Improving Nurse Well-Being And Patient Safety Through A Structured Break Buddy System: A Quality Improvement Project, Elizabeth Harrington

Master's Theses and Capstones

Abstract

Background: Nursing burnout has become an increasing concern due to heavy workloads, staffing shortages, and the inability of nurses to consistently take uninterrupted rest breaks during their shifts. Missed breaks contribute to fatigue, emotional exhaustion, decreased job satisfaction, and an increased risk of patient safety events. Evidence suggests that structured break interventions may improve opportunities for recovery during the workday.

Methods: A quality improvement (QI) project was conducted on a respiratory care unit at a midsized hospital in central New Hampshire using the Plan-Do-Study-Act (PDSA) framework. A microsystem assessment identified inconsistent break-taking as a significant gap. A five-question anonymous …

Magnifying Mental Health In The Perinatal Population: A Systematic Review, Kasey E. Arnold, Alyssa M. Maki

Williams Honors College, Honors Research Projects

Pregnant individuals often experience significant anxiety, which can negatively affect both pregnancy and fetal outcomes. This systematic review evaluates the effectiveness of pharmacologic versus non-pharmacologic anxiety-relieving interventions, primarily focusing on the labor period. The PICOT question is: In perinatal patients, do non-pharmacologic anxiety-relieving measures, compared to pharmacologic anxiety-relieving measures, have a greater impact on ease of delivery and overall mental health during pregnancy and the perinatal period? PRISMA (2020) guidelines were used with inclusion criteria of human subjects, English language, and published within the last six years. Databases included PubMed, CINAHL, and Cochrane Library. Twenty-three studies were analyzed to examine …

To Treat Or Not To Treat: Evaluating Antipyretic Use And Patient Outcomes In Febrile Care, Nico Teodosio, Brynley Harris

Williams Honors College, Honors Research Projects

This honors project aims to critically examine the evidence-based practice use of antipyretics in fever management, questioning whether suppressing fever is truly in the patient's best interests and if it benefits patient outcomes. Grounded in nursing, past nursing courses, and emerging research, this project aims to answer the following PICOT question: In febrile patients, how does withholding, or not administering, antipyretics compared to administering antipyretics affect patient outcomes during hospitalization? Through a literature review, this project will analyze studies from databases like PubMed and Google Scholar, focusing on outcomes like recovery time, symptom severity, complications, and mortality. Using the PRISMA …

Does Guideline-Directed Breast Mri Improve Early Identification In The High-Risk Breast Cancer Population, Cemile Littlepage

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: In the United States, one in eight women will be diagnosed with breast cancer. The American Cancer Society's 2007 guidelines (Onishi & Kataoka, 2020) and the American College of Radiology recommend that MRI screening, alongside annual mammography, be used for women at high risk for breast cancer (Lamb et al., 2023; Sardanelli et al., 2024). Currently, there are various screening models, and no standardized tool or national guideline exists for MRI screening in high-risk patients. This guideline project aims to establish a screening model and recommendations for MRI screening in high-risk women for use in primary care.

Methods: A …

Riddle Me Resilient: Investigating The Impact Of Riddle Based Class Openings On Student Resilience And Well-Being, Carolyn T. Brown

DNP Projects

Abstract

Background: Burnout among nurses and nursing students is a widespread and well‑documented problem that adversely affects professional performance and psychological well‑being. Resilience serves as a key protective factor, helping buffer the effects of academic stress and reducing burnout over time. Incorporating brief, low‑stakes cognitive challenges—such as a riddle—can help foster resilience.

Purpose: This project evaluated the impact of incorporating riddles into a wellness-focused course, Introduction to Mindfulness and Wellness, on resilience and well-being among undergraduate nursing students.

Methods: This project employed an Institutional Review Board approved pre-post survey design to measure the effect of an intervention focused on …

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 …

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 …

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. …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

Precision Education In Health Sciences Education: A Call-To-Action For Developing An Interprofessional Strategy, Arvie Vitente, Jennifer Bosworth, Robert Sweet, Rebecca Cozzi, Christopher Galloway, Piotr Szczurek, Melanie Obispo-Young, Eron Bozec, Erica Brkovic, Tina Bobo, Jennifer Lubinski

Philippine Journal of Physical Therapy

Introduction. Growing learner diversity, expanding biomedical knowledge, and rapid clinical digitization have exposed the limits of on-size-fits-all health sciences training. Competency-Based Education (CBE) has sharpened the focus on outcomes, yet many programs still move learners through fixed sequences, infrequent assessments, and retrospective remediation. Precision Education (PE) offers a complementary, data-enabled approach that uses learning analytics, artificial intelligence (AI), and continuous feedback loops. Embedded within CBE, PE converts competencies from static milestones into dynamic trajectories that can be measured, visualized, and adjusted in real time across the curriculum. This abstract highlights the need for an interprofessional strategy to design, fund, and …

The Relationship Between Individual Innovativeness Traits And Medical Artificial Intelligence Readiness Levels Among Nursing Students In Türkiye, Özlem Öztürk, Tülay Sağkal Midilli

Makara Journal of Health Research

Background: This study examined the relationship between nursing students’ individual innovativeness traits and their readiness for medical artificial intelligence, and the influencing factors.

Methods: This study was a descriptive, correlational study. The study was conducted with 606 nursing students enrolled at the Faculty of Health Science, Manisa Celal Bayar University. Data were collected using the Descriptive Information Form, the Individual Innovativeness Scale (IIS), and the Medical Artificial Intelligence Readiness Scale (MAIRS).

Results: The mean IIS score was 64.23 ± 8.47, indicating that most students fell into the skeptical or interrogator categories. The mean MAIRS score was 75.77 …

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. …

Effects Of Communication Boards On Improving Communication In Assisted Living Care Facilities, Koleen Beatrice Arribas

Master's Projects and Capstones

Problem: A Residential Care facility utilizes paper charting causing limited access to vital information such as code status, allergies, and/or diet for those caring for the resident.

Context: Exceptional charting only when a resident’s condition changes may not provide enough vital information for the caregiver to administer medication or provide proper support during an emergency, such as the resident’s DNR status.

Interventions: A communication board was placed in a secure space near the nurses’ station with key resident information. Nurses would huddle at the board at before the change of shift and make updates as necessary.

Measures: Staff input in …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

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 …

Anesthesia Informed Consent: An Objective Structured Clincial Examination, Joshua Powell

Doctoral Projects

Informed consent is a fundamental component of anesthesia practice and is recognized as professional Standard IV by the American Association of Nurse Anesthesiology (AANA). Despite its importance, anesthesia providers often face challenges in effectively obtaining consent from patients. Within The University of Southern Mississippi (USM) Nurse Anesthesia Program (NAP), a need was identified to strengthen student competency in conducting anesthesia informed-consent discussions. This project developed and implemented an Objective Structured Clinical Examination (OSCE) as a standardized, evidence-based approach to teach and assess informed-consent skills in alignment with the American Association of Nurse Anesthesiology (AANA, 2019) standards. The intervention was designed …

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 …