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 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 …

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 …

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 …

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 …

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 …

Implementation Of A Learning Module To Reduce Advanced Practice Provider Preceptor Burden, Michelle Bloom

Doctor of Nursing Practice (DNP) Student Projects

The transition of advanced practice providers (APPs) from student to provider, or from an experienced provider to a new organization or location, has been identified as a high-stress period with potential turnover for new-hire APPs. APP preceptors play a key role in this transition. Limited time to teach during the clinical day and a limited knowledge base among new hires were two of many factors associated with increased preceptor burden. A brief online educational module that provided pre-clinical, organization-specific education was proposed to improve new-hire APPs’ knowledge base and reduce preceptor burden, among APP preceptors working in a 36-bed surgical/burn/trauma …

Strategies To Improve Outcomes Of Obstetric Emergencies In Sub-Saharan Africa: A Scoping Review, Serah Wachira, Ruth Wagathu, Beth Waweru, Rose Maina, Abednego Ongeso, Constance Sibongile Shumba, Benard Mutwiri, Diana Mbattude, Cliff Aliga, Lucy Kisaka, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background: Obstetric emergencies remain a leading cause of maternal morbidity and mortality in sub-Saharan Africa (SSA) despite increased access to facility-based deliveries and emergency obstetric care. Improving outcomes requires not only life-saving clinical interventions but also effective health system strategies. This review mapped published evidence on strategies used to improve outcomes of obstetric emergencies in SSA.

Objective: This scoping review aimed to identify strategies reported in the literature to improve outcomes of obstetric emergencies in SSA.

Methods: The review was reported in accordance with PRISMA-ScR. A comprehensive electronic search of PubMed, CINAHL, SCOPUS, and CORE identified studies published between January …

Towards Primary Health Care Education Reform: A Reflexive Thematic Analysis Of Nursing Supervisors' Perceptions, Experiences And Challenges, Debbie Procter, Mccullough, Debbie Massey, Karen Strickland

Research outputs 2022 to 2026

Aim: To explore Primary Health Care nurses' experiences of supervising nursing students on clinical placements and their perceptions of academic preparation for placement and future employment. Background: Primary Health Care nurses are essential workers within sustainable health systems but pre-registration educational preparation and access to clinical experiences can be limited. Previous research correlates positive clinical experiences with workforce intentions. Furthermore, nursing supervisors are pivotal to maximising student experiences and education, yet little is known about their perceptions, challenges, and views about how current curriculum prepares students to commence professional careers in primary care. Understanding their perceptions may inform curriculum, improve …

Nurses' Perspectives Of Dysphagia Screening Practices In Irish Residential Long-Term Care Settings: A Qualitative Descriptive Study, Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney

Research outputs 2022 to 2026

Objectives To examine nurses’ perspectives on current dysphagia screening practices in Irish residential long-term care settings (RLTCS), and to investigate barriers and facilitators to nursing-led dysphagia screening within this healthcare context. Methods This study employed a qualitative descriptive design and was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Participants were recruited through purposive sampling from RLTCS located in the northeast of the Republic of Ireland. Eleven in-person focus group interviews were conducted with thirty-four nurses working in clinical and managerial roles. A semi-structured interview guide was utilised, and the data were subsequently analysed using reflexive …

Neonatal Assessment And Vr: Designing 3d Simulation Training For Prehospital Clinicians, Michella G. Hill, Luke Hopper, Belinda Flanagan, Sara Hansen, Alecka Miles, Jess Watson, Sean Cashman, Kirstie Balding, Peggy Dysktra, Joshua Johnson, Brennen Mills

Research outputs 2022 to 2026

Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk …

Pediatric Nurses' Perspectives Of Integrating Spiritual Care Into Everyday Practice: An Integrative Review, Yin May Htay, Mandie Foster, R. Mowat

Research outputs 2022 to 2026

Aim: To explore nurses' perspectives regarding children's spiritual care in pediatric healthcare settings. Background: Spiritual care is a fundamental source of comfort and healing and an essential. component of nursing practice. However, pediatric nurses often lack the competence and confidence to incorporate spiritual care into their clinical routines. Despite its importance, the perceptions and practices of pediatric nurses across various clinical specialties regarding spiritual care remain underexplored in current literature. Methods: The integrative review methodology was chosen to provide a comprehensive and up-to-date synthesis of the literature. Four electronic databases (CINAHL, MEDLINE, Scopus and Google Scholar) were used to search …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Implementation Of Staff Education To Reduce Or Prevent Pressure Injury, Beverley A. Moses

Doctoral Dissertations and Projects

Pressure injuries (PIs) present a significant clinical challenge in healthcare settings, particularly among patients with limited mobility, comorbidities, and complex musculoskeletal injuries. These injuries lead to adverse patient outcomes, such as increased morbidity, prolonged hospital stays, and an increase in healthcare costs. Despite advancements in clinical practice, PI prevention remains a critical area for quality improvement, necessitating a standardized, patient-centered approach to care. This Doctor of Nursing Practice (DNP) project aimed to improve patient outcomes by implementing a standardized educational initiative for nursing staff in a bone and joint unit at a private hospital in Upstate New York. The project …

Improving Advanced Care Planning Conversations And Documentation Through App Education And Standardized Epic Workflow: A Quality Improvement Initiative, Michelle N. Rutter, Emily Goldstein

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Advance care planning (ACP) is essential for ensuring (GOC), particularly in acute care settings, defined in this paper as inpatient hospital environments, including critical and intensive care units (ICU), where a patient’s decision-making capacity could become impaired. ICU patients are often critically ill and may lose the ability to make health care decisions. Family uncertainty regarding patient preferences frequently exacerbates psychological distress regarding GOC. Restricted access to ACP may result in non-concordant medical care, as well as elevated healthcare expenditures driven by the underutilization or inappropriate allocation of critical resources. Despite the recognized importance of ACP and …

Reducing Live Discharges Using A Tiered Protocol In A Rural Hospice: A Quality Improvement Project, Jemma Lowak

Doctor of Nursing Practice Final Project Abstract

Purpose: To reduce 30-day caregiver-driven hospice revocations by implementing a tiered post-admission nursing visit protocol based on caregiver preparedness. Background: Caregiver distress and inadequate support contribute to hospice revocations and interruptions in care. Increased nursing contact during the first week of enrollment may improve caregiver preparedness and reduce crisis-driven hospitalizations. Methodology: An eight-week quality improvement project using the Plan-Do-Study-Act framework was implemented at a rural hospice agency. Caregivers completed a Caregiver Preparedness Survey to assign preparedness tiers and guide additional nursing visits during the first week. Process measures included survey completion and protocol adherence. Outcome measures included caregiver preparedness and …

Improving Cpr Quality In The Emergency Department By Implementing Data Driven Debriefs, Alyssa M. Hughes

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of the quality improvement project was to evaluate the effectiveness of implementing a data driven debrief tool to improve the average compressions in target in adult cardio-pulmonary resuscitation (CPR) events.

Results

In FY23 prior to implementation the average compressions in target was only 1.65%. During the implementation phase of the project the average compressions in target reached 41% (n=3). In addition, the staff provided positive feedback regarding the tool and the integration in the workflow.

Background

The project was completed in a tertiary academic medical center emergency room. All adult CPR events within the emergency department utilizing …

Improving Response To Patient Alarms And Reducing Alarm Fatigue By Implementing An Alarm Fatigue Bundle Protocol In An Intermediate Care Unit At A Small Public Hospital, Christina Galvan

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to reduce alarm fatigue by implementing an alarm fatigue bundle protocol in an Intermediate Medical Unit (IMU) at a mall public hospital in Houston, Texas. The project aimed to achieve 80% compliance with daily electrode changes, improve alarm response times by 10%, reduce telemetry technician calls by 15%, and reduce alarm fatigue levels by 20%.

Background: Frequent non-actionable alarms can lead to desensitization, delayed responses, and missed alarms.

Methodology: The Plan-Do-Study-Act (PDSA) Model guided implementation of the CEASE bundle, focusing on staff education and daily electrode changes. Daily audits assessed skin preparation and …

The Measles Serology Initiative: A Quality Improvement Intervention To Increase Provider Compliance With Rubeola Serology Screening, Erika S. Martinez

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to increase provider adherence to Rubeola IgG serology screening during prenatal visits at an outpatient women’s health clinic by 10% from a baseline adherence rate of 63.3%.

Background

Rubeola remains a highly contagious viral infection that poses health risks for nonimmune pregnant patients and their newborns. With increasing Rubeola cases and the importance of identifying immunity status during pregnancy, consistent prenatal screening practices are essential. Baseline data demonstrated inconsistent adherence to Rubeola IgG screening recommendations, highlighting the need for workflow interventions to improve provider compliance.

Methodology

A pre-post QI design …

Reducing Potentially Preventable Emergency Department Visits (Ppvs) Through A Telehealth Intervention In Children With Asthma Within A Managed Care Organization (Mco), Renee A. Roker

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma …