Nursing Commons^™

Intraoperative Aspiration Risk Reduction Of Diabetic Patients Through Gastric Ultrasound: A Scoping Review, Dakota Sellers Bsn, Rn, Kristy Speight Bsn, Rn, Ginger Chastain Bsn, Rn, Tyler Stone Bsn, Rn, Claudia Bursi Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap, Margaret Harvey Phd, Acnp-Bc, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Patients with diabetes mellitus are significantly more prone to delayed gastric emptying, which can increase their risk for aspiration events in the operating room despite following standard fasting guidelines set by the American Society of Anesthesiologists (ASA). Using point-of-care gastric ultrasound, trained providers can quickly and accurately evaluate gastric volumes and risk-stratify patients based on these findings. However, these methods have not been clearly assessed in the diabetic population. The purpose of this scoping review is to map the existing evidence on the use of gastric ultrasound findings among adult patients with diabetes undergoing anesthesia.

Methods

A scoping review …

Dexmedetomidine As An Adjuvant In Intrathecal Anesthesia Vs. Opioids - Evaluating Adverse Events: A Scoping Review, Autumn Holloman Bsn, Rn, Paige Blackstock Bsn, Rn, Rasmia Ibrahim Bsn, Rn, Chase Logan Bsn, Rn, Hunter Turner Bsn, Rn, Dwayna Accardo Dnp. Crna, Faana, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background 

Spinal anesthesia is widely used in surgical practice because it provides effective anesthesia and analgesia while reducing the need for intravenous anesthesia. Opioids are commonly used as intrathecal adjuvants; however, their use is associated with adverse effects such as pruritus, postoperative nausea and vomiting (PONV), urinary retention, and respiratory depression. Dexmedetomidine, a selective α2-adrenergic agonist, has gained attention as an alternative to opioids due to its sedative and analgesic properties without the opioid side effect profile. This scoping review evaluates current evidence comparing intrathecal Dexmedetomidine and opioids as adjuvants to spinal anesthesia in adult surgical patients.

Methods

A scoping …

Implementation Of Positive Reinforcement To Promote Staff Adherence To Bowel And Bladder Plans At A Long-Term Care Facility, Alfonso Segura Sanchez

Celebrating Scholarship and Creativity Day (2018-)

Background: Bowel and bladder plans (BBPs), also known as toileting programs, are individualized restorative nursing programs that have strategies to promote continence in residents and reduce the negative consequences of incontinence (Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual Version 1.20.1, 2025). Purpose: Senior nursing students implemented positive reinforcement in a quality improvement (QI) project to reduce rates of incontinence and inconsistent adherence to BBPs at Elim Wellspring, a skilled nursing facility for long-term care in Princeton, MN. According to the Minnesota Department of Human Services and Minnesota Department of Health, the most recent report on quality indicators for …

Mortality Risk Comparison Of Doacs And Warfarin In Geriatric Adults With Dementia And Atrial Fibrillation, Laraya Gunter Bsn, Rn, Mariah Cloud Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Atrial fibrillation and dementia frequently coexist in older adults, creating complex challenges for anticoagulation management. Although anticoagulation is recommended to reduce thromboembolic risk in atrial fibrillation, current clinical guidelines lack dementia specific recommendations. Resulting in uncertainty regarding optimal therapy in this population. The purpose of this scoping review was to examine and synthesize current evidence comparing mortality risk and adverse events associated with direct oral anticoagulants (DOACs) versus warfarin in adults age 65 and older with atrial fibrillation and dementia.

Methods

A scoping review was conducted using PRISMA-ScR methodology. Peer-reviewed articles published between 2019 and 2023 were identified through …

Improving New Graduate Nurse Clinical Readiness Through Interprofessional Collaboration And High-Fidelity Simulation, Alyssa M. Starkey

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement (QI) project was to enhance new graduate nurse (NGN) clinical readiness through an interprofessional high-fidelity simulation focused on recognizing and responding to patient deterioration during nurse residency onboarding.

Background

New graduate nurses often feel uncertain about recognizing clinical deterioration and communicating. Research shows that simulation-based and interprofessional training improve judgment, teamwork, and communication. This project aims to achieve at least a 10% increase in NGN clinical readiness following the implementation of a high-fidelity simulation program.

Methodology

A pre–post QI study based on Kolb’s Theory and PDSA principles was conducted in a nurse residency …

Effect Of Music Therapy And Music Focused Interventions On Fall Rates In A Memory Care Unit, Emily Spanier, Cassie Howe, Hannah Reiter, Paige Mauer

Celebrating Scholarship and Creativity Day (2018-)

This quality improvement project examined the effect of music therapy and activity-focused interventions on fall rates in a memory care unit at a long-term care facility. The project was developed after staff identified falls as a major safety concern, with the memory care unit accounting for a disproportionate number of facility-wide falls. Through audits and observations, the team found that boredom, wandering, restlessness, and lack of meaningful engagement were common contributing factors to falls among residents with dementia. To address this issue, the team implemented low-cost, person-centered interventions including playing familiar music through Alexa, encouraging participation in simple arts and …

Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education project aimed at improving the knowledge of psychiatric nurses on the use of structured walking interventions to manage depression. The practice problem was related to the lack of consistency in the application of walking as a treatment for depression. This gap was significant to address because psychiatric nurses are in the center of behavioral activation, and insufficient knowledge may deny patients the right to potentially valuable, affordable, and nonpharmacological treatment. The practice-based question was: Among psychiatric nursing staff does education on structured walking intervention, compared to standard care, improve staff knowledge and skills …

Telehealth Workflow Optimization, Taku Ajongakoh Stella

Walden Dissertations and Doctoral Studies

This evidence-based quality improvement (EBQI) project addresses the 36% telehealth no-show rate at an outpatient behavioral health clinic in Maryland. High attrition rates currently compromise continuity of care and result in a projected annual revenue loss of $124,000. The present project proposed a standardized workflow redesign in the current Integrated Care Approach (ICA) notes Electronic Health Record (EHR) system to address the manual outreach inconsistency. Significant interventions involved the activation of automated multimodal reminders at 72-hour, 24-hour, and 1-hour intervals, and the obligatory 24-hour technical pre-verification connection. Moreover, the project introduced a systematic 48-hour follow-up procedure of missed visits to …

Empowering Nurses To Save Lives: Suicide Prevention Education And Training For Outpatient Nurses In Prince George’S County, Maryland, Oludoyin O. Ajala

Walden Dissertations and Doctoral Studies

Suicide remains a significant public health concern, with increasing prevalence across diverse populations. Outpatient nurses frequently encounter individuals at risk for suicide; however, many report limited confidence and inconsistent use of evidence-based assessment tools, contributing to missed opportunities for early intervention. The purpose of this Doctor of Nursing Practice staff education project was to implement a structured suicide prevention education program to improve nurses’ knowledge, confidence, and ability to identify and manage suicide risk. The practice-focused question examined whether implementing a structured suicide prevention education program for outpatient nurses would increase knowledge and confidence in identifying and intervening with patients …

Perceptions Of Instructional Accommodations Among Nursing Students With Information Processing Disorder, Imaobong Aliyu

Walden Dissertations and Doctoral Studies

Instructional accommodations in nursing education often emphasize testing adjustments, while classroom-based instructional support for students with information processing challenges remains underexamined. This descriptive qualitative study explored pre-licensure nursing students’ perceptions of instructional accommodations for students with information processing disorders in Southern California. Guided by humanistic learning theory, the study addressed the research question: What are the perceptions of instructional accommodations in the classroom setting among pre-licensure nursing students with information processing disorders? Seven pre-licensure nursing students participated in semistructured Zoom interviews. Data were analyzed using an inductive process consistent with Saldaña’s analytic approach. Analysis revealed one overarching theme- Instructional accommodations …

Optimizing The Charge Nurse Role To Improve Workflow And Communication In A Community Living Center, Ndidi Kalu Ibe

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the impact of optimizing the charge nurse role on workflow efficiency and communication within a Community Living Center. Identified practice gaps included role ambiguity, inconsistent delegation, and communication breakdowns, which contributed to delays in care and decreased staff satisfaction. An evidence-based approach was used to standardize charge nurse responsibilities, strengthen leadership practices, and introduce structured communication processes. The project demonstrated that improving role clarity and leadership consistency supports more effective delegation, enhances team communication, and improves care coordination. Outcome included increased staff engagement, improved workflow efficiency, and enhanced patient safety. This initiative …

Staff Education On Structured Phq-9 Administration To Enhance Depression Screening In Outpatient Mental Health Care, Zekarias F. Abessa

Walden Dissertations and Doctoral Studies

In outpatient mental health settings, inconsistent use of the Patient Health Questionnaire-9 (PHQ-9) due to gaps in knowledge and lack of standardized training can lead to missed opportunities for early identification of depression and delayed treatment. Mental health nurses play a key role in screening and early intervention, underscoring the criticality of this role in practice. The Doctor of Nursing Practice (DNP) project explored whether a structured PHQ-9 staff education program could improve staff knowledge compared to baseline practice. The project involved using an intervention-based quality improvement design to enhance staff knowledge of administering and interpreting the PHQ-9 screening tool. …

Inconsistent Post-Fall Follow-Up And Documentation In A Skilled Nursing Facility, Brooke Beier

Celebrating Scholarship and Creativity Day (2018-)

Falls remain a significant safety concern in skilled nursing facilities and are associated with increased morbidity, hospitalization, and loss of independence among older adults. While fall prevention strategies are widely implemented, inconsistent post-fall follow up and incomplete documentation can negatively impact residents and the facility. At a moderate-sized skilled nursing facility in central Minnesota, a review of recent fall reports identified inconsistencies in post-fall follow-up documentation, as well as gaps in staff education and the absence of a clearly defined post-fall documentation policy. The facility experienced 44 resident falls in the month of January alone, highlighting the urgency of addressing …

Evaluating The Impact Of Evidence-Based Education On The Utilization Of Preoperative Gastric Ultrasound For Patients On Glp-1 Agonists, Rachel K. Gibbons, Wesley Johnson, Rachel Cartillar

Create@State

Abstract

Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists have a 30.5% higher prevalence of retained gastric contents at the time of surgery despite being held according to ASA and AANA recommendations, highlighting the need for enhanced preoperative assessment to reduce aspiration risk (Sen et al., 2024; Willson et al., 2024). Although an effective, noninvasive tool for assessing gastric contents and reducing the risk of pulmonary aspiration, gastric ultrasound remains underutilized in anesthesia practice (Pan et al., 2024). This evidence-based project evaluated whether an educational intervention could improve anesthesia providers’ knowledge, attitudes, and readiness to adopt point-of-care gastric ultrasound (POC-GUS) into …

Optimizing Glycemic Control In Type Ii Diabetes: Continuous Glucose Monitoring : A Scoping Review, Sarah Poe, Bsn, Rn, Bailey Li, Bsn, Rn, Tracy Mcclinton, Dnp, Aprn, Ag-Acnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Individuals with Type II diabetes mellitus (T2DM) experience increased risk of cardiovascular disease and higher mortality rates relative to non-diabetic populations. Continuous glucose monitoring (CGM) enables more precise analysis of glucose patterns and trends compared to conventional self-monitoring of blood glucose (SMBG). CGM provides frequent measurements and generate meaningful metrics, such as time in range (TIR), time above range (TAR), and time below range (TBR), allowing evaluation of glucose stability and variability. Despite these advantages, evidence comparing CGM and SMBG remains inconsistent. This scoping review aims to evaluate how CGM compares with SMBG across reported outcomes, including TIR, TAR, …

Evaluating The Screening And Referral Process For The Use Of Phq-9 Screening Tool In Middle-School Aged Students: A Scoping Review, Kaythi Soe, Msn, Pmhnp-Bc, Fnp-Bc, Margaret Harvey Phd, Acnp-Bc, Fhrs, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

No abstract provided.

Improving Inr Monitoring In Outpatient Cardiology: A Quality Improvement Initiative To Enhance Anticoagulation Safety, Antonette Atori

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to reduce uncaptured INR results by 5% over 12 weeks in an outpatient cardiovascular clinic by implementing a standardized tracking workflow.

Background

Suboptimal anticoagulation management in outpatient settings can lead to uncaptured International Normalized Ratio (INR) results, delayed therapy adjustments, and increased risk of bleeding or thromboembolic events.

Methodology

Guided by the Plan-Do-Study-Act (PDSA) framework, a pre–post intervention design was used. Interventions included an electronic medical record (EMR)-based tracking system using a reminders inbox for overdue results and nurse-led follow-up phone calls. Data was collected from the EMR and analyzed using descriptive statistics, …

Use Of The Casper Test As An Admissions Test For Predicting Academic And Clinical Performance In Student Registered Nurse Anesthetists: A Predictive Correlational Study, Barbara A. Acord

Doctoral Dissertations and Projects

This quantitative, non-experimental, predictive correlational study examined the extent to which CASPer test scores predict academic and clinical performance among student registered nurse anesthetists (SRNAs). Certified registered nurse anesthetists (CRNAs) provide over 80% of anesthesia services in the United States, showing the importance of effective admissions processes to identify candidates most likely to succeed academically and clinically. Traditional admissions criteria in nurse anesthesia programs largely prioritize grades and may underrepresent non-cognitive attributes associated with student success. A convenience sample used a medium effect size, power of .8, and alpha level of .05, with G*Power calculated to be 85 participants 2nd …

Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow, Jack Kennady

Books, Presentations, Posters, Etc.

Context/background: Adverse events after hospital discharge are common and represent a major patient safety concern. Approximately 1 in 5 patients experience a safety event after discharge, and 39% of these events are adverse drug events (ADEs), with 26% considered preventable. Medication discrepancies during transitions of care contribute significantly to these events, with an estimated 40% of medication errors resulting from inadequate medication reconciliation. Rural primary care clinics face additional challenges, including limited communication between inpatient and outpatient systems and inconsistent reconciliation workflows. Improving medication reconciliation during the transition from hospital discharge to outpatient follow-up represents an important opportunity for family …

Associate Degree Program Administrator Perceptions Of Clinical Dishonesty, Cynthia Moore Swineford

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to explore the perceptions of associate degree nursing program administrators regarding faculty reporting of dishonest clinical behaviors by pre-licensure nursing students. Aristotle’s theory of virtue ethics guided this examination of how administrators interpret ethical responsibility, leadership influence, and professional accountability related to clinical dishonesty. The central research question asked, “What are the perceptions of associate degree program administrators regarding faculty reporting of dishonest student behaviors in clinical settings?” The sample included 11 associate degree nursing program administrators from programmatically accredited nursing programs in three mid-Atlantic states. Data were collected through semi-structured interviews, …