Recent uci_nursing_dnpspp items

Improving Self-Management of Chemotherapy Induced Nausea and Vomiting in Patients with Breast Cancer through Nurse-Led Education

Wed, 10 Jun 2026 00:00:00 +0000

Background: Chemotherapy-Induced Nausea and Vomiting (CINV) affects over 60% of oncology patients, and can cause dehydration, treatment disruption, and life-threatening emergencies. Current CINV guidelines recommend pharm & non-pharmacological methods to relieve CINV, however, multiple factors may impair self-management.

Objective: This project aimed to improve CINV self-management in a Southern Californian outpatient breast cancer clinic by integrating nurse-led written education, telephone follow-up, and a standardized CINV assessment tool into the existing practice flow.

Interventions/ Methods: The project was a pre/post quality improvement (QI) initiative. Baseline data were obtained via EHR chart review to evaluate CINV symptoms and antiemetic use in breast cancer patients receiving highly emetogenic chemotherapy (HEC). The intervention consisted of a nurse-led CINV patient education handout & antiemetic review, post-chemotherapy follow-up at 24 hrs...

Promoting Cardiovascular Health Education in Postpartum Patients with Hypertension

Wed, 3 Jun 2026 00:00:00 +0000

Introduction

Hypertensive disorders of pregnancy (HDP) are associated with increased maternal morbidity and long-term cardiovascular disease (CVD) risk. Despite recommendations for early postpartum blood pressure (BP) monitoring and cardiovascular risk counseling, postpartum education regarding HDP and future CVD risk remains inconsistent. This quality improvement (QI) project aimed to implement and evaluate feasibility of a standardized multicomponent educational bundle designed to improve patient knowledge of long-term CVD risk and accurate BP measurement techniques and to ensure patient access to a BP cuff at home.

Methods

This QI project was implemented on postpartum inpatient units at an academic medical center. The intervention included a brief educational video, printed educational handouts, interactive counseling, and a BP measurement return demonstration checklist. Educational content...

Nurse-Driven Protocol in Impella Device Management for Patients in Cardiogenic Shock

Wed, 3 Jun 2026 00:00:00 +0000

Purpose / Aims

The purpose of the DNP quality improvement (QI) project is to evaluate and increase the confidence of intensive care unit (ICU) nurses in managing the Impella, a percutaneous mechanical circulatory support (PMCS) device used in patients with cardiogenic shock (CS). The project aims to improve nursing confidence levels by ≥ 10%, increase device knowledge scores by ≥ 30%, and narrow confidence intervals by ≥ 30 % across two hospital ICUs.

Rationale / Background

Despite the increasing involvement of technology in medical practice, the incidence of cardiogenic shock is increasing, yet the in-hospital survivability of patients remains low (Lang et al., 2020). The in-hospital mortality rates of cardiogenic shock (CS) range from 30-60%, with out-of-hospital mortality as high as 50% within 30 days after discharge. A national study conducted between 2007 and 2017 revealed the survival rate was only about 40% from approximately 400,000 patients treated...

Blending Digital and Traditional Approaches for Culturally and Linguistically Sensitive Diabetes Education for Vietnamese Patients

Wed, 3 Jun 2026 00:00:00 +0000

Background and Significance

Vietnamese Americans experience disproportionately high rates of T2DM. Diabetic patients experience healthcare costs 2.6 times higher than healthy patients, as it leads to complications such as heart disease, stroke, kidney failure, and amputations. Culturally appropriate health education has been shown to significantly improve glycemic control and diabetes knowledge among ethnic minorities. The purpose of this quality improvement project is to enhance type 2 diabetes mellitus (T2DM) education for Vietnamese-speaking patients by integrating culturally and linguistically tailored education materials into a digital platform and handouts within a busy clinic workflow.

Method

This project was implemented at an endocrinology clinic for 10 weeks. All providers (3 nurse practitioners) and medical assistants (4 MAs) were invited. The intervention included a bilingual diabetes education website and bilingual handouts covering key diabetes...

Improving Albuminuria Screening in Primary Care: A Quality Improvement Initiative

Tue, 26 May 2026 00:00:00 +0000

Background: Diabetic kidney disease (DKD) is the leading cause of end stage renal disease (ESRD) in the United States and affects one-third of adults with diabetes. Albuminuria is a critical biomarker of renal and cardiovascular morbidity, including coronary artery disease, stroke, heart failure, arrhythmias, and microvascular complications. Early detection through estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (uACR) testing enables timely interventions, improved chronic disease management, and better long-term outcomes. Local Problem: At the project site, only 80% of eligible adults with diabetes completed annual kidney health evaluations, below the NCQA HEDIS KED national benchmark of 90%. Contributing barriers included inconsistent ordering practices, workflow inefficiencies, and underutilized point-of-care testing. The absence of a standardized system-based process limited screening consistency and early disease identification. Objective:...

Improving Provider Teach-Back to Support Diuretic Adherence in Heart Failure Patients

Fri, 22 May 2026 00:00:00 +0000

Background: Heart failure (HF) readmissions remain a significant healthcare challenge, often driven by medication nonadherence. A needs assessment in a transitional care clinic identified diuretic nonadherence as a key contributor to 30-day HF readmissions. The Teach-Back Method (TBM), a structured communication strategy, has been shown to improve patient understanding and adherence. Purposes/Aims: This DNP quality improvement project aimed to increase provider utilization of TBM through structured training and electronic medical record (EMR) integration to support diuretic adherence and reduce 30‑day HF readmissions. Methods: A pre–post intervention quality improvement project was implemented in a heart failure transitional care clinic in Southern California using the Johns Hopkins Evidence-Based Practice model. Providers completed a 30-minute TBM training, and TBM and diuretic adherence SmartPhrases were integrated into the EMR. Provider confidence was assessed pre-intervention,...

Enhancing Palliative Care Self-Efficacy & Knowledge in Among Step-Down Unit Nurses

Fri, 22 May 2026 00:00:00 +0000

Background Palliative care improves symptom management and quality of life for patients with serious illness, with nurses playing a central role in care coordination, symptom management, communication, and end-of-life support. This evidence-based quality improvement project aimed to enhance step-down unit nurses’ knowledge and self-efficacy in providing palliative care at a tertiary medical center in Los Angeles, California. Methods: Guided by the Johns Hopkins Evidence-Based Practice Model, this project used a pre–post design with voluntary participation, recruiting nurses through huddles, peer invitations, and break room signage. The educational intervention consisted of two short, mobile-accessible videos that participants could view independently. Palliative care knowledge was measured using the Palliative Care Quiz for Nurses (PCQN), and self-efficacy was assessed with the Self-Efficacy in Palliative Care (SEPC) before and after the intervention. Data was analyzed using...

Standardized Checklist Implementation for Medication Reconciliation in Older Adults

Fri, 22 May 2026 00:00:00 +0000

Background: Medication reconciliation represents a critical patient safety process in home health care, particularly for older adults managing polypharmacy and multiple chronic conditions. Hospital-to-home transitions increase the risk of medication discrepancies, adverse drug events, and rehospitalization. Implementation of a standardized medication reconciliation checklist may improve the consistency and completeness of Start of Care (SOC) visits in home health settings. Methods: This quality improvement (QI) project implemented a standardized medication reconciliation checklist over 8-weeks in a home health setting. Five registered nurses (5–25 years of experience) completed pre-and post-training surveys using a 5-point Likert scale. The checklist was utilized during eligible SOC visits for patients prescribed five or more medications. Process measures included checklist utilization and fidelity. Outcome measures included nurse-reported ease-of-use and confidence in identifying...

Evaluation of a Preoperative Fluid Preparation Guideline in Anesthesia

Fri, 22 May 2026 00:00:00 +0000

Background: A national intravenous fluid (IV) shortage prompted our institution to implement fluid conservation measures in the perioperative setting. Results from a preliminary survey conducted during the restriction period revealed that most anesthesia providers did not adhere to the restriction guideline, with nearly half opposing its implementation. There was a noticeable increase in anecdotal reports of postoperative nausea and vomiting (PONV) and hypotension in the postoperative anesthesia care unit (PACU). A multidisciplinary anesthesia team subsequently developed and implemented an updated preoperative IV fluid guideline concurrent with the replenishment of IV fluid supplies. This is particularly relevant given persistent gaps in national and local preparedness for supply chain disruptions driven by escalating natural disaster events. Objective: This QI project sought to evaluate improvements in provider reported adherence, workflow efficiency, and perceived utilization...

RSV Provider Knowledge, Screening Confidence and Acceptance Rates in Pediatric Primary Care

Wed, 20 May 2026 00:00:00 +0000

Purpose: To assess provider knowledge and confidence in screening children less than 8 months of age for Respiratory Syncytial Virus (RSV) prophylaxis and assess acceptance rates pre- and post-multilevel provider educational intervention in a pediatric primary care clinic. Background Respiratory syncytial virus (RSV) occurs in 90% of children less than 2 years of age and is the leading cause of hospitalizations in children under 1 year of age (50,000-100,000 per year). RSV is a common respiratory virus, with Infants and young children < 8 months of age at greatest risk for severe illness. The Center for Disease Control (CDC) created new RSV prophylaxis guidelines in 2022 to include either maternal vaccination or infant prophylaxis with early data showing it is 80-90% effective in preventing RSV hospitalization. There is still a significant gap in RSV acceptance rates nationally with only 35% of pregnancy women and 40% of infants having received it. This gap can be improved...

Quieting the Chaos: Reducing Stress and Burnout Through Mindfulness Practices