Nursing Commons^™

Implementing A Nurse-Led, Family Caregiver–Integrated Delirium Prevention Protocol To Improve Bcam Screening Compliance And Caregiver Confidence Among Hospitalized Older Adults, Geraldine K. Ijezie

Doctor of Nursing Practice Final Project Abstract

Purpose:  To evaluate the effectiveness of a nurse-led, family caregiver–integrated delirium prevention protocol in improving bCAM screening compliance and caregiver confidence among hospitalized older adults in an Acute Care for the Elderly (ACE) unit.

Background; Delirium is a common but preventable complication in hospitalized older adults. Baseline assessments on the ACE Unit identified inconsistent bCAM screening and limited caregiver involvement. This quality improvement (QI) project aimed to improve early recognition through routine nurse screening and caregiver education to improve early delirium recognition and prevention.

Methodology: 12-week QI project using three PDSA cycles implemented nurse bCAM education, caregiver education, visual reminders, …

Implementing An Icu-Specific Pressure Injury Prevention Bundle (Skin Safe)To Reduce The Incidence Of Hospital-Acquired Pressure Injuries In Adult Surgical Intensive Care Unit., Komal Ali

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this project was to evaluate the effectiveness of implementing an ICU-specific pressure injury prevention bundle (SKIN SAFE) Sto reduce hospital-acquired pressure injuries (HAPIs) in an adult Surgical ICU.

BACKGROUND

HAPIs remain a major safety concern in critically ill patients. Standardized prevention bundles improve adherence and reduce incidence.

METHODOLOGY

This QI project in a 20-bed Surgical ICU used the PDSA framework to implement the eight-component SKINSAFE bundle. Strategies included staff education, champions, and weekly audits. Data were collected through EMR review, monthly PIP audits for HAPI incidence, and weekly compliance audits.

RESULTS

Pre-intervention data showed two HAPIs …

Evaluating The Effectiveness Of A Mindfulness-Based App To Reduce Stress Among Psychiatric Nurses At A Children’S Hospital, Miracle U. Izevbekhai

Doctor of Nursing Practice Final Project Abstract

The purpose of this quality improvement project was to evaluate the effectiveness and feasibility of a mindfulness-based mobile application (Smiling Mind) to reduce perceived stress and emotional exhaustion among psychiatric nurses on an adolescent inpatient unit at a children’s hospital.

Psychiatric nurses experience high levels of stress and burnout, which threaten staff well-being, retention, and patient safety. Brief, app-based mindfulness practices may offer a low-burden strategy to support nurse wellness in high-acuity environments, but real-world uptake and impact are not well described.

Using a pre–post quality improvement design, a convenience sample of 11 nurses enrolled in a 12-week intervention. Nurses …

Promoting Sleep Hygiene In The Intensive Care Unit- Implementation Of A Sleep Bundle, Emma J. Harris

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project’s purpose was implementation of a sleep bundle for at least 25% of an 18-bed cardiac intensive care unit (ICU) and reduce noise level by 20% (decibels) through education of at least 75% of the patient-care staff 3 months post-implementation.

Background: This quality improvement (QI) project’s purpose was implementation of a sleep bundle for at least 25% of an 18-bed cardiac intensive care unit (ICU) and reduce noise level by 20% (decibels) through education of at least 75% of the patient-care staff 3 months post-implementation.

Methodology: Patients were assessed using the Richard Campbell Sleep Questionnaire …

The Prevention Of Mouth Sores In Breast Cancer Patients Receiving Doxorubicin Using Oral Cryotherapy, Imani Wright

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of the evidence-based project is to implement and evaluate oral cryotherapy to reduce and prevent incidence and severity of chemotherapy-induced mucositis in breast cancer patients receiving Doxorubicin at a large cancer hospital in Southeast Texas.

BACKGROUND

Chemotherapy-induced oral mucositis is a common and painful complication among breast cancer patients receiving Doxorubicin leading to difficulty eating, treatment delays and a decrease in patient satisfaction and adherence to treatment regimen. Despite strong evidence supporting oral cryotherapy, its use is seldomly used in many oncology settings.

METHODOLOGY

A pre- and post- intervention quality improvement design guided by the Plan-Do-Study-Act (PDSA) …

Implementation Of The Pressure Injury Prevention Care Bundle At A Home Based Hospice Program: A Quality Improvement Project, Adaeze U. Amechi-Fannin

Doctor of Nursing Practice Final Project Abstract

Purpose: This Doctor of Nursing Practice project was created to improve the prevention of pressure injuries in hospice patients receiving care through a Home-based Hospice and Palliative program. The project focused on introducing a standard set of care steps (a care bundle), enhancing caregiver education, and tailoring interventions to meet each patient’s unique needs, with the goal of improving overall patient outcomes.

Background: Pressure injuries remain a common and serious problem in hospice care, especially among patients who are immobile or confined to bed. Although effective prevention methods are known, inconsistent use of these methods, limited caregiver training, and poor …

Crc Station: Improving Colorectal Cancer Screening Rates In Primary Care, Kathryn Nanji

Doctor of Nursing Practice Final Project Abstract

Purpose: To improve colorectal cancer (CRC) screening completion rates among eligible patients at a primary care clinic, located in Houston, Texas, by optimizing the medical assistant (MA) workflow and addressing systemic and patient-level barriers.

Background: The project site is a Federally Qualified Health Center that provides comprehensive and inclusive care to diverse and underserved populations, including those with low income, living with HIV/AIDS, experiencing homelessness, and uninsured. Despite the availability of non-invasive screening methods like the fecal immunochemical test (FIT), CRC screening rates remain suboptimal due to workflow inefficiencies, patient barriers, and inconsistent follow-up.

Methodology: A multifactorial intervention was implemented …

Standardizing Ascitic Fluid Panel To Improve Outcomes In A Large State Hospital, Yimei Zhang

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase provider compliance with evidence-based, hepatology-recommended ascitic fluid studies among inpatient providers from a baseline of 50% to 60% within five months through electronic health record (EHR) standardization.

Background: Delayed or incomplete ascitic fluid analysis can increase the risk of preventable complications. Workflow variability and non-standardized ordering practices contributed to inconsistent adherence to evidence-based recommendations.

Methodology: Using the Institute for Healthcare Improvement (IHI) Model for Improvement with Plan–Do–Study–Act (PDSA) cycles, two paracentesis workflows were redesigned. For the Mobile Procedure Team, a standardized ascitic fluid panel with six defaulted, evidence-based tests …

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …

The Impact Of Virtual Reality Simulation On Developing Competence And Confidence In Non-Technical Skills In Nursing. A Scoping Review, Katie Janz, Karen Clark-Burg, Khaya Morris-Binelli, Brennen Mills, Amanda Graf

Research outputs 2022 to 2026

Background: Medical errors are a global concern and can compromise patient safety, with up to 80% of these errors directly linked to non-technical skills (NTS) failures. Traditional simulation using mannikins is resource-intensive, and virtual reality simulation (VR) has the potential to offer comparable outcomes with enhanced consistency and lowered resource requirements, but the effectiveness of VR to teach and enhance NTS has been underexplored.

Aim: This scoping review explores the existing literature on VR simulation as a method for teaching NTS in nursing to evaluate whether VR simulation yields positive learning outcomes, particularly in comparison to traditional training methods such …

Translation, Cross-Cultural Adaptation, And Psychometric Validation Of The Team Emergency Assessment Measure (Team) Into European Spanish: A Multi-Perspective Study Including Peer-Assessment, Esther Leon-Castelao, Jose Luis Medina-Moya, Alejandro Durante-Lopez, Pedro Castro-Rebollo, Simon Cooper, Antoni Ruiz-Bueno, Jordi Bañeras

Research outputs 2022 to 2026

Background: The Team Emergency Assessment Measure (TEAM) is the most widely used tool for evaluating emergency team performance, with robust psychometric evidence across multiple languages and settings. However, no European Spanish version has been validated, and no previous TEAM study has simultaneously assessed teamwork from four complementary rater perspectives: instructors from the learners’ own specialty, instructors from other specialties, self-assessment by the performing participants, and peer-assessment by observing peers. This study aimed to translate, culturally adapt, and psychometrically validate a European Spanish version of the TEAM (s-TEAM) and to evaluate its reliability and validity across these four perspectives in emergency …

Anaemia In Pregnancy In Rural New South Wales: A Retrospective Study Of Prevalence, Risk Factors, And Guideline Adherence, Yuanwei Zhang, Esther Adama, Uchechukwu Levi Osuagwu

Research outputs 2022 to 2026

Aim: To determine the prevalence of anaemia in pregnancy in rural New South Wales (NSW) and assess the alignment of screening and treatment practices with the 2020 Australian Pregnancy Care Guidelines (APCG).

Methods: A retrospective cohort study at the Regional Hospital using records from 301 women who gave birth between 1st January and 4th September 2024. Data were sourced from eMaternity and PowerChart systems, focusing on haemoglobin and ferritin levels, demographic factors, iron deficiency risk factors, and birth outcomes.

Results: Iron deficiency was identified in 61.8% of women, with 6.0% diagnosed with iron deficiency anaemia (IDA). These rates were lower …

Secondary Outcomes Of The Early Collaborative Intervention Eaci On Salivary Cortisol Co Regulation In Preterm Infants And Mothers, Evalotte Mörelius, Charlotte Sahlén Helmer, Thomas Abrahamsson, Elvar Theodorsson, Ulrika Birberg Thornberg

Research outputs 2022 to 2026

The Early Collaborative Intervention (EACI) aims to strengthen early parent–infant relationships among moderate to late preterm infants in neonatal intensive care. This randomized controlled trial evaluated whether EACI influences mother–infant salivary cortisol co-regulation in mother–infant dyads, as well as infant cortisol reactivity and breast milk exposure during early infancy. Secondary outcomes were assessed in 54 dyads in the intervention group and 41 in the standard care group at one and four months’ corrected age. Salivary cortisol was collected before and after a bath at one month and a still-face procedure at four months. Significant mother–infant salivary cortisol co-regulation was observed …

Using Scoping Reviews As Precursors To Systematic Reviews: A Typology And Practical Guidance Derived From Eight Worked Examples, Hanan Khalil, Zachary Munn, Christina Godfrey, Micah D.J. Peters, Ellen Davies, Fiona Campbell, Danielle Pollock, Andrea C. Tricco, Dawid Pieper

Research outputs 2022 to 2026

Objectives: Scoping reviews are often conducted as a precursor to a systematic review (SR), yet guidance on how this relationship should be planned, executed, and reported is limited. We aimed to illustrate, through worked examples, the ways in which scoping reviews can function as precursors to SRs and to derive practical guidance for teams planning linked or sequential syntheses.

Study Design and Setting: We undertook a methodological analysis of eight contemporary evidence synthesis papers and protocols spanning veterinary medicine, animal welfare, public health, mental health, occupational health, and patient and public involvement, identified through the authors’ knowledge of the evidence …

Dnp Final Report: Enhancing Memory Care Staff Knowledge Of Fall Risk In Residents With Alzheimer’S Disease: A Quality Improvement Project, Terese D. Corbin

DNP Final Reports

Background: A 66-bed memory care community in West Texas lacked formalized staff education connecting Alzheimer’s disease progression with fall risk and recorded persistently high monthly fall counts.

Methods: The Johns Hopkins Evidence-Based Practice model and Plan–Do–Study–Act framework guided this quality improvement project. Education included 30-minute sessions, handouts, and posters. Voluntary assessments evaluated foundational knowledge and clinical synthesis. Analysis included five participants with matched assessments; monthly falls were a secondary outcome.

Results: Eleven preintervention and 11 postintervention assessments were completed; five participants had matched assessments. Among matched participants, mean foundational knowledge increased from 88.44% to 92.00%, a 3.56-percentage-point increase that met …

Diploma Nursing Students’ Experiences Through Hospice Simulation With An Actively Dying Patient: A Hermeneutic Phenomenological Study, Karina N. Putman

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to explore the experiences of diploma program nursing students through an actively dying hospice patient simulation with a family component. Kolb’s experiential learning theory (1984) guided the study as it identifies learning as a process that builds on previous experience and reflection. This study took place at a diploma nursing program located in the northeast part of the United States and consisted of a sample of 10 senior-level students selected through purposive sampling. Interviews, observations, focus groups and journaling were used to collect data to answer the research question, “What is the …

Group Learning Experiences Of Multicultural Baccalaureate Prelicensure Nursing Students In The United States: A Hermeneutic Phenomenological Study, Rebecca Lynn Goulette

Doctoral Dissertations and Projects

The purpose of this qualitative, hermeneutic phenomenological study was to describe and interpret the experiences of junior and senior nursing students from differing cultural backgrounds enrolled in clinical laboratory education courses in the United States. The problem was that the prelicensure nursing student population has become increasingly diverse, and there was limited understanding of whether cultural factors affected students’ success in completing all four stages of experiential learning during simulation and clinical experiences. Kolb’s experiential learning theory guided this study. The central research question was, “What were the experiences of junior and senior nursing students of differing cultural backgrounds while …

The Value Of Pilot And Feasibility Studies In Nursing Education Research: A Worked Example, Dhanya Anand Anil Kumar, Natasya Raja Azlan, Hugh Davies, Chandra P. Salgado Kent, Debbie Massey, Karen Strickland

Research outputs 2022 to 2026

Background: Feasibility studies play a critical role in determining whether clinical or educational interventions can be implemented as intended before progressing to large-scale trials. In nursing education, many innovative teaching strategies, particularly complex interventions such as simulation-based learning, are often advanced directly to full trials without first establishing feasibility. This premature progression creates recruitment, acceptability, fidelity, and protocol adherence challenges, which may compromise study quality and valuable resources. This paper addresses this gap by clarifying the purpose and value of feasibility studies in nursing education research and outlining key considerations for designing an early-stage feasibility study that aligns with contemporary …

The Unacknowledged Challenge Of Moral Distress For Nurse Academics, Adam Burston, Glenna Mae Guiriba, Meena Gupta, Sara Bayes

Research outputs 2022 to 2026

The pluralistic nature of healthcare presents nurses with situations challenging their moral values which nurses must navigate. Challenges to moral values can result in the experience of moral distress, a problem that is common within the clinical nursing context. Moral distress is a known and well-researched phenomenon within nursing and has long contributed to detrimental effects such as frustration, anger, anxiety, decreased job satisfaction, burnout and ultimately attrition. However, despite extensive research in clinical environments, minimal research exists detailing this concept within the context of nursing academics and educators. Nurses can experience moral distress if they are in or exposed …

Individual, Social, Economic, And Health System Determinants Of Cervical Cancer Screening Uptake Among Women In Rubanda District, Uganda, Gervase Centinary, Sebastian Baine Olikira, Sezalio Masembe, Ronald Kibonire Arineitwe

School of Nursing & Midwifery, East Africa

Background: Cervical cancer screening uptake in Sub-Saharan Africa is shaped by individual, social, economic, and health system factors, yet few studies test all four domains simultaneously within a single rural district. This study examined individual, social, economic, and health system determinants of screening uptake among women aged 18 years and above in Rubanda District, Uganda, a district with critically low screening coverage.

Methods: A community-based cross-sectional study was conducted among 418 women aged 18 years and above across four sub-counties of Rubanda District, selected through multi-stage sampling. Individual, social, economic, and health system characteristics were collected via structured questionnaire. …

Impact Of A Head-To-Toe Assessment Simulation On The Self-Efficacy Of First Semester Nursing Students, Martin Dole

Nursing Faculty Publications

The transition into clinical practice presents significant challenges for first-semester nursing students, particularly related to self-efficacy and the ability to perform comprehensive patient assessments. Low self-efficacy may negatively influence clinical judgment, skill performance, and patient safety. The purpose of this Doctor of Nursing Practice project was to examine whether participation in a head-to-toe assessment simulation impacted general self-efficacy among first-semester nursing students. Guided by Bandura’s theory of self-efficacy, a quantitative, quasi-experimental, one-group pretest–posttest design was used to evaluate changes in self-efficacy following a high-fidelity simulation experience. A convenience sample of 42 first-semester Bachelor of Science in Nursing students participated in …

Midwifery Student Attrition In Australia: A Scoping Review, Terri Downer, Tanya Capper, Olav Muurlink

Research outputs 2022 to 2026

Problem: Global literature suggests that attrition rates from entry-to-practice midwifery programs are increasing. However, little is known about student attrition in the Australian context.

Background: Australia faces a growing midwifery shortage, prompting calls to increase program enrolments. Evidence from the United Kingdom shows high and rising attrition in entry-to-practice programs. In Australia, the scale of midwifery student attrition and the factors influencing it remain largely underexplored.

Aim: To identify and synthesise existing Australian literature on factors influencing midwifery student attrition.

Methods: A search of PubMed, Medline, CINAHL Ultimate, Embase, MIDIRS, EBSCO, and Google Scholar databases was conducted with key data …

Navigating Study Demands In First-Year Midwifery Education: Mixed-Methods Insights From Students, University Lecturers And Clinical Mentor Midwives, Chantal Soyka, Julia Berger, Dorothee Herrmann, Ruth Martis, Claudia Plappert, Niclas Schaper, Martina Schlüter-Cruse, Dorothea Tegethoff, Marina Weckend, Mechthild M. Gross

Research outputs 2022 to 2026

Aim: To examine:(1) study-related demands faced by first-year midwifery students; and (2) support provided to help them cope with demands.

Background: The recent national transition from vocational training into tertiary midwifery education in Germany resulted in a new teaching environment and adjusted clinical placement settings. Capacity building at tertiary level enabled innovative services to foster supportive learning environments for midwifery students, including processes for onboarding. However, little is known about students’ perceived challenges during this time.

Design: Convergent mixed-methods study.

Methods: An online survey of 304 first-year direct-entry midwifery students from 31 German higher-education institutions and semi-structured interviews with lecturers …

Where Do Nurses Thrive? A Call For Healthy Work Environments, Adrianna Lorraine Watson, Carmel Bond, Rebecca Jarden, Michelle Cleart

Faculty Publications

No abstract provided.

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …

Implementation Of Asynchronous Mentor Education Modules To Improve Mentoring Competency, Elvira Sayfutdinova

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Structured mentorship supports new CRNAs as they transition to practice, fostering confidence, job satisfaction, and professional growth. The WashU Medicine Department of Anesthesiology (WUDA) launched a CRNA Mentorship Program in 2022, but it lacked standardized mentor education, leading to inconsistent mentor preparation and variable mentoring practices.

Review of Literature Findings: Structured mentor education improves mentoring competency across healthcare settings, yet the literature specific to CRNAs remains limited. Asynchronous, self-paced formats reduce barriers to participation for busy clinicians, but no prior study has evaluated a fully asynchronous, prerecorded mentor-education format for CRNAs.

Methods: This pre-/post quality improvement (QI) …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …