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Addressing Human Trafficking in Pediatric Nursing Education: A Simulation-Based Approach to Improve Student Competence
(2026) Gladwell, Courtney
Introduction: Human trafficking is a growing public health crisis, and pediatric nurses are in a unique
position to identify and intervene in suspected cases. However, undergraduate nursing students
often lack training and confidence in recognizing red flags of human trafficking in clinical
settings. This quality improvement project aimed to enhance undergraduate nursing students’
knowledge and self-reported competency related to identifying and responding to human
trafficking in pediatric healthcare settings. The project aligned with the American Association of
Colleges of Nursing Essentials and supported integration of evidence-based content into the
existing pediatric curriculum.
Methods: An asynchronous, one-time educational presentation was developed and made available
through the university’s learning management system (LMS) as a required activity in the
pediatric nursing course. The simulation component used a rapid-cycle deliberate practice model
to reinforce learning in a clinical scenario during scheduled pediatric clinical simulation days.
Pre- and post- intervention surveys were administered using Qualtrics and measured student
knowledge and self-reported competency using the Student Nurses’ Human Trafficking
Education Assessment Tool (SNHTEAT).
Results: Pre- and post- intervention survey data was analyzed to evaluate changes in students’
knowledge and confidence levels regarding the identification and management of pediatric
human trafficking cases. A paired t-test was used to compare mean scores before and after the
intervention.
Discussion: This project demonstrated the feasibility and impact of integrating an educational module
and simulation to prepare undergraduate nursing students to recognize and respond to pediatric
human trafficking. The intervention resulted in improved knowledge and self-reported
confidence among participants. These findings support future curricular integration of targeted
human trafficking education within undergraduate nursing programs.
Reducing Fall Rates in a Rural Hospital
(2026) Berry, Christopher; Lee, Amy
Background: Inpatient falls remain one of the most common and preventable adverse events in
healthcare settings, often resulting in serious injury, extended hospital stays, and increased
healthcare costs. Despite reporting a fall rate below the national benchmark (2.53 vs. 3.3 falls per
1,000 patient-days), a 40-bed rural hospital in the Southeastern United States identified fall
prevention as a strategic priority. Current prevention measures, though widely adopted, are
inconsistently applied across shifts and units. Gaps in communication during nurse handoffs,
incomplete documentation, and variations in adherence to fall prevention protocols were
identified as contributors to the issue.
Purpose: This quality improvement project aimed to reduce inpatient falls by implementing
standardized bedside shift reporting among nursing staff. Guided by the Iowa Model of
Evidence-Based Practice, the intervention sought to improve communication, staff
accountability, and real-time assessment of fall risks.
Methods: A 10-week intervention was conducted across a medical-surgical and intensive care unit
using the Plan-Do-Study-Act framework. The initiative included educational sessions for nursing
staff, a standardized bedside shift report checklist implementation, and weekly audits of
compliance and documentation. Outcomes were measured as fall rates per 1,000 patient-days
with secondary process measures evaluating protocol compliance and staff perceptions.
Results: During the intervention 2 falls occurred over the 1826 patient days, producing a rate of
1.09 falls per 1,000 patient days, compared with the pre-intervention rate of 2.5 falls per 1,000
patient-days, reflecting a meaningful reduction. A Poisson rate comparison confirmed
compatibility with a lower fall rate, despite wide confidence intervals due to low event counts.
Staff feedback indicated improved communication and situational awareness, while audits
demonstrated strong adherence to the bedside reporting protocol.
Conclusion: The introduction of standardized bedside shift reporting was associated with a substantial
reduction in inpatient falls and enhanced fall-prevention practices without additional staffing or
financial burden. The intervention improved staff accountability, patient engagement, and the
consistency of safety practices. The findings support bedside shift reporting as a sustainable low-cost
strategy to improve patient safety in small community hospitals, with implications for
broader adoption and future evaluation across diverse care settings.
Improving Metabolic Lab Tests Compliance in Patients on Antipsychotic Therapy
(2026) Adeboye, Titilola; Cody, Shameka
Background: Metabolic Syndrome (MetS) affects over 30% of the U.S. population and is particularly prevalent among individuals with severe mental illness (SMI), often due to the metabolic side effects of antipsychotic medications. Despite established guidelines for metabolic monitoring, patient compliance with routine testing remains low in outpatient psychiatric settings.
Objective: This project explored the impact of providing on-site metabolic testing within outpatient psychiatric clinics on improving patient compliance.
Methods: The quality improvement (QI) project was conducted in a single outpatient psychiatric clinic located in the Southeast. Providers were educated through a PowerPoint presentation on using a script to ensure all patients received consistent education on the importance of metabolic lab tests. The providers gave each patient a copy of the written script during their visit. Retrospective and prospective chart reviews were conducted to determine whether patients who were prescribed antipsychotics completed their metabolic laboratory tests at the onsite laboratory, at an external facility, or not at all. Electronic chart data were obtained from time points from two prior visits and during the three-month QI period. Descriptive statistics and chi-square analysis were used to compare metabolic testing compliance before and after the education intervention.
Results: Fifty-one individuals were included in the project. Pre-intervention (Test 1), 9 (17.6%) completed metabolic laboratory tests, with 7 (13.7%) onsite. Test 2 showed 9 (17.6%) completions, including 6 (11.8%) onsite. Post-intervention, 10 (19.6%) completed follow-up testing onsite within 12 weeks. Patients aged 45–54 years and 65 years and older demonstrated the highest compliance rates (5.9% each).
Conclusion: On-site metabolic testing did not result in statistically significant improvement in compliance with metabolic testing among patients on antipsychotic therapy. Metabolic lab testing compliance varied across providers, with some providers having higher compliance than others. Findings highlight the importance of standardized and formal provider education, but also the need to investigate barriers (e.g., stigma) that may contribute to low metabolic testing compliance among patients with psychiatric conditions.
The Use of Animal-Assisted Therapy to Improve Perceived Stress, Anxiety, and Clinical Readiness Within Baccalaureate Nursing Students
(2026) Benfield, Mary Pearce; Cody, Shameka
Background: Nursing students frequently experience elevated levels of stress and anxiety
during clinical validation, which may negatively affect perceived clinical readiness. Elevated
anxiety during evaluations has been associated with impaired concentration, reduced confidence,
and reduced psychomotor performance, ultimately contributing to suboptimal validation
outcomes even among well-prepared students. Evidence from academic and healthcare settings
suggests that animal-assisted therapy (AA T) may reduce stress and anxiety while promoting
emotional regulation and overall wellbeing.
Objective: This Doctor of Nursing Practice (DNP) project evaluated the use of animal-assisted
therapy (AA T) in first-semester prelicensure Baccalaureate nursing students to improve stress,
anxiety, and perceived clinical readiness across three validation sessions.
Methods: Students voluntarily interacted with a certified therapy dog prior to three Health
Assessment clinical validation experiences. Analyses were conducted among students who
completed all paired pre- and post-validation surveys (n = 7). Perceived stress and anxiety were
measured using the Perceived Stress Scale (PSS-IO) and Generalized Anxiety Disorder-? (GAD-
7). At the end of the semester, clinical readiness was assessed using Section I of the Casey-Fink
Readiness for Practice Survey (Casey-Fink) and qualitative data were collected from an openended
seven-question reflection journal.
Results: Statistical Package for the Social Sciences (SPSS) Version 29.0 was used to perform
paired-samples t tests and nonparametric analyses. No statistically significant differences
were observed in pre- and post-validation GAD-7 or PSS-10 scores across the three validation
days (p > .05). Validation performance scores, Jc,2(2) = 4.92,p = .085, and therapy dog exposure
time, x2(2) = 0.58,p = .747, did not significantly differ across sessions. Qualitative findings indicated that most students perceived benefits from therapy dog interaction, including decreased
stress and anxiety and increased confidence and clinical readiness. Additionally, the majority of
respondents supported continuation of AAT, with no recommendations for discontinuation.
Conclusions: Although statistically significant reductions in stress and anxiety were not
observed, clinically meaningful outcomes were supported by student-reported benefits, strong
endorsement for continuation, and successful implementation within the academic setting.
Several limitations of the project included a small sample size, incomplete survey data,
unintended cross-exposure among participants, and limited duration of AA T exposure. The
intervention was integrated without disruption to clinical workflow, supporting its feasibility in a
clinical education environment. These findings highlight the importance of considering both
measurable outcomes and student experiences when evaluating AA T as a strategy to enhance
student well-being in nursing education.
Beyond Body Mass Index: Waist Circumference vs. Body Mass Index in Identifying Cardiometabolic Risks
(2026) Lester, Brandi; Parker, Kim
Background: Body mass index is widely used to assess obesity; however, it does not account for fat distribution. Central adiposity, measured by waist circumference, is a stronger predictor of cardiometabolic risk. Despite guideline recommendations, WC is not routinely measured in primary care, which can lead to under-identification of at-risk patients.
Methods: A quality improvement project was conducted in a rural primary care clinic in the southeastern United States. Adult patients (n = 50) underwent both BMI and WC measurements during routine visits. Patients were categorized using established clinical cutoffs (BMI ≥25 kg/m²; WC >35 inches for women and >40 inches for men). Descriptive statistics and comparative analyses were used to evaluate differences in risk classification.
Results: Findings demonstrated that 68% of patients had both elevated BMI and WC, indicating combined general and central obesity. Notably, 4% of patients had a normal BMI but elevated WC, identifying cardiometabolic risk that would have been missed using BMI alone. Overall, the addition of WC improved identification of patients at increased cardiometabolic risk.
Conclusions: Incorporating waist circumference measurement into routine primary care assessments enhances the identification of cardiometabolic risk beyond BMI alone. This low-cost, feasible intervention supports more accurate risk stratification and clinical decision-making.