Nursing Commons^™

Magnet Hospitals And Their Impact On Patient Outcomes, Connie Cochran, Molly A. Collins

Theses, Dissertations and Capstones

Introduction: In the competitive healthcare landscape, patient safety and quality care have remained critical priorities. The Magnet Recognition Program, awarded by the American Nurses Credentialing Center (ANCC), has recognized hospitals that have demonstrated excellence in nursing and improved patient outcomes. Built on five core pillars: transformational leadership, structural empowerment, exemplary practice, innovation, and quality results, this designation has supported professional development and collaborative care. Although only about 10% of U.S. hospitals have been Magnet-designated, they have been linked to reduced hospital mortality, hospital-acquired infections (HAIs), and patient falls.

Purpose of the Study: The purpose of this research was to evaluate …

An Asthma Patient Education Pilot: Utilizing A Hand-Held Tablet To Enhance Self-Management Knowledge, Stephanie Bork, Dana L. Ladd, Li Liu, Rami Hawila, Ashley Reluzco, Le Kang, Farrukh Abbas

VCU Health Nursing

Purpose:

This study aimed to evaluate the impact of pre-recorded educational videos on a hand-held tablet for improving asthma self-management knowledge. Content focused on disease processes, medication management, and medical device usage in an adult asthma clinic at an academic medical center.

Methods:

Pre-recorded asthma education videos were created by study personnel and uploaded to the institutional research electronic data capture (REDCap) platform. Adult participants (≥18 years, English-speaking, with a new or existing asthma diagnosis) were enrolled at an outpatient asthma clinic. The Asthma Self-Management Questionnaire, a validated and reliable tool, was administered before and after participants watched five 1-minute …

The Safe Steps Project: Fall Prevention Amongst Older Adults In A Skilled Nursing Facility, Maiana Cabrera, Nicole Le, Yen Tran, Madeline Turcotte

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

BACKGROUND: The Safe Steps Project aimed to reduce falls at Pine Creek Care Center, a skilled nursing facility located in Roseville, CA. Before this intervention, the fall rate at Pine Creek Care Center had been rising above their 15% goal in the first few months of 2025. Through an in-service education, this project has helped educate and increase nursing staff knowledge on fall prevention, such as intentional rounding with the 4 Ps (pain, position, potty, and possessions).

AIM: The Safe Steps Project addresses a major cause of injury in older adults, falls. The aim of this project was to improve …

Creating A Safe Space: Engaging Graduate Nursing Students In Meaningful Discourse About Racism, Mary J. Isaacson, Brandon Varilek

Journal Articles: College of Nursing

INTRODUCTION: Providing education for graduate nursing students about implicit bias, covert/overt racism in the United States has become challenging due to state and federal policies. Yet, national accrediting bodies require these concepts in doctoral level nursing curricula. While these concepts may be viewed as divisive, faculty can facilitate meaningful discourse by fostering an authentic and safe learning environment.

METHODS: This article describes a curricular revision and our approach of integrating these concepts into a doctoral level ethics course using Mezirow's Transformative Learning Theory and Kitchenham's evolution of Mezirow's theory with instrumental learning, dialogic/discourse learning, and self-reflection.

RESULTS: Students evaluations revealed …

Exploring Maternal-Infant Attachment And Its Relationships With Perinatal Depression And Anxiety Symptoms And Breastfeeding Self-Efficacy Among Predominantly Hispanic, Latina, And African American/Black Marginalized Populations, Leslie B. Lantz, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Merilyn Arikkat, Maria Mooney, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

The purpose of this study is to explore maternal-infant attachment at 26 weeks PP as it relates to concurrent postpartum depression and anxiety symptoms and breastfeeding self-efficacy in ethnically diverse postpartum mothers (from a larger RCT [“Mindful Moms Study”]).

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …

Achieving Optimal Wellness: Exploring The Benefits And Impact Of Community Health, Erin Riley

Doctor of Nursing Practice Projects

Community health is an essential practice that utilizes non-clinical approaches to reduce health disparities, improve health, and prevent disease through engagement with a population of a certain geographical area. Building on earlier research, this study focused on the members of Alamance County and the increasing numbers of diabetes, obesity, hypertension, and hypercholesterolemia cases from year to year. While community resources and health programs have improved over time, they are lacking in certain geographical areas. The aim of this project was to increase the knowledge and conversations around the most common diseases in Alamance County, through health seminars conducted at a …

Overdose Watch: Educate, Prevent, & Respond, Linsey Atis, Jared Burton, Madison Meade, Elizabeth Oliveira

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Implementation Of The Nurse-Driven Palliative Care Referral Protocol: A Quality Improvement Project, Khrystyna Lacombe

Doctor of Nursing Practice Scholarly Projects

Implementation of the Nurse-Driven Palliative Care Referral Protocol

Background and Purpose: Palliative care enhances quality of life, symptom management, and patient–family communication for individuals with serious illness. Despite strong evidence and national recommendations for early integration, referrals remain inconsistent and often occur late. At Advocate Sherman Hospital, only 17.9% of eligible oncology inpatients received palliative care consults. The absence of standardized referral criteria, reliance on provider discretion, and misconceptions equating palliative care with hospice contributed to delayed or missed consults. The purpose of this quality improvement (QI) project was to increase palliative care referrals by 20% within eight weeks through …

Reducing Acute Care Visits In Oncology: A Pilot Quality Improvement Project, Judy Metropulos

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Patients receiving high-toxicity chemotherapy are at risk for post-infusion complications, which can result in unplanned hospital visits or admissions. Structured post-infusion follow-up may improve symptom management and reduce these events.

Local Problem: At North Region hospital, the 30-day post-infusion revisit rate was 31%, substantially exceeding the national average of 14.7%. A pilot program launched in 2021 reduced hospital visits by 7%; however, following its discontinuation due to staffing shortages and inadequate data collection, the rate subsequently increased, underscoring the need for sustainable interventions.

Methods: A quality improvement project was conducted in two, ten weeks phases. Phase 1 included …

Associations Between Older Hispanics’ Diabetes Control And Their Caregiver’S Health Literacy, Jorge Rico

Nursing Dissertations - Archive

Background: Older Spanish-speaking Hispanics are a rapidly growing population in the United States that face disproportionally high rates of diabetes and inadequate health literacy. Familism is valued among Hispanics and caregivers may play an important role in overcoming the social determinants of health facing this vulnerable population. Methods: This descriptive correlation study sought to explore correlations between the caregiver’s health literacy and the patient’s control of diabetes. Findings: Mixed effects model found a significant correlation between the caregiver’s print literacy and the patient’s hemoglobin A1c. Conclusion: The findings are encouraging for future research to explore interventions that target the caregivers …

Perception Of Spirituality By Intensive Care Unit Nurses, Adejoke Felicia Ogidan

Nursing Dissertations - Archive

ICU nurses are identified as a population of nurses with a high risk of experiencing psychological stress due to the nature of their job in the ICU (Lyndon, 2015; Welp et al., 2015). Psychological stress is detrimental to nurses' mental health and the quality of patient care.

According to Watson’s Transpersonal Human Caring Theory, the spiritual perception of the nurse influences the nurse’s spiritual care practice, which in turn affects their self-care and care provided by the nurse to patients (Watson, 2021)This research explored the ICU-Ns' perception of spirituality and its relationships with spiritual care practices and self-assessed competency in …

The Lived Experiences Of Older Adults With Cancer Who Are Non-Adherent To Prescribed Oral Chemotherapy: A Descriptive Phenomenological Study, Ludmila Kosmari

Nursing Dissertations - Archive

Background: Despite the ease of receiving OCT, patients’ OCT adherence is low. With this low prevalence rate, patients are not likely obtaining the full life-promoting effects of OCT. Since medication adherence is often related to lived experiences and standardized medication adherence instruments may not capture these experiences completely, the purpose of this study was to explore how the lived experiences of older adults with cancer influence their adherence to OCT.

Methods: the researcher used a descriptive phenomenological design and conducted individual interviews with 20 older adults with cancer. All participants were prescribed OCT and reported missing at least one dose. …

Case Management For End-Stage Renal Disease Patients, Jamie L. Andrews

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Social determinants of health (SDOH) and health literacy directly impact adults with end-stage renal disease (ESRD) on hemodialysis (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2022; Ulrich, 2020). Adults with ESRD account for 1.5 million hospital admissions and 500,000 re-admissions within 30 days annually (NIDDK, 2022). Case management is essential in reducing re-admissions for adult ESRD patients, requiring abilities to identify factors affecting adult ESRD patients appropriately.

Methods: Therefore, an evidence-based practice (EBP) project using the IOWA Model framework was implemented to increase the knowledge base in identifying care and resources for ESRD patients for telephonic …

Nursing Workplace Rituals: Communication Before, During, And After Covid-19, Angel Infante

Nursing Dissertations - Archive

ABSTRACT

NURSING WORKPLACE RITUALS: COMMUNICATION BEFORE, DURING, AND AFTER COVID-19

Angel Infante, PhD

The University of Texas at Arlington, 2025

Professors: Dr. Deborah Behan (Committee Chair), Dr. Yungfei Kao (Committee Member), and Dr. Jessica Grace Smith (Committee Member)

Background: According to Griner et al. (2021) many disruptions caused confusion for healthcare workers during the pandemic. Communication is imperative when dealing with everyday disruptions in a hospital setting. However, it is even more important to learn about the different types of communication and what is communicated during a past pandemic to know how and what to communicate in a future pandemic. …

Factors Contributing To Technostress In Nursing Education: A Study Of Master Of Science In Nursing (Msn) Education Students, Jennifer Weber

Nursing Dissertations - Archive

This mixed-methods study examined factors contributing to technostress among Master of Science in Nursing (MSN) Education students enrolled in a fully online program. Guided by the Technostress Trifecta Model, the study explored the relationships among age, grade point average (GPA), years of nursing experience, and self-rated technical skills, as well as students’ perceptions of technology use in learning.

Data were collected from 94 participants using the Technostress Scale by Upadhyaya and Vrinda (2021). Quantitative analyses showed that self-rated technical skill was significantly associated with lower perceived technological complexity, while age was significantly associated with both techno-invasion and techno-uncertainty. GPA and …

Guideline On The Education And Use Of The Cognitive Assessment And Care Planning Services Visit For Patients 65 And Older With Cognitive Impairment, Katherine J. Koonce

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: The lack of education and use of the Cognitive Assessment and Care Planning Services (CACPS) visit creates a gap in care for Medicare patients over the age of 65 with cognitive impairment.

Methods: Recommendations were created from a robust collection of graded, evidence-based literature. The recommendations were presented to a set of stakeholders who rated each recommendation on a Likert scale from 1 (poor) to 4 (excellent).

Results: The twelve stakeholders agreed with the recommendations to support the education and use of the CACPS visit for Medicare patients 65 and older.

Conclusion: This guideline promotes provider education to investigate …

Improving Pediatric Delirium Assessment Documentation And Nursing Knowledge In A Pediatric Cardiovascular Intensive Care Unit, Heather E. Herrera

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Pediatric delirium is prevalent in the Pediatric Cardiovascular Intensive Care Unit (PCICU). It is associated with longer PCICU stays, extended hospital stays, prolonged duration of mechanical ventilation, and higher hospital costs (Mallick et al., 2022). It has also been associated with increased mortality risk and decreased quality of life after hospital discharge (Rohlik et al., 2021). Due to the adverse sequelae associated with pediatric delirium, routine screening with a validated screening tool is recommended (Flagg & Mauney, 2023). Despite consensus guidelines advocating routine screening for pediatric delirium, routine screening is not being completed (Flagg & Mauney, 2023).

Decreasing Hospital-Acquired Clostridium Difficile Infections, Angel S. Louder

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Clostridium Difficle Infection (CDI) is a significant healthcare threat due to its ability to be transmitted rapidly in healthcare settings. Patient engagement and participation in infection prevention initiatives at admission will lead to early implementation of isolation precautions, diagnosis of infectious pathogens, and treatment. A quality improvement project was implemented at a south-central Texas acute care hospital to engage alert and oriented adult patients, using a bundled approach to screen for the early detection of CDI within 48 hours of hospital admission, thereby reaching the goal of reducing hospital-acquired CDIs. This initiative improved patient engagement with CDI screening, reducing confirmed …

Enhancing Patient-Centered Efficiency: Reducing Cardiology Clinic No-Shows Using Technology, Pre-Visit Planning & Patient Resources, Pat Shirey

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Cardiovascular disease (CVD) affects 48% of U.S. adults, requiring regular cardiology visits to manage risk factors and the early detection of complications (American Heart Association, 2019). No-shows disrupt continuity of care, worsen health outcomes (Choi et al., 2020), and decrease clinic efficiency (Goossens et al., 2022). A North Texas cardiology clinic reported a 31.9% overall no-show rate and a 42.1% no-show rate for new patients, costing $1.3 million annually.

Purpose: This quality improvement project aimed to reduce no-show rates through a patient-centered cardiology appointment bundle to improve continuity, patient outcomes, and efficiency.

Methods: This eight-week project utilized the Plan-Do-Study-Act …