Nursing Commons^™

Reducing Heart Failure Readmissions Through Standardized Daily 1:1 Education, Neil R. Carlos

Master's Projects and Capstones

Problem: In 2023, a Northern California hospital's Cardiac Procedure Unit (CPU) admitted 100 heart failure patients, with 24 readmissions primarily due to inadequate self-management education. These admissions cost over $8.4 million, highlighting the urgent need for better patient education to reduce readmissions and healthcare expenses.

Context: A quality improvement initiative was launched in the CPU that handles pre- and post-cardiac care, including for heart failure patients. The unit's focus on urgent care and other priorities resulted in insufficient patient education regarding heart failure.

Intervention: From January to June 2024, the initiative implemented daily personalized teach-back education sessions on self-management. These …

Reducing Healthcare-Acquired Pneumonia In A Geriatric Long-Term Care Facility, Jacob R. Magsalin

Master's Projects and Capstones

Problem: Healthcare-acquired pneumonia (HAP) is a nosocomial infection that poses a serious threat in geriatric long-term care facilities due to its high morbidity and mortality.

Context: This evidence-based quality improvement project seeks to reduce the incidence of HAP in a geriatric long-term care facility in the San Francisco Bay Area by utilizing findings

from existing literature.

Interventions: Key interventions include improving and standardizing oral care techniques and promoting education on HAP prevention to allow patients and their families to be more proactive in preventing this complication.

Measures: Outcome measures include HAP diagnosis rates after implementation, any costs saved for the …

Enhancing Communication And Reducing Near Misses Through Comprehensive Handoff Tools At A Residential Nursing Facility, Sabrina Guralnik, Sophia Nguyen, Gabriela Benelyahu, Giselle Peyus

Master's Projects and Capstones

Our quality improvement project at Regina House addresses communication gaps during patient handoffs, which have led to missed or delayed care. The research underscores the critical role of effective communication in patient safety, particularly for vulnerable populations in nursing homes. Current handoff practices at Regina House are inconsistent, especially among Certified Nursing Assistants, resulting in frequent reporting errors and communication disparities.

To enhance patient safety and care continuity, this project introduces a standardized handoff tool and an incident reporting system, aligning with Regina House’s goal of improving care quality. Over three months, CNAs will receive training on the tool, with …

Improving Documentation Compliance And Patient Mobility Using The Bedside Mobility Assessment Tool, Hayley M. Bernard

Master's Projects and Capstones

Objective: Patient immobility during hospitalization contributes to avoidable complications including increased length of stay, pressure injuries, thromboembolic events, reduced functional capacity, and increased rates of discharge to rehabilitation facilities. The Bedside Mobility Assessment Tool (BMAT) was developed to empower Registered Nurses to safely assess and mobilize patients without a physical therapy evaluation. Aim: This quality improvement projects aims to enhance nurse compliance with BMAT documentation by 10% in three medical-surgical units of a 244-bed Northern California Hospital. Preliminary findings indicate an average daily patient census of 23.7 of which only 31.3% are assessed using the BMAT. Methods: Across a six-week …

Optimizing Peripartum Bedside Reports Through Patient-Centered Communication, Harpreet Kaur

Master's Projects and Capstones

Abstract

Background Effective patient-centered communication (PCC) during bedside shift reports (BSR) is crucial in peripartum care, where patients face physical recovery and emotional adjustment. However, communication gaps during transitions from labor and delivery (L&D) to postpartum (PP) units can lead to patient dissatisfaction and misinterpretation of care instructions. Hospital A, an urban tertiary care medical center in San Francisco, operates a peripartum mesosystem across two floors with 35 dedicated beds. Aim The project aims to increase patient satisfaction by implementing patient-centered language in bedside reports for peripartum units from 70% to 80% for a three-week period. Methods Stakeholder engagement, a …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Implementing The Donna Wright Competency Model In Pediatric Perioperative Units For Nursing Professional Development, Benjamin Amezcua

Master's Projects and Capstones

Background Each year, preventable adverse events in hospitals lead to numerous deaths. Research consistently indicates a strong correlation between nurse competency and improved patient outcomes, emphasizing the importance of healthcare organizations prioritizing the continuous development of their staff's skills. Bay Area Children’s Hospital A is taking a proactive step by adopting the Donna Wright Competency Model (DWCM), changing from the traditional approach competencies to a collaborative, shared governance model that incorporates the input and perspectives of the nursing staff. Objectives The project aims to utilize the DWCM to enhance the competencies of 90 nurses in the pediatric perioperative units at …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In The Adult Oncology Population Through Improved Compliance With Oral Hygiene Protocols, Kenneth R. Brown

Master's Projects and Capstones

Objective

Oncology patients receiving chemotherapy are at risk of complications such as mucosal barrier injuries (MBI) and aspiration pneumonia, and aspiration pneumonia rates are higher than desired. Improved oral hygiene protocols and compliance in this population reduces the incidence of these complications.

Context and Background

The microsystem assessed includes six oncology units at Hospital A, a large California academic hospital. Aspiration pneumonia, commonly associated with MBI, is a life-threatening challenge that increases costs and complications in oncological treatment settings. An aspiration pneumonia task force focused on six oncology acute care units is committed to reducing the incidence of hospital acquired …

Utilizing Pupper, A Social Robot Dog, To Increase Happiness And Improve Mood In Pediatric Patients Of A Cardiac Step-Down Unit, Angela Feng Wu

Master's Projects and Capstones

Objective The usage of social robots in pediatrics is an emerging field of study. Preliminary research shows that they are effective at improving the psychosocial well-being of pediatric patients. This quality improvement project focuses on Pupper, a newly developed quadruped social robot dog, and its ability in improving mood and happiness in pediatric patients of a cardiac step-down unit. Aim The aim of this project is to increase average mood scores of pediatric cardiac patients aged 3-25 years by 50% from their baseline of 3.75 to 5.63 on a six-point scale within a one-month time frame. Methods Before intervention and …

Implementing The Brief Confusion Assessment Method (Bcam) Delirium Screening Tool In An Emergency Department, Carolina Van Dalen

Master's Projects and Capstones

Problem: Persons with delirium have an elevated risk of falls. Thus, falls and delirium are inextricably linked. Both should be routinely screened for older adults.

Context: A 40-bed Emergency Department (ED) in the East San Francisco Bay area of Northern California and the first site among all acute care hospitals in the organization to implement the Brief Confusion Assessment Method (bCAM) delirium scoring tool within the Electronic Health Record (EHR).

Interventions: An EHR toolkit for delirium screening using bCAM was developed, tested, and implemented in the ED.

Measures: The outcome measure was the percentage of patients with a reported fall …

Baby-Friendly Hospital Initiative: Becoming Baby-Friendly Designated, Krystal Angelique Mora

Master's Projects and Capstones

Section I: Abstract

Problem Despite efforts to increase breastfeeding rates, the influence of formula companies has contributed to the decrease in rates, affecting the health outcomes of infants. In response, the Baby-Friendly Hospital Initiative (BFHI) introduced standardized education for nursing staff to support infant growth and development. Context Hospital A Birth Center is a 33-bed culturally diverse unit that provides care to mothers in Northern California, delivering approximately 7,400 babies each year and helping patients transition into motherhood. Aim The quality improvement project aims to enhance the retention of BFHI-aligned education provided during hospitalization by 26.2%, raising retention rates among …

Optimizing Fall Prevention: A Quality Improvement Initiative To Enhance Documentation And Intervention Accuracy Using The Hester Davis Scale In Medical-Surgical Units, Kiana Conn, Brooklin Hunter-Johnson, Jashan Kahlon, Adrian Paz

Master's Projects and Capstones

Falls among hospitalized patients remain a critical safety concern, particularly in medical-surgical units caring for geriatric and oncology patients. This quality improvement project aimed to evaluate and address gaps in adherence to fall prevention protocols by utilizing the Hester Davis Scale (HDS) in two medical-surgical units at a large metropolitan hospital in Southern California. The project focused on auditing current practices to identify inconsistencies in documentation and intervention implementation, emphasizing areas such as bed alarm activation, fall risk signage placement, and armband use. Weekly audits were conducted from October 3 to October 29, 2024, to establish baseline data and inform …

Impact Of Supply Organizational Culture Within A Surgical Unit, Irene T. Peng

Master's Projects and Capstones

Objective: This quality improvement project aims to propose an intervention that helps anesthesia technicians improve communication efforts, reduce delays in care, and reduce medical waste. Aim: At least 80% of the anesthesia technicians are educated on properly stocking the pediatric anesthesia medical lockers utilizing the standardized checklist and handoff report tool to reduce waste and increase timely patient care after three months of implementation. Methods: Assessment surveys were used to identify the surgical unit’s current issues and Hospital A’s staff's opinions of pediatric medical anesthesia C-lockers. Resources such as the GANTT Chart, Fishbone Analysis, Budget Analysis, SWOT Analysis, and PDSA …

The Donna Wright Competency Model In Pediatric Perioperative Nursing Development, Nadia Hamid

Master's Projects and Capstones

Abstract

Background Preventable adverse patient events occur daily in hospitals across the United States which can be significantly decreased by effective nurse competency assessment. Bay Area Children’s Hospital X has adopted the Donna Wright Competency Model (DWCM) to support their institutional goal of Magnet status for excellent nursing care. With the goal of changing the traditional approach of competency achievements by engaging nurses through shared governance. Objective The project seeks to attain a higher level of performance for 90 nurses employed on the perioperative unit (PPU) to provide a safer environment to support patient centered care. Aim By December 1, …

An Integrative Review Of Trauma Informed Care With Pediatrics To Minimize Psychological Sequelae Post Discharge, Amber Lee, Courtney Heinzelman

Master's Projects

Each year, a significant number of children sustain injuries requiring hospitalization, and while many recover physically, some face long-term psychological challenges such as post-traumatic stress, anxiety, and depression. This integrative review focuses on adolescents aged 13–18 who have experienced accidental trauma, exploring how trauma-informed care (TIC) in nursing compares to traditional approaches in reducing psychological impacts after discharge. Research suggests that many young patients report mental health symptoms for months following traumatic events. Trauma-informed care prioritizes principles such as safety, trust, peer support, and empowerment, aiming to reduce emotional distress and promote recovery. This review examines the application of these …

Developing A Trauma-Informed Family-Centered Care Toolkit For Neonatal Intensive Care Unit Nurses, Sonja A. Alli-Casella

DNP Qualifying Manuscripts

Background: The neonatal intensive care unit (NICU) may be a stressful, traumatizing, or re-traumatizing experience for parents of critically ill newborns and infants.

Problem: NICU nurses and other healthcare providers may not realize their impact on parental stress responses as neonatal care providers may not have adequate training to support adults experiencing acute emotional distress.

Methods: Strong evidence supports using family-centered care (FCC) in the NICU to promote bonding and parental involvement in caring for their infants. This manuscript aims to review current research and literature on trauma-informed care training and its impact on nurse confidence in managing dysregulated adults, …

Enhancing Ob Healthcare: Impact Of Black Nurse Representation, Devi Wolfe-Reese

Honors Capstones

Increasing Black nurse representation in obstetrics (OB) care is crucial for improving maternal and infant health outcomes, reducing health disparities, and building trust between patients and providers. Research shows that diverse healthcare teams lead to better patient outcomes, including lower mortality rates and higher patient satisfaction. Black nurses bring critical cultural competence to OB care, strengthening patient-provider relationships and ensuring that care is tailored to the unique needs of Black families. A more diverse nursing workforce promotes better collaboration, enhances inclusivity, and contributes to a more equitable healthcare system overall.

To achieve these goals, healthcare institutions must prioritize diversity by …

Consent, Healthy Relationships, And Sexual Misconduct Education, Bergen Babich, Dinorah Blanco Reyes, Samantha Campbell, Balkhita Mweru, Spencer Roth, Alyanna Velasco

Nursing Leadership in Community Engagement Projects

Introduction

Our team of nursing students collaborated with a university's security office and health services to educate the campus community on sexual assault and gender-based violence. According to the University’s Annual Security and Fire Safety Report, there was a 550% increase in rape cases from 2022 to 2023 (personal communication, 2024). This increase in rape cases indicated a need for increased education and awareness of sexual assault and gender-based violence. Our educational sessions aimed to provide the campus community with education and resources on sexual misconduct and consent to promote healthier relationships on campus.

Background

The population that we served …

Increasing Health Literacy Within The Unhoused Population, Alyse Mk Abraham, Zoe J. Foucaultt, Sean P. Sieber, Simran Gill, Andrew Kang, Fatou Goudiaby

Nursing Leadership in Community Engagement Projects

Nursing Leadership Executive Summary

The unhoused population in Washington State increased by 12% from January 2022 to January 2023, underscoring a growing regional crisis (Washington State Department of Commerce, 2024). To serve this population, we partnered with an agency in Western Washington. In collaboration with the agency’s health services administrative director, we developed a multilingual handout on healthcare and insurance options to improve health literacy.

Our project involved a windshield survey, demographic analysis, evidence-based research, and collaboration with translators to ensure accessibility. This paper outlines the project’s development, research process, creation of the handout, and its intended impact.

Background

A …

Stress Management Through Educational Coping Techniques, Margaret Nikitchuk, Maddy Politeo, Sarah Hall, Ben Pham, David Kumar, Kiana George

Nursing Leadership in Community Engagement Projects

Executive Summary

According to the United States Census Bureau, Seattle reported the highest amount of people with stress in the United States with 54.5% (reported by adults) saying they felt ‘nervous, anxious or on edge’ for at least several days during the past two weeks” (Swedish, 2024). Many residents in Seattle cope with stress in unhealthy ways. For instance, in Seattle-Tacoma-Bellevue MSA, 19% of individuals aged 12 or older used illicit drugs, compared to the national rate of 14.7% (SAMHSA, 2012). Additionally, 22.5% of this population engaged in binge alcohol use at least once in the past month (SAMHSA, 2012). …

Take Charge Of Your Health: Start With Your Smile, Jordan L. Lacey, Brizette O. Owusu, Sophia Gardner, Madeline Whitehead, Haeun Park, May Ligno

Nursing Leadership in Community Engagement Projects

Take Charge of Your Health: Start with Your Smile

Oral health is a fundamental component of overall health, yet it is often neglected-particularly among vulnerable populations like houseless individuals (Freitas et al., 2019). Houseless individuals face numerous barriers to accessing healthcare, with dental services being limited. This lack of access contributes to a higher prevalence of oral diseases, which if left untreated, can lead to severe complications. Poor oral health doesn’t just affect the mouth; it negatively impacts one’s overall systemic health, psychosocial well-being, and quality of life (Csikar et al., 2019).

As nursing students engaged in a Community Health …

Impact Of Training For Nursing Staff In The Prevention Of Hapis, Onyinye E. Ohia, Colleen A. Anthony

Master's Projects

Abstract

Background: The incidence of Hospital acquired pressure injuries (HAPIs) have remained a problem in healthcare despite concerted efforts by hospitals and other governmental agencies to eliminate the problem via policy and emphasis on safety. There is support in literature for the training of healthcare professionals as an important tool in the prevention and management of HAPIs. Despite the existence of studies that link training of nurses to a reduction in rates of HAPIs, evidence in support of that is still piecemeal; with poorly defined outcomes.

Aims and objectives: The aim of this integrative review is to identify …

Senior Nursing Students' Perceptions Of Their Effectiveness In The Utilization Of De-Escalation Techniques: A Phenomenological Study, Chinelo N. Anadu

Doctoral Dissertations and Projects

This qualitative phenomenological study explored senior nursing students’ perceptions of their effectiveness in utilizing de-escalation techniques. The theories that guided this study were Bandura’s self-efficacy theory and Kolb’s experiential learning theory. Self-efficacy is one’s ability to organize, conduct, and successfully perform a task. Bandura’s self-efficacy theory focuses on individuals’ perception of their ability to perform a task, not the action’s result. Kolb’s theory emphasizes that learning is a process, and modifying experiences creates knowledge. The participants for this study were senior nursing students from two medium-sized universities in the mid-Atlantic region of the United States. A sample of 11 senior …

Development And Evaluation Of Nurse Practitioner- Driven Appointment Reminder Initiative At An Outpatient Mental Health Clinic, Adaku Ogoke

Doctoral Dissertations and Projects

No-shows or missed appointments have a negative impact on the effectiveness and efficiency of healthcare facilities. No-shows contribute to high healthcare costs and lost revenue due to underutilization of services, unnecessary disruptions in workflow, increased workload, and scheduling challenges. Mental health clinics report high no-show rates due to factors such as forgetfulness among patients. The purpose of this quality improvement project was to implement a text message patient appointment reminder system to reduce the no-show rate and increase provider knowledge in an outpatient mental health clinic in 15 weeks. The project was guided by the Iowa model of evidence-based practice …

The Effectiveness Of Education Utilizing A Digital Patient Education Platform For Nursing Staff Working In A Military Medical Treatment Facility, Meki Bocage

Doctoral Dissertations and Projects

Currently, the use of digital health technology has been found to improve patients’ experiences, health outcomes, and quality of care. Furthermore, the Defense Health Agency (DHA) is focused on leveraging cutting-edge technologies to optimize healthcare delivery and improve patient experiences. The purpose of this evidence-based practice process improvement project supports providing educational intervention to nursing staff through videoconferencing or lecture learning opportunities. The project focused on successfully educating nursing staff from at least three MTFs on the use of a patient education platform by the conclusion of the 30-day intervention through individual web-based pre and post questionnaires. Ultimately, 15 registered …

Exploring Generational Differences Within The Nursing Profession: An Evidence-Based Practice Project, Danielle Sienkiewicz

Doctoral Dissertations and Projects

Nursing practice has evolved since its initial presentation. The 2020 pandemic played a significant role in changing nursing dynamics. Acute care nurses have become responsible for a plethora of tasks once a patient enters the doors of their facility. While education and skills training can be implemented, there are other aspects requiring greater attention. Generational differences have become more apparent in practice. Generational differences are only recently gaining attention and could use more focus in large organizations. The workforce has become a combination of Baby Boomers, Generation X, Millennials, and Generation Z. The Silent Generation, also referred to as Veteran …

Promoting Advance Care Planning In Primary Care: A Pilot Study On The Impact Of Clinician Education And Workflow Development, Lisa Nicole Turcotte

Doctoral Dissertations and Projects

Although evidence supports the efficacy of advance care planning (ACP) in improving quality of care and the overall well-being of patients and families, there are many barriers to engagement in this process. Fortunately, clinician and patient education and workflow development in primary care settings have shown promise in their ability to overcome these obstacles to improve awareness of and engagement with the ACP process as part of preventative care. The purpose of this project was to apply current research on this topic to improve patient engagement with ACP in the primary care setting using the Iowa Model of evidence-based practice. …

Health Literacy And Advocation Amongst Community Health Workers, Dustin R. King

Doctoral Dissertations and Projects

Health literacy is an important component of global health maintenance and can be greatly influenced by the DNP. The trigger for the EBP was related to a limited amount of appropriate application of health literacy in South Asian communities and village medical leaders. Health literacy was assessed by distributing short questionnaires to medical professionals such as chemists, doctors, and community health workers. An educational intervention with one specific disease process, hypertension, was then delivered to those who accepted. Upon completion of the teaching, a re-assessment with the same questions was either distributed or reviewed with the participants. Descriptive statistics were …

Experiences Of Midwest Nursing Faculty Decisions To Leave Academia: A Hermeneutic Phenomenological Study, Teresa H. Moorman

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to explore the lived experiences of Midwest nurses related to their decision to leave academic faculty positions. The theory guiding this study was Herzberg’s motivation-hygiene theory. The motivation-hygiene theory examines the factors that inform the relationship between satisfaction and lack of satisfaction, as well as dissatisfaction and lack of dissatisfaction. Herzberg outlined several motivating factors that influence employees to perform at their best, and several hygiene factors that negatively impact performance. Additionally, Dewey’s experiential learning theory underpinned the study. The lived experience comprises the physical environment, perceptions of the person, and the …

Psychotropics And Fall Reduction Through Nursing Education, Jenny L. Stillman

Doctoral Dissertations and Projects

Falls in long-term care centers (LTC) remain a significant problem due to their association with increased mortality, healthcare costs, and decreased patient outcomes. A major contributing factor to falls is the use of psychotropic medications commonly prescribed in LTC facilities despite evidence against their use. This paper discusses a quasi-experimental study aimed at reducing falls through nursing education on how psychotropics contribute to falls. The study also highlights the regulatory requirements for LTC facilities to monitor and reduce fall occurrences and the efforts made by a State Veterans Home to address the number of falls. The results demonstrate a reduction …