Nursing Administration Commons^™

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …

Ultrasound-Guided Epidural Placement Vs. Conventional Technique - Evaluating Effectiveness: A Scoping Review, Skylar R. Kuehn, Bsn, Rn, Ccrn-Cmc, Jacob B. Morphis, Bsn, Rn, Sarah D. Price, Bsn, Rn, Katherine E. Pritchard, Msn, Rn, Jordan Isaac Dnp, Crna, Sharon Little Dnp, Aprn, Fnp-Bc, Tracy Mcclinton

Doctor of Nursing Practice Projects

Purpose/Background

Epidural anesthesia is a cornerstone of perioperative pain management, offering effective analgesia and reduced opioid dependency. However, traditional landmark-based epidural placement (EP) techniques often result in variable first-pass success rates (FPSR) and increased risks of complications. Ultrasound-guided (USG) EP has emerged as an alternative, providing real-time anatomical visualization to improve accuracy and safety. This scoping review synthesizes evidence on the comparative efficacy of USG EP and conventional techniques in adult patients undergoing perioperative epidural anesthesia.

Methods

This review commenced September 2023 and included full-access, peer-reviewed journal articles published in English between 2014-2023. Databases searched included PubMed, CINAHL, Cochrane Library, …

Design And Implementation Of A Notification System For The Purpose Of Improving Communication Between Nurses And Patients, Aindrila Bhattacharya

2025 Spring Honors Capstone Projects - Archive

Communication is an important part of how nurses administer treatment to their patients. Without proper communication, it is difficult for the nurses to connect with their patients and vice versa. This paper will be going into some previous literature about communication between patients and nurses in general, communication with respect to pediatric patients and how notification systems have been implemented in the past. It will then discuss the methodology and implementation of a notification system for a medical app. The medical app is meant to facilitate communication from the side of the patient to the nurse, while the notification system …

Postpartum Depression Screening At First Year Well-Child Visits: Evaluating The Rate Of Maternal Ppd Detection, Chidera A. Speight, Bsn, Rn, Katherine Scarbrough, Bsn, Rn, Camille Jones, Bsn, Rn, Laura Reed, Dnp Fnp-C

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum Depression (PPD) is a concerning mental health condition characterized by feelings of extreme sadness, exhaustion, and challenges with maternal-infant bonding. PPD effects mothers’ ability to adequately care for themselves and their newborns. Current research suggests that one in seven women experience symptoms of PPD as late as 12 months postpartum. Despite screening guidelines set forth by the American Academy of Pediatrics, 50% of mothers with PPD will not receive a diagnosis.

This study aims to evaluate the rate of PPD detection at well-child visits occurring within the first 12 months postpartum by administering the Edinburgh Postnatal Depression Scale …

Assessing The Efficacy Of Remimazolam Vs. Midazolam In Short-Duration Gastrointestinal Endoscopy Procedures And How They Affect Patient Recovery Time: A Scoping Review, Kelsey Gray, Bsn, Rn, Ccrn, Shannon Guthrie, Bsn, Rn, Ana Grace Holder, Bsn, Rn, Will Howard, Bsn, Rn, Dwayne Accardo Dnp, Crna, Faana, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose

The purpose of this scoping review is to evaluate and compare the efficacy of Remimazolam and Midazolam as sedatives in short-duration gastrointestinal endoscopy procedures.

Efficacy Of Aprepitant And Ondansetron In Managing Postoperative Nausea And Vomiting In Perioperative Obese Patients, Jada Stewart, Reagan Revon, Samantha Castellaw, Ashlee Roberts, Dwayne Accardo Dnp, Crna, Faana, Bobby Belflower Dnsc, Nnp-Bc, Faanp, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Postoperative nausea and vomiting (PONV) is a common adverse event that occurs during the recovery period following anesthesia. PONV has been reported to affect nearly 80% of patients, leading to prolonged hospitalization, increases in cost of care, patient dissatisfaction, dehydration, electrolyte imbalances, acute kidney injury, and pulmonary aspiration. Certain risk factors, including obese patients, female gender, and nonsmoker status, increase the risk of PONV. Traditionally, for all patients going under anesthesia, a prophylactic antiemetic regimen is administered; however, since obese and other high-risk patients are at increased risk of experiencing PONV despite traditional regimens, anesthesia providers should administer multiple …

Social Determinants Of Health Screening – Evaluating Its Influence On Glycated Hemoglobin Levels In The Pediatric Population: A Scoping Review, Lindsay Gibson, Victoria Hutchison, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Social determinants of health (SDOH) have a significant impact on health outcomes. Pediatric patients with type one diabetes mellitus (T1DM) with adverse SDOH have inferior glycemic control, higher healthcare utilization, and increased risks of complications. SDOH screenings are not standard practice in pediatric T1DM care despite literature demonstrating that screening can improve outcomes. This scoping review aims to summarize existing evidence surrounding SDOH screenings and their impact on pediatric T1DM outcomes.

Methods

A scoping literature review was conducted from August 2022 to November 2024 via CINAHL, Cochrane, EBSCO, Elsevier, and PubMed. Inclusion criteria included peer-reviewed articles, English language, publication …

Improving Nurse Confidence Around Communication With Physician Partners Through The Caritas Processes, Deborah M. Yracheta

Doctoral Projects

Nurses are the eyes and ears at the bedside during a patient’s hospital stay. They are responsible for communicating significant changes in a patient’s health status, mainly to their physician partners. Unfortunately, good communication between nurses and doctors is a shortcoming of the nursing profession. Seven thousand reviewed malpractice lawsuits were directly related to poor provider communication, resulting in $1.7 billion in malpractice cases and 2,000 preventable deaths. These communication errors also lead to prolonged hospital delays in care, underscoring the need for improved communication. These poor outcomes compromise patients’ lives, safety, and well-being and decrease patient satisfaction scores, ultimately …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Assessing The Efficacy Of Tranexamic Acid In Adjunct To Oxytocin In Reducing Blood Loss During Cesarean Deliveries: A Scoping Review, Hilary Clair Ray Bsn, Rn, Shelbie Freeman Hendrix Bsn, Rn, Lauren Elizabeth Hubbard Bsn, Rn, Helen Maisen Conley Bsn, Rn, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using …

Evaluation Of Depression Screening Tools For Utilization In Adolescents: A Scoping Review, Helen Whitaker Bsn, Rn, Jade Bray Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Anxiety and depression are prevalent mood disorders among the adolescent population with significant impacts on academic performance, social interactions, and mental well-being. With depression rates continuing to rise and suicide among the leading causes of death in adolescents, there is an urgent need for effective screening and intervention. While depression screening is recommended in the primary care setting, many adolescents do not have regular access to healthcare, complicating early identification and treatment. The purpose of this scoping review is to compare the effectiveness of two depression screening tools, the Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), …

Improving Handoffs Between Outpatient Clinics And Acute Cancer Care Centers At A Tertiary Oncology Hospital Using A Quality Improvement Methodology, Mini George, Mohamed Ait Aiss, Gabriele Urschel, Maria Franco Vega, Susan Gaeta, Diane Bodurka

Advances in Cancer Education and Quality Improvement

Accrediting agencies recommend safe and accurate transfer of clinical information during care transitions. At our institution, a tertiary care cancer hospital, ambulatory clinic providers use multiple methods for communicating essential information to emergency care providers. Therefore, we initiated a quality improvement project using a standardized electronic handoff during the transfer of care between providers at outpatient clinics and acute cancer care centers. The project was launched in May 2023 and aimed to achieve electronic handoff for 70% or more of ambulatory care patients transferred to emergency care by October 2023. A multidisciplinary team developed an electronic handoff, provided training, and …

Enhancing Schizophrenia Treatment Outcomes: Integrating Cbt With Medication Therapy To Reduce Hospital Readmission, Kamauri Fleming Msn, Rn, Grace Adeniji-Ilesanmi Fnp-Bc, Zillah Anagho Tah Fnp-C, Alex Cook Msn, Rn, Margaret Harvey Phd, Acnp-Bc, Chfn, Sharon Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn, Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Schizophrenia is a chronic mental illness that disrupts cognition, emotion, and social functioning, imposing significant personal and societal burdens. While antipsychotic medications are effective in alleviating psychotic symptoms, they are often associated with side effects, poor adherence, and relapse risk. Cognitive behavioral therapy (CBT) has shown promise as an adjunct to medication, addressing persistent symptoms and improving outcomes. This scoping review examines the integration of CBT with medication therapy to reduce hospital readmissions and improve quality of life for adult patients hospitalized with schizophrenia.

Methods A systematic search of databases, including PubMed, PsycINFO, Embase, and Cochrane Library, was conducted …

The Incidence Of Hospital-Acquired Pressure Injuries In The Setting Of The Changing Nursing Workforce Throughout The Covid-19 Pandemic, Jacqueline H. Jacobs

MUSC Theses and Dissertations

Background: This study examines how the experience level of Registered Nurses (RNs) has declined while the incidence of hospital-acquired pressure injuries (HAPIs) has increased from 2018 to 2022. Purpose: To evaluate the association between nurses’ experience level and patient outcomes, specifically HAPIs, on a state-by-state basis. Methods: Retrospective, observational study of Medicare patients hospitalized in 41 states using the Medicare 5% Limited Dataset. Nurse experience was measured by the date of first licensure using the Nursing Sample Survey of Registered Nurses (NSSRN). Outcomes include a comparison of the percent increase in HAPIs and change in RN experience level by state. …

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Central-Line Dressing Protocols: The Effectiveness Of A Standardized Dressing Change Protocol In Reducing Central-Line Associated Bloodstream Infections (Clabsi) In Critically Ill Patients Requiring Central Lines, Cody Jones, Melissa Marino, Ryan Mcfarland, Asia White, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

In the Intensive Care Units (ICU), central lines are an essential way of life. However, central lines have risks such as central line-associated bloodstream infections (CLABSI), which increase hospital stays and mortality. CLABSI significantly impacts patient outcomes in critical care, increases mortality and morbidity, increases medical costs, increases hospital-acquired infections, and reduces hospital reimbursements. Typically, antimicrobial dressing has been associated with decreased mortality and improved CLABSI rates. The scoping review will evaluate the literature and examine the effectiveness of various antimicrobial dressing strategies on CLABSI rates. This study aims to synthesize these findings to develop improved CLABSI prevention protocols …