Nursing Commons^™

Point-Of-Care Lab Testing Reduces Lab Turn Around Times And Decreases Delays In Treatment, Arkayla Beamon

Doctor of Nursing Practice Projects

The purpose of this doctoral project was to explore workflows associated with the preanalytical phase of the lab diagnostic process in a one-hundred-bed long-term acute care hospital, identify the most common errors that occur, and explore the effect of point-of-care lab testing (POCT) education on a reduction in treatment delays. More specifically, the project aims to answer the following question: In nurses, unit clerks, and respiratory therapists what is the impact of POC education on lab diagnostic delays in a long-term acute care hospital over six months?

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca L. Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Nurses Confidence And Knowledge Improvement For Sleep In Sleep Hygiene Education, Rawda Nourain

Doctor of Nursing Practice Projects

The purpose of this DNP project was to increase the knowledge and self-confidence of nurses in relation to sleep hygiene practices for psychiatric patients to improve sleep quality and overall mental health. In this study, a pre- and post-intervention design was used for four nurses in a psychiatric unit. The intervention was comprised of teaching the patients about sleep hygiene practices, altering the environment (light and noise reduction), and using non-drug approaches. Knowledge assessments and self-confidence surveys were used to collect the data. All the participants were able to recall the correct sleep hygiene knowledge after the intervention, and all …

Optimizing Compression In Venous Leg Ulcers To Improve Wound Healing Rates Through Wound Care Nurse Support: A Quality Improvement Project, Temilola Obisesan

DNP Scholarly Projects

BACKGROUND: Venous leg ulcers (VLUs) are the most common lower extremity ulcers, accounting for 75% of chronic leg wounds and affect up to 2% of the population in developing countries. Generally, it has a 1-year recurrence rate of 40-70%. VLUs costs about $11B in the USA and other developed countries annually. Patients with VLUs spend about $7,000 more annually. Compression therapy along with local wound care is the best approach for VLU management, with compression therapy as the gold standard. Currently, compression therapy is underutilized in VLU care. The goal of this QI project is to provide wound nurses who …

Feeding With Competence: Empowering Parents In Ng Feeding For Nicu Graduates: A Quality Improvement Project, Karen Marsh

DNP Scholarly Projects

Abstract

Background: Infants who are born prematurely stay in a neonatal intensive care unit (NICU) until they are able to take full enteral nutrition by mouth. While in the NICU a nasogastric tube (NG tube) would be used to supplement the volume needed to be ingested for optimal nutrition. Infants typically feed better with a consistent caregiver and at home in an environment with less stimulation. Allowing infants to be discharged with an NG tube allows the parents to be more involved in their infant's care with a shorter hospital stay. An increased number of infants being discharged home with …

A Quality Improvement Initiative To Improve Nurse Reassessment And Documentation Of Administered Prn Pain Medication, Stacy L. Brady

DNP Scholarly Projects

BACKGROUND: Effective pain management remains a critical challenge both globally and with the United States, where more than 51 million adults suffer from pain. Veterans are particularly vulnerable due to the lasting impact of service-related injuries. “Pro re nata” (PRN or “as needed”) pain medications are frequently used to manage pain, but timely reassessment and documentation following a PRN pain medication administered is often missed or delayed. Reassessing and documenting the results after the administration of the PRN pain medication is required by The Joint Commission and the Veterans Affairs Providence Healthcare System’s (VAPHS) standard operating procedure (SOP) states reassessment …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

Skills Evaluation Of Adjunct Nursing Faculty: A Quality Improvement Project, Ada Dimino Luong

DNP Scholarly Projects

Abstract

BACKGROUND: With rising student enrollment, colleges and universities are relying more on adjunct clinical nursing faculty as Clinical Nurse Educators (CNEs). Recruiting and retaining qualified CNEs is essential to high-quality clinical education. Although clinically proficient, CNEs may face challenges with teaching methods, instructional strategies, and formative feedback. This quality improvement (QI) project evaluated CNE’s competencies and developed a sustainable multimedia educational tool to enhance feedback skills in clinical education.

METHODS: The Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT), a validated 40-item Likert-scale instrument created by Shellenbarger and Sebach, was used to assess CNE competencies. Pre and post intervention …

Optimizing Electronic Health Record Capability To Provide Mindfulness Education To Oncology Patients Experiencing Anxiety, Cynthia Arcieri

DNP Scholarly Projects

Background: The impact of a cancer diagnosis is significant. In 2020, the Centers for Disease Control (CDC) reported over 1.6 million new cases of cancer (National Institutes of Health, 2023). Non-traditional approaches to supporting patients should be considered in providing high-quality cancer care. Mindfulness can help reduce stress reactions and may be beneficial for individuals with anxiety (Vinci et al., 2019). To best support patient care in the landscape of mobile health (mHeatlh) technology, it is essential to adopt best practices that promote patient engagement and empowerment.

Purpose: This quality improvement project aimed to provide oncology patients with a cognitive …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

Improving End-Of-Life Care: A Nursing Education Initiative, Spring C. Kingsley

DNP Projects

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: …

Development Of An Educational Toolkit For Washington State Nursing Professionals Regarding Climate-Related Impacts On Health, Margaret "Maggie" Pinson

DNP Scholarly Projects

BACKGROUND: Most healthcare professionals (HCPs) know that climate change poses a serious threat to human health, but few physicians and nurses actually discuss climate-related impacts on health with their patients. This knowledge-practice gap poses a risk to patient safety.

PROBLEM: Patients who are unaware of environmental threats to health may develop new illnesses, experience unnecessary exacerbations of underlying health problems and may die.

METHODS: A quality improvement intervention that addressed the educational needs of HCPs as described in the literature was developed and hosted on an online survey platform.

INTERVENTION: Preintervention survey questions captured baseline attitudes, beliefs, and knowledge. The …

Enhancing Resilience In Oncology Nurses Through The Implementation Of A Peer Support Program, Denise M. Robinson-Smith

DNP Scholarly Projects

ABSTRACT

Background: Oncology nurses face high rates of burnout and compassion fatigue, contributing to significant turnover and threatening the stability of the oncology nursing workforce. The projected increase in cancer incidence and the resulting demand for oncology services underscore the urgent need for interventions that enhance nurse resilience. Local Problem: At a major hospital in Jacksonville, Florida, it was found that oncology nurses face a significant gap in emotional support, especially during critical incidents such as patient deaths or traumatic events. Existing resources were insufficient to address the unique stressors faced by this team. Methods: A quality …

Maternal-Infant Attachment, Depression, Anxiety, And Breastfeeding Self-Efficacy Among Marginalized Populations, Leslie B. Lantz, Merilyn Arikkat, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Kimberly Cruz-Lopez, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

No abstract provided.

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Management Of Obesity In Adults 18 And Older, Donna Callicoat

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Obesity is a significant public health concern in the United States, with increasing prevalence and substantial healthcare costs. Despite evidence-based guidelines for obesity management, primary care clinics often fail to implement them effectively, leading to missed opportunities in preventing obesity-related comorbidities such as cardiovascular disease, type 2 diabetes, and certain cancers.

Purpose: This evidence-based project aimed to implement the American Heart Association/American College of Cardiology/Obesity Society (AHA/ACC/TOS) obesity guidelines in a rural Texas primary care clinic. The goal was to assess the effectiveness of these guidelines in reducing weight, body mass index (BMI), and waist circumference among adults with …

Multidisciplinary Approach To Reduce The Heart Failure Readmission Rate, Nisha Thekkedam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States, 6.7 million adults have been diagnosed with heart failure (HF), a number projected to rise to 8.5 million by 2030. National data indicate a 30-day readmission rate of 18.2% among HF patients from 2010 to 2017. In Texas, around 12% of the Medicare population in Texas, and specifically 11% of the Medicare population in North Texas County, have been treated for HF. A North Texas hospital reports an 18-20% HF readmission rate over the past several years. Purpose: This EBP project included the implementation of a care bundle using the Dutch Heart Failure …