Digital Commons Network^™

Determining Impact On Provider Adherence To Current Diabetes Guidelines: A Quality Improvement Project, Rashemia Suber

Doctor of Nursing Practice Projects

The delivery and documentation of evidence-based adult lifestyle counseling for patients with type 2 diabetes mellitus (T2DM) were found to be inconsistent in a clinic that serves an underserved population. This quality improvement (QI) project assessed whether a provider education program based on the 2025 American College of Lifestyle Medicine (ACLM) Diabetes Guidelines would improve provider confidence and documentation of lifestyle recommendations. A quasi-experimental, pretest-posttest design was guided by both Pender's Health Promotion Model as the theoretical framework and Lewin's Change Theory as the change theory. The Plan Do Study Act (PDSA) cycle guided this project as the implementation framework. …

The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu

Doctor of Nursing Practice Projects

Aging causes frailty and multiple comorbidities, necessitating polypharmacy. Complicated drug regimens predispose patients to adverse drug events and hospital readmissions. The practice problem was high rates of medication-related readmissions due to inadequate provider knowledge of medication reconciliation and the lack of a standardized tool. This project aimed at evaluating the impact of provider medication reconciliation education on hospital readmissions in a skilled nursing facility. A pretest-posttest study design was utilized. The Donabedian Model of Healthcare Quality guided the translation of evidence into practice, whereas Lewin’s Change Model and Plan-Do-Study-Act models guided implementation. Eight providers were educated on medication reconciliation using …

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …

Why Do Indonesians Travel Abroad For Medical Treatment? A Qualitative Phenomenological Study, Lucky Sarjono Buranda, Aries Wahyuningsih, Steven Busby

Journal of Indonesian Health Policy and Administration

More than one million Indonesian citizens travel abroad for medical treatment each year, generating financial transactions exceeding IDR 180 trillion (USD 11.5 billion). This study aimed to explore the reasons why Indonesians seek medical treatment overseas. A qualitative phenomenological approach was employed using in-depth interviews with Indonesian citizens who had received or were currently receiving medical treatment outside Indonesia. All interviews were recorded, transcribed, and analyzed through coding to identify themes, subthemes, and related properties. Interviews were conducted with 18 participants from three major Indonesian cities (Makassar, Surabaya, and Batam), as well as individuals receiving treatment in Singapore and Malaysia. …

Expression Of Follicle Stimulating And Luteinizing Hormone Receptors In Porcine Testes After Timing The First Vaccination For Immunocastration, Sayamon Srisuwatanasagul, Rungrueang Yodsheewan, Amornthep Archawakulathep, Suvaluk Seesupa, Kongkiat Srisuwatanasagul, Atthaporn Roongsitthichai, Siriluck Juntautsa

The Thai Journal of Veterinary Medicine

This study aimed to examine the expression of follicle stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHR) in the testes of male fattening pigs based on the timing of the first immunocastration dose. A total of 24 male pigs were randomly assigned to 3 groups: C (n=8) consisted of only intact pigs, T1 (n=8) contained those immunocastrated at 15 and 19 weeks of age, and T2 (n=8) was composed of those immunocastrated at 9 and 19 weeks of age. The expression of FSHR and LHR was evaluated using H-score from immunohistochemistry and protein band intensity from Western blotting. Immunohistochemistry …

Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran

Walden Dissertations and Doctoral Studies

Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …

Quality Improvement Project: The Impact Of Self-Assessed Quality Of Sleep On Illness Experience And Job Satisfaction Among Night Shift Nurses, Eunice Ikpekpe

Doctor of Nursing Practice Projects

Compromised sleep quality, illness experience, and job satisfaction are important concerns among registered nurses working night shifts. The purpose of this quality-improvement project was to evaluate changes in self-assessed sleep quality, illness experience, and job satisfaction following participation in the six-week Sleep Hygiene and Recovery Program (SHRP) among night-shift registered nurses at a large, urban, Level I trauma academic teaching medical center. The project used a quantitative, quasi-experimental, single-group pretest–posttest design guided by the Plan-Do-Study-Act framework and Lewin’s Change Management Theory, with the Neuman Systems Model and Pender’s Health Promotion Model providing the theoretical foundation. SHRP was a structured, evidence-informed …

Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba

Walden Dissertations and Doctoral Studies

This staff education project addressed the gap in standardized knowledge and implementation of evidence-based sleep hygiene interventions among nursing staff on an inpatient behavioral health unit. Sleep disturbances affect 80%–90% of psychiatric patients and directly impact treatment outcomes and recovery. I developed the practice-focused question to consider whether an evidence-based sleep hygiene education program would enhance the awareness, knowledge, and practices of the nursing staff regarding sleep hygiene interventions. A thorough literature review of 23 high-quality sources formed the background for the development of a structured educational intervention that encompassed assessment methodologies, nonpharmacological interventions, environmental interventions, and patient education interventions. …

Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Peter Mufua Tumenta has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Melanie Braswell, Committee Chairperson, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026 Executive Summary Falls are a significant patient safety concern among older adults in long-term care (LTC) facilities. This Doctor of Nursing Practice quality improvement project implemented and evaluated a standardized, evidence-based multifactorial fall-prevention staff education program to improve …

Using An Automated Evaluation System To Improve Medical Student Evaluation Response Rate And Reduce Administrative Burden, Chaiya Laoteppitaks, Alisha Agarwal, Jason Gonzalez, Nina Mingioni, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Email reminders facilitate timely task completion but can create substantial administrative burdens for clerkship staff. In our emergency medicine (EM) clerkship, third-year medical students initiate digital evaluation requests after each clinical shift, requiring frequent manual reminders to maintain completion rates. The time-intensive nature of this process highlights the need for a more efficient and scalable approach.

METHODS: This multi-site, pre-post study evaluated clinical performance evaluation completion rates and time to completion during the required EM clerkship over 48 weeks before and after implementation of an automated reminder system in September 2024. The system integrated existing survey functionality with Microsoft …

Firearm Safety And Suicide Prevention In Older Adults: A Primary Care Clinical Framework., Rebecca Delp, Erik E. Langenau

PCOM Scholarly Works

Firearm-related injury and suicide represent a critical public health challenge in the United States, with older adults experiencing the highest rates of firearm suicide. Approximately 70 % of suicides among older adults involve a firearm, with white males over age 70 at the highest risk. Despite high household firearm access and unsecured storage, standardized screening and counseling in primary care remain underutilized. Primary care physicians are uniquely positioned to identify clinically vulnerable patients and evaluate lethal means safety through longitudinal relationships during routine encounters. This clinical practice report presents an evidence-based framework for firearm suicide risk assessment, clinical communication, and …

Management Of Non-Survivable Head Trauma: Opportunities For Improvement, Sanjana R. Salwi, Mackenzie D. Castellanos, Therese Murphy, Pious D. Patel, Sonia Ajmera, Alex P. Vaz, Connor A. Wathen, Niels D. Martin, Monisha A. Kumar, James M. Schuster, Dmitriy Petrov

Department of Neurosurgery Faculty Papers

BACKGROUND: Managing patients with non-survivable head trauma who do not meet brain death criteria presents significant ethical and clinical challenges. Decisions frequently fall to surrogates with limited guidance, particularly when organ donation status is unknown. This study assessed physician perspectives on communication, interventions, and institutional factors.

METHODS: We conducted a national survey of academic neurosurgery, trauma surgery, and neurocritical care programs. Items examined communication barriers, interventions by donor status, institutional support, and a dissonance measure for interventions viewed as inappropriate.

RESULTS: A total of 133 physicians responded. Top communication barriers were medical literacy, unclear patient values, and intrafamily conflict. Physicians …

Journal Ida 2023 102 4

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2023 102 3

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Indian Standard For Safe Handling Of Biotherapeutic Products Used In Homoeopathy: Guidelines, Kumar Vivekanand, Indra Gaurav Saxena, Divya Taneja, Shailendra K. Saxena, Shrishti Dixit, Raj Kumar Manchanda

Indian Journal of Research in Homoeopathy

Biotherapeutic products used in Homoeopathy are derived from biological sources of human, animal, microbial and other origins and include pathological and non-pathological preparations such as nosodes and sarcodes. Owing to the biological nature of these materials, their safe handling, preparation, storage, testing and documentation require systematic controls to protect personnel, the public and the environment. The Indian Standard `IS 19901:2026, Safe Handling of Biotherapeutic Products Used in Homoeopathy — Guidelines', provides a comprehensive framework for risk assessment, biosafety classification, containment, determination of first safe dilution (FSD), safety and efficacy evaluation, quality assurance, formulation, dispensing and documentation. The standard also establishes …

Prioritising Safe Care For Noncommunicable Diseases: A Call To Action On World Patient Safety Day 2026, Subhash Kaushik

Indian Journal of Research in Homoeopathy

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A Retrospective Descriptive Profile Of Cancer Patients Seeking Homoeopathic Care In A Semi-Rural South African Setting, Radmila Razlog

Indian Journal of Research in Homoeopathy

Background: Patient profiling renders valuable information about the population's healthcare-seeking behaviours, critical for effective patient management. Khula Natural Health Centre (KNHC) in South Africa provides healthcare to rural communities, within the scope of Homoeopathy. Objective: The study aimed to create a preliminary cancer patient profile of KNHC from April 2017 to August 2024. Method: This retrospective study adopted a descriptive, exploratory design. Anonymised patient data was extracted from the KNHC database. Data that met the inclusion criteria were descriptively analysed to summarise and describe the dataset. Results: Forty-six participants' data, presenting a range of cancers, consulted at KNHC for homoeopathic …

World Homoeopathy Day 2026: Homoeopathy For Sustainable Health, Candy Benny, Sonu Kumar, Divya Taneja, Pankhuri Misra, Renu Mittal, Subhash Kaushik

Indian Journal of Research in Homoeopathy

The World Homoeopathy Day (WHD) 2026 – a two-day interactive forum to commemorate the 271^st birth anniversary of Dr. Samuel Hahnemann, founder of Homoeopathy, was held on 10^th – 11^th April 2026 at Vigyan Bhawan, New Delhi, India. The event was organised by CCRH, NCH, and NIH under the aegis of the Ministry of Ayush. Centered on the theme of ``Homoeopathy for Sustainable Health'', the event emphasised the role of Homoeopathy in promoting and ensuring sustainable health. The event witnessed participation from approximately 1,800 delegates comprising policy makers, practitioners, researchers, academicians, and students. There were a …

Cultivating A Culture Of Feedback: Strengthening Picu Nurses Through Peer-To-Peer Feedback, Alex Ramirez, Reese Reddick, Sydney Usselman

2025

No abstract provided.

More Than Words: Enhancing Caregiver Confidence ​Through Health-Literacy-Informed Discharge Teaching, Madelyn Biad, Rachel Jones, Temi Kalejaiye, Aylana Lindsey, Jennifer Nguyen, Jenny Nguyen, Samantha Wigder

2025

No abstract provided.

Patching The Practice Gap: Standardizing Pediatric Transdermal Medication Administration, Grace Mcreynolds, Jennifer Diaz-Miranda, Raven Davis, Cierra Berry, Womietu Arise, Samantha Onyekwere, Jennifer Lugo, Hasina Barlett

2025

No abstract provided.

Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle

Doctor of Nursing Practice Projects

Surgical consent errors increase the risk of inaccurate documentation, compromise patient safety, and disrupt procedure times. Evidence indicates that adopting electronic consent can optimize workflow, support accurate and complete documentation, improve readability, and enhance record reliability. This project evaluated whether initiating electronic consent, compared with handwriting surgical consent forms, reduced the number of improper surgical consent forms completed over six weeks. Roy’s Adaptation Model guided the change process, and the Theory of the Person as an Adaptation System provided the theoretical basis. The Plan-Do-Study-Act model supported evidence-based implementation of the electronic consent intervention. The quality improvement project was conducted on …

Implementing An Evidence-Based Practice Training Program To Impact Nursing Skills Competency And Self-Efficacy In A Long-Term Care Facility, Angela Mcknight

Doctor of Nursing Practice Projects

Long-term care facilities require nursing staff who can competently perform clinical skills; however, the project site relied primarily on written in-service education and attendance verification without direct validation of psychomotor performance. The purpose of this quality improvement project was to evaluate competency-based nursing education in a long-term care facility. The aim was to strengthen demonstrated urinary catheterization competency and evaluate changes in perceived professional nursing competence and general self-efficacy among licensed nurses. A quasi-experimental, one-group pretest-posttest design included 12 registered and licensed practical nurses. Plan-Do-Study-Act guided implementation, Lewin’s Change Theory guided organizational change, and Social Cognitive Theory supported the educational …

Quality Improvement Project: Implementing A Standardized Psychiatric Handoff Tool To Impact Nurse-To-Nurse Communication In An Acute Care Psychiatric Setting, Andrea Ranglin-Johnson

Doctor of Nursing Practice Projects

Evidence supports that inconsistent nurse-to-nurse handoff communication may contribute to omitted information, workflow inefficiencies, and patient safety concerns in acute psychiatric settings. The practice problem was the absence of a standardized psychiatric handoff process, which contributed to inconsistent shift report communication. This quality improvement project examined whether the PSYCH (Patient Profile, Situation, Your Clinical Assessment, Care Plan/ Critical Information, and Hindrance for Discharge) standardized handoff tool impacted nurses' perceptions of nurse-to-nurse communication over six weeks. Lewin's Change Theory guided implementation, while the Donabedian Structure-Process-Outcome Model provided the theoretical framework. The Plan-Do-Study-Act cycle supported implementation. A pre- and post-implementation design was …

Quality Improvement Project: Empowering Change: Evidence-Based Strategies To Improve Ai Use In Pedagogy, Amanda Boyle

Doctor of Nursing Practice Projects

Artificial intelligence (AI) continues to integrate into healthcare and higher education; however, Health Science faculty at the project site lacked formal training to operate or teach AI responsibly. This Doctor of Nursing Practice quality improvement project evaluated whether computer-based AI literacy education improved Health Science faculty members’ self-reported AI literacy. It was predicted that faculty AI literacy scores would improve after completing the intervention. Kotter’s change model and Benner’s novice-to-expert framework informed implementation of change and faculty professional development. The Plan–Do–Study–Act model supported evaluation. In a one-group, quasi-experimental preintervention–postintervention study design at a North Texas two-year college, 19 eligible Health …

A Quality Improvement Project: Impacting Communication Perceptions Among Nursing Staff And Providers Regarding Perioperative Medication Management Impacting Anesthesia Care, Demetria Jefferson

Doctor of Nursing Practice Projects

Medication-related surgical cancellations disrupt patient care, increase healthcare costs, and contribute to inefficient use of perioperative resources. Evidence supports standardized education and communication to improve perioperative medication safety. This quality improvement project aimed to improve staff self-efficacy in communicating medication instructions and reduce surgical cancellations associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and phentermine. Bandura’s Social Cognitive Theory and Lewin’s Change Model guided the project. A quasi-experimental one-group pretest-posttest design included perioperative staff who provided medication instructions across two settings within an academic health sciences center. Using the Plan-Do-Study-Act framework, interventions included standardized staff education, patient …

Training Faculty For Skills Evaluation: A Quality Improvement Project, Shelley Leezer

Doctor of Nursing Practice Projects

There is an identified gap between nursing knowledge learned in academic settings and application of clinical skills in practice settings. Literature contributes this gap to poor knowledge retention, lack of constructive feedback, and inability to apply knowledge to clinical practice. The purpose of this project was to address skill mastery and retention in nursing students within a university. The project aim was to improve faculty feedback and evaluation to best support skill mastery in the skills laboratory. Lewin’s Change Management Model and Dr. Patricia Benner’s Novice-to-Expert Theory guided project design and progress. This pre- and post-intervention study followed a PDSA …

Quality Improvement Project Stress First Aid: Equipping Nurse Leaders, Bethany Russell

Doctor of Nursing Practice Projects

Stress among nurses can negatively affect well-being, workforce stability, and the quality of patient care, highlighting the need for nurse leaders to effectively recognize and respond to stress within their teams. The purpose of this quality improvement project was to evaluate whether education on the 7 Cs of Stress First Aid (SFA) improved leadership self-efficacy among nurse leaders at an urban acute-care hospital. Watson’s Theory of Human Caring provided the theoretical foundation, while Lewin’s Change Theory guided implementation of the practice change. A one-group pretest-posttest design was used, with the Plan-Do-Study-Act framework supporting project implementation. Participating nurse leaders completed an …

Integrating Interprofessional Education To Strengthen Team-Based Mental Health Care, Adebisi Tijani

Doctor of Nursing Practice Projects

Fragmented interprofessional collaboration in outpatient mental health settings compromises care coordination and patient engagement. This quality improvement (QI) project implemented a structured interprofessional education (IPE) workshop series to improve team collaboration and reduce patient no-show rates in an outpatient mental health clinic. Guided by Bandura's Social Cognitive Theory and Lewin's Change Management Model, the project used a pre-post, single-group design with 12 licensed mental health professionals. The team measured collaboration with the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) and collected aggregate patient no-show rates from the electronic health record. The intervention consisted of four monthly, one-hour workshops covering role …

Construction And Application Of Clinical Evidence Framework For Brain-Computer Interface, Wenxiu Qi, Cheng Zhou

Bulletin of Chinese Academy of Sciences (Chinese Version)

Brain-computer interface systems are emerging neurotechnologies that are gradually moving from laboratory research toward clinical application. However, their inherent features, including small sample sizes, heterogeneous technical pathways, and rapid product iteration, make it difficult to integrate safety and efficacy data across studies or to conduct meaningful cross-study comparisons. These challenges not only hinder the cumulative development of evidence in evidence-based medicine, but also complicate the assessment of clinical access and regulatory review. In addition, subjective evidence, such as patient experience, remains insufficiently captured in existing evaluation frameworks. It is therefore necessary to examine the structure of evidence for brain-computer interface …