Digital Commons Network^™

Implementation Of A Nurse-Led Self-Measured Blood Pressure Program In Rural Primary Care, Stephanie Marie Montgomery

Walden Dissertations and Doctoral Studies

Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality, yet blood pressure control remains suboptimal among many adults, particularly those receiving care in rural primary care settings. Reliance on office-based blood pressure measurements may limit opportunities to identify uncontrolled hypertension and actively engage patients in disease self-management. This Doctor of Nursing Practice quality improvement project evaluated the implementation of a standardized self-measured blood pressure (SMBP) program for adult patients with hypertension in a rural primary care practice. The intervention included validated home blood pressure monitors, standardized patient education, teach-back to verify measurement competency, structured home blood pressure …

Staff Education To Improve Hand Hygiene And Personal Protective Equipment Compliance, Suliat Oluwa

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to strengthen hand hygiene and personal protective equipment (PPE) practices among interdisciplinary staff in a long-term care (LTC) facility. The practice problem addressed inconsistent hand hygiene and PPE use across shifts and departments, contributing to healthcare-associated infections (HAIs). Because LTC residents are highly vulnerable due to advanced age, multiple comorbidities, and shared living environments, improving adherence to infection prevention practices is essential for enhancing resident safety, reducing preventable infections, and supporting compliance with Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) infection prevention standards. …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Closing The Loop: Strengthening Cauti Prevention With Urinary Catheter Management, Erika N. Braun

Master's Projects and Capstones

Objective: Catheter-associated urinary tract infections (CAUTIs) are among the most common preventable healthcare-associated infections and are associated with significant patient harm and increased healthcare costs. Baseline assessment across five adult cardiovascular and critical care units within a community-based acute care hospital identified four CAUTI events during the first half of 2026 and revealed important nursing knowledge deficits related to bladder scanning protocols and urinary catheter management practices. Aim: This Quality Improvement (QI) Project aimed to improve nursing knowledge of evidence-based bladder scanning protocols and urinary catheter management practices through targeted educational interventions implemented over a 10-week period, with …

Staff Education To Improve Diabetic Care In A Primary Care Setting, Sally Uyen Nguyen

Walden Dissertations and Doctoral Studies

Inadequate patient education, inconsistent screening, missed referrals, and follow up with diabetes patients are challenges primary care managers and staff must overcome. Patients may experience negative effects that lead to poor health outcomes, delayed diagnosis, and undertreatment when provider and staff members are not educated about diabetes. The practice-focused question guiding the Doctor of Nursing Practice (DNP) staff education project involved exploring whether a staff education intervention on standardized diabetes care and screening protocols could improve physicians, managers, and medical assistants’ (MAs) knowledge of diabetes care in primary care clinics. The purpose of this project was to enhance staff knowledge …

Staff Education To Improve Staff Knowledge On Fall Prevention, Nginjoh Presilia Njofang

Walden Dissertations and Doctoral Studies

Patient safety risks associated with falls are a major issue in adult inpatient medical-surgical environments because nursing inconsistencies with regard to fall risk assessments, individualized fall prevention interventions, and documentation could impede adherence to best practices. To overcome this knowledge gap among RNs in the selected environment, a DNP education project aimed at standardized fall-prevention staff education was initiated. The question for the practice was whether standardized staff education would increase knowledge among nurses regarding fall-risk assessments, preventive measures, and documentation requirements, based on pretest and posttest results. In the course of a one-hour educational session conducted face-to-face, twenty RNs …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Reducing Variation, Improving Outcomes: Standardizing Gestational Diabetes Mellitus Education In A Clinical Microsystem, Thanh Le

Master's Projects and Capstones

Objective: Variations in referral, scheduling, delivery of educational information, patient materials, and documentation hampered the quality of gestational diabetes mellitus (GDM) education in the outpatient maternal-fetal medicine clinic. Purpose: The aim of the quality improvement project was to boost adherence to a standardized GDM group education framework from 0 to 50% in the course of 12 weeks and assess attendance at group visits. Methods: The microsystem analysis was conducted based on observations of group visits conducted in Spanish and English, examination of current processes and resources in use, educator pre-survey, SWOT analysis, and cause and effect analysis. The implementation of …

The Effects Of Hypoxia On Balance Systems, Samuel Drescher Drescher, Heather Bond, Allysa Hayden, Victoria Cornaro, Brandon Ibarra, Noah Clark, Frank Cunningham Iv, Carolina Ferreira, Sierra Martinez, Katie Stubits

Discovery Day - Daytona Beach

Hypoxia, a condition characterized by insufficient oxygen availability to body tissues, is known to impair physiological and cognitive function, particularly at high altitudes above 15,000 ft. However, the effects of mild hypoxia (10,000–15,000 ft) remain less well understood. This study, conducted by the department of Human Factors and Behavioral Neurobiology at Embry-Riddle Aeronautical University, investigates the impact of mild hypoxia at 12,000 ft on human balance systems. Specifically, it examines the three primary components of balance: visual, proprioceptive, and vestibular systems. Participants complete nine balance tasks under both normoxic and hypoxic conditions. Tasks are structured to progressively limit sensory input: …

Ai-Based Pilot Fatigue Monitoring For Enhanced Aviation Safety, Joshua Henderson, Alexander Landau, Braxton Moor, Jacky Yang, Caleb Difabio

Discovery Day - Daytona Beach

Pilot fatigue remains a persistent systemic operational hazard in commercial aviation because it can degrade attention, reaction time, decision-making, and crew coordination during safety-critical phases of flight. Although regulatory duty-time limits and Fatigue Risk Management Systems provide baseline protections, these controls rely heavily on voluntary reporting and post-event analysis, which may fail to detect fatigue in real time. The purpose of this project was to design and evaluate an artificial intelligence-enabled fatigue monitoring concept intended to reduce undetected pilot fatigue risk within the airline Safety Management System framework. The study applied a structured research approach including a literature review to …

The Chameleon Experience: Queer Identity, Mental Health, And Transformation, Cameron Penny

Communication and Theater Association of Minnesota Journal

In this autoethnographic piece, I examine the correlation between queer identity and mental health through reflective analysis of my own experiences within a Western socio-cultural setting. I expand external perspectives on the queer experience by highlighting the normalization of queer prejudice and its adverse impact on self-image. I share how the religious praxis of Catholicism enforces binary conformity by promoting dichotomous thinking that simultaneously constricts queer expression and subjugates implicit biases. In tandem, I utilize autoethnography as my medium because it provides a unique outlet to raise awareness for chronically stigmatized identities by centering marginalized voices (Atay, 2011; Chavez, 2013). …

Psychological Interventions For Children With Neurodevelopmental Disabilities In The Context Of Neurodiversity: A Systematic Review, Kalliopi Megari, Dimitra V. Katsarou, Evangelos Mantsos, Soultana Papadopoulou, Efthymia Efthymiou, Maria Theodoratou, Maria Sofologi, Eugenia Toki

All Works

Highlights What are the main findings? What is the implication of the main finding?Highlights What are the main findings? What is the implication of the main finding?Abstract Background/Objectives: This systematic review examines psychological interventions for children with neurodevelopmental disabilities within a neurodiversity framework, emphasizing that variations in cognition, behavior, and neurological functioning represent natural forms of human diversity rather than deficits. Methods: A systematic literature search was conducted across the PubMed, PsycINFO, and Google Scholar databases for studies published between 2010 and 2025. Studies were included if they focused on children with autism spectrum disorder (ASD), learning or intellectual disabilities …

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …

Implementation Of A Standardized Antibiotic Order Set To Improve Evidence-Based Antibiotic Prescribing In Oral Surgery, Lashundra Miles

Walden Dissertations and Doctoral Studies

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Stewardship In Action: Reducing Unnecessary Antimicrobial Use In Long-Term Care, Mariatu Sulaiman

Walden Dissertations and Doctoral Studies

Antimicrobial overuse in long-term care facilities (LTCFs) contributes to antimicrobial resistance, avoidable healthcare costs, and adverse drug events, particularly when antibiotics are prescribed for asymptomatic bacteriuria rather than symptomatic urinary tract infections (UTIs). Evidence-based clinical practice guidelines, including the McGeer Criteria, provide standardized approaches for differentiating true UTIs from asymptomatic bacteriuria and supporting appropriate antimicrobial prescribing. The purpose of this evidence-based practice project was to evaluate the development and implementation of a clinical practice guideline incorporating the McGeer Criteria into an antibiotic stewardship program in an LTCF. The practice-focused question examined what evidence supports strategies for reducing unnecessary antimicrobial use …

The Impact Of Scar Wires On Dose Distribution Of Electron Fields, Ahmad Nour

Masters Projects

Purpose: This phantom study looked at whether changing the Hounsfield unit (HU) value for radiopaque scar wires in Eclipse changed the calculated electron dose distribution. Methods and Materials: Radiopaque wires were placed in the same abdominal area on an anthropomorphic phantom. The wires were set up in a circle. The CT images were brought into Eclipse, the wires were contoured, and the planning target volume was made 1 cm inside the circle of wire. For every wire size and electron energy, two matching plans were made: one plan with no density override and one plan with a density override applied …

Cone Vs. Volumetric Modulated Arc Therapy (Vmat) Stereotactic Radiosurgery (Srs) Planning For Multiple (7) Brain Targets: Dosimetric Tradeoffs And Clinical Decision Guidance, Juan Garcia

Masters Projects

Purpose: This study compared cone-based stereotactic radiosurgery (SRS) and single-isocenter volumetric modulated arc therapy (VMAT) for multiple (7) intracranial targets to evaluate differences in target coverage, conformality, dose falloff, and normal brain exposure.

Methods: A phantom-based study was performed using progressively increasing configurations of 10-mm spherical targets, from one to seven targets. Cone-based SRS and VMAT plans were evaluated using D99, CI100, CI50, gradient index (GI), maximum dose, V12Gy, and V5Gy.

Results: Both planning techniques achieved similar target coverage. Cone based SRS produced a steeper dose gradient, with a mean GI of 2.99 compared with 4.66 for VMAT ( …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

Resource-Conscious Care: Time To Pregnancy And Iui Cycle Outcomes In Female Same-Sex Couples, Lea George, Devika Sachdev, Kassie Bollig

Department of Medicine Faculty Papers

RESEARCH QUESTION: Does the clinical pregnancy rate (CPR) for the first cycle, time to pregnancy, and cumulative CPR up to six consecutive cycles differ between female same-sex couples undergoing intrauterine insemination (IUI) alone and those undergoing IUI with ovarian stimulation?

DESIGN: This retrospective cohort study evaluated 554 female same-sex couples undergoing IUI alone (n = 264) or IUI with ovarian stimulation (n = 290) at a single centre using cryopreserved donor spermatozoa from January 2012 to January 2022.

RESULTS: Overall, CPR for the first cycle was 17.9% (99/554). In adjusted analyses, there was no significant difference in CPR in IUI …

Shared Equity Leadership In An Offshore Medical School: Distributing Responsibility For Equity, Vishal B. Surender, Sreekrishna Penna, Oluwabusola Osimosu

Journal of Comparative & International Higher Education

This essay applies the Shared Equity Leadership (SEL) framework to an offshore MD program at a private Caribbean medical school where students complete basic sciences on an island and clinical clerkships across multiple international sites. Using SEL scholarship and de-identified institutional data, we ask how equity work is currently distributed, where gaps emerge in assessment, remediation, and mobility for historically underrepresented students in medicine, and how responsibility for equity might be more deliberately shared. The Woven model of SEL provides a lens to map existing structures like curriculum committees, CQI dashboards, advising systems, and clinical site partnerships. We propose a …

Beyond The Clot: A Rare Case Of Extensive Dvt And Pulmonary Embolism Revealing May-Thurner Syndrome, Jorge A. Aboytes, Jose J. Loayza, Ivan Mogollon, Daniel Pena, Michelle Lopez

Research Colloquium

Introduction: Deep vein thrombosis (DVT) in young adults is uncommon and typically associated with identifiable risk factors. In cases where DVT occurs without apparent provocation, congenital anatomical anomalies should be considered. May-Thurner Syndrome (MTS), a vascular compression disorder involving the left iliac vein, is a frequently overlooked cause of iliofemoral DVT in young individuals, particularly women.

Case Presentation: A 28-year-old woman with no significant medical history presented with acute left leg swelling, pain, and discoloration, along with new-onset dyspnea and chest discomfort. She had recently transitioned to a contraceptive patch and reported reduced mobility due to fatigue. Imaging confirmed left …

Implementation Of Artificial Intelligence In Retinoblastoma Diagnosis, Zana Moldavsky

inSIGHT

The retina is essential for vision. It is composed of 10 distinct layers and contains specialized photoreceptor cells, rods, and cones that are responsible for converting photons of light into electrical signals through a process called phototransduction.¹ These electrical signals are transmitted to the brain via the optic nerve where they are interpreted as a visual picture.¹

Retinoblastoma is a rare but aggressive malignant tumor of the retina and represents the most common intraocular malignancy in the pediatric populabon.² The disease follows Knudson's two-hit hypothesis and occurs due to biallelic inactivation of the RB1 tumor suppressor gene …

Glp-1 Receptor Agonists And Ocular Risk, Saharsh Satheesh

inSIGHT

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have moved from second-line diabetes medications toward the frontline of type 2 diabetes, obesity, and cardiometabolic care.¹ A meta-analysis of 10 randomized cardiovascular outcomes trials (n = 71,351) demonstrated that longacting GLP-1 RAs reduce major adverse cardiovascular events by 14%, all-cause mortality by 12%, and composite kidney outcomes by 17%.² With GLP-1 RAs usage increasing, ophthalmology is also increasingly encountering patients who have recently started GLP-1 RAs therapy, often alongside substantial improvements in glycemic control.

In the context of GLP-1 RAs ocular complications, two specific topics currently dominate conversations: (1) worsening diabetic …

Dichoptic Therapy Versus Patching – State Of Literature Review, Eve Miller

inSIGHT

Amblyopia is the most common cause of vision loss in children. A meta-analysis performed by Hu et al. 2022 estimated the global prevalence of amblyopia to be 1.36%.¹ Amblyopia is defined as a reduction in best-corrected visual acuity (BCVA) of one or both eyes caused by abnormal neurologic development in the critical period of visual development. Amblyopia may result from unequal refractive error, strabismus or ocular pathology.² Despite treatment of these inciting factors, suppression of one eye remains, resulting in unequal vision. The clinical consequences of untreated amblyopia include permanent reduction in vision in the affected eye and …

Novel Treatments For Keratoconus, Caroline Paik

inSIGHT

Keratoconus is a progressive condition in which the cornea gradually thins and bulges outward, causing it to become steep and irregular. This leads to irregular astigmatism and worsening vision, most often beginning in adolescence or early adulthood.¹ The management of keratoconus has evolved significantly over the past two decades, with novel therapeutic approaches emerging across three critical domains: halting disease progression, improving visual function, and providing surgical alternatives when conservative measures fail. This review examines the latest advances in keratoconus treatment, focusing on innovative approaches that are reshaping clinical practice.

Insight, Volume 6, Issue 1, 2026

inSIGHT

Contents

7 - Novel Treatments for Keratoconus
By Caroline Paik

12 - Novel Advancements in Glaucoma Surgery
By Eshani Ragam

16 - Dichoptic Therapy versus Patching – State of Literature Review
By Eve Miller

24 - GLP-1 Receptor Agonists and Ocular Risk
By Saharsh Satheesh

33 - Home-use OCT for Neovascular Age- Related Macular Degeneration
By Sneh Shah

40 - Implementation of Artificial Intelligence in Retinoblastoma Diagnosis
By Zana Moldavsky

Transfemoral Approach To Patent Ductus Arteriosus Occlusion Using Acdo In A Dog With Complex Surgical History, Nawat Sannamwong, Hataichon Owatdhumma, Kornrawee Tharavanij, Thitinan Tangarsasilp, Nardtiwa Chaivoravitsakul, Kongthit Horoongruang, Patmanachatr Bunnag, Nakkawee Saengklub, Krishaporn Kradangnga, Sirilak Disatian Surachetpong, Anusak Kijtawornrat

The Thai Journal of Veterinary Medicine

A five-year-old spayed female Welsh Corgi weighing 12.4 kg presented with exercise intolerance and was diagnosed with a patent ductus arteriosus (PDA). Due to signs of left-sided volume overload, the dog was initially managed with oral pimobendan and was subsequently referred to the Small Animal Teaching Hospital at Chulalongkorn University for further evaluation and intervention. Upon presentation, the patient was bright, alert, and responsive, with a body condition score of 6 out of 9 and normal muscle condition. The mucous membranes were pink and moist, with a capillary refill time of 1 to 2 seconds. A continuous heart murmur was …

Predictive Factors For Humeral And Ulnar Stem Loosening After Total Elbow Arthroplasty: A Retrospective Cohort Study, Akash Singh, James Satalich, Miguel Fiandeiro, Harrison S. Fellheimer, Matthew Ramsey, Surena Namdari

Rothman Institute Conference Posters

BACKGROUND: There has been a significant increase in the use of total elbow arthroplasty (TEA) in advanced osteoarthritis, post-traumatic arthritis, and complex distal humerus fractures. The purpose of this study is to determine the incidence of total elbow loosening and association with patient demographics, implant specifications, and cement mantle characteristics.

METHODS: A retrospective cohort study was conducted of patients who underwent primary TEA between 2013 and 2022 at a single institution. Revisions and conversions from prior open reduction and internal fixation were excluded. Pre-operative distal humeral cortical thickness and bone quality were assessed. Variables included anterior humeral flange contact with …

What Do Children Think About Bouncy Bands: A Mixed Methods Examination Of Bouncy Bands' Influence On Attention And Physical Activity, Ken Murfay, Sarah Collins

International Journal of Physical Activity and Health

Purpose: To examine how bouncy bands put onto elementary students’ classroom desks influenced students’ physical activity and attention/concentration, in addition to exploring students’/teachers’ opinions of the bands. Methods: Students within both experimental and control groups wore pedometers to assess movement during instruction and completed the d2 test for attention. Results: The group with bouncy bands on the desks had significantly more movement compared to the control group. For d2 scores, there was no significant difference between the two groups, nor was there a significant linear relationship between movement and d2 scores. Interviews were conducted with the students in the experimental …