Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Senior Theses

Background: Quality patient handoff from Emergency Medical Services to the Emergency Department is a crucial transition of care that directly impacts patient safety, medical intervention, and patient outcomes. If concise, effective communication is not achieved, critical details can be left out resulting in medical errors, delayed intervention times, and lack of identification of clinical deterioration.

Aim: This study aims to understand how paramedic to nurse handoff quality impacts a nurse’s early identification of clinical deterioration.

Proposal:

Methodology: A quasi-experimental study of mixed-method research.

Recruitment strategy: A fire department in Marin County, CA and ED nurses from the base trauma center …

Pocus Implementation Via Multiprofessional Training Workshop With Mixed Didactic And Simulation Guided Intravenous Access In The Nicu For Quality Improvement, Kristen Carrierfenster, Eileen Hollis, Rehman Chowdhry

DNP Scholarly Projects

Background. Rapid evolving technology and the use of Point-of-Care (POCUS) for Intravenous (IV) access requires a foundational understanding of ultrasound imaging, gadgetry, along with a basic understanding of anatomy and physiology. Initially, there is a steep learning curve; this is reduced with standardized training and techniques that will improve overall procedural performance. Designing educational frameworks is necessary as technology innovation expands to improve the way we prevent, screen, diagnosis, and treat patients.

Problem Statement. The national standard of care and best practice in pediatrics allows two attempts per provider for IV access. Unsuccessful IV attempts lead to patient discomfort and …

Implementation Of A Pressure Injury Prevention Bundle To Reduce Hospital-Acquired Pressure Injuries In The Intensive Care Unit, Xibo Lan

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement project was to utilize the SKINSAFE pressure injury prevention bundle during 12 weeks of implementation to increase evidence-based pressure injury prevention practices adherence and decrease risk of hospital-acquired pressure injury (HAPI) in the intensive care units (ICU).

Background

ICU patients experience high risk for hospital acquired pressure injuries (HAPIs) secondary to immobility and device related pressure. Initial adherence to SKINSAFE bundle was 55-56%. There was inconsistent use of heel offloading devices, wound photography and documentation. Prevention bundles were affected by staffing fluctuations and leadership turnovers.

Methodology

The Plan-Do-Study-Act cycle for this project included …

Implementation Of A Ventilator-Associated Pneumonia Bundle To Reduce The Incidence Of Ventilator-Associated-Pneumonia And Improve Patient Care, Taylor Ryan Rice

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Ventilator-associated pneumonia (VAP) is a concerning complication that can

develop from complications when a patient is placed on a mechanical ventilator. Endotracheal

intubation puts patients at risk for micro aspiration, which can lead to VAP.

Evidence Review: Nine articles were selected for review; after critical appraisal, seven were

kept for further review. Evidence in these articles shows that using evidence-based methods in a

VAP bundle can decrease the length of stay, mechanical ventilator days, and the incidence of

VAP.

Purpose: The purpose of this project was to improve oral care for intubated patients and keep

the incidence of VAP …

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 …

A Quality Improvement Initiative To Reduce Pressure Ulcers In Spinal Cord Injury Patients, Nicholas Post

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pressure ulcers are a significant concern for hospitalized patients, leading to various complications and increased medical costs. Despite common preventative interventions, pressure ulcer rates remain elevated. The prevalence of pressure ulcers contributes to patient suffering, extended hospital stays, increased healthcare expenses, and even fatalities. This emphasizes the critical need for additional prevention strategies. The reported increase in pressure ulcer injuries among spinal cord injury patients in the Surgical Intensive Care Unit (SICU), along with 7E and 8NE step-down units, at a large academic hospital highlights the pressing issue.

Purpose: The purpose of this project was to develop and …

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 …

Mid-Shift Huddle To Improve Icu Nurse Well-Being And Reduce Burnout, Jesse Cannizzo

Doctor of Nursing Practice Final Project Abstract

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Mid-Shift Huddle to Improve ICU Nurse Well-Being and Reduce Burnout

Purpose

Burnout among ICU nurses negatively affects well-being, job

satisfaction, and retention. This quality improvement project

evaluated a mid-shift support huddle to identify staff stressors

and improve nurse well-being.

Results

The mid-shift support huddle identified high-stress events during 44% of

completed huddles, with workload and unsafe assignments as the

primary concerns. ProQOL scores improved, while employee

engagement findings were mixed, with unchanged well-being and lower

perceived stress manageability.

Background

ICU nurses provide high-acuity care, manage heavy workloads, and

experience emotional fatigue. Brief team huddles and leadership

engagement may improve …

Combating Pressure Injuries In Critical Care: A Dnp Project On Nursing Education And Prevention Strategies In The Icu, Tijuana M. Johnson

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) are preventable complications that significantly increase patient morbidity, mortality, length of stay, and healthcare costs, particularly in intensive care units (ICUs). At a rural 146-bed hospital, the ICU pressure injury rate of 1.17 per 1,000 discharges exceeded the national benchmark of 0.58 per 1.000 discharges, identifying a critical gap in prevention practices. This Doctor of Nursing Practice (DNP) project aimed to improve ICU nurses' knowledge of pressure injury prevention and reduce unit-based educational intervention grounded in Patricia Benner’s Novice to Expert Theory and implemented using the Plan-Do-Study-Act (PDSA) quality improvement framework.

A pre-and post-intervention design was …

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 …

Propofol Vs Dexmedetomidine: Impact On Reintubation And Respiratory Depression, Dominic J. Hamad, Stephanie Wodrich, Logan Campola

Williams Honors College, Honors Research Projects

This project aims to compare the effects of Dexmedetomidine and Propofol on breathing recovery in ICU patients who have been mechanically ventilated. Specifically, we want to find out whether one sedative is more likely than the other to lead to respiratory depression or reintubation after sedation is stopped. These outcomes are important because they directly affect patient safety, ICU length of stay, and overall recovery. Our team will conduct a systematic review of randomized controlled trials found through databases like PubMed, CINAHL, and Cochrane Library. We will focus on adult ICU populations and only include studies that report on relevant …

Improving Staff Knowledge And Consistency In Sat And Sbt Practices In The Critical Care Unit: A Quality Improvement Initiative, Morgan Crapo

Master's Theses and Capstones

Abstract

Background: Spontaneous Awakening Trails (SATs) and Spontaneous Breathing Trials (SBTs) are key components of the ICU Liberation Bundle and have been associated with shorter durations of mechanical ventilation, reduced intensive care unit (ICU) length of stay (LOS), and improvement in patient outcomes. Despite having strong evidence supporting their use, implementation remains inconsistent due to knowledge gaps, workflow barriers and interdisciplinary communication challenges.

Local Problem: This quality improvement (QI) project aimed to improve critical care nurses’ knowledge and confidence regarding the implementation of SATs and SBTs through an evidence-based educational intervention.

Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, this QI …

Implementation Of A Cardiomems Screening Tool To Increase Provider Awareness And Referrals In Eligible Patients, Monica Rios

DNP Projects

Background: Heart failure affects over 6 million Americans and causes more than one million hospitalizations annually. CardioMEMS, a remote pulmonary artery pressure monitoring device, effectively reduces hospitalizations, yet its use remains limited due to provider and system barriers. The purpose was to increase CardioMEMS referrals for eligible heart failure patients through targeted provider education and a standardized screening tool.

Local Problem: Kentucky experiences higher heart failure hospitalization rates than the national average, contributing to prolonged hospital stays and rising healthcare costs.

Methods: A pre—post quasi-experimental study was conducted at an academic medical center. Baseline chart review of 47 patients evaluated …

Implementation Of An Acute Critical Event Debriefing To Enhance The Quality Of Cardiopulmonary Arrest Resuscitation In The Cardiovascular Intensive Care Unit At A Safety-Net Hospital, Shara Baker

Doctor of Nursing Practice Final Project Abstract

Purpose

This scholarly project aimed to implement an Acute Critical Event Debriefing (ACED) program in an intensive care unit to improve resuscitation quality by increasing post–cardiopulmonary arrest debriefing completion rates and enhancing documentation of airway confirmation during resuscitation events. The project took place in a 12-bed intensive care unit at a large academic safety-net hospital in Dallas, Texas.

Background

Structured debriefing after cardiopulmonary arrest events was recommended to enhance team performance, clinical education, and resuscitation quality. However, debriefing following code events was inconsistently conducted across many intensive care units, limiting opportunities for team reflection and quality improvement.

Methodology

The Plan-Do-Study-Act …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

Impact Of Rapid Response Team On In-Hospital Cardiac Arrest Events, Sara Everard Tucker, Julie Gale Bell, Stephanie Pigg, Shelby Austin, Kelsey Sawyer, Stephan Smith, Michelle Bradberry, Jonathan Ortegon, Matt Mitchell

Covenant Nurses Week 2026

No abstract provided.

Enhancing Early Seizure Detection In Cricial Care Through Nurse-Driven Rapid Eeg, Dylan Delaney, Brenna Gale Jackson, Ruben Sanchez, Amanda Garza, Rebecca Kilgore

Covenant Nurses Week 2026

No abstract provided.

Mental Health Effects Of Post-Intensive Care Syndrome In Adult Acute Respiratory Distress Syndrome Survivors Hospitalized During Or After The Covid-19 Pandemic, Brooke M. Leggiero

Honors Undergraduate Theses

Introduction: Post-Intensive Care Syndrome (PICS) is "new or worsening problems in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization.” This study examined the prevalence of PICS mental health conditions in adult ARDS survivors hospitalized between 2020 and 2025 and differences in mental health conditions between those hospitalized during and after the COVID-19 pandemic.

Methods: This retrospective, descriptive, cross-sectional study enrolled adult survivors hospitalized between 2020 and 2025 who required mechanical ventilation and were at least 1 month removed from the intensive care unit (ICU). Individuals with prior brain injury were excluded. …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Enteral Nutrition Guidelines Improve Critically Ill Patients’ Outcomes: A Quasiexperimental Study, Marwa Abdo, Sara Elsayed Hegazy

Nursing

Background: Optimal nutritional support is a fundamental element of treatment for critically ill patients. Adherence to evidence-based enteral nutrition guidelines is essential to promote patient care and prevent potential complications. Objectives: To assess the effectiveness of enteral nutrition guidelines in improving critically ill patients’ outcomes. Method: A quasiexperimental study evaluated 68 critically ill patients divided into 2 groups. The intervention group received their nutrition based on the evidence-based enteral nutrition guidelines, while the control group received their nutrition based on the unit’s routine care. The study was conducted in the surgical intensive care units of Mansoura Emergency Hospital in Egypt. …