Nursing Commons^™

Inactive Nurses In New Mexico: Insights Into License Lapse And Inactive Reserve Status, Kiyoko Dell Davis

Doctor of Nursing Practice Scholarly Projects

Nursing shortages have varied over the decades, yet persist at local, national, and global levels. Nurses report leaving the workforce for many reasons, including professional environment factors resulting from these shortages, further exacerbating a shrinking workforce and population growth. Recent efforts include recruitment and education incentives and implementation of the New Mexico Board of Nursing (NMBON) Inactive Reserve Licensure option, which allows retiring nurses to maintain a reduced-scope nursing license with fewer barriers. Despite these efforts, questions remain: why are nurses in New Mexico leaving the profession and would this licensure category have impacted retention? The purpose of this project …

Improving Continuity Of Care: Evaluating Universal Nursing Handoff Sheets, Elizabeth Ifeloluwa Sanya

Doctor of Nursing Practice Scholarly Projects

Effective communication during nursing handoffs is essential for safe, patient-centered care, as breakdowns in communication are a leading cause of adverse patient outcomes. At a large academic level I trauma center, inconsistent nursing handoff practices were identified across progressive care units following the COVID-19 pandemic. This variability contributed to incomplete transfer of patient information and was associated with increased patient safety incidents, including delayed wound care, central line dressing lapses, and medication errors involving high-alert therapies. The purpose of this DNP project was to plan, implement, and evaluate the use of  standardized nursing handoff sheet and its impact on continuity …

Implementing A Professional Wellness Session To Foster Improvement In Oncology Nurse Retention And Well-Being, Connie Tran

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement chaplain-led professional wellness sessions to improve the well-being of nurses on an oncology pilot unit.  Aims were to increase nurse retention by 5%, decrease staff absenteeism by 3%, and improve Perceived Stress Scale (PSS) scores by 10%, and Professional Quality of Life (ProQOL) scores by 10% from baseline.

Background

The emotionally taxing nature of oncology patient care creates a high-pressure environment, which can lead to turnover. Literature has shown that allowing staff to pray, debrief and engage in peer support groups to discuss work-related stressful encounters reduces stress …

Improving Physiologic Monitoring Adherence During Behavioral Emergencty Sedation In A Prehospital Ems System, Jared Aucoin

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:

This quality improvement (QI) project evaluated whether provider education and standardized documentation improved adherence to evidence-based physiologic monitoring during behavioral emergency sedation in a prehospital EMS setting.

Background:

Behavioral emergencies are common and often require rapid chemical sedation, with risks of hypoxia, hypercapnia, and cardiovascular instability. At baseline, inconsistent adherence to recommended monitoring and documentation of end-tidal carbon dioxide (EtCO₂) and pulse oximetry (SpO₂) presented an opportunity to improve patient safety.

Methodology:

This QI project educated current adult behavioral emergency protocol in a prehospital EMS setting, re-emphasizing standardized documentation and evidence-based monitoring practices. Utilizing Plan-Do-Study-Act (PDSA) through pre- …

Reducing Missed Opportunities For Crc Screening Via Provider Reminder System In A Primary Care Setting, Komfort Cofield

Doctor of Nursing Practice Projects

Background: Although highly preventable with screening, colorectal cancer (CRC) continues to be a major source of illness and mortality in the United States. Healthcare providers at the Doctor of Nursing Practice (DNP) project site inconsistently ordered CRC screening for eligible patients due to deficiencies in the point-of-care reminder system. These system failures created missed opportunities for CRC prevention and reduced compliance with established practice guidelines.

Purpose: This DNP project aimed to implement and evaluate a CRC screening checklist given to patients at appointment check-in, serving as a reminder for providers to order appropriate screening tests.

Project Design: Using the National …

Addressing Hypertension Medication Non-Adherence Through The Use Of Reminders And Morisky Medication Adherence Scale In Adults Diagnosed Within The Past Year In A Rural Primary Care Clinic, Amanda M. Weaver

Doctor of Nursing Practice Projects

Background: Adherence to antihypertensive medications is essential for decreasing long-term consequences of uncontrolled hypertension, including stroke, kidney failure, and cardiovascular diseases. However, nonadherence is a widespread problem among patients diagnosed with hypertension. In patients who have been diagnosed with hypertension in the past year, more than half stop taking their medications. Mobile health interventions, such as text message or telephone reminders, are a low-cost way to improve medication adherence.

Purpose: The purpose of this Doctor of Nursing Practice project is to examine how a weekly text message or telephone reminder impacts medication adherence among patients taking antihypertensives in a rural …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Reducing Asthma-Associated Absenteeism At A School-Based Health Center Using Asthma Control Test (Act) Scoring, Concetta Terry

Doctor of Nursing Practice Projects

Background: Asthma is a common chronic condition that can lead to increased school absences and lower academic performance. A needs assessment at a rural school-based health clinic identified gaps in care for students with asthma and high absenteeism rates.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce asthma-related absences by personalizing care using Asthma Control Test (ACT) scoring.

Project Design: Using a pre- and post-intervention design, this DNP quality improvement project followed the Plan-Do-Study-Act (PDSA) framework to evaluate the impact of implementing the ACT on asthma-related absenteeism in a rural school-based health center. The project …

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Improving The Accuracy Of Medication Reconciliations For Medicare Advantage Patients At A Primary Care Clinic Using An Interdisciplinary Team, Sallie Mann

Doctor of Nursing Practice Projects

Background: Medication-related problems (MRPs) are a significant and often preventable cause of patient harm, particularly among older adults with complex medication regimens. In primary care settings, inaccurate or incomplete medication reconciliations contribute to adverse drug events, avoidable hospitalizations, increased healthcare costs, and reduced patient satisfaction.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether implementing an interdisciplinary medication reconciliation process using the Medications at Transitions and Clinical Handoffs (MATCH) Toolkit would improve reconciliation accuracy in Medicare Advantage patients aged 65 and older in a primary care clinic.

Project Design: This DNP project used the …

Optimizing Workflow In Advanced Gastroenterology: An Initiative To Improve Turnaround Times, Aundrea Prewitt

Doctor of Nursing Practice Projects

Background: Procedure room turnaround time in advanced gastroenterology is defined as the interval between one patient exiting the procedure room and the subsequent patient entering. Prolonged turnaround times contribute to decreased operational efficiency, delays in care delivery, and suboptimal resource utilization. Current facility turnaround time is 39 minutes, and there is no standardized policy to guide the turnaround process.

Purpose: The purpose of this quality improvement project was to develop a standardized operating procedure that guides policy change in advanced gastroenterology through implementing a sustainable turnaround process that reduces procedure room turnaround time.

Project Design: The quality improvement initiative used …

Patient Ratio Impact On Patient Safety In The Emergency Department, Erin Griffin Rn, Rhonda Leavitt Rn

Nurse Residency

How does high patient to nurse ratios effect patient outcome and satisfaction compared to lower nurse to patient ratios?

Implementation Of Acute Pain Management Protocols And Effect On Rescue Opioid Administration During Ed Stay, Victoria Nordbeck Rn, Avegail Avila Rn, Sarah Durocher Rn, Isabel Dimek Rn

Nurse Residency

In patients presenting with acute pain processes in the emergency department, how does the implementation of acute pain protocols compared to standard opioid based therapies affect needs for rescue medication and overall length of stay?

Efficacy Of Volume-Based Enteral Feeding Compared With Standard Rate-Based Enteral Feeding, Tashia Stevens Rn, Kelly St Jean Rn, Darah Thomas Rn

Nurse Residency

Is volume-based enteral feeding more effective than standard rate-based enteral feeding in achieving nutritional goals and improving clinical outcomes in critically ill patients?

Fall Prevention, Alicia Frasier Rn, Paige Sperry Rn, Heather Tozier Rn

Nurse Residency

In elderly patients (P), does education of fall prevention (I) compared to bed/chair alarms (C) reduce falls.

The Implementation Of Q2 Turns Compared To Air Mattresses For Hapi Prevention In Adult Medical Surgical Patients Over The Course Of Their Stay, Elizabeth Mchugo Rn, Lily Fifield Rn

Nurse Residency

How does the implementation of q 2 turns compare to air mattresses for preventing HAPIs in adult medical surgical patients over the course of their stay?

Does Apply Boarder Foam Dressings Decrease Hapi In High-Risk Patients In The Acute Care Setting, Felicia Burton Rn, Kathryn Twombly Rn, Amanda Ring Rn

Nurse Residency

Does applying border foam dressings (i.e.mepilex dressings) to patients at risk for skin breakdown prevent pressure injuries and skin breakdown during a patient's hospital stay?

Improving Continuity Of Care: Evaluating Universal Nursing Handoff Sheets, Elizabeth Ifeloluwa Sanya

Doctor of Nursing Practice Posters and Presentations

Effective communication during nursing handoffs is essential for safe, patient-centered care, as breakdowns in communication are a leading cause of adverse patient outcomes. At a large academic level I trauma center, inconsistent nursing handoff practices were identified across progressive care units following the COVID-19 pandemic. This variability contributed to incomplete transfer of patient information and was associated with increased patient safety incidents, including delayed wound care, central line dressing lapses, and medication errors involving high-alert therapies. The purpose of this DNP project was to plan, implement, and evaluate the use of  standardized nursing handoff sheet and its impact on continuity …

Improving Iv Access Outcomes In Obstetric Care Through A-Diva Scale Utilization And Point-Of-Care Ultrasound, Parth S. Patel, Matthew T. Komorowski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric (OB) patients frequently present physiological changes, including edema, obesity, and peripheral vasoconstriction, that increase the risk of difficult intravenous access (DIVA). Multiple IV attempts can delay time-sensitive therapies in obstetric emergencies and increase patient discomfort and provider workload. Research studies have supported the use of the Modified Adult Difficult Intravenous Access (A-DIVA) scale to assess patients for DIVA, and the use of point-of-care ultrasound (POCUS) guided peripheral intravenous access (PIVA). In 2025, a preceding Doctor of Nurse Anesthesia Practice (DNAP) project implemented A-DIVA in the Labor & Delivery (L&D) unit of an OB department and found that 35% of …

Improving Medication Reconciliation Compliance In Home Health Admissions, Paula A. Petrie-Rivas

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Clinician compliance with medication reconciliation at a home health agency was below regulatory expectations, with agency performance significantly lower than state and national averages. Workflow inefficiencies, inconsistent clinician practices, and limited training contributed to noncompliance, increasing the risk of medication discrepancies, preventable rehospitalizations, and Medicare reimbursement penalties.

Aim: This quality improvement project implemented a standardized medication reconciliation workflow using the Agency for Healthcare Research and Quality’s MATCH toolkit to improve clinician compliance during admission to home health.

Evidence: Literature supports structured medication reconciliation as an effective strategy to improve safety during transitions of care. The MATCH toolkit provides a …

Poor Adherence To Established Clinical Guidelines In Outpatient Bladder Cancer Management, Melanie Boren

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The outpatient urology practice encountered challenges with adherence to Clinical Practice Guidelines (CPGs), primarily due to unfamiliarity and lack of operational accountability. This led to a low adherence rate of only 40% among patients with bladder cancer. Key issues included inadequate training and knowledge gaps regarding CPGs.

Aim of the Project: The project aimed to improve patient care and outcomes in bladder cancer treatment by enhancing patient retention and adherence to treatment protocols. Evidence-based interventions were implemented to optimize care delivery and support adherence to prescribed treatments.

Review of Evidence: A literature review highlights the effectiveness of nurse navigator …

Increasing Referrals To The Lung Cancer Screening Program, Megan Randall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Lung cancer is the leading cause of cancer-related deaths worldwide and is frequently diagnosed at advanced stages when treatment options are limited. A Veterans Administration (VA) primary care clinic demonstrated lower referral rates to the lung cancer screening (LCS) program than a comparable VA clinic despite having a higher prevalence of tobacco users. Existing electronic health record reminders focused on smoking cessation and did not systematically assess eligibility for LCS, contributing to underutilization of the screening program.

Aim of the Project: The aim of this quality improvement project was to increase referrals to the LCS program by improving identification …

Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship In A Long-Term Acute Care Hospital, Lesley Moore

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The opioid crisis continues to negatively affect patient safety and healthcare outcomes across the United States. Long-term acute care hospitals (LTACHs) care for medically complex patients who often require prolonged pain management and are at increased risk for opioid-related adverse events. At the project site, a 32-bed LTACH, 72% of reviewed patient charts included an opioid prescription upon admission, exceeding recommended prescribing benchmarks and identifying a gap in opioid stewardship practices. The absence of a standardized opioid stewardship program (OSP) and opioid risk screening process increased the risk of opioid misuse, dependency, and adverse patient outcomes.

Aim of the …

Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Emergency department (ED) boarding increases overcrowding and delays care. A 200-bed acute care hospital in the southeastern United States has a median time from inpatient bed readiness to ED departure that exceeds its hospital benchmarks, resulting in prolonged boarding and delays. Hospital data showed a median bed-ready-to-departure time of 76 minutes, exceeding the target of less than 45 minutes. Workflow analysis identified delays in transport activation, communication, and accountability as major contributors to inefficiency.

Aim of the Project: ED throughput quality improvement project aimed to reduce the median time from when an inpatient bed is marked ready to …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Improving Timely Hospice Pain Reassessments Through A Quality Improvement Initiative, Brianna Strong-Mosley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a hospice care organization, a practice gap was observed in prompt pain reassessment with an onset or increase of pain, as mandated within a 48-hour timeframe by the Centers for Medicare and Medicaid Services (CMS). Baseline data showed that only 40% of eligible patients with a pain score of ≥ 6 received a documented pain reassessment within 48 hours. Overall patient satisfaction with hospice services was 45%.

Aim of the Project: The quality improvement project aimed to enhance pain management by increasing the percentage of eligible hospice patients with a documented pain score of ≥ 6 from a …