Recent uci_nursing_fp items

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...

EMPOWERING FRONTLINE CNAS TO ENGAGE IN EFFECTIVE COMMUNICATION THROUGH AN INTERACTIVE LEARNING EXPERIENCE

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

Abstract

While considerable efforts have been directed towards continuing education for bedside nurses and providers, certified nursing assistants (CNAs) are often marginalized, despite their substantial involvement in patient care within skilled nursing and rehabilitation facilities. Collaborating with 36 sites throughout Orange County and Los Angeles County, California, our GWEP team identified crucial curricular topics to address geriatric-specific knowledge deficits among CNAs. These topics focused on the 4-Ms and included fall risk management, care for patients exhibiting challenging behaviors, addressing mental health conditions, effective communication with healthcare team members, and self-care strategies to mitigate burnout. Recognizing the importance of engaging and interactive education and trauma-informed pedagogy, we designed participatory activities such as gaming, storytelling, meditation, yoga, journaling, and sharing into the curriculum. Over a span of three...

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

Tue, 19 May 2026 00:00:00 +0000

Critical care nurses are exposed to high-acuity, emotionally demanding environments that contribute to elevated stress and burnout. Burnout is associated with emotional exhaustion, decreased job satisfaction, increased turnover, and potential negative impacts on patient safety and quality of care. Although mindfulness-based interventions (MBIs) have demonstrated effectiveness in reducing stress and improving resilience, their implementation in inpatient critical care settings remains limited. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to implement and evaluate an 8-week MBI to reduce stress and burnout while improving Keyword: mindfulness among critical care nurses in an intensive care unit (ICU), and to assess feasibility and acceptability, poster, DNP Scholarly Project Poster 2026 This project utilized a pre- and post-intervention QI design guided by the Johns Hopkins Nursing Evidence-Based Practice Model. The intervention consisted...

Oxygen Matters: Elevating TBI Care with PbtO₂ Monitoring

Tue, 19 May 2026 00:00:00 +0000

Background: Based on the BOOST II study and Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) guidelines, evidence indicates that brain tissue oxygen (PbtO₂) monitoring in severe traumatic brain injury (TBI) patients results in lower mortality and improved Glasgow Outcome Scale-Extended Scores. A large academic hospital's neurocritical care unit lacks standardized PbtO₂ monitoring protocols for TBI patients despite clinical recommendations for invasive intraparenchymal catheter monitoring. Purpose: This project aimed to implement PbtO₂ monitoring in severe TBI patients and assess its impact on mortality, Glasgow Coma Scale (GCS), hospital, and ICU length of stay. Additional goals included promoting provider and nursing knowledge of PbtO2 monitoring and ensuring sustainability through policy development. Methods: This evidence-based practice project was a pre- and post-intervention design which included the implementation...

Passing the Baton: Structured Handoff from Operating Room to Pediatric Cardiovascular ICU

Tue, 19 May 2026 00:00:00 +0000

Purpose: To develop and implement a Structured Handoff from the operating room (OR) to pediatric cardiovascular intensive care unit (CVICU) to improve interdisciplinary team participation, completeness and timeliness of handoff information, and team satisfaction at a Southern California Children’s Hospital. Background: Ineffective handoffs have been identified as the 3rd most common cause of medical error and posing a significant threat to patient safety. Hand-offs from the OR to the pediatric CVICU represent one of the most demanding care transfers and, if inadequate, may result in loss or unreliable information and adverse events. Despite the Joint Commission recognition as an important patient safety goal, some centers have not incorporated handoff standards among their interdisciplinary teams. Methods: An Evidence Based Practice (EBP) methodology guided development of the handoff tool using current literature and unit-specific workflows. The tool was refined through staff...

A Peer-Led Workshop to Improve Perceived Value and Promote Engagement in Specialty Nursing Certification

Tue, 19 May 2026 00:00:00 +0000

Purpose: This Doctor of Nursing Practice (DNP) quality-improvement (QI) project evaluated the impact of a peer-led certification workshop on the perceived value of specialty certification among medical-surgical and telemetry (MST) nurses and assessed certification engagement and barriers. Background: Specialty certification for registered nurses (RNs) is associated with improved patient outcomes, professional satisfaction, and career advancement. Despite these benefits, certification rates remain <1% among MST nurses at an acute care community hospital, compared to the average 51% in Magnet hospitals and 34% in non-Magnet hospitals. Barriers such as lack of time, limited confidence, and insufficient access to resources persist despite institutional support, including books, certification reimbursement, and a $500 incentive. Methods: This pre-post QI project was conducted at a community hospital in California. MST nurses were invited to attend a 1-hour Zoom workshop covering...

Implementing the Modified Early Warning Score in an Observation Unit to Improve Patient Outcomes

Mon, 18 May 2026 00:00:00 +0000

Delayed recognition of patient deterioration in acute care settings is associated with increased morbidity, mortality, unplanned transfers to higher levels of care, and failure to rescue. Early warning systems, such as the Modified Early Warning Score (MEWS), provide standardized criteria to identify at-risk patients and facilitate earlier escalation of care, including activation of the Rapid Response Team (RRT). Despite evidence supporting MEWS, staff awareness and consistent utilization remain variable, highlighting the need for targeted education and structured implementation. This quality improvement project aimed to enhance early recognition of patient deterioration and improve outcomes in a Level II trauma center observation unit in Southern California. The intervention included standardized staff education on MEWS scoring and escalation protocols, reinforcement of MEWS use and RRT activation, and provision of MEWS reference tools. During the 7-week implementation period,...

Implementing A Nurse-Driven Preoperative Optimization Bundle To Improve Workflow And Chlorhexidine Gluconate Hygiene Practices In Same Day Services

Mon, 18 May 2026 00:00:00 +0000

Background: A significant concern contributing to morbidity and mortality among perioperative population is Surgical Site Infections (SSIs) compromising patient safety, readmissions and healthcare cost. In Same Day Services (SDS), variation in preoperative hygiene education and documentation created opportunities to improve workflow, standardize nursing practice and support reliable patient optimization prior to surgery. Purpose/Aims: The purpose of the Doctor of Nursing Practice (DNP) quality improvement (QI) was to implement a nurse-driven preoperative optimization bundle to improve workflow consistency, strengthen chlorhexidine gluconate hygiene (CHG) education and promote standardized documentation among SDS nurses. Methods: The QI project was implemented over a four-week period at a Magnet designated hospital ambulatory SDS within the perioperative department in Orange County, California. The intervention consisted of staff education, laminated patient centered educational...

Tailoring Post-Operative Education to the Needs of Older Adults in the Mohs Surgery Clinic

Mon, 18 May 2026 00:00:00 +0000

Purpose: To improve comprehension and self-efficacy about post-operative care in older adult patients after their Mohs surgery, using multi-faceted education tailored to the individual. Methods: This quality improvement project used a pre- and post-intervention design, following the guidance of the Johns Hopkins EBP Model. The intervention consisted of revised written instructions tailored to the learning needs of older adults, an educational video, electronic health portal access to all materials for home review, and involvement of caregivers in teaching—in addition to standard verbal instruction. Written materials were refined iteratively with provider and clinical team input. A 10-item paper survey assessing knowledge and self-efficacy was administered at the post-operative visit. Primary outcomes consisted of patient knowledge and self-efficacy about post-operative care after Mohs surgery. Secondary outcomes assessed patient preference for educational method, material readability,...

The Impact of Mindful Clinical Aromatherapy on Intensive Care Unit Nurses' Stress Experience: A Quality