Nursing Commons^™

Improving Provider Documentation For Procedure Authorizations: A Nursing Perspective On Enhancing Outcomes And Compliance, Juli Legg

All Doctor of Nursing Practice (DNP) Scholarly Projects

Insurance denials resulting from non-standardized documentation and communication gaps in the prior authorization process adversely impacted financial performance and patient care within the electrophysiology (EP) department of a large Midwest academic medical center. High denial rates for costly procedures revealed a need for improved alignment with payer medical necessity criteria. This quality improvement (QI) project aimed to enhance provider documentation, reduce denials, improve care delivery, and increase revenue by implementing standardized documentation templates. A review of the literature supports that standardized documentation and clinical decision support tools enhance consistency, reduce errors, and improve prior authorization success rates. Guided by the …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

Preventing 30-Day Rehospitalization In Congestive Heart Failure Utilizing Transitional Care Teams, Esther Baminrin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Congestive Heart Failure (CHF) continues to be a prevalent and challenging health issue, contributing significantly to hospital readmissions within the first 30 days of patients transitioning to home health care. Rehospitalization affects the patient's quality of life and the agency's revenue, as reimbursements are paused when patients are hospitalized during the first 30 days of admission to a home health agency. The agency experienced a 22% rehospitalization rate within a year, slightly higher than the national average of 10%.

Aim of the Project: The primary objective of this project was to decrease rehospitalization of patients with CHF within the …

Fall Prevention In Long-Term Care, Steven Zissler

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls among older adults residing in long-term care facilities continue to rise, resulting in injuries that contribute to adverse outcomes, a reduced quality of life, and increased healthcare costs. Despite existing safety interventions, falls persist, indicating a gap in effective, sustainable fall prevention strategies. Repeated failures to reduce falls among adults aged 65 years and older highlight the need for a structured, evidence-based approach aimed at addressing this critical patient safety issue.

Aim of the Project: The aim of this project was to reduce falls and fall-related injuries by 25% for older adults residing in a long-term care facility …

Reducing Catheter-Associated Urinary Tract Infections In The Intensive Care Unit, Rosa Shiffman

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Despite established prevention guidelines, inconsistent practices in catheter removal and gaps in daily necessity reviews persist. At the project site’s 24-bed ICU, the CAUTI rate was 1.9 per 1000 catheter days, which exceeds the national benchmark of 1.0. Gaps in consistent assessment of necessity and delays in removal contributed to an elevated infection risk.

Aim of the Project: This project aimed to reduce CAUTI rates in the ICU through evidence-based interventions …

The Effects Of A Triaging Educational Training Program On Triaging Knowledge, Self-Efficacy And Accuracy In Emergency Department Nurses In A Private Hospital In Saudi Arabia, Sawsan Falatah, Janice Hawkins, Craig Cunningham

Graduate Student Government Association Research Conference

Inaccurate triage decisions can lead to increased length of patient stays in the emergency department, increased rehospitalizations, and increased risk of mortality, all of which are quality of care indicators (Srinivas et al., 2021). The triaging decisions in the emergency department at our facility are conducted by relatively new and inexperienced nurses. Anecdotal evidence from the emergency department leadership suggests that inaccurate triaging decisions are being made. In addition, 60 percent of a limited sample of 30 charts that were recently reviewed contained inaccurate triaging decisions. The accuracy of these triaging decisions has not been systematically evaluated at our facility. …

Correlation Between Drug-Related Problems And The Treatment Cost For Geriatric Ischemic Stroke Patients In Tulungagung, Dhanang Prawira Nugraha, Martanty Aditya

Jurnal Ekonomi Kesehatan Indonesia

Ischemic stroke was one of the diseases that frequently occurred in geriatric patients, while hemorrhagic stroke had a higher prevalence. Geriatric patients who experienced a stroke were not exempt from drug-related problems (DRP) due to the complexity of treatment and comorbid factors they encountered. This study aimed to determine the correlation between DRP and the cost of care for ischemic stroke patients, particularly in the geriatric population. The study design was cross-sectional, with data collected retrospectively, and the sample comprised 53 geriatric stroke patients who met the inclusion and exclusion criteria. DRP was assessed using the PCNE 6.2 criteria, and …

Women Managing Heart Disease: Involvement Of Spouse And Non-Spouse Care Partners, Elizabeth Richards

School of Nursing Faculty Publications

Purpose: Heart health is integral to promoting women’s overall health and healthcare. Following a cardiac event, engagement in recommended health-related activities (e.g., maintaining a healthy diet) speeds recovery and improves health. We investigate women’s perception of care partners who are involved in helping manage their heart disease. Methods: Data were drawn from two pilot studies (N = 54); interviews with women from hospital-based outpatient cardiac rehabilitation centers (study one), and online surveys completed by women with heart disease (study two). We compared women’s reports of involvement of their care partner (spouse vs non-spouse) in their health-related activities. Results: The proportion …

Staff Education On Evidence-Based Interventions To Reduce Fall Rates Among Hospitalized Adult Psychiatric Patients, Blessing Rita Ugbor

Walden Dissertations and Doctoral Studies

A staff education initiative was implemented in an inpatient psychiatric facility in the Southern United States to address the significant practice problem: inadequate knowledge of fall prevention strategies among psychiatric nurses. The identified knowledge gap impairs the nurses’ ability to recognize fall risk factors and apply evidence-based interventions. Psychiatric inpatients are particularly vulnerable to falls, which compromise patient safety, increase health care costs, and contribute to poor outcomes. The project was guided by a practice-focused question addressing whether staff education on evidence-based fall prevention strategies would enhance nurses’ knowledge and reduce fall rates. The purpose of the project was to …

An Exploration Of Adventist Nursing Practice In Liberia, Lendeh E. Seboe, Erhuvwukorotu S. Kollie, Boffa L. Kollie Nyumah

Adventist Human-Subject Researchers Association

This study explored nursing practice in Liberia using the integrated global framework for nursing education and practice. A descriptive Qualitative method was used through a group interview and purposive sampling technique for participant selection. FGD utilized for data collection and theoretical sampling for data saturation. Findings highlighted for improvement at the researched hospital and other SDA health care settings.

Provision Of Transportation To Psychiatric Follow-Up Appointments, Eliane Sandrine Tueche Fankam

Walden Dissertations and Doctoral Studies

This quality improvement initiative is focused on the lack of transportation as a significant barrier to obtaining health care services for patients with severe psychiatric disorders. Transportation issues remain an important factor that hinders the attainment of health care services by the members of this population. Transportation challenges should be addressed as much as possible for improving healthcare accessibility and providing timely care. Prior to the implementation of the transportation service, only 30% of patients with severe mental illness (SMI) attended their scheduled appointments, demonstrating the need for intervention. This project focused on whether providing transportation services would improve compliance …

Implementation Of An Education Program For A Ptsd Screening Tool To Increase Knowledge Among Providers Within The Primary Care Setting, Kimberly Inez Schat

Doctoral Dissertations and Projects

Post-Traumatic Stress Disorder (PTSD) is frequently underdiagnosed or misdiagnosed in primary care settings, leading to delays in treatment and poorer patient outcomes. This scholarly project aims to enhance primary care providers' knowledge and application of PTSD screening tools, specifically the PC-PTSD-5, through a structured educational intervention. The project follows a quasi-experimental pre-test/post-test design, assessing providers' baseline knowledge, delivering targeted education, and measuring changes in knowledge and confidence post-intervention.

Data analysis revealed a statistically significant improvement in providers' ability to identify PTSD symptoms, utilize appropriate screening tools, and refer patients for timely treatment. The project highlights the clinical significance of routine …

Decreasing Medication Errors Among Unlicensed Assistive Personnel, Tamara J. Carroll

Doctoral Dissertations and Projects

Unlicensed assistive personnel, although their role is controversial, are present in many different settings and have many varying roles and job responsibilities. Yet, removing this type of healthcare worker from the job pool may lead to increased labor costs, which could be stifling to some organizations and facilities. Digging deeper, data suggests errors are due to lack of a defined scope of practice, a lack of understanding of job roles and responsibilities and decreased confidence when working in the healthcare setting. The purpose of this project utilizes a setting specific educational intervention and skills check off to increase job self-efficacy …

Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was conducted to develop a clinical practice guideline (CPG) to address a gap at a southeastern hospital where frontline nurses often call rapid response teams for severe hypotension without a standard guideline for necessary interventions. Therefore, the practice gap identified at the project site was the lack of a CPG geared for rapid response nurses (RRNs) to use when responding to a call to intervene on a patient with hypotension. RRNs are nurses with advanced clinical training who provide immediate medical care to rapidly hemodynamically declining patients. The guiding question for this DNP …

Staff Education To Educate Healthcare Providers On Effective Communication And Support Strategies For Child Sexual Abuse Victims, Njideka Ajemba

Walden Dissertations and Doctoral Studies

With this project, I sought to enhance the quality of care provided to child sexual abuse (CSA) survivors by improving healthcare providers’ skills in trauma-informed communication and support strategies. The project was undertaken at a large, private behavioral health facility located in the mid-Atlantic region of the United States, where an assessment of the practice environment revealed a critical gap in provider training. This gap often resulted in missed indicators of abuse, limited emotional support, and poor therapeutic outcomes for children affected by sexual abuse-related trauma. To address this, the project implemented a targeted educational intervention grounded in current evidence …

Quality Improvement Project Reducing Pediatric Anesthesia In Magnetic Resonance Imaging: The Role Of Preparedness And Education, Rachel Turner

Doctor of Nursing Practice Projects

Pediatric hematology-oncology patients undergo general anesthesia (GA) for various medical procedures, including magnetic resonance imaging (MRI) scans. Overexposure to GA increases the potential for long-term neurocognitive effects in pediatric patients. Despite the growing research literature on GA-related neurotoxicity and the Food and Drug Administration's (FDA) warnings, advanced practice providers (APP) often lack the knowledge to advocate for and support reductions in pediatric GA use. The Doctor of Nurse Practice (DNP) quality improvement (QI) project aimed to reduce unnecessary GA in pediatric hematology-oncology patients undergoing MRI scans by addressing the primary clinic APPs' knowledge deficits through interprofessional education (IPE). Structured in …

Did You Clean It? - An Evidence-Based Project To Improve Environmental High Touch Area Cleaning Practices, Lauren Hagglund, Hailey Holt, Ainsley Ingebrigtsen, Emily Keller, Stuti Khadka, Kit Mallari, Gavin Martinez, Sahira Monroy, Hannah Pendarvis, T.A. Stockton

2024

No abstract provided.

Yucky Mouth? Clean It Up., Alexandra Thomson, Catherine Barry, Katie Spallo, Sabreen Al Bashiti, Chandler Conerly, Linda Smith

2024

No abstract provided.

Fostering Bright Beginnings: Exploring The Impact Of Cycled Ambient Lighting On Neurological Outcomes Of Infants In A Level Iv Nicu, Julie Acton, Cameron Hartnett, Abeni Kratzmeyer, Grace Madrinan, Elicha Saunders, Alexis Serrano, Morgan Van Der Weert, Erin Wood

2024

No abstract provided.

Do You Have A Second? Nurse Interruptions And Medication Errors, Beaux Brownlow, Camryn Fleming, Sarah Jermstad, Lydia Moore, Nicole Rickert, Sydney Snyder

2024

No abstract provided.