Nursing Commons^™

Improving Nurse Confidence And Perceived Readiness For Early Code Blue Response: A Quality Improvement Project, Elexia Butler, Annette Sotelo Rodriguez, Paulene Rones, Evangelyne Vue

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Improving Nurse Confidence and Perceived Readiness for Early Code Blue Response

Purpose

In many acute care units that are predominately dealing with chronic conditions, cardiac arrest is a low frequency, high stakes event. The purpose of this project is to improve early cardiac arrest response by increasing nurse confidence and perceived readiness to initiate high-quality CPR prior to Rapid Response Team (RRT) arrival.

Background

Over the past three years, there has been a significant increase in Code Blue events on the Surgical Acute Telemetry Unit. Initial management observations noted that staff response lacked clear role delineation, immediate pulse identification, and …

Use Of Standard Visual Education Tools To Improve Npo Compliance In Pediatric Day Surgery, Alma Rivera

EBP Fellowship

Practice Problem Non-compliance with perioperative fasting (NPO) instructions is an ongoing safety and operational challenge in pediatric day surgery. Day-of-surgery cancellations result in financial losses, with unproductive OR time costing $1,430-$2,025 per hour. NPO violations cause 4.5% - 13.6% of lost OR time in children's hospitals and are the third leading cause of elective surgery cancellations. At our pediatric hospital, NPO violations contribute to same-day surgical delays and cancellations, particularly in the high-volume Otolaryngology (ENT) service line. This Evidence-Based Practice (EBP) project sought to answer whether, among caregivers of pediatric patients scheduled for ENT Day surgery (P), implementing a health …

Pulse (Ox) Check! Smarter Monitoring, Stronger Outcomes, Christina Reyna

EBP Fellowship

Practice Problem: Infants and children are a vulnerable patient population at an inherently higher risk of detrimental effects of hypoxia or hypoxemia. Literature shows that early detection of hypoxemia can facilitate timely interventions which in turn can reduce morbidity and mortality. On an inpatient pediatric pulmonary unit, there have been multiple instances of staff concern for inaccurate pulse oximetry readings, leading to evaluation of potential technological interventions to improve early detection of hypoxia. In one year, there were 3 code/MET events, in which uncertainty of device accuracy delayed response time and interventions. To address this problem, an evidence-based practice project …

Moving To Adult Care: The Impact Of Transition Readiness Assessments In The Hct Of Yas With Epilepsy, Tanika A. Middleton, Shley Mccool

EBP Fellowship

Practice Problem: Health Care Transition (HCT), the process of planning, preparing, transferring from pediatric healthcare and integrating into adult healthcare, is increasingly necessary as more adolescents with complex and chronic health conditions reach adulthood. Assessing transition readiness is identified as a key component of HCT. At a large, academic pediatric healthcare system, there was an opportunity to more consistently incorporate readiness assessments in HCT services of specialty clinics and determine the impact of readiness assessments on HCT outcomes. To address this, an evidence-based practice project was implemented using the following PICOT question: In patients ages 18-22 seen in the outpatient …

Implementing The Community Health Worker Role Into A Nurse-Led Diabetes Management Program, Blanca Cruz Escalante

EBP Fellowship

Practice Problem: Unmet social needs lead to poor outcomes in pediatric diabetes patients. While nurse-led interventions such as follow-up calls and care coordination can improve self-management of diabetes, social needs often extend beyond what nurses can directly provide. At the project facility, the diabetes management program historically has not included a community-based component, essential for addressing social determinants of health (SDOH). Notably, Community Health Workers (CHWs) play a crucial role in addressing health disparities through community-based interventions. To examine this practice gap, the following PICOT question was developed: In high-risk pediatric patients with Type 1 diabetes (T1D) enrolled in the …

Implementation Of The Cease Bundle In The Pediatric Icu, Ayanna Brown-Gomez

EBP Fellowship

Practice Problem: Clinical alarms in the Pediatric Intensive Care Unit (PICU) are intended to indicate potentially life-threatening events requiring timely assessment. Excessive alarm frequency can contribute to alarm fatigue, resulting in delayed or missed responses and creating a significant patient safety concern that must be assessed in a timely manner. There is a need to address alarm management. [AT1.1] Literature Review: A literature search was conducted using OVID, Medline, and CINAHL. A quasi-experimental research study demonstrated the CEASE bundle as an effective nurse-led alarm management strategy. Multiple systematic reviews support several interventions included within the bundle. The literature review also …

Engaging The Nurse’S Voice: Committee Alignment In The Unit Practice Council, Kris Noel

EBP Fellowship

Practice Problem: In this multi-site hospital system, unit committees were meeting outside of the Unit Practice Council (UPC) but were not consistently returning to the council to share information, request input, or seek decisions. This created a disconnect between committee work and nursing priorities. To address this problem, an evidence-based practice project was initiated using the PICO(T) question: Does the practice of having all unit committees report to their Unit Practice Council (UPC) to share information and for decision-making improve nurse engagement compared to the current practice of multiple committees meeting outside of their UPC within a three-month pilot period? …

Aid Me! Introducing Health Literate Insulin Pump Training Materials Into Patient, Katherine Hamilton Doyle

EBP Fellowship

Practice Problem: Automated Insulin Delivery (AID) systems are insulin pumps that communicate with continuous glucose monitors to administer insulin at set intervals to alter one’s blood glucose to a preset target. AID systems have been proven to lower patients’ Hemoglobin A1Cs, but successful operation of the AID system can be complicated for patients and their families. This can lead to diabetes-related emergency room visits and hospital admissions. In a review of 164 patients started on an AID system over a period of six months, 27 patients visited the emergency department for a diabetes-related reason and 18 of those patients were …

Loma Linda Nurse - Vol. 35, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | From Behind the Lens to by the Bedside—Nicole Mackey

6 | Coming Home— CRNA Alumni Faculty Feature

8 | From NICU Miracle Baby to Nurse—Nito Gil

10 | Change the Game— Miguel Aguayo

12 | Standing in the Shadow of a Miracle—Joyce Rusch

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-29 | ACADEMICS

30-33 | HOMECOMING

34-38 | FACULTY UPDATES

Beneath The Surface: The Promotion Of Bedside Involvement In The Dissemination Of Wound Progression, Jaiden Ware, Aline Ramirez, Emily Rayas

2025

No abstract provided.

Cultivating A Culture Of Feedback: Strengthening Picu Nurses Through Peer-To-Peer Feedback, Alex Ramirez, Reese Reddick, Sydney Usselman

2025

No abstract provided.

Fueling Tiny Hearts: Optimizing Enteral Mct Oil Utilization In Patients With Congenital Heart Disease, Paige Baxter, Bailey Beard, Ashton Mudd, Isabelle Stallings

2025

No abstract provided.

More Than Words: Enhancing Caregiver Confidence ​Through Health-Literacy-Informed Discharge Teaching, Madelyn Biad, Rachel Jones, Temi Kalejaiye, Aylana Lindsey, Jennifer Nguyen, Jenny Nguyen, Samantha Wigder

2025

No abstract provided.

Raising The Bar: Post-Operative Pneumonia In The Pediatric Pectus Patient Population​, William Anoka, Ishana Banerjee, Taylor Emond, Inala Gant, Policia Travis

2025

No abstract provided.

Patching The Practice Gap: Standardizing Pediatric Transdermal Medication Administration, Grace Mcreynolds, Jennifer Diaz-Miranda, Raven Davis, Cierra Berry, Womietu Arise, Samantha Onyekwere, Jennifer Lugo, Hasina Barlett

2025

No abstract provided.

Developing Superusers To Improve Piv And Phlebotomy Competency In The Ccbd Patient Population​, Grace Grief, Karen Pedro, Toni Lieberman, Maddie Mccombs, Sophia Figueroa

2025

No abstract provided.

Extra Hands, Better Care? Evaluating The Impact Of A Resource Nurse, Cy Love, Ivana Ye, Mackenzie Hodge, Melanie Pescina

2025

No abstract provided.

Impact Of Exercise On Mental Health In Inpatient Settings, Samuel Blake Rn, Nathaniel Clark Rn

Nurse Residency

In adult psychiatric inpatients with mental illness, how does participation in a structured exercise program compared with standard inpatient care affect depression, anxiety, and overall mental health outcomes during hospitalization?

Night Shift-Specific Training & Engagement, Keith Procell Rn, Kyleigh Keitel Rn

Nurse Residency

In night shift hospital workers (P) does mandatory daytime attendance for required education (I), compared to shift-aligned, asynchronous, or flexible scheduling of education (C), increase health risks associated with circadian disruption (O), as supported by current research?

Reducing Falls In The Cardiac Care Unit: An Improvement Project, Andrea Otero, Aryanna Campa, Nia Butac

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Patient falls persist as a leading cause of preventable harm in hospitals, particularly among cardiac care patients who are at increased risk because of medication effects and mobility limitations. Despite existing fall `prevention measures in the Cardiac Care Unit (CCU) at Sutter Medical Center, Sacramento, 43 falls occurred, highlighting the need for improved patient education and consistent staff communication.

Purpose: This quality improvement project evaluated the effectiveness of implementing a standardized fall prevention communication script to reduce the average monthly fall rate in the CCU from 3.583 to fewer than 2 falls per month.

Methods: Using the Plan-Do-Study-Act …

Improving Knowledge Of Obesity-Related Risks And Healthy Lifestyle Behaviors In Adolescents, Tehroop Notra, Samreet Kaur, Karina Heredia

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

This quality improvement project evaluated the effectiveness of a school-based educational intervention aimed at improving ninth-grade students’ knowledge and understanding of obesity prevention, nutrition, and physical activity. Adolescent obesity remains a significant public health concern, showcasing the need for early, evidence-based education. A total of 57 students participated in the two classroom sessions. Of these students, 49 completed the pre-intervention survey, and 48 completed the post-intervention survey. The intervention included an interactive presentation, group discussions, and educational materials. Student knowledge was assessed using a six-item survey administered before and after the session. The results demonstrated improvements across multiple knowledge areas, …

Improving Mobility Awareness And Jh-Amp Tool Utilization On A Cardiac Care Unit, Courtney Joe, Clarissa Chaires, Jocelyn Martin, Eunice Sanchez

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

The quality improvement project evaluated the impact of staff education and a unit-wide mobility awareness campaign on the use of the Johns Hopkins Activity and Mobility Promotion tools and patient mobilization in a 48-bed Cardiac Care Unit (CCU). The project involved registered nurses, nursing assistants, unit leaders, and adult cardiac patients represented by aggregate mobility data. A preliminary survey completed by 42 CCU staff members, CCU Partnership Council focus group, meetings with clinical nurse specialists, and a baseline unit audit identified inconsistent mobility practices, uncertainty regarding Johns Hopkins Highest Level of Mobility tool, and limited completion of in-room mobility signs. …

Mind Over Scrubs – A Peer-Led Anxiety Reduction Program, Nhi T. Tran, Angelica Dirige, Adeleke Fashola

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Nursing students experience elevated anxiety during the transition into accelerated programs, which can negatively affect academic performance, well-being, and retention. This quality improvement project evaluated Mind Over Scrubs, a peer-led anxiety reduction program for incoming Entry-Level Master of Science in Nursing students at the University of the Pacific, consisting of four 45-minute sessions on evidence-based coping strategies. Generalized Anxiety Disorder-7 surveys were administered at baseline, before and after each session, and at two- and four-week follow-ups; Wilcoxon signed-rank tests evaluated matched changes. Thirty-one of 62 enrolled students (50%) attended at least one session. Post-session scores fell below individual baselines for …

​​Hospital-Acquired Pressure Injury Prevention In The Sutter Sacramento Cardiac Care Unit ​Qi Proposal, Angelina Lucido, Amy Roderick, Karly Link

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Hospital-acquired pressure injuries (HAPIs) remain a significant source of preventable patient harm despite established prevention protocols. In the Cardiac Care Unit (CCU) at Sutter Medical Center Sacramento, inconsistent patient education and limited patient engagement were identified as potential contributors to ongoing HAPI occurrence. This quality improvement (QI) project evaluated whether implementing structured, individualized patient education could strengthen existing pressure injury prevention efforts.

Methods: A seven-week QI project was conducted in the CCU using the Plan-Do-Study-Act (PDSA) framework. The intervention consisted of nurse-led, individualized pressure injury prevention (PIP) education supported by a standardized patient handout tailored to each patient's risk …

From Birth To Better Health: Educating Mothers With Gestational Diabetes On Breastfeeding Benefits And Glucose Management, Jesse A. Soria Jr, Sarah Smith, Audrey Nolan Smith, Keeley Kosier

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Gestational diabetes mellitus (GDM) increases a mother's risk of developing type 2 diabetes mellitus (T2DM) later in life and can affect an infant's future health. Breastfeeding can help improve a mother's blood sugar control and may lower her future risk of diabetes, but many mothers with GDM do not know about these benefits. This quality improvement (QI) project evaluated a standardized education program on breastfeeding and diabetes prevention for postpartum mothers with GDM at the Family Birthing Center at St. Joseph's Medical Center (SJMC) in Stockton, California. The intervention included a 10- to 15-minute education session and an evidence-based educational …

Improving Clostridioides Difficile Prevention Practices Through Standardized Stool Collection And Hand Hygiene, Dunya Khateeb, Laura Martin, Jessica Zhang

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Healthcare-associated Clostridioides difficile (C. diff) infections increase patient morbidity, length of stay, and healthcare costs (Simor, 2010). Our quality improvement project seeks to reduce C. diff infection rates and enhance prevention practices on the Med-Acute Unit at Sutter Medical Center Sacramento (SMCS) by utilizing the Plan-Do-Study-Act (PDSA) framework. Interventions will be implemented between March 2026 and July 2026. The project examined whether introducing a standardized stool collection tote and improving hand hygiene compliance would reduce C. diff infection rates. Participants included all nursing staff on the unit. Data is being collected through observational hand hygiene audits, collaboration with the SMCS …

Know Your Birth, Jasmine Mckelvey, Reagan L. Hunt, Michaela M. David

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Maternal mortality remains a significant public health concern in rural Kenya because of limited healthcare resources, inadequate emergency obstetric training, and barriers to accessing timely, high-quality maternal care. This quality improvement project evaluated the implementation of the Know Your Birth educational intervention, a culturally responsive, simulation-based training program designed to improve healthcare providers' knowledge, confidence, and competency in evidence-based maternal and newborn care. The project was conducted at Sega Dispensary in Sega, Siaya County, Kenya, and included 26 healthcare staff members. Guided by the Plan-Do-Study-Act framework, participants completed a brief educational presentation followed by three interactive skills stations focused on …

Tiny Hearts, Big Questions: Navigating Research And Clinical Trials In Pediatric Cardiology, Madison Dollar, Monica Ganaden, Gracie Gilbert, Mena Mohamedaman, Bellina Osei, Savine Valenzuela, Zachary Xayaphanh

2025

No abstract provided.

Standardizing Neurological Assessments, Delaney Miller, Hannah Dorsey, Lauren Sulzen, Olivia Garrett, Patricia Rios, Sukhmanpareet Kaur

2025

No abstract provided.

Snap Into Better Pediatric Neuro Assessments, Irene Chacko, Nayelli Fuentes, Annie Mazon Kellejian, Claire Ring, Ibrahim Shaikh

2025

No abstract provided.