Nursing Commons^™

Implementing Bedside Shift Reporting On An Adult Medical-Surgical Unit: An Evidence-Based Intervention For Inpatient Fall Reduction, Halie Blackerby

Doctor of Nursing Practice Projects

Background: Patient falls are a continuous issue in healthcare facilities because they increase patient length of stay and hospitals receive no reimbursement for these falls from insurance providers. Falls are a patient safety issue and can result in long-lasting damage for patients in the healthcare facility, including fear of ambulation. Falls in a facility can impact a facility’s ability to meet strategic planning goals and receive state and federal funding.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce inpatient falls during shift change by implementing an evidence-based bedside shift reporting (BSR) protocol.

Methods: Quantitative data …

Strengthening Medication Adherence In African Americans Diagnosed With Hypertension, Daphne James

Doctor of Nursing Practice Projects

Background: African Americans have a high rate of hypertension, which varies by region. Additionally, African Americans struggle to understand the risks of uncontrolled high blood pressure and the necessity of medication adherence in lowering strokes, heart attacks, and quality of life.

Purpose: The project aims to implement a patient education program to improve medication adherence and blood pressure control for African American patients in a primary care setting.

Methods: Twenty African Americans ages 18–65 with hypertension (130/80 mm Hg or above) and six months of nonadherence participated in this project. The pre-, mid-, and post-questionnaires assessed medication adherence and blood …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Improving Early Detection And Treatment Of Chlamydia By Implementing A Routine Chlamydia Screening And Testing In Females Between The Ages Of 18–24, Isabelle Vikumitsi

Doctor of Nursing Practice Projects

Background: Chlamydia Trachomatis is the most frequently reported bacterial sexually transmitted infection in the United States. One in 20 sexually active females between the ages of 15 and 24 have chlamydia. Most people with the infection are asymptomatic and do not seek treatment. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy, leading to higher medical costs.

Purpose: The project aimed to implement early screening for chlamydial infections in the young adult population to increase early detection of the disease.

Methods: A pre-post design was used for this project to compare chlamydia diagnosis rates …

Standardization Of Chlorhexidine Gluconate Bathing: A Quality Improvement Project In Central Line Bloodstream Infection Prevention, Faustina Muruako

Doctor of Nursing Practice Projects

Background: Central Line-Associated Bloodstream Infections (CLABSIs) are severe healthcare-related infections that can lead to sepsis, organ failure, and even death. Several healthcare agencies provide guidelines to prevent CLABSIs, with Chlorhexidine Gluconate Bathing (CHGB) as one of the preventive measures for individuals with central venous lines (CVL).

Purpose: The Doctor of Nursing Practice (DNP) project aims to standardize CHGB procedures for maintaining CVLs on a specific unit for CLABSI prevention through evidence-based practice.

Methods: A quality improvement project was implemented at a Central Alabama hospital to standardize CHGB procedures for CVL patients utilizing a CLABSI unit champion monitoring system to establish …

Ekg Is Key: A Quality Improvement Project To Decrease Door-To-Ekg Time In A Rural Emergency Department, Amanda Southwell

Doctor of Nursing Practice Projects

Background: Electrocardiograms (EKGs) are the priority when evaluating patients with chest pain who present to the Emergency Department (ED). The American Heart Association and other governing bodies suggest a 10-minute door-to-EKG (DTE) time. The target facility displayed a delay in DTE times.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to decrease the average DTE time for patients over 18 years old with chest pain who presented to the ED registration area.

Methods: The DNP project consisted of an EKG suite to perform EKGs near the ED registration/triage area. Registration and ED staff were educated on …

Increasing Lung Cancer Screenings In A Family Medicine Clinic, Ashley Williams

Doctor of Nursing Practice Projects

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Although lung cancer screening is an established guideline for intervention in primary care, eligible patients do not receive it. Patients at high risk of developing lung cancer are aged 50 to 80 and currently smoke or have quit smoking within the last 15 years. Obtaining an annual low-dose computed tomography for patients at high risk of developing lung cancer helps detect lung cancer earlier and, therefore, improves patient outcomes.

Purpose: The Doctor of Nursing (DNP) project aimed to increase lung cancer screenings in patients at high risk of developing …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

A Quality Improvement Project: Improving The Clinical Practice For Assessing Hemoglobin A1c On Admission In Diabetic Ketoacidosis Patients Admitted To The Intensive Care Unit, Tiara Lawson

Doctor of Nursing Practice Projects

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC …

Implementing The Fall Tips Tool To Reduce Falls In Older Adults, Ruth C. Santiago

Master's Projects and Capstones

Problem: In many organizations, falls and associated major injuries create a large barrier to maintaining patient safety. Patient falls impact quality of care and create financial difficulty for all parties involved. It is important that prevention measures are effective and individualized.

Context: A significant increase in falls and major injuries have been documented in unit F1 of Facility A in Northern California. Current strategies to prevent falls have not been successful in reducing fall rates over the past year.

Interventions: The intervention to decrease falls on this unit is the Fall Tailoring Interventions for Patient Safety (TIPS) tool. The tool …

Correlations Of Physical And Psychological Health In Parents Of Individuals With Autism Spectrum Disorder, Norah L. Johnson, Abir K. Bekhet, Emily Zint, June Wang, Sylvia Peña, Amy V. Van Hecke, Mauricio Garnier-Villarreal, Alexander V. Ng

College of Nursing Faculty Research and Publications

Background: Individuals with autism spectrum disorder (ASD) have social communication difficulties and restricted, repetitive, and/or sensory behaviors or interests. The prevalence of ASD is now 1 in 36 individuals. Parents of individuals with ASD face challenges that can affect their physical and psychological wellbeing.

Objective: With the long-term goal to tailor an exercise program, the purpose of this study was 2-fold: (1) establish the baseline physical and mental health of parents of individuals with ASD and (2) estimate the relationship of physiologic variables with psychological variables of health for parents of individuals with ASD.

Methods: This descriptive, cross-sectional study (N …

Contraceptive Use Among Women Experiencing Intimate Partner Violence And Reproductive Coercion: The Moderating Role Of Ptsd And Depression, Jessica L. Zemlak, Lea Marineau, Tiara C. Willie, Helena Addison, Gabrielle Edwards, Trace S. Kershaw, Kamila A. Alexander

College of Nursing Faculty Research and Publications

Women experiencing reproductive coercion (RC) report more unintended pregnancies and mental health symptoms that can influence contraceptive use patterns. We examined associations between RC and contraceptive use among intimate partner violence (IPV) exposed women aged 18–35 (N = 283). We tested depression, post-traumatic stress disorder (PTSD), and co-morbid depression and PTSD as effect modifiers. Though no association was found between RC and contraception, PTSD significantly modified this relationship. Among Black women (n = 112), those reporting RC and either PTSD or comorbid PTSD and depression were less likely to use partner-independent contraception compared to those reporting RC without …

No Difference In Surgical Outcomes Between Stand-Alone Devices And Anterior Plating For 1-2 Level Anterior Cervical Discectomy And Fusion: A 1:1 Exact Matched Analysis, Xu Tao, Abhijith V. Matur, Seth Street, Geet Shukla, Julia Garcia-Vargas, Jay P. Mehta, Kelly Childress, Henry Ofori Duah, Justin Gibson, Daryn Cass, Andrew Wu, Benjamin Motley, Joseph Cheng, Owoicho Adogwa

College of Nursing Faculty Research and Publications

Study Design. 

Retrospective cohort.

Objective. 

To compare rates of all-cause surgical and medical complications between zero-profile (ZP; stand-alone) implants versus any graft type with an anterior plate in patients undergoing 1-2 level anterior cervical discectomy and fusion (ACDF) for treatment of degenerative cervical myeloradiculopathy.

Summary of Background Data. 

Degenerative cervical myeloradiculopathy is increasingly prevalent in older adults. ACDF is a common surgical procedure for decompression of neural structures and stabilization and has been shown to have excellent outcomes. Although ACDFs performed with graft and plate have been the gold standard, more recently, ZP implants were developed to decrease implant-related complications, …

A Guide To Understanding Big Data For The Nurse Scientist: A Discursive Paper, Henry Ofori Duah, Samantha J. Boch, Sara Arter, Nichole Nidey, Joshua Lambert

College of Nursing Faculty Research and Publications

Big data refers to extremely large data generated at high volume, velocity, variety, and veracity. The nurse scientist is uniquely positioned to leverage big data to suggest novel hypotheses on patient care and the healthcare system. The purpose of this paper is to provide an introductory guide to understanding the use and capability of big data for nurse scientists. Herein, we discuss the practical, ethical, social, and educational implications of using big data in nursing research. Some practical challenges with the use of big data include data accessibility, data quality, missing data, variable data standards, fragmentation of health data, and …

Sex Workers’ Experiences Of Screening For Intimate Partner Violence, Jessica L. Zemlak, Kamila A. Alexander, Deborah Wilson, Randi B. Singer, Joni S. Williams, Susan G. Sherman

College of Nursing Faculty Research and Publications

Objective

To examine experiences of intimate partner violence (IPV) screening among women who sell sex.

Design

A qualitative descriptive study.

Setting

Telephone interviews during the COVID-19 pandemic (June 2020 to October 2020).

Participants

Women aged 18 to 49 years who sold or traded sex for food, drugs, money, or shelter at least three times during the past 3 months before recruitment (N = 22).

Methods

We used individual, semistructured telephone interviews to collect data about participants’ experiences with IPV and IPV screening during health care encounters. We used reflexive thematic analysis to examine these data.

Results

We identified two …

Sharps Injuries Among Healthcare Workers In Liberia And Ghana: A Cross-Sectional Survey, Laura Jean Ridge, John Arko-Mensah, Josh Lambert, Lydia Aziato, G. Clinton Zeantoe, Henry Ofori Duah, Marjorie Mccullagh

College of Nursing Faculty Research and Publications

There are little data on sharps injuries among healthcare workers in West Africa despite the region’s high rate of hepatitis B and human immunodeficiency virus. The purpose of this study is to investigate healthcare workers’ history of sharps injuries in Liberia and Ghana. An electronic cross-sectional survey was conducted among healthcare workers in Liberia and Ghana from February to June 2022. A link to the survey was texted to participants through professional association membership lists, including nursing, midwifery, and physician assistant organizations in both Liberia and Ghana and a physician organization in Ghana only. Five hundred and nine participants reported …

Communication, Electrodes, Appropriateness Setup, And Education (Cease) Bundle Implementation In The Surgical Intensive Care Unit, Tina J. Garcia Miller

All Doctor of Nursing Practice (DNP) Scholarly Projects

An estimated 85-99% of alarms in the intensive care unit (ICU) do not require nursing intervention. This overabundance of non-actionable alarms can contribute to sensory overload and is a significant factor in alarm-related safety events. The aim of this project was to reduce the prevalence of non-actionable alarms through the implementation of an evidence-based alarm management bundle. The CEASE Bundle, a comprehensive five-step protocol encompassing Communication, Electrodes, Appropriateness, Setup, and Education, was implemented in an 11-bed surgical intensive care unit. Continuous alarm data was collected for 12 weeks before and 12 weeks after the implementation of the bundle for comparative …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC compared …

Exploring The Impact Of Neonatal Transport On The Health Of Black Preterm Infants And Psychosocial Challenges Faced By Parents In Relation To Social Determinants Of Socioeconomic And Racial Inequities, Karen Faye Warren

Theses and Dissertations

Neonatal transport is a unique aspect of preterm birth. This descriptive, exploratory dissertation study used a multiple-case study design, and mixed methods approach to describe the trajectory of Black preterm outborn infants and their mothers from birth, through transport to a referral center through NICU hospitalization until discharge, for a detailed analysis of each case. The specific aims were 1) Describe each infant's transport trajectory, including baseline characteristics of the community hospital of birth (size, level of care, birthing resources), transport characteristics (mode, distance, personnel), and infant health from birth to arrival of regional referral neonatal intensive care unit; 2) …

Evidence-Based Strategies For Fall Prevention, Angelia Palmer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Patient falls represent the largest category of preventable adverse events in hospitals, with 700,000 to 1,000,000 falls occurring annually in U.S. hospitals and 30-35% resulting in injuries. The cost of fall-related injuries exceeds $50 billion globally, with an average of $14,056 per fall.

The aim of this project was to introduce a standardized fall prevention approach to improve performance and reduce falls in the medical-surgical department.

A comprehensive literature review indicates multifactorial bundled approaches, clinical pathways, purposeful rounding, and patient and family engagement as effective fall prevention strategies.

This quality improvement (QI) project design was based on the Plan, Do, …

Reducing Patient Falls In A Skilled Nursing Facility, Mariah De Los Santos

All Doctor of Nursing Practice (DNP) Scholarly Projects

Falls in skilled nursing facilities (SNFs) pose a significant safety risk, causing injuries, extended stays, and increased morbidity mortality. With a fall rate 6.08 per 1,000 patient bed days, exceeding the national benchmark of 5.3, this project aimed to reduce falls using an evidence-based prevention bundle in a facility lacking a comprehensive fall prevention program. A literature review indicated multifaceted fall prevention bundles reduce falls in SNFs. Key components include risk assessment tools, patient education, post-fall huddles, and purposeful hourly rounding. This quality improvement project used Deming's Model for Improvement and the OhioHealth Change Management Model. An interprofessional team of …

A School-Based Asthma Initiative To Improve Student Self-Management Behaviors, Jenni R. Newland

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a Midwest public school system, students received robust academic education. Health education programs, specifically asthma management, were not offered. Over 400 elementary students with asthma lacked the knowledge and skills to effectively recognize and manage their asthma symptoms resulting in increased school clinic visits and absences, highlighting the urgent need for targeted intervention.

Aim of the Project: The aim of this project was to improve students’ asthma self-management skills by providing education based on the Open Airways for Schools (OAS) curriculum. Improving asthma self-management skills reduces student absences and time away from the classroom.

Review of Evidence: A …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Sexual Quality Of Life In Sexual And Gender Minority Women After Cancer, Heather Schneider Miles

Theses and Dissertations

Sexual quality of life (SQoL) is a critical aspect of well-being, encompassing physical, emotional, and social dimensions. For sexual and gender minority women (SGMW)—lesbian, bisexual, transgender, or queer—cancer presents unique challenges. This dissertation examined the relationships between cancer treatment symptoms, social support, and communication with the cancer care team (CCT) on SQoL among SGMW survivors of breast, gynecological, and colorectal cancers. Quantitative data from 37 participants were collected using PROMIS® measures, assessing demographics, treatment history, post-treatment symptoms, perceived social support, and communication with the CCT. Additionally, in-depth interviews with five participants provided qualitative insights into their experiences and the meaning …

Sleep Quality And Quantity Assessment Among African American Survivors Of Lung Cancer With And Without Chronic Obstructive Pulmonary Disease (Copd), Amanda Rae Myhren Dyer

Theses and Dissertations

Introduction: Improving the quality of life of survivors of early-stage lung cancer (NSCLC, Stages I - IIIa) requires attention to persistent, burdensome symptoms, including sleep disturbances. While research exists regarding sleep quality, sleep quantity, and sleep disturbances in cancer survivors, minimal research targets this minority survivor population. The purpose of this study was to measure and assess sleep quality, sleep quantity, and sleep disturbances among African American survivors of lung cancer. Based on the Symptom Management Theory, our comprehensive assessment focuses on a racial minority group and multiple diagnostic groups (COPD vs. No COPD). Methods: This two-group, cross-sectional, descriptive study …

Parental View On Hpv Vaccination, Rebecca Elaine Rhodes

Electronic Theses and Dissertations

The human papillomavirus (HPV) is a sexually transmitted infection widely seen in the United States. Millions of Americans are affected by it each year, especially those in their late teens and early 20s. Although most infections will resolve on their own, 1 in 10 will lead to health problems such as cancer. The HPV vaccine can prevent over 90% of associated precancers and cancers. However, uptake of the HPV vaccine and its completion among adolescents are significantly lower than other recommended adolescent immunizations, falling short of the Healthy People 2030 goal of 80% coverage. Understanding parental attitudes, beliefs, and perceptions …

Implementation Of A Mobile-Based Mindfulness Intervention To Lower Perceived Stress Levels In Undergraduate Nursing Students, Wendy S. Carley

Electronic Theses and Dissertations

This project analyzed the effect of the daily use of a mindfulness-based mobile application on associate degree nursing undergraduate prelicensure students’ perceived stress levels. Nursing students experience elevated stress levels that may be reduced through mindfulness behaviors. Undergraduate, prelicensure nursing students participated in establishing the impact of mindfulness on perceived stress levels in a quantitative pre/postintervention study. The evidenced-based studies chosen for this review consisted of randomized controlled trials, pilot studies, pre/posttest designs, systematic reviews, and quantitative and qualitative studies. The investigator collected presearch data using a pre/posttest design to evaluate the effectiveness of a stress management program in reducing …

Using Implementation Science To Improve Short Peripheral Intravenous Catheter Outcomes, Mary Hook, Aimee A. Woda, Kelsey Bohr, Cailin Ford, Maharaj Singh

College of Nursing Faculty Research and Publications

Short peripheral intravenous catheters (short PIVCs) are commonly used in acute care, guided by evidence-based policy with interventions to limit premature failure. Research on how nurses use evidence and change processes to optimize outcomes is needed. The study objective was to use a theory-based implementation science approach to evaluate and improve short PIVC insertion and care processes and reduce removals for adverse outcomes in acute care. This mixed-methods study was conducted with inpatient nursing units (n = 23) at a large urban quaternary medical center. Units identified and implemented one PIVC care intervention that could lower catheter removals for adverse …