Nursing Commons^™

Enhancing Nursing Documentation Accuracy For Female External Urinary Collection Devices Through Structured Documentation Huddles, Tiffany Ealy

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Accurate documentation of female external urinary collection devices (EUCDs), such as the PureWick, is crucial for maintaining continuity of care and ensuring efficient resource utilization. However, inconsistent nursing documentation practices have led to gaps in regulatory compliance and communication among healthcare teams. Baseline data revealed frequent omissions and inaccuracies in female EUCD charting, indicating a significant practice gap that requires targeted improvement.

Aim of the Project: The purpose of the evidence-based practice (EBP) project was to improve nursing documentation accuracy for female EUCDs by implementing structured documentation huddles, thereby enhancing organizational compliance.

Review of the Evidence: A …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Integrating Artificial Intelligence And Evidence-Based Guidelines Into Nursing Education, Allyson Kornahrens, Kerriann Latten

International Journal of Transformative Teaching and Learning in Higher Education

Artificial Intelligence (AI) and emerging technologies are transforming the healthcare system and patient care delivery. Due to this, there is an essential need for faculty to incorporate AI into the nursing curriculum to educate students about its use and improve preparation for clinical practice. This practice-based article addresses the integration of AI into nursing education for students using AI-driven academic learning activities. These activities, created in alignment with the American Association of Colleges of Nursing (AACN) Essentials, explore clinical decision-making by comparing AI recommendations to evidence-based guidelines. Students are tasked with reflecting on AI’s accuracy and the ethical implications of …

The Effects Of A Breastfeeding Educational Program On Nurses’ Self-Efficacy And Knowledge, Amanda Quinn

Doctor of Nursing Practice Projects

Breastfeeding, a cornerstone of maternal and infant health, faces barriers due to inadequate healthcare provider education, contributing to low exclusive breastfeeding rates. The purpose of this quality improvement project was to evaluate the impact of a four-week educational program on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. This project evaluated a four-week educational program’s effect on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. Using a quasi-experimental pre-post design, nine licensed/certified staff (medical assistants, licensed practical nurses, registered nurses, advanced practice registered nurses) …

Evidence-Based Pain Management Bundle For Pediatric Postoperative Orthopedic Patients, Samantha Firmstone

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postoperative pain management in pediatric orthopedic patients is often inconsistent due to variability in provider practices and a lack of standardized protocols. At a Central Texas pediatric orthopedic clinic, all patients received opioid prescriptions post-knee surgery regardless of procedure severity, leading to frequent caregiver calls for clarification. This practice revealed a critical gap in preoperative education and multimodal pain management strategies, contributing to patient safety concerns and increased clinic workload.

Aim of the Project: The primary aim of the project was to improve pain control, reduce opioid reliance, and decrease postoperative pain-related follow-up calls by implementing a standardized, evidence-based …

Quality Improvement Project Evaluating The Impact Of Specialized Blood Pressure Measurement (Bpm) Training On Nursing Faculty's Knowledge And Self-Efficacy In Teaching Bpm, Heba Sadaka

Doctor of Nursing Practice Projects

Accurate blood pressure measurement (BPM) is crucial for the proper diagnosis and management of hypertension. However, BPM errors are common and may lead to under- or overtreatment, negatively impacting patients. The purpose of this quality improvement (QI) project was to retrain nursing faculty on BPM practices based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) clinical guidelines. A quasi-experimental pre-/post-intervention design was used. The intervention consisted of an online specialized training video developed by the Idaho Diabetes, Heart Disease, and Stroke Prevention Program. Nursing faculty’s BPM knowledge and self-efficacy were measured before and after the training using the …

Use And Interpretation Of Patient Health Questionnaire-9, Rufina Ewane

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to address the lack of knowledge on how to use and interpret the Patient Health Questionnaire (PHQ-9) tool. The practice problem highlights a knowledge gap, leading to the underutilization of the PHQ-9 tool for depression screening. This underutilization hinders timely diagnosis and effective management, presenting a significant challenge to achieving optimal patient outcomes. The project explores the question: Will implementing a staff education program on the use and interpretation of the PHQ-9 tool improve staff knowledge? The project was designed to enhance staff knowledge in utilizing and interpreting the PHQ-9 tool …

Pain Management Educational Module For Nursing Staff, Kathyrina Lucy Pham

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in pain management among nursing staff in the rehabilitation unit. Frequent pain-related patient calls contributed to inconsistent clinical practices. This project aimed to evaluate whether a brief, evidence-based educational intervention could enhance nurses’ knowledge of pain management. 47 registered nurses participated in an educational module delivered during both day and night shifts. Pre- and post-test scores were collected and analyzed to assess knowledge acquisition. T-test results indicated a statistically significant improvement in nurses’ pain management knowledge. The findings support the effectiveness of brief, targeted education in promoting clinical outcomes …

Policy Proposal For Integrating Pediatric Mental Health Into Nursing Practice In Uganda, Giselle S. Perez

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Mental health disorders affect over 1 in 7 individuals aged 10 to 19 globally. In low- and middle-income countries like Uganda, limited access to mental health specialists and pervasive stigma exacerbate the gap in care. Nurses, often the first point of contact, typically lack adequate pediatric mental health training. The proposal aims to address this gap by equipping nurses with the knowledge and competencies to identify, intervene, and support children with mental health disorders. Purpose: This proposal advocates for implementing targeted, continuing education in pediatric mental health for Ugandan nurses. The goal is to enhance the quality of …

Increasing Advance Directive Completion: A Future Initiative For All, Hilda A. Lince

Doctor of Nursing Practice Final Manuscripts

Abstract

Problem Statement: Healthcare providers focus on delivering quality and patient-centered care. Yet, without any direction, healthcare providers treat patients as a full code until someone can speak on the patient’s behalf. Therefore, it is crucial that patients make their wishes known.

Description of Innovation: On a cardiac step-down unit, registered nurses were educated on the PREPARE advance directive. Upon admission to the unit, patients were asked if they had an advance directive. If the patient did not have an advance directive, they were educated on the importance of having an advance directive. Then they were given the PREPARE …

Optimizing Warfarin Management In Cardiovascular Care, Tessa A. Martinez

Doctor of Nursing Practice Final Manuscripts

Background: Maintaining a therapeutic International Normalized Ratio (INR) is essential to reduce bleeding and thromboembolic risks in patients on warfarin therapy. In a rural outpatient cardiac clinic serving a predominantly underserved population, many patients face financial and access barriers that preclude the use of newer non-vitamin K antagonist oral anticoagulants (NOACs). Patients with atrial fibrillation (AF) or mechanical valve replacements who rely on warfarin require consistent monitoring and management, which can be challenging in settings with limited resources and staffing.

Purpose: The purpose of this evidence-based pilot project was to improve therapeutic INR outcomes through the implementation of a standardized …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

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

Evidence-Based Practice Project Reports

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

Effectiveness Of Music Therapy In Managing Pain And Anxiety In Pediatric Burn Patients Compared To Traditional Methods Alone, Alejandro Miguel Santos, Maekalagail Santos

Nursing | Student Research Posters

Introduction:

Burn injuries are among the most painful conditions for children. While pharmacological interventions are commonly used, non-pharmacological strategies like music therapy are gaining attention for their potential to improve patient outcomes. Previous research indicates that music therapy can reduce pain and anxiety in various settings, but its impact on pediatric burn patients remains underexplored.

Objective:

This study aims to explore the effectiveness of music therapy in managing pain and anxiety in pediatric burn patients, comparing it to traditional pain management methods alone.

Research Question:

Does music therapy affect pain and anxiety in pediatric burn unit patients when added to …

How Valuable Is An Implementation Toolkit For Midwives? An Exploratory Study, Annemarie (Annie) De Leo, Linda Sweet, Peter Palamara, Dianne Bloxsome, Sara Bayes

Research outputs 2022 to 2026

Background: Incorporating evidence-based approaches in maternity care throughout the entire trajectory from pregnancy through to the postnatal phase is integral to good public health. Yet, despite developing theories, frameworks, and models to guide midwives’ implementation efforts, implementing new evidence-based practices in midwifery practice settings remains challenging. Methods: An exploratory study design was used to conduct an initial assessment of the appeal and suitability of an implementation ‘how to’ Toolkit for Australian change-leader midwives. We aimed to determine the effectiveness of the intervention by evaluating midwives’ experience of using the Toolkit, and report on the usability of the Toolkit in maternity …

Providing Community Education On Opioid Addiction And Emergency Intervention, Chasity Vargas

Doctor of Nursing Practice Projects

Introduction: The opioid crisis remains a significant public health concern, with opioid-related overdoses continuing to rise. Naloxone (Narcan) is a life-saving medication that can reverse opioid overdoses, yet many community members lack awareness and training on its use. This Doctor of Nursing Practice (DNP) project aimed to implement and evaluate a community-based Narcan education program to improve knowledge, accessibility, and confidence in administering Narcan.

Method: Using a quality improvement framework, the project targeted community members servicing the homeless population. Pre- and post-education surveys assessed changes in participants' knowledge and attitudes toward opioid overdose response.

Results: Findings demonstrated a significant increase …

Using Educational Intervention To Impact Provider And Nurse Knowledge And Self-Efficacy In Contingency Management At An Sud Clinic, Chinwe Egwudo

Doctor of Nursing Practice Projects

The US opioid epidemic crisis led to 700,000 deaths in 2019 alone. Poor adherence to medications for opioid use disorder (MOUD) strains individuals, families, and the healthcare systems, with rising relapses at the project site highlighting the need for evidence-based intervention. Studies show that contingency management (CM), a behavioral intervention that incentivizes desired behaviors, improves adherence to MOUD. Despite its effectiveness, CM remains underutilized in clinical settings due to healthcare providers’ lack of knowledge and self-efficacy. This project aimed to bridge the knowledge gap by implementing an educational intervention to impact healthcare providers’ knowledge and self-efficacy in applying CM protocols …

Management Of Obesity In Adults 18 And Older, Donna Callicoat

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Obesity is a significant public health concern in the United States, with increasing prevalence and substantial healthcare costs. Despite evidence-based guidelines for obesity management, primary care clinics often fail to implement them effectively, leading to missed opportunities in preventing obesity-related comorbidities such as cardiovascular disease, type 2 diabetes, and certain cancers.

Purpose: This evidence-based project aimed to implement the American Heart Association/American College of Cardiology/Obesity Society (AHA/ACC/TOS) obesity guidelines in a rural Texas primary care clinic. The goal was to assess the effectiveness of these guidelines in reducing weight, body mass index (BMI), and waist circumference among adults with …

Evidence-Based Discharge Bundle To Reduce Heart Failure Readmissions, Chelsea Zepeda

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) affects over 6.7 million adults in the United States, resulting in frequent hospitalizations and readmissions, increased mortality, and billions of dollars spent annually on healthcare costs. Reducing readmission rates is a priority for the healthcare industry.

Objective: This evidence-based practice project aimed to reduce HF readmission rates through a bundled approach to address socioeconomic factors that place patients at higher risk for readmission, provide patient-centered education for HF management at home, and provide follow-up phone calls after discharge to assess patient symptoms.

Methods: English-speaking patients, aged 65 or older, with any active diagnosis of HF were …

Intrapartum Hydration Assessment And Management: A Cross-Sectional Survey Of Australian And New Zealand Maternity Units, Brianne G. Mcintyre, Debbie Massey, Nigel Lee, Lauren Kearney

Research outputs 2022 to 2026

Background: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols. Aim: Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope …

Building A Meditation Room To Improve Critical Care Nurse’S Work Environment: An Evidence-Based Practice Project, Jennifer Alonso, Daphne Pierre, Stephanie Wald, Stephen Breazeale

Nursing & Health Sciences Research Journal

Background: Burnout, stress, and compassion fatigue are common among nurses, especially for those working in intensive care and during night shifts, and may contribute to the global nursing shortage. Thus, nursing organizations have issued recommendations to improve workplace health. Aligned with these initiatives, we sought to improve nurses' stress by creating a meditation room in the intensive care unit at a hospital in Miami. Methods: This evidence-based practice project took place from March to August 2023. The meditation room opened in May 2023 with a variety of therapeutic modalities, including meditation, music, and aromatherapy. We conducted two custom-designed surveys to …

Inspiring And Supporting Nurses’ Scholarly Works Through A Special Issue Highlighting Nursing-Sensitive Indicators, Sammie Mosier, Elizabeth Card, Caryn Alper

HCA Healthcare Journal of Medicine

Nursing represents the largest discipline in health care, with just over 5 million nurses in the United States, and the discipline is under increasing pressure to make evidence-based decisions in the delivery of patient care. This special issue of the HCA Healthcare Journal of Medicine can inspire and support nurses’ scholarly work with an eye to dissemination in peer-reviewed medical journals. This issue highlights nursing’s contributions to improving patient outcomes through nurse-sensitive indicators, with the hope of elevating the quality of tomorrow’s health care.

Implementation Of Eat Sleep Console For Neonatal Abstinence Syndrome: A Quality Improvement Project, Harley Addison Kennington

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A level III NICU and mother-baby unit within an inpatient hospital in the Southeast United States transitioned from the Finnegan Neonatal Abstinence Scale (FNASS) to the Eat, Sleep, Console (ESC) for treating Neonatal Abstinence Syndrome (NAS). Prior to ESC implementation, there was limited nursing education of ESC practice guidelines or consideration for proper implementation protocol. Purpose: The purpose of this evidence-based quality improvement project was to reintroduce nursing staff to the ESC NAS Care Tool and ESC charting guidelines within the NICU and mother-baby units. Methods: This project followed the PDSA process – Plan, Do, Study, Act, underscored …

Reducing Hapi On A Medical Surgical Telemetry Unit, Emily Nicole Johansen

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired pressure injuries (HAPI) are a global issue that harms patients, prolongs lengths of stay, and increases hospital costs and financial burdens. Because HAPIs are preventable, hospital organizations worldwide are implementing prevention strategies to improve the quality of care and quality of life and decrease costs associated with them.

Context: The 24-bed medical-surgical telemetry unit is one of five adult inpatient units within a Northern California hospital. The patient population includes an increased number of patients who are at risk of HAPI. The unit struggles with HAPI prevention, and the staff is challenged with implementing proper HAPI prevention …

Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi

Student Scholarly Projects

Practice Problem: The project targeted low job satisfaction and high nurse turnover in a Central Florida bone marrow transplant unit, impacting patient care and costs.

PICOT: (P) For registered nurses (RNs) on the bone marrow transplant unit, (I) does implementing an evidence-based practice employee recognition program (C) compared to no employee recognition program, (O) lead to an increase in job satisfaction (T) over 10 weeks?

Evidence: The evidence supported the effectiveness of meaningful recognition programs, such as personalized verbal acknowledgment from leadership, in boosting job satisfaction among nurses.

Intervention: The intervention involved nurse managers using a weekly employee recognition …

Anticoagulation Stewardship Initiative For The Outpatient Management Of Atrial Fibrillation, Ryleigh Hawker

Doctoral Dissertations and Projects

Anticoagulation prescribing for patients with atrial fibrillation at a local primary care and urgent care office has largely been conservative and unstandardized, leaving patients at risk for cardioembolic strokes. As more and more patients are diagnosed with this condition, the greater the need becomes for appropriate management within these settings. This includes preventing strokes with anticoagulation and utilizing an integrative or collaborative approach between specialty and non-specialty centers. The Anticoagulation Stewardship Initiative is the first step in promoting effective and safe anticoagulation practices in primary and urgent care centers, while simultaneously streamlining care for newly diagnosed patients. Some of the …

Reducing Patient Falls In A Skilled Nursing Facility, Mariah De Los Santos

All Doctor of Nursing Practice (DNP) Scholarly Projects

Falls in skilled nursing facilities (SNFs) pose a significant safety risk, causing injuries, extended stays, and increased morbidity mortality. With a fall rate 6.08 per 1,000 patient bed days, exceeding the national benchmark of 5.3, this project aimed to reduce falls using an evidence-based prevention bundle in a facility lacking a comprehensive fall prevention program. A literature review indicated multifaceted fall prevention bundles reduce falls in SNFs. Key components include risk assessment tools, patient education, post-fall huddles, and purposeful hourly rounding. This quality improvement project used Deming's Model for Improvement and the OhioHealth Change Management Model. An interprofessional team of …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Implementing Fall Prevention Safety Agreement And Fall Tips To Improve Patient Safety With Postoperative Cancer Patients, Marguerite Ndoko

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to implement targeted fall prevention interventions within an oncology surgical unit to reduce the rate of patient falls by 30%.

BACKGROUND

Hospital patient falls are a major safety concern, particularly in oncology surgical patients due to postoperative weakness and altered mobility. Consistent high fall rates in the unit prompted targeted interventions to address this risk.

METHODOLOGY

Two interventions were implemented over 14 weeks using PDSA cycles. Patient Fall Safety Agreements (PFSA) were initiated between patients and bedside nurses upon admission, while fall Tailoring Interventions for Patient Safety (TIPS) were posted in patient rooms to …