Nursing Commons^™

Vocal Toning Increasing The Parent-Child Bond In Neonatal Care: A Proposed Method, Mikki Mcintire

Expressive Therapies Theses

Vocal toning in the Neonatal Intensive Care Unit (NICU) is an innovative therapeutic method that greatly improves emotional connections between caregivers and fragile infants. This practice is more than just a new idea; it fosters the crucial relationships essential for developing newborns. Vocal toning also aids in stabilizing physiological responses and promoting emotional regulation in infants, who are often subjected to high-stress situations. Using structured vocalization techniques, caregivers can provide consistent auditory and vibrational cues that encourage relaxation and promote co-regulation with the infants in their care. This proposed approach examines the theoretical foundation, solid methodology, practical application, and anticipated …

The Impact Of Maternal Mental Health On Child Development, Jessica White

Nursing | Student Research Posters

No abstract provided.

Improving Therapeutic Communication Between Patients And Nurses Using The Commit To Sit Method In The Obgyn/Postpartum/Mother-Baby Unit, Simisola A. Shodunke

Doctor of Nursing Practice Final Project Abstract

Purpose

To improve patients’ perceptions of nurses by listening to their needs, helping nurses to engage with their patients therapeutically in the OBGYN/Postpartum/Mother-Baby unit. Aiming to increase patient satisfaction scores from 62.5% to 70% by December 2024 using the "Commit to Sit" method.

Background

The project was implemented in an OBGYN/Postpartum/Mother-Baby Unit, addressing the concerns of the patient’s perception of nurses not listening and addressing their needs which has contributed to a decline in patient satisfaction scores.

Methodology

The Plan-Do-Study-Act (PDSA) model was used. Nurses were trained to sit at eye level with patients for 3–5 minutes per shift. Data …

Staff Education To Early Detection And Response To Patient Decline, Kein Gareth Rufino Pantaleon

Walden Dissertations and Doctoral Studies

This doctoral project implemented a staff education program to enhance early recognition and escalation of patient deterioration. Conducted at a 343-bed acute care hospital, the initiative addressed the ongoing problem of delayed detection and response to clinical decline, which often results in rapid response team activations and code blue events. Delays in intervention increase patient morbidity and mortality, despite many of these events being preventable through timely action. The project evaluated whether an interactive targeted education program could improve nursing staff’s knowledge, confidence, and willingness to activate escalation protocols, including Condition H and Code Help. Pre- and post-education surveys were …

Staff Education To Reduce Medication Error In Psychiatric Intensive Care Unit, Christiana Omodugba-Udeh

Walden Dissertations and Doctoral Studies

Summary This staff education project was an initiative designed to address the practice problem of medication errors in the psychiatric intensive care unit (PICU). The project’s purpose was to improve the nursing staff’s knowledge regarding medication administration and documentation through a structured educational intervention. The practice-focused question was: Will staff education on medication administration and documentation in the electronic medical record (EMR) result in an increase in staff knowledge with an aim to promote a reduction in medication errors in the PICU? The education was delivered through in-person sessions during regularly scheduled staff meetings to ensure full participation without disrupting …

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

A Multicomponent Quality Improvement Initiative For The Early Identification, Prevention, And Management Of Delirium In The Medical-Surgical Setting, Sarah K. West

Doctor of Nursing Practice Scholarly Projects

Hospital-acquired delirium affects older adult patients, across the healthcare continuum. The incidence in frail older adults is high, costly, and often deemed preventable. Hospital-acquired delirium is associated with a multitude of short- and long-term complications, resulting in an increased rate of morbidity and mortality. The challenges of early recognition and management are prevalent in healthcare literature. While published guidelines exist, hospital systems continue to struggle with the standardization of geriatric delirium care. Given medical-surgical nursing is the cornerstone of hospital care, it is imperative to establish a standardized delirium prevention and management guideline, at this level of care, to optimize …

Enhancing Advanced Practice Nursing: Implementing A Simulation-Based Point-Of-Care Ultrasound Training Program, Brandy Younge, John Chovan, Bonnie Fagan, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Nurse practitioners (NPs) are advanced practice nurses entrusted with diagnosing and treating illnesses, managing acute and chronic diseases, and engaging in continuous education to remain knowledgeable of evidence-based advancements. NPs offer a comprehensive range of healthcare services, catering to patients from wellness check-ups to those requiring complex care, such as individuals hospitalized with sepsis. One technological advancement that can support NPs in delivering optimal patient care is point-of-care ultrasound (POCUS). In the United States, over 385,000 NPs practice in patient care settings that may use POCUS. Numerous medical societies have issued position statements supporting the use of POCUS in the …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Diabetes Self-Management Education For Older Adults In Primary Care, Makilah Rae Furlan

Doctor of Nursing Practice Scholarly Projects

Type 2 Diabetes (T2DM) is a chronic disease that impacts 27.2 million seniors 65 and older. Evidence-based care for T2DM includes a combination of medication and disease-management behaviors. Access to education to teach patients healthy behaviors to manage their disease is limited and even less accessible to geriatric patients with aging learning needs. The scholarly project addresses this gap in patient education by implementing evidence-based diabetes self-management education for geriatric patients to increase patient knowledge and confidence in implementing self-management behaviors. The scholarly project aims to assess health behaviors in patients aged 65 and older with established type 2 diabetes …

Evidence-Based Practice Guidelines For Perioperative Use Of Dexmedetomidine In Pediatric Congenital Cardiac Surgery, Kayla Thomsen

Doctor of Nursing Practice Scholarly Projects

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of …

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

A Proposal: Gap Analysis On Novice Advanced Practice Provider Role Transition Within The Inpatient Setting, Erin Cornelius

Doctor of Nursing Practice Scholarly Projects

Background: Healthcare specialties are an integral part of patient care yet are briefly discussed throughout the academic journey of the advanced practice provider (APP). Hiring departments or facilities must provide further education on complex specialties. Due to a decline in practicing physicians, APPs will provide more patient care within specialties by 2032.

Purpose: To emphasize the importance of a high-quality onboarding program for the success of the APP, the department, and the hiring facility.

Method: Proposed data collection involves a two-part survey using the Novice Nurse Practitioner Role Transition (NNPRT) scale and an onboarding experiences survey.

Results: A literature thematic …

Development Of An Evidence Based Orientation Model For The Newly Graduated Nurse, Sandra L. Takach

Doctor of Nursing Practice Scholarly Projects

Healthcare in the acute hospital setting experienced a significant increase in highly acute patients with multiple comorbidities requiring competent, experienced clinicians who can provide high quality, safe care. The nursing shortage paired with the post pandemic hospital environment has altered the landscape of nurses entering the workforce and created a gap in competency of the bedside nurse. A loss of tenured nurses who typically onboard and mentor the novice nurse coupled with less than adequate clinical preparation of those graduating college led to elevated levels of stress and staggering turnover rates for the newly graduated nurse. Research validates efficient orientation …

Quality Improvement Initiative: Implementing Wellness Visit (Wv) Education To Improve Staff Self-Efficacy, Preston T. Holifield

Doctor of Nursing Practice Projects

Preventive care delivery is a cornerstone of value-based primary care, yet non-provider staff often lack the confidence and training to engage patients in Medicare Annual Wellness Visits (AWVs). Non-provider staff included Registered Nurses (RN’s), Licensed Practical Nurses (LPN/LVN’s), Secretaries, Medical Aids (MA’s), and Practice Managers (PM’s). This quality improvement project aimed to evaluate whether a brief educational intervention could improve self-efficacy among non-provider staff related to AWV discussions and workflow. Conducted in two primary care clinics in Southeast Missouri, this one-group pretest-posttest study involved six participants and utilized the General Self-Efficacy Scale (GSES) and Learning Self-Efficacy Scale (LSES) to measure …

Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison

Doctor of Nursing Practice Scholarly Projects

Thoracic surgery is considered one of the most painful surgical procedures due to its severity and the duration of the procedure. Pain is detrimental to the patient experience, and poor patient satisfaction results in revenue loss for hospitals. Maintaining adequate pain control after surgery is crucial in preventing pulmonary complications such as atelectasis and respiratory failure that prolong patient recovery. It is the responsibility of the anesthesia provider to ensure adequate pain control throughout the perioperative experience. Although current evidence-based data shows that regional anesthesia provides superior thoracic postoperative pain control, the current practice continues to be the utilization of …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Pulmonary Embolism Response Team In Acute Care Settings: A Scoping Review Of The Evidence, Tia Glover Bsn, Rn, Leslie Asplund Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Pulmonary embolism (PE) is a critical cardiovascular emergency associated with high morbidity and mortality. Despite its prevalence, traditional PE management often lacks cohesion, leading to suboptimal outcomes. Pulmonary Embolism Response Teams (PERTs) offer a multidisciplinary approach aimed at improving patient outcomes by streamlining diagnosis, facilitating timely interventions, and promoting evidence-based treatment. This scoping review evaluates the evidence supporting PERT efficacy across various clinical and resource-related outcomes with the aim to decrease mortality rates, shorten inpatient length of stay, improve cost efficacy, and minimize adverse events from treatment modalities.

Methods

A comprehensive literature search was conducted using PRISMA guidelines across …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Improving Communication And Job Satisfaction: Utilizing Team Strategies And Tools To Enhance Performance And Patient Safety (Teamstepps) For Interventional Service Areas, Sukhbinder Kaur Sangha

Doctoral Projects

Purpose: Improved communication and job satisfaction among staff are essential for those working in high-stress critical care environments like the cardiac catheterization laboratory (Cath Lab). The purpose of this investigation was to utilize the quality improvement initiative Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve attitudes and job satisfaction in the Cath Lab. Method: A total of 30 subjects participated in a TeamSTEPPS educational intervention. After obtaining informed consent, a demographic survey, a pre- and post-test TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Job Satisfaction Survey (JSS) were administered. The post-test included open-ended questions for feedback …

Smoking Cessation Education In Caregivers Of Pediatric Patients Hospitalized With Asthma Exacerbation, Maya Emptage, Kaitlynn Lineberry, Suzanne Kayali, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Michelle Rickard Dnp, Pnpac-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Pediatric asthma is rising globally, currently affecting over 300 million individuals and projected to reach 400 million by 2025. This scoping review aims to summarize existing evidence on the impact of providing smoking education to caregivers during hospitalization on reducing pediatric asthma exacerbations, with the goal of encouraging further research.

Methods

The search spanned from August 2022 to November 2024, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria focused on studies involving human participants and caregivers of children receiving smoking cessation education in relation to asthma exacerbation and hospital admission. Databases searched included …

Addressing Gaps In The Continuum Of Care: A Quality Improvement Project Focused On Adolescent Youth With Depression Symptoms At A School-Based Health Clinic, Leah Nigon

Theses and Graduate Projects

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted …

Implementing Lean Methodology To Decrease Wait Times In A Psychiatric Emergency Department, Kristina S. Baxter

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to implement Lean strategies to optimize the intake process in a psychiatric emergency department, thereby reducing patient wait times, minimizing left-without-being-seen (LWBS) occurrences, and improving access to timely psychiatric care.

Background

The project was conducted in a hospital-based psychiatric emergency department in Southeast Texas, serving adults and children six years and older.

Methodology

Lean methodology and PDSA cycles were employed to refine the intake process and eliminate inefficiencies. Key interventions included patient transport by technicians to minimize delays, using tele-clinicians for assessments to reduce staff burden, and restructuring nursing assessments to prioritize telehealth consultations …

Evaluation Of The Library Session In A Health System Rn Research Fellowship Program, Frances Chu, Basia Delawska-Elliott, Carrie Grinstead, Dana Kopp, Heather Martin

Articles, Abstracts, and Reports

No abstract provided.