Other Nursing Commons^™

The Prevention Of Mouth Sores In Breast Cancer Patients Receiving Doxorubicin Using Oral Cryotherapy, Imani Wright

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of the evidence-based project is to implement and evaluate oral cryotherapy to reduce and prevent incidence and severity of chemotherapy-induced mucositis in breast cancer patients receiving Doxorubicin at a large cancer hospital in Southeast Texas.

BACKGROUND

Chemotherapy-induced oral mucositis is a common and painful complication among breast cancer patients receiving Doxorubicin leading to difficulty eating, treatment delays and a decrease in patient satisfaction and adherence to treatment regimen. Despite strong evidence supporting oral cryotherapy, its use is seldomly used in many oncology settings.

METHODOLOGY

A pre- and post- intervention quality improvement design guided by the Plan-Do-Study-Act (PDSA) …

Improving Response To Patient Alarms And Reducing Alarm Fatigue By Implementing An Alarm Fatigue Bundle Protocol In An Intermediate Care Unit At A Small Public Hospital, Christina Galvan

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to reduce alarm fatigue by implementing an alarm fatigue bundle protocol in an Intermediate Medical Unit (IMU) at a mall public hospital in Houston, Texas. The project aimed to achieve 80% compliance with daily electrode changes, improve alarm response times by 10%, reduce telemetry technician calls by 15%, and reduce alarm fatigue levels by 20%.

Background: Frequent non-actionable alarms can lead to desensitization, delayed responses, and missed alarms.

Methodology: The Plan-Do-Study-Act (PDSA) Model guided implementation of the CEASE bundle, focusing on staff education and daily electrode changes. Daily audits assessed skin preparation and …

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

Enhancing Heart Failure Transitional Care To Reduce 30-Day Readmission Rate, Thuy Nhu Uyen Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project is to reduce 30-day readmissions for adult patients with heart failure (HF) by implementing a standardized HF pathway beginning in the intensive care unit (ICU) and continuing through discharge.

Background: The project was implemented within a large healthcare organization in Northwest Houston, Texas.

Methodology: This project utilized a pre- and post-implementation design guided by the Plan-Do-Study-Act (PDSA) model. Eligible adult patients (≥18 years) with a primary or secondary HF diagnosis were identified during March 2026. The My Pathway to Wellness HF education pathway was initiated at the time of ICU downgrade …

Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

Dnp Final Report: Enhancing Self-Regulated Learning And Metacognition For First-Semester Undergraduate Nursing Students, Carla S. Biondillo

DNP Final Reports

Background. First-year undergraduate nursing students often struggle to adapt their learning strategies to the higher-order thinking and clinical reasoning demands of nursing education. Ineffective study habits, low academic self-efficacy, and limited self-regulated learning (SRL) skills are consistently identified as predictors of attrition, which ranges from 20–50% nationally and internationally.

Purpose. At an academic medical center in rural East Texas, first-semester students report academic overwhelm and inadequate study strategies, consistent with national trends. A structured, evidence-based faculty coaching intervention targeting SRL and metacognition was found to be feasible within the collaborative, student-centered organizational culture.

Methods. A quality improvement (QI) design …

Dnp Final Report: Community-Based Advance Care Planning Education For Older Adults: A Quality Improvement Project, Teresa Hill

DNP Final Reports

Background: Advance care planning (ACP) supports patient autonomy and promotes care aligned with individual values and preferences. Despite these benefits, fewer than half of adults aged 50–80 have completed formal ACP documentation, and community-dwelling older adults rarely engage in ACP before serious illness, representing a persistent gap in early engagement.

Purpose: This quality improvement (QI) project evaluated the effectiveness of a community-based ACP educational intervention in improving ACP knowledge, confidence, and engagement among older adults.

Methods: A nurse facilitator trained in the Five Wishes framework delivered a structured, 60-minute ACP workshop at a senior center in North Texas. A pre–post …

Nurses’ Knowledge And Practices Regarding Infection Prevention Measures In Cardiac Intensive Care Unit, Marwa G. Abouheiba, Maha Adel Salem, Jean Bertin Mudenge

Nursing

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices …

Implementing A Professional Wellness Session To Foster Improvement In Oncology Nurse Retention And Well-Being, Connie Tran

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement chaplain-led professional wellness sessions to improve the well-being of nurses on an oncology pilot unit.  Aims were to increase nurse retention by 5%, decrease staff absenteeism by 3%, and improve Perceived Stress Scale (PSS) scores by 10%, and Professional Quality of Life (ProQOL) scores by 10% from baseline.

Background

The emotionally taxing nature of oncology patient care creates a high-pressure environment, which can lead to turnover. Literature has shown that allowing staff to pray, debrief and engage in peer support groups to discuss work-related stressful encounters reduces stress …

Improving Physiologic Monitoring Adherence During Behavioral Emergencty Sedation In A Prehospital Ems System, Jared Aucoin

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:

This quality improvement (QI) project evaluated whether provider education and standardized documentation improved adherence to evidence-based physiologic monitoring during behavioral emergency sedation in a prehospital EMS setting.

Background:

Behavioral emergencies are common and often require rapid chemical sedation, with risks of hypoxia, hypercapnia, and cardiovascular instability. At baseline, inconsistent adherence to recommended monitoring and documentation of end-tidal carbon dioxide (EtCO₂) and pulse oximetry (SpO₂) presented an opportunity to improve patient safety.

Methodology:

This QI project educated current adult behavioral emergency protocol in a prehospital EMS setting, re-emphasizing standardized documentation and evidence-based monitoring practices. Utilizing Plan-Do-Study-Act (PDSA) through pre- …

The Effects Of Sugammadex Vs. Neostigmine On Intraoperative Heart Rate In Pediatric Patients Under Two Years: A Scoping Review, Saumel Abston, Jackson Cobb, Elle Dean, Tanner Dillard, Pauline Dinh, Dwayne Accardo Dnp, Crna, Faana, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Neuromuscular blockade (NMB) reversal is a critical component of anesthesia care, particularly in infants under two years of age who have immature autonomic regulation and heightened vagal tone, predisposing them to bradycardia. Neostigmine, the traditional reversal agent, is associated with parasympathomimetic effects such as bradycardia, requiring anticholinergic co- administration. Sugammadex, a selective relaxant binding agent, offers rapid and predictable reversal of aminosteroidal neuromuscular blocking agents with less cholinergic side effects. Although the safety profile of sugammadex is well established in older pediatric populations, limited evidence exists regarding its cardiovascular effects in infants under two years of age.

Methods

A …

The Impact Of Structured Family Meetings In The Intensive Care Unit, Loyce T. Mofor

Doctor of Nursing Practice Final Project Abstract

The Impact of Structured Family Meetings in the Intensive Care Unit (ICU)

Purpose

Train providers at an academic institution in a large metropolitan area to conduct family meetings using a structured approach and evaluate this intervention's impact on family satisfaction with communication in the ICU.

Background

Inadequate communication between families and healthcare teams leads to lower family satisfaction, heightened feelings of guilt, and diminished capacity for making clinical decisions.

Methodology

VitalTalk training was utilized to improve providers’ communication skills. Structured family meetings were conducted for Surgical and Thoracic ICU patients with an ICU length of stay of > 5 days or …

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 …

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 …

Improving Quality Of Bowel Preparation Through Digital Innovation In The Gastroenterology Clinic, Arlena S. Grays

Doctor of Nursing Practice Final Project Abstract

Improving Quality of Bowel Preparation Through Digital Innovation in the Gastroenterology Clinic

Purpose

This quality improvement project (QIP) aimed to enhanced bowel preparation quality by supplementing traditional verbal and written instructions with digital guidance using quick response (QR) code access and artificial intelligence (AI).

Background

The project was implemented at an outpatient gastroenterology practice within a medical center, which encompasses an outpatient endoscopy center in Houston, Texas.

Methodology

The project utilized the Boston Bowel Preparation Scale (BBPS) to evaluate the impact of the intervention on bowel preparation scores. The study used a 5-point Likert questionnaire to assess perceived ease of …

Improving Inr Monitoring In Outpatient Cardiology: A Quality Improvement Initiative To Enhance Anticoagulation Safety, Antonette Atori

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to reduce uncaptured INR results by 5% over 12 weeks in an outpatient cardiovascular clinic by implementing a standardized tracking workflow.

Background

Suboptimal anticoagulation management in outpatient settings can lead to uncaptured International Normalized Ratio (INR) results, delayed therapy adjustments, and increased risk of bleeding or thromboembolic events.

Methodology

Guided by the Plan-Do-Study-Act (PDSA) framework, a pre–post intervention design was used. Interventions included an electronic medical record (EMR)-based tracking system using a reminders inbox for overdue results and nurse-led follow-up phone calls. Data was collected from the EMR and analyzed using descriptive statistics, …

Dnp Final Report: An Evidence-Based Project To Decrease Stress In Undergraduate Nursing Students, Elaine Wallace

DNP Final Reports

Stress among undergraduate nursing students is a well-documented concern that negatively affects academic performance, clinical readiness, well-being, and program retention. Stress levels are often heightened before clinical skills check-offs, highlighting the need for practical, evidence-based interventions. This Doctor of Nursing Practice quality improvement project examined whether mindfulness-based mandala coloring could reduce perceived stress in undergraduate nursing students. Using the PICOT framework, the project evaluated whether undergraduate nursing students (P) who participated in mindfulness-based mandala coloring (I), compared with no intervention (C), experienced reduced perceived stress levels (O) over a 12-week implementation period (T).

A comprehensive search of the literature supported …

Free Money And Safer Patients, Kaitlyn R. Livingston, Kennedy G. Crites, Jazmine Razo, Erin Radigan, Kennedy Crites

SPARK Symposium Presentations

This quality improvement project aims to improve consistency of nurse compliance with daily chlorhexidine gluconate (CHG) bathing in a local oncology unit to reduce the risk of central line-associated bloodstream infections (CLABSI’s). CLABSI’s remain a preventable source of patient morbidity, prolonged hospitalization, delayed cancer treatment, and increased healthcare costs, particularly among immunocompromised oncology patients who frequently require central venous access. Evidence supports daily CHG bathing as an effective infection prevention intervention; however, inconsistent completion and documentation across day and night shifts limit reliability in practice. This project addresses both documentation accuracy and actual bathing completion to ensure care consistency. Implementation …

Implementation Of A Turn Team To Reduce Hospital-Acquired Pressure Injuries In A Medical Intensive Care Unit, Heather A, Adair

Doctor of Nursing Practice Final Project Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the …

Acuity-Based Staffing Tool: Improving Patient Outcomes And Nurse Wellbeing In A Local Critical Care Unit, Grace Watson, Rachel Nazha, Madeline Ruffin, Evvy Lewis

SPARK Symposium Presentations

This change project proposes implementation of the CAMEO (Complexity Assessment and Monitoring to Ensure Optimal Outcomes) acuity-based staffing tool in a local critical care unit to improve patient safety, nurse wellbeing, and organizational outcomes (Hurtig et al., 2021). Current staffing practices rely on floating nurses from other units during census fluctuations, creating skill mismatches, increased burnout, and risk for adverse events. Evidence links inadequate staffing with increased mortality, infections, length of stay, and nurse turnover, revealing the need for a more systematic approach (Elmdni, 2025). The CAMEO tool quantifies cognitive workload across 18 domains of care and aligns nurse expertise …

Improving Remote Monitoring Compliance For Pediatric And Adult Congenital Electrophysiology Patients With Cardiac Implantable Electronic Devices (Cieds), Christine Meliones

Doctor of Nursing Practice Final Project Abstract

Improving Remote Monitoring Compliance for Pediatric and Adult Congenital Electrophysiology Patients with Cardiac Implantable Electronic Devices (CIEDs)

Purpose

The purpose of this scholarly project was to implement a quality improvement (QI) project to improve patient safety by improving cardiac implantable electronic device remote monitoring (RM) which has traditionally failed to achieve published benchmarks.

Background

The project was implemented at a healthcare institution in Houston, Texas. The practice area includes pediatric and adult patients with cardiac implantable electronic devices (CIEDs) in an outpatient setting. Current compliance with 14-day post-implementation enrollment (44%) and ongoing compliance (60%) did not meet published benchmarks.

Methodology …

Voice Your Choice, Sarah Olson, Mercy Bustamante-Vizarretea, Hannah Bauman, Sally Hall

SPARK Symposium Presentations

Our proposal seeks to develop and implement a standardized Charge Nurse Interest Survey which will create a structured process for identifying those most interested and best suited for the position of charge for all registered nurses on a local med-surg unit. Nurses on this unit are appointed and eligible to serve in the charge nurse role after six months of experience on the unit. Research shows that charge nurses who demonstrate emotional stability, composure under pressure, strong organizational skills, and proactive planning contribute to improved team functioning and decreased workplace strain (Gottlieb & Gøtzsche-Astrup, 2018).

To clarify the charge nurse …

Improving Handoff Communication Among Uaps In A Group Home By Implementing Standardized Sbar Tool And Evaluating Its Impact On Communication Quality And Resident Safety, Ola Iweala

Doctor of Nursing Practice Final Project Abstract

Purpose

Improving handoff communication among unlicensed assistive personnel (UAPs) in a group home through Situation, Background, Assessment, Recommendation (SBAR) tool implementation.

Background

Communication failures during shift handoffs among unlicensed assistive personnel (UAPs) in a group home contributed to missed information, inconsistent care, and resident safety events. Baseline observations showed that only 37.5% of handoffs met criteria for high-quality communication, and approximately 75% of safety incidents were related to communication breakdowns.

Methodology

This project was conducted in a group home serving adults with intellectual and developmental disabilities and included 19 UAPs. The Plan-Do-Study-Act (PDSA) model and Adult Learning Theory guided implementation. …

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. …

Bridging Disability Studies And Nursing Education: A Curricular Intervention, Serena Karim

2025 Fall Honors Capstones Projects - Archive

Although one in four Americans experience disability in their lifetimes, the majority of nurses and other healthcare professionals feel ill-prepared to care for patients with disabilities (PWD). Factors such as inaccessible healthcare facilities, insufficient clinical knowledge, and biases about the quality of life of PWD contribute to mounting health inequities between PWD and non-disabled people. To further understand how education can impact nursing students’ comfortability and confidence toward caring for PWD, a 30-minute disability studies lesson was implemented for junior-level nursing students. 51 students who attended the lecture provided anonymous pre- and post-lecture surveys, which contained Likert scale and free …

Digital-Based Nutrition Interventions Employing The Dietary Approaches To Stop Hypertension (Dash) Diet: A Systematic Scoping Review, Elizabeth Dodge, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. Methods: A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. Results: The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare …

Implementation Of A Patient Engagement Program In A Federally Qualified Health Center, Cami A. Stone

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project is implementation of a patient engagement program at a Federally Qualified Health Center (FQHC) clinic. This program intends to increase patient self-management of disease without increasing tasks of the clinic staff.

Background

FQHCs have limited resources and staff; their populations are marginalized and transient. The care gap is between the clinic’s resources and patient self-management of disease, specifically hypertension. Evidence shows that personalized coaching of patients aids them with disease self-management.

Methodology

This project delivers personalized coaching via weekly brief phone calls from two assigned nurses to patients, without disrupting clinic duties. Calls involve …

Implementation Of A Standardized Onboarding Program, Sarah J. Wall

Doctor of Nursing Practice Final Project Abstract

Purpose: To evaluate the impact of a standardized onboarding program on Advanced Practice Provider (APP) retention and productivity within an academic department.

Background: High APP turnover in specialized settings disrupts care and leads to financial losses. Previously, onboarding lacked structure, leading to early attrition and delayed productivity. A 24-week phased, competency-based orientation program was developed to improve retention, job satisfaction, and clinical performance.

Methods: The program, implemented in April 2024, included clinical precepting, didactic modules, and mentorship. Retention and Relative Value Units (RVUs) were measured before and after implementation. Qualitative data was collected through mentorship surveys and APP focus groups. …

Living In Fear: Be Empathetic (Life)-Tool Kit, Desiree A. Díaz, Heather Peralta, Samantha Stephenson, Danny Hernandez, Geraldine Luzincourt, Syretta Spears, Ann Marie Parker, Trysten Altamirano

Nursing Handouts, Tools, and Other Documents

Open source materials to immerse learners in rural and public health experiences are needed to ensure the new work force is equipped to care for a variety of people in differing circumstances. Public health remains a vital yet underemphasized component within healthcare education, specifically nursing education. This often limits opportunities for students to develop the skills necessary to become strong advocates for equity and systemic change. A

This project emerged from a commitment to provide experiential opportunities replicating the communities we serve. A Empathy Walk and LIFE Clinic (Díaz et al., 2025) was created as a strategy designed to engage …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …