Nursing Commons^™

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

Doctor of Nursing Practice Projects

Purpose/Background

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

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

Doctor of Nursing Practice Projects

Purpose/Background

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

Methods

A comprehensive search was conducted across …

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

Doctor of Nursing Practice Projects

Background

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

Objective

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

Methods

A …

Connecting Through Activities: How Social Engagement Impacts Isolated Older Adults, Lekisha Wilde

Doctor of Nursing Practice Projects

Executive Summary

Problem Description: Loneliness and social isolation are associated with higher rates of depression and contribute to a variety of mental and physical conditions. In socially isolated older adults, managing depression and chronic medical conditions can lead to negative outcomes that include poor quality of life, increased disability and morbidity leading to higher healthcare costs, and elevated mortality rates.

Setting: Project took place in a community behavioral health clinic in the Pacific Northwest.

Rationale: This project is guided by the Iowa Model. The model was tailored to assist in identifying the problem, gathering and evaluating relevant evidence from the …

Closing The Wellness Gap: Distribution Of Health & Wellness Resources To Families Of High School Students During Summer Break, Danielle Harvey

Doctor of Nursing Practice Projects

Closing the Wellness Gap

Background: During summer break, when schools are closed, students in K-12 schools lose critical resources to support their social, emotional, and physical wellbeing. This project addresses the critical gap in rural Southeastern Washington, where schools act as the primary support system by providing activities, food security, and wellness services.

Aim: Increase families’ awareness and confidence accessing resources to support students when schools are closed.

Methods: To identify key resources a Community Resource Gap Questionnaire was distributed to families. Eight weekly community resource guides were shared electronically with families based on the top priorities identified in the …

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

Doctor of Nursing Practice Projects

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

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

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

Needs Assessment: Examining Nurse Mentorship In A Military Treatment Facility, Laurie E. Chavez

Doctor of Nursing Practice Projects

Background

Despite 4.3 million registered nurses (RNs) in the United States, nearly a third are not practicing, exacerbating nursing workforce shortages across the nation’s healthcare settings. The Military Health System (MHS) reported significant attrition, with some specialties losing up to 37% annually. Research shows mentorship boosts job satisfaction and retention, yet the MHS lacks a formal program to support and sustain its nursing workforce long-term.

Aim

This needs assessment investigates the feasibility of establishing a nurse mentorship program at a Military Treatment Facility (MTF) to help elevate job satisfaction and strengthen nursing retention.

Methods

Anonymous questionnaires, structured interviews, and stakeholder …

Program Evaluation: Family Centered Rounding To Support Communication In Pediatric Care, Kristy M. Schmidt

Doctor of Nursing Practice Projects

Background: Family centered rounding (FCR) is a pediatric evidence-based practice intended to bring healthcare teams, patients, and families together at the bedside in a collaborative approach to care planning. FCR emphasizes communication and shared decision-making between healthcare teams and families, leading to improved patient outcomes. Despite well-documented benefits of FCR, challenges such as inconsistent nursing participation, variability in practices, and workflow disruptions hinder implementation and sustainability of FCR.

Aim: This program evaluation was designed and conducted at an urban pediatric hospital to assess the processes, perceptions, and impact of FCR. The overall quality of FCR and the strengths and barriers …

Traumatic Brain Injury Prevention Through Helmet Safety Education For Parents And Free Helmets For Elementary-Aged School Children, Kelli E. Camp

Doctor of Nursing Practice Projects

Problem Description: Head injuries from bicycle accidents are a leading cause of emergency visits among elementary-aged children, particularly in rural areas (Safe Kids Worldwide, 2017). Helmets significantly reduce traumatic brain injuries (TBIs) up to 88% (Field Neurosciences Institute, n.d.). However, low-income families, especially in rural areas, often lack access to helmets and safety education, resulting in lower helmet use and higher injury rates. These challenges are amplified in communities facing high traffic injury rates, limited access to safety resources, and economic constraints (Gilna et al., 2022; World Health Organization, 2023).

Setting: This project took place in Othello, WA (pop. 8,915), …

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

Doctor of Nursing Practice Projects

Abstract

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 …

The Effects Of An Onboarding Checklist On Nursing Faculty Satisfaction, Taressa W. Poole

Doctor of Nursing Practice Projects

Nurse educators play an integral part in combating the nursing shortage. Transitioning clinical nurses to the academic setting can be challenging because experienced clinical nurses often enter the academic setting as novice nurse educators. A literature review suggested that the lack of structured onboarding programs contributes to the satisfaction, retention, and professional development of nurse educators. The Doctor of Nursing Practice (DNP) project aims to improve new nurse faculty onboarding by implementing a checklist to structure the onboarding process at the DNP project site. The process change project assesses the effects of a checklist on faculty satisfaction with the onboarding …

Provider Burnout Related To Patient Satisfaction, Sherita A. 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 …

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

Doctor of Nursing Practice Projects

Purpose/Background

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

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

Doctor of Nursing Practice Projects

Purpose/Background

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

Using Ehr Reminders To Control Hypertension, Umme Kulsoom Ghous, Logan Mcculley, Danielle C. Hall, Linda Katherine Lambert, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Hypertension is a significant risk factor for cardiovascular and kidney diseases but is often under-diagnosed and poorly managed. Electronic Health Records (EHR) can help by providing automated reminders to recheck elevated blood pressure (BP) readings, ensuring accurate measurements, and guiding clinical interventions. This study aims to determine if EHR-based reminders improve BP control in adult patients aged 21 and older, focusing on hypertension diagnosis accuracy and timely management.

Methods

After a literature review, the study took place in a primary care clinic and only included patients with an existing diagnosis of hypertension. Thirty patients were included in the study. …

The Predictors Of Success For Pre-Licensure Bsn Students: An Exploratory Analysis Of Assessment Methods, Nihimu Nkechinyere Evulukwu

Doctor of Nursing Practice Projects

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing …

The Impact Of Continuous Glucose Monitor Education On Primary Care Providers Prescribing Behavior, Heather Tyson

Doctor of Nursing Practice Projects

Continuous glucose monitors (CGMs) estimate glucose levels in the interstitial fluid, updated every few minutes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, CGMs are used by patients with Type 1 diabetes. However, research demonstrates that patients with Type 2 diabetes can also benefit from their use. The primary function of CGMs is to enhance glucose management, provide emergency alerts, and reduce the need for frequent fingerstick evaluation, promoting better long-term health. CGM use has lowered hemoglobin A1C levels in the primary care setting. This is due to the correlation between frequent glucose monitoring and increased …

Knowledge Is Power: Educating The Community About The Dangers Of Vaping, Heather B. Hector

Doctor of Nursing Practice Projects

Background: The purpose of this quality improvement (QI) project was to increase knowledge among parents, coaches, teachers, nurses, community leaders, and members about the dangers of e-cigarette use among adolescents by implementing a community-based education session vital to protecting the health and well-being of adolescents in the target community. Education and preventative measures have been proven to decrease the use of tobacco cigarettes, and the same needs to be done with e-cigarettes and vaping, especially among adolescents, to protect the future of their health. Education and prevention programs are not only targeted at adolescents but also at adults who …

Affecting Test Anxiety In Nursing Students, Michelle S. Porterfield

Doctor of Nursing Practice Projects

Nursing students often face significant test-taking anxiety, which negatively impacts both their academic performance and overall well-being (Samuel et al., 2022). This project aims to explore the effects of mindfulness coloring with mandalas on reducing pre-test anxiety among pre-licensure nursing students. The intervention, spanning one semester, will assess changes in anxiety levels and student academic test performance. The anticipated outcome is a reduction in pre-test anxiety, leading to improved academic performance and enhanced mental well-being. The findings will provide valuable insights into non-pharmacological strategies for managing anxiety in students.

Stress To Success: The Impact Of Aromatherapy On Nursing Students With Test Anxiety, Patricia A. Mullens

Doctor of Nursing Practice Projects

Test anxiety has been identified as a significant problem in pre-licensure nursing students. This project aims to investigate how aromatherapy can alleviate the stress and anxiety associated with lower test scores and the emotional and psychological impacts it has on students' overall well-being. A literature review supported that students who experience test anxiety characteristically scored lower on high-stakes nursing exams than students who did not experience the same stress. The potential results of this project are multifaceted and include improved test scores, enhanced students’ psychological well-being, and completion of their nursing degree.

Implementing A Pressure Injury Prevention Bundle On A Medical Surgical Unit: A Quality Improvement Project, Katrina Daye-Whitehead

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) continue to be one of the biggest challenges healthcare facilities face which has required increased attention on prevention. The national cost of treating HAPIs ranges from approximately $3 billion to $22 billion annually and as a result, hospitals have faced a tremendous financial burden, which has led hospitals to strengthen reduction strategies (Padula & Delarmente, 2019). The aim of this evidence-based project was to increase nurses’ knowledge about HAPI prevention bundles and increase the compliance with a HAPI prevention bundle implemented within 8 hours of admission or transfer to the unit. The preventative HAPI bundle consists …

Breastfeeding Education In Peripartum Women, Kristen Chassner

Doctor of Nursing Practice Projects

Breastfeeding is nature’s medicine. Though it is considered a natural experience between a mother and a child, it does not always come easy. Education is imperative for peripartum women to learn more about breastfeeding in general, its benefits to the mother and the child, identifying improper latching, and resources to seek help. The purpose of this project was to provide introductory breastfeeding education to peripartum women at a government-funded public health facility in Cleveland County, North Carolina, to increase breastfeeding knowledge, self-efficacy, and the intention to breastfeed for the baby’s first 6-months of life in 100% of the participants. Though …

The Use Of Music Therapy And Various Mechanisms Of Diversion To Aid Caregivers Of Those With Alzheimer’S Disease And Dementia, Sarah Elizabeth Kane

Doctor of Nursing Practice Projects

Background: Alzheimer’s Disease and Dementia inhabit an increasingly alarming number of individuals within the United States with the majority of their caregivers being loved ones with limited to no healthcare education. This DNP project was designed to specifically educate caregivers of those with Alzheimer’s Disease and Dementia. The goal of this project was to increase the knowledge of the disease while also increasing the ability and confidence to better care for their loved ones. In using the resources outlined in this project, such as music therapy and diversional tools, the caregiver would see a decrease in emotional outbursts and …

Achieving Optimal Wellness: Exploring The Benefits And Impact Of Community Health, Erin Riley

Doctor of Nursing Practice Projects

Community health is an essential practice that utilizes non-clinical approaches to reduce health disparities, improve health, and prevent disease through engagement with a population of a certain geographical area. Building on earlier research, this study focused on the members of Alamance County and the increasing numbers of diabetes, obesity, hypertension, and hypercholesterolemia cases from year to year. While community resources and health programs have improved over time, they are lacking in certain geographical areas. The aim of this project was to increase the knowledge and conversations around the most common diseases in Alamance County, through health seminars conducted at a …

Human Trafficking In The Er: Will You Recognize The Signs?, Lauren Neff

Doctor of Nursing Practice Projects

Current data reveals that 88% of human trafficking (HT) victims seek some form of health care while being trafficked. More specifically, 63% seek care in the emergency department setting (McAmis et al., 2022). A recent literature review indicates that regarding human trafficking and healthcare, there is a lack of awareness and knowledge on the issue. Healthcare team members often have little to no education or knowledge of potential signs and symptoms of a victim in a trafficking situation. The purpose of this DNP project was to increase healthcare staff knowledge of human trafficking (HT) and, more specifically, nurses in an …

Enhancing Sleep Quality: The Interrelationship Between Sleep Hygiene And Comprehensive Well-Being, Marissa Strenkert

Doctor of Nursing Practice Projects

In North Carolina, many adults face sleep loss, negatively impacting cognitive functioning, mental health, and physical well-being. This project aimed to educate the public about sleep hygiene techniques and their benefits. An informational session was conducted on sleep hygiene. The informational session included 31 participants, who then completed a voluntary survey to assess their likelihood of adopting the techniques and their satisfaction with the session. Out of 31 participants, 18 completed the survey. The survey consisted of 10 questions, scored on a scale from 1 (strongly disagree) to 5 (strongly agree), allowing for total scores between 0 and 50. Higher …

Increasing The Knowledge And Access To Naloxone (Narcan) For High-Risk Populations, Jessica E. Jones

Doctor of Nursing Practice Projects

This study investigated the knowledge and access to Naloxone (Narcan) in high-risk populations in Robeson County, NC. In order to mitigate the rate of overdose in tribal members who are part of the Lumbee Tribe of North Carolina. Indigenous populations have had the highest overdose rate of increase since 2019. In collaboration with CORE Pathways, a quality improvement project was implemented at the Harvest Moon Fall Powwow. Opioid overdose education was provided to voluntary participants, free Naloxone was provided to individuals, along with a created video presentation of Naloxone education. Pre- and post-surveys were utilized to gauge participants' knowledge before …

Educational Sessions On Opioid Use Disorder In A Rural Community: A Faith-Based Approach, Tarrelle Reade

Doctor of Nursing Practice Projects

This scholarly project aimed to evaluate the effectiveness of a faith-based community education program regarding opioid use disorder (OUD) in a rural area of Person County, North Carolina. Through 4 weekly sessions hosted at Lattisville Grove Missionary Baptist Church, the program provided education on the signs and symptoms of opioid misuse, associated risks, available treatment options, support resources, and the use of Narcan. A pre- and post-survey design using a Likert scale measured changes in knowledge and confidence across five key domains. Data from participants (n = 54 total) showed statistically significant improvements in awareness and self-efficacy in most areas, …

Sleep Promotion In Neonatal Intensive Care Units, Maelyn G. Cranford

Doctor of Nursing Practice Projects

Sleep is a fundamental requirement for the human body to achieve and sustain overall health and well-being. In Neonatal Intensive Care Units (NICU), sleep is a vital step in an infant’s routine to allow for proper neurodevelopment and growth. Parents of infants in the NICU may be unaware of the critical role sleep plays in their child’s health. Without realizing it, they can unintentionally disrupt their infant’s sleep by speaking loudly, using bright lights, or playing loud sounds from their phone. This DNP project was created to increase NICU parent education on the importance of sleep promotion and involve them …

Complementary And Alternative Therapies To Improve Quality Of Life For People With Chronic Pain And Addictions, Nicole K. Smith

Doctor of Nursing Practice Projects

There is a known opiate crisis prevalent in the United States. There is similarly an addiction crisis in the United States that saw a marked increase during the COVID-19 pandemic. Interestingly, there are many Americans who experience a connection between chronic pain and the onset of addiction. This project sought to introduce the idea of complementary therapies such as square breathing, mindfulness, and essential oil (EO) aromatherapy that could improve the quality of life for people who have chronic pain and/or addiction. The project consisted of a pre-test prior to education about square breathing, mindfulness, and EO aromatherapy, followed by …