Nursing Commons^™

Evaluation Of The Prevention And Management Of Assaultive Behaviors (Pmab) Training For Outpatient Ambulatory Care Staff, Michaela Bowles

Doctor of Nursing Practice

Background: Workplace violence (WPV) disproportionately affects healthcare workers and harms both staff well-being and the healthcare organization. Despite growing attention to WPV prevention, effective solutions remain limited. The purpose of this project was to evaluate the Prevention and Management of Assaultive Behaviors (PMAB) training in an outpatient ambulatory care setting and to assess staff’s confidence and ability to respond to escalating situations. Methods: A pre/post observational survey using Likert-scale, multiple choice, yes/no questions and narrative responses measured confidence before, immediately after, and 3 to 12 months following PMAB training. A retrospective review of WPV incident reports three months before and …

Mindbodystrong: A Pilot To Address Nursing Burnout & To Promote Wellness, Leilah Hunt

Doctor of Nursing Practice

Background: Nursing burnout rates have increased significantly since the Covid-19 pandemic, not only within the United States but throughout the world. As burnout is multifaceted in nature, identifying and addressing the root cause of burnout has been challenging. One approach to remedy burnout effects is by enhancing wellness through daily practice of healthy habits. Purpose: The purpose of this DNP project was to pilot and evaluate the effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on self-rated anxiety, stress, depressive symptoms, and burnout symptoms in a sample population of nurses at a large psychiatric hospital. This program has …

Measuring Provider Confidence In Using Long-Acting Injectable Antipsychotics In Hospitalized Adults With Schizophrenia Spectrum Disorders, Rachel Mccluskey

Doctor of Nursing Practice

Background: Schizophrenia spectrum disorders are severely disabling conditions requiring ongoing pharmacological management. Rates of medication nonadherence among individuals with schizophrenia spectrum disorder are high and strong evidence exists for the benefits of long-acting injectable antipsychotics (LAI) over oral antipsychotics. Despite this, only 10% of patients in Washington State with schizophrenia spectrum disorders are administered longacting injectable antipsychotics. Purpose: The purpose of this project was to measure change in provider’s confidence in prescribing LAI for hospitalized patients with schizophrenia spectrum disorders following one-on-one motivational information (MI) style informational/discussion sessions coupled with a prescribing reference. Methods: This quality improvement project surveyed provider’s …

Blink & Beat: Pupillometry Response In Autonomic Nervous System Monitoring, Ximena Castillo

2026 Spring Honors Capstones Projects

In the neuroscience intensive care unit (NSICU), nurses rely on advanced monitoring tools to detect neurological deterioration. Two noninvasive measures, heart rate variability (HRV) and pupillary light reflex (PLR), are used to assess autonomic nervous system function; however, it remains unclear whether these indicators provide overlapping or distinct information. The purpose of this observational prospective study is to evaluate the relationship between HRV and quantitative pupillometry measurements to determine whether these noninvasive indicators provide congruent information. Data already collected as routine care from NSICU patients is extracted from the medical record for analysis. Understanding the correlation between HRV and PLR …

Vap Prevention By Improving Icu Oral Care, Chi Hao Su

Doctor of Nursing Practice Final Project Abstract

Purpose 
To increase night-shift adult ICU nurse compliance with standardized oral care documentation by at least 20% as a core ventilator-associated pneumonia (VAP) prevention process.
Background
VAP is a preventable healthcare-associated infection associated with increased morbidity, mortality, ICU length of stay, and costs. Oral-care documentation is often inconsistent because of competing priorities and workflow barriers.
Methodology
Guided by the Knowledge-to-Action framework, this QI project used three PDSA cycles after a September 2025 baseline in a 16-bed ICU. Interventions included 1:1 simulation, EPIC prompts, and bedside coaching; manual audits addressed EPIC misclassification. Trends and run charts analyzed 183 records; surveys assessed …

Reducing Computed Tomography Delay In A High-Volume Emergency Department, Sarah Ouedraogo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Delays in computed tomography (CT) imaging contribute to prolonged emergency department (ED) length of stay and delayed clinical decision-making. At the project site, baseline data demonstrated an average ASAP CT order-to-scan time of approximately 116 minutes for non-critical ED patients, with CT readiness compliance rates of 0%. Gap analysis identified inconsistent patient preparation and fragmented communication between ED nursing and radiology as key contributors to avoidable delays. PICOT question: In non-emergent emergency department (ED) patients (P), how does the use of a CT readiness checklist by ED nurses (I), compared with no standardized readiness checklist (C), affect patient readiness …

Dnp Final Report: An Evidence-Based Project To Decrease Stress In Undergraduate Nursing Students, Elaine Wallace

DNP Final Reports

Stress among undergraduate nursing students is a well-documented concern that negatively affects academic performance, clinical readiness, well-being, and program retention. Stress levels are often heightened before clinical skills check-offs, highlighting the need for practical, evidence-based interventions. This Doctor of Nursing Practice quality improvement project examined whether mindfulness-based mandala coloring could reduce perceived stress in undergraduate nursing students. Using the PICOT framework, the project evaluated whether undergraduate nursing students (P) who participated in mindfulness-based mandala coloring (I), compared with no intervention (C), experienced reduced perceived stress levels (O) over a 12-week implementation period (T).

A comprehensive search of the literature supported …

Safe (Stop-Ask-Feel Empowered), Heather Smith, Allie Dunlap, Madi Rabideaux, Sonia Cardeiro

SPARK Symposium Presentations

The SAFE (Stop–Ask–Feel Empowered) initiative strengthens patient safety by increasing bedside nurses’ confidence and consistency in questioning provider orders and clinical decisions. Hierarchical culture, fear of negative reactions, and low confidence often prevent nurses from seeking clarification, increasing the risk of preventable errors. SAFE directly addresses these barriers by embedding structured inquiry into daily nursing practice. 

Guided by Lewin’s Change Theory, SAFE will be implemented over six months. All unit nurses will receive standardized SAFE badge cards that provide clear, formatted prompts to support respectful, effective communication with the interdisciplinary team. These badge cards serve as a practical, visible reminder …

Peri-Op Protect: A Unified Pre-Op To Pacu Medication Reconciliation System, Tyler G. Van Note, Ariana Amalia Anast, Samantha Ashley Steiner, Tara Gilbert

SPARK Symposium Presentations

Peri-Op Protect: A Unified Pre-Op to PACU Medication Reconciliation System

Peri-Op Protect is a nurse-led change initiative designed to improve medication safety and communication during surgical patient transitions from pre-operative care through the operating room and into the post-anesthesia care unit at a local hospital. Transitions of care are among the most vulnerable moments in the surgical process, as critical medication information – including home medications, last doses, allergies, intraoperative medications, and pain management plans – must be accurately communicated across multiple teams. Communication breakdowns are a leading contributor to adverse events in healthcare, and inconsistent medication handoff processes can …

Free Money And Safer Patients, Kaitlyn R. Livingston, Kennedy G. Crites, Jazmine Razo, Erin Radigan, Kennedy Crites

SPARK Symposium Presentations

This quality improvement project aims to improve consistency of nurse compliance with daily chlorhexidine gluconate (CHG) bathing in a local oncology unit to reduce the risk of central line-associated bloodstream infections (CLABSI’s). CLABSI’s remain a preventable source of patient morbidity, prolonged hospitalization, delayed cancer treatment, and increased healthcare costs, particularly among immunocompromised oncology patients who frequently require central venous access. Evidence supports daily CHG bathing as an effective infection prevention intervention; however, inconsistent completion and documentation across day and night shifts limit reliability in practice. This project addresses both documentation accuracy and actual bathing completion to ensure care consistency. Implementation …

Gamification And Serious Games In Undergraduate Nursing Education For Disaster Preparedness In The United States, Jacob Fast

Dissertations

Disaster preparedness is a critical component of undergraduate nursing education, yet traditional instructional approaches often inadequately prepare students for the complexity and uncertainty of real-world emergencies. Emerging literature suggests that gamification and serious games may enhance engagement and applied learning; however, limited research has examined their integration within nursing curricula from the perspective of faculty responsible for instructional design. This convergent mixed-methods study investigated the extent of integration, perceived effectiveness, and practical utility of gamification and serious games in undergraduate nursing education for disaster preparedness. Quantitative data were collected through a national survey of faculty teaching in CCNE- and ACEN-accredited …

Understanding The Experiences Of Black Women Becoming Single Mothers By Choice Using Assisted Reproductive Technology, Jessica Chantal Prepetit

Theses & Dissertations

The term Single Mothers by Choice (SMBC) refers to women who choose to have a child without a partner. According to the American Society for Reproductive Medicine (ASRM), ovarian reserve decreases with a woman’s age. Women are born with approximately 1 million eggs; this number decreases over time. When a woman reaches 35 years of age, which is considered advanced maternal age, their egg count and quality decline. These factors of low ovarian reserve can place a woman in a category of infertility. Also, a woman may unknowingly suffer from uterine abnormalities that may hinder a successful pregnancy. As women …

Improving Throughput: A Quality Improvement Initiative To Expedite Inpatient Psychiatric Placement From The Emergency Room, Candice J. Battle

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of a standardized psychiatric transfer workflow designed to reduce emergency room (ER) boarding time for psychiatric patients in a 30-bed acute care hospital from an average of 3-5 days to an average of 2-3 days.

Background

Psychiatric patients often experience prolonged ER boarding while awaiting inpatient psychiatric placement. These delays contribute to delayed treatment, worsening psychiatric symptoms, ER overcrowding, and increased healthcare costs.

Methodology

This four-week quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework. Interventions included a standardized psychiatric transfer protocol, simplified transfer checklist and staff education. …

The Benefits Of Glucagon-Like Peptide 1 Agonists In Adult Women With Polycystic Ovary Syndrome, Bethany A. Johnson

Nursing Capstones

Background: PCOS is the most common endocrinopathy in women of reproductive age, affecting 5-6 million women in the United States. Symptoms include hirsutism, acne, hormone imbalances, menstrual irregularity, obesity, infertility, hypertension, and hyperlipidemia. GLP-1s are being studied for their benefits in women with PCOS.

Purpose: To review the current evidence on the efficacy of GLP-1 receptor agonists in improving symptoms and complications of PCOS.

Methods: This scoping literature review used three databases, including CINAHL Ultimate, PubMed, and ClinicalKey. Inclusion criteria were women 18 and older diagnosed with PCOS and studies that evaluated any type of GLP-1 and their effect on …

Optimizing Vbac Outcomes Through A Structured Tolac Pathway, Alexandra E. Williams

Doctor of Nursing Practice Final Project Abstract

Evaluate whether implementing a structured TOLAC clinical pathway improves VBAC success, increases TOLAC attempts among eligible patients, and improves maternal and neonatal outcomes. The project was conducted at a Southeast hospital in Houston, Texas. 

Women with a prior cesarean often have limited labor options because many hospitals default to repeat cesarean delivery. TOLAC remains underutilized due to safety concerns, limited provider education, and lack of standardized protocols. Evidence shows that appropriate counseling, standardized management, and close maternal–fetal monitoring can support safe vaginal birth after cesarean (VBAC).

A pre–post implementation design guided by the RE-AIM framework was used. Eligible participants included …

Streamlining Patient Workflow: Enhancing The Screening Process For Social Determinants Of Health To Ensure Consistent Patient Intake In A Medical Clinic, Candice L. Bruce

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to increase social determinants of health (SDOH) screening rates by incorporating an enhanced patient history form into the patient intake process in a women’s health clinic.

Background: The project was implemented in a small, rural clinic led by advanced practice providers that is affiliated with a large academic healthcare institution in southeast Texas. Addressing SDOH is essential for improving health outcomes and supporting value-based care initiatives, yet screening is often inconsistent in outpatient settings.

Methodology: The Plan–Do–Study–Act (PDSA) framework was used for implementation. A brief SDOH screening tool was embedded …

Modeling Early Indicators For Success In An Associate Degree In Nursing Program, Joseph D. Moss

Educational Leadership & Workforce Development Theses & Dissertations

Persistent nursing workforce shortages across the United States have increased the importance of Associate Degree in Nursing (ADN) programs as primary entry points into the profession. Community colleges prepare a substantial portion of the nursing workforce; however, attrition within ADN programs limits the number of graduates entering practice. Understanding factors associated with academic performance and program completion is essential for strengthening nursing education pathways and supporting workforce development. The purpose of this quantitative study was to examine early academic and sociodemographic factors associated with successful completion of an ADN program at a suburban community college.

Guided by Becker’s Human Capital …

Analyzing Pressure Injury Trends Among Hospitalized Older Adults From Tarrant County, Oluwafunto M. Olorundare

2026 Spring Honors Capstones Projects

Pressure injuries occur when skin and underlying tissues are damaged due to unrelieved pressure that reduces blood circulation to the affected area. Hospitalized older adults are vulnerable to pressure injuries due to factors such as limited mobility, physiological changes associated with aging, chronic conditions, and longer hospital stays. Despite multiple studies on the prevalence and incidence of pressure injuries at the national and global levels, there is limited research that analyzes trends among hospitalized older adults at the county level, specifically Tarrant County. This research aims to examine pressure injury trends among hospitalized older adults residing in Tarrant County. Using …

Reducing Humpty Dumpty Syndrome In Pediatric Inpatients, Jeanene Burns

Electronic Theses and Dissertations

The Doctor of Nursing Practice project examined pediatric inpatient falls. The healthcare agency involved in the project identified concerns regarding pediatric inpatient falls. Data were collected on pediatric inpatient falls that occurred on two nursing units at this agency based on the Generalized Risk Assessment for Pediatric Inpatient Falls and the Humpty Dumpty Falls Prevention Scale. Results from the project indicated marginal statistical significance, with approximately a 60% reduction in falls after the implementation of the Humpty Dumpty Falls Prevention Scale. A recommendation for future research is a comparison of the two pediatric fall risk assessment tools after the Humpty …

Optimizing Communication In The Periprocedural Area: Implementing Sbar: A Quality Improvement Project, Autumn Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The primary aim of this project is to improve standardized nurse-to-nurse communication at the electrophysiology lab of a large Los Angeles hospital. By providing nursing education on a unit-specific, structured handoff communication framework (SBAR) and incorporating a procedure-specific handoff form for electrophysiology (EP) across pre-, intra-, and post-procedure units, this project aims to improve nurses’ perceptions of the handoff process and the effectiveness of handoff education across the periprocedural units. The project further aims to assess nursing incorporation of the training four weeks post-education and changes in patient satisfaction related to nursing teamwork and communication.