Nursing Commons^™

Staff Education To Enhance Provider Knowledge On Lifestyle Modification For Hypertension Management, Chinyere Maria Assumpta Ofoegbu

Walden Dissertations and Doctoral Studies

Summary A doctor of nursing practice (DNP) staff education project was designed to enhance healthcare providers' knowledge of lifestyle interventions for hypertension management. At the practice site, primary healthcare providers were not regularly integrating lifestyle counseling. The practice-focused question guiding this project was: In primary care providers, how does implementing an evidence-based lifestyle education training program for hypertension management affect provider knowledge? An in-person educational session was provided to ten (10) healthcare practitioners who voluntarily participated. Pre- and post-training knowledge assessments was the analytical techniques employed to examine changes in provider comprehension of lifestyle-based hypertension care. Descriptive statistics and paired-sample …

Multidisciplinary Approach To Reducing Healthcare-Associated Infections: A Dnp Project, Jovinsky Jonaldo Eliscard

Walden Dissertations and Doctoral Studies

Healthcare-associated infections are increasingly common in healthcare facilities due to multiple concerns, including negligence, human error, and poor conditions. According to Chuwa (2024), secondary infections are a significant threat to patient safety and wellness, reducing an organization’s ability to realize clinical objectives. The facility is a large healthcare provider operating numerous hospitals and care homes across the United States. The organization continues to report increased infection rates across its branches owing to a lack of standardized infection prevention and control protocols, reducing its efficiency and appeal. Internal audits point to inconsistencies in general sanitation, cleanliness, and hygiene. The organization also …

Eeg Pressure Injuries, Paula Ebert

Nursing Grand Rounds

EEG Pressure Injuries. Paula Ebert, MS, RN, CNS, ACCNS-AG, CCRN, SCRN

Objectives:

• Understand the clinical impact of pressure injuries related to EEG
• Understand the implemented changes to reduce pressure injuries related to EEG
• Understand the multidisciplinary approach to addressing the problem

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Staff Education Project For Nursing Staff At An Adult Mental Health Clinic To Address Inconsistencies And Inadequacies In Suicide Risk Screening, Grace Oluwasade Awodele

Walden Dissertations and Doctoral Studies

This staff education initiative was designed for nursing personnel at an adult mental health clinic, aiming to address inconsistencies and inadequacies in suicide risk screening practices among health care providers. Despite regular patient interactions, staff frequently lack the necessary knowledge, confidence, and standardized tools to identify individuals at risk for suicide, leading to missed opportunities for early intervention. The existing gap in practice jeopardized patient safety, led to preventable harm, and highlighted the need for evidence-based screening protocols, such as the Ask Suicide-Screening Questions (ASQ) tool, to facilitate timely, equitable, and effective suicide prevention in nursing practice. The project focused …

Staff Education To Improve Patient Safety Using Standardized Medication Transcription Verification, Beloved Martey

Walden Dissertations and Doctoral Studies

This staff education project was a quality improvement initiative aimed at reducing medication transcription errors by implementing a standardized verification protocol. The project addressed the critical practice problem of transcription-related medication errors, which contribute to wrong medication administration, adverse drug events, and patient harm. The practice-focused question was: How does implementing a staff education program on standardized medication transcription verification processes in healthcare institutions affect the rate of wrong medication administration compared to traditional transcription methods without education? The project was implemented over 8 weeks in an outpatient clinic with 20 participants (8 prescribers and 12 nurses). The primary data …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

Prevalence Of Sexual Harassment Among Nurses And Nursing Students In A Culturally Conservative Country, Hanadi Mohamad Nur Steitiyeh, Fatin Ahmad Safa, Jana Daoud Al Hajj Daoud, Adam Tarek Ikkawi, Sahed Ali Fawaz, Hiba Deek

BAU Journal - Science and Technology

The prevalence of sexual harassment among nurses and nursing students in Lebanon is an unidentified social concern. This study aims to identify this prevalence and assess the related factors. Using a self-administered questionnaire the sociodemographic characteristics, workplace variables, physical appearance, and the Sexual Experience Questionnaire (SEQ) were assessed, the data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A total of 380 participated with 71.8% being female and 63.9% aged between 18 and 25. Sexual harassment was experienced by 91 participants (23.9%) and occurred mainly in the patients’ rooms and during procedures. Policies were absent or …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Tiny Heart Bundle Qi Project: 3d Modeling To Improve Care Of Cardiac Nicu Patients, Stacy Ranee Harris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background—Infants with congenital heart disease (CHD) are being care for in the neonatal intensive care unit (NICU) by increasing numbers of novice nurses. Understanding complex cardiac anatomy is imperative to novice nurses’ readiness to care. Parents of infants with CHD may not understand their child’s anatomy, which impacts many facets of their care.

Purpose— The purpose of this quality improvement (QI) project was to determine if education, including 3D heart models improved novice nurse readiness to care for NICU patients with CHD and if parental understanding improves after receiving education with 3D heart models.

Methods— This was a plan-do-study-act (PDSA) …

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

How Instructor Engagement Shapes Nursing Students’ Perceptions And Specialty Preference, Marissa M. Sigel

Nursing | Senior Theses

Background: As nursing students approach graduation, choosing a specialty becomes a key decision. Although clinical rotations offer exposure to different practice areas, the role of the clinical instructor is equally influential. Instructor engagement extends beyond teaching skills and may shape how students perceive clinical environments. Objective: This study examines how clinical instructor engagement influences senior nursing students’ specialty preferences. Method: A longitudinal cohort design will be used with pre-licensure BSN students at a small private university in Northern California. Students will complete the same survey twice during their program, and paired t-tests will be used to assess changes in specialty …

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

The Prediction Of All-Cause Mortality In End-Stage Kidney Disease Patients Using Social Determinants Of Health: A Machine Learning Framework, Addy Smith, Maxwell Donelan, Hossein Moradi Rekabdarkolaee, Patti Brooks, Brandon Varilek, Surachat Ngorsuraches, Jerry Schrier, Adam Dell, Semhar Michael

Journal Articles: College of Nursing

End-stage kidney disease (ESKD) is the irreversible final stage of chronic kidney disease in which the kidneys lose their independent function. This study presents a machine learning framework to predict all-cause mortality in ESKD patients by the end of a follow-up period. We combined patient-specific clinical factors with social determinants of health (SDOH) to assess their influence on survival outcomes. Data were obtained from the United States Renal Data System, including patients admitted in 2015 and followed through August 2021. Community-level SDOH data were integrated from the Agency for Healthcare Research and Quality, with variable screening techniques and expert input …

Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

Routine Guided Meditation In Nicu Nurses: A Coping Strategy For Nicu Nurses Dealing With Newborn Deaths, Gianna Wong

Nursing | Student Research Posters

Purpose: This research study aims to investigate the emotional impact of newborn deaths on Neonatal Intensive Care Unit (NICU) nurses in addition to evaluating their perceptions of routine guided meditation as an effective coping mechanism to manage professional grief and enhance psychological well-being. Methods: Utilizing an exploratory descriptive research design grounded in Pender’s Health Promotion Model (HPM), this study examines the lived experiences and health-promoting behaviors of neonatal nurses following newborn deaths. Data: Anticipatory collection of data will be from a sample of NICU nurses based in California through a twelve-question survey featuring open-ended questions. Qualitative content …

Radiation Therapy Without Anesthesia For A 7-Month-Old Child Using Audio-Visual Assisted Therapeutic Ambience In Radiation Therapy (Avatar), Johnathan Muddle

Faculty Publications - College of Nursing

Radiation therapy (RT) plays a crucial role in the treatment of many childhood cancers. Precise delivery of RT is important for minimizing dose to critical structures and reducing late toxicity. However, young children often struggle with the need to remain still in the treatment room for sessions lasting up to 45 minutes, leading to frequent use of daily anesthesia over the treatment course. Though anesthesia utilization rates vary, up to 50% of children aged 7 to 8 are reported to require anesthesia during treatment, with rates potentially higher in limited settings.

Dexmedetomidine Versus Propofol For Reducing Emergence Delirium In Pediatric Anesthesia: A Scoping Review, Hannah Laxton Bsn, Rn, Hannah Mclain Bsn, Rn, Robert Mohr Bsn, Rn, Sarah Rocha Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Dwanye Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched …

Optimizing Efficiency In Joint Injections In An Outpatient Orthopedic Oncology Clinic Using Lean Six Sigma, William Alexander Byrd

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Prolonged in-room wait time in an outpatient orthopedic oncology clinic was identified as an important driver of dissatisfaction and operational inefficiency. Baseline in-room times in this setting were reported as M=96.2 minutes for patients receiving injections and M=92.9 minutes for those not receiving injections. This quality improvement project used Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, Control) framework to streamline clinic workflow for the joint injection process. Over an eight-week period, four key interventions were introduced: a standardized order set for medications, pre-bundled supplies and portable supply toolbox, telephone pre-consenting of patients, and optimized scheduling of …

Quantification Of Illicit And Prescription Drug Residues In Pasteurized Donor Human Milk: A Comprehensive Analytical Approach, Michelle Brenner, Kaytlin Krutsch, Ashlynn Baker, Dhavalkumar Patel, Palika Datta

Department of Pediatrics Faculty Publications

Objective

To assess the risk of infant exposure to illicit and prescription drug residues, from infant-ready, pooled, pasteurized donor human milk (PDHM) provided by healthy, screened, voluntary non-remunerated donors to a not-for-profit milk bank.

Study Design

A total of 150 pooled samples, representing 742 donor contributions, were analyzed for 15 illicit and prescription drug analytes using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Detected concentrations were evaluated for clinical significance.

Result

All 150 PDHM samples tested negative for residues of marijuana, amphetamines, benzodiazepines, fentanyl, hydrocodone, and morphine. Three samples (2%) contained trace amounts of oxycodone (< 0.6 parts per billion), yielding exposures over 455 times lower than established standards for infant safety (Relative Infant Dose: < 0.022%; standard safety threshold 10%).

Conclusion

Comprehensive analysis detected no clinically …

Comparing The Evolution Of The Advanced Practice Nurse Role: Insights From Switzerland And Kenya, Carole Mackavey, Sara Kohler, Eunice Ndirangu, Rachel Kimani, Constance Shumba, Bernard Mutwiri, Colette Henderson, Anna Jones

School of Nursing & Midwifery, East Africa

The article explores the evolution of Advanced Practice Nurse (APN) roles in Switzerland and Kenya, highlighting their development, challenges, and influence on healthcare delivery. Despite notable differences in income levels and healthcare infrastructure, both countries are committed to strengthening primary care through the deployment of APNs. Switzerland uses APNs to address provider shortages and improve chronic disease management, whereas Kenya uses them to increase access in underserved areas. A comparative analysis explores how regulatory frameworks, educational models, scope of practice, and health system priorities influence the adoption of advanced practice nursing (APN). Switzerland’s established healthcare system supports the integration of …

Differences In Comorbidities, Presenting Symptoms, Demographics, And Patient Reported Outcomes In Long Covid By Initial Test Status, Stephanie Georgoudiou

Nursing Dissertations - Archive

Importance Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), remains a major global health concern. Recovery may result in persistent symptoms known as post-acute sequelae of SARS-CoV-2 (PASC), or long COVID. Most studies focus on individuals with laboratory-confirmed infection; however, some patients with COVID-like illness and negative tests also develop persistent symptoms. Testing status should not delay appropriate interventions or specialist referrals. Early, symptom-based care is essential to improve outcomes.

Objective To compare patient-reported outcomes and demographics between long COVID patients who tested positive versus negative during their initial illness.

Design, Setting, and Participants This secondary …

Implementing A Change Process To Support Respectful Communication In Newborn Units In Kenya: A Qualitative Study, Mwanamvua Boga, Peris Musitia, Dorothy Oluoch, Dyuti Sen, Hiza Dayo, Ane Haaland, Lisa Hinton, Jacinta Nzinga, Mike English, Sassy Molyneux

Institute for Human Development, East Africa

Background: In contexts of high workloads, resource shortages, and environmental inadequacies, neonatal nurses in many low- and middle-income countries face high levels of stress and burnout, as well as significant communication challenges. Advancing care in these ‘on the edge’ emotionally fraught contexts requires a multi-layered systems approac:, including context-sensitive courses that support respectful communication.

Methods: We share our learning from the implementation of a communication and emotional competence training process in two public hospital newborn units in Kenya. We adapted an existing course in collaboration with newborn unit nurse managers, with the aim of enhancing relationships among staff and …

Implementation Of A Turn Team To Reduce Hospital-Acquired Pressure Injuries In A Medical Intensive Care Unit, Heather A, Adair

Doctor of Nursing Practice Final Project Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the …

Proof-Of-Concept Development And Preclinical Evaluation Of A Microarray Patch Platform For Codelivery Of Multiple Broadly Neutralizing Antibodies For Hiv Prevention, M. Melissa Peet, Vivek Agrahari, Parbeen Singh, Lam Luong Hoai Nguyen, Louise A. Ouattara, Eun Sung Yang, Carolina Herrera, Amarendra Pegu, Theodore C. Pierson, Thanh D. Nguyen, Gustavo F. Doncel

CONRAD Publications

Broadly neutralizing antibodies (bnAbs) are advancing as a preventative or treatment option for HIV infection, but currently must be administered parenterally, typically as a large injection or infusion, an invasive method of delivery, especially for the pediatric population. Here, we present proof-of-concept data on a minimally invasive microneedle (MN) patch platform codelivering three bnAbs, PGT121, VRC07-523LS, and PGDM1400LS, from separate MN patch units or pixels. Each 1 cm² patch pixel, fabricated via solvent casting, contained similar to 2 mg of one bnAb. In ex vivo porcine skin tests, the MNs effectively penetrated the skin. When tested in vitro in PBS …