Nursing Commons^™

Mapping The Evidence On The Maternal–Fetal Triage Index (Mfti): A Scoping Review, Taylor Harris, Kelsey Downie, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Maternal morbidity and mortality remain persistent challenges in the United States, with obstetric triage serving as a critical point of entry for timely recognition and management of high-acuity maternal-fetal conditions. Despite recommendations for acuity-based triage models, many obstetric units continue to rely on non-specific emergency triage tools, such as the Emergency Severity Index (ESI), which inadequately account for pregnancy-specific physiological changes and fetal status. To address these limitations, the Association of Women’s Health, Obstetric and Neonatal Nurses developed the Maternal-Fetal Triage Index (MFTI), a five-level obstetric-specific triage tool. Although the MFTI has been increasingly adopted in clinical practice, the …

Staff Education To Integrate Evidence-Based Practice Of Music Therapy As An Adjunct To Cognitive Behavioral Therapy For Anxiety And The Use Of Anxiety Screening Tool In An Outpatient Clinic, Virginia Bahena

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is essential for improving quality, safety, and outcomes in healthcare; however, gaps in staff knowledge and readiness continue to limit consistent implementation in outpatient settings. This Doctor of Nursing Practice project was a practice-focused quality improvement initiative designed to evaluate the impact of a targeted staff education intervention on EBP knowledge and readiness. The practice-focused question guiding the project was: Does a targeted staff education intervention improve knowledge and readiness to integrate brief music therapy as an adjunct to cognitive behavioral therapy (CBT) and appropriately utilize the Generalized Anxiety Disorder-7 (GAD-7) screening tool in an outpatient setting? …

Staff Education To Improve Knowledge On Discharge Planning And Transitions Of Care For Chronically Ill Patients, Cynthia Adebisi Kadiri

Walden Dissertations and Doctoral Studies

Patients with chronic conditions have the tendency to return to the hospital. Staff education to address high-rate re-hospitalization among patients with chronic conditions is the focus of my Doctor of Nursing Practice project. This is a significant practice problem, since patient outcomes and increased healthcare costs is compromised. Regarding re-hospitalization prevention and ultimate aid in reducing readmissions among people with chronic conditions, the project was used to enhance the knowledge of the nursing staff and competence in transitions of care and discharge planning. The project included 10 nurses who are regularly involved in discharging patients in the medical outpatient clinic. …

Using Chatgpt Ai To Analyze Clinical Judgment In Immersive Virtual Reality Simulation From Prelicensure Nursing Students, Shari Ann Fehrenbach

Dissertations (1934 -)

This retrospective, descriptive study examined how clinical judgment was demonstrated across two immersive virtual reality simulation (IVRS) experiences in a cohort of Direct Entry Master of Science in Nursing (DEMSN) students using a generative large language model artificial intelligence, ChatGPT, for categorization of clinical judgment cognitive processes. The National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM) guided the study (NCSBN, 2022). Nurse expert-derived CJMM-aligned scoring rubrics were applied to deidentified, developer-generated IVRS performance reports, and ChatGPT categorized whether rubric actions were demonstrated and generated case-level, scored excel files. Total CJMM and cognitive component scores were …

Quality Improvement Project: Improving The Clinical Teaching Experience Through Clinical Adjunct Orientation, Elissa Saunders

Doctor of Nursing Practice Projects

Clinical adjunct nursing faculty often transition into academic roles without formal preparation, leading to role insecurity and high turnover rates that negatively impact student clinical experiences. The purpose of this quality improvement (QI) project was to implement a structured orientation checklist to improve perceived clinical teaching competency among novice clinical adjunct faculty. The project aimed to standardize onboarding and support the transition from clinical practice to academia. A quantitative pre-post intervention design was used with a convenience sample of clinical adjunct faculty employed for less than one year at a rural university nursing program. The project was guided by Kotter’s …

Enhancing Provider Self-Efficacy And Documentation In Hypertension Management, Stephanie Nsiah

Doctor of Nursing Practice Projects

Primary care providers often experience inconsistent confidence and incomplete documentation when managing hypertension, contributing to suboptimal blood pressure control. This quality improvement project addressed the need for structured provider education at an outpatient family clinic. The purpose was to evaluate the impact of a structured educational intervention on provider self-efficacy and documentation completeness. Using a quasi-experimental pre-post design guided by the Plan-Do-Study-Act model and Lewin's Change Theory, a 60-minute educational session was delivered to 12 licensed providers. Participants completed pre- and post-intervention self-efficacy surveys using the Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM) and Feasibility of Intervention …

Strengthening Evaluation For Student Success, Hollan Scrivner

Doctor of Nursing Practice Projects

Student evaluation is an important factor in guiding students to develop self-confidence and gain competency in nursing skills. For evaluation to be effective, it must be consistent. The purpose of this quality improvement project is to implement a training program to improve consistency and interrater reliability among faculty conducting skill evaluations. The impact of the training program will be measured by a pre- and post-grading exercise using a skills rubric. Data will be extracted from the rubrics and entered into a codebook for data analysis. The project was guided by the theoretical framework of Stephens’ Star Model of Knowledge Transformation …

Implementation Of A Process For Tracking Hgb A1cs In A Community Mental Health Organization, Devin Gill

Doctoral Dissertations & Projects

Background: Individuals with a serious mental illness (SMI) are 2 to 3 times more likely to develop type 2 diabetes, yet are less likely to receive routine screening of hemoglobin A1c (HbA1c) testing. The purpose of this quality improvement project is to implement a standardized workflow process to ensure consistent tracking of HbA1cs in adult consumers greater than 18 years of age with SMI receiving services at a rural community mental health (CMH) organization.

Methods: The primary intervention is a workflow process, with focus on the clinical information systems and organizational system. This quality improvement project was guided utilizing the …

Quality Improvement Project Enhancing Maternal Health Outcomes: Evaluating The Impact Of Universal Social Determinants Of Health (Sdoh) Screening In An Interdisciplinary Pregnancy Care Model, Shannon Morgen

Doctor of Nursing Practice Projects

Social determinants of health (SDOH), including housing instability, food insecurity, transportation barriers, and interpersonal violence, significantly influence maternal outcomes and contribute to disparities such as preterm birth and maternal morbidity. Despite national recommendations for universal SDOH screening, implementation in prenatal care remains inconsistent, limiting opportunities to identify and address social needs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a standardized SDOH screening and documentation process to improve referral completion and examine its impact on hospital readmissions among obstetric patients. Guided by Bronfenbrenner’s Socio-Ecological Model and the Plan-Do-Study-Act framework, the project …

Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

Quality Improvement Project: The Impact Of The Clinical Judgment Measurement Model In Nursing Faculty, Lamia Zeidan

Doctor of Nursing Practice Projects

Clinical judgment is essential for nursing practice and can be taught using the Clinical Judgment Measurement Model (CJMM). A needs assessment conducted at the project site revealed that students had limited clinical judgment skills, there was no emphasis on clinical judgment in nursing skills courses, and the faculty had a limited understanding of the CJMM. In response to the findings of the needs assessment, the quality improvement (QI) project was developed using a quasi-experimental design. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Educator theoretical framework, the project aimed to provide faculty with education on the CJMM and …

Optimizing Central Line Discontinuation In The Surgical Intensive Care Unit: A Quality Improvement Initiative Using A Visual Aid To Reduce The Risk Of Central Line-Associated Bloodstream Infections, John Quyen D. Van

Doctor of Nursing Practice Final Project Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline …

Impact Of Provider Self-Efficacy On Caring For Patients With Prediabetes, David R. Knight

Doctor of Nursing Practice Projects

Prediabetes affects millions of adults in the United States, yet inconsistent provider knowledge and confidence limit evidence-based screening and management in primary care, a gap well-documented in the literature. The purpose of this quality improvement project was to evaluate whether a structured educational intervention improved provider self-efficacy related to prediabetes identification and management. Guided by Social Cognitive Theory and the Transtheoretical Model, with implementation guided by the Plan-Do-Study-Act cycle, this project asked: among family practice providers, how does prediabetes education affect provider self-efficacy over four weeks? A quasi-experimental pre/post design was used. Four asynchronous educational modules focused on evidence-based screening, …

Quality Improvement Project: The Critical Role Of Provider Knowledge In The Golden Hour, Kimberly Mcglothan

Doctor of Nursing Practice Projects

Maternal and infant mortality rates in the Southern United States remain disproportionately high, and inconsistent implementation of the Golden Hour, defined as uninterrupted skin to skin contact for at least the first hour after birth, continues to limit its evidence based maternal and neonatal benefits. The aim of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of a structured provider education intervention on Golden Hour compliance and provider confidence. Guided by Benner’s Novice to Expert Theory and implemented using Kotter’s 8-Step Change Model, a quantitative, quasi experimental pre-post design was used. The project was …

Quality Improvement Project: Faculty Preparedness For Recognition, De Escalation, And Reporting Of Violence In Clinical Education Settings, Dawn "Deedee" D. Moline

Doctor of Nursing Practice Projects

Violence and aggression in healthcare settings present ongoing safety concerns for nursing faculty supervising students during clinical education, particularly when teaching occurs in hospital environments where faculty are not employed. Faculty often rotate across multiple clinical sites and may lack consistent preparation or access to standardized safety education and reporting systems. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effect of a targeted educational intervention on nursing faculty perceived preparedness to recognize, de escalate, and report aggression encountered during clinical instruction. Guided by Bandura’s Social Cognitive Theory and Lewin’s Three Stage Change Model, …

An Educational Intervention To Increase Nurses’ Knowledge And Confidence Of Patient Mobility, Debbie Ann Pytak

Walden Dissertations and Doctoral Studies

Immobility is a significant concern given that nearly half of all hospitalized adults are immobile during their hospitalization, placing them at increased risk for adverse outcomes. As a result, it is critical for nurses to implement strategies that promote safe, structured patient mobility. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an educational intervention focused on patient mobility and standardized mobility tool utilization increased knowledge and confidence among nursing staff in an acute care setting. Ten participants volunteered to attend the educational intervention. The average age of the participants was 44.30 years (SD …

Enhancing Post‑Discharge Outcomes: A Quality Improvement Project To Reduce 30‑Day Readmission Rates For Patients With Schizoaffective Disorder, Samson Laryea Norteye

Walden Dissertations and Doctoral Studies

This DNP quality improvement project aimed to reduce 30-day readmission rates for patients with schizoaffective disorder (SAD) by enhancing discharge planning interventions. Using pre- and post-intervention methods, the project compared readmission rates before and after implementing interventions and gathered feedback from patients and staff to identify barriers and facilitators. The intervention bundle included patient education, participation in psychotherapy or support groups, medication reconciliation, and the use of long-acting injectables (LAIs) during hospitalization and prior to discharge. Evaluation of postintervention data revealed that none of the 10 patients in the intervention group were readmitted within 30 days, indicating a significant reduction …

Dnp Final Report: Can Implementing A Mindfulness-Based Program Help Reduce Stress In Nursing Students?, Shelby Devreeze Msn, Rn, Cpn, Cne-Cl

DNP Final Reports

Stress among nursing students is a well-documented problem that contributes to physical, mental, and emotional issues, substance abuse, and program dropout. A mindfulness-based stress reduction program was implemented with nursing students to evaluate its impact on perceived stress levels over a five-week period. A review of evidence-based articles provides strong evidence that this intervention correlates with reduced reported stress. An MBSRP was implemented with nursing students who completed a Perceived Stress Scale 10 (PSS-10) before the intervention and again after five weeks.

Results from this project showed a statistically significant reduction (t=2.725, p=0.025) in stress among the nursing student population …

Moving From Pico To Ppco, Amy Six-Means

PPCO Resources & Education

No abstract provided.

Dementia De-Escalation Staff Education Program, Gretchan Edwards

Walden Dissertations and Doctoral Studies

Behavioral and psychological symptoms of dementia (BPSD), including agitation and aggression, present significant challenges in acute care settings and contribute to increased staff injury risk and inconsistent patient care. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of a structured dementia de-escalation education program on staff knowledge, confidence, and perceived ability to manage dementia-related behaviors. The guiding PICOT question asked: In acute care staff, how does participation in a structured de-escalation training program that incorporates environmental modifications and organizational support, compared with no formal de-escalation training, affect staff knowledge, confidence, and perceived impact …

Assessment Of Undergraduate And New Graduate Nursing Confidence In Caring For Actively Dying Patients, Alyssa Boersma

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Undergraduate nursing students and new graduate nurses frequently report feeling underprepared and uncomfortable when caring for actively dying patients. The purpose of this study was to identify potential gaps in the current curriculum and assess what improvements were needed to better prepare students. Dorothea Orem’s Self-Care Deficit Theory highlights the importance of providing holistic and self care needs when patients are not able to do it themselves. A cross-sectional, quality improvement design was utilized. A 17 item Likert-scale survey was administered to investigate the level of confidence that participants have when caring for actively dying patients. Senior level nursing students …

Servant Leadership In Undergraduate Nursing Students: A Concept Analysis, Ellie Bonanni

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Leadership is necessary in the nursing profession and can be cultivated within undergraduate nursing programs. Servant leadership shows great promise as an appropriate leadership model for nurses. The purpose of this study was to complete a concept analysis of servant leadership (SL) and apply it in cases of undergraduate nursing students. The theoretical framework was Greenleaf’s Servant Leadership Model. This study was completed using Walker and Avant’s model of concept analysis, which clarifies the defining attributes, defining characteristics, antecedents, and consequences of a concept. A literature review was performed using CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature) …

Human Interactions With Artificial Intelligence: A Pilot Study, Kjersten Heinlein

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Emerging research shows that college students increasingly use artificial intelligence (AI) tools in academic and personal contexts; however, little is known about how factors such as computer literacy and digital comfort influence their communication with AI. This pilot study seeks to establish a protocol to investigate the influence that undergraduate students’ digital comfort and computer literacy has on the style, tone, and effectiveness of interactions with AI during socially-oriented tasks. Grounded in Margaret Newman’s Theory of Health as Expanding Consciousness, this work views students’ digital comfort and literacy as evolving factors that expand their awareness and enable more effective interactions …

Human Interactions With Artificial Intelligence: A Pilot Study, Miracle Yunana, Kjersten Heinlein

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

As artificial intelligence (AI) becomes increasingly integrated into daily life, understanding AI’s impact on human communication is essential for nursing education where both effective socialization and digital literacy are key components of professional development. This pilot study seeks to establish a protocol to explore the relationship between undergraduate students’ socialization and their communication styles when interacting with AI tools. Peplau’s Interpersonal Relations Theory serves as the foundation for this study, emphasizing the importance of social connectedness and communication, highlighting how interpersonal dynamics may extend to AI-mediated interactions. A mixed methods pilot study was conducted, consisting of structured sessions with seven …

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

Nitrous Oxide Use In Labor, Aimee Aberson, Janae Cam, Rylie Franken, Rachel Henriksen, Ben Robinson, Pam Hulstein

Celebration of Research

Effective pain management during labor is a critical part of maternal care. It influences the mother’s physical and emotional experiences of childbirth. Epidural anesthesia and intravenous opioids are commonly used as analgesia in laboring mothers, but nitrous oxide (N₂O) has proven to be a safe, noninvasive alternative. It allows mothers to maintain mobility and consciousness while still reducing some pain perception. The purpose of this evidence-based practice project is to evaluate the effectiveness, safety, and satisfaction associated with N₂O use during active maternal labor. It reviews current literature on N₂O use during labor, focusing on maternal and neonatal safety, effectiveness …

Role Of Dental Screening In Preventing Hip Prosthetic Joint Infections, Aidan Anderson, Cailee Dix, Emma Franken, Erin Keizer, Zavyr Metzger, Tyra Snyder, Pam Hulstein

Celebration of Research

Hip arthroplasty is a common procedure, but Periprosthetic joint infection (PJI) remains a serious postoperative complication associated with increased hospital stays, readmissions, and costs. Evidence suggests that poor oral health may contribute to PJIs through the spread of bacteria from the mouth to the surgical site. This project examined the relationship between preoperative dental health and postoperative outcomes in adults aged 50–90 undergoing hip replacement. A literature review using the Johns Hopkins Research Evidence Appraisal Tool evaluated 19 studies from databases such as PubMed and ScienceDirect. While no clear association was found between specific dental risk factors and PJIs, untreated …

Inpatient Treatment Compared To Outpatient Treatment For Borderline Personality Disorder, Paige Auch, Jaylin Gaston, Jori Harskamp, Ella Peterson, Kenzie Vonrentzell, Pam Hulstein

Celebration of Research

Borderline personality disorder (BPD) is a complex mental illness characterized by emotional instability, impulsivity, and unstable relationships. Individuals with BPD often require frequent hospitalizations and experience significant functional impairment. With increasing BPD admissions, Spencer Hospital seeks evidence-based strategies to improve patient outcomes and reduce readmissions. A literature review of ten studies (2016-2025) was conducted using PubMed, CINAHL, and Science Direct, appraised with the Johns Hopkins Nursing Evidence-Based Practice Model to compare inpatient and outpatient treatments for adults with BPD, focusing on symptom manage and quality of life. Findings indicate inpatient care with specific programs such as dialectical behavior therapy (DBT), …

Gut Health Interventions On Major Depressive Disorder, Hannah Beckloff, Ellie Erickson, Olga Furmanova, Hailey Van Dyken, Ashtyn Wobig

Celebration of Research

This evidence-based project aims to evaluate the potential benefits of probiotics, stress management, and a healthy diet for adults diagnosed with major depressive disorder at Promise Community Health Center. Through a comprehensive review of the literature, the project examines how interventions related to gut health can help alleviate depressive symptoms and implements the necessary tools to support this population at Promise. Our research findings suggest that combining probiotics, stress relief, and diet changes, along with adjunctive treatment for major depressive disorder, may reduce depressive symptoms and encourage a more holistic lifestyle for these individuals.

Understanding How Nurses Could Utilize Child Life Specialists, Paige Perkins

Honors Projects

Do pediatric nurses notice improvement in patient education levels when they use the resources of Child Life Specialists, understand their role, and utilize their resources to educate their patients, compared to hospitals without Child Life Specialists?