Nursing Commons^™

Ask Me 3® In Action Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

EBP Fellowship

Background: Parents and caregivers’ understanding of how to provide safe and effective care at home is vital. However, elevated levels of stress and limited health literacy face significant challenges in understanding discharge instructions.

For parents of pediatric patients seen in an acute perioperative setting, how will the use of the Ask Me 3® health literacy tool impact understanding of medical information and communication with healthcare providers?

Literature Evidence: Patients who understand heath instructions make fewer mistakes when they take their medicine, follow treatment plans, and prepare for medical appointments (Six-Means, Amy, et al, May 2012). Patients have reported …

Empowering Nurses: A Training Initiative On Essential Oils For Pediatric Neurosurgery Patients, Sheri Sacks

EBP Fellowship

PICO Question: In pediatric neurosurgical bedside nurses, does education on lavender essential oil, compared to no education, improve knowledge, confidence and intent to integrateit as a complementary therapy for TBI patients?

Literature Review: Pediatric neurosurgery patients often face increased anxiety and agitation. Nurses may lack knowledge of non-pharmacological interventions to reduce agitation and anxiety in their patients. Literature review used MeSH Headings and keywords to find recent English articles. Evidence shows EO reduces anxiety. Lavender inhalation lowers anxiety, pain, and vital signs in pediatric dental patients. In adults, aromatherapy decreases anxiety, pain, blood pressure, and improves sleep, also …

Fierce And Focused - Virtual Reality Support For Pediatric Oncology Patients, Javarius Barber-Esparza

EBP Fellowship

Practice Problem: Pediatric oncology patients often experience anxiety during needle procedures. Even with anesthetic pain management in place, visually encountering the needle can be more distressing than the procedure itself. Virtual Reality (VR) has emerged as a nonpharmacological tool that provides immersive distraction, effectively lowering pain perception and anxiety. Studies show VR reduces anxiety during medical procedures, including accessing Implanted venous access devices (IVAD). Yet, its adoption in pediatric oncology settings remains limited.

Literature/Evidence: Search strategy in the CINAHL (EBSCOhost) database used MeSH headings and keywords, including English articles published within the last five years. Studies show that …

Improving Confidence And Competence In Treating Pediatric Peripheral Intravenous Extravasation, Ann Gosdin

EBP Fellowship

Practice Problem: Peripheral Intravenous Infiltrations and Extravasation (PIVIE) can cause severe skin and tissue damage. Prompt intervention helps prevent moderate or severe skin tissue damage. In the U.S. PIVIE complications can cost $10,895 versus $7,009 per patient without PIVIE. An Australian ED estimated the annual cost of PIV occlusion/infiltration and dislodgement of $14.01 million Australian dollars.

Quality event reviews demonstrated a staff knowledge deficit of treating extravasations per guidelines. Treatment could be delayed if the Vascular Access Team (VAT) was not available. Education on treatment of IV extravasation was needed to address this practice gap.

PICO(T) Question: In …

Quality Improvement Project Diabetes Self-Management Education Training Program, Guylene Lucien

Doctor of Nursing Practice Projects

Diabetes is among the leading causes of morbidity and mortality in the United States; therefore, effective Diabetes Self-Management Education (DSME) is vital in improving patient outcomes. A needs assessment of the Practice site identified gaps in provider confidence and frequency and consistency of delivering DSME that correlated with poor patient adherence and readmissions. The purpose of this quality improvement (QI) project was to implement a structured, evidence-based DSME training program to improve healthcare provider self-efficacy to provide DSME. The project utilized Bandura's Social Cognitive Theory and the ADKAR change model and employed a quasi-experimental, one-group pretest–posttest design. Ten providers (six …

Quality Improvement Project Optimizing Opioid Screening: The Impact Of Staff Education In A Pain Management Clinic., Khairunnisa Khan

Doctor of Nursing Practice Projects

Chronic pain is a complex condition that often requires long-term opioid therapy, creating challenges for safe prescribing and patient monitoring. Inadequate screening for opioid misuse risk can contribute to unsafe practices, regulatory noncompliance, and patient harm. Validated instruments such as the Opioid Risk Tool (ORT) and the Current Opioid Misuse Measure (COMM) are available to guide risk assessment, yet their use in everyday practice remains inconsistent. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to evaluate whether targeted staff education improved compliance with opioid risk assessment documentation in a rural pain management clinic. A pre-/post-intervention design was …

Music For Self-Care, A Nurse Well-Being Strategy, Kristen Gilmore Msn, Rn, Cen, Tcrn, Ne-Bc, Nc-Bc, Allison Mccrea Mmt, Mt-Bc, Stephen Didonato Phd, Lcp

Jefferson Hospital Staff Papers and Presentations

Background

• Evidence suggests that individuals with trauma exposure, such as the impact of crisis such as COVID-19, may benefit from music therapy.
• In 2021, the Hospital and Healthsystem Association of Pennsylvania (HAP) recognized the importance of ensuring well-being of the nursing workforce identifying the vital role that nursing plays upholding the highest standards of patient care.
• HAP, in partnership with the Pennsylvania Council on the Arts, created a three year, first of its kind program, to support the provision of music therapy program services for healthcare workers.
• Through this grant-funded program, Jefferson Health- Pennsylvania hospitals, were awarded $162,000. This grant …

Simulation Strategies For Safer Student Medication Administration: A Quality Improvement Project, Rochelle D. Beaver

Doctor of Nursing Practice Projects

Medication administration is an essential skill for nurses, but there are few opportunities for students to practice this skill to prepare for clinical practice. Literature shows that best practice to bridge the gap is simulation. The purpose of this quality improvement project is to implement an evidence-based simulation activity for students. The problem is that not all faculty are trained to teach via simulation. The aim of the project is to increase the nursing faculty’s competence in facilitating a medication administration simulation activity focusing on pre-briefing and debriefing utilizing evidence-based standards from International Nursing Association for Clinical Simulation and Learning. …

Reducing Stigma And Enhancing Outcomes: An Antistigma Education Program For Mental Healthcare Professionals, Chidi Oriaku

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project that addressed the stigmatization of patients with mental illness (PMI) within psychiatric contexts. The project site healthcare organization’s mental health professionals had a high rate of stigmatization of PMI. Stigma is linked to poor medication adherence rates, delays in accessing healthcare, lower healthcare utilization among PMI, psychiatric morbidity and mortality, and poor quality of life. Despite recognizing this problem, the healthcare organization had no targeted antistigma interventions. I developed an antistigma education to improve outcomes. The practice-focused question was: In mental health staff, will an educational program on …

Staff Education To Improve Knowledge On Facilitation Of Psychoeducational Groups, Kenyett Moody

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Kenyett Moody has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Margaret Harvey, Committee Chairperson, Nursing Faculty Dr. Robert McWhirt, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Background and Purpose: Nurse-led psychoeducation groups are essential for improving patient outcomes by educating individuals about health conditions and coping strategies. In a dual-diagnosed inpatient psychiatric unit, a quality improvement (QI) project …

Staff Education To Increase Knowledge About The Workflow Process, Mwikali Mutia-Lamin

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was conducted to address staff’s lack of knowledge about the workflow process in an outpatient mental health setting. Evidence has shown that staff’s lack of knowledge about workflow processes creates ineffective communication and collaboration in care as well as reduces patient outreach. The practice-focused question was focused on determining whether training staff in an outpatient mental health setting about the organization’s workflow process increased their knowledge on how to use the workflow process in an effort to improve patient care and care outcomes. Thirteen of the 20 staff members participated in this educational …

Quality Improvement Project Optimization Of Bed Capacity Management At A Tertiary Pediatric Facility, Barbara M. Stewart

Doctor of Nursing Practice Projects

Emergency department (ED) overcrowding can be defined as a circumstance in which the number of patients seeking care has exceeded the resources available. ED overcrowding can have significant negative impacts on patient safety, quality of care, and hospital finances. The use of an ED saturation measurement is supported by research and widely used in adult emergency departments. The quality improvement project evaluated the correlation between a modified National Emergency Department Crowding Scale (mNEDOCS) and established ED metrics- length of stay (LOS) and left-without-being-seen (LWBS) rates. The intervention was guided by the revised Iowa Model and the Model for Improvement, both …

Staff Education About Cultural Awareness In A Healthcare Setting, Phylis Titty Tarawally

Walden Dissertations and Doctoral Studies

Summary This quality improvement project was carried out to address a practice gap in culturally responsive care among nursing staff working in a skilled nursing facility. African-American residents often face disparities in healthcare due to staff’s limited knowledge of cultural health beliefs and confidence in engaging with diverse populations. To improve this, an educational intervention was designed using the ADDIE instructional model and evaluated to see if it could enhance staff knowledge and confidence related to African-American cultural practices. The project was guided by the practice-focused question: Will a structured African-American cultural awareness program improve staff knowledge and confidence to …

Glucometer Cleanliness On A Neuro-Medical Intensive Care Unit, Abbey Camire

Operations Transformation

Glucometers on the Neuro-Medical ICU are being docked with visible reddish/brown residue, indicating they are not properly cleaned beforehand. This poses a risk of transmitting pathogens, endangering patient and staff safety, and violates hospital policy and regulatory standards. Proper disinfection of mobile medical equipment is essential for infection control and hospital accreditation.

Staff Education To Pediatric Healthcare Providers On How To Prevent Unintentional Childhood Injuries., Peter Cleveland Collins

Walden Dissertations and Doctoral Studies

This staff education quality improvement Doctor of Nursing Practice (DNP) project was focused on teaching pediatric healthcare providers how to provide education during wellness visits to prevent unintentional childhood injury. The practice problem at the clinic was that pediatric providers lacked knowledge about injury prevention. A literature review showed that unintentional childhood injuries are the leading cause of death in this population. The practice-focused question determined was to determine if, after educating providers, they have improved knowledge and intent to educate their patients. I used the analysis, design, development, implementation and evaluation (ADDIE) model to guide this project. The participants …

Staff Education On Mindfulness-Based Therapy To Address Compassion Fatigue, Samson Ajibola Omowumi

Walden Dissertations and Doctoral Studies

The nature of nursing practice—persistent exposure to patient suffering—often results in compassion fatigue for staff. Compassion/emotional fatigue can affect nurses’ mental well-being, which can manifest in burnout, decreased empathy, and emotional numbness. These outcomes can eventually reduce job satisfaction for nurses and nursing assistants, increase errors during patient care, and lead to poorer patient outcomes. Prioritizing caregivers' mental health may improve the quality of nursing care. Mindfulness-based therapy (MBT) is an approach that may ensure the mental health and emotional stability of those who care for patients while also being a comparatively easy, accessible, and affordable tool. The goal of …

Education For Home Infusion Nurses, Ann Marie Wilson

Walden Dissertations and Doctoral Studies

This document presents an executive summary of a staff education initiative designed for home infusion nurses, submitted in fulfillment of requirements for the Doctor of Nursing Practice at Walden University. The project aims to address the specialized educational needs of nurses in the home infusion setting, where evolving clinical procedures and patient safety standards demand advanced competency and knowledge. Through the development and implementation of targeted educational strategies, the project seeks to enhance nurses' skills, promote best practices in infusion therapy, and improve health outcomes for patients receiving infusion care at home. Key objectives include identifying gaps in current education, …

From Novice To Expert: A Quality Improvement Project For Novice Faculty Role Confidence, Delainey Asher

Doctor of Nursing Practice Projects

A major contributor to the overall nursing shortage is the lack of adequately prepared faculty. This is especially prevalent among novice educators who struggle with transitioning from clinical expert to novice educator. Novice educators report challenges with role confidence and limited knowledge of mentorship, contributing to retention and faculty development concerns. The purpose of this quality improvement project was to evaluate the impact of a targeted six-week educational intervention on novice nurse educators’ role confidence and knowledge of mentorship. Guided by the Plan-Do-Study-Act (PDSA) change framework, the project employed a repetitive cycle for improvement: identify the problem, plan and implement …

Staff Education To Implement The Phq-9 For Depression Screening, Lydia Emuobosa Opara

Walden Dissertations and Doctoral Studies

Depression is common yet frequently underdiagnosed in group home settings serving adult and geriatric residents. This Doctor of Nursing Practice (DNP) project aimed to improve staff knowledge and promote routine use of the Patient Health Questionnaire-9 (PHQ-9), a validated depression screening tool, through an evidence-based educational intervention. A practice gap was identified at the project site due to inconsistent use and documentation of the PHQ-9, primarily linked to staff knowledge deficits. The project explored whether educating staff on PHQ-9 administration, scoring, and documentation would lead to improved knowledge, as measured by pre- and post-intervention assessments. Guided by the ADDIE instructional …

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …

Evaluating The Active Learning Experience Of Prelicensure Nursing Students By Role And Level In Simulation, Delisa Flynn

Dissertations

As the complexity of healthcare continues to grow, it is essential that nursing graduates enter the workforce with strong clinical judgment, confidence, and practice readiness. Simulation is an active learning strategy that creates a realistic, hands-on experiences for learners. Despite its widespread use, the impact of simulation roles within a simulated experience (participant versus observer) on student engagement remains unclear, particularly across different levels of nursing education. This study investigated differences in active learning engagement among sophomore and senior prelicensure nursing students (N = 161) based on their assigned role in a high-fidelity simulation scenario. Grounded in Kolb’s Experiential Learning …

Improving Glucose Monitoring Using Smart Phone-Based Monitoring Devices, Yetunde Ogunjumelo

Walden Dissertations and Doctoral Studies

The use of continuous glucose monitoring devices (CGMs) has become essential for improved glycemic control and the prevention of complications among patients. However, a significant number of nurses lack proper training in supporting patients with these devices, leading to a gap in practice. The project addressed the problem of insufficient staff knowledge and confidence in supporting patients with smartphone based CGMs through staff education on CGMs and evidence-based training on glucose monitoring techniques, interpretation of monitoring results, and patient education strategies. The question that guided the project was as follows: Does implementing a staff education program on smartphone-based CGMs improve …

Social Determinants Of Health In Lesbian, Gay, Bisexual, Transgender, Queer, And Other Sexual And Gender Minority (Lgbtq+) Older Adults: Impact Of Socioeconomic Disadvantage On Inpatient Hospitalizations, Jennifer T. May Phd, Rn, Anp-Bc, Devon Noonan, Susan G. Silva

Publications

Introduction

Little is known about the impact of socioeconomic disadvantage on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults (≥50 years). The aim of this study is to determine whether the distribution of LGBTQ+ inpatient hospitalizations are related to structural socioeconomic factors.

Methods

A secondary analysis of retrospective electronic health record data for LGBTQ+ older adults hospitalized from 2018 to 2022 was conducted at one large health system. The average county area deprivation index where the patient resided was calculated.

Results

The analysis included 2270 LGBTQ+ older adult inpatient hospitalizations, with 1508 (66.4%) from …

Development Of A Clinical Practice Guideline To Improve Appointment Adherence Among Adults With Depression In An Outpatient Setting Using The Agree Ii Framework, Udenma Okafor-Bryden

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was designed to develop a clinical practice guideline (CPG) to enhance appointment adherence among adults with depression in an outpatient mental health clinic, thereby improving outcomes. The practice-focused question was Will a CPG utilizing a multimodal reminder system improve appointment adherence? Missed appointments in outpatient mental health care contribute to delayed treatment, increased symptom severity, and higher rates of emergency care utilization. These disruptions not only compromise clinical outcomes but also financially burden healthcare systems and disrupt continuity of care. The CPG was developed using the Johns Hopkins evidence-based practice model and a …

Resilience, Elapsed Time Since Exposure To Workplace Violence, And Job Satisfaction Among Emergency Nurses In The United States, Ginny Glisson Ennis

Walden Dissertations and Doctoral Studies

The emergency nursing profession faces a critical challenge with a declining workforce and a high prevalence of workplace violence (WPV), which negatively impacts nurse job satisfaction. This quantitative study examined the relationships among nursing resilience, time elapsed since WPV exposure, and job satisfaction among emergency nurses (ENs) in the United States. Grounded in resilience and Herzberg’s two-factor theories, this study used a cross-sectional, correlational design. A national, anonymous online survey was distributed via social media, using a sharable QR code to recruit participants. The survey consisted of a total of 52 items, and collected demographic data, and time elapsed since …

Increasing Staff Knowledge In An Assisted Living Facility, Lindy Hilding

Walden Dissertations and Doctoral Studies

The practice problem I identified was a rising number of resident falls throughout the past 6-12 months at a 29-bed assisted living facility (ALF). The organization requested an education program on evidence-based practices on fall prevention in older adults. I used the project question to explore if an education program would increase the knowledge of the staff and caregivers at the ALF. Numerous sources of evidence supported the practice guidelines including fall risk assessment tools. During the facility monthly staff meeting, participants completed a six-question knowledge assessment on falls. The participants completed the same assessment after the education program, as …

Sense Of Belonging Of Bachelor Nursing Students: A Descriptive-Comparative Study, Evangeline Fangonil-Gagalang, Phoebe (Yeon) S. Kim, Justin Schneider, Renee Gregg

Nursing Faculty Publications

ackground: A sense of belonging, defined as acceptance, inclusion, and identity within a group, significantlyinfluences nursing students’ academic and social integration into college. Limited belonging causes studentattrition.Aim: This research explored factors influencing nursing students’ sense of belonging and identified elementspromoting or hindering this feeling.Methods: This is a cross-sectional, descriptive comparative study that was conducted with undergraduatenursing students (N = 201) from multiple campuses at a southwestern U.S. university. Data were collectedvia an anonymous survey using the Department Sense of Belonging and Involvement (DeSBI) tool. Descrip-tive and comparative statistics were analyzed.Results: Campus location significantly influenced students’ sense of belonging. Satellite campus …

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Differences In Peer Social Connections Between Traditional And Online Nurse Residency Programs, Tatum Leonard

Electronic Theses and Dissertations

The anticipated retirement of baby boomer nurses by 2030 will intensify the global nursing shortage, a crisis that demands innovative strategies for onboarding and retaining new graduate nurses. Nurse residency programs (NRPs) are designed to ease the transition from student to practicing nurse, reduce turnover, and foster professional resilience. Amid the COVID-19 pandemic, many NRPs rapidly transitioned from traditional, in-person seminars to synchronous, online formats. This study explored differences in peer social connections between traditional and online NRPs, focusing on three constructs: sense of community, collaborative learning, and peer social support. Using a quasi-experimental, mixed methods approach, this secondary data …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …