Nursing Commons^™

Fingernail Enhancement Microbiomes Study, Kendall E. Bare

Undergraduate Honors Theses

Policies in healthcare regarding fingernail enhancements have not been supported by current science. This study examined bacterial colony growth on gel nail enhancements, regular nail polish, and bare natural nails to evaluate which condition harbors the least bacterial microbiota. The hypothesis proposed that gel enhancements would demonstrate the lowest bacterial counts compared to regular polish and unpolished nails. This investigation was conducted in the context of a local healthcare system dress code policy permitting only regular nail polish in clinical settings. Six participants volunteered and underwent nail swabbing in a microbiology laboratory using sterile cotton applicators and a neutral solution. …

The Lived Experience Of Nursing Students Sitting With Patients: A Phenomenological Study, Emma L. Dalton

Undergraduate Honors Theses

In an inpatient healthcare setting, patient sitters play a key role in maintaining the safety of patients who are exhibiting acute psychiatric or behavioral issues. These sitters are often nursing students working as nurse technicians. There is a gap in the literature surrounding sitting with patients, also known as specialling, concerning the lived experiences of nursing students assigned to be patient sitters as part of their job. The aim of this phenomenological study is to elucidate their experiences. The research question guiding this study is: what is the lived experience of nursing students working as patient sitters? Student nurses …

Healthy Living For Unhoused Women, Aliya K. Jatoi

Undergraduate Honors Theses

This capstone thesis details the importance of healthcare for unhoused women. Unhoused women do not have the ability to receive women’s healthcare nor receive proper education surrounding the topic of women’s healthcare. After participating in several events with unhoused women throughout Johnson City, a lack of attention to improving the quality of women’s healthcare was noticed. To address this issue, I began by surveying unhoused women, talking with unhoused women, and collecting online data and statistics regarding homelessness, prevelant diseases, and infection rates among unhoused women. After collecting data, educational materials, such as flyers with information about local resources and …

Improving The Quality Of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation And Supervised Procedures, Ethel C. Estrada

Doctor of Nursing Practice Final Project Abstract

Improving the Quality of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation and Supervised Procedures

Purpose

This quality improvement (QI) project aimed to implement powered bone marrow simulation training and supervised procedures for the Advanced Practice Provider (APP) proceduralists to increase proceduralists' use of powered bone marrow devices and reduce poor bone marrow sampling.

Background

This project was implemented within the Bone Marrow Aspiration Clinic (BMAC) of an academic cancer center in Houston, Texas.

Methodology

Five APP proceduralists completed powered bone marrow device simulation training on the Bone Marrow (BM) Skills Simulator, followed by supervised procedures. Data were …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

Newly Registered Nurses With Neurodiversities: A Qualitative Study Of Their Experiences During Transition To Professional Practice, Heather Wallace

Dissertations and Theses (Open Access)

Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND …

Exploring Teamwork Between Virtual And Bedside Nurses, Caitlin Weinheimer

Dissertations and Theses (Open Access)

Background: Advancing technologies and the use of telehealth have expanded in hospitals to include telenursing. Telenursing introduces a unique dynamic where virtual and bedside nurses work together as a remote team to provide patient care. Published literature reports that teamwork among nurses and healthcare professionals impacts patient and workforce outcomes. However, there is a gap in exploring teamwork between virtual and bedside nurses. Addressing this knowledge gap is critical to ensure positive patient and nursing workforce outcomes in hospital-based telenursing settings.

Objective: To generate a grounded theory that explains teamwork between virtual and bedside nurses in the hospital setting. A …

Breastfeeding Education Preferences Of Pregnant People With Low Incomes, Megan Kindred

Dissertations and Theses (Open Access)

Background: The proportion of infants breastfed at 1 year in the United States remains below the Healthy People 2030 goal. Longer breastfeeding durations are important due to dose-response benefits, but disparities are greater among those with low incomes. Prenatal breastfeeding education (PBE) interventions can increase breastfeeding duration. Additionally, incentivization and gamification can be used to increase use of educational technology but are underexplored in this domain. Prior studies examining PBE format preferences do not reflect currently available technology. PBE format preferences of childbearing people should be reexamined.

Purpose: This purpose of this study is to: (1) identify PBE format preference …

Implementation Of A Standardized Short Stay Pain Protocol To Reduce Pain In Short Term Care Facility, Maggie O'Brien, Kenzie Reuter, Holly Hansen, Elle Wichmann

Celebrating Scholarship and Creativity Day (2018-)

Pain is a common symptom across all areas of nursing care, yet it is often undertreated in skilled nursing facilities, particularly among residents receiving rehabilitation services. Pain in this population may result from a variety of causes, including musculoskeletal conditions, wounds and pressure injuries, neuropathic pain, and chronic illnesses. A review of Minimum Data Set (MDS) reports and resident pain reports from the short-term rehabilitation unit revealed a concern of disparity. Long-term care residents demonstrated strong quality indicator scores (9.21 out of 10), while short-term stay residents scored significantly lower (2.76 out of 10). This discrepancy raised concerns about pain …

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Disease (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Posters and Presentations

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …

The Eating Patterns Of College Students In Appalachia, Corinne A. Geffen

Undergraduate Honors Theses

Historically, the Appalachian region of the United States has higher levels of poverty than other areas of the country. Food insecurity rates are highest for households with incomes below the poverty line. Americans with food insecurity who participate in the Supplemental Nutrition Assistance Program (SNAP) consume more ultra processed foods (UPFs). Higher rates of UPF consumption can lead to an increased risk of noncommunicable diseases. The production of UPFs is a trillion-dollar industry that puts profits over public health. This is now a global health concern as noted by the World Health Organization. An ethnographic investigation was conducted to understand …

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

Undergraduate Nursing Students’ Reactions To Germ Exposure Based On The Big 5 Personalities, Elizabeth Macdonald

Honors Scholar Theses

Despite extensive didactic and clinical training, variability in adherence to infection prevention practices in undergraduate nursing students exists. Individual differences, such as personality, may help to explain this inconsistency. The purpose of this study was to examine the extent to which the Big Five personality traits were associated with self-reported pathogen mitigation or avoidance behavior in undergraduate nursing students. An online survey design was used with undergraduate nursing students. Participants were presented with scenarios depicting different pathogen exposures and asked to indicate their likelihood of engaging in pathogen mitigation behaviors. The Big Five personality traits were also assessed, and bivariate …

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Honors Theses

Background: Few studies examine language barriers in the neonatal intensive care unit (NICU). Miscommunication and lack of understanding between the healthcare team and a NICU infant’s parents may easily occur when the relationship is inhibited by a language barrier. Previous studies show that a lack of parent-provider communication creates additional anxiety for parents. The purpose of this study is to explore and describe the experiences and barriers in communication between an English-speaking nurse, an English-Spanish bilingual nurse, and a Spanish-speaking mother of a NICU infant.

Methods: This project was a case study using an exploratory mixed methods qualitative design. Qualitative …

Community Perceptions Of A Hospital-Based Doula Program In Mobile, Alabama, Sarah Laney

Honors Theses

Background: The maternal mortality ratio in the United States is much higher than the mortality rate for women who live in other countries with similar Human Development Index scores. Black women are more likely to die than their white counterparts. Most of these deaths are preventable. Patients feel like they are being ignored, or that they are not being seen. Doula care is a possible solution to these problems.

Purpose: The purpose of this study was to assess patient understanding and perception of doulas as well as comparing desire for doulas to demographics and past experiences to search for relationships. …

A Program Evaluation Of A Family-Based Healthy Weight Program For Overweight And Obese Children And Their Families, Ashley Heimbouch, Margaret Platel, Kelly Betts

Doctor of Nursing Practice Projects: College of Nursing

This project’s purpose was to complete a program evaluation of the Building Healthy Families (BHF) program to determine its effect on children and their families’ health outcomes. The specific aims of success were 1) an improved perception of health-related quality of life for children and parents and 2) decreased body mass index (BMI) percentiles for age and sex in children from baseline measurements and scores compared to measurements and scores at 3 months and 6 months of program completion. The project was completed in a community setting on the University of Nebraska Medical Center’s Western Nebraska campus, and the population …

Improving Quality Of Bowel Preparation Through Digital Innovation In The Gastroenterology Clinic, Arlena S. Grays

Doctor of Nursing Practice Final Project Abstract

Improving Quality of Bowel Preparation Through Digital Innovation in the Gastroenterology Clinic

Purpose

This quality improvement project (QIP) aimed to enhanced bowel preparation quality by supplementing traditional verbal and written instructions with digital guidance using quick response (QR) code access and artificial intelligence (AI).

Background

The project was implemented at an outpatient gastroenterology practice within a medical center, which encompasses an outpatient endoscopy center in Houston, Texas.

Methodology

The project utilized the Boston Bowel Preparation Scale (BBPS) to evaluate the impact of the intervention on bowel preparation scores. The study used a 5-point Likert questionnaire to assess perceived ease of …

Improving Documentation Compliance During Obstetric Massive Transfusion Events Through Implementation Of A Standardized Flowsheet, Kirstie Barrick

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to implement a standardized MTP documentation flowsheet in a Level IV maternal Labor and Delivery unit and increase documentation compliance to ≥80% within one month of implementation.

Results: One-month post-implementation, documentation compliance reached 82%, exceeding the established goal of 80%. Compliance remained stable across monitoring periods, suggesting early adoption and short-term sustainability. Staff reported high usability ratings, improved workflow efficiency, and increased confidence in documenting MTP events following simulation-based education. Minimal missing data and consistent survey responses supported reliability of findings.

Background: Obstetric hemorrhage is a leading cause of maternal morbidity. …

Improving Nursing Engagement In Fall Prevention Strategies Using The Stay Independent Check Your Risk For Falling Questionnaire Instrument On A Geriatric Trauma Unit, Savanah Weaver

Doctor of Nursing Practice Final Project Abstract

Purpose

The CDC validated Stay Independent Check Your Risk for Fall (SICRFQ) tool was integrated on a geriatric trauma unit. This initiative sought to improve nurse-driven, individualized fall prevention through the identification of patient-specific fall risk factors among older adults.

Background

Inpatient falls are burdensome on patients and hospitals. The SICRFQ tool can aid in screening for patient specific risk factors. Screening and nurse-led fall prevention strategies can reduce falls in the acute care setting.

Methodology

The PDSA cycle was utilized to guide project implementation. The SICRFQ was assessed at admission and screened every shift by nursing staff. Pre and …