Nursing Commons^™

Baccalaureate Nursing Students’ Beliefs About Peer Feedback In The Nursing Skill Lab: Value, Quality, And Importance, Danielle Elizabeth Fleming

Walden Dissertations and Doctoral Studies

Peer feedback is an instructional method used in nursing education to support student success in the nursing program and professional practice. While a large body of evidence supports the merits of peer feedback as an instructional method, there is limited research on its use in nursing students, especially within the skill lab. The purpose of this study, guided by the feedback intervention theory, was to examine nursing students’ beliefs about peer feedback in the nursing skill lab and how those beliefs change over time. Archival data from the Beliefs About Peer Feedback Questionnaire (BPFQ) from a public midwestern university was …

Assessing The Efficacy Of Tranexamic Acid In Adjunct To Oxytocin In Reducing Blood Loss During Cesarean Deliveries: A Scoping Review, Hilary Clair Ray Bsn, Rn, Shelbie Freeman Hendrix Bsn, Rn, Lauren Elizabeth Hubbard Bsn, Rn, Helen Maisen Conley Bsn, Rn, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using …

Effects Of Exercise On Adhd Symptoms In Children And Adolescents, Morgan Mozinski

Nursing Capstones

The purpose of this study was to assess the impact of exercise compared to traditional treatment methods on symptoms of ADHD in children, such as improved executive function. A systematic literature review utilizing PubMed, CINAHL, and UND Medical Library resulted in a total of 113 articles, with 15 articles meeting inclusion and exclusion criteria. Results were filtered to studies within the past 5 years. Studies suggest that physical activity could be used as an adjunct to current treatment. Results of various studies support this concept as children showed an improvement in attention, a decrease in impulsivity and hyperactivity, and an …

Evaluation Of Depression Screening Tools For Utilization In Adolescents: A Scoping Review, Helen Whitaker Bsn, Rn, Jade Bray Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Anxiety and depression are prevalent mood disorders among the adolescent population with significant impacts on academic performance, social interactions, and mental well-being. With depression rates continuing to rise and suicide among the leading causes of death in adolescents, there is an urgent need for effective screening and intervention. While depression screening is recommended in the primary care setting, many adolescents do not have regular access to healthcare, complicating early identification and treatment. The purpose of this scoping review is to compare the effectiveness of two depression screening tools, the Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), …

Improving Handoffs Between Outpatient Clinics And Acute Cancer Care Centers At A Tertiary Oncology Hospital Using A Quality Improvement Methodology, Mini George, Mohamed Ait Aiss, Gabriele Urschel, Maria Franco Vega, Susan Gaeta, Diane Bodurka

Advances in Cancer Education and Quality Improvement

Accrediting agencies recommend safe and accurate transfer of clinical information during care transitions. At our institution, a tertiary care cancer hospital, ambulatory clinic providers use multiple methods for communicating essential information to emergency care providers. Therefore, we initiated a quality improvement project using a standardized electronic handoff during the transfer of care between providers at outpatient clinics and acute cancer care centers. The project was launched in May 2023 and aimed to achieve electronic handoff for 70% or more of ambulatory care patients transferred to emergency care by October 2023. A multidisciplinary team developed an electronic handoff, provided training, and …

Enhancing Schizophrenia Treatment Outcomes: Integrating Cbt With Medication Therapy To Reduce Hospital Readmission, Kamauri Fleming Msn, Rn, Grace Adeniji-Ilesanmi Fnp-Bc, Zillah Anagho Tah Fnp-C, Alex Cook Msn, Rn, Margaret Harvey Phd, Acnp-Bc, Chfn, Sharon Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn, Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Schizophrenia is a chronic mental illness that disrupts cognition, emotion, and social functioning, imposing significant personal and societal burdens. While antipsychotic medications are effective in alleviating psychotic symptoms, they are often associated with side effects, poor adherence, and relapse risk. Cognitive behavioral therapy (CBT) has shown promise as an adjunct to medication, addressing persistent symptoms and improving outcomes. This scoping review examines the integration of CBT with medication therapy to reduce hospital readmissions and improve quality of life for adult patients hospitalized with schizophrenia.

Methods A systematic search of databases, including PubMed, PsycINFO, Embase, and Cochrane Library, was conducted …

The Incidence Of Hospital-Acquired Pressure Injuries In The Setting Of The Changing Nursing Workforce Throughout The Covid-19 Pandemic, Jacqueline H. Jacobs

MUSC Theses and Dissertations

Background: This study examines how the experience level of Registered Nurses (RNs) has declined while the incidence of hospital-acquired pressure injuries (HAPIs) has increased from 2018 to 2022. Purpose: To evaluate the association between nurses’ experience level and patient outcomes, specifically HAPIs, on a state-by-state basis. Methods: Retrospective, observational study of Medicare patients hospitalized in 41 states using the Medicare 5% Limited Dataset. Nurse experience was measured by the date of first licensure using the Nursing Sample Survey of Registered Nurses (NSSRN). Outcomes include a comparison of the percent increase in HAPIs and change in RN experience level by state. …

Streamlining A Faculty Simulation Educational Program To Improve Faculty Confidence And Proficiency, Megan Lannom

Doctor of Nursing Practice Projects

Simulation-based education is essential to clinical preparedness in nursing. This quality improvement project aimed to enhance nursing faculty confidence and proficiency through a structured training program. Faculty at a private university participated in training grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards of Best Practice, addressing core components including facilitation, prebriefing, debriefing, evaluation, and terminology. A mixed-methods, quasi-experimental design guided the project. Data analysis ensured methodological rigor through appropriate statistical and qualitative strategies. The Simulation Educator Needs Assessment Tool (SENAT) was administered pre- and post-intervention with thirteen faculty participants. Descriptive statistics summarized demographic …

Policy Project Optimizing Post-Discharge Process: Creating A Policy For Improved Efficiency, Deniece S. Parkinson

Doctor of Nursing Practice Projects

The immediate period following hospital discharge is critical for ensuring continuity of care and reducing adverse outcomes. However, the current post-discharge processes utilized in community care could be more effective. The fragmented approach involves multiple individuals, often leading to patient confusion, missed visits, and inefficient communication. These issues contribute to high rehospitalization rates, frequent emergency room visits, and increased healthcare costs. This project proposes a streamlined post-discharge policy managed by a centralized team of one provider and a Nurse Care Manager. The policy aims to refine the processes currently used in each market into a consolidated, well-defined care model to …

Quality Improvement Project Enhancing Patient Care In Nurse Practitioner Private Practices: A Train-The-Trainer Approach To Implementing Evidence-Based Chronic Mental Disease Management Interventions, Chioma Waters

Doctor of Nursing Practice Projects

Chronic mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are frequently treated by nurse practitioners (NPs) in outpatient private practices. Despite the evidence supporting Cognitive Behavioral Therapy (CBT) as a first-line intervention, its utilization remains limited in NP settings, often due to lack of training and confidence. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether a structured train-the-trainer program could improve NP confidence in applying CBT in practice. Guided by the Iowa Model and Kotter’s 8-Step Change Model, this quality improvement project utilized a quasi-experimental, pre-post survey design to assess …

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Nurses Confidence And Knowledge Improvement For Sleep In Sleep Hygiene Education, Rawda Nourain

Doctor of Nursing Practice Projects

The purpose of this DNP project was to increase the knowledge and self-confidence of nurses in relation to sleep hygiene practices for psychiatric patients to improve sleep quality and overall mental health. In this study, a pre- and post-intervention design was used for four nurses in a psychiatric unit. The intervention was comprised of teaching the patients about sleep hygiene practices, altering the environment (light and noise reduction), and using non-drug approaches. Knowledge assessments and self-confidence surveys were used to collect the data. All the participants were able to recall the correct sleep hygiene knowledge after the intervention, and all …

Quality Improvement Project Staff Development For Fall Prevention In Community Living Center, Morayo Olatunbosun

Doctor of Nursing Practice Projects

Falls among elderly residents in the community living center continue to be a serious public health concern, increasing mortality, morbidity, and healthcare costs. Despite existing prevention measures, fall-related incidence remains high. The purpose of this quality improvement project is to reduce fall rate in a community living center by implementing structured staff training. A facility needs assessment revealed gaps in fall prevention knowledge, inconsistent protocol use, and limited staff confidence in managing fall risks. In the methodology used to answer the PICOT question, the Donabedian Model guided structure, process, and outcome evaluation, while Kotter’s Change Model informed implementation strategies. The …

Quality Improvement Project Provider Burnout Related To Patient Satisfaction, Sherita Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Quality Improvement Project The Impact Of Weekly Reminders On Clinician Adherence To Standardized Order Sets, Blair Robillard

Doctor of Nursing Practice Projects

Clinical decision support tools are commonly utilized in clinical practice to assist with decision making and encourage use of evidence-based practices. This quality improvement (QI) project addressed the problem of inconsistent use of CDS tools in clinical practice. Specifically, this QI project addressed suboptimal adherence to standardized order sets (SOS) for congestive heart failure (CHF) treatment by hospitalist providers in an inpatient setting. The purpose of this QI project was to evaluate the impact of weekly educational reminder emails, known as nudges, on CHF SOS utilization over six weeks. A pre- and post-intervention design compared SOS usage rates before and …

Impact Of Nursing Burnout On Preceptors During The Transition Phase Of New Graduates Into The Workforce, Janessa Truss

Doctor of Nursing Practice Projects

There is a massive threat to healthcare systems posed by the growing burnout of inexperienced RNs working in practice transition to new graduate preceptors. Currently, this "Doctor of Nursing Practice (DNP) project" examines the role of the nurse in burnout within Long Term Acute Care (LTAC) facilities through the preceptorship. In the project, burnout factors and their effects on patient care and nursing workforce retention will be investigated, and interventions for burnout and its effects will develop. A mixed methods project involving qualitative and survey and interview analyses of five-year and older patients was performed. Burnout and job satisfaction were …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

Men’S Preconception Health: Impact On Pregnancy And Awareness Strategies., Kara I. Carr

Honors Capstones

Men’s preconception health plays a critical role in pregnancy outcomes, but it continues to be overlooked in healthcare education. While women are routinely counseled by OBGYN providers on how nutrition, lifestyle, and chronic conditions can affect fertility, men often receive little to no guidance from their primary care providers. This project uses a literature review to look deeper into how limited awareness and involvement in men’s preconception health may impact pregnancy and infant health outcomes. The gap is linked to cultural norms, healthcare practices, and the lack of clear resources for men. This research aims to develop strategies that promote …

Unlicensed Assistive Personnel’S Attitudes, Knowledge, And Perceptions Of Alternatives To The Application Of Physical Restraints, Gale Marie Knight

Walden Dissertations and Doctoral Studies

The use of physical restraints in mental health care settings is a common practice, yet it poses significant risks to patients’ physical and psychological well-being. The issue of excessive restraint use was addressed through this doctoral project by designing an educational program aimed at promoting alternative strategies. The practice-focused question was: How can an educational program for unlicensed assistive personnel (UAP) impact their knowledge and attitudes towards alternatives to physical restraints? The purpose of the project was to develop and evaluate an education program to improve UAP knowledge and attitudes to reduce reliance on physical restraints. The project was informed …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

An Educational Intervention Focused On The Importance Of Nurse Leader Rounds, Shantelle Mobley

Walden Dissertations and Doctoral Studies

Nurse leader rounding (NLR) is essential in most healthcare organizations as NLR has been associated with improved nurse recruitment and retention, increased patient satisfaction, and increased quality of care. In the local organization, leadership identified that there was a lack of knowledge and awareness of NLR among nurse managers and charge nurses. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an education intervention focused on structured NLR increased knowledge and awareness among charge nurses and nurse managers. Thirty-seven individuals were invited to participate in the educational intervention. With the support of leadership, 34 …

Enhancing Dermatologic Education In A Family Nurse Practitioner Program: A Quality Improvement Project That Promotes Skin Assessment Competency In Diverse Populations, Solonge Schiavone

DNP Projects

Background: Dermatologic education in Nurse Practitioner (NP) programs often lacks adequate representation of skin conditions in patients with darker skin tones, contributing to diagnostic disparities and delayed treatment. This quality improvement (QI) project aimed to integrate culturally competent dermatologic content into the Primary Care I course at Sacred Heart University to enhance diagnostic accuracy and student confidence.

Purpose: The primary goals were to improve NP students’ knowledge and confidence in diagnosing dermatologic conditions across diverse skin tones and to evaluate the effectiveness of an educational intervention using pre- and post-intervention assessments.

Methods: The project utilized the Six Sigma DMAIC framework. …