aimed to enhance nursing faculty confidence and proficiency through a structured training program. Faculty at a private university participated in training grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards of Best Practice, addressing core components including facilitation, prebriefing, debriefing, evaluation, and terminology. A mixed-methods, quasi-experimental design guided the project. Data analysis ensured methodological rigor through appropriate statistical and qualitative strategies. The Simulation Educator Needs Assessment Tool (SENAT) was administered pre- and post-intervention with thirteen faculty participants. Descriptive statistics summarized demographic …

Policy Project Optimizing Post-Discharge Process: Creating A Policy For Improved Efficiency, Deniece S. Parkinson

Doctor of Nursing Practice Projects

The immediate period following hospital discharge is critical for ensuring continuity of care and reducing adverse outcomes. However, the current post-discharge processes utilized in community care could be more effective. The fragmented approach involves multiple individuals, often leading to patient confusion, missed visits, and inefficient communication. These issues contribute to high rehospitalization rates, frequent emergency room visits, and increased healthcare costs. This project proposes a streamlined post-discharge policy managed by a centralized team of one provider and a Nurse Care Manager. The policy aims to refine the processes currently used in each market into a consolidated, well-defined care model to …

Quality Improvement Project Enhancing Patient Care In Nurse Practitioner Private Practices: A Train-The-Trainer Approach To Implementing Evidence-Based Chronic Mental Disease Management Interventions, Chioma Waters

Doctor of Nursing Practice Projects

Chronic mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are frequently treated by nurse practitioners (NPs) in outpatient private practices. Despite the evidence supporting Cognitive Behavioral Therapy (CBT) as a first-line intervention, its utilization remains limited in NP settings, often due to lack of training and confidence. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether a structured train-the-trainer program could improve NP confidence in applying CBT in practice. Guided by the Iowa Model and Kotter’s 8-Step Change Model, this quality improvement project utilized a quasi-experimental, pre-post survey design to assess …

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 …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Nurses Confidence And Knowledge Improvement For Sleep In Sleep Hygiene Education, Rawda Nourain

Doctor of Nursing Practice Projects

The purpose of this DNP project was to increase the knowledge and self-confidence of nurses in relation to sleep hygiene practices for psychiatric patients to improve sleep quality and overall mental health. In this study, a pre- and post-intervention design was used for four nurses in a psychiatric unit. The intervention was comprised of teaching the patients about sleep hygiene practices, altering the environment (light and noise reduction), and using non-drug approaches. Knowledge assessments and self-confidence surveys were used to collect the data. All the participants were able to recall the correct sleep hygiene knowledge after the intervention, and all …

Quality Improvement Project Staff Development For Fall Prevention In Community Living Center, Morayo Olatunbosun

Doctor of Nursing Practice Projects

Falls among elderly residents in the community living center continue to be a serious public health concern, increasing mortality, morbidity, and healthcare costs. Despite existing prevention measures, fall-related incidence remains high. The purpose of this quality improvement project is to reduce fall rate in a community living center by implementing structured staff training. A facility needs assessment revealed gaps in fall prevention knowledge, inconsistent protocol use, and limited staff confidence in managing fall risks. In the methodology used to answer the PICOT question, the Donabedian Model guided structure, process, and outcome evaluation, while Kotter’s Change Model informed implementation strategies. The …

Quality Improvement Project Provider Burnout Related To Patient Satisfaction, Sherita Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Quality Improvement Project The Impact Of Weekly Reminders On Clinician Adherence To Standardized Order Sets, Blair Robillard

Doctor of Nursing Practice Projects

Clinical decision support tools are commonly utilized in clinical practice to assist with decision making and encourage use of evidence-based practices. This quality improvement (QI) project addressed the problem of inconsistent use of CDS tools in clinical practice. Specifically, this QI project addressed suboptimal adherence to standardized order sets (SOS) for congestive heart failure (CHF) treatment by hospitalist providers in an inpatient setting. The purpose of this QI project was to evaluate the impact of weekly educational reminder emails, known as nudges, on CHF SOS utilization over six weeks. A pre- and post-intervention design compared SOS usage rates before and …

Impact Of Nursing Burnout On Preceptors During The Transition Phase Of New Graduates Into The Workforce, Janessa Truss

Doctor of Nursing Practice Projects

There is a massive threat to healthcare systems posed by the growing burnout of inexperienced RNs working in practice transition to new graduate preceptors. Currently, this "Doctor of Nursing Practice (DNP) project" examines the role of the nurse in burnout within Long Term Acute Care (LTAC) facilities through the preceptorship. In the project, burnout factors and their effects on patient care and nursing workforce retention will be investigated, and interventions for burnout and its effects will develop. A mixed methods project involving qualitative and survey and interview analyses of five-year and older patients was performed. Burnout and job satisfaction were …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

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 …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie R. Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

Quality Improvement Project Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

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 …

Impact Of Hypertension Education On The Self-Efficacy Of Patients With Uncontrolled Hypertension, Sharita Thompson

Doctor of Nursing Practice Projects

Self-efficacy is an essential aspect of patients being able to manage their uncontrolled hypertension. While it is important to give patients medications for their hypertension, it is just as important to educate the patients about their disease process. Teaching patients risk factors, acceptable blood pressure readings, and signs/symptoms of the disease process can help with decreasing further harm that the disease can cause to the body. This quality improvement project aimed to close the knowledge gap and increase self-efficacy among adult individuals, ages 18-75, who have uncontrolled hypertension by generating data that shows that education on the disease process will …

Quality Improvement Project Enhancing Mental Health Clinic Practices: Increasing Healthcare Professionals' Knowledge And Self-Assurance In Opioid Abuse Screening Tools In Healthcare Professionals Treating Adolescents, Festus Obonna

Doctor of Nursing Practice Projects

This study aimed to address the psychiatric mental health nurse practitioner’s unfamiliarity and inadequate confidence in utilizing the CAGE-AID screening tool in detecting opioid use in adolescents undergoing treatment at a psychiatric mental health clinic. The goal was to find out how structured training affected providers' understanding of and confidence in using the screening tool. Eight psychiatric mental health nurse practitioners, participated in a quasi-experimental pre- and post-intervention design. Descriptive statistics, paired t-tests, and Cronbach's alpha reliability analysis were used to look at the data. There was a significant improvement in providers' self-reported familiarity, confidence, and efficacy in using the …

Quality Improvement Project New And Novice Nurse Faculty: Orientation Bootcamp, Megan Titus

Doctor of Nursing Practice Projects

The ongoing shortage of nurse educators across the United States has led to a critical need among nursing programs, particularly in rural areas. A quality improvement project was developed in response to literature regarding the need for new and novice nurse educator orientation programs and limited structured onboarding at the implementation site. The quality improvement project implemented an orientation boot camp for new and novice nurse educators. Guided by Benner’s Novice to Expert Theory (Benner, 2023) and Lippitt’s Phases of Change Theory (Barrow, 2022), the project aimed to enhance faculty preparedness through educational support related to seventeen key nursing education …

Scoping Review Of Algorithms For Electronic Fetal Monitoring, Katherine Sabatier, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to review the use of an algorithm in evaluating continuous external fetal heart rate (FHR) monitoring in labor as opposed to clinician judgment for improved fetal outcomes, including earlier recognition of abnormal tracings (Clark et al., 2017). FHR monitoring was created to evaluate for fetal hypoxia in labor and has become standard practice (Gyllencreutz et al., 2018). One of the goals of the use of cardiotocography is to decrease hypoxia-induced fetal metabolic acidemia and neurologic injury. There are multiple options for individual or computer-based algorithms in evaluating FHR to reduce fetal acidemia …

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 Hidden Populations Through Faculty Identification And Intervention In Higher Education, Jimmie K. Wetmore

Doctor of Nursing Practice Projects

College students who have endured trauma through experiences in the foster care system, homelessness, justice system involvement, poverty, violence, and/or abuse are at greater risk of not completing college and returning to the circumstances that perpetrated their initial traumas. These students are known as “hidden populations.” Mentorship and resources can help these students to break the social and economic cycles that have placed them in a high-risk category. Higher education faculty are in a unique position to help bridge the gap that exists for these students. The problem can be impacted by more faculty being aware of the population and …

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 …