Nursing Commons^™

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Standardizing Ascitic Fluid Panel To Improve Outcomes In A Large State Hospital, Yimei Zhang

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase provider compliance with evidence-based, hepatology-recommended ascitic fluid studies among inpatient providers from a baseline of 50% to 60% within five months through electronic health record (EHR) standardization.

Background: Delayed or incomplete ascitic fluid analysis can increase the risk of preventable complications. Workflow variability and non-standardized ordering practices contributed to inconsistent adherence to evidence-based recommendations.

Methodology: Using the Institute for Healthcare Improvement (IHI) Model for Improvement with Plan–Do–Study–Act (PDSA) cycles, two paracentesis workflows were redesigned. For the Mobile Procedure Team, a standardized ascitic fluid panel with six defaulted, evidence-based tests …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Proactive Recognition Of Patient Violence Risk: Enhancing Emergency Department Staff Awareness Through Structured Education, Lindsey Frasure

Doctoral Projects

Background: Workplace violence is a significant concern in emergency departments (EDs), where early recognition of behavioral and situational warning signs may help prevent escalation. However, warning signs may be missed, misinterpreted, or recognized too late.

Purpose: This project evaluated a structured educational intervention designed to improve ED staff knowledge of early warning signs and risk factors associated with patient violence. Lewin’s Change Theory guided the project.

Methods: A quasi-experimental pre-/post-intervention design was conducted with 10 ED staff members. Participants completed baseline assessments of knowledge and confidence, received structured education on violence risk factors and early warning signs, and completed post-intervention …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …

The Impact Of Virtual Reality Simulation On Developing Competence And Confidence In Non-Technical Skills In Nursing. A Scoping Review, Katie Janz, Karen Clark-Burg, Khaya Morris-Binelli, Brennen Mills, Amanda Graf

Research outputs 2022 to 2026

Background: Medical errors are a global concern and can compromise patient safety, with up to 80% of these errors directly linked to non-technical skills (NTS) failures. Traditional simulation using mannikins is resource-intensive, and virtual reality simulation (VR) has the potential to offer comparable outcomes with enhanced consistency and lowered resource requirements, but the effectiveness of VR to teach and enhance NTS has been underexplored.

Aim: This scoping review explores the existing literature on VR simulation as a method for teaching NTS in nursing to evaluate whether VR simulation yields positive learning outcomes, particularly in comparison to traditional training methods such …

Evaluating Falls Prevention Processes And Implementation Fidelity In Acute Rehabilitation: A Quality Improvement Project, Bouncy Igweka, Justin Baltazar, Ashley Navas, Clarisse Baligad

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Patient falls remain a significant safety concern in inpatient rehabilitation settings, where patients with neurological and mobility impairments work toward regaining functional independence. Despite established fall-prevention protocols at Stockton Regional Rehabilitation Hospital (SRRH), falls continue to occur, highlighting the need to evaluate existing prevention practices and identify potential implementation gaps.

Purpose: This quality improvement project aimed to evaluate the implementation fidelity of existing fall-prevention practices at SRRH, identify recurring factors associated with patient falls, and develop evidence-based recommendations to strengthen patient safety.

Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, a retrospective review of facility fall reports and patient …

Development Of A Standardized Evidence-Based Onboarding Process For Primary Care Providers In A Rural Health Setting, Corrie Goodier

Doctoral Scholarly Projects & Capstones

Primary care in the United States continues to face a critical provider shortage. This shortage is especially elevated in the rural regions of the country and is exacerbated by longstanding issues with subpar onboarding and high turnover rates. Failure to retain advanced practice providers in rural primary care settings further diminishes patient access to services, negatively impacts continuity of care, and complicates efforts to maintain patient trust in the nation’s delicate healthcare system.

Improved provider orientation and support processes within rural healthcare systems have the potential to increase satisfaction rates and productivity. The purpose of this DNP scholarly project was …

Improving Nurse Confidence And Perceived Readiness For Early Code Blue Response: A Quality Improvement Project, Elexia Butler, Annette Sotelo Rodriguez, Paulene Rones, Evangelyne Vue

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Improving Nurse Confidence and Perceived Readiness for Early Code Blue Response

Purpose

In many acute care units that are predominately dealing with chronic conditions, cardiac arrest is a low frequency, high stakes event. The purpose of this project is to improve early cardiac arrest response by increasing nurse confidence and perceived readiness to initiate high-quality CPR prior to Rapid Response Team (RRT) arrival.

Background

Over the past three years, there has been a significant increase in Code Blue events on the Surgical Acute Telemetry Unit. Initial management observations noted that staff response lacked clear role delineation, immediate pulse identification, and …

Translation, Cross-Cultural Adaptation, And Psychometric Validation Of The Team Emergency Assessment Measure (Team) Into European Spanish: A Multi-Perspective Study Including Peer-Assessment, Esther Leon-Castelao, Jose Luis Medina-Moya, Alejandro Durante-Lopez, Pedro Castro-Rebollo, Simon Cooper, Antoni Ruiz-Bueno, Jordi Bañeras

Research outputs 2022 to 2026

Background: The Team Emergency Assessment Measure (TEAM) is the most widely used tool for evaluating emergency team performance, with robust psychometric evidence across multiple languages and settings. However, no European Spanish version has been validated, and no previous TEAM study has simultaneously assessed teamwork from four complementary rater perspectives: instructors from the learners’ own specialty, instructors from other specialties, self-assessment by the performing participants, and peer-assessment by observing peers. This study aimed to translate, culturally adapt, and psychometrically validate a European Spanish version of the TEAM (s-TEAM) and to evaluate its reliability and validity across these four perspectives in emergency …

Anaemia In Pregnancy In Rural New South Wales: A Retrospective Study Of Prevalence, Risk Factors, And Guideline Adherence, Yuanwei Zhang, Esther Adama, Uchechukwu Levi Osuagwu

Research outputs 2022 to 2026

Aim: To determine the prevalence of anaemia in pregnancy in rural New South Wales (NSW) and assess the alignment of screening and treatment practices with the 2020 Australian Pregnancy Care Guidelines (APCG).

Methods: A retrospective cohort study at the Regional Hospital using records from 301 women who gave birth between 1st January and 4th September 2024. Data were sourced from eMaternity and PowerChart systems, focusing on haemoglobin and ferritin levels, demographic factors, iron deficiency risk factors, and birth outcomes.

Results: Iron deficiency was identified in 61.8% of women, with 6.0% diagnosed with iron deficiency anaemia (IDA). These rates were lower …

Secondary Outcomes Of The Early Collaborative Intervention Eaci On Salivary Cortisol Co Regulation In Preterm Infants And Mothers, Evalotte Mörelius, Charlotte Sahlén Helmer, Thomas Abrahamsson, Elvar Theodorsson, Ulrika Birberg Thornberg

Research outputs 2022 to 2026

The Early Collaborative Intervention (EACI) aims to strengthen early parent–infant relationships among moderate to late preterm infants in neonatal intensive care. This randomized controlled trial evaluated whether EACI influences mother–infant salivary cortisol co-regulation in mother–infant dyads, as well as infant cortisol reactivity and breast milk exposure during early infancy. Secondary outcomes were assessed in 54 dyads in the intervention group and 41 in the standard care group at one and four months’ corrected age. Salivary cortisol was collected before and after a bath at one month and a still-face procedure at four months. Significant mother–infant salivary cortisol co-regulation was observed …

Using Scoping Reviews As Precursors To Systematic Reviews: A Typology And Practical Guidance Derived From Eight Worked Examples, Hanan Khalil, Zachary Munn, Christina Godfrey, Micah D.J. Peters, Ellen Davies, Fiona Campbell, Danielle Pollock, Andrea C. Tricco, Dawid Pieper

Research outputs 2022 to 2026

Objectives: Scoping reviews are often conducted as a precursor to a systematic review (SR), yet guidance on how this relationship should be planned, executed, and reported is limited. We aimed to illustrate, through worked examples, the ways in which scoping reviews can function as precursors to SRs and to derive practical guidance for teams planning linked or sequential syntheses.

Study Design and Setting: We undertook a methodological analysis of eight contemporary evidence synthesis papers and protocols spanning veterinary medicine, animal welfare, public health, mental health, occupational health, and patient and public involvement, identified through the authors’ knowledge of the evidence …

Enhancing Nursing Care And Confidence In Early Pregnancy Loss, Julia L. Herrera, Giezy Ahumada, Hallie Yanez, Katie Cotterell

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Pregnancy loss is a complex healthcare experience that requires nurses to address both the physical and emotional needs of patients and families. Providing high-quality care during these experiences requires clinical knowledge, effective communication, emotional preparedness, and confidence in supporting patients through loss. This quality improvement project focused on strengthening nursing preparedness for the care of patients experiencing pregnancy loss before 20 weeks gestation through targeted education, standardized resources, and hands-on training. The following sections describe the practice gap that prompted the project, the evidence supporting the selected interventions, and the framework and methods used to guide implementation and evaluation.

Improving Elmsn Student Knowledge, Awareness, And Confidence In Postpartum Depression Recognition And Intervention Through Evidence-Based Education, Britney Mendoza, Mary Harris, Elyssa Ortiz, Nayeli Puente

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Postpartum depression (PPD) is a common maternal mental health condition that can negatively affect mothers, infants, and families. Nurses play an important role in recognizing symptoms, screening for PPD, providing education, and connecting patients with appropriate resources. However, nursing students may have limited opportunities to develop confidence in recognizing and responding to maternal mental health concerns.

Local Problem: At the University of the Pacific Sacramento Campus, ELMSN students receive education about postpartum care and maternal mental health within the maternal-child nursing curriculum. However, no dedicated educational intervention focuses specifically on recognizing, screening for, intervening in, and referring for …

Type 2 Diabetes Prevention Education In Adolescents, Amber Shergill, Melissa Gonzales, Sabrina Mendez, Ian Neves

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Type 2 diabetes mellitus (T2D) is an increasing public health concern among adolescents in the United States. Lifestyle factors contribute to this, including unhealthy dietary habits, a lack of physical activity, and inadequate sleep. Providing early education is essential to promoting healthy behaviors and reducing future health risks. This quality improvement project is aimed at increasing high school students’ knowledge and awareness of T2D risk factors and prevention strategies through evidence-based intervention. The project was implemented at Benjamin Holt College Preparatory Academy in Stockton, California, among students in grades 9-12. Students participated in an interactive educational session addressing T2D risk …

Increasing Patient Education For Induction Of Labor In A Labor And Delivery Unit In Sacramento, Kiran Gill, Kelsi Mcneil, Kayla Quan, Brianna Beltran

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

BACKGROUND: Patients receive inconsistent education regarding their scheduled induction of labor before arrival to Sutter Medical Center Sacramento. Some patients may receive enough education, whereas others receive little education and learn more after their admission.  

LOCAL PROBLEM: Within the microsystem, it was acknowledged by nurses and patients that patients lacked prior knowledge about their induction of labor (IOL) when arriving for their scheduled induction, which can cause decreased satisfaction and increased anxiety.

METHODS: This Quality Improvement (QI) project used the Plan-Do-Study-Act (PDSA) cycle. The Plan phase took place during spring and summer of 2026 and consisted of literature review, …

Reducing Clabsi Through Nurse Peer Review Audits In A Blood And Marrow Transplant Unit, Skylar Nouvongsa, Kyne Wong, Nicholas Henry, Jaskaran Singh

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Transforming Crrt Education Through Simulation, Alexis Valtierra,, Lainey Segovia,, Taelor Pena

2026

No abstract provided.

The Golden Hour: Reducing Time To Antibiotics In Pediatric Gi Patients With Central Venous Access And Fever, Virginia Elizondo,, Nicole Claybon,, Christian Delgadill

2026

No abstract provided.

The First Call Matters: A Nurse-Led Initiative To Improve Timely Organ Donation Notification, Virginia Elizondo,, Ashley Collins

2026

No abstract provided.

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

Safety Pause: Standardizing Personal Belongings Management For Pediatric Patients Requiring Cvo For High-Risk Behaviors, Rose Anne Dela Cruz,, Angela Mcnutt

2026

No abstract provided.

Paths Leading To Discharge Opioid Standardization, Karisa Price,, Adam Alder,, Carrie Moore,, William , Morris, Israel Nosnik

2026

No abstract provided.

When Two Worlds Meet - Preparing Pediatric Emergency Nurses For Labor, Delivery, And Postpartum Care, Virginia Elizondo, Ashley Collins

2026

No abstract provided.