Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

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 …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Using Video Education To Improve Patient Knowledge Of Cellular Therapy Side Effects: Cytokine Release Syndrome, Neurological Toxicities, & Prolonged Pancytopenia, Leslie Bennett

Doctoral Projects

This project evaluated the effectiveness of short educational videos on CAR T-cell therapy, cytokine release syndrome, neurological toxicities, and prolonged pancytopenia for blood cancer patients. At Stanford Health Care in California, in the ambulatory clinic of Blood and Marrow Transplantation and Cellular Therapy (BMT-CT), we obtained a convenience sample of individuals with multiple myeloma or lymphoma preparing for CAR T-cell therapy. A pre-and post-questionnaire assessed the patients' knowledge of CAR T-cell therapy and its side effects. Wilcoxon signed-rank tests were used to determine changes in knowledge. Thirteen patients enrolled, eight completed post-surveys, and four watched the videos. The median knowledge …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

An Evidence-Based Preceptor Development Program For Nurse Anesthetists, Raleigh Todd

Doctoral Projects

Abstract

Problem Statement: The success of the student registered nurse anesthetists (SRNA) is heavily influenced by experiences in the clinical setting, often encompassing a variety of preceptors throughout their respective anesthesia programs. Despite the importance of the preceptor role, many preceptors feel unprepared, and it is estimated most certified registered nurse anesthetists (CRNAs) who precept students have received no formal training in the preceptor role.

Purpose: The purpose of this project is to develop and evaluate an evidence-based preceptor education program for CRNA preceptors, utilizing evidence from literature and input from practicing nurse anesthetists. This program helps provide support by …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

The Impact Of Electronic Health Record Unintended Consequences On Quality Of Care Within A High Complexity Healthcare Organization, Joetta Powell

ATU Theses and Dissertations 2021 - Present

“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute …

The Implementation Of Student Success Coaches At Augusta Technical College To Foster The Development Of Diverse And Competent Nurses, Heather R. Vincequere

SACAD: Scholarly Activities

Abstract

This project explores the implementation of Student Success Coaches at Augusta Technical College (Augusta Tech) and their potential impact on the rates of overall program completion and the rate of diverse student program completion. Framed within the GROW model and Sociocultural Learning Theory, the project aims to determine if coaching interventions address barriers to completion and foster a supportive learning environment. A mixed-methods exploratory approach was employed, combining empirical data such as retention rates and demographics with qualitative information from surveys. Anticipated results suggest an increase in overall completion rates from 55.34% to 80% and an increase in diverse …

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 …

Bundle For Left Ventricular Assist Device (Lvad) In The Ed, Tina Morris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff …

A Structured Diabetes Continuous Glucose Monitor Education Program To Improve Patient Knowledge And Self-Efficacy, Krystal Abucevicz-Swick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/background: Continuous glucose monitor (CGM) is a recommended method of glucose monitoring for patients living with diabetes who are on insulin or experience documented hypoglycemia. CGM is a tool that can improve patient management of diabetes but works best when paired with education to achieve the maximum therapeutic benefits.

Purpose: The purpose of this project was (1) to develop an evidence-based structured CGM education program toolkit for people with diabetes who are ordered CGM, (2) to implement the CGM education toolkit into the Diabetes Self-Management and Education Services (DSMES) program at the project site, (3) to improve patient knowledge about …

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Jillian J. Abinader

Master's Projects and Capstones

Problem: A sepsis protocol and bundle has been implemented in an urban Emergency Department to help screen patients and treat sepsis efficiently and effectively. The benchmarks from the bundle are not being met consistently every month and are below the targeted 90%.

Context: A microsystem assessment and a gap survey sent out to nurses, helped determine that there is room to improve nurses’ knowledge and confidence about sepsis and the sepsis bundle workflow. Sepsis is one of the most expensive and burdensome conditions in U.S. hospitals. Literature supports staff education to improve sepsis bundle compliance.

Intervention: A video was created …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

An Integrative Review: Best Practices For Educating And Engaging Care Partners Of Patients With New Ostomies, Lauren Flook Brown

Master of Science in Nursing Final Projects

PURPOSE: The purpose of this integrative review was to identify and synthesize the best practices of engagement and education for care partners of patients with new ostomies to support adaptation.

METHODS: Five-stage integrative review process: (1) problem identification, (2) systematic literature search, (3) data evaluation, (4) data analysis, and (5) presentation.

RESULTS: Four themes with sub-themes emerged to understand effective engagement and education of care partners: (1) care partner influences on patient outcomes; (2) care partner needs; (3) barriers to care partner adaptation; and (4) diverse engagement strategies. Each theme and sub-themes related to care partners could not be separated …

Implementing An Educational Intervention Aimed At Nursing Staff To Improve Patient Hand Hygiene, Bonita Moore

DNP Projects

Abstract

Background/Purpose: Healthcare organizations are responsible for ensuring that healthcare workers adhere to effective hand hygiene (HH) protocols, and ample research exists on the best methods for monitoring and encouraging compliance. Despite the importance of HH for infection prevention, there has been little focus on patient hand hygiene (PHH). The purpose of this pilot project was to focus on improving nursing staff’s knowledge and attitudes about PHH with the expectation of showing a correlation between these factors and an increase in the performance PHH.

Methods: The project used a quasi-experimental study that took place on one hospital unit at …

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …

Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton

Doctor of Nursing Practice Projects

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).

Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.

Methods: …

Fluid State And Diet Control In Patients With Acute Kidney Injury On Hemodialysis, Carolyn Evans-Howard

Master of Science in Nursing Theses and Projects

Prolonged hospitalization, high number of readmissions, and high mortality rates are associated with patients diagnosed with Acute Kidney Injury (AKI). The purpose of this quality improvement proposal is to address the need for more education for nurses caring for these patients. If the kidneys shut down temporarily due to acute illness or medication taken, fluid and toxins will build up in the body with no way of being released. It is proposed that if dietary and fluid restrictions are followed it may help the patient recover faster. The method proposed is to have nurses learn the necessary dietary and fluid …

Engaging Nurses In Public Policy, Carlene Ferrier

DNP Scholarly Projects

Background: Nurses have been engaged in public policy since the inception of the profession. Academicians and thought leaders recognize the importance of nurses engaging in public policy to improve health and healthcare. Nurses are also the largest healthcare group and the most trusted profession for twenty years, yet they are minimally represented in the state and federal legislature. Nurses possess a skill set that is directly transferable to the policy arena such as listening and communicating effectively, leading by inspiring a shared vision, applying evidence-based research, and collaborating and building relationships to achieve a common goal. Locally, the New Hampshire …

Raising Awareness Of Second Victim Phenomenon And Supportingyou: A Quality And Safety Initiative, Megan Renee Bryant

Graduate Theses, Dissertations, and Problem Reports (ETD)

Current literature has established a need for practice change in management of healthcare-related critical incidents. Peer-support programs have been cited as the most impactful resource healthcare professionals request following a critical incident (Daniels & McCorkle, 2016). SupportingYOU, a peer-support program, is in the process of expansion at a large academic children’s hospital in northern West Virginia in anticipation for the opening of a new facility. The specific aim of this project was to raise awareness of second victim phenomenon (SVP), SupportingYOU, and perception of awareness of resiliency. Interventions included multi-formatted educational sessions on SVP and SupportingYOU via PowerPoints, brochures, flyers, …

Ophthalmic Nursing Education: The Key To Unlocking Patient Access To Retina Services, Jacob P. Mcginnis

Master's Theses and Capstones

Background: Ophthalmology, the medical field dedicated to the human eye and visual system infrequently uses nurses due to a lack of nursing knowledge about ophthalmology.

Local Problem: An ophthalmic microsystem in the Northeastern United States is experiencing increased demand for services and decreased access to their retina section. The microsystem does not utilize nurses in the clinic because of education and training barriers. The specific aim of this quality improvement (QI) project is to increase nursing knowledge about ophthalmology from baseline to an overall passing score of 80%.

Methods: This QI project sought to see if registered nurses could …

Effects Of An Educational Module On Perceived Knowledge, Perceived Barriers, And Attitudes Related To Sleep-Promoting Practices Among Bedside Nursing Staff Within A Medical Intensive Care Unit, Arden Gross

DNP Projects

Background: Adult patients in the critical care setting are at risk for experiencing sleep disruption due to critical illness and environmental factors. The effects of disruption to the sleep/wake cycle has been associated with dysregulation of biological processes such as healing and immune system functioning. Current literature includes the use of sleep-promoting protocols that aim to reduce environmental disruptors of sleep in the critical care setting. However, there is a disconnect between the perceived importance of sleep and clinical practice. Additionally, there is a gap in literature exploring the effects of educational-modalities on nursing staff knowledge, perceptions, and attitudes related …

Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan

Master's Projects and Capstones

Section I: Abstract

Problem: January and February 2021 data showed a rise in readmissions for the NSTEMI population. This is significant as 2020 had a readmission rate of 5.6% and 7.3% in 2019. This sudden increase in readmissions within the first two months of the year is a cause for concern and immediate action is needed.

Context: 2020 had a reduction in cardiac catheterizations due to the multiple canceled cases during the COVID 19 pandemic. As the cases were being rescheduled along with new cases in 2021, the institution experienced an uptake in readmissions.

Interventions: The staff of department 220 …

A Mixed-Methods Approach To Investigating The Influence Of Education On Nurses’ Attitudes Toward Sex Trafficking Victims, Tabitha Mcdaniel

Nursing Theses and Dissertations

Significance of problem: Sex trafficking (ST) impacts victims of all ages, genders, races, and ethnicities. It is a significant public health issue which is shrouded in secrecy. Although victims are typically isolated by their trafficker, they will still seek out health care services. Nurses are frontline staff with rare access to victims in a setting where help can be given.

Purpose: The primary purpose of this mixed-methods study is to explore targeted education about sex trafficking and its influence on nursing attitudes and knowledge about sex trafficking and its victims. This study also analyzes demographic information and how those variables …