Nursing Commons^™

Patient Experiences Of Receiving Home-Based Immunotherapy Infusions - A Constructivist Grounded Theory Study, Patricia Ann Cook

Theses: Doctorates and Masters

Context: The treatment of cancer and chronic health conditions has been greatly revolutionised via intravenous immunotherapy infusions. Demand, both globally and in Australia, is increasing due to several factors including aging and increased populations, subsequent increases of cancer cases, new immunotherapy indications and increased survival rates.

In Perth, Western Australia, a private service provider commenced delivering a home based immunotherapy infusions model of care as a hospital substitution service provider in 2013 and the service has now been extended across Australia. The safety and efficacy of home-based infusions have been well documented in research, and an increasing number of patients …

Nurses' Experiences Of Pain Management For Patients With Diagnosed Mental Health Conditions: A Systematic Review, Aaron Lapuz Alejandro, Middlewick, Seng Giap Marcus Ang, Rosemary Saunders, Irene Ngune

Research outputs 2022 to 2026

Aim: To synthesise the available evidence related to nurses' pain assessment and management practices for patients with diagnosed mental health conditions. Design: Mixed-methods systematic review. Data Sources: Medline, CINAHL, PsycINFO, SPORTDiscus and Psychology and Behavioural Sciences Collection. Methods: Databases search was conducted in March 2024 and updated in June 2025. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis followed the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Results: Of the 1318 eligible studies identified, 12 met the inclusion criteria. The included studies were methodologically robust overall but frequently neglected nonresponse bias and were predominantly conducted …

Non-Pharmacological Sleep Interventions For Dementia Caregivers: A Systematic Review Of Randomized Controlled Trials, Aisling Smyth, Lambert, Mark Jenkins, Adugnaw Zeleke Alem, Misganaw Gebrie Worku, Sujatha Shanmugasundaram

Research outputs 2022 to 2026

Background: Caregivers of people living with dementia frequently report poor sleep. This systematic review describes evidence from randomised controlled trials of non-pharmacological sleep interventions for dementia carers. Methods: A systematic search of major databases was undertaken. Risk of bias was assessed using the Cochrane ROB 2.0 tool. Narrative synthesis followed Synthesis Without Meta-analysis (SWiM) guidelines due to substantial heterogeneity. Findings: Eighteen articles were included. Risk of Bias analyses revealed most studies had high overall risk of bias, primarily from selection of reported result bias. Interventions comprised of five categories: sleep-promoting, carer well-being, exercise, technology-based and complementary therapy. High variability between …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

A Quality Improvement Initiative To Decrease The Length Of Stay In The Post-Anesthesia Care Unit For Children Undergoing Iv Anesthetic Inductions For Gastrointestinal Procedures, Kaylee Bahret Bangs

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pediatric patients at WVU Medicine Children’s (WVU-CH) are emerging slowly from anesthetics during diagnostic gastrointestinal procedures which delays discharge from the post-anesthesia care unit. The cumulative effect is an increased length of hospital stay and the associated increases in costs. This project explores a novel method to reduce the amount of medication pediatric patients receive by using virtual reality goggles as a nonpharmacologic intervention to reduce preprocedural anxiety.

Purpose: This quality improvement project seeks to reduce time spent in PACU for children undergoing IV induction GI procedures by using preoperative virtual reality (VR) headsets during IV placement …

A Quality Improvement Initiative To Reduce Pressure Ulcers In Spinal Cord Injury Patients, Nicholas Post

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pressure ulcers are a significant concern for hospitalized patients, leading to various complications and increased medical costs. Despite common preventative interventions, pressure ulcer rates remain elevated. The prevalence of pressure ulcers contributes to patient suffering, extended hospital stays, increased healthcare expenses, and even fatalities. This emphasizes the critical need for additional prevention strategies. The reported increase in pressure ulcer injuries among spinal cord injury patients in the Surgical Intensive Care Unit (SICU), along with 7E and 8NE step-down units, at a large academic hospital highlights the pressing issue.

Purpose: The purpose of this project was to develop and …

Implementation Of A Ventilator-Associated Pneumonia Bundle To Reduce The Incidence Of Ventilator-Associated-Pneumonia And Improve Patient Care, Taylor Ryan Rice

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Ventilator-associated pneumonia (VAP) is a concerning complication that can

develop from complications when a patient is placed on a mechanical ventilator. Endotracheal

intubation puts patients at risk for micro aspiration, which can lead to VAP.

Evidence Review: Nine articles were selected for review; after critical appraisal, seven were

kept for further review. Evidence in these articles shows that using evidence-based methods in a

VAP bundle can decrease the length of stay, mechanical ventilator days, and the incidence of

VAP.

Purpose: The purpose of this project was to improve oral care for intubated patients and keep

the incidence of VAP …

Comparing Us Medicare Coverage Options As A Contributing Mechanism To Sticking Or Switching To An Insurance Plan, Lisa M. Grabert, Brian J. Miller, Kathryn L. Wagner

College of Nursing Faculty Research and Publications

Background

In 2025, the US Medicare program is expected to spend over $1.1 trillion taxpayer dollars. A growing trend in the US Medicare program is more beneficiaries electing a private insurer, referred to as Medicare Advantage (MA), to manage their care. Since 2023, a slight majority of Medicare beneficiaries have elected to enroll in MA, yet little is understood about the mechanisms that drive beneficiaries toward their choices.

Methods

Our objective was to examine the association between comparing coverage options and ‘switching’ or ‘sticking’ with Fee-for-Service (FFS) Medicare or Medicare Advantage (MA). We conducted a panel study, using data from …

Nurse Leaders’ Perceptions Of Organisational Policies, Guidelines, And Practices That Enact Children And Young People’S Involvement In Hospitals, Mandie Jane Foster, Julie Blamires, Virginia Jones, Smita Keshoor, Chris Moir, Annette Dickinson

Research outputs 2022 to 2026

There is limited literature on nurse leaders’ perceptions of organisational policies, guidelines, and practices that enact children and young people’s (CYP) involvement in hospitals. Nurse leaders within what were the four District Health Board providers of children’s tertiary health services in New Zealand (Auckland, Counties Manukau, Wellington, and Canterbury) were invited to respond to an online survey during November 2022 through to January 2023. The survey was developed by the researchers in accordance with the literature and included 11 open-ended questions. The open-ended questions were analysed iteratively through inductive thematic analysis. Eight out of 24 invited nurse leaders responded to …

How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

The Development Of A Midwifery Specific Tool To Identify The Barriers And Enablers To Change Within The Midwifery Setting, Sara Davis

Theses: Doctorates and Masters

Despite being well-positioned to identify service gaps and propose improvements, many midwives lack the knowledge, skills, confidence, or tools to effect practice change. Implementation science (IS) offers a structured approach to moving evidence-based innovations into practice; however, existing IS theories, models, and frameworks do not reflect the unique context of midwifery practice. The first step in the intentional implementation of an evidence-based practice innovation is to conduct a context assessment to identify factors that may facilitate or impede its uptake. There are numerous evidence-based checklists for this, but none capture all the influences on midwifery practice environments.

In this study, …

An Evidence-Based Practice Initiative To Promote Debriefing Within The Obstetrics Surgical Team, Rachel Lynn Runatz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Operating room debriefing is an evidence-based strategy shown to improve communication, efficiency, patient safety, and safety culture; however, debriefing is inconsistently performed in obstetric operating rooms due to workflow, cultural, and time-related barriers.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to increase the frequency of debriefings in the Birthing Center operating rooms at WVU Medicine Children’s Hospital through implementation of a nurse-driven, evidence-based debriefing initiative.

Intervention: A nurse-driven debriefing protocol was implemented using the Iowa Implementation for Sustainability Framework. Interventions included staff education, accessible laminated debriefing documents, identification of nurse champions, leadership support, and …

The Effects Of Music Therapy On Anxiety And Sedation Requirements For Total Knee Arthroplasty Patients Undergoing Regional Anesthesia: An Evidence-Based Practice Pilot Initiative, Kyra Marie Savrese

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Excessive noise in the operating room negatively impacts patient comfort and outcomes, particularly in patients undergoing spinal anesthesia who have the potential for awareness.

Background: Research demonstrates that music therapy is a low-cost, low-risk intervention that reduces perioperative anxiety and sedative requirements. Literature supports the use of music as an adjunct to anesthesia care, especially in orthopedic populations.

Purpose: At J.W. Ruby Memorial Hospital, orthopedic procedures with regional anesthesia expose patients to high noise levels, often leading to increased anxiety, sedation use, and longer recovery times. Addressing this problem aligns with institution goals for safe, patient-centered care.

Methods: Using …

An Evidence-Based Practice Initiative To Expedite Pediatric Recovery And Discharge Following Myringotomy Tube Placement, Nicole Marie Rillera

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The use of multiple sedatives, anxiolytics, and analgesics to prevent emergence agitation (EA)in pediatric patients undergoing myringotomy (MT) placement at West Virginia University Medicine Children's is leading to prolonged lengths of stay in the post-anesthesia care unit (PACU). These extended stays are causing delays in subsequent procedures and raising concerns for staff, patients, and their families.

Evidence Review: The combination of intranasal dexmedetomidine given preoperatively and intramuscular ketorolac given intraoperatively for pediatric patients reduces the incidence of EA more effectively than oral midazolam and acetaminophen.

Purpose: This evidence-based practice project aims to establish a standardized, evidence-based anesthesia plan to …

A Qualitative Analysis Of Counseling And Nurse Practitioner Trainee Experiences Engaging With An Integrated Behavioral Health (Ibh) Training, Alexander M. Fields, Margaret Emerson, Stephanie Burge, Jill R. Reed, Therese L. Mathews Ph.D., Aprn, Bcba-D, Abby L. Bjornsen

Teaching and Supervision in Counseling

Integrated behavioral health (IBH) is recognized as the standard for holistic healthcare, addressing the intersection of mental and physical health. As IBH gains prominence, graduate healthcare programs must equip students with strategies to meet its demands. However, limited research exists on training methods that address diverse professional identities and the unique needs of graduate students. Our novel IBH training incorporates interprofessional education (IPE) through modules and simulations grounded in Bandura’s (2001) social cognitive theory. We explored the experiences of 12 counseling, family nurse practitioner, and psychiatric/mental health nurse practitioner students through focus groups. Through interpretative phenomenological analysis (IPA), we analyzed …

Co-Developing Strategies For Leprosy Management In Malaysia: A Transdisciplinary Research Approach Involving Individuals Affected By Leprosy And Other Stakeholders, Norana Abdul Rahman, Vaikunthan Rajaratnam, Ruth Mh Peters, Marjolein Bm Zweekhorst, Pamela Wright Phd, Ms, Med, Rn, Cen, Karen Morgan, Mohamed Rusli Abdullah

Publications

Despite Malaysia's low leprosy prevalence, new cases continue to emerge in rural and Indigenous communities. National strategies often prioritise elimination and surveillance, while overlooking the needs and challenges of individuals affected by leprosy and those managing their care. This study employed a transdisciplinary research approach, guided by the Dialogue Model, to co-develop context-specific strategies to improve the lives of those affected through participatory engagement with both groups. Conducted across three high-burden states in Peninsular Malaysia, the research involved a desk review and stakeholder mapping, followed by 40 in-depth interviews with affected individuals and other stakeholders. These were complemented by a …

Staff Education To Improve Patient Outcomes Through Bedside Shift Report In A Skilled Nursing Facility, Ngum Avwontom

Walden Dissertations and Doctoral Studies

Abstract Problem: Inconsistent shift handoff communication in skilled nursing facilities (SNFs) contributes to adverse patient outcomes, including medical errors, falls, and pressure ulcers. Bedside shift reports (BSRs) are an evidence-based, patient-centered strategy to mitigate these risks, yet implementation at the project site was inconsistent. Methods: This staff education project implemented a standardized BSR program in a 100-bed SNF over seven weeks. The intervention trained 18 nursing staff (RNs, LPNs, CNAs) on BSR using the Situation-Background-Assessment-Recommendation (SBAR) communication framework. A pre- and post-test design was used to evaluate the impact on staff knowledge, shift report duration, and patient safety outcomes, including …

For Evidence-Based Suicide Risk Assessment, Monica Molah

Walden Dissertations and Doctoral Studies

This clinical practice guideline (CPG) project was developed to address a practice gap regarding the lack of systemic approach to suicide assessment in adult patients. This Doctor of Nursing Practice (DNP) project identified a significant gap in care at a private mental health clinic, which lacked a consistent, evident-based approach to suicide risk assessment. The inconsistency increased the likelihood of under-identifying at risk patients, posing substantial medical-legal and patient safety concerns. The practice-focused question guiding this project was: Does the evidence support the development of a CPG for suicide risk screening that receives an AGREE II quality score by an …

Improving Timely Administration Of Scheduled Short-Acting Insulin In Hospitalized Diabetic Patients, Edward S. Qu

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to improve compliance with the administration of scheduled short-acting insulin within 30 minutes of point-of-care blood glucose testing among hospitalized diabetic patients.

Background

This project was implemented in an inpatient hospital unit caring for patients with diabetes who require scheduled short-acting insulin. Internal audit data showed that compliance with administering insulin within 30 minutes of blood glucose testing was approximately 60%, indicating an opportunity to improve workflow and care coordination.

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement method was used to guide the project. Baseline data were collected from electronic health record …

The Therapeutic And Physiological Effects Of Citrus Peel Extraction On Helicobacter Pylori Bacteria, Sara Saeb Rasheed, Rawnaq Z. Fadhil, Marwah Amer Qamandar, Salah M.M. Al-Chalabi

Al-Esraa University College Journal for Medical Sciences

The antibiotic resistance has emerged as a growing international concern affecting not only human health but also the environment, animal population, and global economy. The increasing prevalence of antibiotic resistance poses a serious and escalating threat to public health. This problem is further exacerbated by the limited development of new antibiotic, high production costs, and risks about its side effects. Identifying novel antibiotic agents is crucial for managing fungal and bacterial infection. Consequently, numerous natural compound have been investigated as potential alternative therapies. Plant extracts are valuable source of bioactive compounds and represent a promising strategy to control pathogenic microorganisms. …