Nursing Commons^™

Factors Influencing Senior Practicum Readiness For Nursing Practice: A Descriptive Correlational Study, Beth Nease Phd, Dnp, Rn, Ne-Bc, Cynthia F. Corbett Phd, Rn, Faan, Stephanie Armstrong Phd, Msn, Rn, Kesheng Wang Phd, Ma, Bs, Kathy Casey, Kong Chen

Faculty Publications

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Background:

This study investigated the influence of belongingness, self-efficacy, and clinical learning support on readiness for nursing practice and explored the role of demographic factors and nursing program differences.

Method:

A quantitative, descriptive approach was used to explore undergraduate prelicensure senior nursing students' perceptions across the United States.

Results:

Descriptive statistics, Pearson correlation, and multiple linear regression demonstrated students in traditional Bachelor of Science in Nursing programs reported significantly higher scores across all domains compared with those in associate degree programs (p < .01). Similarly, students in programs with ≤400 clinical hours and those assigned only one preceptor scored significantly higher on all measures (p < .01 and p < .05, respectively). Regression analysis indicated self-efficacy and learning support explained 47.9% of the variance in practice readiness (p < .05).

Conclusion:

These findings share how clinical experiences shape students' readiness for nursing practice. Recommendations …

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Improving Nursing Compliance With Pain Reassessment Documentation After Analgesic Administration, Dorcas Okunola

Doctor of Nursing Practice Final Project Abstract

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Improving Nursing Compliance with Pain Reassessment Documentation After Analgesic Administration

PURPOSE: This quality improvement project aimed to increase registered nurse (RN) compliance with documenting pain reassessment within 30–60 minutes after analgesic administration in an adult medical–surgical trauma unit at a large academic medical center.

BACKGROUND: Timely pain reassessment is essential for evaluating treatment effectiveness and ensuring safe, patient-centered care. Baseline audits showed inconsistent documentation and compliance below institutional expectations. Evidence supports the use of electronic health record (EHR) prompts combined with targeted nursing education to improve adherence.

METHODOLOGY: A 12-week quality improvement initiative was conducted to reinforce adherence to the …

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Implementing An Evidence-Based Wound Care Protocol For Inpatient End-Of-Life Residents That Aligns With Hospice Comfort Care Goals, Oge C. Okeke

Doctor of Nursing Practice Final Project Abstract

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Implementing an evidence-based wound care protocol for inpatient end-of-life residents that aligns with hospice comfort care goals.

Purpose

This quality improvement (QI) project aimed to adopt a patient-centered, comfort-focused approach to wound care at the DNP project site and improve patient outcomes by increasing nursing staff's knowledge of evidence-based wound treatment strategies by 20%.

Background

Curative treatments involving aggressive methods do not align with hospice principles. Residents at the project site experience increased suffering at the end of life because of limited nursing knowledge of evidence-based, atraumatic wound care practices for end-of-life patients.

Results

Pre-intervention nursing knowledge survey scores ranged …

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Improving Handoff Communication Among Uaps In A Group Home By Implementing Standardized Sbar Tool And Evaluating Its Impact On Communication Quality And Resident Safety, Ola Iweala

Doctor of Nursing Practice Final Project Abstract

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Purpose

Improving handoff communication among unlicensed assistive personnel (UAPs) in a group home through Situation, Background, Assessment, Recommendation (SBAR) tool implementation.

Background

Communication failures during shift handoffs among unlicensed assistive personnel (UAPs) in a group home contributed to missed information, inconsistent care, and resident safety events. Baseline observations showed that only 37.5% of handoffs met criteria for high-quality communication, and approximately 75% of safety incidents were related to communication breakdowns.

Methodology

This project was conducted in a group home serving adults with intellectual and developmental disabilities and included 19 UAPs. The Plan-Do-Study-Act (PDSA) model and Adult Learning Theory guided implementation. …

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Improving First Case-On-Time Starts In The Operating Room By Implementing A Visual Patient Readiness Assessment Tool: A Pilot Quality Improvement Project, Xochitl I. Miranda-Khayat

Doctor of Nursing Practice Final Project Abstract

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Purpose

Delays in first case on-time starts (FCOTS) impact operating room (OR) efficiency, causing compounding schedule delays. This quality improvement (QI) project implemented a visual readiness tool to standardize communication and increase FCOTS rates.

Background

The project was implemented in a 5-room OR in an academic teaching hospital in the Texas Medical Center.

Methodology

Plan-Do-Study-Act (PDSA) cycles and the Consolidated Framework for Implementation Research (CFIR) guided continuous improvement and contextual factors evaluation. Following multidisciplinary education, the visual tool was implemented. De-identified FCOTS data was extracted from the electronic health record (EHR). Qualitative feedback was gathered via Qualtrics (n=17 pre-implementation) and …

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Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

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Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

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Improving Clinic Workflow To Enhance Rubeola Immunity Screening In Pregnant Patients, Courtney Mcduffie

Doctor of Nursing Practice Final Project Abstract

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Purpose: The purpose of this quality improvement (QI) project was to improve provider adherence to Rubeola IgG serum order entry for prenatal care visits by implementing a standardized workflow and an electronic medical record (EMR)-based order-entry process in a high-risk maternal outpatient clinic.

Background: Rubeola infection during pregnancy is associated with significant maternal and fetal complications. Despite recommendations from the American College of Obstetricians and Gynecologists (ACOG) to use serologic testing to determine immunity status, inconsistent provider ordering practices and workflow gaps contribute to missed opportunities for identifying non-immune patients and planning post-partum vaccination.

Methodology: A ten-week intervention period utilized …

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Mid-Shift Huddle To Improve Icu Nurse Well-Being And Reduce Burnout, Jesse Cannizzo

Doctor of Nursing Practice Final Project Abstract

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Mid-Shift Huddle to Improve ICU Nurse Well-Being and Reduce Burnout

Purpose

Burnout among ICU nurses negatively affects well-being, job

satisfaction, and retention. This quality improvement project

evaluated a mid-shift support huddle to identify staff stressors

and improve nurse well-being.

Results

The mid-shift support huddle identified high-stress events during 44% of

completed huddles, with workload and unsafe assignments as the

primary concerns. ProQOL scores improved, while employee

engagement findings were mixed, with unchanged well-being and lower

perceived stress manageability.

Background

ICU nurses provide high-acuity care, manage heavy workloads, and

experience emotional fatigue. Brief team huddles and leadership

engagement may improve …

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Music Interventions For Critically Ill Patients: Evaluating Effects Of Music On Psychoemotional Symptoms In Critically Ill Patients Receiving Respiratory Support, Allyson Crighton

Honors Undergraduate Theses

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Critically ill adults receiving respiratory support in intensive care units (ICUs) frequently experience psychoemotional disturbances such as agitation, anxiety, and delirium, which contribute to prolonged ventilation, increased sedative use, and adverse patient outcomes. While pharmacologic management remains standard practice, associated risks including oversedation and delirium highlight the need for safe, complementary interventions. Emerging evidence suggests that music-based interventions may offer a non-invasive, cost-effective strategy to reduce psychological or emotional distress in this vulnerable population. This integrative literature review examined the effects of music interventions, including passive music listening and structured music therapy, on agitation and related psychoemotional outcomes in critically …

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Parenting Stress And Its Association With Parental Technoference: An Integrative Literature Review, Emily S. Machuca

Honors Undergraduate Theses

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Introduction: Today, digital devices are a part of daily life, but can serve as a distraction that interrupts important relationships, a process referred to as technoference. In the context of parenting, device use during child interactions may reduce parental attentiveness and engagement, with potential implications for child development and behavior. Parenting stress may influence how and why parents engage with digital devices in the presence of their children. However, the association between parenting stress and parental technoference remains unclear in the current literature. This integrative literature review aimed to synthesize existing evidence examining the relationship between parenting stress and parental …

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Bridging The Gap: Investigating The Impact Of Adequate Prenatal Care On Adverse Maternal Outcomes Among Black And African American Women, Ciaera Ambroise

Honors Undergraduate Theses

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The United States continues to face a maternal health crisis marked by persistent racial disparities, with Black women experiencing pregnancy-related mortality rates three times higher than those of White women. Despite national efforts to expand access to prenatal services, inequities in maternal outcomes remain, indicating that the quality of prenatal care may be as critical as its timing and frequency. The purpose of this thesis is to examine whether adequate prenatal care, compared to inadequate prenatal care, is associated with reduced adverse maternal outcomes among Black and African American women in the United States. Guided by a PICO question, this …

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Examining The Effectiveness Of Icu Diaries In Reducing Post–Intensive Care Syndrome (Pics) Psychological Symptoms: A Rapid Review Of United States–Based Studies, Lananh Tran

Honors Undergraduate Theses

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Background: The growing recognition of Post-Intensive Care Syndrome (PICS) has prompted investigation into interventions, such as ICU diaries, to mitigate the long-term psychological effects of PICS. Intensive care unit (ICU) diaries – journals written by clinicians and loved ones during an ICU admission – are a tool that can help patients reconstruct the events of their critical care experience. Entries in the diary may include clinical updates, explanation of treatments, and encouraging words from loved ones or staff. Previous research in European countries found ICU diaries may be effective in reducing psychological effects post ICU admission.

Research question: The aim …

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Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

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Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

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Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

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Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

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Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

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Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

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Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

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Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

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Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

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Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

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Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

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Background

Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.

Purpose

This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).

Methods

In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they …

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Impact Of Fast Track On Emergency Department Length Of Stay, Kayce Carrick Bsn, Rn, Kelsey Richmond Rn, Stacy Duncan Rn

Nurse Residency Posters

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Facilitator: Melissa Harper, BSN, RN

OhioHealth O'Bleness Hospital

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Impact Of Exercise And Cognitive Behavioral Therapy On Anxiety And Depression, Ranjita Subedi, Rachel Affeldt, Abigail Bentley, Gavin Gump, Madison Mitchell, Taylor Rodgers, Bayley Mullins, Libbie Woodland, Sophia Rubenkoenig

Nurse Residency Posters

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OhioHealth Grant Medical Center

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Hands-Free Tech For Fall Prevention, Sierra Dixon Rn, Jessica Gillam Rn, Bryan Hatheway Rn, Taightam Hicks Bsn, Rn, Kelsey Tignor Bsn, Rn, Hailie Tomsik Rn, Jeremiah Waworoendeng Rn

Nurse Residency Posters

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Facilitator: Kasey Gillen, MHA, BSN, RN, NPD-BC

OhioHealth Mansfield Hospital

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Impact Of Intentional Leadership Styles On Staff Nurse Satisfaction And Retention, Monica Patrick Rn, Camie Mitchell Rn, Amelia Kennedy Rn, Rachel Geiger Rn, Zachary Foster Rn, Katherine Leahy Rn

Nurse Residency Posters

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Facilitator: Tess Wagner, BSN, RN

OhioHealth Riverside Methodist Hospital

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Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

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ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

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Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

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Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

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Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

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This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

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Preventing G-J Tube Dislodgement - A Device And Communication Innovation, Sarah Clark

2026

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Abstract

The Problem: G/J tube dislodgement is a frequent complication in pediatric patients.

Leads to:

• Emergency department visits
• Hospital admissions
• Delays in nutrition/medication

Impact on Patients & Families:

• IV placement (traumatic)
• Radiation exposure
• Overnight hospital stays

Impact on Nurses & System:

• Increased workload (admissions, coordination)
• Occupied inpatient beds for stable patients
• Inefficient care processes

Aims/Objectives Aim: Reduce unplanned G/J tube dislodgements and related hospital utilization.

Objectives: Develop a breakaway connector prototype

Implementation and Evaluation:
Setting: Pediatric inpatient & outpatient system
Participants: Nurses (bedside, GI, IR), caregiver, innovation team
Process: Roundtable discussions → identified workflow gaps Communication/workflow audit Developed …

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How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

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Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

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Professional Identity Development Among Nursing Students: The Impact Of Structured Reflective Practice, Abdelmonim El Fadely, Kamal Takhdat, Charaf-Eddine Ahraiba, Rahma Bouali, Sabah Selmaoui, Boujemaa Agorram

Health Professions Education

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Purpose This study aimed to assess the impact of a structured reflective practice intervention on the development of professional identity among nursing students. Method A mixed-methods design was adopted. The intervention, based on guided reflective practice, was implemented with a voluntary sample of 58 participants. The evaluation relied on a quasi-experimental quantitative approach using the Macleod Clark Professional Identity Scale, with a comparison group and both pre-test and post-test measurements. A qualitative component was also included to explore the dimensions of the studied concept in greater depth. Results Quantitative findings showed a statistically significant difference between the post-test means (p < 0.001), indicating that the reflective practice intervention had a positive effect on the experimental group compared to the control group. The qualitative results further illuminated students’ reflections, which were organized into ten themes corresponding to the study’s conceptual framework: professional knowledge and skills, values and ethics, the nursing role, leadership, professional self-image, social image of the profession, sense of belonging, identification with role models, theory–practice integration, and career choice. These dimensions provided a comprehensive and nuanced understanding of professional identity, capturing the complexity of the concept. Conclusion These results support the integration of reflective practice as a pedagogical approach to fostering the construction and development of a positive professional identity. Professional identity, as a rich and multidimensional concept, goes beyond the process of professionalization—it represents its ultimate achievement.

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Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

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Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

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Implementation Of An Acute Critical Event Debriefing To Enhance The Quality Of Cardiopulmonary Arrest Resuscitation In The Cardiovascular Intensive Care Unit At A Safety-Net Hospital, Shara Baker

Doctor of Nursing Practice Final Project Abstract

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Purpose

This scholarly project aimed to implement an Acute Critical Event Debriefing (ACED) program in an intensive care unit to improve resuscitation quality by increasing post–cardiopulmonary arrest debriefing completion rates and enhancing documentation of airway confirmation during resuscitation events. The project took place in a 12-bed intensive care unit at a large academic safety-net hospital in Dallas, Texas.

Background

Structured debriefing after cardiopulmonary arrest events was recommended to enhance team performance, clinical education, and resuscitation quality. However, debriefing following code events was inconsistently conducted across many intensive care units, limiting opportunities for team reflection and quality improvement.

Methodology

The Plan-Do-Study-Act …

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