Digital Commons Network^™

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …

Empowering Domestic Violence Survivors Through Community-Based Self-Regulation Suppor, Xen Gabrielle O. Advincula

Occupational Therapy Student Capstones

Purpose: Program development of trauma-informed, occupation-based resources and program and incorporating OT-related principles to support occupational balance and engagement of survivors of DV and IPV

Goal: Enhance and support the staff’s capacity and understanding of OT-scope in community settings and incorporation of OT-focused self-regulation strategies

Outcome: Increase the staff’s confidence levels of knowledge on the scope of OT within community-based settings and OT-related strategies to support self-regulation levels

An Epilepsy Community Collective Towards Occupational Justice And Empowerment, Tyler Debuty

Occupational Therapy Student Capstones

Underutilization of epilepsy-specific resource programs, lack of public awareness about epilepsy, limitations in community belonging, and implications for self-management programs aimed towards improving quality of life and reducing the burden of care during the transition into adulthood and throughout the lifespan for people with epilepsy.

Promoting Mental Health Awareness, Advocacy, And Occupational Justice For First-Generation College Students, Gilberto Duran Garcia

Occupational Therapy Student Capstones

First Generation College Students (FGCS) face a high prevalence of mental health concerns

Stress, anxiety, depression, financial burden, cultural expectations, imposter syndrome, pressure to meet expectations, fear of the unknown, lack of guidance, and lack of preparedness

Enhancing New Mother's Mental Health And Confidence After Discharge, Breana De La Cruz

Occupational Therapy Student Capstones

New mothers lack guidance, education and resources for common postpartum complications resulting in a decreased overall wellbeing in the postpartum period.

Going With The Flow: Psychological Flow & The Mental Health Of Occupational Therapy Students, Sydney Buchanan

Occupational Therapy Student Capstones

Despite a growing interest in psychological flow as a factor associated with positive mental health outcomes, its relationship to OTD student well-being has remained underexplored.

Kickin' It Old School: Connecting The Ages, Elyssia Lambert

Occupational Therapy Student Capstones

Problem Statement

Lack of social participation is associated with negative impacts on QoL in individuals with dementia

Lack of awareness and knowledge of OT as a career option

Supporting The Transition: A Summer Camp Model For Students With Adhd Entering Middle School, Anna G. Schene

Occupational Therapy Student Capstones

Students transitioning from elementary school to middle school experience newfound independence, requiring sufficiency in their executive functioning skills. The school-based OT service delivery does not always include or target this population, leaving students without the support needed to develop these skills.

Learn As You Are: Equipping Key Educational Stakeholders With Neuro-Affirming Knowledge To Support Inclusion Of Autistic Students, Jessalyn Sulamo

Occupational Therapy Student Capstones

Students throughout the autism spectrum often experience challenges relating to social and communication difficulties, sensory challenges, and inflexible approaches that hinder their social, emotional, and academic well-being (Black et al., 2024).

Dnp Final Report: Implementing The 5-2-1-0 Lifestyle Framework To Address Elevated Bmi In Pediatric Primary Care, Mary K. Williams

DNP Final Reports

Pediatric obesity remains a significant public health concern, particularly in rural areas where access to specialty care is limited. Primary care settings provide an important opportunity for early identification and intervention through family-based lifestyle modification. The purpose of this quality improvement project was to evaluate the feasibility and preliminary impact of implementing the 5-2-1-0 healthy habits framework, developed by researchers at Penn State, in a rural pediatric primary care clinic to promote improved lifestyle behaviors among children with elevated body mass index (BMI).

This project included pediatric patients ages 5–16 years presenting for well-child visits with a BMI at or …

Empowering Amputees Through Education And Resources To Improve Independence And Quality Of Life, Brooke A. Hodges, Wendy M. Tremaine

Summer 2026 OTD Capstone Symposium

This doctoral capstone project aimed to develop and implement an evidence-based educational toolkit to increase community resource awareness for individuals with amputations. The project was completed at Baylor Scott & White Institute for Rehabilitation in Dallas, Texas, and involved adult patients with limb loss and rehabilitation healthcare professionals. A needs assessment was conducted using surveys, semi-structured interviews, and informal discussions to identify educational gaps and resource needs. Findings informed the development of educational materials addressing mental health, peer support, financial assistance, transportation, driving rehabilitation, home modifications, adaptive recreation, prosthetic resources, and community organizations. The toolkit was designed to accommodate varying …

Navigating Concussion Recovery: An Educational Module-Based Approach To Strengthening Occupational Therapist Confidence And Effectiveness In Concussion Rehabilitation, Alejandra Abella, Wendy Tremaine

Summer 2026 OTD Capstone Symposium

Background: Mild traumatic brain injury (mTBI), commonly known as concussion, presents with complex physical, cognitive, visual, vestibular, and emotional symptoms that can significantly affect an individual's ability to participate in meaningful daily occupations. Although occupational therapists play an essential role in concussion rehabilitation, many clinicians report that confidence in evaluating and treating this population develops primarily through years of clinical experience rather than structured education. Inconsistent exposure to concussion cases and limited access to current evidence-based resources contribute to variations in clinical confidence and practice.

Purpose: The purpose of this doctoral capstone project was to develop and implement a comprehensive …

Beyond The Athlete: An Autoethnographic Exploration Of Occupational Identity, Sofia Paniagua-Bauer, Karen Park

Summer 2026 OTD Capstone Symposium

Adolescent student-athletes experience unique demands as they navigate the expectations of competitive sport alongside academic, social, and developmental responsibilities. These demands may influence mental health, executive functioning, occupational balance, and the development of occupational identity. The purpose of this Doctor of Occupational Therapy (OTD) capstone project was to explore the development of occupational identity through the lived experience of growing up as a competitive athlete and to examine how participation in sport influenced mental health, self-regulation, executive functioning, and engagement in meaningful occupations. An autoethnographic approach was used to reflect on my personal experiences while completing a capstone experience at …

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.

Explosive Weapons Trauma Care Collective (Extracct) Clinical Practice Guideline: Transfer Of Critically Injured Casualties, Emma Butterfield, Gavin Wooldridge, Solomon Asfaw, Mervat Alhilal, Mardi Steere, Benjamin Wachira, Paul Reavley, Roman Shtybel, Marius Rehn

Emergency Medicine, East Africa

Introduction Blast-injured patients often present to healthcare facilities which cannot definitively meet their clinical needs. This clinical practice guideline (CPG) reviews and describes best practice for inter-facility transfer of casualties in resource limited and conflict-afflicted contexts where there may not be a formal referral pathway or specialized inter-facility transfer service.

Methods A narrative literature review and synthesis of expert opinion were used to develop this CPG.

Results The guideline describes current standards and best practice in inter-facility transfer in a low resource context—particularly during conflict when referral and transfer pathways may be overwhelmed—and advises on the selection and preparation of …

A Leadership Trait Analysis Of U.S. Vice President Jd Vance, Aubrey Immelman, Sophie J. Heck

Psychology Faculty Publications

This paper presents the results of an indirect leadership trait analysis of U.S. vice president JD Vance, conducted for the purpose of anticipating Vance’s likely leadership style in a high-level executive role in politics, from the conceptual perspective of Margaret Hermann’s leadership trait analysis (LTA) model, employing an empirically based “psychodiagnostic meta-analytic” methodology.

Psychodiagnostically relevant data relating to Vance were collected from biographical sources and media reports and synthesized into a personality profile using the Hermann Leadership Trait Inventory (HLTI) — constructed expressly for the present study — which taps seven leadership trait dimensions: belief in one’s ability to control …

The Personality Profile Of Entrepreneur And Business Leader Elon Musk, Amelia Brower, Aubrey Immelman

Psychology Faculty Publications

This paper presents the results of an indirect personality assessment of entrepreneur and business leader Elon Musk, from the conceptual perspective of personologist Theodore Millon.

Psychodiagnostically relevant data relating to Musk were collected from biographical sources and media reports and synthesized into a personality profile using the Millon Inventory of Diagnostic Criteria (MIDC), which yields 34 normal and maladaptive personality classifications congruent with DSM-III-R, DSM-IV, and DSM-5-TR.

The personality profile yielded by the MIDC was analyzed in accordance with interpretive guidelines provided in the MIDC and Millon Index of Personality Styles (MIPS) manuals. Musk’s primary personality patterns …

Correlation Between Overthinking And Procrastination Behavior Among Nurses, Mona Hassan Abdelaal

Nursing

ABSTRACT Context: A key challenge in understanding internalizing psychological disorders is identifying the cognitive processes that sustain distress and disrupt effective functioning. Recurrent, hard-to-interrupt thinking patterns may interfere with individuals’ ability to initiate and complete intended tasks. Concurrently, individuals may persistently delay necessary actions despite recognizing their negative consequences, indicating a breakdown between intention and behavior. This pattern of delay appears to be associated with seeking short term emotional relief, reduced consideration of future outcomes, and avoidance of prolonged effort. While these issues have been studied independently, their overlapping mechanisms require further investigation. The potential role of repetitive cognitive processes …

Neighbourhood Social Vulnerability And Preterm Birth Risk Among Infants With Trisomy 21: A Statewide Analysis, Fatima R Sheriff, Renata H Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A J Agopian

Faculty, Staff and Student Publications

Background: Residing in socioeconomically vulnerable areas is known to be associated with increased preterm birth (PTB) risk in the general population. However, the relationship between social vulnerability and PTB remains unexplored among infants with trisomy 21, who experience more than twice the PTB rate of the general population.

Objectives: The primary objective was to examine the association between maternal socioeconomic vulnerability, as measured by the SVI, and PTB among infants with trisomy 21.

Methods: We conducted a retrospective cohort study among infants with trisomy 21 born in Texas (1999-2018). We examined the association between neighbourhood vulnerability, measured by Social Vulnerability …

Social Phobia, Coping Strategies, And Socio-Demographic Associations Among Late Adolescents: A Cross-Sectional Study, Ezhilan B U, Jesymol Joy, Smitha Chandrashekarappa Dr.

Digital Journal of Clinical Medicine

Background: Adolescence is a transitional period from childhood to adulthood, often marked by psychological challenges such as social anxiety, also known as social phobia. It is characterized by excessive fear of social interactions and can lead to impaired functioning or depression. Globally, its prevalence ranges from 6-10% in developed countries and 10-44% in developing countries. Coping strategies play a crucial role in managing social phobia, varying by individual characteristics. This study aimed to determine the prevalence of social phobia, identify coping strategies, and evaluate their association with socio-demographic factors among late adolescents.

Methodology: A cross-sectional study was conducted …

Da Mosang Tarsier Series: Developing Digital Bullying Prevention Materials For Filipino Parents Of Grade School Students, Rudy M. Danganan Jr., Ann Christine V. Braga, Maria Kristina S. Alfonso, Romelito Manuel D.S. Clorina, Ma. Regina Hechanova

Children and Families

Bullying remains a significant public health and educational concern worldwide and is particularly prevalent in Philippine public schools, with Grade 7 students identified as a vulnerable group. Although the Anti-Bullying Act of 2013 (Republic Act No. 10627) mandates school-based policies and procedures, persistent implementation gaps underscore the need to strengthen home–school partnerships and equip parents with practical, culturally grounded response strategies. This paper describes the development of the Da Mosang Tarsier Series, a set of digital psychoeducational comic strips designed for Filipino parents of Grade 7 students. Guided by a user-centered design (UCD) framework, the project began with a Generative …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

Aadej Comm 12 2 2026

AADEJ - The Communicator

The Communicator is the official publication of the American Association of Dental Editors & Journalists (AADEJ), promoting awareness of the association’s activities and offering valuable insights for dental editors and journalists to enhance their publications. It is published quarterly, distributed digitally via email to members, and posted on the Association’s website at aadej.org, with archives on ADA Commons. Regular contributions from the Editor-in-Chief, Executive Director, President, and Associate Editor cover various topics.