Nursing Commons^™

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Recurrent Urinary Tract Infections In The Urgent Care Clinic, Stephanie Krol

Evidence-Based Practice Project Reports

Nearly 60% of women will suffer from a urinary tract infection (UTI) in their lifetime, with 20- 40% of them suffering from multiple (Anger et al., 2022). The primary purpose of this evidence-based project was to implement a multi-modal intervention to improve identification of women who suffer from recurrent urinary tract infections (rUTIs) and to assist in the prevention and treatment of future UTIs. Additionally, the project aimed to increase the number of referrals to urology for better management of these patients. This project was implemented at an Urgent Care Clinic (UCC) in northwest Indiana. Eligible participants who presented with …

Sugammadex For Reversal Of Neuromuscular Blocking Agents Versus Neostigmine - Safety Comparison, Amanda K. Butler, Daniel Belu, Bailey Accardo, Courtney Ayana Bullard, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Sugammadex and neostigmine are two common drugs used to reverse neuromuscular blockade in anesthesia, but they differ in mechanism of action, side effects, and cost.

Sugammadex provides rapid reversal, has fewer side effects, and has a lower risk of bradycardia than neostigmine. This scoping review examines the frequency of bradycardia in adult surgical patients receiving sugammadex versus neostigmine.

Methods

A scoping review was completed of peer-reviewed articles comparing the incidence of bradycardia in adult surgical patients after the administration of sugammadex and neostigmine for neuromuscular blockade reversal. Findings indicate that sugammadex resulted in fewer adverse events, including bradycardia, than …

Activity Of Novel Ceftibuten-Avibactam, Ceftazidime-Avibactam, And Comparators Against A Challenge Set Of Enterobacterales From Outpatient Centers And Nursing Homes Across The United States (2022-2024), Aliaa Fouad, May M. Bobenchik, Robin Chamberland, Andrew E. Clark, Holly K. Huse, Isabella W. Martin, A Brian Mochon, Erik Munson, Maroun M. Sfeir, Monica Srodon, Kimberly A. Taylor Dnp, Rn, Nea-Bc, Cnor, Clssbb, Yungchou Wang, Lars F. Westblade, David P. Nicolau, Tomefa E. Asempa

Publications

Ceftibuten is being developed in combination with the oral prodrug of avibactam. Outpatient isolates (n = 500) from 11 US states underwent susceptibility testing with manual broth microdilution. Ceftibuten had susceptibility rates of 64% (CLSI) and 23% (EUCAST). Ceftibuten-avibactam achieved 96.4% inhibition at MIC ≤ 1 µg/mL. Susceptibility rates were as follows: cefpodoxime (2.6%), ceftriaxone (1%), ceftazidime-avibactam (99.6%), tebipenem (89%), ertapenem (94.4%), levofloxacin (26.6%), trimethoprim-sulfamethoxazole (40.2%), and fosfomycin (96.8%). Ceftibuten-avibactam demonstrates potent in vitro activity against cephalosporin non-susceptible isolates.

Patient Perception Of Nurse Practitioner Care, Nurse Practitioner Scope Of Practice And How That Influences Provider Choice, Naomi Hemp

Doctoral Projects

This project investigates patients' perceptions of nurse practitioner (NP) care versus physician (MD) care, the factors influencing these perceptions, and patients' understanding of NP scope of practice. A cross-sectional design was used, gathering quantitative data through an anonymous one-time survey distributed via Qualtrics, open for three months. Questions were based on The Watson Caritas Patient Score (WCPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). Data were analyzed using Intellectus Statistics software™, with descriptive statistics summarizing the findings. A two-tailed paired samples t-test revealed statistically significant differences in favor of patients' perceptions of NP care versus …

De-Escalation Techniques To Combat Workplace Violence Against Nurses, Sarah Jones

Aurora

Abstract

Problem: Workplace violence is on the rise in healthcare systems across the world, which is a major concern. Studies have found that nurses do not feel they can do their jobs effectively due to worries of potential harm to themselves and even their patients. There has been evidence that there are no effective methods in place to help healthcare workers remain safe and know how to handle these violent situations properly.

Purpose: The purpose of this project is to determine if de-escalation training increases nurses' feelings of preparation for violent situations and decreases incidences of workplace violence.

Methods: This …

Stethoscope Hygiene And Its Relationship To Healthcare Acquired Infections: A Research Proposal, Thomas P. Baker

Aurora

Problem: Healthcare Acquired Infections (HAIs) are an increasingly prevalent issue in healthcare. While hand hygiene is the most effective method to prevent HAIs, stethoscope hygiene may be an underutilized practice that can further prevent HAIs.

Purpose: The purpose of the research proposal is to determine if patients are more at risk of acquiring a HAI from improperly sanitized stethoscopes in comparison to stethoscopes that are cleaned in accordance with best practice methods while being treated in a hospital.

Methods: This proposal is a mixed-methods study. A 30-minute educational seminar on the importance of stethoscope hygiene and evidence-based …

The Lasting Legacy Of Dr. Fritz Smith And Dr. Aminah Raheem: Founders Of Zero Balancing And Soul Lightening/Insight Acupressure, Deanna Waggy Otr

Journal of Transformative Touch

Dr. Fritz Smith and Dr. Aminah Raheem were pioneers in the field of holistic bodywork. Their innovative techniques, Zero Balancing (ZB) and Insight Acupressure (formerly Soul Lightening International), helped shape integrative medicine practitioners around the globe. Their marriage not only symbolized a personal union but also a professional synergy, with their complementary therapies offering a yin-yang approach to mind-body healing. Their legacy continues through the many practitioners trained in Zero Balancing and Soul Lightening/Insight Acupressure and the various organizations that uphold their commitment to research, education, and professional standards.

Psychological Impact Of Ulcerative Colitis On Pregnancy And Postpartum Period, Stephanie C. Carver

Nursing | Student Research Posters

No abstract provided.

Cardiovascular Health In The Transition From Adolescence To Emerging Adulthood: A Scientific Statement From The American Heart Association, Jewel Scott Phd, Rn, Fnp-C, Anandita Agarwala, Carissa M. Baker-Smith, Matthew J. Feinstein, Karen Jakubowski, Jill Kaar, Niyati Parekh, Kershaw V. Patel, Janna Stephens

Faculty Publications

Cardiovascular disease remains a leading cause of death in the United States, with an alarming rise in the proportion of young adults experiencing cardiovascular events. Many adolescents enter adulthood with significant cardiovascular disease risk factors. This scientific statement addresses the critical need for cardiovascular health promotion during emerging adulthood, a transitional stage between the ages of 18 and 25 or 29 years of age. We discuss the significance of social determinants of health and the interplay between individual-level risk factors and developmental changes, including shifts in substance use, social connections, and emotional well-being. We conclude by outlining strategies for optimizing …

Implementation Of An Evidence-Based Hearing Education Project For Patients And Their Care Partners, Jennifer Mahoney

Doctoral Projects

Hearing loss is a significant communication issue that impacts relationships, safety, and mental and physical health. There is an increased risk of dementia as well as increased mortality associated with untreated hearing loss. Hearing aids are one of the main treatments for hearing loss, but they are frequently not used. Cognitive impairment, osteoarthritis of the hands, cost and complexity are some of the reasons that hearing aids do not get utilized. But research has shown that involving family members and care partners in trainings on how to use hearing aids may increase use of them. The goal of this project …

Seeking Healthcare In Many Different Places: Mental Health Strengths And Challenges Among Omani Female Adolescents, Zeyana Al Ismaili, Faye Gary, Cheryl M. Killion, Diana Lynn Morris, Sharon E. Milligan

Student Scholarship

Background: Adolescents undergo overwhelming physiological, psychological, social, and cognitive changes. The stress can be worse when they must meet cultural expectations. However, there is a paucity of literature regarding the cultural impact on adolescent mental health. Purpose: The phenomenological study aimed to describe Omani female adolescents' lived experiences with mental health issues within their cultural context and future well-being. Methods: The study employed semi-structured individual interview questions using a secured videoconferencing Zoom meeting. The participants were recruited using purposive sampling. The participants included single female Omani adolescents (aged: 18–24 years). A horizontalization analysis followed the transcription, translation, and backward translation …

Decreasing Incidence Of Intramuscular Emergency Psychiatry Medications In Psychiatric Adult Patients Through The Acute Violent Assessment Tool (Avat), Edidiong G. Ebong

Doctor of Nursing Practice Final Project Abstract

Purpose The purpose of this QI project was to reduce emergency IM psychiatric medication usage by implementing the Acute Violent Assessment Tool (AVAT) to improve early aggression management. Background The frequent use of emergency intramuscular (IM) psychiatric medications in inpatient psychiatric settings raises concerns regarding patient safety, autonomy, and staff burden. This quality improvement (QI) project aimed to reduce emergency IM medication administration by 20% over three months by implementing the AVAT to improve early identification, prediction, and management of aggression and violence. Methodology A Plan-Do-Study-Act (PDSA) framework guided the AVAT implementation in an adult psychiatric unit. Three weeks of …

A Quality Improvement Project On Implementing A Nurse-Driven Foley Catheter Removal Protocol Using Modified Houdini Criteria For Oncology Patients To Reduce The Catheter-Associated Urinary Tract Infection (Cauti) And Catheter Days In The Intensive Care Unit (Icu), Rittu K. Justin

Doctor of Nursing Practice Final Project Abstract

Purpose: This scholarly project aimed to develop modified criteria for oncology patients regarding Foley catheter removal guidance and implement a nurse initiative in the ICU to reduce CAUTI and catheter days.

Background: CAUTIs are considered preventable nosocomial infections; hence, a nurse-driven Foley catheter removal protocol has become an essential strategy in healthcare to reduce CAUTIs. The project was implemented in a 43-bed ICU in an academic hospital at the Texas Medical Center. The 12-week pilot project included adult patients with a primary diagnosis of cancer.

Methodology: A quantitative design with a PDSA framework was employed. The institutional infection control trend …

Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Staff Education On The Importance Of Polypharmacy Management, Ronie Emmanuel

Walden Dissertations and Doctoral Studies

This DNP project was a staff education created to address the practice problem of staff knowledge deficit around polypharmacy management in an outpatient internal medicine clinic. Inadequate staff education and inconsistent use of validated tools contribute to medication errors, adverse drug events, and fragmented care, thereby increasing health care costs and patient risk. The practice-focused question was: Will staff education on the importance of polypharmacy management increase staff knowledge? The purpose of this education project was to implement and evaluate a targeted staff education program focused on polypharmacy risks, safe prescribing practices, and the application of evidence-based strategies, such as …

The Effects Of Healthcare Professionals Wearing Nail Enhancements, Sydney Johnson

Honors Capstones

Healthcare-associated infections (HAIs) continue to be a major concern in hospital settings, with one in thirty-one patients affected daily in the United States (CDC, 2020). While hand hygiene is widely promoted, the impact of nail enhancements worn by healthcare workers is often overlooked. Acrylics, gels, and other artificial nails can harbor bacteria even after handwashing and glove use, increasing the risk of infection transmission.

The purpose of this study was to explore whether hospitals with stricter nail enhancement policies have better staff hygiene practices and potentially lower rates of HAIs. This research used an original survey distributed to registered nurses …

Staff Education To Early Detection And Response To Patient Decline, Kein Gareth Rufino Pantaleon

Walden Dissertations and Doctoral Studies

This doctoral project implemented a staff education program to enhance early recognition and escalation of patient deterioration. Conducted at a 343-bed acute care hospital, the initiative addressed the ongoing problem of delayed detection and response to clinical decline, which often results in rapid response team activations and code blue events. Delays in intervention increase patient morbidity and mortality, despite many of these events being preventable through timely action. The project evaluated whether an interactive targeted education program could improve nursing staff’s knowledge, confidence, and willingness to activate escalation protocols, including Condition H and Code Help. Pre- and post-education surveys were …

Vocal Toning Increasing The Parent-Child Bond In Neonatal Care: A Proposed Method, Mikki Mcintire

Expressive Therapies Theses

Vocal toning in the Neonatal Intensive Care Unit (NICU) is an innovative therapeutic method that greatly improves emotional connections between caregivers and fragile infants. This practice is more than just a new idea; it fosters the crucial relationships essential for developing newborns. Vocal toning also aids in stabilizing physiological responses and promoting emotional regulation in infants, who are often subjected to high-stress situations. Using structured vocalization techniques, caregivers can provide consistent auditory and vibrational cues that encourage relaxation and promote co-regulation with the infants in their care. This proposed approach examines the theoretical foundation, solid methodology, practical application, and anticipated …

The Impact Of Maternal Mental Health On Child Development, Jessica White

Nursing | Student Research Posters

No abstract provided.

Improving Therapeutic Communication Between Patients And Nurses Using The Commit To Sit Method In The Obgyn/Postpartum/Mother-Baby Unit, Simisola A. Shodunke

Doctor of Nursing Practice Final Project Abstract

Purpose

To improve patients’ perceptions of nurses by listening to their needs, helping nurses to engage with their patients therapeutically in the OBGYN/Postpartum/Mother-Baby unit. Aiming to increase patient satisfaction scores from 62.5% to 70% by December 2024 using the "Commit to Sit" method.

Background

The project was implemented in an OBGYN/Postpartum/Mother-Baby Unit, addressing the concerns of the patient’s perception of nurses not listening and addressing their needs which has contributed to a decline in patient satisfaction scores.

Methodology

The Plan-Do-Study-Act (PDSA) model was used. Nurses were trained to sit at eye level with patients for 3–5 minutes per shift. Data …

Staff Education To Reduce Medication Error In Psychiatric Intensive Care Unit, Christiana Omodugba-Udeh

Walden Dissertations and Doctoral Studies

Summary This staff education project was an initiative designed to address the practice problem of medication errors in the psychiatric intensive care unit (PICU). The project’s purpose was to improve the nursing staff’s knowledge regarding medication administration and documentation through a structured educational intervention. The practice-focused question was: Will staff education on medication administration and documentation in the electronic medical record (EMR) result in an increase in staff knowledge with an aim to promote a reduction in medication errors in the PICU? The education was delivered through in-person sessions during regularly scheduled staff meetings to ensure full participation without disrupting …

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

A Multicomponent Quality Improvement Initiative For The Early Identification, Prevention, And Management Of Delirium In The Medical-Surgical Setting, Sarah K. West

Doctor of Nursing Practice Scholarly Projects

Hospital-acquired delirium affects older adult patients, across the healthcare continuum. The incidence in frail older adults is high, costly, and often deemed preventable. Hospital-acquired delirium is associated with a multitude of short- and long-term complications, resulting in an increased rate of morbidity and mortality. The challenges of early recognition and management are prevalent in healthcare literature. While published guidelines exist, hospital systems continue to struggle with the standardization of geriatric delirium care. Given medical-surgical nursing is the cornerstone of hospital care, it is imperative to establish a standardized delirium prevention and management guideline, at this level of care, to optimize …

Enhancing Advanced Practice Nursing: Implementing A Simulation-Based Point-Of-Care Ultrasound Training Program, Brandy Younge, John Chovan, Bonnie Fagan, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Nurse practitioners (NPs) are advanced practice nurses entrusted with diagnosing and treating illnesses, managing acute and chronic diseases, and engaging in continuous education to remain knowledgeable of evidence-based advancements. NPs offer a comprehensive range of healthcare services, catering to patients from wellness check-ups to those requiring complex care, such as individuals hospitalized with sepsis. One technological advancement that can support NPs in delivering optimal patient care is point-of-care ultrasound (POCUS). In the United States, over 385,000 NPs practice in patient care settings that may use POCUS. Numerous medical societies have issued position statements supporting the use of POCUS in the …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Diabetes Self-Management Education For Older Adults In Primary Care, Makilah Rae Furlan

Doctor of Nursing Practice Scholarly Projects

Type 2 Diabetes (T2DM) is a chronic disease that impacts 27.2 million seniors 65 and older. Evidence-based care for T2DM includes a combination of medication and disease-management behaviors. Access to education to teach patients healthy behaviors to manage their disease is limited and even less accessible to geriatric patients with aging learning needs. The scholarly project addresses this gap in patient education by implementing evidence-based diabetes self-management education for geriatric patients to increase patient knowledge and confidence in implementing self-management behaviors. The scholarly project aims to assess health behaviors in patients aged 65 and older with established type 2 diabetes …

Evidence-Based Practice Guidelines For Perioperative Use Of Dexmedetomidine In Pediatric Congenital Cardiac Surgery, Kayla Thomsen

Doctor of Nursing Practice Scholarly Projects

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of …

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

A Proposal: Gap Analysis On Novice Advanced Practice Provider Role Transition Within The Inpatient Setting, Erin Cornelius

Doctor of Nursing Practice Scholarly Projects

Background: Healthcare specialties are an integral part of patient care yet are briefly discussed throughout the academic journey of the advanced practice provider (APP). Hiring departments or facilities must provide further education on complex specialties. Due to a decline in practicing physicians, APPs will provide more patient care within specialties by 2032.

Purpose: To emphasize the importance of a high-quality onboarding program for the success of the APP, the department, and the hiring facility.

Method: Proposed data collection involves a two-part survey using the Novice Nurse Practitioner Role Transition (NNPRT) scale and an onboarding experiences survey.

Results: A literature thematic …