Nursing Commons^™

Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice (DNP) staff education project addressed a gap in guideline-based antibiotic prescribing among advanced practice registered nurses (APRNs) in an urgent care setting. The practice problem identified at the local project site was inconsistent adherence to Centers of Disease Control and Prevention (CDC) outpatient stewardship expectations, resulting in unnecessary antibiotic use for viral conditions and contributing to antimicrobial resistance. The practice-focused question for this project was as follows: In urgent care APRNs, does implementing a staff education program on guideline-based antibiotic prescribing improve provider-reported knowledge on antibiotic prescribing use? The purpose of this doctoral project …

Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project addressed the absence of evidence-based depression screening among military members and veterans with chronic pain. Contrary to national guidelines, no standardized depression screening process was in place. This gap in practice was attributed to inadequate staff knowledge and understanding in using such tools. The purpose of this project was to evaluate whether staff education on the Patient Health Questionnaire-9 (PHQ-9) improved knowledge and confidence, in evaluating for and identifying depression in a high-risk population. The practice-focused question asked: Will staff education on the importance and consistent use PHQ-9 increase knowledge and confidence in depression …

Personalized Resistance Exercise With Peer Support For Women With Pcos Using A Smart Home Video Device: Pilot Randomized Controlled Trial Guided By Self-Determination Theory, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Cynthia F. Corbett Phd, Rn, Faan, Kesheng Wang

Faculty Publications

Background

Women with polycystic ovary syndrome (PCOS) report exercise barriers as stigma-related stress, lack of peer support, and facility issues. “Resistance exercise (RE) with peer support and bands/ball and digitally-based supervision” (REPS w/BANDS) was designed to help mitigate exercise barriers. Underscored by self-determination theory (SDT), the 12-week intervention was remotely delivered via digital technology and inclusive of peer support.

Purpose

The purposes of this pilot randomized controlled trial (RCT) were to test the feasibility and acceptability of REPS w/BANDS and explore signals of within- and between-group differences on outcomes (e.g., depressive symptoms and fitness).

Methods

Participants (N = 25) …

Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott

Walden Dissertations and Doctoral Studies

Background: Treatment-resistant depression (TRD) presents a significant clinical and administrative challenge, delaying access to evidence-based therapies such as intranasal esketamine (Spravato). Inconsistent documentation and lack of standardized clinical pathways contribute to insurance authorization delays, exacerbating health inequities and care fragmentation. Purpose: This DNP project aimed to develop and implement a standardized Treatment History Checklist and Clinical Practice Guideline to streamline documentation, support timely insurance authorization, and promote equitable access to Spravato therapy for patients with TRD. Methods: Using a systems change framework, the project employed gap analysis, stakeholder engagement, and iterative validation to design tools aligned with payer requirements and …

Development Of An Evidence-Based Educational Intervention To Advance Nurse Knowledge In Comprehensive Care Of Patients With Congestive Heart Failure, Jessica Smith

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project was a staff education intervention to increase nursing staff knowledge. Congestive heart failure (CHF) remains one of the leading causes of hospitalizations and has the highest readmission rates within 30 days of a previous admission. Consistent evidence reveals improving nursing knowledge reduces complications, improves self-management support, lowers readmission rates in this particular patient population. The DNP project was developed as a staff education intervention and focused on 30 nurses working on a telemetry unit in an acute care hospital. The project question was whether an educational intervention would increase general nursing knowledge caring …

Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to develop an evidence-based clinical practice guideline (CPG) to reduce missed follow-up appointments and improve care continuity in a family medicine outpatient clinic. Missed follow-ups, especially common in underserved populations, compromise safety, delay treatment, and increase costs. The purpose of this doctoral project was to develop and appraise a CPG that integrates evidence-based strategies to improve follow-up procedures, reduce missed appointments, and enhance patient safety and care continuity in an outpatient setting. This project addressed the practice-focused question: Will a CPG around structured follow-up for patient visits in an outpatient clinic …

Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education initiative to address underutilization of low-dose computed tomography (LDCT) lung cancer screening among Medicare-eligible patients at the project site. Lung cancer is the leading cause of cancer death, and LDCT screening reduces mortality by up to 20%. Internal data from the project site revealed that only 20.13% of eligible patients completed screening, underscoring the need for structured staff education to improve knowledge and support early detection. The practice focused question asked: Will a staff education on Medicare LDCT screening and processes increase staff knowledge towards the ultimate goal of increasing LDCT screening rates? …

Development Of An Evidence-Based Clinical Practice Guideline For Discharging Patients With Substance Use Disorder (Sud) From Outpatient Treatment To Community Care, Emmanuel Onyeani

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient treatment center for discharging patients with substance use disorder (SUD), addressing the need for follow-up care and relapse prevention due to the widespread impact of SUD. Clinical practice guidelines (CPG) help healthcare professionals make informed decisions for specific clinical situations. The guiding question asked whether an expert panel would evaluate and validate a CPG developed from current, evidence-based literature and recommendations with 70% agreement using the AGREE II tool. The CPG focused on continuity of care, access to resources, and relapse prevention strategies. Seven expert …

Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education initiative addressed the problem of polypharmacy, a common issue in home health care that increases the risk of drug interactions, side effects, and hospitalizations. Nurses and aides often provide daily care but may not recognize high-risk medications or warning symptoms. Addressing this gap was vital to nursing practice because staff are on the front line of patient monitoring and safety. The practice-focused question asked whether structured education for home health staff would improve knowledge of polypharmacy risks by 20%, increase recognition of high-risk medications by 75%, and result in at least 75% …

Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter

Walden Dissertations and Doctoral Studies

The purpose of this Executive Summary is to address a gap in knowledge that I attempted to close regarding restraint utilization. Restraints, both physical and chemical, have been prevalent over the past ten years and with their increased utilization during the pandemic which has continued post-pandemic. Nursing as a culture has become more reliant on restraints as it allows more time for nurses to provide care elsewhere. Both physical and psychological complications have been recognized during the utilization of physical restraints. Their prominence, although helpful with time constraints for nurses, have shown to negatively impact the patients who they are …

Planning For Prevention: Implementing Pressure Injury Bundles In Hospice Settings, Ellie M. Martin, Mckenzie Pool

Scholars Week

There is an increased prevalence of pressure-related injuries in the hospice setting. This can be due to age, diagnosis, comorbidities, inadequate nutrition or hydration, lack of mobility, or inadequate care due to lack of education. Prevention bundles and policies are at every facility, but are not as effective as needed. This looks at the theoretical framework and ways to prevent pressure injuries as effectively as possible. Pulling information from multiple other research studies to put the best care bundle together to decrease the amount of pressure injuries.

Improved Patient Outcomes With Continuous Video Monitoring, Ethan Morrison, Drake May, Jack L. Rideout

Scholars Week

Improved Patient Outcomes with Continuous Video Monitoring

Objective

The use of human sitters has been the normal policy in hospitals across the United States for years. Recently, there has been an introduction to remote video monitoring systems that are aimed at replacing the need for human sitters. Our goal is to change the policy of a local hospital in our area to adjust their stance on human sitters and implement remote video monitoring.

Methods/Results

Our method of accomplishing this involved a PowerPoint presentation and an evidence-based practice paper with three different scholarly research articles that have been peer-reviewed. We presented …

Antibiotic Stewardship And The Prevention Of Healthcare-Associated C.Diff, Nevaeh Tyson, Angel Pearson

Scholars Week

Healthcare-associated Clostridium difficile (C.difficile) infections remain a significant burden to many healthcare facilities across North America. This infection is often linked to long-term antibiotic use and ineffective infection control methods. This presentation addresses current evidence-based practice protocols on the prevention of C.difficile, emphasizing the need for increased monitoring of antibiotic therapy and improved infection control strategies.

Implementing Evidence-Based Cluster Care To Improve Preterm Infant Stability, Kendal B. Hargrove, Mattie C. Kent

Scholars Week

Premature infants in neonatal intensive care units (NICUs) are frequently exposed to excessive handling, light, and noise, which can disrupt sleep and hinder growth. This project investigates whether current caregiving schedules at Deaconess Henderson Hospital’s NICU support adequate rest and development in preterm neonates. Analysis revealed an absence of clear policies regarding clustered care, inconsistent implementation, and limited staff understanding of its evidence-based benefits. Guided by the Roy Adaptation Model, this project proposes the development and implementation of a standardized clustered care policy to promote neonatal adaptation and stability. Evidence from multiple studies (Wang et al., 2021; Hendy et al., …

The Importance Of Deep Vein Thrombosis Prophylaxis In Post-Surgical Patients, Abigail N. Nelson, Madison R. Holmen

Scholars Week

Deep vein thrombosis (DVT) is a preventable postoperative complication that poses significant risks to patient safety. This evidence-based practice project applies the Iowa Model of Evidence-Based Practice to implement a mandatory DVT prophylaxis training module for newly hired surgical nurses. The training includes interactive instruction on pharmacologic and mechanical prevention methods, such as anticoagulant use, sequential compression devices, and early ambulation. Effectiveness will be evaluated through post-training assessments, observation of nursing practice, and manager feedback. By standardizing DVT prevention education and promoting consistent use of evidence-based interventions, this project seeks to improve nurse competency, reduce postoperative DVT incidence, and enhance …

Preventing Falls On Trauma Units: A Nurse-Led Initiative For New Graduates, Callie Brown, Erin Mytt

Scholars Week

Patient falls are a leading cause of preventable injury in hospital trauma units. This nurse-led initiative introduces a structured educational program based on Dorothea Orem's Self-Care Deficit Theory to strengthen new nurses' skills and act as reinforcement for veteran nurses in fall prevention. The program includes risk assessment, envrionmental safety checks, patient education, nurse education and safe transfer training. Evidence from recent studies supports edcuation based, multidisciplinary interventions as the most effective strategy to reduce hospital falls. Implemented in phases, the intiative requires all new graduate trauma nurses to complete fall prevention training within six months of hire. Expected outcomes …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Implementing Diabetes Education And Prevention Protocol, Lilyanna B. Conkle, Alyssa M. Woodall

Scholars Week

This Evidence-Based Practice project proposes the implementation of a diabetes education and prevention protocol in school systems to address the rising prevalence of diabetes among students. The initiative includes mandatory pre-academic year training for school staff to improve recognition and response to diabetes related emergencies. To support school nurses, often the sole healthcare provider on campus; a mobile app will be introduced to alert personnel during emergencies and provide evidence-based intervention steps. This approach aims to enhance student safety, improve health outcomes, and ensure timely, coordinated care.

Implementation Of No Wake Times, Chloe Martin, Drew Mullinax

Scholars Week

Hospitalized patients frequently experience poor sleep quality due to clinical activities that occur during typical sleeping hours such as vital sign checks and medication administration. These nighttime disruptions negatively impact patient recovery times and decrease patient satisfaction. This evidence-based practice evaluated if restructuring nighttime clinical activities would minimize sleep disturbances and improve sleep quality in hospitalized patients. Patient surveys were used to assess the frequency of nighttime awakenings as well as the different sources of these awakenings. Interventions included moving nighttime clinical activities (blood pressure checks and medication administrations) to not be done during the hours of 10pm to 5am …

Post Discharge Phone Calls Improve Compliance And Reduce Return Visits, Carley Dowdy, Avery Greer

Scholars Week

This evidence based practice project evaluated the effectiveness of implementing a policy of post-discharge phone calls within 24 hours of the first phone call and 72 of the second phone call by a nurse. The nurse provides assessment and education for the patient as well as answers any questions by the patient. Implementing the policy improves patient compliance, enhances satisfaction, and reduces unnecessary emergency department return visits. Evidence from multiple studies demonstrated that post-discharge phone calls significantly decrease return rates and improve patient compliance and satisfaction. Implementing this policy can have the potential to improve this facility's patient outcomes, improve …

Family Planning Interventions Across The League Of Arab States: A Regional Scoping Review, Basil H. Aboul-Enein, Suha Ballout, Patricia J. Kelly

College of Nursing Faculty Papers & Presentations

Family planning is crucial in improving maternal and child health, reducing fertility rates and promoting gender equity. Despite global advancements in contraceptive access, disparities persist across the League of Arab States due to sociocultural, economic and policy barriers. Understanding the effectiveness of existing family planning interventions in this region is essential for addressing unmet needs and guiding policy improvements. This scoping review aims to identify and appraise family planning interventions conducted across the League of Arab States. A comprehensive search of 14 databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, focusing …

Improving Cpr Confidence And Competence Of Medical-Surgical Nurse Residents, Anthony Joseph Alvarado

DNP Qualifying Manuscripts

Novice nurses often lack cardiac arrest training, jeopardizing patient outcomes and staff confidence. This pilot project addressed gaps in CPR preparedness, early recognition, timely response, and confidence among nurse residents. The goal was to develop, implement, and evaluate a competency-based code blue simulation to strengthen the residents’ knowledge and skills. Professional Development Specialists will learn strategies for integrating a code blue simulation experience into a nurse residency curriculum to enhance patient safety.

Enhancing Diabetes Self-Management Education And Support Knowledge And Awareness Among Nurses, Tamba Sam-Manimoi

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) affects 12% of the United States population at an annual cost of $412.9 billion. In the local clinic, 20% of the patient population has a diagnosis of DM. Despite the importance of diabetes self-management education and support (DSMES) in managing DM, patients are often not educated on this important strategy. Leadership identified that patients were reporting a lack of knowledge regarding DSMES practices and that the nurses lacked the necessary knowledge and awareness to educate patients in DSMES. Thus, the purpose of this DNP project was to determine if an educational intervention focused on DM and DSMES …

Compassion Fatigue And Burnout In Community-Based Psychiatric Staff, Faith Carini-Graves

Advances in Clinical Medical Research and Healthcare Delivery

Community-based psychiatric staff, such as the Youth ACT teams that are being initiated across New York State, are at risk for compassion fatigue due to their proximity to the trauma of their patients. This literature review explores current evidence that is available on the topic and grapples with what can be done to support psychiatric staff who work in the community with patients who experience trauma.

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Quality Improvement Project: Impact Of Educational Intervention On Post-Acute And Long-Term Care Staff's Confidence And Accuracy In Aims Screening For Tardive Dyskinesia, Tana Whitt

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a chronic, often irreversible movement disorder associated with prolonged antipsychotic use. In post-acute and long-term care (PALTC) settings, inconsistent Abnormal Involuntary Movement Scale (AIMS) screening practices and limited clinician education contribute to under recognition and delayed treatment. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated whether an educational intervention impacted clinicians’ knowledge, confidence, and perceived importance of AIMS screening among licensed and unlicensed PALTC staff. Guided by Donabedian’s Model of Quality and Kotter’s 8-Step Change Model, the project used a pre-test/post-test design to measure outcomes before and after completion of the Drug-Induced Movement …

Impact And Effectiveness Of Phq-9 Training For School Counselors On Mental Health Referrals For High School Students, Sherikee Dorice Grim Bsn, Rn, Ja’Quay Brister Dnp, Pmhnp-Bc, Margaret Harvey Phd, Aprn, Acnp, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Adolescents' mental health has worsened and become a public health issue, with depression being a primary concern. There is an urgent need for early screening, school-based referral pathways, and interventions to address common problems in high schools. Patient Health Questionnaire-9 (PHQ-9) is a validated, evidence-based tool for detecting depression; however, its systematic use in school-based counseling settings through organized training has not been studied for implementation in high schools. This review assesses the current literature on the impact and effectiveness of PHQ-9 training for school counselors on mental health referrals among high school students, with a focus on early …

Hospitalized Adult Patients With Hypokalemia (Cont.), Lisa Mclaughlin

Nurse Residency

In hospitalized adult patients with hypokalemia, how does intravenous potassium supplementation compare to oral (PO) potassium supplementation in affecting the time to normalization of serum potassium levels within a 72-hour inpatient stay?

Improving Patient Safety In Hospitals With Smartwatch Technology, Shelby Giannelli Rn, Katrina Thibodeau Rn

Nurse Residency

In hospitalized adult patients, how does the use of smart bracelets compare to standard care affect patient safety and monitoring outcomes?

Scheduled Ambulation Twice Per Shift To Reduce Hospital-Acquired Delirium, Rylee Collins Rn

Nurse Residency

In older adult inpatients ages 65 and older on a medical-surgical telemetry unit, does scheduled ambulation twice per shift with staff assistance, compared to as-needed ambulation, reduce the incidence of hospital-acquired delirium during hospitalization?