Digital Commons Network^™

Sustaining Clabsi Prevention Through Central Line Bundle Compliance: A Focus On Iv Tubing Labeling, Visual Cues And Peer Support, See Elizabeth Vang

Master's Projects and Capstones

Abstract  

Problem: Inconsistent IV tubing labeling compliance on a telemetry unit was identified as a gap in central line maintenance practices that could affect adherence to the CLABSI prevention bundle.

Intervention: A quality improvement project reinforced existing IV tubing labeling practices through a visual job aid, staff education, and peer verification during Nursing Knowledge Exchange (NKE) bedside handoff.

Outcome Measure: The primary outcome measure was IV tubing labeling compliance, with a goal of increasing compliance from 86.5% to at least 95% on 24 bed Telemetry unit.

Results: The project did not achieve the desired improvement in compliance. Multiple concurrent quality …

Th17 Effector Cytokines Induce Shared And Distinct Microglial And Endothelial Cell Responses In A Mouse Model For Post-Streptococcal Encephalitis, Charlotte Wayne, Uğur Akcan, Travis Faust, Violeta Durán-Laforet, Danny Jamoul, Luca Bremner, Nicole Ampatey, Büşra Akcan, Sarah Ho, Bogoljub Ciric, Shannon Delaney, Wendy Vargas, Susan Swedo, Vilas Menon, Dorothy Schafer, Tyler Cutforth, Dritan Agalliu

Department of Neurology Faculty Papers

Group A Streptococcus (GAS) infections cause neuropsychiatric complications in children, but the mechanisms linking peripheral infection to brain dysfunction remain unclear. Using mouse genetics, single-cell RNA sequencing, and spatial transcriptomics, we show that GAS infections induce inflammatory transcriptional programs in microglia and brain endothelial cells (BECs), accompanied by loss of blood-brain barrier (BBB) gene expression in female mice. Spatial transcriptomic analyses reveal that GAS-responsive microglia localize near infiltrating CD4+ T cells. Several microglial chemokines induced in mice are elevated in sera from affected patients. Deletion of GM-CSF in CD4⁺ T cells partially reduces microglial chemokine gene expression, without restoring BBB …

Transient Activation Of Potent Progenitor Cells Is Required For Spinal Cord Regeneration, Chase Alexander Weinholtz

Arts & Sciences Graduate Student Theses and Dissertations

Mammalian spinal cord injury is an intractable biomedical problem driven by interlocking maladaptive cellular responses that prioritize acute stabilization over long-term recovery. However, this deficient regenerative capacity is not an inherent limitation. The zebrafish, for example, capably regenerates and regains motor function with 2 months of a full transection injury. This ability is thought to rely on the transient expansion of stem cell-like progenitors marked by sox2 expression. Yet our understanding of the identities and contributions of this crucial population remains limited. Here, we determine the molecular identities and cellular contributions of sox2+ progenitors during innate spinal cord repair in …

Assessing Non-Thermal Plasma In Cutaneous Regeneration, Arden Rodriguez, Meliah Martin, Graeme Grainger, Arineh Shahbazi

Discovery Day - Daytona Beach

Chronic and acute wounds remain a significant clinical challenge, particularly in austere and resource-limited environments where access to advanced care is restricted. Non-Thermal Plasma (NTP) has emerged as a promising, non-invasive modality with reported antimicrobial and regenerative properties; however, its mechanisms of action and effects on human skin tissue require further characterization. The scope of this project is to engineer and utilize a 3D human skin epithelial model to evaluate the effects of NTP on wound healing. We will first build a 3D epithelial tissue model that will simulate human skin, followed by modeling and evaluation of wound pathology and …

Analysis Of Non-Thermal Plasma’S Effects On Melanoma: A Biological Examination, Violet Ochrietor, Mia Nilsen, Arden Rodriguez, Ally Schwennesen

Discovery Day - Daytona Beach

Melanoma is a serious form of skin cancer that may present as a real and increased risk during long-term spaceflight due to radiation exposure and limited treatment options. Non-Thermal Plasma (NTP) has emerged as a promising therapeutic tool due to its ability to generate reactive oxygen and nitrogen species (ROS and RNS) that affect cellular functioning without causing temperature related damage to surrounding tissues. This project investigates the effects of NTP on melanoma cells through a biological examination of exposure time, frequency of plasma, and cellular growth conditions. Human melanoma cells and keratinocytes will be cultured and exposed to the …

Steam Distillation Of Jasmine, Mikayla Hulvey, Meliah Martin

Discovery Day - Daytona Beach

This experiment aimed to isolate various components, including benzyl acetate, linalool, indole, and farnesene, from jasmine buds. The functional groups include an ester in benzyl acetate, an alcohol in linalool, an amine in indole, and alkenes in farnesene. Jasmine buds were combined with distilled water and steam distilled using a standard distillation apparatus. The distillate, containing hydrosol and trace amounts of essential oil, was then collected for extraction using methyl tert-butyl (MTBE) for a liquid-liquid extraction. The organic layer was then separated, washed using brine, dried over anhydrous sodium sulfate, and then transferred for later analysis. The essential oil obtained …

Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Impacting Competency In C-Ssrs Suicide Risk Screening On An Inpatient Psychiatric Unit, Fidelis Sangye

Doctor of Nursing Practice Projects

Suicide remains a leading public health concern, and inconsistent application of the Columbia-Suicide Severity Rating Scale (C-SSRS) may contribute to variability in suicide risk assessment and delayed intervention within inpatient psychiatric settings. The purpose of this quality improvement (QI) project was to evaluate the effectiveness of a standardized C-SSRS-guided educational intervention on staff competency in suicide risk screening. Guided by Lewin’s Change Theory and implemented using the Plan-Do-Study-Act (PDSA) framework, this quantitative pretest-posttest QI project was conducted on an adult inpatient psychiatric unit. The intervention consisted of a 25-minute instructor-led PowerPoint presentation on standardized C-SSRS administration and evidence-based suicide risk …

Malt1 Protease Inhibition Restrains Glioblastoma Progression By Reversing Tumor-Associated Macrophage-Dependent Immunosuppression In Mice, Juliana Hofstätter Azambuja, Saigopalakrishna Yerneni, Lisa Maurer, Hannah Crentsil, Gabriela Debom, Linda Klei, Mei Smyers, Chaim Sneiderman, Kristina Schwab, Rajesh Acharya, Aivi Nguyen, Josie Emery, John Little, Jeffrey Meridew, Yijen Lin Wu, Prasanna Ekambaram, Dong Hu, Pete Gough, John Bertin, Ari Melnick, Gary Kohanbash, Riyue Bao, Peter Lucas, Linda Mcallister-Lucas

College of Life Sciences Faculty Papers

MALT1 protease is an intracellular signaling molecule that promotes tumor progression via cancer cell-intrinsic and cancer cell-extrinsic mechanisms. MALT1 has been mostly studied in lymphocytes, and little is known about its role in tumor-associated macrophages. We show that MALT1 is expressed in glioblastoma (GBM)-associated macrophages. Mechanistically, GBM tumor cells induce a MALT1-NF-κB signaling axis in macrophages, leading to enhanced macrophage migration and polarization toward an immunosuppressive ('M2-like') phenotype. Inactivation of MALT1 protease promotes transcriptional reprogramming that reduces migration and restores a macrophage anti-tumor 'M1-like' phenotype. Preclinical in vivo analysis shows that MALT1 inhibitor treatment results in immuno-reactivity of GBM-associated macrophages …

Fieldwork Educators' Perspectives On Occupational Therapy Students Addressing Sexuality And Intimacy: Expectations, Supports, And Barriers, Elizabeth Deluca-Berg

Student Dissertations

Sexuality and intimacy are recognized as meaningful occupations within occupational therapy practice; however, they remain inconsistently addressed in clinical care. Previous research has identified limited educational preparation as a contributing factor to occupational therapists' discomfort and lack of confidence in addressing these occupations. Although classroom instruction provides foundational knowledge, Level II fieldwork serves as the primary setting in which students apply knowledge within authentic clinical environments. Despite the central role of FW educators in facilitating students' professional development, little research has explored how they prepare OT students to address sexuality and intimacy during fieldwork. The purpose of this basic qualitative …

Potential Effects Of Sugar-Sweetened Beverage Taxation On Oral And Systemic Health Outcomes, Rahnuma Ahmad, Muhammad Noorani, Mainul Haque, Mohammed Razzaque

School of Medicine Publications

No abstract provided.

Vitamin D As A Candidate Host Susceptibility Factor In Sugar-Driven Oral Dysbiosis, Moldir Turaliyeva, Nuraly S. Akimbekov, Ilya Digel, Adil Y. Yerezhepov, Mohammed Razzaque

School of Medicine Publications

Introduction: Sugar-sweetened beverages (SSBs) represent a modifiable dietary factor that promotes oral dysbiosis by supplying fermentable sugars and generating low-pH conditions that favor acidogenic and acid-tolerant biofilms. Vitamin D plays a biologically significant role in oral host defense through regulation of the epithelial barrier, induction of antimicrobial peptides, immune modulation, inflammatory control, and mineral metabolism. However, the extent to which vitamin D modifies the SSB -oral microbiome -disease pathway in humans remains unclear.

Methods: This narrative-conceptual review employed structured evidence mapping. Relevant literature was identified through PubMed/MEDLINE, Scopus, and Web of Science Core Collection, with additional sources obtained via citation …

Reduction Of Length Of Stay For Total Joint Replacement Patients, Melody C. Golden

Master's Projects and Capstones

Abstract

Problem: Prolonged LOS in the PACU for patients undergoing total joint replacement surgery contributes to inefficiencies in patient flow, delayed throughput, and increased resource utilization. At Hospital A, recent LOS averages exceed internal and regional benchmarks, indicating a need for process improvement.

Context: The PACU is a high-volume, fast-paced environment requiring coordination among nursing, physical therapy, anesthesia, and discharge planning teams. Variability in workflow, communication gaps, and inconsistent timing of key processes contribute to delays in discharge readiness.

Interventions: From May through July 31^st, 2026, a quality improvement project was implemented using the Baldrige Excellence …

Bibliometric Analysis Of The Top 100 Most Cited Publications From Saudi Arabia Reveals The Predominance Of Medical Fields, Mahmoud Kandeel, Abdulla Al-Taher

Saudi Medical Journal

Objectives: To explore the citation impact, journals, international collaborations, trends of research topics and gain more visibility for the Saudi contribution to the global scientific landscape. Methods: This bibliometric study analyzes the top 100 cited publications affiliated with Saudi Arabia in Scopus, from inception to January 2026. The extracted bibliometric indicators include total citation metrics, sources, collaboration maps, and co-occurrence networks of keywords and collaborations. Results: The results indicate a strong predominance for medicine and health sciences as the subjects of the most prolific and significant number of citations. A substantial proportion of the most cited papers originates from major …

Patterns And Determinants Of Medication Errors Across The Medication-Use Process: A 3-Year Retrospective Study In A Saudi Tertiary Hospital, Nawaf S. Alqurashi, Mazen S. Alshehri, Mohammed J. Almalki, Mustafa M. Muradkhudhari, Rozan M. Radwan, Mohammed M. Aldurdunji, Saleh A. Almazam, Ohood K. Almuzaini, Saad M. Wali

Saudi Medical Journal

Objective: To characterize medication errors across the full workflow and identify stage-specific predictors in a tertiary care setting. Medication errors remain a major global patient safety concern, with limited comprehensive analyses across all stages of the medication-use process in Saudi Arabia. Methods: A retrospective observational study was conducted using medication error reports from Al-Noor Specialist Hospital, Makkah, between January 2023 and August 2025. Errors were classified by stage and severity using the National Coordinating Council for Medication Error Reporting and Prevention index. Multivariable logistic regression was performed to identify predictors associated with each stage. Results: A total of 6,546 errors …

Patient Safety Culture Among Healthcare Professionals In Jeddah First Health Cluster: A Multi-Professional Cross-Sectional Study, Saad S. Alyazidi, Salah S. Alshagrawi

Saudi Medical Journal

Objective: Patient safety culture (PSC) is essential to improve healthcare quality and reduce preventable harm. Despite ongoing healthcare transformation in Saudi Arabia, there is limited evidence on healthcare professionals' (HCPs) perceptions of PSC in newly established health clusters. Methods: We conducted a cross-sectional study among HCPs in 6 government hospitals within the Jeddah First Health Cluster, Saudi Arabia. Data were gathered utilizing the Hospital Survey on PSC (HSOPSC). Descriptive measurement sand multiple linear regression analyses were used to evaluate perceptions of PSC and associated factors. Results: A total of 256 HCPs participated in the study. Overall, PSC was perceived as …

The Al-Bahah Paradox: Divergent Patterns Of Increased And Decreased Infectious Disease Incidence Relative To National Saudi Rates Over 12 Years Of Surveillance, Mohammed A. A. Alqumber

Saudi Medical Journal

Objective: To identify statistically significant deviations in notifiable infectious disease incidence between Al-Bahah region and national Saudi averages, and to generate hypotheses that may inform future epidemiological, microbiological, and public health investigations. Methods: In April 2026, a 12-year retrospective ecological study (2013–2024) was conducted using surveillance data from the Saudi Ministry of Health for 37 notifiable infectious diseases across 20 health regions. Cumulative incidence rates, standardized morbidity ratios (SMRs), and Z-tests compared observed cases in Al-Bahah against national estimates. Results: Overall incidence was 15.8% lower in Al-Bahah than nationally (86.42 versus 102.68; incidence rate ratios = 0.842; p …

Exploring Translational Medical Research Progress In G20 Countries: 5-Year Study, Hana A. Alhumud, Fars K. Alanazi, Edward B. Devol

Saudi Medical Journal

Objectives: Biomedical research is crucial for advancing medical knowledge and improving public health. However, the research process is often disjointed and lacks seamless progression, leading to delays and missed opportunities. To address this, the concept of translational research has emerged, focusing on the smooth transition of research results to the next stage of inquiry. Methods: This study analyzed approximately 40,000 research publications from the Web of Science database to identify research activities associated with translational research. Publications from Group of 20 (G20) countries over the past 5 years were examined to explore patterns of research focus and progress in this …

Evaluation Of Implementation Of An Evidence-Based Screening Tool For Genitourinary Syndrome Of Menopause, Anna L. Myers

Doctor of Nursing Practice Projects

Genitourinary syndrome of menopause (GSM) is a prevalent yet underrecognized and undertreated condition despite evidence-based therapies in the urology setting. The purpose of this Doctor of Nursing Practice quality improvement was to provide education on the 2025 American Urological Association/ Society of Urodynamics and Female Pelvic Medicine & Urogenital Reconstruction/American Urogynecological Society GSM guidelines and integrate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire into practice, evaluate outcomes of acceptability, appropriateness, and feasibility of the intervention, and the impact on diagnosis and associated GSM prescribing. The aim was to impact provider screening and treatment of patients with GSM. Kolcaba's Comfort …

Surgical Outcomes Of Hidradenitis Suppurativa Excision: Factors Impacting Wound Healing Time, Christina Huang, Scott H. Koeneman, Sherry Yang, Sami Tannour

Department of Surgery Faculty Papers

Hidradenitis suppurativa (HS) can be treated surgically to excise recurrent and recalcitrant regions of disease activity. However, surgical outcomes are highly variable depending on closure method, concomitant medical management and area of excision. In this study, we aim to characterise the healing courses from HS excision in a case series. To reduce operator variability, we opted to conduct a case series from a single surgeon. Surgeries conducted from June 2024-December 2025 by surgeon S.T. were included, and the postoperative course was followed until February 2026. Surgical details and postoperative course for 34 sites of HS across 20 patients were analysed. …

Demographic Influences On Awareness Of Speech-Language Pathology Services In The U.S., Phil Weir-Mayta, Joshua Ayala

Communication Sciences and Disorders Faculty Articles and Research

Introduction

Methods

Implementation Of A Cognitive Aide To Guide The Use Of Non-Invasive Hemodynamic Monitoring For Goal-Directed Fluid Therapy During Cesarean Deliveries, Ashley George, Ashley Walbert

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, with delayed recognition contributing to adverse outcomes during cesarean delivery. In cesarean deliveries, traditional intermittent non-invasive blood pressure monitoring may not detect early hemodynamic instability, creating a need for more structured interpretation of continuous hemodynamic data. This Doctor of Nurse Anesthesia Practice quality improvement project implemented a cognitive aid to support anesthesia providers using the Edwards EV1000/ClearSight platform during goal-directed fluid therapy. A pre–post implementation design using provider surveys evaluated feasibility, usability, confidence, and perceived impact. By organizing continuous values such as stroke volume, cardiac output, and systemic …

A Staff Nurse-Led Clinical Instructional Competency Program To Improve Clinical Judgement In Undergraduate Nursing Students: A Quality Improvement Initiative, Shana Skeffrey

Doctor of Nursing Practice (DNP) Manuscripts

There is increasing concern that new graduate nurses are leaving bedside roles early in favor of less stressful positions due to rising patient acuity and heightened organizational expectations, increasing the effects of the nursing shortage (McClosky et al., 2022; AACN, 2024). A standardized clinical experience, combined with fair and consistent access to skill application in the hospital setting can support a collaborative approach for undergraduate nursing students. This quality improvement project is aimed to implement a Staff Nurse-Led Clinical Instructional Competency Program that will provide a structured opportunity for clinical instructors to help fill the gap in preparing undergraduate nurses …

Feasibility And Acceptability Of A Home-Health Aide-Delivered Loneliness Reduction Program In A Small Home Care Agency: The Caring Connections Quality Improvement Project, Tontalayia L. Robinson

Doctor of Nursing Practice (DNP) Manuscripts

Loneliness is a significant public health concern that adversely affects mental, cognitive, and physical health, with consequences comparable to smoking 15 cigarettes per day. Home care recipients experience loneliness at rates of 15.9% to 24.2%, yet home-health aides (HHAs), who often have the most consistent contact with homebound clients, lack structured tools for recognizing and responding to loneliness. This gap highlights the need for practical, evidence-based strategies that can be integrated into routine home care practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the feasibility, acceptability, and appropriateness of a home-health aide–delivered loneliness …

A Quality Improvement Initiative Utilizing Help To Reduce Delirium, Improve Patient Outcomes, And Provide Age Friendly Care For Patients 65 Years Of Age Or Older With Modifiable Delirium Risk Factors., Maggie Blake

Doctor of Nursing Practice (DNP) Manuscripts

Background: Delirium, an acute change in cognition, occurs in 21% of hospitalized patients and is linked to increased length of stay, readmissions, and increased mortality (Shen et al., 2024). In older adults, delirium prevalence increases and is linked to poor outcomes that inhibit patients' health care goals (Shen et al., 2024). Despite the well-published harms of delirium and standardized prevention measures, delirium prevention is not prioritized. Methods: HELP, originally the Hospital Elder Life Program, now preferred to be known as HELP, is a standardized delirium prevention model specifically designed to address the unique needs of hospitalized older adult patients. HELP …

Improving Chlamydia Testing For Females Through Universal Screening In Outpatient Pediatric Primary Care: An Adolescent Quality Improvement Initiative, Christina Howard

Doctor of Nursing Practice (DNP) Manuscripts

Chlamydia is the most common sexually transmitted infection in the United States in adolescents and young adults (Dutra & Lazenby, 2023). Per Smith, Reirden, and Nyquist (2022), adolescents and young adults between the ages of 15 and 24 account for more than 60% of new chlamydia infections each year. Testing for chlamydia is not standardized, and it is estimated that only 50% of those who qualify receive a yearly screening American Sexual Health Association. (2021). If outpatient testing and treatment is not improved these asymptomatic cases will be missed, infections in general will increase, and reinfections may occur leading to …

Enhancing New Graduate Nurse Confidence And Patient Safety Through Clinical Development Coach Integration, Megan T. Kramer

Doctor of Nursing Practice (DNP) Manuscripts

The transition from student to professional nurse is a critical developmental stage often marked by heightened stress, emotional exhaustion, and uncertainty in clinical judgment. These challenges frequently contribute to lower confidence levels, increased anxiety, and higher risks for patient safety events among new graduate nurses. This program evaluation project aims to assess the effectiveness of integrating a Clinical Development Coach (CDC) role to enhance new graduate nurse’s confidence, comfort, and overall competence while reducing patient safety incidents on a trauma/surgical inpatient unit in a medical center on the East coast. The CDC role is a structured mentorship and resource position, …

Implementation Of A Deteriorating Patient Simulation For New Graduate Nurses To Improve Clinical Judgment: A Quality Improvement Project, Kasey Mundell

Doctor of Nursing Practice (DNP) Manuscripts

New graduate nurses (NGNs) often have trouble recognizing and responding to patient deterioration because of limited clinical judgment and confidence during the transition to practice. This quality improvement project evaluated the implementation of a high-fidelity deteriorating patient simulation within a new graduate nurse orientation program at a Level I trauma center. Guided by the Plan-Do-Study-Act framework and the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice, the simulation focused on the assessment and management of a patient experiencing pulmonary embolism. Eight NGNs participated in the simulation and completed the Attitudes Toward Recognizing Early and Noticeable …

Evaluating The Implementation And Progress Of A Bereavement Care Program In An Acute Care Adult Hospital, Nancy Abraham

Doctor of Nursing Practice (DNP) Manuscripts

Bereavement care is a significant component of patient and family centered care; however, it remains inconsistently addressed in acute adult hospital settings. Families of patients who die in hospitals frequently experience grief, anxiety, and emotional distress, which may be exacerbated by fragmented or inadequate bereavement support (Kustanti et al., 2021). Evidence supports the use of structured, interdisciplinary approaches to bereavement care to ensure timely, consistent, and compassionate support for families. To address this gap, a Bereavement Committee was established at a Level I trauma center in eastern Pennsylvania to implement a standardized Bereavement Care Program aimed at improving bereavement practices …

From Novice To Competent: Enhancing Orientation And Readiness For Post-Anesthesia Care Nurses, Gerri Y. Young

Doctor of Nursing Practice (DNP) Manuscripts

Post-anesthesia care unit (PACU) nurses are responsible for managing complex postoperative patients requiring advanced clinical judgment, airway management, hemodynamic monitoring, and rapid recognition of complications. Many nurses transition into the PACU without formal perianesthesia education, resulting in variability in orientation practices, competency validation, and preparedness for independent practice. At a military treatment facility (MTF) in Mississippi, 78% of newly assigned PACU nurses had only one to two years of medical-surgical experience, and a standardized orientation program was not available.

This quality improvement project aimed to implement and evaluate a standardized, evidence-based PACU orientation program designed to improve nurse knowledge, confidence, …