Digital Commons Network^™

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 …

Glp-1 Receptor Agonists And Wound Healing In Diabetic Foot Ulcers: A Scoping Review, Merlin Sajeev, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Level of Evidence: Level 5

Poster Category: Non-sponsored

Introduction: Diabetic foot ulcers (DFUs) are a major complication of diabetes and are associated with delayed wound healing, infection, amputation, and substantial morbidity. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve glycemic control and may influence inflammation, vascular function, and tissue repair. However, clinical evidence evaluating their relationship with DFU healing remains limited.

Aim: To characterize available clinical evidence examining the association between GLP-1 RA use and wound-healing outcomes in patients with diabetic foot ulcers.

Methods: PubMed and Google Scholar were searched for English-language studies published from 2021–2026 using terms combining “GLP-1 receptor …

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. …

Graduate Medical Education (Gme) In The Mountain West, 2025, Mia Tschan, Phillip Seo, Kerima Awol, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on graduate medical education (GME) capacity and physician retention across five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. Data are reported on the number of Doctor of Medicine (MD) and Doctor of Osteopathy (DO) granting institutions, teaching hospitals, residents in training, Medicare-supported GME slots, residents training in slots not supported by Medicare direct GME (DGME), and the percentage of physicians trained in each Mountain West state. The data are derived from the 2025 Association of American Medical Colleges (AAMC) report, “State-by-State Data on Graduate Medical Education,” which includes graduate medical education data …

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 …

Palopegteriparatide For Adults With Chronic Hypoparathyroidism: Skeletal Dynamics Through 3 Years Of The Phase 2 Path Forward Trial, Mishaela Rubin, Bart Clarke, Lorenz Hofbauer, Aliya Khan, Peter Schwarz, Tamara Vokes, Intekhab Ahmed, Andrea Palermo, Filomena Cetani, Uberto Pagotto, Carol Zhao, Michael Ominsky, Bryant Lai, Jenny Ukena, Aimee Shu, Lars Rejnmark

Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers

Hypoparathyroidism is an endocrine disease caused by insufficient levels of PTH, which acts directly on bone and kidney and indirectly on the intestine to regulate calcium and phosphate balance. In clinical trials, palopegteriparatide (TransCon PTH) treatment enabled independence from conventional therapy (no active vitamin D, ≤600 mg/d calcium) and maintained serum biochemistries within normal ranges. The current analyses describe patterns of change in BMD, serum bone turnover markers, and serum and urine calcium in adults with chronic hypoparathyroidism treated with palopegteriparatide through 3 years of the PaTH Forward trial. Baseline BMD Z-scores for the LS, TH, FN, and 1/3 distal …

Nepal Brick Dust And Silica Exposure 2023-2025 Combined Data, Brinly Openshaw, Willow A. Call, Parker D. Willis, Claire Owens, Gregory L. Snow, Seshananda Sanjel, James D. Lecheminant, Neil E. Peterson, Andrew J. South, Clifton B. Farnsworth, Jayson Gifford, Scott C. Collingwood, James D. Johnston

ScholarsArchive Data

A quantitative, cross-sectional study was conducted over an approximately three-year period with sample collection events occurring March 13-21, 2023, March 17 – 23, 2024, and February 18 – 26, 2025. Samples were taken across 4 brick kilns in Bhaktapur, Nepal, including Kiln 1 in 2023, Kiln 2 in 2024, and Kilns 3 and 4 in 2025. Participants (N = 248) were recruited by convenience sampling from kiln 1 (n = 49), kiln 2 (n = 70), kiln 3 (n = 69), and kiln 4 (n = 60).

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 …

Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson

Walden Dissertations and Doctoral Studies

Multiple myeloma (MM) patients have the lowest 5-year cancer survival rates due, in part, to the time it takes for symptoms to develop and the presence of one to four high-risk cytogenetic abnormalities (HRCA). The Terminal Nucleotidyltransferases 5 (TENT5) subfamily, which regulates myeloma cell migration and tumorigenesis, may also increase the risk for developing MM and impact survival rates. The purpose of this study was to investigate the association between the number of HRCA and TENT5 mutation hits with disease outcomes in MM patients while controlling for the stage of the disease (i.e., I, II, or III) at diagnosis. The …

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 …

Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr

Walden Dissertations and Doctoral Studies

Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …

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 …

Common Symptoms In Homoeopathy. Are They Really Useless? Results From An Empirical Assessment Of Best Cases Data From A Bayesian Perspective: An Observational Study, José Enrique Eizayaga, Lex L. Rutten

Indian Journal of Research in Homoeopathy

Background: In seeking the homoeopathic medicine that best fits their case, homoeopaths traditionally yield greater value to the most peculiar symptoms, while dismissing those they believe to be common, according to the number of medicines found in repertories' rubrics. Objectives: To assess the validity of the following homoeopathic usual practice notions: common symptoms are useless and prescription should rely on peculiar ones. Methods: Empirical data from the Best Chronic Homeopathic Cases (BCHC) and the COVID-19 cases collection databases were analysed by using a Bayesian approach. Symptoms' prevalence and likelihood ratio (LR) were calculated. Results from three very common symptoms in …

Vaccinosis And Its Cure By Thuja With Remarks On Homoeoprophylaxis By Dr J. Compton Burnett, Rahul Yadav, J. P. Tripathi

Indian Journal of Research in Homoeopathy

NA

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.

Quality Improvement Project: Improving Nursing Knowledge And Confidence Of Dysglycemia In Pediatric Oncology Patients, Lindley Abrams

Doctor of Nursing Practice Projects

Treatment-induced dysglycemia is a frequently underrecognized complication of pediatric cancer therapy. Pediatric oncology nurses play a critical role in recognizing and managing dysglycemia; however, limited exposure to specialized dysglycemia education may contribute to gaps in knowledge and confidence. A site needs assessment found that 53% of nurses reported discomfort with glycemia-related concepts, supporting the need for targeted education. The purpose of the project was to evaluate changes in pediatric oncology nurses’ knowledge and confidence in recognizing and responding to treatment-induced dysglycemia. The project aimed to provide a structured educational intervention and measure pre- and post-intervention changes. Newman’s Health as Expanding …

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 …

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 …

Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White

Doctor of Nursing Practice Projects

Variability in clinical teaching practices can contribute to inconsistent faculty preparation and student learning experiences. This quality improvement project addressed the absence of a standardized clinical teaching resource within an Associate Degree Nursing (ADN) program at a public technical college in the southeastern United States. The purpose was to implement a standardized, evidence-based clinical teaching guide to improve faculty confidence and clinical educator skill acquisition. Social Cognitive Theory provided the theoretical framework, and Lewin’s Change Theory guided practice change. A quantitative, quasi-experimental one-group pretest-posttest design was used. Fourteen eligible nursing faculty and clinical instructors were invited to participate; 10 participated, …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

Progress, Poetry, And Peace: Romantic Ideals And The Present Day, Kristen Dawn Morgan Hess

Masters Theses

In the busy, technologized, and mechanized life that most people live today, it can be difficult to find true rest, comfort, and peace because the very technology and machinery that is marketed as providing these 21st-century amenities often fall short in their delivery. Taking a look backward at the Romantic era ideals presented in the poetry of William Wordsworth can offer people today the chance to gradually improve their mental, physical, and emotional health by slowing down, minimalizing, and moderating their lifestyles. This thesis talks about the historical background of three of Wordsworth’s poems— “Lines Written in Early Spring,” “The …

Evaluating Electronic Health Record Intervention Efficacy In Enhancing Inpatient Initiation Of Guideline-Directed Medical Therapy, Sheraz Qamar, Trisha Sindhu, Charlotte Pirquet, Benjamin Richter, Charlotte Sacksteder, Tatianna Branch, Jeffrey Riggio, Cara Martino, Patricia C. Henwood, Alan Kubey

Department of Medicine Faculty Papers

BACKGROUND: Heart failure (HF) is a leading cause of hospitalization, morbidity, and mortality. Despite evidence supporting guideline-directed medical therapy (GDMT), prescribing remains suboptimal, particularly at hospital discharge.

PROJECT RATIONALE: Hospitalization provides an opportunity to initiate or optimize GDMT, but workflow barriers and practice variation limit implementation. To address this gap, our system implemented a system-wide HF quality improvement initiative featuring evidence-based order sets and an electronic health record smart phrase ("HFNOTE") to centralize and standardize documentation and encourage GDMT use.

PROJECT SUMMARY: We analyzed 2,859 HF hospitalizations across 10 hospitals between December 1, 2024 and June 30, 2025. Use of …

Ehr-Based Quality Interventions Associated With Differential Gdmt Prescribing In Community Versus Academic Hospitals, Trisha Sindhu, Charlotte Pirquet, Sheraz Qamar, Tanay-Veer Gandhi, Patricia C. Henwood, Cara Martino, Jeffrey Riggio, Jared Vanderzell, Charlotte Sacksteder, Alan Kubey

Department of Medicine Faculty Papers

BACKGROUND: Institutional barriers are associated with suboptimal guideline-directed medical therapy (GDMT) prescribing at heart failure discharge.

PROJECT RATIONALE: Practice variations between academic medical centers (defined as "teaching" hospitals with residents) and community hospitals are poorly understood. Evaluating how diverse settings respond to quality improvement strategies is vital.

PROJECT SUMMARY: A multicenter study across 10 electronic health record-unified hospitals evaluated 3,535 heart failure encounters. Phase 1 implemented educational work groups and financial incentives; phase 2 introduced clinical decision support systems. Community hospitals responded significantly to phase 1 education/incentives, with mean discharge of GDMT agents rising from 2.19 to 2.44 (P = …

Feasibility And Acceptability Of Perioperative Application Of Biofeedback-Based Virtual Reality Vs Control For Pain And Anxiety In Children And Adolescents Undergoing Surgery: Pilot Randomized Controlled Trial, Anna Lin, Brenna Rachwal, Lindsey Asti, Zandantsetseg Orgil, Isabela Santiago, Lili Ding, Susmita Kashikar-Zuck, Christopher King, Sara Williams, William Black, Peter Minneci, Vanessa Olbrecht

Department of Anesthesiology Faculty Papers

BACKGROUND: The impact of biofeedback-based virtual reality (VR-BF) on pain and anxiety in pediatric surgical patients remains unexplored.

OBJECTIVE: The objective of this study was to evaluate the feasibility and acceptability of perioperative VR-BF use in children and adolescents.

METHODS: We performed a single-blind, 2-arm, randomized pilot trial. Children aged 12 to 18 years undergoing surgery with expected moderate-to-severe postoperative pain and more than 1 overnight admission were randomized (1:1) to the intervention or control group. Participants in the intervention group received VR-BF using ForeVR (functional outcome response to engaging virtual reality [VR]), a novel, gamified digital intervention that integrates …

Successful Treatment Of Recurrent Epithelioid Trophoblastic Tumor (Ett) With Pembrolizumab After Pembrolizumab: A Case Report And Review Of Literature In Treatment Of Ett, Sarah Mokma, Sarah Alnaif, Nicholas Cardillo

Abington Jefferson Health Papers

BACKGROUND: Epithelioid Trophoblastic Tumors (ETT) are rare, which makes an optimal treatment regimen difficult to determine. Since PD-L1 is expressed in placental tissue and in gestational trophoblastic neoplasia (GTN), immunotherapies such as pembrolizumab have been proposed as possible treatments.

CASE PRESENTATION: The case presented is a 50-year-old postmenopausal female who presented with postmenopausal bleeding and a large, fungating cervical mass. Cervical biopsies confirmed ETT. The patient underwent primary debulking surgery with radical abdominal hysterectomy, bilateral salpingo-oophorectomy, and sigmoid colon resection. The patient was diagnosed with a FIGO Stage IV ETT due to tumor extension to sigmoid colon with a high-risk …

Data For Advocacy Intention Using Pmt, Alice Ann Crandall

ScholarsArchive Data

This includes the deidentified data and code for the article Advocacy Intention Across Politically Sensitive Health Issues: A Cross-Sectional Study Using Protection Motivation Theory