Nursing Commons^™

The Use Of A Safety Screening Tool To Improve Sedation Holiday Compliance And Nurse Confidence, Shelby Marchisio

Doctor of Nursing Practice Final Project Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation …

Reduction Of Waste And Cost In A Cardiac Intensive Care Unit, Jincy C. Skaria

Doctor of Nursing Practice Final Project Abstract

Purpose:
To reduce medical supply waste and associated costs in a Cardiac ICU using a standardized supply cart system.
Background:
Pre-packed post-operative recovery kits were routinely opened for all admissions in the Cardiac ICU, resulting in disposal of unused supplies due to infection control and single-use policies. This practice contributed to avoidable waste, increased costs, and poor resource stewardship.
Methodology:
This quality improvement project was conducted in a 20-bed Cardiac ICU from September 28 to December 6, 2025. The intervention replaced routine opening of full recovery kits with selective retrieval of supplies by nurses from a standardized cart located outside …

Dexmedetomidine (Precedex) Versus Propofol: In Patients Requiring Sedation While Mechanically Ventilated,, How Does The Use Of Dexmedetomidine (Precedex) Compared To Propofol, Affect Reintubation Within 48 Hours Post Extubation?, Kimberly Barbee, Markela Albright, Malak Amro, Evelyn Caty-Pletcher, Margaret Havey Phd, Aprn, Acnp-Bc, Chfn, Fhrs, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within …

Implementing Hypertension Guidelines Into Clinical Practice, Misti Michele Mays

Electronic Theses and Dissertations

Hypertension is a complex chronic disease process, and it is essential to educate the patient on the disease process, as well as on all aspects of self-management. It is essential that providers choose an evidence-based guideline by which they will manage their hypertensive patients. In addition, providers must schedule regular follow-up appointments with their patients, along with a wide variety of other multifactorial components in regard to the management of patients diagnosed with hypertension. In addition, providers have a responsibility to stay informed on new approaches to blood pressure management by reviewing the professional literature on a regular basis. Much …

Introducing The Ppco Framework, Children's Health

PPCO Resources & Education

Haven't heard of the PPCO Framework yet? It is a framework developed by nurses for nurses that fits nursing questions when searching for literature to support EBP. 

To learn just a little more, we've created a short cheat sheet, with tips, and some examples, and most importantly - links to the original works.

The Significance Of Vaccine Education In Vaccination Status, Emma Webb

Honors College Theses

In recent years, more of the general population of the United States has become skeptical about vaccines and overall vaccination numbers have declined. Since the Covid-19 pandemic, vaccines have become somewhat of a controversial topic due to varying opinions about the adverse reactions and effectiveness of vaccines. The purpose of this study was to determine if there is a correlation between a person’s overall knowledge of vaccinations and a person’s vaccination status by asking a series of questions about the science used in vaccines and identifying the participant’s vaccination status in regards to influenza and Covid-19. This study also asked …

Examining The Relationship Of Work Stressors And Resilience Among Inpatient Oncology Nurses: A Cross-Sectional Study:, Blanca Melida Vasquez-Clarfield

Theses & Dissertations

Burnout among inpatient oncology nurses remains a concern in a specialty marked by high patient acuity, complex care regimens, emotional intensity, and repeated exposure to suffering and death. Resilience is often discussed as a protective resource in nursing, yet less is known about how personal resilience and work resilience relate to work stress and burnout within inpatient oncology practice. This study examined the relationships among perceived work stress, personal resilience, work resilience, and burnout among registered nurses working in inpatient oncology units. It also explored whether selected nurse characteristics were associated with these variables and how nurses described workplace stressors, …

Exploring The Relationship Between Workplace Social Capital, Organizational Commitment, And Intent To Stay Among Clinical Nurses In The Acute Care Setting, Leigh Erin Griffis-Cogan

Theses & Dissertations

Background

The persistent nursing shortage, exacerbated by the COVID-19 pandemic and the subsequent “Great Resignation,” continues to challenge healthcare systems nationwide. High turnover rates among acute care nurses negatively affect patient outcomes, organizational stability, and healthcare costs. Prior research highlights the importance of workplace factors, such as social capital and organizational commitment, in shaping nurses’ intentions to stay in their roles. However, limited studies have examined these relationships collectively within the acute care setting.

Purpose

The purpose of the quantitative cross-sectional study was to examine the relationships between workplace social capital, organizational commitment, and intent to stay among clinical nurses …

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …

Improving Documentation Efficiency Through Implementation Of Emr Note Templates In A Multidisciplinary Stroke Clinic, Mirriam Hijazi

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to increase documentation efficiency in a multidisciplinary stroke clinic through implementation of standardized neurological note templates within the electronic medical record (EMR) system.

Background: EMR documentation is essential for safe and coordinated patient care, but can be time-consuming for healthcare providers. Neurological documentation requires detailed clinical information, contributing to increased documentation burden. At the multidisciplinary stroke clinic, providers reported spending significant time on documentation, with some notes finalized up to 48 hours after patient encounters.

Methodology: Standardized neurological note templates were developed with provider input. Documentation efficiency metrics included note completion time, proportion of …

Reducing Unplanned Copd Readmissions Through Utilization Of A Nursing Discharge Checklist, Rachael Mcallister

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The quality improvement (QI) project aimed to decrease readmission rates at the project site through implementation of a nurse-driven disease-specific discharge checklist when compared to the same timeframe the year prior.

BACKGROUND

The project site’s 2024 national ranking declined due to unplanned chronic obstructive pulmonary disease (COPD) readmissions. COPD readmissions remained at national average and was not nationally competitive. This metric increased cost to the hospital and contributed to worse quality outcomes for the patient.

METHODOLOGY

Project design used the IOWA Model Revised framework and supported with an evidence-based review of the literature. PDSA cycles were conducted during implementation. …

Improving Patient Satisfaction In The Emergency Department Waiting Room Through Enhanced Communication Strategies: A Quality Improvement Initiative, Wael P. Karaki

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to improve ED waiting room experience by standardizing communication to increase transparency and expectation management, targeting an increase in Net Promoter Score (NPS) from 33.5 to ≥35.4 within three months.

Background: ED waiting room dissatisfaction is driven by uncertainty (unclear wait times, inconsistent updates, and limited understanding of triage and ED flow), supporting structured communication over individual clinician delivery.

Methodology: A 3-month, single-site QI project in an urban ED used iterative PDSA cycles and included all ED encounters (n=17,444). The bilingual intervention included orientation pamphlets (print/QR-based), standardized triage verbalization of …

Improving First Time Iv Success Rates In The Emergency Department Through The Implementation Of An Ultrasound-Guided Iv Training Program, Tram Dinh

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project was conducted at a Level III trauma emergency department (ED) in Fort Worth, TX. The aim was to improve first-attempt intravenous (IV) success rates for patients with difficult IV access (DIVA) to at least 50% and reduce average disposition times.

Background

Patients with DIVA frequently experience delays in care, including prolonged time to establish IV access, obtain laboratory studies, perform contrast-enhanced imaging, and administer IV medications. Ultrasound-guided IV (USGIV) access is an evidence-based technique shown to reduce these delays and improve timely care for patients with DIVA.

Methodology

The Plan-Do-Study-Act (PDSA) model guided development …

Standardized Home Blood Pressure Log Implementation For Patients With Hypertension To Increase Patient Awareness And Clinical Action, Ashley Alcala

Doctoral Dissertations & Projects

Background: Home blood pressure monitoring (HBPM) is recommended for hypertension management, yet primary care clinics often lack standardized workflows for distributing, collecting, and using home blood pressure (BP) data. Inconsistent reporting and limited patient understanding of their own BP trends, such as whether readings are stable, elevated, or unchanged, reduce providers ability to make timely clinical decisions.

Problem: Despite evidence supporting HBPM, patients rarely brought usable BP logs to follow‑up visits, limiting providers ability to assess BP control, identify trends, and make timely medication or care plan adjustments.

Approach: This project used a Plan‑Do‑Study‑Act (PDSA) model to implement a standardized …

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 …

Dna Methylation Of Slc6a4 And Nr3c1 In Term And Preterm Infants: A Pilot Study Of Nicu-Associated Stress, Kathryn J. Malin, Yvette P. Conley, Aleigha Barry, Rosemary White-Traut

College of Nursing Faculty Research and Publications

Background: Preterm infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU) are often exposed to early-life stress, which may contribute to long-term health consequences. Epigenetic markers, particularly DNA methylation (DNAm) of stress-related genes such as SLC6A4 and NR3C1, have been identified as potential biomarkers of early-life stress. Limited research has compared DNAm patterns between term and preterm infants or examined associations between NICU-related stress and DNAm in preterm populations. Objectives: This pilot study aimed to (1) compare DNAm patterns between preterm and term infants, (2) examine relationships between NICU-related stress and DNAm alterations in preterm infants, and …

Predictors Of Opioid Misuse And Abuse Among Pregnant Women In The Us, Henry Ofori Duah, Diane Von Ah, Ethan Morgan

College of Nursing Faculty Research and Publications

Introduction

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of …

Educating Nurses On Caring For Patients With Intellectual And Developmental Disabilities – An Evidence-Based Practice Project, Amyela Adarlo

Loma Linda University Electronic Theses, Dissertations & Projects

Intellectual and developmental disabilities (IDD) refer to a range of conditions that begin before age 18 and impact physical, cognitive, and socioemotional development. Patients with IDD often experience poorer health outcomes due to healthcare providers’ limited training in effective communication strategies. This evidence-based project aims to evaluate whether educating nurses on effective communication with IDD patients improves nurse self-efficacy and confidence in communication and enhances caregiver perceptions of nursing care.

Use Of A Structured Rounding Model To Improve Interprofessional Communication And Collaboration Among Mds And Rns In A Medicine Unit – An Evidence-Based Practice Project, Jackie Raygoza,

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

This DNP project aims to improve communication and collaboration between physicians (MDs) and registered nurses (RNs) on medical units by implementing a structured three-step communication-rounding model integrated into the daily workflow and leveraging existing communication tools. As patients’ conditions become more complex and healthcare demands increase, it is crucial to foster an environment where communication among providers and staff is clear, transparent, respectful, and collaborative. By leveraging information technology and evidence-based strategies, the project seeks to strengthen interprofessional collaboration and improve patient satisfaction and the quality of care. The project includes educational sessions for both MDs and RNs to …

Early Mental Health Screening In The Gi Patient Population: A Quality Improvement Project, Jacqueline Sagala

Loma Linda University Electronic Theses, Dissertations & Projects

Aims

This quality improvement project aimed to increase awareness and better integrate mental health screening in a GI clinic by educating staff and providers. The project evaluated changes in depression literacy, attitudes toward mental illness assessment, perceived training effectiveness, use of the training in clinical practice, and referrals to the Resiliency Clinic.

Background

Patients with chronic GI disorders commonly experience anxiety and depression, yet mental health concerns are often overlooked in specialty care. Although annual depression screening was already a part of the standard care at the Digestive Disease Center at Loma Linda University Faculty Medical Clinics, staff education and …