Nursing Commons^™

Cultural Competence Among Nursing Faculty And Staff Utilizing An Educational Course To Promote Diversity, Equity, And Inclusion Individually And Within The Baccalaureate Nursing Program, Jessica Shippee

Doctor of Nursing Practice Scholarly Project

Nurse educators play a pivotal role in fostering cultural competence among nursing students. The purpose of this quasi-experimental project was to provide an educational course to help nursing faculty and staff identify implicit bias, develop cultural competence, and recognize the importance of incorporating diversity, equity, and inclusion into practice. A pretest-posttest design collecting demographic data and the Healthcare Provider Cultural Competence Instrument (HPCCI) was given to 21 participants, the course was six-hours and delivered over two days. Participants were asked the day of, before the intervention, to complete the instrument and immediately after the intervention on the second day. Varying …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Recurrent Urinary Tract Infections In The Urgent Care Clinic, Stephanie Krol

Evidence-Based Practice Project Reports

Nearly 60% of women will suffer from a urinary tract infection (UTI) in their lifetime, with 20- 40% of them suffering from multiple (Anger et al., 2022). The primary purpose of this evidence-based project was to implement a multi-modal intervention to improve identification of women who suffer from recurrent urinary tract infections (rUTIs) and to assist in the prevention and treatment of future UTIs. Additionally, the project aimed to increase the number of referrals to urology for better management of these patients. This project was implemented at an Urgent Care Clinic (UCC) in northwest Indiana. Eligible participants who presented with …

De-Escalation Techniques To Combat Workplace Violence Against Nurses, Sarah Jones

Aurora

Abstract

Problem: Workplace violence is on the rise in healthcare systems across the world, which is a major concern. Studies have found that nurses do not feel they can do their jobs effectively due to worries of potential harm to themselves and even their patients. There has been evidence that there are no effective methods in place to help healthcare workers remain safe and know how to handle these violent situations properly.

Purpose: The purpose of this project is to determine if de-escalation training increases nurses' feelings of preparation for violent situations and decreases incidences of workplace violence.

Methods: This …

Decreasing Incidence Of Intramuscular Emergency Psychiatry Medications In Psychiatric Adult Patients Through The Acute Violent Assessment Tool (Avat), Edidiong G. Ebong

Doctor of Nursing Practice Final Project Abstract

Purpose The purpose of this QI project was to reduce emergency IM psychiatric medication usage by implementing the Acute Violent Assessment Tool (AVAT) to improve early aggression management. Background The frequent use of emergency intramuscular (IM) psychiatric medications in inpatient psychiatric settings raises concerns regarding patient safety, autonomy, and staff burden. This quality improvement (QI) project aimed to reduce emergency IM medication administration by 20% over three months by implementing the AVAT to improve early identification, prediction, and management of aggression and violence. Methodology A Plan-Do-Study-Act (PDSA) framework guided the AVAT implementation in an adult psychiatric unit. Three weeks of …

Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

In-Person And Virtual Adaptation Of An Interprofessional Palliative Care Communications Skills Training Course For Pediatric Oncology Clinicians, Karen Moody, Clark R. Andersen, Robert M. Arnold, Julie Bradley, Allie Carter, Lauren Draper, Timothy Garrington, Jonathan B. Gill, Douglas J. Harrison, Masanori Hayashi, Amy Heaton, Cynthia Holladay, Alex Lion, Alakh Rajan, Beatriz N. Rozo, Daniel V. Runco, Shermini Saini, Laura K. Salvador, Kathryn Sutton, Verna Ferguson

Advances in Cancer Education and Quality Improvement

Introduction

Empathic communication is crucial for clinicians when discussing palliative and end-of-life (PC/EOL) care with parents of children with cancer. Unfortunately, many parents report inadequate communication at these distressing times. This study evaluates the communication skills training (CST) clinicians received to deliver a PC/EOL communication intervention as part of a multi-site randomized-controlled trial (RCT). Training was provided using an in-person format and then adapted to a virtual platform to accommodate remote learners.

Methods

Clinicians were trained in dyads (one physician and one nurse [RN] or advanced practice provider [APP]) over 3 days (in-person or virtually). Four pediatric oncology cases were …

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …

Improving Breast Cancer Modifiable Risk Factor Knowledge Among Patients In A High Risk Breast Cancer Prevention Clinic In The Midwest, Bailee Torneden

Doctor of Nursing Practice Scholarly Project

Preventative health care is the best choice in moving forward to reduce disease incidence. In the case of breast cancer, prevention clinics have been set up for those who have been determined as a high risk status for developing breast cancer over the course of their lifetime. There are many risk factors for breast cancer that are out of the patient’s control, but there are lifestyle health behaviors that could be implemented to lower the patient’s risk. The potential impact of these can not only lower the incidence of breast cancer, but can be linked with reduction of other disease …

The Moderating Effect Of Self-Efficacy On The Interaction Between The Patient-Provider Relationship And Medication Adherence, Jonas M. Manalo

2025 Spring Honors Capstone Projects - Archive

Older adults taking multiple medications are at high risk for experiencing adverse drug events that result in hospitalization. Nurses are one of the first points of contact for patients and serve as patient educators. Many factors influence medication adherence, such as the patient-provider relationship and patient self-efficacy. This study aims to assess what impact patient self-efficacy has on the interaction between the patient-provider relationship and medication adherence.

The sample comprises adults aged 50 or older taking five or more medications. The Medication Understanding and Use Self-Efficacy (MUSE) Scale was used to measure patient self-efficacy and the patient-provider relationship while the …

Implementation Of Nurse-Driven Oral Care For Inpatient Oncology Patients Receiving Chemotherapy To Reduce Mucosal Barrier Injury Associated Bloodstream Infections, Ariana Av Allen

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this project was to reduce unit CLABSI rates by targeting mucosal barrier injury associated bloodstream infections through implementation of nurse-driven diligent oral care for all inpatient oncology patients receiving chemotherapy.

BACKGROUND

The project was implemented on a 23-bed inpatient oncology unit in a county, safety-net hospital in north Texas.

METHODOLOGY

The project utilized the PDSA framework for implementing nurse-driven oral care for all inpatient oncology patients receiving chemotherapy. Staff and patients were educated on the ideal frequency and methods of performing oral care during the project. Patients were provided unit-supplied oral hygiene items on admission. Nursing …

Global Perspectives In Nursing Education: The Impact Of Study Abroad Programs On Nursing Students, Julia E. Molleston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Studying abroad as a nursing student is an under-researched topic that has many perceived and identified beneficial outcomes for students who participate. This expanded literature review utilizes 20 studies and one literature review to explore the facets of an immersive and international study abroad program on nursing and healthcare students. There are many benefits to professional, personal, and cultural growth that come from the experience of international study abroad. Such programs have shown to positively impact students' perceptions of their own cultural competence, abilities to overcome barriers, expand their perspectives, and grow in confidence. There are also many precipitating and …

From Call To Care: A Study On Call Bell Efficiency And Response Lag In Patient Care Settings, Mackenzie Manero

Senior Honors Projects

The efficiency of call bell systems throughout healthcare environments is

directly related to patient safety, satisfaction, and overall quality of care.

Delayed response times to call bells can have significant negative

consequences, such as increased falls, unmet patient needs, and decreased

confidence in the healthcare system as a whole. This paper explores the critical

role that call bells play in various healthcare settings by conducting an in-depth

review of current studies alongside original research. Surveys targeting nurses,

certified nursing assistants (CNAs), and nursing students were distributed

across both Rhode Island and Massachusetts. The questions were designed to

assess caregivers' experiences …

Efficacy Of A Novel Role-Playing Based In-Class Simulation On Enhancing Clinical Judgment Skills In Senior Baccalaureate Nursing Students, Melodie Jolly

Dissertations

Clinical judgment is a critical skill for nurses, directly impacting patient outcomes and quality of care. However, studies have shown that newly graduated nurses often lacked sufficient clinical judgment abilities to meet the demands of increasingly complex patient populations. This quasi-experimental study aimed to evaluate the efficacy of a novel role-playing based in-class simulation designed to enhance clinical judgment skills among senior baccalaureate nursing students. The study employed a single-group pre-assessment and post-assessment design using Lasater’s Clinical Judgment Rubric (LCJR) as the primary measurement tool. Using a convenience sample, 37 senior nursing students who enrolled in a Term 4 clinical …

The Lived Experience Of Women Who Have Experienced Intimate Partner Violence In Trinidad And Tobago, Lyris Antoinette Greenidge

Theses & Dissertations

Background: Intimate partner violence (IPV) is an increasing public health issue worldwide and is predominantly committed by males against females. One in every three women worldwide has experienced IPV (World Health Organization [WHO], 2024). The Pan American Health Organization studied IPV in 12 Latin American and Caribbean countries (Bott et al., 2019), and the Republic of Trinidad and Tobago was included. At the inception of this study in 2018, the prevalence and effect of IPV, though captured in the media by Fraser (2014) and others, were recognized as a widespread monumental problem in Trinidad and Tobago. However, it appeared to …

Development And Validation Of An Adolescent Sleep Algorithm For Pediatric Primary Care, Holly Hink

Doctoral Scholarly Projects & Capstones

Poor sleep quality is a common challenge for many adolescents due to various developmental, environmental, and social factors. Nearly half of all adolescents reported regularly experiencing sleep disruptions. Poor sleep quality among adolescents might have severe mental, emotional, and cognitive consequences including an increased risk for several psychiatric conditions, obesity, and poor academic performance. However, sleep disorders among this population frequently go unreported and are rarely screened during annual well-child exams with primary care providers. The purpose of this project was to develop an evidence-based sleep algorithm for pediatric primary care providers designed to improve screening and treatment of adolescent …

The Effects Of Retrieval Practice On Knowledge Acquisition And Durable Learning In Undergraduate Nursing Students, Jessica Everritt Gay

Dissertations

Recent reports of unpreparedness and failure to rescue incidents among new graduate nurses are concerning for nurse educators and health care. New graduates must retrieve and apply learned knowledge to make sound clinical decisions, emphasizing the need for durable learning and knowledge acquisition. Durable learning, which involves understanding and recalling learned information days, weeks, or months later is crucial for clinical judgment. Nurse educators should facilitate durable learning through effective, evidence-based learning techniques such as retrieval practice (RP), which has shown promise in health professions education but is underutilized in nursing education.

This study explored the impact of RP on …

Is There A Relationship Between Motivation And Nursing Student Engagement? A Quantitative, Cross-Sectional, Correlational Study, Angela Coes

Dissertations

Nursing education is concerned with helping to alleviate the nursing shortage in the United States; this can be done by graduating safe competent novice nurses. Motivation and engagement levels in nursing students have been tied to better academic outcomes including graduation rates, transition to practice, and first time National Council Licensure Examination for Registered Nurses pass rates. There was a gap in prelicensure nursing education research in the United States concerning the relationship among motivation, engagement, and possible influential variables.

The purpose of this study was to investigate the relationship between motivation and academic engagement among prelicensure nursing students in …

The Role Of Self Esteem Upon The Recovery Of Eating Disordered Patients, Samanta Flores Velazquez

Undergraduate Honors Theses

Eating disorders such as anorexia-nervosa, bulimia-nervosa, and binge-eating disorders are detrimental to overall health and well-being. The demands of beauty ideals and attitudes impact young adults negatively as they attempt to meet societal beauty standards. The need for approval, fitting in with the community, and confidence drive the behaviors of people in negative ways. In recent years, the modernization of social media has contributed to dieting cultures, the thin ideal, harmful weight-loss practices, and the cycle to use the body as a means to control or repent. External factors affect the risk of eating disorders which contribute to the challenge …

Interventions Of Eating Habits And Healthy Behaviors, Diego Armando Mazariegos Espinosa

Undergraduate Honors Theses

About thirty to fifty percent of college students report having negative emotions such as anxiety, depression, sadness, anger, hopelessness, shame, fear, and more. And over seventy percent feel exhausted or overwhelmed by schoolwork. According to scholarly research, these emotions pose obstacles during college life impacting the eating habits and healthy behaviors of college students. These habits can have a possibility of bringing lifelong issues in social, educational, and self-esteem aspects. Technology has revolutionized the world in a spectacular way in a short period of time. As students today have access to all sorts of technology like phones and computers, the …

Sexual And/Or Gender Minority (Sgm) Stigma Within Nursing Schools: The Relationship Between Stigmatic School Attributes, Minority Stressors, And Sgm Nursing Student Mental Health, Michelle Gee

Dissertations

Nursing education is heteronormative and cis-normative, which has been correlated to stigma and ignorance exhibited by nurses towards sexual and/or gender minorities (SGM). Minority Stress Theory (MST) states that circumstances in the environment that promote stigma related to minority identities lead to unique minority stressors, such as discrimination. These minority stressors subsequently affect mental health. While it is known that SGM patients experience mental health issues that relate to stigma and discrimination in healthcare settings, nothing is known about SGM nursing students dealing with stigma and discrimination within nursing education. The aim of this descriptive correlational study was to inform …

Impact Of Education For Bedside Nurses In A Community Hospital To Increase Intent Or Utilization Of A Career Ladder Advancement Tool, Carrie E. White

Doctoral Dissertations and Projects

This scholarly project is centered on lack of engagement in a new career ladder program. This project includes the creation of career ladder education with an intent to help with understanding, support, and engagement of the nursing caregivers. Education was created to propel the work of the career ladder within a small rural hospital. The program is 12 weeks long and covers eligibility criteria, activity details, technology education, and one-on-one support for understanding of the career ladder program. The hopes for the educational program were to increase nursing satisfaction, with the intent to stay with the organization, and foster participation …

Use Of Interdisciplinary Rounds For The Identification Of Hospitalized Adults In Need Of Palliative Care, Brenda A. Blunt

Evidence-Based Practice Project Reports

Palliative care (PC) is specialized care that aims to provide relief from the stress and symptoms of living with a serious illness (Center to Advance Palliative Care, 2022). PC services are often underutilized in the hospital, leaving a significant number of patients with unmet needs (Haranis et al, 2023; Kawashima & Evans, 2023; Smith et al, 2019). The purpose of this evidence-based practice project was to improve processes for identifying hospitalized patients for referral to specialty inpatient PC. The intervention involved interdisciplinary rounds (IDR) for adult inpatients on two medical-surgical (MESG) units in an 84-bed community hospital in suburban Milwaukee, …

The Effect Of Nursing Students' Level Of Readiness For Professional Practice On Self-Efficacy And Clinical Stress Perception: A Cross-Sectional Study, Uğur Öner, Dilek Yılmaz, Sinan Aslan, Ercan Çınar

Makara Journal of Health Research

Background: It is essential to evaluate students’ readiness before graduation and support them with education accordingly. This study investigates the effect of the level of readiness for professional practice as a purpose on the self-efficacy and clinical stress perceptions of nursing students.

Methods: The data for this cross-sectional study were collected between May and July 2024. The study included 733 3rd and 4th-year students studying nursing departments at state universities in Turkey. The Student Identification Form, Casey-Fink Readiness for Practice Scale (CFRPS), Student Self-Efficacy Scale (SSS), and Nursing Students Perceptions of Clinical Stressors Scale (NSPCSS) were used.

Results …

Health Literacy, Health Perception, And Influencing Factors Among Immigrants, Canan Birimoglu Okuyan, Ebru Deveci, Fatma Karasu

Makara Journal of Health Research

Background: Individuals living in rural areas face several healthcare disadvantages, including limited access to medical facilities and specialists during emergencies. This study examines healthy lifestyle behaviors, health perceptions, and influencing factors among immigrants in a rural region of southern Türkiye.

Methods: This cross-sectional study involved immigrants registered at a family health center. Data were collected using a sociodemographic questionnaire, the Perception of Health Scale, and the Health Literacy Scale.

Results: Statistically significant differences in THLS-32 scores were found based on participants’ occupation, marital status, and education level (p < 0.05). A moderately positive correlation was observed between health literacy and health perception scores (p < 0.05).

Conclusions: Research on the relationship between …