Occupational and Environmental Health Nursing Commons^™

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

A Planetary Health Approach To Address Food Insecurities In New Mexico, Mariah Kennell

Doctor of Nursing Practice Scholarly Projects

Food insecurity remains a persistent public health concern throughout New Mexico, impacting both rural and urban populations and contributing to significant health disparities. Limited access to affordable, locally sourced fresh foods exacerbates chronic disease burden and undermines community health. The purpose of this Doctor of Nursing Practice project was to conduct a comprehensive policy analysis to identify feasible state-level strategies to improve food access through strengthening local food systems. Using the Centers for Disease Control and Prevention POLARIS policy analysis framework, a structured evaluation of existing and potential state and community-level policies was conducted. The analysis incorporated stakeholder interviews with …

Ambient Air Pollution In New Mexico: Nurse Practitioner Awareness, Mckenzie Hemmes, Grayson Kemp

Doctor of Nursing Practice Scholarly Projects

Ambient air pollution is a significant public health concern in New Mexico and contributes to respiratory disease, cardiovascular illness, and adverse pregnancy outcomes (Dominski et al., 2021; Di et al., 2022). Despite well-established evidence linking environmental exposures to health outcomes, environmental exposure screening is not routinely incorporated into clinical practice. The purpose of this Doctor of Nursing Practice (DNP) project was to improve environmental health literacy (EHL) among advanced practice registered nurses (APRNs) in New Mexico and to increase their intention to integrate ambient air pollution exposure screening and mitigation counseling into routine clinical practice. A virtual educational intervention guided …

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

Efficacy And Safety Of Stem Cell-Based Interventions For Burn Wound Healing: A Systematic Review And Meta-Analysis Of Pre-Clinical And Early Clinical Evidence, Prayuth Poowaruttanawiwit, Patsanan Kulla, Naveeya Pakpoomkamonlert

The Thai Journal of Pharmaceutical Sciences

Background: Burn injuries remain a major therapeutic challenge, with conventional treatments often failing to achieve complete functional skin regeneration. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and exosome derivatives, have demonstrated regenerative and immunomodulatory potential, yet their translation to clinical practice remains limited.
Objectives: To systematically evaluate the efficacy and safety of stem cell-based therapies for burn wound healing across pre-clinical and clinical studies.
Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, four databases (PubMed, Embase, Scopus, and Cochrane) were searched through April 2025. Eligible studies included randomized controlled trials and controlled pre-clinical …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

The Impact Of Night Shift On New Nurses: Effects On Mental Health And Work-Life Balance, Avery Windham, Abby Maruskin, Elizabeth Yoder

Williams Honors College, Honors Research Projects

This research examines the impact of night shift schedules on new nurses' mental health and work-life balance as they transition into professional practice. The transition from nursing school to the workforce presents challenges that are further compounded by shift work, which can disrupt circadian rhythms and contribute to stress, fatigue, and reduced job satisfaction. The purpose of this research is to evaluate how starting on night shift versus day shift influences nurses’ self-evaluation of work-life balance within their first year of practice. This systematic review synthesizes findings from peer-reviewed sources to assess the physical, emotional, and professional consequences of night …

Evaluation Of A Nicotine Prevention Program In A Third Grade Classroom, Jennifer A. Pile

DNP Projects

Purpose: The purpose of this project was to increase knowledge of nicotine products and promote negative perceptions of nicotine use among third-grade students through early prevention education.

Background: Prevention is key and to prevent nicotine use, there must be an educational program with that aim in a much younger population. Third grade encompasses 8-, 9-, and 10-year-olds. This group is in the middle childhood stage and begin more complex thinking and problem-solving skills. There is physical and emotional development among this group.

Methods: This is a quasi-experimental study among third grade students in Breckinridge County Kentucky with pretest and …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Patient Perception Of Nurse Practitioner Care, Nurse Practitioner Scope Of Practice And How That Influences Provider Choice, Naomi Hemp

Doctoral Projects

This project investigates patients' perceptions of nurse practitioner (NP) care versus physician (MD) care, the factors influencing these perceptions, and patients' understanding of NP scope of practice. A cross-sectional design was used, gathering quantitative data through an anonymous one-time survey distributed via Qualtrics, open for three months. Questions were based on The Watson Caritas Patient Score (WCPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). Data were analyzed using Intellectus Statistics software™, with descriptive statistics summarizing the findings. A two-tailed paired samples t-test revealed statistically significant differences in favor of patients' perceptions of NP care versus …

Environmental Concerns Of Women In Appalachia, Kristen Montgomery, Adebayo Adeeko, Jessica Binns, Sarah Hall, Paula Hawkins, Allyson Newer, Michaela Outlaw, Karenna Turley

Epsilon Sigma at-Large Research Conference

Purpose: Environmental contamination is rampant in the United States and other parts of the world. There are potential health implications related to environmental contamination.
/="/">/="/">
/="/">/="/">

Aims: The purpose of this study was to investigate how concerned women in Appalachia are regarding the environment. The following research question was addressed: What concerns do women have regarding the environment? The objective of this study was to understand how women perceive their environment and to evaluate what concerns they have regarding the environment. We also evaluated demographic factors to see if any demographics contributed to particular concerns related …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Reducing Appointment No-Shows In An Occupational Medicine Clinic: A Quality Improvement Project, Diana S. Torres, Cynthia D. Linkes

Nursing Faculty Publications

Abstract

Background: Appointment no-shows in occupational medicine delay recovery, disrupt workers’ compensation processes, and undermine employer trust. A South Texas clinic reported an average 11% no-show rate over 16 months—above the ≤8% benchmark—resulting in an estimated $379,406 in lost revenue. Contributing factors included inconsistent reminder practices, unverified contact information, and language barriers within a predominantly Spanish-speaking population.

Objective/Project Aim: This project aimed to reduce no-shows to ≤8% by implementing a structured, bilingual, multimodal reminder system that improved patient adherence and operational efficiency without increasing staff workload.

Methods: Guided by the “Getting To Outcomes” 10-Step framework, interventions included …

Munchausen Syndrome By Proxy Presentation, Giovanna Tomassoni, Meredith Mackenzie

Master's Projects

Munchausen syndrome by proxy (MSBP) is a serious form of child abuse in which the perpetrator is typically the victim’s maternal caregiver. Assessing for MSBP can be very challenging for medical providers due to symptom mimicry and a dearth of information about the disorder. This Integrative Review seeks to shine a light on common symptomatology of MSBP and to make sure that providers leave it on the differential diagnosis until alternative diagnoses can effectively exclude it. A total of 240 records from online databases were reviewing for content, currency, and rigor. This search was narrowed to 10 records for in-depth …

Evaluation Of A Smoking Cessation Program In Primary Care, Yolanda Duncan-Watt

Dissertations

Abstract

Problem: The adult tobacco smoking rate exceeds 12.5%. The problem is the insufficient attention given to smoking cessation education in low socioeconomic status(SES) communities. There is a lack of access to and awareness of smoking cessation programs for low-income populations.

Methods: This quality improvement (QI) study will use a descriptive, observational approach. A retrospective medical record review will be conducted to determine the rate of individuals who got the smoking cessation intervention and the rate of those who successfully quit one month after the intervention. Data was collected throughout the spring of 2024, during primary care visits and phone …

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 …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Cultural Education Interventions Impact On Cultural Competence, Kaylie V. Griffin Ms

ONU Student Research Colloquium

Problem: In the United States, there is a substantial increase in diversity. This increase in diversity poses multiple challenges for healthcare workers and healthcare systems. Because nurses care for patients with various cultural backgrounds, health beliefs and practices, and languages, cultural competency plays a pivotal role in providing patient-centered care. There is a need to enhance cultural education for healthcare workers to ensure that healthcare workers have the skills and knowledge to effectively engage with all patient populations. Implementing cultural education interventions seeks to increase healthcare workers' competency, communication, and patient outcomes. Purpose: The purpose of this research question is …

The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson

The Eleanor Mann School of Nursing DNP Capstone Projects

Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.

Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.

Results: In a comparison …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Using The 4ms Framework To Prevent Falls, Gina L. Edgeworth

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Hospital falls are rising in inpatient facilities, requiring analysis and a plan of action to address the ongoing falls. A strategy taken among facilities is implementing a 4Ms Framework that allows the nurse to address what matters to the patient and assess their mentation, medications, and mobility upon admission. With an increase in falls on a med-surg unit, it was found that there was no straightforward process for addressing the needs and concerns of patients and no assessment of medications, mobility, or mentation for those aged 65 years and older. This knowledge gap prevents nurses from providing a structured framework …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Guide And Algorithm Creation For Hepatitis B Vaccination And Tuberculosis Testing Requirements For A Nursing Program., Jumoke Owolabi

Doctor of Nursing Practice Papers

This project developed a guide and algorithm for hepatitis B vaccination and tuberculosis (TB) testing requirements for nursing students at the University of Louisville [UofL] School of Nursing [SON] before clinical placement. Clarifying the requirements for hepatitis B vaccination, testing, and tuberculosis testing was paramount for clinical compliance because the current policy was determined to be ambiguous. The literature review revealed discrepancies with policies for hepatitis B and TB among countries and with individual institutions confirming the need for aligning with evidence-based vaccination guidelines. Based on these findings, an evidence-based guide and algorithm were created. Feedback from the clinical compliance …

Understanding The Experiences Lived By Nurses Caring For Patients With Covid-19: A Hermeneutic Approach, Awatif Mansoor Alrasheeday, Ma. Venus Borja, Eddieson Pasay-An, Farhan Alshammari

Makara Journal of Health Research

Background: Nursing is highlighted among professions that value caring and is perceived as the profession’s heart and soul because of its critical role in providing and delivering high-quality patient care, especially during this coronavirus disease 2019 (COVID-19) pandemic. However, little is understood about the experiences of the frontline workers in caring for persons diagnosed with COVID-19. This study aimed to explore the experiences of nurses in caring for persons diagnosed with COVID-19 inspired by the four lived worlds of van Manen.

Methods: The hermeneutic phenomenology was used in nine nurses working in hospitals of Hail region. This study …