Nursing Commons^™

Impact Of Proviq Process Confirmations And Daily Management Systems On Catheter Associated Urinary Tract Infection Rates, Missy Thingelstad, Caitie Van Eerden, Travis Scott, Tiara L. Benson, Allison Engle, Shih-Ting Chiu, Ma Fe Chase, Melissa Scheck, Cecilia Malama, Brooke Higgins

Articles, Abstracts, and Reports

Problem Statement: Our 539-bed tertiary care center observed an increase in the Catheter Associated Urinary Tract Infection (CAUTI) Standardized Infection Ratio (SIR) from 0.88 to 1.28 when comparing October to December of 2023 to 2024. CAUTIs are associated with increased patient discomfort, mortality, morbidity, length of stay, and cost. Methods: Using ProvIQ methodology, process confirmation cards were introduced in eight pilot units, including critical care, medical-surgical, and maternal-child specialties, from October to December 2024. ProvIQ is an evidence-based quality improvement methodology including a basket of measures from Lean, Six Sigma, and change management. This program was developed by Quality Management …

Expediting Toxicological Evidence Collection In Patients Presenting To The Emergency Department With Report Of Drug Facilitated Sexual Assault (Dfsa): A Quality Improvement Project, Adelene Egan

DNP Projects

Title: Expediting Toxicological Evidence Collection in Drug-Facilitated Sexual Assault: A Quality Improvement Project

Background/Significance: Drug-facilitated sexual assault (DFSA) involves substance use to incapacitate victims, with rapid drug metabolism necessitating prompt evidence collection. Delays in blood collection reduce toxicology detection rates, compromising legal outcomes. In one New York ED, DFSA kits (Part B) were routinely collected after biological evidence (Part A), creating a critical gap.

Purpose: To improve compliance with evidence-based prioritization of blood collection (Part B before Part A) for DFSA cases through a structured QI initiative.

Methods: The project synthesized evidence from a systematic review of …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

Mental Health Screening And Its Effects On Obese And Overweight Patients: Quality Improvement Project, Amanda Ivos

DNP Projects

Obesity is a growing, multifactorial epidemic. The CDC recommends a 5% weight reduction in order to prevent potential complications associated with overweight or obese status. Mental health, particularly depression, contributes to weight issues with obese individuals having an 18% greater risk of depression, and those with depression having a 37% greater risk of obesity. Both conditions may increase the risk of cardiovascular disease and mortality. Evidence suggests screening and managing depression in overweight/obese patient may lead weight loss and better health outcomes in this patient population.

Project Goals

1. To improve weight loss outcomes in obese or overweight patients with a …

Effects Of The Vitality Acupunch Exercise Program On Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study, Brittany Murley, Kuei-Min Chen, Christine S. Gipson, Kevin Gosselin, Jenna Thornhill, Allison Ross, Kennedy Gladding, Beth Mastel-Smith

Nursing Faculty Publications and Presentations

Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants …

A Hot Topic: Standardization Of Fire Safety Training In Perioperative Areas, Megan Benner Msn-Ed, Rn, Cpan, Npd-Bc

MaineHealth Maine Medical Center

Introduction: Fires in perioperative areas, while rare, are considered high-risk events. Up to 650 fires occur in the operating room annually in the United States with head and neck procedures having the highest rate of injury and mortality.

Outpatient Physical Therapy Attendance By Older Adults After Emergency Department Discharge Was A Predictor For Lower 30-Day Revisits—But Demographic Factors Affected Attendance, Suzanne Ryer, Michelle Simpson, Maharaj Singh

College of Nursing Faculty Research and Publications

Objective

Given the high risk of functional loss and revisits among older adults presenting to the emergency department (ED), there is a need to understand how post-ED discharge outpatient physical therapy affects outcomes. This study sought to examine patient demographics and their association with outpatient physical therapy utilization after ED discharge and physical therapy attendance with 30-day ED revisits among older adults discharged to home.

Methods

In this retrospective cohort study, we analyzed data from 1395 older adults (65 years old and older) who had a referral to outpatient physical therapy upon discharge from 15 EDs between January 2021 and …

Integrated Mental Health Care In Specialty Clinics For Children With A Diagnosis Of Asthma Or Diabetes: A Mixed Methods Study, Joan P. Totka, Maria Peña, Joshua A. Steinberg, Peter M. Wolfgram

College of Nursing Faculty Research and Publications

Introduction

Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method

Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n= 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results

Targeted PROM met feasibility goals (80%) …

To Address The Nursing Faculty Shortage, Start With The Salary Gap, Jacqueline Christianson, Christine A. Schindler, Lisa M. Grabert

College of Nursing Faculty Research and Publications

Nurses must advocate with policymakers for meaningful change.

There is a national shortage of nursing faculty to educate the future nurse workforce. The biggest barrier to recruiting and retaining nursing faculty is the salary gap between the faculty and clinical nursing roles. Many full-time nursing faculty earn a lower salary than the new graduate nurses they educate. According to our recent research (American Nurse, July 2024), NPs who have a comparable education level to nursing faculty take an average $43,000 pay cut if they leave clinical practice to teach full-time. Even the salaries of PhD-prepared faculty often lag …

Experiences Among Parents Caring For Children With Juvenile Idiopathic Arthritis At A Tertiary Referral Hospital In Kenya, Hassan Silim, Susan Wamithi, Roselyter Riang’A, Angela Migowa

Paediatrics and Child Health, East Africa

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Despite the availability of effective treatment strategies such as disease-modifying antirheumatic drugs (DMARDs), JIA is reported to have a negative impact on the quality of life of the patients and their caregivers. Ascertaining the perceptions of the parents will help facilitate more effective management strategies and improve outcomes for these patients. This study aimed to ascertain parental experiences and perceptions of caring for children with juvenile idiopathic arthritis (JIA).

Methods: This was a single-center facility-based qualitative study. An in-depth interview guide was used to collect …

Decolonizing Global Health Research: Experiences From The Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Study, Ahmed Adam, Lisa Lazarus, Bernadette Kina, Robert Lorway, Bilali Mazoya, Michaela Mantel, Marleen Temmerman, Lisa Avery, Evaline Chepchirchir Langat

Centre of Excellence in Women and Child Health

Decolonizing global health research involves rethinking power structures and research collaboration to prioritize the voices and experiences of communities that have been historically marginalized. Cross-sectoral and cross-regional partnerships based on reciprocity, trust, and transparency can be facilitated by decolonized research frameworks. To address global health issues in a way that is inclusive, context-specific, and genuinely advantageous to all parties involved, especially communities most impacted by health disparities, the ethics behind this change is imperative. We applied a decolonizing health research approach to the Women in Health and their Economic, Equity, and Livelihood Statuses During Emergency Preparedness and Response (WHEELER) study …

Management If Aggressive And Disruptive Behavior In The Emergency Department Using De-Escalation Techniques And Simulation: A Quality Improvement Project To Improve The Knowledge And Confidence Of Emergency Department Nurses And Clinical Staff, Ernestine Darby-Littlejohn

Electronic Theses and Dissertations

Abstract

Approximately 40% of all healthcare workers have reported episodes of violence by patients over the last 2 years. This Veteran’s Health Agency reported 824 disruptive events reported in the last 5 years, of which 56 occurred in the emergency department. Research shows that interventions are not always timely, resulting in the clinical staff requesting the Veteran’s Health Agency Police to intervene when a veteran’s level of stress is escalating. The gap in practice is shown to be related to a lack of knowledge in the clinical staff in managing high stress levels exhibited by some veterans, limited knowledge of …

The Predictors Of Success For Pre-Licensure Bsn Students: An Exploratory Analysis Of Assessment Methods, Nihimu Nkechinyere Evulukwu

Doctor of Nursing Practice Projects

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing …

Acknowledging: A Classic Grounded Theory Explaining How Nurses' Employ Clinical Judgement When Complying With Early Warning System Protocols, Justine Connor, Tracy Flenady, Trudy Dwyer, Deb Massey

Research outputs 2022 to 2026

Background: Recognition and response to clinical deterioration of hospitalised patients is a worldwide health priority area. In response to this concern, international bodies have implemented early warning systems to help clinicians keep people safe and prevent patient deterioration. Registered nurses hold a significant role in managing care provision and utilise early warning system tools to support their clinical judgement when making decisions about patient care. Objective: To generate a theory explaining how registered nurses employ their clinical judgement when complying with an early warning system protocol. Design: Classic grounded theory. Participants: Participants included twenty registered nurses working with early warning …

Midwives Experience Of Working With Maternity Assistants: A Qualitative Study, Carol Crevacore, Annie De Leo, Peta Fisher, Sara Bayes

Research outputs 2022 to 2026

Introduction: The midwifery workforce is essential for delivering safe, high-quality maternity care, however, global staffing shortages pose significant challenges. To address these issues, incorporating midwifery assistants, including undergraduate midwifery students into the model of care has been proposed as a strategy to support midwives and maintain effective service delivery. Aim: This study explores the Registered Midwives' experiences working with Midwifery Assistants (MAs) in an Australian tertiary maternity service. Methods: This study employed a qualitative exploratory design and was conducted using semi-structured interviews with 9 midwives who had experienced working with MAs in the tertiary maternity care setting. Results: The discussion …

A Qualitative Analysis Of Australian Midwifery Students’ Perspectives Of Midwifery Practice Experience: Characteristics That Enhance Or Diminish Clinical Education Placements, L. Kearney, Dianne Bloxsome, S. Hunter, A. Brown, Simon Cooper, F. Bogossian

Research outputs 2022 to 2026

Background: Midwifery education in Australia faces challenges in combining theoretical and practical experiences, with reports of inconsistent support and supervision during Midwifery Practice Experience (MPE), alongside significant financial and personal costs to students. National evaluation and improvement initiatives are essential to ensure that midwifery students receive effective and high-quality clinical learning opportunities. Aim: This study aimed to answer two research questions: 1) How do midwifery students describe their Midwifery Practice Experiences? 2) What are the characteristics of Midwifery Practice Experiences that enhance or diminish midwifery student learning? Methods: National midwifery student survey data, collected through the National Placement Evaluation Centre. …

The Evolving Role Of Nursing Informatics In The Era Of Artificial Intelligence, Abdulqadir J. Nashwan, J. C.A. Cabrega, Mutaz I. Othman, Mahmoud Abdelwahab Khedr, Yasmine M. Osman, Ayman Mohamed El-Ashry, Rami Naif, Ahmad A. Mousa

Research outputs 2022 to 2026

Aim: This narrative review explores the integration of artificial intelligence (AI) into nursing informatics and examines its impact on nursing practice, healthcare delivery, education, and policy. Background: Nursing informatics, which merges nursing science with information management and communication technologies, is crucial in modern healthcare. The emergence of AI presents opportunities to improve diagnostics, treatment, and healthcare resource management. However, integrating AI into nursing practice also brings challenges, including ethical concerns and the need for specialized training. Sources of evidence: A comprehensive literature search was conducted from January 2013 to December 2023 using databases like PubMed, Google Scholar, and Scopus. Articles …

Professional Identity In Nursing: A Narrative Review Of The Ispin Definition And Domains Usage, Sarah M. Geoghan Marold, Susan M. Strouse, Dan Butcher

Open Access Publishing Support Funded Articles

Introduction

Established in 2020, the International Society for Professional Identity in Nursing (ISPIN) developed a definition of professional identity in nursing (PIN). This definition encompasses four domains: values and ethics, knowledge, nurse as leader, and professional comportment.

Objective

This narrative review aimed to summarize and synthesize identified published evidence, the extent of discussion of PIN domains, and literature gaps for the ISPIN definition of PIN.

Methods

Sources included peer-reviewed literature published between 2018 to 2025 from CINAHL and PubMed. Gray literature through Google Scholar and ISPIN archived publications were also searched. These were identified by two researchers and a PRISMA …

Nursing Leaders’ Perceptions Of A Revised Patient Dismissal Policy, Judi L. Brendle

Walden Dissertations and Doctoral Studies

Patient aggression related to behavioral health and emotional issues is an ongoing concern in primary health care. Disruptive patient behaviors include a broad spectrum of outward conduct, from verbal violence to physical assault. The focus of the Doctor of Nursing Practice project was a quality improvement project. The purpose encompassed improving the perception of primary care nursing leaders and provider practice leadership by enhancing the current organizational policy on patient dismissal from practices. Analytical strategies included pre- and post-surveys to determine the perception of the nursing supervisors and provider practice leadership. Survey questions encompassed an understanding of the original policy, …

A Nursing Education Intervention In An Adult Inpatient Setting To Improve Compliance Rate With Pressure Injury Prevention Intervention, Brooklynn Jane Janke

Doctoral Dissertations and Projects

Pressure injuries can lead to life-threatening health complications for patients and cause physical, psychological, and financial stress to patients suffering from them. The literature review demonstrated that bedside nursing staff often have not received the appropriate education about pressure injury prevention and care. The literature review also revealed that nurses prefer to be educated one-on-one and peer-to-peer. Therefore, providing focused and frequent education on pressure injury prevention and improving nurses’ understanding of the importance of pressure injury prevention can improve the quality of care a nurse provides, and patients receive, thus reducing the number of health care-acquired pressure injuries. The …

A Nurse-Led Blood Pressure Program To Improve Blood Pressure In The Underserved Population Of Patients With Hypertension, Kyiana P. Adams

Doctoral Dissertations and Projects

Hypertension is one of the most chronic conditions in the United States and worldwide. Patients with lower socioeconomic class tend to have poor control of their blood pressure and higher morbidity and mortality rates. The scholarly project was conducted to identify if a nurse-led eight-to-10-week telehealth program improves blood pressure in the uninsured and underinsured community. The project was conducted in a community cares clinic that is part of a large organization. The criteria included adults aged 18 and older diagnosed with hypertension without resistant hypertension. Participants were required to agree to having a phone call once weekly for four …

Implementing An Exercise Program In Prediabetic Patients On Glp-1 Ras To Increase Self-Efficacy And Decrease Hgba1c, Bmi, And Weight, Tamara Alston

Doctoral Dissertations and Projects

Obesity is a significant factor in the progression from prediabetes to type 2 diabetes mellitus. Obesity is a condition of excess adipose tissue caused by an imbalance between the calories a person takes in, the absorption of those calories, and energy expenditure or how many of those calories a person burns. In 2022, the total cost of care for people with diabetes was $413 billion. Evidence indicates increased physical activity is directly associated with weight loss and decreased waist circumference. The literature supports that 150 minutes of weekly exercise can reduce HgbA1c, weight, and body mass index. Additionally, improved self-efficacy …

The Clinical Impact Of A Standardized Pathway For Chest Pain Evaluation In The Urgent Care Setting, Tysheena L. Jones

Doctoral Dissertations and Projects

This study aimed to evaluate the deficiencies in the current chest pain evaluation practices compared to standard of practice at urgent care centers and to develop an evidence-based clinical workflow prioritizing the reduction of the door-to-EKG times utilizing the Marburg heart score assessment tool. Conducted in three urgent care centers within a larger not-for-profit healthcare system, the retrospective pretest-posttest design involved 44 patients presenting with chest pain. Utilizing t-tests, the study found a significant reduction in door-to-EKG times from 39 minutes pre-intervention to 14 minutes post-intervention (p < 0.05). The pre implementation chart reviews revealed that 7 (32%) of the charts had the required risk assessment tool used, and score documented in the EMR. The post implementation chart reviews revealed that 6 (27%) of the charts had the required risk assessment tool used and score for chest pain documented in the EMR. The Marburg Heart Score facilitated timely identification of high-risk patients while minimizing unnecessary EKGs for low-risk individuals, though protocol adherence and external workflow disruptions were noted limitations. The findings underscore the importance of standardized workflows in enhancing care efficiency and patient outcomes, suggesting that future research explore long-term sustainability and broader implementation in urgent care settings.

The Differences In Perceived Stress And Coping For Prelicensure Nursing Students After A Positive Reappraisal Coping Intervention, Deanna Lynne Walborn

Doctoral Dissertations and Projects

Academic stress has become a common problem among nursing students, which can lead to undesirable student outcomes if their stress goes unabated. The purpose of this quasi-experimental pretest/posttest study is to determine if an intervention using a positive reappraisal coping intervention (PRCI) can reduce student nurse stress. Knowles’ theory of adult learning along with Lazarus and Folkman’s transactional model of stress and coping (TMSC) provided a foundation for the study. Olejnik’s (1984) table was used to determine the minimal total sample size required for this research. A sample of 26 nursing students from those who are enrolled in a public …

Building Capacity For Trauma-Informed Care: Enhancing Knowledge, Attitudes, And Practice Of Trauma-Informed Care Among Nurses, Kim G. Cudjoe

Doctoral Dissertations and Projects

Exposure to trauma is a global and pervasive phenomenon that is known to have negative consequences on the health, health outcomes, and well-being of individuals and at-risk populations to include Veterans. The implementation of trauma-informed care concepts and principles in the delivery of healthcare services among all staff and across the span of healthcare allows healthcare professionals to realize the impact of trauma on individuals, to recognize the signs and symptoms of trauma, to respond to trauma through improved practices, procedures, and policies; and to prevent re-traumatization while receiving care. The purpose of this evidence-based project is to develop and …

Staff Education Project Staff Education To Encourage The Accurate Use The Dynamic Appraisal Of Situational Aggression In A U.S. State Psychiatric Facility, Tracy Ann Reid-Saunders

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project involved the development and implementation of a staff education program to enhance the use of the Dynamic Appraisal of Situational Aggression (DASA) tool. The aim of the project was to address the inconsistent and inaccurate applications of the DASA tool by health staff, leading to missed opportunities for early intervention to address patient aggression and increased risk of violence to both staff and patients. The importance of addressing this issue within the context of nursing practice rests on the DASA tool’s importance as a means for nurses to assess patients with aggressive behavior, …

Hollow Fiber-Based Strain Sensors With Desirable Modulus And Sensitivity At Effective Deformation For Dexterous Electroelastomer Cylindrical Actuator, Yang Zhang, Keqi Deng, Tingting Shen, Yong Huang, Zhenjin Xu, Jinhui Zhang, Hang Jin, Xin Liu, Lida Xu, Lianjie Lu, Shiying Li, Daoheng Sun, Dezhi Wu

Publications

The electroelastomer cylindrical actuators, a typical representation of soft actuators, have recently aroused increasing interest owing to their advantages in flexibility, deformability, and spatial utilization rate. Proprioception is crucial for controlling and monitoring the shape and position of these actuators. However, most existing flexible sensors have a modulus mismatch with the actuation unit, hindering the free movement of these actuators. Herein, a low-modulus strain sensor based on laser-induced cellular graphitic flakes (CGF) onto the surface of hollow TPU fibers (HTF) is present. Through the electrostatic self-assembly technology, the flexible sensor features a unique hybrid sensing unit including soft HTF as …

Analysis Of Interprofessional Education Perceptions At The Team Level: A Study Across Three Student Cohorts, Tina Gunaldo, Kelsey Witmeier, Harun Mazumder, Sharon Duffy, Colette Baudoin, Henry Sauviac, Susanne Straif-Bourgeois, Scott Edwards

Center for Interprofessional Education and Collaborative Practice Papers

The interprofessional education (IPE) literature showcases many studies reporting results at the all-student and academic program levels. However, if the purpose of IPE is to develop collaborative-practice ready professionals, analysis at the team level would better support the advancement of the IPE literature and future health care goals. Pre-licensure students engaged in a two-year IPE curriculum and individually completed the Student Perceptions of Interprofessional Clinical Education-Revised survey, version 2 (SPICE-R2), at the end of the first and second year. Teams were comprised of health profession students from 12 academic programs associated with the university. Exploratory and longitudinal analyses of the …

Education Module To Improve Staff Medication Administration Practice, Linda Ikegwuoha

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Education Module to Improve Staff Medication Administration Practice by Linda C. Ikegwuoha BSN, Austin Community College, 2021 ADN, Austin Community College, 2019 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2025

Staff Education Project Enhancing Provider Knowledge And Integration Of Freestyle Libre Continuous Glucose Monitoring In A Family/Occupational Health Clinic, Kesha Lebron

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on enhancing provider knowledge and supporting the integration of FreeStyle Libre continuous glucose monitoring (CGM) technology in a family medicine and occupational health clinic. A gap in provider understanding of CGM technology and its role in diabetes management was identified. The intervention targeted a diverse group, including medical assistants, management, clerical staff, occupational health specialists, and medical providers. A pre- and post-education knowledge assessment was conducted, and results showed an increase in provider understanding. The pre-intervention average score was 76.52 (SD = 2.64), which increased to 98 (SD = 3.34) post-intervention. While …