Nursing Commons^™

Quality Improvement Project Stress First Aid: Equipping Nurse Leaders, Bethany Russell

Doctor of Nursing Practice Projects

Stress among nurses can negatively affect well-being, workforce stability, and the quality of patient care, highlighting the need for nurse leaders to effectively recognize and respond to stress within their teams. The purpose of this quality improvement project was to evaluate whether education on the 7 Cs of Stress First Aid (SFA) improved leadership self-efficacy among nurse leaders at an urban acute-care hospital. Watson’s Theory of Human Caring provided the theoretical foundation, while Lewin’s Change Theory guided implementation of the practice change. A one-group pretest-posttest design was used, with the Plan-Do-Study-Act framework supporting project implementation. Participating nurse leaders completed an …

Integrating Interprofessional Education To Strengthen Team-Based Mental Health Care, Adebisi Tijani

Doctor of Nursing Practice Projects

Fragmented interprofessional collaboration in outpatient mental health settings compromises care coordination and patient engagement. This quality improvement (QI) project implemented a structured interprofessional education (IPE) workshop series to improve team collaboration and reduce patient no-show rates in an outpatient mental health clinic. Guided by Bandura's Social Cognitive Theory and Lewin's Change Management Model, the project used a pre-post, single-group design with 12 licensed mental health professionals. The team measured collaboration with the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) and collected aggregate patient no-show rates from the electronic health record. The intervention consisted of four monthly, one-hour workshops covering role …

Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White

Doctor of Nursing Practice Projects

Variability in clinical teaching practices can contribute to inconsistent faculty preparation and student learning experiences. This quality improvement project addressed the absence of a standardized clinical teaching resource within an Associate Degree Nursing (ADN) program at a public technical college in the southeastern United States. The purpose was to implement a standardized, evidence-based clinical teaching guide to improve faculty confidence and clinical educator skill acquisition. Social Cognitive Theory provided the theoretical framework, and Lewin’s Change Theory guided practice change. A quantitative, quasi-experimental one-group pretest-posttest design was used. Fourteen eligible nursing faculty and clinical instructors were invited to participate; 10 participated, …

Nurse-Led Remote Patient Monitoring In Outpatient Heart Failure, Jackline Ukadike

Walden Dissertations and Doctoral Studies

Chronic heart failure (HF) remains a leading cause of avoidable hospital readmissions and emergency department visits due to delayed recognition of early symptom exacerbation between routine outpatient encounters. This doctoral quality improvement project evaluated whether the implementation of an evidence-based, nurse-led remote patient monitoring (RPM) standard operating procedure (SOP) improved early identification of symptom exacerbation compared to standard episodic care among adult heart failure patients (NYHA Class II–III) in an outpatient primary care setting over a 10-week period. Guided by the Plan-Do-Study-Act (PDSA) framework, an evidence-based clinical practice guideline (CPG) and escalation protocol were developed and appraised by a 3-member …

Staff Education On Teaching Evidence-Based Chronic Pain Management, Valdane Eleonu Robinson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on educating providers to fill in knowledge gaps in how to effectively manage chronic pain. The lack of knowledge about the evidence-based recommendations for treating chronic pain was the practice gap. Standardized training protocols to instruct pain management professionals and address disparities in chronic pain management care should be in place to guarantee that all patients in need of chronic pain management have access to culturally appropriate education.

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

Standardized Screening And Monitoring Of Bioidentical Hormone Replacement Therapy In Women Ages 35–50, Amanda Ellen Hampton

Walden Dissertations and Doctoral Studies

In this quality improvement project, I evaluated a pilot implementation of a standardized bioidentical hormone replacement therapy (BHRT) screening and monitoring tool embedded within the electronic health record (EHR) at an integrative medicine practice in the southeastern United States. Grounded in the Johns Hopkins evidence based practice (EBP) model, the project addressed a documented gap in consistent screening, initiation, and monitoring of hormone replacement therapy (HRT) for women ages 35 to 50 presenting with menopausal symptoms. The practice focused question examined whether a standardized, EHR embedded BHRT screening and monitoring tool could improve screening rate compliance, laboratory monitoring adherence, and …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Enhancing Early Detection Of Suicide Risk In Outpatient Settings Through Standardized Implementation Of The Ask Suicide Screening Questions Tool, Shayla Lee

Doctor of Nursing Practice Projects

Suicide is a leading cause of death in the United States, highlighting the need for routine suicide risk identification. Evidence supports standardized suicide screening can promote early identification of suicide risk. A needs assessment at an outpatient mental health clinic identified the absence of a standardized suicide screening and referral process. The purpose of this quality improvement project was to implement the Ask Suicide-Screening Questions (ASQ) Tool and a standardized referral protocol. The aim was to evaluate ASQ documentation, referral rates, and staff self-efficacy over four weeks. Peplau’s Interpersonal Relations Theory, Lewin’s Change Theory, and the Plan-Do-Study-Act (PDSA) framework guided …

Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) remains a significant public health concern in rural communities, where limited specialty care, geographic isolation, transportation barriers, and stigma may delay testing and entry into care. The Texas Panhandle is a geographically expansive rural region served by rural hospitals with limited resources. Although area HIV services are available, they are inconsistently utilized. Although chief nursing officers (CNOs) influence practice and care coordination, knowledge gaps regarding HIV guidelines, prevention strategies, and regional resources may limit identification, referral, and continuity of care. The purpose of this doctor of nursing practice (DNP) project was to determine whether a targeted …

Development Of An Evidence-Based Clinical Practice Guideline For Glp-1 Medication Management And Weight-Loss Monitoring In Adults, Jeannette Mariela Pena

Walden Dissertations and Doctoral Studies

This doctor of nursing practice project addressed the lack of a standardized clinical practice guideline for glucagon-like peptide-1 (GLP-1)-based medication management and weight-loss monitoring in an outpatient functional health setting. The purpose was to develop an evidence-based guideline to improve provider consistency, patient education, monitoring, documentation, and treatment safety for adults receiving GLP-1-based weight-management therapy. The Johns Hopkins Evidence-Based Practice Model guided question development, evidence appraisal, synthesis, translation, and implementation planning. The guideline incorporated evidence related to adult obesity management, GLP-1-based pharmacotherapy, lifestyle intervention, eligibility assessment, medication selection and titration, adverse-effect monitoring, follow-up, and documentation. Three content experts—a nurse practitioner …

Implementation Of Asynchronous Mentor Education Modules To Improve Mentoring Competency, Elvira Sayfutdinova

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Structured mentorship supports new CRNAs as they transition to practice, fostering confidence, job satisfaction, and professional growth. The WashU Medicine Department of Anesthesiology (WUDA) launched a CRNA Mentorship Program in 2022, but it lacked standardized mentor education, leading to inconsistent mentor preparation and variable mentoring practices.

Review of Literature Findings: Structured mentor education improves mentoring competency across healthcare settings, yet the literature specific to CRNAs remains limited. Asynchronous, self-paced formats reduce barriers to participation for busy clinicians, but no prior study has evaluated a fully asynchronous, prerecorded mentor-education format for CRNAs.

Methods: This pre-/post quality improvement (QI) …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …

Implementation Of A Learning Module To Reduce Advanced Practice Provider Preceptor Burden, Michelle Bloom

Doctor of Nursing Practice (DNP) Student Projects

The transition of advanced practice providers (APPs) from student to provider, or from an experienced provider to a new organization or location, has been identified as a high-stress period with potential turnover for new-hire APPs. APP preceptors play a key role in this transition. Limited time to teach during the clinical day and a limited knowledge base among new hires were two of many factors associated with increased preceptor burden. A brief online educational module that provided pre-clinical, organization-specific education was proposed to improve new-hire APPs’ knowledge base and reduce preceptor burden, among APP preceptors working in a 36-bed surgical/burn/trauma …

Reimagining Clinical Education: Interprofessional Simulation And Clinical Skill Readiness In Nursing And Occupational Therapy Curricula, Gretchen Johnson, Linda Barnett, Lori Aaron-Brija, Emily Berkowitz

Internet Journal of Allied Health Sciences and Practice

Purpose: As the healthcare landscape evolves, education for health professionals must prepare future practitioners to meet emerging challenges and navigate diverse care settings. Integrating interprofessional education (IPE) opportunities within healthcare curricula supports the development of essential clinical skill competencies and collaboration across multiple disciplines. The Clinical Skill Readiness interprofessional model prepares students for successful clinical rotations by integrating assessment and skill development. Students develop vital interprofessional skills, with specific emphasis on communication, professionalism, and role clarity, all of which are essential for effective practice in a collaborative clinical setting. Methods: Nursing and occupational therapy students participated in timed treatment sessions …

Strategies To Improve Outcomes Of Obstetric Emergencies In Sub-Saharan Africa: A Scoping Review, Serah Wachira, Ruth Wagathu, Beth Waweru, Rose Maina, Abednego Ongeso, Constance Sibongile Shumba, Benard Mutwiri, Diana Mbattude, Cliff Aliga, Lucy Kisaka, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background: Obstetric emergencies remain a leading cause of maternal morbidity and mortality in sub-Saharan Africa (SSA) despite increased access to facility-based deliveries and emergency obstetric care. Improving outcomes requires not only life-saving clinical interventions but also effective health system strategies. This review mapped published evidence on strategies used to improve outcomes of obstetric emergencies in SSA.

Objective: This scoping review aimed to identify strategies reported in the literature to improve outcomes of obstetric emergencies in SSA.

Methods: The review was reported in accordance with PRISMA-ScR. A comprehensive electronic search of PubMed, CINAHL, SCOPUS, and CORE identified studies published between January …

Neonatal Assessment And Vr: Designing 3d Simulation Training For Prehospital Clinicians, Michella G. Hill, Luke Hopper, Belinda Flanagan, Sara Hansen, Alecka Miles, Jess Watson, Sean Cashman, Kirstie Balding, Peggy Dysktra, Joshua Johnson, Brennen Mills

Research outputs 2022 to 2026

Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk …