Nursing Commons^™

Point-Of-Care Gastric Ultrasound For Preoperative Assessment Of Gastric Contents: An Objective Structured Clinical Examination, Joshua Mann, Michael Sykes

Doctoral Projects

Pulmonary aspiration remains a leading cause of anesthesia-related mortality. The current nil per os (NPO) guidelines are proving unreliable in the presence of delayed gastric emptying due to comorbidities and the increasing use of glucagon-like peptide-1 (GLP-1) agonists. Gastric point-of-care ultrasound (POCUS) use provides a non-invasive, evidence-based, and cost-effective approach to assess gastric content and volume directly. However, limited formal training exists for advanced practice registered nurses (APRNs), and this lack of training contributes to the lack of its utilization. This doctoral project evaluated the effectiveness of an educational intervention that incorporated a didactic lecture as well as a hands-on …

The Artful Aging Project, Maria Carmelita Fernandez, Sah'neya Fryer, Kathleen Morris, Maya Price

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

As the older adult population in Sacramento County continues to expand, addressing age-related declines in fine motor function, cognition, and social well-being has become increasingly critical. Such declines can compromise activities of daily living, reduce independence, and exacerbate risks associated with social isolation. Evidence suggests that art-based interventions may mitigate these effects by enhancing motor coordination, promoting social engagement, and stimulating cognitive processes. The Artful Aging Project was designed to evaluate the effectiveness of structured art activities in improving fine motor skills and social wellness among older adults served by the Stanford Settlement Neighborhood Center (SSNC). Grounded in community-based participatory …

The Impact Of Awake Prone Positioning In The Patient With Covid-19, Ellie Butsch, Margo Halm, Ann Alway, Eliza Burkholder, Julia Koos

Nursing & Health Sciences Research Journal

Background: Prone positioning has been shown to improve clinical outcomes for sedated, mechanically ventilated individuals with moderate to severe respiratory illnesses. Some studies also show potential benefit to awake individuals with COVID-19.

Objectives: The primary aim of this study was to investigate if hospitalized non-critically ill individuals diagnosed with SARS-CoV-2 who engage in frequent proning are more likely to have improved outcomes compared to non-proning individuals.

Methods: A retrospective cohort design was used to assess outcomes associated with awake prone positioning. A convenience sample was used to select two cohorts of individuals admitted with COVID-19 from April 2020-March 2021. Cohort …

The Role Of Forgiveness In Health And Healthcare: Perspectives From Graduate Nursing Students And Faculty At A Private Faith-Based University In The United State[S], Rachel A. Joseph, Shanna W. Akers, Jichan J. Kim

Faculty Publications and Presentations

No abstract provided.

Cv: Daisy Sherry (Nursing), Daisy Sherry

Nursing Department Faculty Curricula Vitae

No abstract provided.

Lived Experiences And Educational Needs Of Women With A History Of Preeclampsia: A Qualitative Phenomenological Study In Indonesia, Fitriana Fitriana, Ani Kristianingsih, Nopi Anggistaputri

Journal of Asian Midwives (JAM)

Background: preeclampsia (PE).\ is one of the leading causes of maternal morbidity and mortality worldwide Many pregnant women fail to recognize early warning signs of the condition despite attending antenatal care, for reasons such as limited understanding of PE symptoms and/ or inadequate communication of health information by healthcare providers. Women with a previous history of PE are particularly vulnerable and require targeted educational support during subsequent pregnancies.
Methods: Eight pregnant women with a documented history of PE in their second or third trimester participated in in-depth semi-structured interviews using an interpretative phenomenological technique.  To ensure credibility and reliability, the …

Too Young, Too Risky: Maternal And Neonatal Outcomes Of Teenage Pregnancy In Pakistan, A Scoping Review, Sumia Andleeb Abbasi, Noor E Marfa Shivji, Warisha Qamar, Tayyaba Riaz Abbasi, Abdullah Riaz Abbasi, Raja Adan Asif

Journal of Asian Midwives (JAM)

Introduction: Teenage pregnancy is a global concern that affects both the developed and developing regions. Adolescent pregnancy is associated with serious maternal and child health outcomes. This paper aims to identify the prevalence and patterns of maternal child health outcome of adolescent’s pregnancies.
Methods: This review utilized the PRISMA-ScR guidelines. To identify the outcomes of the adolescent pregnancies, a wide-ranging search strategy was implemented. Data were extracted from 15 eligible studies with a total population of 5692participants from Pakistan. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Only quantitative methods were included.
Results: The review of 15 …

Predictors Of Complications Among Adult Patients Diagnosed With Type 2 Diabetis Mellitus At Thika Level Five Hospital, Kenya, Bernard Wambua Mbithi

MSc in Advanced Practice Nursing

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients …

Bridging Disability Studies And Nursing Education: A Curricular Intervention, Serena Karim

2025 Fall Honors Capstones Projects - Archive

Although one in four Americans experience disability in their lifetimes, the majority of nurses and other healthcare professionals feel ill-prepared to care for patients with disabilities (PWD). Factors such as inaccessible healthcare facilities, insufficient clinical knowledge, and biases about the quality of life of PWD contribute to mounting health inequities between PWD and non-disabled people. To further understand how education can impact nursing students’ comfortability and confidence toward caring for PWD, a 30-minute disability studies lesson was implemented for junior-level nursing students. 51 students who attended the lecture provided anonymous pre- and post-lecture surveys, which contained Likert scale and free …

A Change In Practice: Improving Uti Management In A Long-Term Care Facility By Implementing Rapid Urinary Culture Collection Protocols To Enhance Timely Treatment And Reduce Hospitalizations, Tania Ojeda

Doctor of Nursing Practice

ABSTRACT

Background: Urinary tract infections (UTIs) remain a leading cause of morbidity among elderly residents in long-term care facilities, where diagnosis is frequently delayed due to atypical presentation, cognitive impairment, and inconsistent urine specimen handling. Purpose: This quality improvement (QI) project aimed to improve the timeliness and accuracy of UTI management in a memory care facility through standardized evidence-based protocols. Objectives: The project sought to ensure that: (a) 100% of staff would be educated on the protocol; (b) 100% of residents with suspected UTIs would have urine sent for urinalysis and culture within 8 hours of symptom onset; (c) 100% …

Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey

Doctor of Nursing Practice

Background: Alcohol withdrawal is a potentially life-threatening condition frequently seen in psychiatric inpatient settings, especially among individuals with co-occurring alcohol use disorder and mental illness. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised, while widely used, depends on patient self-report, making it less effective for individuals with altered mental status or psychosis.

Purpose: This quality improvement project implemented the Modified Severity Assessment Scale, an objective, observation-based alcohol withdrawal protocol, in an inpatient psychiatric setting to improve safety, treatment accuracy, and care standardization.

Objectives: The project focused on ensuring full staff adoption of the protocol, reducing intensive care unit transfers …

Enhancing Adherence To Veterans Affairs/Department Of Defense And American Psychiatric Association Clinical Guidelines For Alcohol Use Disorder, Corinna M. Trevino

Doctor of Nursing Practice

Alcohol use disorder continues to be significantly undertreated within outpatient behavioral health settings, particularly concerning pharmacological interventions. Despite the presence of robust national clinical guidelines recommending medications such as naltrexone for individuals with moderate to severe dependence, the rates of prescribing these medications remain modest owing to inconsistent screening procedures, limited referral practices, and provider follow-through barriers. This project was implemented at a substance use treatment center in a large metropolitan area to improve adherence to clinical practice guidelines. The purpose of this project was to increase prescribing of naltrexone and improve referral for patients with moderate to severe alcohol …

Examining And Addressing Increased Hospital Inpatient Falls Rates At An Urban Community Hospital, Juan Lira

Doctor of Nursing Practice

Abstract

Background: Falls are the leading cause of reported injuries within the hospital setting. Injuries from falls occur in about20-45% of the time and is the leading cause of injury and injury death among the adult population. Inpatient falls are associated with an additional $14,0000 per occurrence and a prolonged hospitalization by 6.3 days. Increased falls rates affect hospitals rating, accreditation and reimbursements. This hospital is experiencing inpatient falls that exceed national average and corporate goals.

Purpose: The purpose of this project is to reduce the hospital falls rate by 10% within 90 days of initiating evidence-based evaluation and facility-wide …

Implementation Of An Information Sheet For Pediatric Patients With Autism Spectrum Disorder In An Inpatient Setting To De-Escalate Aggressive Behaviors And Reduce Seclusion Rates, Megan R. Castro

Doctor of Nursing Practice

Introduction: Research shows that most seclusion events in pediatric psychiatric settings involve pediatric patients with neurodevelopmental disorders, particularly autism spectrum disorder (ASD). A lack of provider expertise contributes to elevated seclusion rates, highlighting the need for evidence-based, ASD-informed care.
Purpose: To reduce seclusion events within a pediatric psychiatric facility in South Texas, by implementing an evidence-based intervention upon admission that could decrease aggressive behaviors and the likelihood of requiring seclusion. Evidence summary: Literature and guidelines underscore the importance of identifying sensory triggers and calming strategies at admission. Collaborative care and personalized interventions, such as a patient information sheet that identifies …

Implementing A Cardiac Catheterization Pre-Procedure Protocol To Decrease Avoidable Same-Day Cancellations, Christina C. Perry

Doctor of Nursing Practice

Background and significance of the problem: Pediatric congenital heart defect patients are amongst the sickest hospital population. These patients require planned palliation in the cardiac catheterization lab (cath lab), which has a limited number of providers and appointments available. In the cath lab, the percentage of avoidable same-day cancellations for interventional procedures was found to be greater than 30%, representing significant resource utilization opportunities.

Purpose: The purpose of this project was to develop and implement a standardized, evidence-based pre-procedure protocol to decrease avoidable same-day cath lab cancellations.

Goals and objectives: The goals of this project were a 10% decrease in …

Evaluating Perceptions Of Clinical Sports Pharmacists: Insights From An Orthopedic Clinic Survey, Brandon K. Welch, Sara Panella, Michael Swartzon, Eli Friedman, Samantha Cossin

Nursing & Health Sciences Research Journal

Introduction: Athletes have unique pharmaceutical needs due to injury risk, supplement use, and anti-doping regulations. Despite this, pharmacists remain underutilized in sports medicine. This quality improvement project evaluated clinician and staff perceptions of clinical sports pharmacists at Baptist Health, a large healthcare system in South Florida.

Methods: A 12-question REDCap survey was distributed to 19 staff and clinicians— including physicians, athletic trainers, and medical assistants—across five Baptist Health Orthopedic and Sports Medicine clinics. Responses were measured using a Likert scale and analyzed using descriptive statistics and thematic analysis.

Results: The survey achieved a 100% response rate. Most participants had over …

Well-Being And Quality Of Life Of Kenyan Nurses, Midwives And Community Health Volunteers: Measurement Properties And Correlates Of The Bbq And Who-5, Paul Mwangi, Sabina Odero, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Healthcare workers’ quality of life (QoL) and well-being is directly linked to the quality of services they deliver. However, there is a shortage of validated measures to assess QoL, well-being and their predictors among healthcare workers in Kenya, as in other LMICs. This study aimed to assess the reliability and validity of the Brunnsviken Brief Quality of Life Scale (BBQ) and WHO-5 well-being index (WHO-5) among nurses, midwives and community health volunteers (CHVs) in Kenya. The BBQ and WHO-5 were selected due to their established psychometric strengths, brevity, and prior use in healthcare settings. Additionally, the sociodemographic, psychological, and health …

Evaluating The Impact Of Evidence-Based Guidelines On Corticosteroid Prescribing For Acute Upper Respiratory Infections In Outpatient Primary Care, Cody Allen Boyd Hyatt

Doctoral Projects

Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.

The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders …

Code Crimson Ob: A Lifeline For Maternal Health, Colleen Cowie, Elizabeth Barrera, Leah Williams-Jones, Mercy R. Banaszak, Leonor Ruiz, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: Postpartum hemorrhage (PH) accounts for 12% of maternal deaths in the U.S. and affects approximately 5% of obstetric individuals. Despite available treatments, delays in recognition and response can lead to severe complications or death. The purpose of this evidence-based practice project was to improve maternal outcomes by implementing Code Crimson OB, a specialized obstetric rapid response team (RRT) for managing maternal hemorrhage.

Methods: An unannounced maternal hemorrhage drill revealed critical delays in mobilizing appropriate personnel. In response, the RRT protocol was revised to include Code Crimson OB, ensuring rapid, coordinated intervention. Hospital-wide education was conducted, and the protocol officially …

Implementation Of A Pharmacist-Driven Monitoring Protocol For Individuals Receiving Multiple Qt-Prolonging Medications In Acommunity Hospital, Maria A. Ruiz, Maura Falli, Kristina Lee, Mario Pascual, Radhan B. Gopalani

Nursing & Health Sciences Research Journal

Background: Torsades de pointes is a life-threatening polymorphic ventricular tachycardia, associated with QT interval lengthening on an electrocardiogram. Hospitalized individuals are routinely administered multiple medications with the potential to prolong the QTc interval. This quality improvement project sought to implement a pharmacist-driven protocol to identify and monitor individuals on multiple QT-prolonging medications using pharmacovigilance software, VigiLanz®, and the Tisdale risk score, aiming to reduce adverse drug reactions (ADRs) in a community hospital.

Methods: This was a single-center prospective quality improvement project of individuals admitted to the hospital from February through March 2024. Individuals with two or more scheduled QT-prolonging medications …

A Case Of Monocular Diplopia In The Setting Of High-Grade Urothelial Bladder Carcinoma Treated With Pembrolizumab, Leanne Dumeny, Joana Nuraj, Roshni Bisoondial, Nicole Moscoso, Arvinder Singh, Lorena Bonilla Md

Nursing & Health Sciences Research Journal

Case Presentation: We present the case of a 70-year-old male with a history of highgrade urothelial carcinoma who had been treated with multiple cycles of immune checkpoint treatment, pembrolizumab, presenting to the emergency department with worsening bone pain, abdominal discomfort, and hematuria.

Clinical Course: He reported blurry vision and monocular diplopia in the right eye for the past month. Physical examination revealed an inability to fully track with the right eye along with fatigue-induced diplopia, raising concerns for metastatic or immunotherapy-related ocular involvement. Imaging primarily revealed metastatic disease in the right orbital apex involving the rectus muscles, intraconal fat, and …

Quality Improvement Project: Enhancing Learning Through Structured Debriefing In Simulation, Catherine Jones

Doctor of Nursing Practice Projects

This quality improvement (QI) project examined the impact of structured debriefing training on nursing faculty perceptions of confidence, competence, and skill in simulation-based education (SBE) at a northeast Texas community college. The problem addressed was the lack of a standardized debriefing process, leading to inconsistent faculty practices and variable student learning outcomes. The QI project, guided by the National League for Nursing (NLN) Jeffries Simulation Theory and Lewin’s Change Theory, used a one-group pretest–posttest design to evaluate faculty outcomes following training in Debriefing for Meaningful Learning (DML) and guided self-evaluation using the Debriefing Assessment for Simulation in Healthcare (DASH) Instructor …

Shared Decision Making In Women's Health: A Quality Improvement Project, Brittney Butler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is the best practice in contraceptive counseling, yet it remains underutilized in primary care, particularly within underserved communities. Limited SDM use reduces patient autonomy, weakens satisfaction, and contributes to inconsistent documentation. This quality improvement (QI) project aimed to evaluate whether an educational intervention on SDM for contraceptive counseling improved provider self-efficacy and the electronic medical record (EMR) documentation of SDM practices. Guided by Bandura’s Social Cognitive Theory and Lewin’s Change Management Model, the project sought to enhance provider confidence and foster sustainable behavioral change. A quasi-experimental, one-group pretest–posttest design was implemented at a rural Federally Qualified Health …

Integrating Sbirt Training Into The Family Nurse Practitioner Curriculum: A Pilot Dnp Project, Fiji Simmons

Doctor of Nursing Practice (DNP) Projects

Background: Substance Use Disorder (SUD) and Alcohol Use Disorder (AUD) are major public health concerns, particularly in underserved populations. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is evidence-based models that promote early detection and care. Integrating SBIRT into Family Nurse Practitioner (FNP) curricula prepares future providers to address substance use in primary care. Local Problem: Despite the effectiveness of SBIRT, its use in primary care remains inconsistent. Barriers, including limited training, low confidence, and unfamiliarity with referral resources, hinder implementation. Structured education and protocols are needed to support provider readiness. Methods: SBIRT was integrated into the FNP curriculum of …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

The Fascia Iliaca Regional Nerve Block Using Ultrasound And Landmark Technique: An Objective Structured Clinical Examination For Nurse Anesthetists, Braxton T. Beech, Parker F. Rigby

Doctoral Projects

The fascia iliaca block (FIB) is an effective regional anesthesia technique used in various clinical settings, including operating rooms, emergency departments, and pain management clinics. Despite its advantages in reducing postoperative complications and minimizing opioid use, FIB remains underutilized among Certified Registered Nurse Anesthetists (CRNAs), primarily due to limited exposure and training. This doctoral project examines the implementation of an Objective Structured Clinical Examination (OSCE) as an educational intervention to enhance CRNA proficiency in performing FIB using both ultrasound-guided and landmark techniques.

A pre- and post-test study design was conducted with 18 CRNA participants attending a continuing education workshop. Demographic …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

The Effect Of Exercise On The Development Of Gestational Diabetes Mellitus In Pregnancy: A Systematic Review Of Literature, Abigail Reiche

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review is to synthesize literature examining the relationship between using exercise as a preventative method for gestational diabetes development during pregnancy, and the effect it may have on lowering glycemic levels. Health Source: CINAHL and PubMed were systematically searched for peer-reviewed journal articles that studied pregnant women (P), and the relationship of consistent exercise (I), compared to no physical exercise (C), on lowering glycemic levels resulting in positive pregnancy outcomes (O), throughout gestation (T). Twenty articles were retrieved in accordance with the PICOT objectives. Additional criteria included only articles from 2019-2024 and articles that were …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Prevention Of Burnout Among Critical Care Nurses, Jenelle Balaoing, Junela Bautista

Nursing | Student Research Posters

Background: Nursing burnout is a state of mental and physical exhaustion caused by excessive stress among nurses. Critical care nurses face challenges with direct patient care that contribute to emotional and psychological strain that are greatly influenced by workplace adversity and emotional management. Purpose: This research examines the prevalence of burnout among pediatric and adult intensive care unit (ICU) nurses, highlighting particularly high rates of burnout among those with extended years of service. Method: ICU nurses will participate in a qualitative interview that involves open ended questions relevant among burnout and resilience during shifts. Aspects specifically years of critical experience …