Nursing Commons^™

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Improving Colorectal Cancer Screening Referrals In A Rural Health Clinic, Kysha Mcbee

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Colorectal cancer is the second leading cause of cancer death in the United States. Preventive screening for colorectal cancer has been associated with early detection and improved 5-year survival rates. The referral rates for colorectal cancer screening at the practicum site were 17.7%, well below the national benchmarks of 71.8%.

Aim of the Project: The aim of this project was to increase the screening referral rates in adults aged 45 to 75 years by 50% over a ten-week period by implementing an evidence-based toolkit.

Review of the Evidence: Literature review highlighted barriers to colorectal cancer screening, such as knowledge …

Reducing Emergency Department Length Of Stay, Chelsea Zigan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Rising Emergency Department (ED) volumes and Registered Nurse (RN) shortages have led to overcrowding, delayed care, and inefficiencies. In 2023, patient visits exceeded budget projections by 14% for six months. From July to December 2024, discharged patients’ average ED length of stay (LOS) exceeded the three-hour target by over one hour, left without being seen (LWOBS) rates surpassed the 1% benchmark for five months, and diversion hours increased, restricting ambulance admissions. These issues strained nursing resources, reduced care quality, and heightened risks of complications and financial losses, emphasizing the need for a redesigned care model to optimize staff roles …

The Impact Of A Nurse Navigator On The Completion Of Medicare Annual Wellness Visits, Nanette L. Snyder

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Despite being a covered service designed to support individualized prevention planning, the Medicare Annual Wellness Visit (MAWV) remains underutilized at a rural Federally Qualified Health Center (FQHC). Barriers include low patient awareness, inconsistent outreach, and a reactive scheduling process that excludes patients without upcoming appointments. These issues limit the FQHC’s ability to meet preventive care goals and sustain performance in value-based reimbursement models.

Aim of the Project: This quality improvement project evaluates the impact of implementing a nurse navigator on MAWV completion. The intervention incorporates proactive scheduling and cohort engagement to address barriers related to awareness, access, and outreach. …

Preventing 30-Day Rehospitalization In Congestive Heart Failure Utilizing Transitional Care Teams, Esther Baminrin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Congestive Heart Failure (CHF) continues to be a prevalent and challenging health issue, contributing significantly to hospital readmissions within the first 30 days of patients transitioning to home health care. Rehospitalization affects the patient's quality of life and the agency's revenue, as reimbursements are paused when patients are hospitalized during the first 30 days of admission to a home health agency. The agency experienced a 22% rehospitalization rate within a year, slightly higher than the national average of 10%.

Aim of the Project: The primary objective of this project was to decrease rehospitalization of patients with CHF within the …

Improving Medication Nonadherence In Clients With Attention Deficit Hyperactivity Disorder Using Medication Reminder Applications, Christian Durand

All Doctor of Nursing Practice (DNP) Scholarly Projects

At an outpatient clinic in Southern California, a 77% medication adherence rate was observed in August 2024 among clients with ADHD. Medication nonadherence in ADHD clients may result in difficulty reaching therapeutic levels, leading to adverse outcomes, such as family disruptions, substance addiction, injuries, criminal occurrences, and even suicide. The project aims to reduce the number of ADHD clients who are noncompliant with their medications and surpass the national benchmark of 80% medication adherence. Evidence has suggested that MRAs may improve medication nonadherence among ADHD clients. Current research has supported the use of MRAs for various chronic diseases including diabetes …

Reducing Catheter-Associated Urinary Tract Infections In The Intensive Care Unit, Rosa Shiffman

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Despite established prevention guidelines, inconsistent practices in catheter removal and gaps in daily necessity reviews persist. At the project site’s 24-bed ICU, the CAUTI rate was 1.9 per 1000 catheter days, which exceeds the national benchmark of 1.0. Gaps in consistent assessment of necessity and delays in removal contributed to an elevated infection risk.

Aim of the Project: This project aimed to reduce CAUTI rates in the ICU through evidence-based interventions …

Implementing An Evidence-Based Transitional Care Toolkit To Reduce Postpartum Readmissions In Women With Chronic Conditions, Cassidy La Fleur

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postpartum women with preexisting chronic conditions are at increased risk of hospital readmissions due to fragmented care transitions and poor follow-up adherence. At the project site, the 30-day postpartum readmission rate was 10%, exceeding the national benchmark of 7.15%. Gaps in standardized discharge planning and limited patient engagement were identified as contributing factors.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce 30-day postpartum readmissions in women with chronic health conditions by implementing an evidence-based transitional care toolkit within a women’s outpatient clinic.

Review of the Evidence: Evidence supports the use of structured, …

Fall Prevention In Long-Term Care, Steven Zissler

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls among older adults residing in long-term care facilities continue to rise, resulting in injuries that contribute to adverse outcomes, a reduced quality of life, and increased healthcare costs. Despite existing safety interventions, falls persist, indicating a gap in effective, sustainable fall prevention strategies. Repeated failures to reduce falls among adults aged 65 years and older highlight the need for a structured, evidence-based approach aimed at addressing this critical patient safety issue.

Aim of the Project: The aim of this project was to reduce falls and fall-related injuries by 25% for older adults residing in a long-term care facility …

Promoting Inclusion Through Diverse Simulation Equipment, Patricia Pence, Valerie M. Wright, Myoungjin Kim, Kileigh J. Guido

Faculty Publications - Mennonite College of Nursing

Currently, simulation laboratory equipment predominantly represents patients with light-colored skin tones. A lack of varied skin-toned simulation equipment limits learning experiences if it does not reflect a diverse patient population or facilitate an inclusive learning environment. Simulation experiences should be designed to prepare students for the unique challenges of managing care for a diverse patient population. The literature notes that nursing schools across the United States are beginning to diversify simulation laboratory equipment to support an inclusive learning environment. However, sparse literature exists on evaluating diversity in simulation laboratory experiences. Little is known about student and faculty perceptions of satisfaction …

The Impact Of Utilizing Injectable Platelet-Rich Fibrin And Collagen Plugs For Maintaining The Tooth Extraction Socket: A Review Study, Esraa Hameed Hassan, Ali H. Abbas Alhussaini

Al-Esraa University College Journal for Medical Sciences

Tooth extraction initiates a cascade of biological changes that result in alveolar bone resorption, compromising both the esthetic and functional outcomes of future dental rehabilitations, particularly implant placement. Socket preservation strategies have emerged as crucial interventions aimed at minimizing post-extraction ridge collapse. This review explores the synergistic effects of injectable platelet-rich fibrin (I-PRF) and collagen plugs in enhancing socket preservation outcomes. Collagen plugs serve as biocompatible scaffolds, promoting hemostasis, cellular migration, and angiogenesis, while supporting soft tissue healing and bone regeneration. Concurrently, I-PRF-an autologous, growth factor-rich biomaterial-provides a dynamic reservoir of platelets, leukocytes, and key cytokines such as Platelet-Derived Growth …

Impact Of Insulin Resistance In Pcos (Lh/Fsh) In A Group Of Woman In Baghdad City, Roua Shehab-Aldeen Ahmed, Fatima Amer Abd Aljabar, Nadia Mohammed Mahdi Al-Shakir

Al-Esraa University College Journal for Medical Sciences

Background: Polycystic ovarian syndrome is an endocrinological disorder influencing ladies, and it is the foremost common cause of menstrual unsettling influence amid the regenerative age. Polycystic ovary disorder (PCOS) is in fact a chronic form of anovulation that is usually observed besides a large spectrum of clinical symptoms and signs. Objectives: The study's main goal is to evaluate the hormonal indicators of ``PCOS'' and insulin resistance and determine how insulin resistance affects these hormones. Materials and methods: This study included 130 women, aged 19--38, who were separated into three bunches: 40 women with ``PCOs'' who were treated with metformin and …

Exploring The Role Of Hepcidin And Some Biochemical Indicators In Β-Thalassemia Major Patients With Negative And Positive Entamoeba Histolytica, Jafar Jamal Abdullah, Mohammed Mezher Hussain, Abdul Rasool Kh. Saeed

Al-Esraa University College Journal for Medical Sciences

Thalassemia syndromes encompass a wide range of hemoglobin disorders characterized by either the absence or diminished production of normal globin chains. Hepcidin, a peptide produced by the liver with antimicrobial properties, is mainly synthesized by hepatocytes situated near the portal veins, which are responsible for transporting dietary iron, as well as by Kupffer cells. Before blood transfusions, increased erythropoietic activity leads to a reduction in hepcidin, resulting in lower hepcidin levels that enhance the absorption of dietary iron. Parasite protozoa depend on iron for their survival, as it plays a crucial role in the growth and enzymatic functions of E. …

Characterizing The Influence Of Racism-Related Stress And Pandemic-Related Changes In Social Connections On Cardiovascular Health: Study Protocol And Theoretical Framework, Jewel Scott Phd, Rn, Fnp-C, Victoria Money, Charles Ellis, Chanita Hughes-Halbert, Michelle A. Birkett, Gayenell Magwood

Faculty Publications

Background Cardiovascular-related morbidity and mortality among young adults are rising, and disparities between young Black and White women are immense. Health behaviors including physical activity and diet are essential for optimal cardiovascular health. Psychosocial factors, such as racism, perceived stress, and lack of social support, contribute to racial inequities in cardiovascular disease, which were further exacerbated by the COVID-19 pandemic. The proposed study aims to assess the influence of racism-related stress and other social determinants of health, including social connectedness, on quality of life and cardiovascular-related health behaviors. Methods This is a concurrent, triangulation, mixed-methods study combining survey data on …

Implementation Of A Zen Room And Mindfulness Techniques To Decrease Perceived Burnout, Danika Scott

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a Zen room and mindfulness techniques, aiming to improve job satisfaction by 65% and reduce perceived burnout by 10% among behavioral health staff. The project was conducted at a substance abuse center in Deer Park, TX.

Background: Behavioral health staff face high levels of emotional exhaustion and job-related stress, leading to increased burnout.

Methodology: The Plan-Do-Study-Act model guided the QI methodology using a sample of 23 behavioral health staff. Interventions included an equipped Zen space and wellness resources. Data collection utilized the Maslach Burnout Inventory and a …

Reporting And Tracking Of Occupational Bloodborne Pathogen Exposures, Olivia Smith

Doctor of Nursing Practice Final Project Abstract

Purpose/Background: Underreporting of occupational bloodborne pathogen (BBP) exposures remains a significant patient and employee safety issue. At UT Health, outdated paper-based systems hindered accurate tracking, timely follow-up, and reporting compliance. The aim of this quality improvement (QI) project was to achieve a 30% increase in quarterly BBP exposure reports, from 30 to 39, by implementing an electronic reporting system between January 1 and March 31, 2025.

Methodology: Guided by the Health Belief Model and using the Implementation and Improvement Science (IIS) Framework, the project replaced the existing paper form with an external, user-friendly digital system. Staff received structured training, and …

Using Meta-Analysis: What Exercise Helps Kids With Excess Weight The Most?, Marilyn Frenn

College of Nursing Faculty Research and Publications

No abstract provided.

Childhood Obesity Body Mass Index And Gut Microbiome: A Cluster Randomized Controlled Pilot Feasibility Study, Marilyn Frenn, Nita Salzman, Vy Lam, Mary Holtz, Andrea Moosreiner, Mauricio Garnier-Villarreal, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity.

Methods:

This cluster randomized controlled feasibility trial included an online program designed to improve …

The State Of The Science Of Natural Family Planning: A Report From Nfp Scientists’ Meeting Held In Orlando, Fl, September 4, 2024, Michael D. Manhart, Richard J. Fehring

College of Nursing Faculty Research and Publications

A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work was convened to review the available evidence in four topical areas: (i) evidence for effectiveness of NFP methods to postpone and achieve pregnancy, (ii) evidence for effectiveness in the postpartum and perimenopause transition periods, (iii) evaluate the current state of technology in NFP (specifically app and quantitative hormone monitoring), and (iv) evidence examining the impact of NFP on marital relations. In each topical area, the panel worked to reach a …

A Mixed Methods Study Exploring The Lived Experience Of Shared Trauma In Psychiatric Nurses During Covid-19, April Lynne Hutto

Theses and Dissertations

Introduction: Psychiatric nurses (PNs) had a unique lived experience of shared trauma (ST) during the COVID-19 pandemic. These nurses experienced the same traumatic event, COVID-19, with associated trauma symptoms as their patients. This mixed methods study aims to triangulate data on ST in PNs using a quantitative and qualitative study. Methods: PN (N=24) completed a semi-structured interview during the summer and fall of 2024. A quantitative study PN (N=552) in spring 2023, using the Shared Trauma and Professional Posttraumatic Growth (STPPG) inventory, was completed with descriptive and inferential statistics using SAS 9.4. A thematic analysis of the interviews was completed …

Assessing Health And Academic Disparities In The Deep South: The Enduring Impact Of Segregation And Redlining In Georgia, Bridget Hamilton

Theses and Dissertations

Background: Within the American South, marginalized Black populations continue to suffer from health disparities. A key resource that could aid in the prevention of health disparities such as teen pregnancy is the school nurse. School nurses are well positioned to assist in the development of independent health maintenance among student populations. However, school nurses remain understaffed and underfunded throughout most of the United States, which limits their effectiveness. It is possible that within southern states there are inequities in how school resources are allocated that have ties to segregation and redlining practices that systemically marginalized Black populations throughout the 1900s. …

Postoperative Care Pathways For Patients Following Coronary Artery Bypass Grafting Surgery: An Observational Study, Dima Nasrawi, Sharon Latimer, Debbie Massey, Brigid M. Gillespie

Research outputs 2022 to 2026

Aims: The aim of this study was to describe the postoperative care pathway, with phase 1 cardiac rehabilitation (CR) delivery, for adult patients following coronary artery bypass grafting (CABG) surgery at one large hospital in Queensland, Australia. Design and methods: This observational study involved structured observations, patient electronic medical record audits, and field notes to gather postoperative data. Four continuous hours of patient and healthcare professional (HCP) observations gathered at 30-min intervals occurred on 12 separate days over a 1-month period (February–March 2023). We observed post-CABG patients and HCPs involved in delivering direct care. Data were gathered on the clinical …

Midwifery Students' Evaluation Of Midwifery Practice Experiences In Australia: A National Survey, F. Bogossian, A. Hyun, D. Bloxsome, A. Brown, S. Cooper, S. Hunter, L. Kearney

Research outputs 2022 to 2026

Aim: To report the findings of the first 12 months of a national survey of midwifery students’ evaluation of midwifery practice experiences in Australia. Background: Accreditation standards for midwifery programs globally and in Australia, require evidence of monitoring and evaluation of student midwifery practice experiences. In 2022 the National Placement Evaluation Centre was commissioned to measure and enhance the quality of nursing and midwifery practice experiences. Design: Survey Methods: A national survey of midwifery students who completed midwifery practice experience in Australia between 1 July 2023 and 30 June 2024. Results: Midwifery practice experiences (n = 871) were evaluated; most …

Understanding Perceptions, Attitudes And Experiences Of Nursing Students During Clinical Placement In Primary Health Care Settings – A Scoping Review, Debbie Procter, Kylie Mccullough, Debbie Massey, Karen Strickland

Research outputs 2022 to 2026

Aims: Critically analyse literature on undergraduate nursing students' perceptions, attitudes and experiences during Primary Health Care (PHC) placements and identify factors influencing their satisfaction. These insights may improve educational outcomes, shape career intentions and address workforce shortages. Background: Global nursing shortage, driven by increased demands and high attrition, impacts healthcare worldwide. Australia faces projected shortfalls of 79,473 nurses by 2035, significantly in PHC. Attributing factors include remuneration disparities, inadequate training/mentorship and limited career pathways. Strengthening the PHC nursing workforce is crucial, with undergraduate nursing students providing an important workforce pipeline. Design/Method: Scoping Review protocol was registered using Joanna Briggs Institute's …

A Cross-Sectional Examination Of Missed Infection Control Practices Among Nurses In The Jordanian Hospitals, Muhammad Ahmed Alshyyab, Rania Ali Albsoul, Gerard Fitzgerald, Diana Arabiat

Research outputs 2022 to 2026

Background: Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined. Methods: A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using …

The Effects Of A Triaging Educational Training Program On Triaging Knowledge, Self-Efficacy And Accuracy In Emergency Department Nurses In A Private Hospital In Saudi Arabia, Sawsan Falatah, Janice Hawkins, Craig Cunningham

Graduate Student Government Association Research Conference

Inaccurate triage decisions can lead to increased length of patient stays in the emergency department, increased rehospitalizations, and increased risk of mortality, all of which are quality of care indicators (Srinivas et al., 2021). The triaging decisions in the emergency department at our facility are conducted by relatively new and inexperienced nurses. Anecdotal evidence from the emergency department leadership suggests that inaccurate triaging decisions are being made. In addition, 60 percent of a limited sample of 30 charts that were recently reviewed contained inaccurate triaging decisions. The accuracy of these triaging decisions has not been systematically evaluated at our facility. …

Correlation Between Drug-Related Problems And The Treatment Cost For Geriatric Ischemic Stroke Patients In Tulungagung, Dhanang Prawira Nugraha, Martanty Aditya

Jurnal Ekonomi Kesehatan Indonesia

Ischemic stroke was one of the diseases that frequently occurred in geriatric patients, while hemorrhagic stroke had a higher prevalence. Geriatric patients who experienced a stroke were not exempt from drug-related problems (DRP) due to the complexity of treatment and comorbid factors they encountered. This study aimed to determine the correlation between DRP and the cost of care for ischemic stroke patients, particularly in the geriatric population. The study design was cross-sectional, with data collected retrospectively, and the sample comprised 53 geriatric stroke patients who met the inclusion and exclusion criteria. DRP was assessed using the PCNE 6.2 criteria, and …

Women Managing Heart Disease: Involvement Of Spouse And Non-Spouse Care Partners, Elizabeth Richards

School of Nursing Faculty Publications

Purpose: Heart health is integral to promoting women’s overall health and healthcare. Following a cardiac event, engagement in recommended health-related activities (e.g., maintaining a healthy diet) speeds recovery and improves health. We investigate women’s perception of care partners who are involved in helping manage their heart disease. Methods: Data were drawn from two pilot studies (N = 54); interviews with women from hospital-based outpatient cardiac rehabilitation centers (study one), and online surveys completed by women with heart disease (study two). We compared women’s reports of involvement of their care partner (spouse vs non-spouse) in their health-related activities. Results: The proportion …

Staff Education On Evidence-Based Interventions To Reduce Fall Rates Among Hospitalized Adult Psychiatric Patients, Blessing Rita Ugbor

Walden Dissertations and Doctoral Studies

A staff education initiative was implemented in an inpatient psychiatric facility in the Southern United States to address the significant practice problem: inadequate knowledge of fall prevention strategies among psychiatric nurses. The identified knowledge gap impairs the nurses’ ability to recognize fall risk factors and apply evidence-based interventions. Psychiatric inpatients are particularly vulnerable to falls, which compromise patient safety, increase health care costs, and contribute to poor outcomes. The project was guided by a practice-focused question addressing whether staff education on evidence-based fall prevention strategies would enhance nurses’ knowledge and reduce fall rates. The purpose of the project was to …

An Exploration Of Adventist Nursing Practice In Liberia, Lendeh E. Seboe, Erhuvwukorotu S. Kollie, Boffa L. Kollie Nyumah

Adventist Human-Subject Researchers Association

This study explored nursing practice in Liberia using the integrated global framework for nursing education and practice. A descriptive Qualitative method was used through a group interview and purposive sampling technique for participant selection. FGD utilized for data collection and theoretical sampling for data saturation. Findings highlighted for improvement at the researched hospital and other SDA health care settings.