Nursing Commons^™

Exploring The Relationships Between Emotional Intelligence, Perceived Organizational Support, Job Satisfaction, And Intent To Stay Among Minnesota School Nurses, Kristin K. Coudron

Dissertations, Theses, and Projects

School nurses face escalating job demands driven by increasing student health complexity, chronic condition management, and expanding public health responsibilities. Often serving as the sole healthcare professional within a school or district, they work in settings characterized by high autonomy, variable organizational support, and growing concerns about job satisfaction and retention. Limited empirical research has examined how personal and organizational resources jointly relate to school nurses’ intent to remain in practice. Guided by the Job Demands–Resources (JD–R) theory and the National Association of School Nurses School Nursing Practice Framework, this quantitative, correlational, cross-sectional study explored relationships among emotional intelligence, …

The Impact Of Virtual Discharge Interventions Compared To Traditional Methods On Adult Patient Population Readmission Rates: An Integrative Review, Tiffany Providence, Carrie Brooks, Nannono Kayondo, Courteney Lovell, Alice Smith

Master's Projects

Hospital readmissions are a persistent quality and cost burden to the healthcare system, prompting evaluation of modern strategies to strengthen transitional care. This integrative review synthesized findings from thirteen studies published between 2011 and 2025 to assess the effectiveness of virtual discharge interventions in reducing readmission rates among adult patients. Virtual discharge interventions included programs utilizing technology, such as phone calls, video visits, apps, or remote monitoring, to help patients understand their care and improve positive outcomes. Many of these studies showed that virtual support can reduce hospital readmissions, especially for people with heart failure. Some programs also improved patients’ …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

Facilitating Timely Hospice Referrals Using A Screening Toolkit In A Rural Hospital: A Quality Improvement Initiative, Jessica Muse

Doctoral Projects

End of life care is often a difficult time for patients, families, and caregivers. Hospice is a valuable resource for individuals who are considered terminally ill and have a life expectancy of six months or less. Many patients who are near the end present to acute care settings for treatment needs. While there are several clinical indicators that may suggest hospice care is the best plan of care for a patient, identifying hospice appropriate patients can be difficult in an acute care setting and there are currently no numerical assessment tools available in the literature that provides a quick reference …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Staff Education To Increase Knowledge And Awareness Of Sexually Transmitted Diseases, Alie Sholola Sahid

Walden Dissertations and Doctoral Studies

Background STIs or sexually transmitted diseases (STDs) are consequential public health emergencies that affect millions of people globally and have long-term health implications (Garcia et al., 2024). STIs are infections that are passed from one person to another through sexual contact with the most common types of STIs include chlamydia, trichomoniasis, general herpes, and human papillomavirus (HPV). It is estimated that each year, more than 20% of the U.S. population has had an STI, with around 26.2 million cases per year (Centers for Disease Control and Prevention [CDC], 2024a). The common types of STIs include chlamydia, trichomoniasis, general herpes, and …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh

Walden Dissertations and Doctoral Studies

Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …

Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …

Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson

Walden Dissertations and Doctoral Studies

Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …

Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project aimed to improve staff knowledge of the newly implemented electronic scheduling and booking kiosk system. A transition from a paper-based to an electronic scheduling system led to reduced staff efficiency, communication challenges, scheduling errors, and delays in patient care. An evaluation identified inconsistent staff knowledge of the newly implemented electronic scheduling system. The practice-focused question for the project was: Among healthcare staff in an intensive outpatient program, how does a one-time structured education and training session affect staff knowledge of a new electronic scheduling system? The purpose of this project was to …

The Evaluation Of The Epic Epidural Assessment Event And The Effects Of The Conversion Of Epidural To General Anesthesia For Cesarean Sections, Rebecca Turney, Bridget Shinnick

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Unplanned conversion from labor epidural analgesia to general anesthesia (GA) for cesarean delivery is associated with increased maternal and neonatal risk and may occur when inadequate epidural function is not recognized before operative delivery. This Doctor of Nursing Anesthesia Practice quality improvement project evaluated implementation of the Epic Epidural Assessment Event, a structured electronic medical record documentation tool designed to standardize epidural assessment during labor at a high-acuity obstetric referral center in Western Pennsylvania. Using a Plan-Do-Study-Act framework, the project compared pre- and post-implementation epidural-to-GA conversion trends, reviewed Epic audit data for documented tool utilization, and collected anonymous anesthesia provider …

A Quality Improvement Project On Maternal Hemorrhage Protocol Adherence, Cyrus Masih, Richard Zapata

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage is a leading cause of preventable maternal morbidity and mortality and requires rapid, coordinated response among obstetric, anesthesia, nursing, and blood-bank teams. This quality improvement project implemented and evaluated a California Maternal Quality Care Collaborative (CMQCC)-based Code OB maternal hemorrhage intervention at a western Pennsylvania hospital. The project aimed to improve anesthesia provider knowledge, confidence, and readiness to recognize, stage, and respond to maternal hemorrhage using standardized guidance, quantitative blood loss (QBL) measurement, and point-of-care cognitive support. Guided by the Institute for Healthcare Improvement Model for Improvement and a Plan-Do-Study-Act cycle, the intervention included a focused educational presentation …

Implementation Of A Discharge Planning Protocol, Sylvia Ngwikooh Forku

Walden Dissertations and Doctoral Studies

This doctoral project was a nursing led quality improvement initiative focused on standardizing discharge planning on an adult inpatient psychiatric unit. The goal of the project was to strengthen evidence-based, person-centered transitions of care to reduce readmissions and promote safer community reintegration for adults with serious mental illness. The practice focused question guiding this project was whether implementing an evidence based, standardized discharge planning protocol on an adult inpatient psychiatric unit would improve staff knowledge and adherence to best practice discharge elements and contribute to a favorable decrease in 30-day readmission rates. Analytical strategies included descriptive analysis of pre and …

Improving K-Card Observation Fidelity To Sustain A Culture Of Continuous Learning, John L. Ricks Iii

Master's Projects and Capstones

Problem

            Despite improvements in central line-associated bloodstream infection (CLABSI) attribution, variability in Kamishibai card (K-card) observation practices and documentation limited the unit's ability to identify, learn from, and correct persistent deviations from expected practice. Baseline data showed frequent incomplete documentation and a pattern of completing K-card observations outside bedside shift report.

Context

This project took place in a 20-bed medical-surgical ICU, using the existing K-card process to support high-reliability prevention of hospital-acquired conditions (HAC). Baseline assessment revealed inconsistent observation workflows, incomplete documentation, and unclear roles and expectations.

Interventions

A standardized K-card observation workflow was developed through rapid-cycle testing. Observations were …

Don’T Fall For It: Just-In-Time Staff Education To Reduce Patient Falls On An Adult Telemetry Unit, Forrest Wilcox, Kyle Knight, Jennifer Paiz, Zaira Garcia-Vega

Master's Projects and Capstones

Objective: Patient falls remain a leading cause of preventable harm among hospitalized adults and carry significant clinical and financial consequences. On an adult medical-surgical telemetry unit at this study site, a one-year review of 45 fall events found that most falls occurred among patients classified as high risk on the Morse Fall Scale, frequently without continuous observation or consistent purposeful rounding. Aim: The aim of this project is to reduce falls on the telemetry unit to the national benchmark of 3.2 falls per 1,000 patient days within a 6-month period. Methods: A just-in-time (JIT) education intervention was delivered to registered …

Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey

Walden Dissertations and Doctoral Studies

Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …

Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu

Walden Dissertations and Doctoral Studies

The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …

Staff Education To Improve Confidence Of Triage Decision-Making In Hospice After-Hours Care, Kelly Hurst

Walden Dissertations and Doctoral Studies

A quality improvement project addressed variability in after-hours hospice telephone triage through implementation of structured communication and symptom-based decision-support tools. The practice-focused question examined hospice triage nurses’ perceived confidence following implementation of these tools. A descriptive quality improvement design was used. Five hospice triage nurses received education on the CALMER communication technique and symptom-specific decision-support guides for anxiety and dyspnea. Outcomes were evaluated through a postimplementation survey assessing confidence, tool utilization, intervention perceptions, and practice recommendations. Quantitative responses were summarized using descriptive statistics, and qualitative responses were reviewed for themes. All participants reported high baseline confidence in hospice telephone triage. …