Nursing Commons^™

Bridging The Gap: Enhancing Medical Interpreter Utilization For Patients With Limited English Proficiency In Healthcare Settings, Rocio J. Tapia-Nuss

Doctor of Nursing Practice (DNP) Projects

The Impact of Utilizing Medical Interpreters and Associated Patient Outcomes

Abstract

Background: In the United States, approximately 21% of households speak a language other than English, emphasizing the need for accessible language services for patients with limited English proficiency (LEP).

Problem: Despite legal mandates, medical interpreters remain underutilized, leading to adverse health outcomes, such as misunderstanding discharge instructions, medication use, and disease processes.

Methods: This DNP student-led evidence-based project explored barriers to medical interpreter utilization among healthcare professionals.

Intervention: A continuing education module was implemented by a DNP student at the University of San Francisco’s School of Nursing and Health …

Saving Lives: Naloxone Education And Training For Mental Health Re-Entry Program Providers, Remigus C. Nwaokoro

Doctor of Nursing Practice (DNP) Projects

Background Opioid overdose fatalities are a major public health concern with significant cost implications. Naloxone effectively reverses opioid overdose symptoms and prevents fatalities, yet many healthcare professionals lack the confidence and knowledge to administer it. This knowledge gap delays efforts to combat opioid overdose. Local Problem Opioid-related fatalities are among the leading causes of preventable deaths. In a northern California county, opioid overdose deaths increased by 20% from 2018 to 2021, with 48 fatalities in 2021. A needs assessment revealed that healthcare providers at a reentry program in that county had limited knowledge and confidence in using naloxone. Methods A …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

Doctor of Nursing Practice (DNP) Projects

Background: Suicide among adolescents and youth is a serious public health issue that requires immediate intervention to reduce ideation and death. The increasing rate of suicide among children and adolescents has a profound effect on families, friends, and the community.

Problem: Suicide among school aged children and adolescents can create significant challenges for school nurses, who are often the first contact for students who recognize suicidal ideation and mental health crises. This issue is particularly significant for the Alameda school nurses in California, as they play a significant role in identifying and supporting students in a crisis.

Methods: A …

Trauma-Informed Care: A Therapeutic Communication, Nicole Anne Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Educating Community Health Workers: To Improve Maternal And Infant Health In Rural Areas, Katerina Markova Shikhvarg

Doctor of Nursing Practice (DNP) Projects

Background

Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.

Local Problem

Despite the benefits of CHW involvement, they lack standardized training that could improve their services.

Methods

A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Amir Rashid

Doctor of Nursing Practice (DNP) Projects

Background Schizophrenia cases and their associated healthcare costs have drastically increased over time in the United States. Antipsychotic nonadherence is a primary contributor to the high rates of relapse and rehospitalization among adult patients with schizophrenia. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underutilized in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses hold a unique position to potentially change practice and address some of the barriers to LAI usage. Local Problem A Mental Health Rehabilitation Center in California …

Leading The School Team: A Professional Development Training On Eating Disorders For School Nurses, Michelle Samaniego Concepcion

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The COVID-19 pandemic sharply increased the prevalence of eating disorders (EDs) among youth. These conditions are associated with high treatment costs and have the second-highest mortality rate among mental illnesses, surpassed only by opioid overdose, making them a critical concern for school communities.

Local Problem: A learning needs assessment conducted by the Alameda County School Nurses Network identified gaps in school nurses’ knowledge and confidence regarding ED identification, referral, and care coordination. Methods: In response, a Doctor of Nursing Practice (DNP) student scholar developed and implemented an evidence-based, virtual professional development training focused on EDs. The module was …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Staff Education Program Utilizing A Workflow Template To Streamline Care In Occupational Health, Alicia Vogleson

Walden Dissertations and Doctoral Studies

This DNP Project is one designed to educate Occupational Health Staff. As there are varying levels of skills and education of staff working with patients, it is important to identify staff that who can play a large role in helping gather important information to help in treatment decisions early on in the process of patient care. The practice-focused question and the purpose of the project was to answer the following question: will a staff education program for Medical Assistants and Front Desk Staff in an Occupational Health clinic on the utilization of a template to streamline workflow improve their knowledge? …

Exploring The Public Health Agency Of Canada’S And The Ontario Government’S Vaccine-Related Crisis Communication On X During The Covid-19 Pandemic, Sheraza Burney, Lori Donelle Phd, Rn, Fcan, Anita Kothari

Publications

Crisis communication strategies must be tailored to the unique nature of social media. In response to the COVID-19 pandemic, public health agencies have widely used social media to address vaccine hesitancy and misinformation. This research utilized the social media pandemic communication model to describe the key themes disseminated through the Ontario government and the Public Health Agency of Canada's vaccine-related crisis communication on X (formerly Twitter). Between 27 January 2020 and 6 April 2021, 1271 posts related to COVID-19 vaccination were collected from three official government X accounts—two from the province of Ontario and one from Canada. Posts were analyzed …

Secondary Educators’ Knowledge And Perceptions Of Their Own Self-Efficacy As It Relates To 504 Plan Accommodations For Students Diagnosed With Adhd, Anne Richardson

Seton Hall University Dissertations and Theses (ETDs)

This study investigated the role of Section 504 accommodations in meeting the needs of secondary students with attention-deficit/hyperactivity disorder (ADHD) in the United States. While legislation requires equitable education for students with disabilities, gaps remain in understanding how educators perceive their own abilities in implementing Section 504 plans for students with ADHD. The study used a qualitative research design to explore the academic and organizational challenges faced by secondary school students with ADHD, specifically examining the knowledge, perceptions, and self-efficacy of secondary educators regarding ADHD strategies and 504 plan accommodations. Semi-structured interviews were conducted via Zoom with 11 educators from …

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

Master's Projects and Capstones

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

Effect Of Clean Closing Tray Use On Surgical Site Infection Following Colorectal Surgeries, Elizabeth Carlson, Nora Laban, Shelli Bergeron, Diana Lee, Donna Kayal, Kristin Lemarbe, Scarlett Hao, Jacob Mesiti, Bradley Krasnick, Harry Wasvary

Conference Presentation Abstracts

Introduction:  Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and postoperative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs are shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.  Methods:  A retrospective cohort study was conducted at a single tertiary care center of all intraabdominal colorectal surgeries performed between 2016 and 2021. Patients with documented infection present at the …

The Wright Way: Advancing Pediatric Perianesthetia Nursing Competencies, Marisela E. Acevedo-Padilla

Master's Projects and Capstones

Objective Implementing the Donna Wright Competency Model at a Bay Area Children’s Hospital in its peri-anesthesia units. Throughout available literature it was possible to observe the positive effects of implementing a competency model such as the DWCM has on the confidence of nursing staff and patient outcomes. An important point shown by literature was addressing more than technical skills and incorporating critical thinking and ethical considerations regarding patient care. Aim We aim to improve nurse competency in pediatric peri-anesthesia units at a Bay Area Children's Hospital by implementing Donna Wright’s Competency Model. Data obtained in August 2024 from a series …

Bridging The Gap In Early Mobilization: Implementing The Bmat 2.0 To Enhance Patient Care And Outcomes, Elyas Gul

Master's Projects and Capstones

Objective: Early mobilization of patients is correlated to enhanced functional recovery (Zhang et al., 2019), decreased hospital stays (Zhang et al., 2019), and a reduction in healthcare costs (Liu et al., 2019). Unfortunately, inconsistency in hospital staff training and an absence of mobility assessment standardization have served as barriers to successful implementation. Aim: This quality improvement project aims to increase the percentage of RNs and CNAs who effectively use the BMAT 2.0 to promote early mobilization of medical-surgical endocrine and stroke patients by 20%, from 31.4% to 51.4% by April 22, 2025. The project will occur during a 12-week …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Implementing A Mindfulness Program To Reduce Burnout Rates, Nadine G. Kakanou

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Nadine Kakanou 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. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Mary Bemker Houghtaling, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Summary Burnout rates among mental healthcare workers remain a concern affected by the increasing demands of the profession and the COVID-19 pandemic. The identified practice gap among mental healthcare staff members at the northern …

Staff Education Program On The Vanderbilt Adhd Diagnostic Rating Scale, Rabiatu Bangura

Walden Dissertations and Doctoral Studies

This DNP project evaluated the effectiveness of a structured staff education program designed to enhance healthcare professionals’ knowledge and utilization of the Vanderbilt ADHD Assessment Scale (VAS) in children aged ≥2 to ≤18 years. The practice problem addressed in this project was the inconsistent use and limited knowledge of the VAS among healthcare staff, which can lead to underdiagnosis or delayed diagnosis. The practice-focused question was: Will a staff education program specifically designed to instruct healthcare professionals on using the Vanderbilt ADHD Assessment Scale in children ≥2 years to ≤18 years increase their knowledge? Targeted educational sessions were implemented, and …

Enhancing Patient Outcomes: Improving Hcahps Scores Via Implementing Pressure Injury Prevention Care Bundle Education In Acute Care Setting, Jasmeen Kaur

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) have a powerful effect on patient outcomes, satisfaction, and health costs. In the face of multiple interventions, nurse-patient communication failures and decreased HCAHPS scores reveal patient safety hazards. Aim: The purpose of this quality improvement effort was to enhance HCAHPS nurse communication scores by instituting a Pressure Injury Prevention Care Bundle (PIPCB) on a 93-bed medical-surgical/telemetry unit. Methods: The intervention was nurse-implemented education through educational posters and education cards distributed at admission and shift report. Nurse participation and education delivery were measured through pre- and post-intervention questionnaires and observations. The change in the HCAHPS nurse …

Strengthening The Birthing Bridge: Educating Labor And Delivery Nurses On Scope And Impact Of Volunteer Doulas, Catherine H. De La Torre

Master's Projects and Capstones

The objective of this quality improvement project was to address the lack of collaboration between the Labor and Delivery (L&D) nurses and the volunteer doulas on a L&D unit at a Bay Area hospital. There were reports of not understanding the role of the volunteer doula, which may have led to a lack of collaboration between both teams. The aim of this project was to improve the L&D nursing staff's understanding of the scope of practice of the volunteer doula to increase positive perception and collaboration between both professions by 25%, from 63% to 88%, following an educational intervention at …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

Enhancing Bedside Mobility Assessment Tool (Bmat 2.0) Competency To Promote Early Mobilization, Ensure Patient Safety, And Maximize Health Outcomes, Shaun C. Cunanan

Master's Projects and Capstones

Objective: Immobility among hospitalized patients is linked to serious complications, including muscle deconditioning, increased risk of falls, and functional decline, particularly in older adults (Boynton et al., 2020). Early mobility interventions can help mitigate these risks and improve patient outcomes (Gabele et al., 2023). Context: The Bedside Mobility Assessment Tool (BMAT 2.0) is a standardized tool designed to assess patient mobility and guide safe mobilization practices. In two medical-surgical units (endocrine and stroke) of a 200+ bed general acute care hospital in Northern California, only 31.4% of staff reported being knowledgeable about BMAT 2.0. This quality improvement project aimed to …

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

Master's Projects and Capstones

The objective of this Quality Improvement (QI) project was to increase patient ambulation rate and improve documentation compliance with Patient-reported Level of Function (PLOF) and Clinician-assessed Level of Function (CLOF) on cardiac units at a hospital in San Francisco. Literature highlights that early ambulation reduces hospital-acquired complications, length of stay, and functional decline, yet inconsistent mobility practices and documentation were identified as barriers within this microsystem. The aim of this project was to increase patient ambulation rates by 20% and achieve at least 80% of documentation compliance within four weeks. The interventions included the development and distribution of an educational …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Ehealth For Older Adults: Building Digital Confidence For Better Health, Alejandra M. Fernandez

Master's Projects and Capstones

Abstract

Problem The healthcare field is becoming more technologically advanced than ever before, the older adults are often left behind due to decreased technology literacy. The quality improvement project revolves around enhancing the digital health literacy of older adults at Facility A a low income independent living facility in the greater San Francisco Bay Area. The technology workshops are imperative to improve the digital divide that older adults are experiencing. Aim The goal of the workshops is to improve the confidence of older adults through weekly workshops that were conducted over a six week period where they were instructed on …

Accelerating Initial Cardiac Arrest Response In Medical-Surgical Nurses Through Virtual Reality Training, Carissa A. Hernandez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Through their limited exposure, non-critical care nurses may feel unprepared to respond when faced with a sudden emergency such as cardiac arrest. This Quality Improvement (QI) project employed virtual reality (VR) technology to improve nurse confidence, adherence to the American Heart Association (AHA) basic life support (BLS) algorithm, and documentation accuracy among medical-surgical nurses in a Veterans Affairs hospital in Nevada. The project addressed their ability to react promptly and effectively during these high-stakes emergencies. Methods: Following a scoping literature review from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed databases, this Evidence Based …