Collected here are the ePortfolios from students in the Nursing Program of the School of Health Sciences at University of the Pacific.
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Camino a la Salud: Culturally Tailored Diabetes Education for Hispanic Older Adults in Stockton, California
Alondra Aldaba, Alexis Irvine, Jazmyn Monares, and Marissa Doblados-Wood
AIM: Camino a la Salud addresses diabetes in one of the most affected populations in San Joaquin County, older Hispanic adults and their caregivers. This project aims to increase diabetes knowledge, confidence, and self-management among older adults in Stockton through culturally tailored education and hands-on learning. The project also provided glucometers and visual teaching tools to support skill development and improve diabetes awareness and prevention in this community.
METHODS: This project included three weekly bilingual diabetes education sessions held at El Concilio during their senior food distribution program. Each session covered a different topic: diabetes risks and complications, understanding glucose and blood pressure numbers, and lifestyle changes for prevention and management. Education was delivered through short presentations, teach-back techniques, and culturally relevant examples. Participants completed pre- and post-surveys, including Likert-scale questions to measure changes in knowledge and confidence. The ADA diabetes risk test, printed materials, and live demonstrations supported learning. Surveys and observations were analyzed using SQUIRE guidelines.
RESULTS: Across the project, there were 66 total session encounters (23 in Session 1, 23 in Session 2, and 20 in Session 3), with 19 participants completing demographic intake forms. Participants were mostly older adults with a mean age of 70.8 years, and the majority identified as Hispanic or Latino. Knowledge and confidence improved following the educational sessions, with survey scores increasing by at least 20 percent across all sessions. Confidence in understanding glucose and blood pressure values increased to a mean of 4.17 (≈30 percent improvement). In the final session, participants reported the highest overall outcome, with a mean score of 4.77, and the majority indicated they planned to adopt at least one healthy lifestyle change, such as improving their diet or incorporating gentle physical activity. These findings show meaningful increases in diabetes literacy and self‑management readiness.
CONCLUSION: Camino a la Salud demonstrated improved diabetes knowledge, confidence, and intention to practice healthier behaviors among older Hispanic adults in Stockton, California. Delivering education in a trusted community setting with bilingual materials and culturally tailored content supported engagement and understanding. Participants showed improved awareness of diabetes risks, greater confidence with glucometer use and interpretation of numbers, and strong motivation to adopt healthier practices. Continued access to culturally relevant education and community partnerships may strengthen long-term health outcomes and reduce disparities for Hispanic older adults living with or at risk for diabetes.
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Reducing Opioid Overdose Harm Through Narcan Access and Education
Shane Alexander Role Alihan, Jared Timothy Chua, Siwapond (Taylor) Yuen, and Matthew Reynon
Background: The overuse of opioids has led to an epidemic that affects the health of young adults in Sacramento, CA. Social and economic factors have influenced the use of opioids which has led those individuals to acquire an addiction and dependency to such drugs. This age group is typically engaged in college and career-minded endeavors. Thus, the impact on this age group is substantial, requiring impactful interventions.
Aim: The purpose of this intervention is to provide a foundation for educating those affected by opioid overdose. This strategic goal is to equip students at the University of the Pacific’s Entry-Level Master of Science in Nursing program with ways to improve outcomes and prevent deaths. Students should be educated and informed on how to respond to opioid overdose and the proper use of Narcan.
Methods: Surveys using the Likert-scale questionnaire were developed to determine whether the pre and post-interventions were impactful. The data from the 50 participants were collected anonymously via Google Forms and analyzed using Intellectus.
Results: Results showed significant improvements, including improvement from 63% to 81% in the total correct of knowledge questions. The result of the two-tailed independent samples t-test was significant based on an alpha value of .05, (t80) = -5.75, p < .001, indicating the null hypothesis can be rejected. This finding suggests the mean of Knowledge survey was significantly different between the pre and post categories.
Conclusion: Implementing opioid educational interventions and emphasizing training in a university setting with a focus on healthcare professionals is highly impactful. Understanding causation and remedies in a university setting helps build the foundation for addressing concerns and providing a basis for meaningful interventions.
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The Sweet Solution Project - Improving Gestational Diabetes Management of the Mothers in Stockton, California
Joelynn Ali, Cayla Cook, Jessica Frey, Hector Rizo, and Teresa Serna
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Overdose Watch: Educate, Prevent, & Respond
Linsey Atis, Jared Burton, Madison Meade, and Elizabeth Oliveira
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Empower Birth: Black Maternal Health Project Improving Health Literacy and Health Management in Black Pregnant Women
Harman Aujla, Carsyn Hoogendoorn, Blair Price, and Morgan Rohmann
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The Safe Steps Project: Fall Prevention Amongst Older Adults in a Skilled Nursing Facility
Maiana Cabrera, Nicole Le, Yen Tran, and Madeline Turcotte
BACKGROUND: The Safe Steps Project aimed to reduce falls at Pine Creek Care Center, a skilled nursing facility located in Roseville, CA. Before this intervention, the fall rate at Pine Creek Care Center had been rising above their 15% goal in the first few months of 2025. Through an in-service education, this project has helped educate and increase nursing staff knowledge on fall prevention, such as intentional rounding with the 4 Ps (pain, position, potty, and possessions).
AIM: The Safe Steps Project addresses a major cause of injury in older adults, falls. The aim of this project was to improve knowledge regarding fall prevention to nursing staff at Pine Creek Care Center through an education in-service, ultimately reducing fall rates.
METHODS: This project was conducted through planned education in-services with a pre- and post-questionnaire, along with an interactive activity. Utilizing this method was aimed at increasing knowledge on fall prevention through a concise in-service that staff were already accustomed to this education format. The interactive activity provided the opportunity for staff to recall their knowledge prior to taking the post-survey. Data was collected from 56 participants via these questionnaires and analyzed using SQUIRE.
RESULTS: Results from 45 participants with completed surveys showed an improvement in knowledge regarding intentional rounding and the 4 Ps. Certified nursing assistants (CNAs) represented the largest group of participants. The mean participant age was 33.8 years old. The mean survey score increased from the pre-survey to the post-survey.
CONCLUSIONS: The Safe Steps Project was conducted at Pine Creek Care Center, where participating nursing staff exhibited improvement in knowledge of fall prevention education related to intentional rounding and the implementation of 4 Ps. The provision of continued education opportunities for facility nursing staff on fall prevention and access to educational materials is essential to improve and sustain positive outcomes in older adults in SNFs who are at higher risk of experiencing falls and fall injuries.
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Hygiene Heroes: Strengthening Oral Hygiene to Reduce Central Line-Associated Bloodstream Infections in Pediatric Hematology/Oncology Patients
Sidney Clymer-Engelhart and Kirstie Shulman
Background: Central line-associated bloodstream infections (CLABSIs) impact pediatric patient outcomes, increasing mortality, hospital stays, and healthcare costs. At Sutter Medical Center Sacramento (SMCS), the CLABSI prevention bundle includes proper line care, dressing assessments, and hygiene practices, including twice-daily oral care, daily linen changes, and chlorhexidine gluconate (CHG) bathing. Sutter found their CLABSI bundle compliance at approximately 76–78%, with oral hygiene identified as the most frequent gap in care.
Aim: This quality improvement project, partnered with SMCS, targeted oral care compliance to enhance overall bundle adherence, strengthen staff-leadership communication, and ultimately reduce CLABSI rates in the hematology/oncology units. In a wider perspective, this project sought to support Sutter’s broader commitment to preventing hospital-acquired infections through evidence-based care.
Methods: Targeting all 80 registered nurses and 9 technicians working on the pediatric and hematology/oncology units at SMCS, staff education was delivered through Tuesday Teaching Tip (“T3”) emails, huddle reminders, and weekly patient rounds, focusing on proper oral hygiene practices for patients with central lines. Educational hygiene flyers were provided to patients and families during weekly oncology rounding to deliver individualized education and assess oral care practices. Kamishibai cards (K-card) audits tracked pre- and post-intervention bundle adherence to evaluate the effectiveness in improving oral care compliance and decreasing CLABSI rates.
Results: Mean oral care compliance improved from 71% (SD = 0.30) during the pre-intervention phase to 91% (SD = 0.06) in phase 1 and 87% (SD = 0.03) in phase 2. The difference between the pre-intervention phase and phase 1 was statistically significant (p = .043). The rolling 12- month CLABSI rate decreased from 0.87 (SD = 0.40) to 0.61 (SD = 0.24) per 1,000 catheter days by phase 2, though changes were not statistically significant (p > .05). Overall, the intervention was associated with improved oral care compliance and a downward trend in CLABSI rates.
Conclusion: This project was used to enhance and improve oral hygiene compliance in hematology/oncology pediatric patients with central lines at SMCS as a strategy to reduce CLABSIs. This supported an existing quality improvement project at SMCS and aimed to reinforce best practices through two primary interventions: nurse education through “T3” email updates and huddle reminders, as well as the implementation of an educational hygiene flyer for patients and their families. Through these interventions, oral care compliance increased within the unit, ranging between 80% and 90%, and is expected to continue improving over the next several months.
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Enhancing Empathetic Dementia Care Through Cognitive Training: A Holistic Approach to Improving Patient Outcomes
Truyen Do, Yasmin Khouri, Millie Patel, and Levan Petrossian
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The Artful Aging Project
Maria Carmelita Fernandez, Sah'Neya Fryer, Kathleen Morris, and Maya Price
As the older adult population in Sacramento County continues to expand, addressing age-related declines in fine motor function, cognition, and social well-being has become increasingly critical. Such declines can compromise activities of daily living, reduce independence, and exacerbate risks associated with social isolation. Evidence suggests that art-based interventions may mitigate these effects by enhancing motor coordination, promoting social engagement, and stimulating cognitive processes. The Artful Aging Project was designed to evaluate the effectiveness of structured art activities in improving fine motor skills and social wellness among older adults served by the Stanford Settlement Neighborhood Center (SSNC). Grounded in community-based participatory principles, the project involved strong collaboration with SSNC leadership to develop culturally inclusive programming for a diverse and multilingual senior population. Participants engaged in four weekly sessions featuring origami, calligraphy, mosaic, and collage between July and August 2025. Pre- and post-intervention assessments utilized adapted versions of the Manual Ability Measure (MAM-36) and the Functional Status Questionnaire (FSQ) to evaluate fine motor function and social well-being, respectively.
Seven participants completed both MAM-36 surveys, demonstrating an average improvement of 1.8 points, with 85.7% showing maintained or enhanced scores. Six participants completed both FSQ surveys, with 66.7% exhibiting improved post-intervention scores and an average increase of 4.2 points.
These findings indicate that structured, culturally responsive art interventions can effectively preserve or enhance fine motor abilities and social wellness in older adults, supporting the integration of art-based programming within community health initiatives for aging populations.
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Mindful Aging Project Mental Wellness Education in Partnership with Older Adults in Sacramento County
Yesica Garcia, Sarah Molla, Kristin Provencher, and Sharon Yeong
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The Bonding Project: Addressing Mental Health Issues in the Older LGBTQ+ Community in Sacramento
Jose A. Gonzalez-Villasenor, Morgan Taniguchi, Claire Tousley, Jessica Landmark, and Jacqueline Paine
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Improving Maternal Mental Health Awareness and Support in Perinatal Black and Latina Women
Jasman Hans, Lesly Carrillo, Kayla Huynh, and Brianna Harrison
Background: Black and Latina women in California experience disproportionately high rates of perinatal mental health disorders due to limited access to care, stigma, and systemic inequities.
Aim: In collaboration with BeMomAware, this Quality Improvement project aimed to enhance maternal mental health literacy among Black and Latino individuals in the Oak Park community of Sacramento. The project sought to increase awareness, knowledge, and access to culturally appropriate mental health resources through an educational video and community session.
Methods: Interventions included a short educational video and an in-person community session providing culturally relevant information about perinatal depression and anxiety disorders, available resources, and strategies for seeking help. Participants completed pre- and post- surveys to assess knowledge and attitudes before and after the intervention.
Results: Results from a two-tailed independent samples t-test indicated a statistically significant improvement in post-survey knowledge scores (p < 0.05). Participants also reported greater confidence in identifying perinatal mental health symptoms (p = .005).
Conclusion: This Quality Improvement project demonstrated that culturally sensitive education can effectively improve maternal mental health literacy within underserved communities. By promoting awareness and reducing stigma, the project supports the integration of nursing practice and public health efforts to advance health equity. Sustained collaboration with community organizations such as BeMomAware will further strengthen maternal mental health education and support for communities of color in Sacramento.
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Staying Ahead of the Pressure: A Multimodal Intensive Care Unit Hospital-Acquired Pressure Injury Quality Improvement Project at Sutter Medical Center, Sacramento
Mijung Lim, Daniela Tobler, and Raquel Youkhana
Background: Hospital-acquired pressure injuries (HAPIs) are a major quality and safety concern, particularly in the intensive care units (ICUs) where critically ill and immobile patients face elevated risk. At Sutter Medical Center Sacramento (SMCS), nine confirmed HAPIs and two under investigation were reported within the medical ICU, cardiac ICU, and neurosurgical ICU by May 2025, exceeding the hospital’s target and prompting a system-wide quality improvement initiative.
Aim: The aim of this project was to: (a) reduce ICU-acquired HAPIs to fewer than four cases per quarter by December 2025 and (b) increase nursing compliance with early and ongoing prevention strategies, including repositioning, nutrition optimization, and risk assessment accuracy.
Methods: Guided by the Iowa Model Revised, this quality improvement project was implemented across the Cardiac (CICU), Medical (MICU), and Neurosurgical (NSSICU) ICUs. Interventions included: (1) staff education, (2) Wound Champion designation, (3) wound care supply room reorganization, (4) nutritional supplementation with Juven and enteral feeding catch-up protocols, (5) wedge repositioning trials that led to full implementation, and (5) beta testing of the Braden and Cubbin–Jackson (CJ) scales for enhanced risk identification. In addition, beta-test data from the Leaf and Atlas mobility monitoring systems were collected to assess repositioning adherence but not adopted for routine use. Enteral feeding data was verified through EPIC chart audits and bedside rate checks, documented in Excel for trend analysis.
Results: Among 22 ICU patients assessed, the CJ scale identified 55% as moderate to high risk compared with 18% using the Braden scale, suggesting improved sensitivity for critically ill patients. Leaf system data showed high repositioning adherence (87% and 84.7%), while nutrition audits revealed declining compliance with Juven implementation and documentation (58.8% → 20% → 0%) and enteral feeding catch-up goals. As of October, a total of twenty-one HAPIs were reported across three ICUs, with an estimated 33.6 HAPIs prevented during the reporting period.
Conclusion: Integrating evidence-based interventions strengthened prevention practices and early risk recognition. Sustained progress will require leadership engagement, standardized audit tools, and policy integration of nutritional and positioning protocols to maintain improvements in patient safety.
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Enhancing Pediatric Sun Safety: A Parent-Focused Intervention in El Dorado County
Ashley Riley, Calvin Nauer, and Alaina Godwin
Background:
Childhood ultraviolet (UV) exposure is the most significant modifiable risk factor for skin cancer, yet proper sun protection remains inconsistently practiced by parents. In El Dorado County, California, where high altitude and intense sun exposure amplify UV risk, knowledge gaps and misinformation persist despite resource availability. This quality improvement (QI) project aimed to strengthen parental knowledge, confidence, and modeling of sun-safe behaviors for their children through an evidence-based community education program.
Aim:
The goal of this QI initiative was to improve parental attitudes, self-efficacy, and photoprotective behaviors by implementing a three-part, nursing-led educational intervention focused on UV risk awareness, myth correction, and modeling of sunscreen application.Methods:
Using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model, the “Sun Smart Families” program was conducted at Steve Wallen Swim School with 32 parents of children aged 3–8. Over four weeks, participants attended three interactive sessions addressing UV risks, sunscreen myths, and parental role modeling. Pre- and post-intervention surveys adapted from the Environmental Protection Agency (EPA) SunWise Program and O’Riordan et al. (2003) measured changes in knowledge and behaviors. Data were analyzed using Mann-Whitney and chi-square tests.Results:
Participants demonstrated a statistically significant increase in composite Likert-scale scores for sun-safe attitudes and behaviors (M = 25.4 to 40.6, p = .039). Five of ten survey items improved significantly, with one knowledge item (correct sunscreen volume) showing marked post-intervention gains (χ² (1) = 8.47, p = .0036). Parents reported greater confidence and intent to model photoprotective behaviors.Conclusions:
Brief, community-based education improved parental self-efficacy and sun safety attitudes, aligning with Healthy People 2030 objectives to reduce childhood sunburns. The project demonstrates a sustainable, scalable model for integrating nursing-led prevention into community recreation settings. -
Fall Prevention in the Lobby of the Emergency Department at Sutter Medical Center Sacramento
Tanya Rodriguez Duarte, Vaneza Espino, Roshni Hayer, and Yajari Mendoza
Background: In 2024, Sutter Medical Center Sacramento (SMCS) reported 17 patient falls in the Emergency Department (ED) lobby, with 94% (n = 16) occurring in the triage area. Patients awaiting placement after triage are not classified as admitted and thus are not included in CMS’s inpatient fall reporting program. However, due to the known safety risk, SMCS ED leadership began tracking lobby falls locally and partnered with University of the Pacific nursing students to address this issue.. Aim: This quality improvement project aimed to reduce the incidence of falls in the ED lobby through enhanced fall risk identification, timely reassessment, and improved patient education. The project aligned with Sutter’s mission to prioritize safety and minimize preventable harm. Methods: The quality improvement project was conducted in the ED lobby at SMCS. Patients were screened at triage using the Hester Davis Scale, and those deemed high-risk received a yellow fall risk bracelet and bilingual educational pamphlets developed and validated using the Patient Education Materials Assessment Tool (PEMAT). The intervention included: (1) targeted staff education delivered during ED shift huddles, (2) continuous reassessment of fall risk every two hours, and (3) the use of visual reminders to prompt patient safety behaviors. University of the Pacific nursing students monitored implementation through distribution logs and informal observations. Results: In 2025, four falls were reported in the lobby, occurring in February, March, April, and September. Three of these incidents occurred earlier in the year, and one occurred later. Year-to-date shows 29 total falls, with lobby falls accounting for 14% of the total, down from 17 in 2024. Conclusion: The project reinforced the importance of reassessing fall risk in not formally admitted ED patients. Interdisciplinary collaboration contributed to improvements in lobby safety practices and highlighted opportunities for future system-level interventions. Local tracking of lobby falls, although not mandated by CMS, provided valuable data to inform safety efforts.
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Addressing Nursing Student Burnout through Mindfulness and Zen Den at University of the Pacific
Jeremy Seaton, Tanairi Ingram, and Natalia Zelayandia
Background:
Burnout among nursing students is a critical issue that negatively impacts academic performance, mental well-being, and long-term professional retention. Entry-Level Master of Science in Nursing students at University of the Pacific experience heightened stress due to rigorous coursework, clinical demands, and underdeveloped institutional mental health support.
Aim:
This Quality Improvement project aimed to reduce stress and strengthen emotional resilience among nursing students through Mindfulness-Based Stress Reduction education and the creation of a peer-supported wellness space, the “Zen Den.”
Methods:
A pre- and post-intervention design was implemented, utilizing surveys to measure mindfulness knowledge, attitudes toward self-care, and stress awareness. Zen Den utilization was tracked weekly through QR codes to assess engagement with the wellness space.
Results:
Post-intervention findings demonstrated a 5% increase in mindfulness knowledge, with Likert scale scores showing improved attitudes toward stress management and self-care (pre-intervention M = 3.56; post-intervention M = 4.38). Qualitative feedback emphasized the value of accessible wellness spaces and mindfulness practices as effective coping strategies during program demands.
Conclusions:
Integrating structured mindfulness education and wellness resources into nursing curricula provides a sustainable, low-cost strategy to address student burnout. These interventions successfully increased confidence in self-awareness, emotional resilience, and ability to cope. Long term these outcomes can support academic success and long-term professional retention.
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Know Your Birth: Improving Patient Education through Informed Maternity Care in Sega, Kenya
Morgan Thaxter, Puneet Dhillon, Angela Kokhovets, Sarah Aguiar, and Zainab Bahia
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Navigating Burnout in Caregivers of Patients with Alzheimer’s Disease
Kristie Tsao, Avenal Nair, and Elijah Saavedra
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The Kangaroo Care Project: Implementation of Skin-to-Skin (STS) in Sutter Medical Center, Sacramento, Neonatal Intensive Care Unit
Bianca Wong, Katherine Do, Martha Calero, and Lydia Nambala
Background: Skin-to-skin contact, also known as kangaroo care or kangaroo mother care, is an intervention typically done after birth to promote physiologic stability, bonding, and breastfeeding.
Aim: The Kangaroo Care project aimed to increase the incidence of skin-to-skin contact in the neonatal intensive care unit at Sutter Medical Center, Sacramento.
Methods: A pre-survey was conducted to assess staff comfort with skin to skin. Interventions to increase skin-to-skin rates included staff e-learning, unplanned extubation mock codes, nurse champions, and a policy change to Sutter Medical Center, Sacramento’s handbook.
Results: TBD. Preliminary results indicated use of STS in the NICU and post-results from the nurses’ survey are pending.
Conclusion: Increasing skin-to-skin care rates in the Sutter Medical Center Sacramento neonatal intensive care unit addressed critical barriers such as staffing shortages, limited space, and equipment availability. By enhancing staff support, education, and training, the NICU fostered greater parental involvement, which is essential for improving outcomes in preterm and low-birth-weight infants. This initiative promoted safer, more effective neonatal care, supported infant growth and development, and strengthened family-centered practices within Sacramento’s diverse community, ultimately contributing to better short- and long-term health outcomes.
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Fit & Fueled For Two Project: Nutrition and Exercise Education for Pregnant Women in Placer County
Nadine Abed, Salma Elnaggar, Chelsea Enriquez, and Ariana Gutierrez
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Care Beyond Incarceration: Grassroots Support for Community Reentry Success
Chelsea Bigelow, Rachel Bovenizer, and Jessica Lebedeff
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Breathe Easy Project: A Quality Improvement Project on Management of Asthma at Hoover Elementary School
Alex Butts, Jessica Leung, and Jaynah Palma
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Healthy Heart and Soul: A Qualitative Report on How Faith-Based Programs Can Provide Effective Education on Cardiovascular Health
Damaris Carlson, Haley Grieger, Claire Madrona, and Ingrid Scott
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Empowering Community Health Promoters for Healthy Births in Sega, Kenya
Melissa Castro, Trang Ha, Dominique Tagupa, and Kaliah Vang
