Nursing Commons^™

Improving The Experience Of Self-Injection In Medical Weight Loss Patients Prescribed Glp-1 Agonists: A Quality Improvement Project, Maegan Wing

DNP Projects

Background/Introduction: Obesity is a chronic disease linked to numerous health complications. Glucagon-like peptide-1 (GLP-1) agonists, including Semaglutide, Liraglutide, Dulaglutide, and Tirzepatide, are effective in weight management but require self-injection. Many patients experience barriers such as needle fear, technique difficulties, and anxiety, leading to early medication discontinuation. Data indicates that only 46.3% of patients continue GLP-1 therapy after 180 days, with adherence rates as low as 27.2% (Gleason et al., 2024). Addressing these barriers through structured provider-led self-injection training is essential to improve adherence, enhance patient outcomes, and reduce healthcare costs. Currently, at this DNP project site, there is a …

Reducing The Use Of Opioids In Post-Operative Pain Management: A Pilot Patient Education Quality Improvement Project, Nia Greene

DNP Projects

Background

The opioid crisis highlights the urgent need for safer postoperative pain management. Many patients lack knowledge about proper opioid use, associated risks, and alternative options, increasing the risk of misuse. This pilot quality improvement project aimed to evaluate the impact of preoperative patient education on opioid knowledge and use at a high-volume orthopedic practice in the Northeast.

Project Goals

The primary goals were to assess the feasibility of implementing a full-scale quality improvement initiative, reduce postoperative opioid use, and enhance patient understanding of opioid therapy, including safe use and alternative pain management strategies.

Methods

Using the Iowa Model of …

Standardizing Heart Failure Discharges: Reducing 30-Day Readmission Rates, Angela Keziah

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Patients readmitted with heart failure (HF) suffer increased mortality, reduced quality of life, and heightened medical expenses, though most readmissions are preventable with a consistent HF discharge regimen.

Purpose: To determine if a consistent HF discharge regimen using an evidence-based HF discharge checklist tool, including standardized HF education and a scheduled follow-up appointment with their cardiologist within 7-10 days post-discharge, impacted HF 30-day readmission rates.

Methods: An evidence-based HF discharge checklist tool was placed on participants’ charts on the Progressive Care Unit (PCU) and utilized by the PCU nurses to standardize HF discharges.

Inclusion Criteria: The study included …

Evaluating The Effectiveness Of A Behavioral Emergency Response Team In An Emergency Department, Kim Jai

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The increasing incidence of occupational workplace violence (OWPV) in hospitals, especially in emergency departments (EDs), has become a significant concern in the United States. Given the increasing risk of the occurrence of workplace violence (OWPV) from patients and family members, hospitals have instituted the Behavioral Emergency Response Team (BERT) protocol, comprising trained staff members with expertise in acute psychiatric disorders and de-escalation techniques for managing assaultive behaviors.

Purpose: Evaluate a Behavioral Emergency Response Team (BERT) protocol implemented in an emergency department and make recommendations for improvement.

Methods: Using the Centers for Disease Control and Prevention's Logic Model, this …

Intramuscular Injection Guideline Revisions Are Needed Based On Body Mass Index, Needle Length, Sex, And Skin To Muscle Depth, Pamela Strohfus

Boise State University Publications and Presentations

Background: Medications and vaccines are delivered via intramuscular injection throughout the world to improve health and to prevent or treat illness. Intramuscular injections are an essential nursing and pharmacist skill which includes choosing an appropriate injection site and selecting needle lengths and gages based on weight and muscle mass. Scientific evidence suggests changes in current practice and national guidelines to fully reach medication and vaccine efficacy.

Results: There is a direct relationship between medication/vaccine efficacy and health outcomes. The variance in weight provides vital information on the needle length and site of injection. Body mass index, age, sex, and skin …

Dnp Final Report: An Evidence-Based Initiative To Improve Bowel Preparation Quality For Colonoscopy, Jennifer L. Gassett

DNP Final Reports

Good colonic bowel preparation (CBP) is an important component of colonoscopy but is often inadequate. Improving CBP can help increase detection of precancerous polyps, prevent procedures from being canceled or repeated, and decrease medical expenses. A quality improvement project was implemented to increase adequate CBP rates at an ambulatory surgery center specializing in endoscopy. Several factors correlate with suboptimal CBP, but the practice question focused on patient education. The PICOT question guiding evidence synthesis was posed: In adult patients preparing for outpatient colonoscopy, how do revised instructions with visual aids compared to written instructions affect CBP adequacy and patient satisfaction? …

Dnp Final Report: Stress Less, Teach More: A Stress Reduction Initiative Utilizing A Mindfulness-Based Approach For Nursing Faculty, Jewelle Johnetta Welleh

DNP Final Reports

This paper explores the pervasive issue of stress among nursing faculty, particularly within the context of the Central Texas two-year college. Analyzing the nature, causes, and effects of stress experienced by nursing educators, the Doctor of Nursing Practice (DNP) project emphasizes the important elements contributing to this phenomenon, including workload, administrative duties, and the most recent difficulties brought on by the COVID-19 epidemic. The initiative emphasizes the need for efficient stress management strategies to improve faculty well-being and job satisfaction by utilizing internal and external evidence. The DNP Scholarly project aims to reduce stress levels among nursing faculty by implementing …

Exploring Resilience In Nursing Education, Kylie P. Newsom

MUSC Theses and Dissertations

This dissertation investigates the feasibility of integrating resilience education into nursing curricula. It evaluates the effects of the Registered Nurse Personal Resilience Enhancement Plan (RN-P.R.E.P.) on resilience and professional quality of life. An integrative review synthesized literature on educational interventions to enhance resilience among health science students, focusing on techniques and targeted internal protective factors. The multi-method study included a pilot implementation of the RN-P.R.E.P. intervention, collecting quantitative data from pre-/post-participant surveys and qualitative interviews with nursing faculty and administrators.

The integrative review followed Whitemore and Knafl's five-step methodology, guided by the PRISMA reporting guidelines. Interventions were analyzed using the …

Integrating Workplace Violence Prevention Into Nursing Curriculum: Preparing Future Nurses For Safer Practice ​, Noah Briere, Sarah Kegerreis, Molly Lasyone, Savannah Orris

SPARK Symposium Presentations

Nurses are under attack. 80% of nurses have experienced some form of workplace violence (WPV), which is seen as “part of the job.” Unfortunately, the agency responsible for protecting nurses, the Occupational Safety and Health Administration (OSHA), only offers voluntary guidelines. We have determined that nursing students are the best group to educate about WPV prevention in healthcare. Including this teaching to fit within their pre-clinical requirements, only needing one faculty to teach with an average salary of $80k, to further help set what should be foundational skills. By adding WPV de-escalation techniques and adequately preparing students prior to graduation. …

How Does Racial Bias Impact The Perceptions Of Black Women Regarding Maternal Care?, Tanner K. Braddy

Honors College Theses

Between 1999–2002 and 2018–2021, the maternal mortality rate in the United States increased by 144% from 9.65 to 23.6 deaths per 100,000 live births. Although women of all races are affected by maternal mortality yearly, it is especially prevalent in black women. In the United States, black women are three times more likely to die from pregnancy-related causes than non-black women. Despite advanced medical technology and ongoing research, black women are continuing to die because of pregnancy at an alarming rate. Many studies suggest that discrimination and implicit bias - defined as subconscious feelings, attitudes, prejudices, and stereotypes an individual …

Using Musical Interventions As A Non-Pharmacological Strategy To Improve Chronic Pain Levels And Satisfaction Among Patients With Sickle Cell Disease, Fredeline Metellus

Doctor of Nursing Practice Final Project Abstract

Background

Sickle Cell Disease (SCD) is a chronic, inherited blood disorder characterized by severe pain episodes that are often poorly managed with standard pharmacological treatments. In response to patient dissatisfaction with pain control and the desire for holistic alternatives, this quality improvement project explored music therapy as a non-pharmacological pain management strategy.

Purpose

The primary aim was to reduce chronic pain by at least 20% and improve patient satisfaction with pain management among adults with SCD using a structured musical intervention.

Methodology

This project was implemented at a comprehensive outpatient SCD clinic using the Plan-Do-Study-Act (PDSA) model. Five adult patients …

Navigating Excellence: A Comprehensive Program Evaluation Of An Academic Clinical Nurse Educator Pilot Course, Rachel Marquart, Jennifer Sternberg, Kathryn Dambrino, David Phillippi, Jessica Savage, Tammy Legge

SPARK Symposium Presentations

Project title: Navigating Excellence: A Comprehensive Program Evaluation of an Academic Clinical Nurse Educator Pilot Course

Background and Rationale: Clinical instructors play a key role in nursing education, yet clinical instructors have varying degrees of formal preparation for the role. These inconsistencies affect student outcomes and instructors’ ability to effectively teach, mentor, and evaluate students. To address this, Belmont University developed the Academic Clinical Nurse Educator Program online course. This project conducted a comprehensive program evaluation to assess its effectiveness.

Aim: This project evaluated the effectiveness, success, and sustainability of an online Clinical Nurse Educator and Preceptor course designed to …

Enhancing Well- Being In Individuals With Special Needs: The Power Of Music Therapy, Nicole Love Lazaro

Nursing | Student Research Posters

No abstract provided.

Optimizing Pelvic Health: Evaluating The Efficacy Of Prenatal Strength And Resistance Training Combined With Pelvic Floor Muscle Exercises In Reducing Pelvic Organ Prolapse Risk, Samantha Requilman

Nursing | Student Research Posters

Pelvic organ prolapse (POP) is the descent of pelvic organs—such as the bladder, rectum, or uterus—into the vaginal canal, causing symptoms like discomfort, incontinence, and pain. Beyond physical effects, postpartum women may also experience anxiety, decreased self-confidence, and fear of symptom progression. Research by O’Boyle et al. (2002) highlights that POP studies have focused more on treatment than prevention and suggests that while pelvic floor muscle exercises (PFME) are supported as effective preventive strategies, POP remains prevalent in pregnancy. There are limited research studies on the effectiveness of prenatal resistance training in the prevention of pelvic dysfunctions and this study …

The Sound Of Survival: The Effect Of Personalized Music Selection On Cpr Performance And Anxiety Levels, Carmin A. Dotario

Nursing | Student Research Posters

No abstract provided.

Advanced Screening For Intimate Partner Violence To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Student Research Posters

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of …

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

Doctor of Nursing Practice Projects

Abstract

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 …

The Effects Of An Onboarding Checklist On Nursing Faculty Satisfaction, Taressa W. Poole

Doctor of Nursing Practice Projects

Nurse educators play an integral part in combating the nursing shortage. Transitioning clinical nurses to the academic setting can be challenging because experienced clinical nurses often enter the academic setting as novice nurse educators. A literature review suggested that the lack of structured onboarding programs contributes to the satisfaction, retention, and professional development of nurse educators. The Doctor of Nursing Practice (DNP) project aims to improve new nurse faculty onboarding by implementing a checklist to structure the onboarding process at the DNP project site. The process change project assesses the effects of a checklist on faculty satisfaction with the onboarding …

Provider Burnout Related To Patient Satisfaction, Sherita A. 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 …

Duty To Care And Job Turnover Intention In The Post-Pandemic Nursing Workforce, Cathleen A. Lopez

Nursing Theses and Dissertations

Natural and human-made disasters are increasing in number and intensity. In 2020, approximately 688.3 million people required assistance from disaster response personnel. During a disaster or pandemic, nurses must weigh their personal and/or family safety against the ethical code of caring for others. The purpose of this convergent mixed-methods study was to examine duty to care and job turnover intention of registered nurses working in patient-facing roles. A convergent mixed method design was used to address research questions by employing the Nash Duty to Care Scale (NDCS) and the Turnover Intent Scale (TIS-6). Open-ended survey questions were used to explore …

Implementing Home Blood Pressure Monitoring To Identify Essential Hypertension: A Quality Improvement Project, Julianne Peterson

DNP Projects

Background White coat hypertension (WCH) affects around 12-15% of the population and may lead to a misdiagnosis of hypertension (HTN) and unnecessary treatment. The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend home BP monitoring (HBPM) to aid in differentiating between WCH and HTN. A HBPM program was implemented in a primary care office.

Project Goals

1. Educate providers about the ACC/AHA guidelines promoting HBPM to assist in differentiating between WCH and HTN in patients with elevated office blood pressures (BP).

2. Implement a HBPM algorithm for patients presenting with a BP > 130/80 mmHg.

Methods The …

Implementing Breast Milk Expression Education Protocol: A Quality Improvement, Brenda Balarezo

DNP Projects

Significance and Background: Prematurity related complications (PRC) are the second leading cause of death for children under the age of five. Breast milk (BM) contains bio-actives that reduce PRC. However, delayed BM expression (BME) reduces BM availability. Adherence to Baby Friendly Hospital Initiative’s recommendation for BME within 6 hours in mothers of neonatal intensive care unit (NICU) infants remain poor without a standardized BME protocol.

Purpose: To increase the percentage of NICU mothers initiating BME within 6 hours of birth. To educate labor and delivery nursing staff on early BME.

Methods: The Institute for Healthcare Improvement’s Model for Improvement Plan-Do-Study-Act …

Strategies To Improve Nurse Documentation Compliance And Confidence In The Delivery Of Preprocedural Education, Danielle A. Burris

Doctor of Nursing Practice Final Project Abstract

Strategies to Improve Nurse Documentation Compliance and Confidence in the Delivery of Preprocedural Education:

Abstract

Introduction:This project aimed to implement tools to improve preprocedural education compliance between nurses and patients in an interventional radiology department. The secondary aim was increasing staff confidence in providing education, reducing the potential for avoidable harm and adverse procedural-related outcomes. The project was implemented within an interventional radiology department of a healthcare system in the Texas Medical Center, Houston, Texas.

Methodology: The project utilized the Model for Improvement and followed the steps of the Plan-Do-Study-Act cycle to implement change. Strategies included checklists, reminder tools, …

A Psychometric Validation Of The Neonatal Abstinence Syndrome: Exploring Neonatal Nurses' Attitudes, Knowledge, And Practice Tool, Megan A. Ventrello

Theses & Dissertations

Background:

The National Center for Drug Abuse Statistics estimates that as of 2020, 3.8% of American adults have abused opioids in their lifetime (Centers for Disease Control and Prevention, n.d.). In addition, around 7% of women self-reported that they were using opioid pain relievers during their pregnancy, and 1 in 5 of these women reported misusing these medications while pregnant (Centers for Disease Control and Prevention, 2022a; Ko, 2020). Women who use opioids throughout their pregnancy give birth to infants who are born with Neonatal Abstinence Syndrome. The symptoms can be marked by a signature high-pitched cry and inconsolability, making …

A Holistic Perspective On Pain Assessments, Focusing On The Multidimensional Measurement Of Comfort Levels: A Quantitative Analysis And Psychometric Evaluation Of The 13-Item Shortened General Comfort Questionnaire, Victoria A. Marner

Theses & Dissertations

Background: Pain is multidimensional. It is a physical, psychospiritual, environmental, and sociocultural experience (Ebrahimpour & Hoseini, 2018). Current measures of pain tend to be unidimensional, only focusing on the physical aspect of pain. The entire experience of pain may not be effectively communicated by patients or adequately controlled by interventions (e.g., analgesics, repositioning, physical therapy). Adults in pain may struggle to participate in daily activities and responsibilities. A scale encompassing all pain contexts and comfort levels could provide a more comprehensive view of the patient’s experience. Transitioning from measuring pain to measuring comfort holistically would provide patient satisfaction and improved …

Monitoring Opioid-Use-Disorder Treatment Adherence Using Smartwatch Gesture Recognition, Andrew Smith, Kuba Jerzmanowski, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Cynthia F. Corbett Phd, Rn, Faan, Homayoun Valafar

Publications

The opioid epidemic in the United States has significantly impacted pregnant women with opioid use disorder (OUD), leading to increased health and social complications. This study explores the feasibility of using machine learning algorithms with consumer-grade smartwatches to identify medication-taking gestures. The research specifically focuses on treatments for OUD, investigating methadone and buprenorphine taking gestures. Participants (n = 16, all female university students) simulated medication-taking gestures in a controlled lab environment over two weeks, with data collected via Ticwatch E and E3 smartwatches running custom ASPIRE software. The study employed a RegNet-style 1D ResNet model to analyze gesture data, achieving …

Improving Medication Adherence For Post-Operative Pediatric Patients With Spanish-Speaking Caregivers Using A Written Medication Action Plan, Carissa Vicente

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aims to improve written discharge education, medication adherence for pediatric patients, and medication education retention for Spanish-speaking caregivers.

BACKGROUND

The project was implemented in a children’s hospital in the Pediatric Post-Anesthesia Care Unit. The discharge process for post-operative pediatric patients lacked appropriate written medication education for Spanish-speaking families, placing patients at an increased risk for improper medication use.

METHODOLOGY

A quality improvement method utilizing Plan-Do-Study-Act (PDSA) cycles was used for implementation, with three cycles completed. A written Spanish-translation medication action plan (MAP) was implemented during discharge for Spanish-speaking caregivers, including adaptions to an electronic health record version …

Medicaid Patient Experiences With Nurse Practitioners And Other Providers: A Big Data Analysis, Deanna Jan Emory, Thomas A. Kippenbrock

The Eleanor Mann School of Nursing Faculty Publications and Presentations

There is a current and ongoing shortage of primary care providers that is projected to increase through 2034. Over the last decade, this shortage has resulted in increased reliance on nurse practitioners and physician assistants to fill the gap. The pur-pose of this study was to investigate Medicaid recipients’ experiences with their respective primary care providers using responses from the Consumer Assessment of Healthcare Providers and Systems database with a focus on nurse practitioners compared to other provider types identified. Responses from 68,761 Medicaid recipients were analyzed. The results showed that Medicaid recipients’ scores for nurse practitioners were comparable to …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …