Nursing Commons^™

Enhancing Shared Decision-Making In Mental Health Care: A Quality Improvement Initiative, Joanna L. Hysler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is an evidence-based approach that enhances patient engagement, treatment adherence, and clinical outcomes in psychiatric care. Despite strong support in the literature, SDM remains inconsistently implemented in mental health settings due to limited provider training, time constraints, and organizational barriers. The purpose of this Doctor of Nursing Practice quality improvement project was to implement and evaluate an educational intervention designed to improve SDM utilization and provider confidence within a private outpatient psychiatric practice. The project was guided primarily by the Plan-Do-Study-Act framework to support structured practice change, with Lewin’s Change Theory providing additional conceptual support. The intervention …

Quality Improvement Project: Reimplementation Of Bedside Reporting, Veronicah Banga

Doctor of Nursing Practice Projects

Communication breakdown during nursing shift handoffs is a major patient safety challenge in healthcare today. At the project site, 85% of handovers occurred at the central nursing station, and most staff nurses expressed dissatisfaction with the quality of the bedside reporting. In psychiatric nursing, unique barriers exist that make bedside reporting challenging, including patient confidentiality and an individual's diagnosis. Such barriers eroded bedside reporting (BSR) over time, leading to measurable safety risks and nursing dissatisfaction. The purpose of this quality improvement project was to reintroduce bedside handoffs using the Situation, Background, Assessment, and Recommendation (SBAR) framework and to maintain BSR …

Organizational Governance Capacity And Organizational Resilience In Hospitals: A Cross-Sectional Study, Leyla Afşar, Selim Yazıcı

Makara Journal of Health Research

Background: This study aims to examine the relationship between organizational governance capacity (OGC) and organizational resilience (OR) in hospitals, with a focus on cross-institutional differences.

Methods: A cross-sectional study was conducted among 1,143 employees from six hospital types in Istanbul, including university, Ministry of Health (state, training and research, and city), and private hospitals. Validated scales were used to measure OGC and OR. Data were analyzed using descriptive statistics, nonparametric tests, and structural equation modeling (SEM) to assess the relationships between these dimensions.

Results: Private hospitals demonstrated the highest levels of both OGC and OR (70%), followed …

Frailty And Fall Risk In Older Adults With Type 2 Diabetes: A Cross-Sectional Study, Hatice Yılmaz, Nazmiye Çıray

Makara Journal of Health Research

Background: This study aimed to examine the effect of frailty on the risk of falls in older adults aged 65 years with type 2 diabetes.

Methods: The study is cross-sectional and correlational. The sample included 146 individuals aged 65 years who had type 2 diabetes and visited the internal medicine outpatient clinic of a state hospital in Türkiye. The participants were assessed based on a personal information form, the Mini-Mental State Examination, Edmonton Frail Scale, Morse Fall Scale, and Katz Index of Independence in Activities of Daily Living. IBM SPSS Statistics version 22.0 was used for data analysis. …

Examination Of Health-Seeking Behavior In Individuals With Chronic Diseases, Dilan Aktepe Coşar, Hatice Demirağ, Aynur Cin

Makara Journal of Health Research

Background: Chronic illnesses are long-term, noncommunicable diseases that significantly affect daily life. In addition to physical symptoms, they can reduce quality of life by causing psychological effects such as anxiety and depression. Patients often seek health information to better manage their condition.

Methods: This study aimed to examine the level of health information-seeking behavior among individuals with chronic diseases and the factors influencing this behavior. The sample group for this descriptive study consisted of 306 individuals with chronic illnesses who visited X Hospital in northeastern Türkiye between April 1, 2024, and February 1, 2025. All individuals completed a …

The Mediating Role Of The Care Factor In The Effect Of Nomophobia On Nurses’ Job Satisfaction, Uğur Öner, Sinan Aslan, Erhan Ekingen

Makara Journal of Health Research

Background: This study aimed to examine the mediating role of the Care Factor in the relationship between nomophobia and job satisfaction among nurses.

Methods: A descriptive, cross-sectional study was conducted with 1,083 nurses working in a province in Turkey between May and September 2024. Data were collected using a Descriptive Form, the Fırat Nomophobia Scale (FNS), the Care Factor Scale (CFS), and the Job Satisfaction Scale for Nurses (JSSN). All analyses were performed using SPSS 25, including descriptive statistics, Pearson correlation, and regression. Mediation was tested using PROCESS Macro version 4.0 (Model 4).

Results: The CFS-CS and …

Implementing A School Nurse-Facilitated Communication And Tracking Bundle To Improve Vision Care Follow-Up Rates, Natalie Autumn Johnston

ONU Student Research Colloquium

Abstract

Problem: Children’s cognitive, physical, and social development are influenced by vision. This means that early interventions in school-aged children are critical. While school-based vision screenings are standardized and effective in identifying visual deficits, post-screening follow-up rates with eyecare professionals remain low. This trend is especially prevalent in underserved school districts, perpetuating systemic healthcare gaps.

Purpose: The purpose of this study is to evaluate whether the rates of follow-up eye care among school-aged students who fail vision screening will improve following the implementation of school nurse facilitated follow-up communication and referral tracking bundle.

Methods: This study will …

Staff Education To Improve Knowledge Of Evidence-Based Engagement Strategies To Reduce No-Show Rates, Jerrica Luster

Walden Dissertations and Doctoral Studies

High no-show rates in outpatient mental health settings remain a persistent barrier to effective care delivery, negatively affecting continuity of care, patient outcomes, and access to services. In the identified practice setting, inconsistent use of evidence-based engagement strategies beyond standard reminder practices contributed to missed appointments. The purpose of this Doctor of Nursing Practice project was to evaluate whether a structured staff education intervention on evidence-based engagement strategies would improve staff knowledge as a foundation for enhancing appointment adherence. A quantitative pre- and posttest design was used to evaluate knowledge change following the intervention. Participants included outpatient mental health clinic …

Community-Based A1c Screening Initiative To Improve Diabetes Risk Identification Among People Experiencing Homelessness, Rebecca Drake, Deedee Long, Mariita Carter

Student Works

Abstract

Purpose: People experiencing homelessness (PEH) experience high rates of undiagnosed diabetes yet face significant barriers to preventive screening. This quality improvement project aimed to improve access to diabetes screening for PEH through on-site hemoglobin A1C (A1C) testing in a trusted community setting.

Methods: On-site A1C screening was implemented at the Utah County Food and Care Coalition (F&CC) using a low-barrier, community-based approach. Screening was conducted during routine service hours and integrated into existing workflows. Process, outcome, and balancing measures were used to evaluate feasibility, reach, and unintended effects.

Results: The intervention primarily supported identification of diabetes risk and referral …

Optimizing Costs & Efficiency With Heartcode Complete: A Quality Improvement Project, Jessica Bryant

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to implement HeartCode Complete (HCC), a simulation-based BLS training platform, at a 154-bed community hospital. The goal was to replace instructor-led BLS training, improve training efficiency, reduce costs, increase certification compliance, and enhance staff satisfaction.

BACKGROUND

Maintaining competency in CPR is a regulatory requirement for healthcare providers. Traditional instructor-led BLS training requires scheduled classes, instructor availability, and staff time away from clinical duties, contributing to certification delays and operational inefficiencies. Simulation-based training platforms offer self-directed learning with real-time feedback.

METHODOLOGY

This quality improvement project used Lean Six Sigma principles and Plan-Do-Study-Act cycles to guide …

Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project aims to fill the gaps in the management of knee osteoarthritis (OA) in adults aged 40 to 75 years in a primary care practice. Knee OA is a common chronic disease that significantly impacts pain, mobility, and quality of life. Although there is empirical evidence that nonpharmacological interventions, including exercise, weight control, and self-management education, are effective, these methods are not consistently used in clinical practice, and pharmacologic treatment continues to be used. The project was designed to inform healthcare personnel about evidence-based nonpharmacological strategies to improve patient outcomes and reduce reliance on …

Hospital-Acquired Pressure Injury Prevention Using A Care Bundle In A Neuroscience Intensive Care Unit, Sarah Dolick

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement DNP project was to implement a preventative care bundle to reduce the number of hospital-acquired pressure injuries.Compliance with bundle elements was monitored through weekly bedside audits. HAPI data were collected for 12 weeks pre-intervention and 12 weeks post-intervention to evaluate outcomes. The project utilized Plan-Do-Study-Act (PDSA) cycles to refine implementation and address barriers in real time.

Background: The project was implemented in a 32-bed neuroscience intensive care unit in an academic center in the Texas Medical Center.

Results: After implementation of the care bundle, average HAPIs decreased from 4.6 per survey (pre-intervention) to …

Staff Education On Early Sepsis Recognition For Medical-Surgical Nurses In The Acute Care Setting, Nadine Nzenga Udom

Walden Dissertations and Doctoral Studies

In this staff education project, I targeted early sepsis recognition and response among medical-surgical nurses. The practice gap at the site was nurses’ limited knowledge of sepsis indicators and screening tools, which contributed to delayed escalation of care. The practice-focused question guiding the project was “Does educating medical-surgical nurses on early sepsis recognition and response improve knowledge of early sepsis recognition and response?” I applied the analysis, design, development, implementation, and evaluation (ADDIE) and Johns Hopkins Evidence-Based Practice (JHEBP) models to design a structured sepsis education program for nursing staff. I searched for peer-reviewed literature via databases accessed through the …

Gamification As A Strategy For Interprofessional Learning, Chisom S. Enebechi, Aislinn M. Dorko

Research & Creative Achievement Day

Background: A Community-based, student-led clinic provides free health services to underserved areas, bringing together students from allied health disciplines to promote interprofessional collaboration and health promotion. Previous orientation sessions were lecture-based with a team-building activity providing limited opportunities for active learning. To address this, a gamified orientation activity was developed using realistic, scenario-based cases designed to exemplify common community health situations. Purpose: This quality improvement project aims to evaluate whether gamification improves students' perceived ability to communicate, collaborate, and understand roles and responsibilities when delivering team-based care. Methods: The project was guided by Bandura's Social Learning Theory and implemented using …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray Johnson

Wisdom & Compassion: The LUSON Journal

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to adolescents aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was the framework used to implement the quasi-experimental study. The two …

Non-Alcoholic Fatty Liver Disease, Diet And Contributing Factors: A Narrative Literature Review, Rachel Joseph, Ashley Tharpe, Sherri Ann Walker

Wisdom & Compassion: The LUSON Journal

Objectives: The purpose of this narrative literature review is to explore the relationship between Non-alcoholic fatty liver disease (NAFLD) and dietary habits, and identify factors that contribute to the development, progression, and potential management of NAFLD.

Methods: Search terms such as non-alcoholic fatty liver disease (NAFLD), diet, and nutrition, including plant-based and vegetarian diets, were used to identify 45 peer-reviewed publications published within the last five years.

Results: Dietary factors, biological, environmental, obesity, mental health, and genetic factors can contribute to the development of NAFLD. This multisystem problem can have economic, social, and psychological consequences that affect a person’s quality …

Resilience In Nursing Education: A Literature Review Examining The Experiences Of Ukrainian Nursing Students In The United States, Katherine Ferrell, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

The purpose of this literature review is to examine the experiences of international students who originate from war-torn areas, who live in the United States (US). Drawing from peer-reviewed sources, the review examines the academic, psychological, and social challenges these students face, including trauma, cultural adjustment, and gaps in institutional support. It highlights the resilience and coping strategies employed by students, as well as the role of universities in fostering inclusive environments. The review also identifies critical gaps in current research, particularly regarding long-term mental health outcomes and culturally responsive support services. This paper aims to synthesize existing literature on …

Navigating Life And Death: A Moral Critique Of Euthanasia Practices Worldwide, Brooke Fuzie, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Euthanasia and physician-assisted death remain deeply debated ethical issues shaped by history, law, and cultural values. This narrative review explores how diverse ethical frameworks, shifting global legislation, and cultural perspectives inform current discourse, with special attention to the role of nurses guided by the American Nurses Association (ANA) Code of Ethics. Drawing on peer-reviewed studies, legal documents, and recent case analyses published between 2013 and 2025, the review identifies three key insights. Ethical frameworks influence whether society accepts or opposes euthanasia; robust legal safeguards are needed to protect autonomy and prevent misuse; and palliative care and advance care planning, including …

Perceived Knowledge, Attitude, Practice, And Barriers Of Jordanian Nursing Faculty To Integrate Genomic Concepts In The Curriculum: A Cross-Sectional Descriptive Study, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Background: Rapid advances in genomics knowledge and the expansion of precision medicine have amplified expectations for nurses to integrate genomic concepts into education and clinical practice. Evidence regarding genomic knowledge, attitudes, practices, and barriers among nursing faculty in the Middle East is limited. To equip practicing and emerging nurses, faculty must be equipped. Faculty preparedness is critical to successful curriculum integration and to preparing future nurses for genomic-informed care.

Purpose: This study examined the perceived knowledge, attitudes, practices, and barriers related to integrating genomic concepts in the nursing curriculum among nursing faculty in Jordan.

Methods: A cross-sectional descriptive design was …

More Than Machines: Our Identity In Christ, Jerrod A. Boggs

Wisdom & Compassion: The LUSON Journal

No abstract provided.