Digital Commons Network^™

Staff Education Project:  Cultural Competency For Outpatient Nurses Caring For Adult Patients With Suds, Chloe Hylaire

Walden Dissertations and Doctoral Studies

No abstract provided.

Ebp Project In A Primary, Foster Care Medical Home: Implementation Of The Ages & Stages: Social Emotional Screener, Sara Moore

2026

Background: Children in the foster care system have increased diagnoses, mental health concerns, and developmental delays.
Purpose: The pilot used the ASQ-SE to determine if the protocol was feasible and if the screener identified social-emotional difficulties in a primary care clinic that serves children in foster care. 
Method: A pilot was created, and the ASQ-SE was administered to 33 patients during well-child visits (ages 2 months-70 months) over six weeks.
Results: Implementing a social-emotional screener was feasible in the foster care primary care clinic. The infants and toddlers screened (N=33) were grouped by referral status: 57.6 % (19) …

Structured Communication Education Program To Improve Interprofessional Communication In An Outpatient Mental Health Organization, Doris Ofodile

Walden Dissertations and Doctoral Studies

No abstract provided.

Recommendations Made And Accepted By A Telehealth-Enabled Antimicrobial Stewardship Program Implemented At Rural Veterans Affairs Medical Centers, Taissa A Bej, Jason P Burnham, Joshua D. Nordman, Et Al.

2020-Current year OA Pubs

BACKGROUND: To support Antimicrobial Stewardship programs (ASPs) as well as the clinical care of patients with infections, we disseminated and implemented a Videoconference Antimicrobial Stewardship Team (VAST) to connect multidisciplinary teams from rural Veterans Affairs (VA) medical centers with geographically distant ID experts. Here, we describe the clinical syndromes discussed and the response to recommendations made during VAST sessions.

METHODS: Between September 2021 to February 2024, eight ID consultants established VASTs with ten rural VAMCs, holding regularly scheduled videoconference sessions to discuss clinical cases and provide recommendations. Data were collected on patient demographics, clinical syndromes, and recommendations. Acceptance of recommendations …

Ais26s: Ai In Biomedicine, Shiqian Shen

Paul English Applied Artificial Intelligence (AI) Institute Publications

This presentation explores the role of artificial intelligence in advancing biomedical research and clinical practice from the perspective of a physician-scientist. Dr. Shiqian Shen discusses current challenges in neuroscience and medicine, including limitations in human observation, data analysis, and decision-making across complex biological systems. The talk highlights how AI-driven approaches such as computer vision, neural signal processing, and large-scale data modeling can improve the understanding of disease mechanisms, enhance experimental workflows, and enable more precise, patient-centered care. Specific applications include automated classification of neural activity, behavioral analysis in animal models, and multimodal data integration. A key concept introduced is “shadow …

A Cross-Cultural Investigation Of Consumer Hoarding Behavior During Covid-19: Differences Between Sweden And The United States, Christy M. Cook, Pia A. Albinsson, James E. Stoddard

Atlantic Marketing Journal

This study is a cross-cultural exploration of consumer hoarding behavior during Covid-19; specifically, a comparison between Sweden and the United States. This research analyzes whether Swedish and American consumer hoarding behavior factors of prosocial orientation, consumer resilience and consumer risk-taking propensity reflect identical relationships during less predictable environmental forces (i.e., Covid-19 or global pandemic). Results from Partial Least Squares-Structural Equation Modeling (PLS-SEM) show that consumer prosocial orientation is negatively related to consumer hoarding and prosocial orientation is positively related to consumer resilience. In turn, both prosocial orientation and consumer resilience exhibit a positive relationship towards consumer hoarding. Consumer resilience is …

Evidence-Based Practice Guidelines For The Risk Stratification And Anesthetic Management Of Geriatric Surgery Patients At High Risk For Postoperative Cognitive Dysfunction Undergoing Non-Cardiac Surgery, Patrick M. Garvey

Doctor of Nursing Practice Scholarly Projects

As the global geriatric surgical population rapidly expands, managing complications like postoperative cognitive dysfunction is increasingly essential, given its adverse impacts on recovery, quality of life, and healthcare costs. Postoperative cognitive dysfunction can lead to extended hospital stays, delayed recovery, and significant cognitive decline, particularly among elderly patients exposed to general anesthesia. This quality improvement final scholarly project develops and hypothetically implements evidence-based practice guidelines for anesthetic management in geriatric patients at high risk for postoperative cognitive dysfunction undergoing non-cardiac surgery. This Doctor of Nursing Practice (DNP) project uses preoperative cognitive assessments, such as the Mini-Cog tool, to identify patients …

Practice Considerations For Perioperative Ondansetron Use In Parturients Undergoing Cesarean Sections With Spinal Anesthesia, Mackenzie Glaros

Doctor of Nursing Practice Scholarly Projects

Elective cesarean sections are often performed with spinal anesthesia, a form of neuraxial anesthesia that offers superior pain relief and reduces the risks associated with general anesthesia. However, over 50% of parturients experience side effects from spinal anesthesia, including shivering, hypotension, nausea, and vomiting, which can cause both physiological and psychological issues for the laboring mother and be detrimental to the fetus. Preventing these side effects is vital for improving safety, patient satisfaction, and minimizing complications. While various interventions and medications have been explored to manage these effects, no standardized guidelines exist for their prevention. A review of existing literature …

Proposed Evidence-Based Practice Consideration: The Use Of Remimazolam Tosilate Instead Of Propofol For Endoscopic Procedures Under Monitored Anesthesia Care In The Elderly Population, Tayler Lynn Detwiler

Doctor of Nursing Practice Scholarly Projects

Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, particularly in a growing elderly population. The selection of sedative agents significantly influences patient safety and procedural outcomes. Propofol, the traditional choice, is successful but associated with risks such as hypotension, bradycardia, and respiratory depression, particularly in elderly patients. This hypothetical Doctor of Nursing Practice (DNP) project explores the use of remimazolam tosilate (RT), a novel ultra-short-acting benzodiazepine, as an alternative to propofol during monitored anesthesia care (MAC) for elderly patients undergoing endoscopic procedures. The project utilizes a randomized controlled trial (RCT) design to compare RT and propofol regarding hemodynamic …

Evidence-Based Practice Guidelines For Lung Protective Ventilation In Adult Patients Undergoing Abdominal Laparoscopic Surgery, Marco A. Spada

Doctor of Nursing Practice Scholarly Projects

The rise in abdominal laparoscopic surgeries has underscored the need for improved ventilation strategies to reduce postoperative pulmonary complications, such as atelectasis, ventilator-induced lung injury, and pneumonia. These complications can increase hospital stays, healthcare costs, and mortality. This final scholarly project investigates the impact of lung protective ventilation in adult patients undergoing abdominal laparoscopic procedures and proposes guidelines for implementation. Lung protective ventilation strategies, including low tidal volume ventilation, individualized positive end-expiratory pressure, and recruitment maneuvers. Current research shows potential in mitigating postoperative pulmonary complications by improving intraoperative oxygenation and lung compliance. Using the Johns Hopkins Evidence-Based Practice model, this …

Evidence-Based Guidelines For Intraoperative Quantitative Neuromuscular Monitoring, Noah Graham

Doctor of Nursing Practice Scholarly Projects

Nondepolarizing neuromuscular blocking agents are routinely used medications vital to anesthetic care. When administering neuromuscular blocking agents, monitoring neuromuscular blockade depth and degree of recovery is a standard of nurse anesthesia practice to facilitate adequate recovery. If not adequately reversed, postoperative residual neuromuscular blockade can cause severe complications. Traditional qualitative neuromuscular monitoring practices largely contribute to the continuing high incidence of postoperative residual neuromuscular blockade, as supported by research that qualitative monitoring methods are insensitive to the depth of blockade and clinical situations, providing unreliable physiologic information. As recommended in practice guidelines by the American Society of Anesthesiologists, quantitative neuromuscular …

Implementation Of Evidenced Based Practice Guidelines For Reducing Emergence Delirium In Elderly Patients Undergoing A Total Hip Replacement, Luke D. Kleinfelder

Doctor of Nursing Practice Scholarly Projects

A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the …

Proposed Evidence-Based Practice Guidelines For Using Esmolol To Blunt The Sympathetic Stress Response To Laryngoscopy And Intubation, Maya Kurdi

Doctor of Nursing Practice Scholarly Projects

Direct laryngoscopy (DL) and endotracheal intubation (ETI) are standard procedures performed during general anesthetic induction, which provoke a sympathetic stress response that can result in intraoperative hemodynamic instability. Traditional agents like lidocaine and fentanyl, commonly used to mitigate the stress response, have limitations and can lead to adverse effects. Recent literature suggests that esmolol, an ultra-short-acting, cardio-selective beta-1 adrenergic receptor antagonist, may be an effective alternative due to its rapid onset, short duration, and minimal side effects. This final scholarly project (FSP) aims to develop evidence-based practice guidelines for using esmolol as an adjunctive induction agent. A systematic literature review …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

Understanding And Measuring Functional Communication In Adults Living With Alzheimer's Disease And Related Dementias, Sarah Toledo

Honors Capstones

Functional communication declines across all stages of dementia and directly affects quality of life, yet traditional standardized assessments may not fully capture everyday communication abilities. This capstone examines how functional communication in older adults living with dementia can be conceptualized and measured beyond standard tools. The study analyzes previously recorded video conversations between adults with dementia and student partners. Conversations are transcribed and coded using two observational measures: the Verbal and Nonverbal Interaction Scale–Care Recipient (VNVIS-CR) and the Adapted Measure of Participation in Conversation for Dementia (MPC-D). Gestures, facial expressions, responsiveness, and engagement are included in the analysis, and double …

Empowering Voices: A Qualitative Exploration Of Shared Governance Among Healthcare Workers In Clinical Practice, Ayman Alhazaymeh

Doctoral Projects

This project intervention evaluated the implementation of shared governance (SG), focused on partnership council activities and staff perception. The shared governance framework has several pillars, such as Partnership, Equity, Ownership, Accountability, and Shared Decision-Making, to support the design of healthcare organizations for excellent patient care (Porter-O’Grady, 2009). To effectively evaluate the SG implementation and ensure the ongoing success of the SG process, the author investigated staff contributions and actively sought feedback. He provided templates and guidelines for the partnership council and collected staff feedback. Murray et al. (2016) stated that the partnership council reported empowering staff to implement innovative solutions …

Enhancing The Diversity And Number Of Certified Registered Nurse Anesthetists: A Proposed Pipeline Program For Underrepresented Students, Alexis Lamoreaux

Doctor of Nursing Practice Scholarly Projects

The underrepresentation of minority groups in the Certified Registered Nurse Anesthetist (CRNA) profession impacts healthcare providers’ diversity and cultural competence. This Final Scholarly Project (FSP) proposes a pipeline program to increase diversity within the CRNA field by providing academic support, mentorship, and clinical exposure to students from underrepresented backgrounds. Given the shortage of anesthesia providers, especially in underserved areas, improving access to the CRNA profession for minority students is critical for enhancing patient outcomes. This FSP suggests establishing mentorship and skill development concepts through a 12-month structured program that targets minorities, first-generation college students, or those from rural backgrounds. The …

Tropomyosin-Related Kinase Receptor Type B Agonism In Geographic Atrophy-The Translational Challenges From Preclinical Data To A First-In-Human Trial, David Brown, Oliver Zeitz, Clare Bailey, Sunir J. Garg, Karl Csaky, James Talks, Sobha Sivaprasad, Peter M. Benz, Rolf Herrmann, Remko A. Bakker, Sebastian Bandholtz, Ankit Mittal, Qihong Huang, Serge Kosobokovs, Gudrun Simons, Andrea Giani, Jochen Huber, Martin Gliem

Wills Eye Hospital Papers

OBJECTIVE: To report results of the first-in-human trial of intravitreal tropomyosin-related kinase receptor type B (TrkB) agonist BI 754132 in participants with geographic atrophy (GA). To discuss BI 754132 clinical data in the context of the preclinical findings and their translation into human data.

DESIGN: An open-label, uncontrolled, nonrandomized phase I trial (NCT04002310) assessing the safety, tolerability, and pharmacokinetics of BI 754132 in participants with GA supported by preclinical data.

PARTICIPANTS: Participants with GA recruited between July 2019 and August 2022 in the United States and UK.

METHODS: Clinical trial comprising a single rising dose (SRD) part (n = 15) …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

How Do Autobiographical Memory Abilities Compare With Other Cognitive Functions In An Adult Presenting With Hsam (Highly Superior Autobiographical Memory) And Autism? A Case Study., Emilia Rzeszutek, Dr. Jamie Mayer

Honors Capstones

Autism Spectrum Disorder (ASD) is a condition widely researched in relation to social communication differences and challenges in areas such as memory and executive functioning. Many areas of research highlight ASD’s deficits, shortcomings, and risk factors. However, research has begun to recognize that autistic individuals demonstrate cognitive strengths that differ from typical patterns of functioning. An example of such ability is Highly Superior Autobiographical Memory (HSAM), a rare phenomenon characterized by the ability to recall specific life events with remarkable accuracy and detail. This study was conducted on a 25-year-old male diagnosed with ASD and presents with characteristics of HSAM. …

Developing Engagement Programming To Increase Leisure Participation Among Individuals Living With Cognitive Impairments, Anthony Valentino, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Low-cost leisure activities are implemented at The Bridge Center to increase engagement and promote health and well-being. This program incorporates occupational therapy perspectives to promote engagement through meaningful activities to expand people with cognitive impairments opportunities. The results of this project will provide intrinsic benefits to people with cognitive impairments and aid the development of future projects at The Bridge Center.

Choosing Your Line: Training Adaptive Ski Instructors How To Facilitate Occupational Participation For Individuals With Complex Communication Needs., Jordan E. Chizmadia, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

The project will explore communication methods for individuals with complex communication needs (CCN) in adaptive skiing, focusing on alternative communication methods and the development of a Picture Exchange Communication System. A communication training program for ski instructors will be implemented. Findings will advance occupational therapy by highlighting the role of self-directed communication and autonomy in promoting occupational engagement for individuals with CCN.

Advancing Neurodiverse-Affirming Care: Educating Caregivers To Improve Knowledge And Confidence​, Olivia Miller, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

This capstone project aimed to implement a six-week education course on neurodiverse-affirming care to caregivers of neurodiverse children at Extraordinary Kids Therapy outpatient clinic in Chepachet RI. The goal of this capstone project was to increase confidence and knowledge of neurodiverse-affirming care in the caregivers participating in the course. To analyze the impact of the education course, pre and post surveys, along with semi-structured asynchronous zoom interviews were administered and analyzed.

Building Adolescents' Social Emotional Wellness Through Physical Fitness Programming, Serena Mora, Tania Rosa Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This scoping review investigates the effect of participation in PA on behaviors and well-being connected to ND conditions.

A Multifaceted Approach To Managing Agitation In Assisted Living Residents With Dementia ​, Emily Hamed

Occupational Therapy Doctorate Capstones

Purpose: Dementia is a growing concern and will continue to increase. One symptom of dementia is agitation, which can be disruptive in an assisted living facility (ALF) and can impact quality of life for residents and caregivers/staff. Evidence shows that creating a conducive environment and equipping staff with skills can lead to better resident outcomes (Wong et al., 2024). This capstone project aims to address agitation by implementing physical and social environmental modifications in an (ALF). Design: This quasi-experimental mixed methods design will be conducted in an ALF to measure resident agitation pre and post intervention and staff confidence in …

“Empowering Peer Mentorship” Developing Best Practices Of Peer Mentoring At Empowersci Inc., Caitlyn Menard, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

Each Year, 250,000-500,000 people sustain a spinal cord injury (SCI) , facing challenges in social participation, quality of life, activities of daily living (ADLs), returning to work, and unmet needs in mental health, self-efficacy, and community mobility (Beauchamp et al., 2016 & Divanoglou et al., 2017). While interdisciplinary rehabilitation and peer mentorship aim to support adaptation, growth, and independence, there remains a lack of standardization in adequately preparing individuals for the peer mentor role (Rocchi et al., 2022). Aim: EmpowerSCI is a nonprofit organization that aims to bridge the gap in rehabilitation by offering in-person, holistic residential programming. EmpowerSCI currently …

Utilization And Impacts Of Pediatric Caregiver Programming On Therapeutic Engagement And Wellbeing: A Pilot Program, Venisa Rodriguez, Tania Rose Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: The proposed doctoral capstone aims to measure the utilization and impacts of pediatric caregiver programming on therapeutic engagement and wellbeing. A scoping literature review and needs assessment of pediatric caregivers of children receiving OT services found that limited access to quality, caregiver-specific resources and programming impact the wellbeing of caregivers, their ability to care for their child, and their confidence and ability to engage in the therapeutic process. The literature points to a want and need for caregiver-specific programming and the use of a family-centered care approach to improve caregiver and child outcomes.

Design: This study will utilize a …

Evaluating The Impact Of A Meaningful Recognition Bundle On The Health Of The Emergency Department Work Environment And Emergency Nurse Burnout, Sean Truesdell

Doctoral Projects

Background: The health of the work environment significantly influences emergency nurse practice. The Emergency Nurses Association and the American Association of Critical-Care Nurses have called for the establishment of a healthy work environment (HWE) to improve outcomes, reduce burnout and turnover, and increase job satisfaction. Meaningful recognition is consistently among the lowest-performing HWE standards. Purpose: To implement a bundle of meaningful recognition elements in the Emergency Department (ED) and evaluate the outcomes. Methods: A quality improvement project was conducted in the ED of a non-profit community health system in Northern California. The Healthy Work Environment Assessment Tool (HWEAT) and Oldenburg …

Advancing Equitable Nurse Assignments Through Nursing Workload Score Categorization In An Adaptable Acuity Unit At An Academic Health Center, Moses Albaniel

Doctoral Projects

Inpatient nursing shift assignments often rely on clinical judgment, which can lead to inequitable workload distribution on mixed‑acuity units. This quality improvement project evaluated assignment equity using the coefficient of variation (CV) of nursing workload acuity scores and examined the relationship between workload balance and perceived assignment burden. A single‑group pretest–posttest design was implemented on a cardiac adaptable acuity unit at Stanford Health Care over a 12‑week period, encompassing 168 shifts from December 14, 2025, to March 7, 2026. The intervention, implemented with 11 charge nurses, combined structured charge nurse education with an optimized Epic Reporting Workbench tool incorporating dynamic …