Nursing Commons^™

Evaluation Of A Brief Mindfulness-Based Intervention Of Work-Related Stress, Job Satisfaction, Retention, And Quality Care: A Quality Improvement (Qi) Project, Laura M. Bragg

DNP Projects

Burnout among advanced practice providers (APPs) remains a significant concern nationally and within the University of Kentucky Healthcare system, with post-COVID evidence showing persistently elevated stress and emotional exhaustion. This quality improvement (QI) project implemented and evaluated a brief, app-based mindfulness intervention using the Headspace “Learn the Basics of Meditation” program for work-related stress, job satisfaction, mindfulness, and retention intentions among APPs. A one-group pre-post design was implemented, with 45 APPs completing the pre-intervention survey and four completing both the pre- and post-intervention surveys. Although no statistically significant improvements were observed, nonsignificant decreases in emotional exhaustion, fatigue, and turnover intention …

Evaluating The Impact Of Epic Integration And Dual Registered Nurse Check-Off On Pressure Injury Prevention Workflow Compliance, Darlene Y. Olowu

Doctor of Nursing Practice Final Project Abstract

Background

Hospital-acquired pressure injuries (HAPIs), particularly sacral and heel injuries, remain a persistent challenge in critical care settings, leading to increased morbidity, mortality, and healthcare costs.

Purpose

This quality improvement project aimed to improve compliance with a pressure injury prevention (PIP) workflow by integrating a dual RN check-off system within EPIC, thereby reducing sacral and heel pressure injuries. The project sought to enhance accountability, standardize documentation, and optimize compliance with evidence-based PIP measures.

Methodology

A Plan-Do-Study-Act (PDSA) framework guided the project implementation in an oncologic intensive care unit (ICU). Key interventions included: (1) EPIC integration of a dual RN check-off …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

Implementation Of Behavioral Emergency Response Team In Triage, Brianna Millen

Doctor of Nursing Practice Final Project Abstract

Introduction: The aim of this project is to improve the admission process of psychiatric patients in the emergency department (ED) by implementing a Behavioral Emergency Response Team (BERT). The goal is to reduce wait times, decrease patient aggression, and enhance overall patient and staff safety.

Background: Emergency departments are experiencing an influx of psychiatric patients presenting with acute psychosis. Long wait times often lead to increased agitation, requiring physical or chemical intervention. Literature suggests that timely care can reduce aggression and psychiatric admissions. Currently, no similar interventions exist at Houston Methodist West Hospital.

Methodology:

This quality improvement project follows a …

Evaluation Of A Quality Cpr Coach Simulation-Based Competency Training: From Learning Outcomes To Patient Outcomes, Katie L. Mcdermott, Kari L. Rajzer-Wakeham, Jennifer M. Andres, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Variability in cardiopulmonary resuscitation (CPR) quality and skill decay result in suboptimal application of CPR, which impacts patient outcomes following an arrest. Quality CPR Coach is a supplementary code team role that provides real time, verbal feedback directly to chest compressors to cognitively offload the team leader and ensure high-quality, goal-directed CPR delivery.

Methods

Design, implementation, and evaluation of a simulation-based Quality CPR Coach competency curriculum. Multi-modal assessment and evaluation methods were used.

Results

Statistically significant increase in confidence, perceived ability to verbalize Coach responsibilities, and knowledge. Participants demonstrated accurate Coach role performance across progressively scaffolded simulated compression event …

Resilience As Accusation: A Critical Examination Of Individual Resilience Training For Burnout Mitigation, Jacqueline Christianson, Bonnie Sommers-Olson, Jessica Leiberg, Dana Kaminstein

College of Nursing Faculty Research and Publications

Burnout, a syndrome of work-related exhaustion and cynicism, is prevalent among nurses and is associated with workplace stressors. Resilience training programs are a prevalent method of burnout mitigation employed by healthcare institutions that aim to improve or alter how individuals respond to chronic stressors. Through the lens of General Systems Theory, we describe resilience training as a method of individualizing a systemic problem by problematizing a response to chronic stress exposure. Resilience training may furthermore serve as a mechanism which allows subversion of institutional responsibility for nurses’ well-being in the workplace. We describe several suggestions for nurses to resist being …

Health Equity And Children With Medical Complexity/Children And Youth With Special Health Care Needs: A Scoping Review, Elizabeth A. Flasch

College of Nursing Faculty Research and Publications

Children with medical complexity (CMC) and children and youth with special health care needs (CYSHCN), compared with the general population, engage with the health care system at increased rates, at multiple life stages, and for a myriad of reasons (Berry et al., 2015). Operational definitions of CMC and CYSHCN are very limited, with the terms conflated and differentiated across the literature. Because of the lack of standardized definitions and general conflation of the two terms across the literature, CMC and CYSHCN will be used interchangeably for this review. Allshouse et al. (2018) defined CMC as a subset of CYSHCN “as …

Rapid Implementation Of Open-Access Pandemic Education For Global Frontline Healthcare Workers, Jacqueline Christianson, Erica Frank, Stacen Keating, Susan Boyer, Miriam Chickering

College of Nursing Faculty Research and Publications

Background

The recent global pandemic posed extraordinary challenges for healthcare systems. Frontline healthcare workers required focused, immediate, practical, evidence-based instruction on optimal patient care modalities as knowledge evolved around disease management.

Objective

This course was designed to provide knowledge to protect healthcare workers; combat disease spread; and improve patient outcomes.

Methods

A team of global healthcare workers responded by rapidly creating a competency-based online course. To promote transcultural applicability, the course was developed by an international team of more than 45 educators from over 20 countries. Course delivery included a built-in language translation tool, routine updates, and several innovative course …

Nurse Perspectives On Labor Union Participation Prior To Implementation Of A Collective Bargaining Agreement: A Qualitative Study, Jacqueline Christianson, Bonnie Sommers-Olson, Cathleen Fox, Norah L. Johnson

College of Nursing Faculty Research and Publications

Background: Patient advocacy is a duty for professional nurses; however, not all nurses are empowered to advocate for meeting patients’ needs. Participation in labor unions may serve as a venue for nurses with limited institutional decision-making authority to advocate for patient needs; however, unionization can be a time-intensive and fraught process.

Purpose: This study examined how nurses participating in a new union in an urban United States hospital described their reasons for participating in a labor union during collective bargaining.

Methods: Content analysis of participant's interviews that took place between January and March 2023, after the nurses voted to unionize …

Evaluating Nurse Conscientious Objection: Application Of A Novel Framework, Maya Zumstein-Shaha, Lucia D. Wocial, Vicki D. Lachman, Norah Louise Johnson, Cynda Hylton Rushton, Pamela J. Grace

College of Nursing Faculty Research and Publications

Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse’s Conscientious Objection (EENCO), is applied to expose hidden elements and nuances in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated …

Assessing Family Caregiver Readiness For Hospital Discharge Of Patients With Serious Or Life-Limiting Illness Using Electronic Health Record And Self-Reported Data, Joan M. Griffin, Diane E. Holland, Catherine E. Vanderboom, Brystana G. Kaufman, Allison M. Gustavson, Jeanine Ransom, Jay Mandrekar, Ann Marie Dose, Cory Ingram, Zhi Ven Fong, Ellen Wild, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective

To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

Study Setting and Design

This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Data Sources and Analytical Sample

Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, …

Sex Work Patterns Among Transgender And Gender Diverse People: A Latent Class Analysis, Madeline Stenersen, Anjum Umrani, Irelan Fricke, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

Sex work is a diverse profession encompassing a broad range of people, and services. Though overrepresented in sex work communities, transgender and gender diverse (TGD) individuals are underrepresented in sex work literature. Further, sex work literature continues to underrepresent the heterogeneity evident in the sex work community and the practices that occur within it. The present study utilized data from the 2015 United States Transgender Survey (USTS) to conduct a latent class analysis (LCA) to identify patterns of different types of sex work among TGD adults (N = 2,153) and understand the demographic characteristics associated with engagement in different types …

“Ringleader Who Has No Power”: A Qualitative Study Of Parent Uncertainty During A Nicu Admission Unrelated To Prematurity, Erin Rholl, Steven R. Leuthner, Kathryn J. Malin, Joanne Lagatta, Krisjon R. Olson

College of Nursing Faculty Research and Publications

Background

Parents of preterm infants experience stress related to uncertainty which impacts parent health outcomes. Less is known about the experience of parents whose infants are admitted for reasons other than prematurity. In this study we sought to describe (1) the experience of parents whose infants are admitted to a level IV NICU for reasons unrelated to prematurity in relation to uncertainty and (2) the effect of social and structural determinants on parent experience with uncertainty.

Methods

This single center qualitative study utilized interviews, questionnaires, and chart review at 2 time points: 2 weeks after admission and 3 months after …

Critical Care Advanced Practice Providers As Partners In Advancing Pediatric Intensive Care Unit Nursing Knowledge: A Needs Assessment., Mary Seidl, Meghan Roller, Whitney Seul, Laura Rose, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Critical care advanced practice providers (APPs) are frontline providers in many pediatric intensive care units (PICUs). From 2020 to 2022, there was a significant downward shift in nursing experience level in the PICU at the authors’ institution. APPs may help provide additional in situ education.

Methods

Data were collected using role-specific needs assessment of PICU nursing staff and providers, assessing concept related to knowledge and job stress.

Results

Findings overwhelmingly demonstrated desire for more APP-led education. Overall, 27% of nurse respondents strongly agreed that current knowledge was adequate to provide safe and best care for their patients, and 47% …

Reframing Recovery: Comparing Music Interventions And Traditional Rehabilitation Methods For Cognitive Function In Traumatic Brain Injury Patients, Laura Velez

Honors Undergraduate Theses

Traumatic brain injury (TBI) affects millions annually, often resulting in long-term cognitive deficits that hinder independence and quality of life. While traditional rehabilitation methods address many physical and functional limitations, cognitive impairments—such as deficits in attention, memory, and executive function—often persist. Emerging evidence highlights music-based interventions as a promising complement to standard therapies, yet comparative research remains limited. This integrative literature review examined the effects of music interventions versus traditional rehabilitation methods on cognitive function in adults with TBI. Using a systematic search of databases including MEDLINE, CINAHL Ultimate, APA PsycInfo, and Music Index, eight peer-reviewed studies were selected for …

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Enhancing Engagement In Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (Mtm) In An Underserved Population Of Memphis, Tennessee, Lindsey H. Dao

DNP Projects

Enhancing Engagement in Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (MTM) in an Underserved Population of Memphis, Tennessee

Functional And Traditional Medical Management Of Endometriosis: An Integrative Review, Madison G. Daniels

Senior Honors Theses

Endometriosis, a progressive disease that affects many women worldwide, has been managed primarily through hormonal medication, pain management and surgical intervention. However, there is a growing desire among women to use more natural and holistic methods to control the progression of this disease as well as effectively manage the severe symptoms that accompany it. This integrative review examines the efficacy of functional management as compared to traditional medical management. The pathophysiology of each treatment method and provide statistical evidence as to its efficacy. The progression of the disease, symptom management, and related side effects are all taken into consideration in …

Post-Traumatic Stress Disorder Among Critical Care Nurses Caring For Covid-19 Patients, Marwa Abdo

Nursing

Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, with a substantial number of severe cases requiring admission to isolated intensive care units (ICUs). This unprecedented situation exposed critical care nurses (CCNs) to a highly stressful traumatic environment, placing them at increased risk for developing post-traumatic stress disorder (PTSD). Early identification and intervention for PTSD are crucial to mitigate the negative consequences for nurses' well-being, job performance, and overall quality of life. Aim: This study aimed to assess post-traumatic stress disorder among CCNs caring for COVID-19 patients. Method: A descriptive cross-sectional design with a convenience sample of 109 CCNs …

Delayed Newborn Bathing To Increase Breastfeeding, Nadia Martino, Amanda Bace, Carrie Moneysmith, Mary Brooks, Shelly Wu, Wala Safi

Nurse Residency Posters

Facilitator: Ellie Barte, RN

Reducing Falls In Hospitalized Adults With The Use Of Bed Alarms, Tracy Hock Bsn,Rn, Marzane Hawthorne Rn, Prabesh Acharya Bsn,Rn, Megan Kuck Bsn,Rn, Jonna Hicks Bsn,Rn

Nurse Residency Posters

Facilitator: Megan Sowder

Grant Medical Center

Occupation-Based Activities For Neuroatypical Adults In Inpatient Settings, Kim Miller, Angelina Mills, Latasha Sheets

Nurse Residency Posters

Facilitators: Melissa Harper and Donita Warren

OhioHealth O-Bleness Hospital

Promoting A Culture Of Well-Being On A Nursing Unit, Jayla Campbell Rn, Jessica Detty Rn, Rebekah Krider Rn, Abby Winegardner Rn

Nurse Residency Posters

Facilitator: Ellen Villalobos

OhioHealth Berger Hospital

Closing Racial And Ethnic Disparity Gaps In Pediatric Asthma Follow Up Care - A Quality Improvement Initiative, Ayodele Ayeko

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Closing racial and ethnic disparity gaps in pediatric asthma follow up care - A quality improvement initiative

Ayodele Ayeko

Introduction/Background: Inadequate management of asthma significantly contributes to poor asthma control, poor quality of life (QOL), and high hospitalization rates among pediatric patients. The Global Initiative for Asthma (GINA) guidelines offer recommendations designed to enhance asthma control and improve the quality of life for those affected (2015), including recommendations for close follow up care. At WVU Medicine Children’s Hospital (WVUMCH), insufficient asthma control has been associated with lower clinic follow-up rates and an increase in hospitalization. Although educational initiatives …

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

Nursing Articles

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 …

Impact Of Bundled Care: Optimizing Pain Management Outcomes In Acute Care, Mary Kelly, Denise Danna, Marsha Bennett, Karen Rice, Helen Calmes, Paige Fisher, Mary Dioise Ramos

School of Nursing Faculty Publications

Purpose: Despite therapeutic advances, inadequate pain management in hospitalized patients often leads to chronic pain and opioid dependency. Nonpharmacologic strategies offer potential benefits, especially when integrated into a bundled care approach that enhances pain management and patient engagement. This research aimed to test the effect of a standardized bundle of evidence-based pain care strategies on medical-surgical patients' perceived pain quality outcomes. Design & Methods: This study employed a 2-group, quasi-experimental design to assess the impact of a unit-based intervention, PAIN-X Therapy, on pain care quality outcomes compared to usual pain care. Results: There were 365 participants included in the study …

Everyday Decision-Making Involvement Among Hispanic & Latinx Dementia Caregivers And Its Associations With Daily Anxiety And Daily Depressive Symptoms, Abigail Poe

All ETDs from UAB

Background: Hispanic and Latinx (H&L) caregivers of individuals living with Alzheimer’s disease and related dementias (ADRD) experience elevated caregiving burden and poorer mental health outcomes compared to caregivers from other racial and ethnic groups. Limited research has examined H&L caregivers’ involvement in everyday decision-making for persons living with dementia (PLWD), particularly how this involvement may relate to daily mental health symptoms such as anxiety and depression. Purpose: This study examined baseline decision-making involvement (DMI), its associations with individual-level factors, and its relationship with daily anxiety and depressive symptoms in H&L ADRD caregivers. Methods: A secondary analysis was conducted using data …

Nursing Professional Liability: Bridging Rn & Aprn Perspectives On Risk, Coverage & Evolving Practice Authority, Michelle Hileman Msm, Rn, Cnm, Parkview Health

Nursing Publications, Posters, & Presentations

Presented at the 2025 Parkview Nursing Research Symposium.

The purpose of this literature review is to explore professional liability for RNs and APRNs. Specific objectives include:

• Identify patterns in malpractice claims for RNs and APRNs

• Compare employer-provided and personal malpractice coverage

• Examine the impact of scope-of-practice laws on APRN liability

• Clarify principles of vicarious liability

• Recommend lifelong strategies for education, risk management, and professional practice

Provider Perspectives On Produce Prescription Programs In A Rural Community, Heather Ward Dnp,Fnp-Bc, Sarah Giaquinta Md, Mph, Susan Storey Phd, Rn, Aocns

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium.

Purpose:

• To evaluate healthcare provider perspectives on PPPs in a rural community
• To identify barriers and facilitators to implementing a PPP
• To lay the groundwork for the successful implementation of a PPP in the Count

Pairing Vashe And Cavilon Advanced Skin Protectant For An Innovative Approach To Neonatal Diaper Dermatitis Treatment, Jennifer Thieman Msn, Rn, Accns-P, Rnc-Nic, C-Elbw, Cls

Nursing Publications, Posters, & Presentations

This poster was presented at the 2025 Nursing Research Symposium.

Objective: To implement a new process that allows Vashe and Cavilon Advanced Skin Protectant to be used together in order to improve healing time of diaper dermatitis.