Digital Commons Network^™

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 …

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, …

Fast Mr Imaging: Reducing Sedation And Improving Patient Experience, Hajir Aljumaily

Radiologic Sciences

Purpose To examine the impact of fast magnetic resonance (MR) protocols on sedation requirements, patient tolerance, workflow efficiency, and diagnostic accuracy in musculoskeletal and brain imaging.

Method An integrative literature review was conducted using PubMed, CINAHL, and Google Scholar to identify peer-reviewed, original research articles published between 2019 and 2026. Studies were selected for relevance, human subjects, and outcomes related to sedation, patient experience, or diagnostic effectiveness.

Results Fast MR protocols were consistently associated with reduced sedation use, improved patient comfort, and increased exam completion rates. Workflow efficiency improved due to shorter scan times. Although minor reductions in image quality …

Disengagement And Reconnection: Investigating The Role Of Purpose And Identity Seeking Across Career Stages In Healthcare, Charmel Renee Jeffery

Radiologic Sciences

Purpose To examine the generational purpose gap in healthcare by identifying the psychological and environmental factors underlying early-career disengagement and late-career reconnection.

Method An integrative literature review was conducted using four academic databases. An artificial intelligence (AI)-assisted thematic synthesis was applied to extract and organize findings within a standardized analytic matrix. To ensure accuracy and rigor, all AI-generated outputs were validated against the original source data.

Results Two primary themes emerged. Early-career healthcare workers commonly experienced disengagement associated with destiny beliefs, while later-career professionals demonstrated renewed purpose and resilience despite ongoing stressors.

Discussion The findings revealed a pronounced generational divide …

Mr-Linac Technology, Katherine Orellana

Radiologic Sciences

Purpose To examine the clinical advantages of magnetic resonance-guided linear accelerator (MR-Linac) technology in radiation therapy, with a focus on treatment accuracy, adaptive planning, and patient outcomes.

Method A literature review was conducted using peer-reviewed articles identified through The University of Texas MD Anderson Cancer Center Research Medical Library. Studies published between 2022 and 2026 were included if they addressed the clinical advantages of MR-Linac technology. Findings were synthesized using thematic analysis.

Results Three primary themes emerged: (a) superior soft-tissue visualization improved tumor delineation and treatment accuracy; (b) daily adaptive treatment planning and real-time tumor tracking enhanced precision by accounting …

Impact Of Music On Patient Comfort During Mr Scans: A Literature Review, He Yan

Radiologic Sciences

Purpose To investigate the influence of auditory stimuli on patient comfort levels during magnetic resonance (MR) imaging, with particular emphasis on indicators of distress, duration of patient positioning, and utilization of emergency signaling devices.

Method An integrative literature review was undertaken utilizing peer-reviewed research articles sourced from journals within the fields of radiology, music therapy, and clinical practice. A comprehensive search was conducted across databases such as PubMed, ScienceDirect, SpringerLink, and Oxford Academic employing keywords including MR anxiety, music therapy, and patient comfort.

Results The body of literature consistently indicated that auditory stimuli significantly mitigate patient anxiety and distress in …

Enhancing Cancer Diagnosis And Treatment Planning Through Multi-Modal Imaging Techniques: A Literature Review, Ngan Kim Le

Radiologic Sciences

Purpose To examine how combining magnetic resonance (MR), computed tomography (CT), and positron emission tomography (PET) enhances clinical outcomes in complex or metastatic cancers, focusing on diagnostic performance, staging accuracy, and effects on treatment decisions.

Method Data were extracted and analyzed using a thematic synthesis approach for this literature review. Key variables included study design, sample size, cancer type, imaging modalities used, and reported diagnostic outcomes such as sensitivity, specificity, and accuracy.

Results The integration of multiple imaging modalities enhanced diagnostic performance, improved differentiation between tumor recurrence and posttreatment changes, and increased detection of occult metastatic disease. Advanced imaging approaches, …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

08-19-26 Bor Hsc Committee Notice Of Meeting, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

08-19-26 BOR HSC Committee Notice of Meeting

Quality Improvement Project From Novice-To-Expert: Training Nurse Faculty On Virtual Simulation, Dae'visha Kinniebrew

Doctor of Nursing Practice Projects

Virtual simulation is an evidence-based teaching strategy that enhances student learning; however, inconsistent faculty preparation limits its implementation in nursing education. A needs assessment identified a practice gap, with 70% of nursing faculty reporting no virtual simulation training within the previous 12 months. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of a structured non-immersive virtual simulation training program on nursing faculty confidence, perceived competence, and technology readiness in an Associate Degree Nursing (ADN) program. The aim was to improve faculty preparedness to implement non-immersive virtual simulation. A quantitative, quasi-experimental, …

Ai-Enhanced Ct Reconstruction: Effects On Image Quality Across Dose Levels And Implications For Radiation Dose Optimization: A Systematic Review, Matthew R. Alberto

Radiologic Sciences

Purpose To evaluate how deep learning image reconstruction (DLIR) affects diagnostic image quality and noise characteristics at different radiation dose levels and how it influences dose optimization compared with conventional reconstruction methods.

Method A systematic review was conducted using major databases for studies published between 2020 and 2026. Eligible studies assessed DLIR across multiple dose levels, reported radiation dose, included quantitative image quality metrics, and compared DLIR with filtered back projection or iterative reconstruction.

Results Thirty‑seven studies met criteria, and 15 were synthesized. Three themes emerged: (a) DLIR reduced noise by 15–82% and often improved signal-to-noise and contrast-to-noise ratios while …

Reducing Mr Acquisition Times Using Artificial Intelligence: A Systematic Review, Fatin M. Arief

Radiologic Sciences

Purpose To synthesize existing evidence on artificial intelligence (AI) applications for reducing magnetic resonance (MR) imaging acquisition time, evaluate their impact on image quality, and identify challenges in clinical implementation.

Method A systematic literature review was conducted using PubMed, CINAHL, and Scopus including peer reviewed, English-language articles published between 2020 and 2026. Both qualitative and quantitative primary research were eligible and had to be on AI use in MR processes. Findings were analyzed through thematic synthesis, and the quality of each study was appraised using relevant critical appraisal tools.

Results Three major themes emerged: AI methods in MR procedures, perceived …

Gadolinium Deposition Concerns In Magnetic Resonance Imaging, Emily Tran

Radiologic Sciences

Purpose To examine how concerns about gadolinium deposition have influenced the use of macrocyclic versus linear contrast agents in magnetic resonance (MR) practice.

Method A structured literature review was conducted using AI-assisted research tools and academic databases to identify recent peer-reviewed original research articles related to gadolinium deposition and contrast agent use patterns in MR. Only studies published between 2020 and 2026 were included.

Results Recent research confirmed that gadolinium can accumulate in human tissues following contrast-enhanced MR examinations. Multiple studies demonstrated that linear gadolinium-based contrast agents are associated with greater levels of tissue retention compared with macrocyclic agents due …

High-Definition Healing: Investigating Ai-Driven Mr Reconstruction Methods, Jerell R. Jones

Radiologic Sciences

Purpose To analyze recent artificial intelligence (AI)-driven magnetic resonance (MR) reconstruction methods aimed at addressing long acquisition times, image artifacts, and workflow inefficiencies.

Method A systematic literature review was conducted using PubMed, Scopus, and Scopus AI, targeting peer‑reviewed studies published between 2015 and 2026. Search terms included “MRI,” “magnetic resonance imaging,” “artificial intelligence,” “deep learning,” and “machine learning.” Eligible studies included methodology, validation, and review papers. Extracted data included algorithm type, study design, key findings, and limitations. Themes were identified through content analysis and generative AI use.

Results Prominent themes identified were the emergence of generative adversarial networks, advanced neural …

Administrative And Clinical Impacts Of Theranostic Program Expansion In Nuclear Medicine, Karmela Kljajic Pascual

Radiologic Sciences

Purpose To synthesize current evidence on theranostic trials, nuclear medicine clinical workflow models, and organizational readiness, with a focus on how healthcare organizations and medical imaging leaders are adapting to the rapid expansion of theranostic services.

Method A comprehensive search was conducted across Scopus, PubMed, MEDLINE, and Google Scholar. Inclusion criteria required peer‑reviewed articles published between 2002 and 2026 addressing nuclear medicine leadership, theranostic implementation, workflow design, and organizational factors influencing theranostic program development. Exclusion criteria removed editorials, blog posts, and nonpeer‑reviewed sources.

Results Four major themes emerged: workforce and staffing demands, infrastructure and resource requirements, regulatory and administrative pressures, …

Evaluating The Safety Of Mr Exposure For Electronic Devices And Implants: A Literature Review, Molly O'Dowd

Radiologic Sciences

Purpose To review literature examining the factors that determine magnetic resonance (MR) compatibility of electronic implants and wearable devices, including device materials, engineering design, regulatory approval processes, and clinical monitoring requirements.

Method An integrative literature review was conducted using peer-reviewed literature addressing MR safety and device compatibility. Databases searched included PubMed, Wiley Online Library, ScienceDirect, and Google Scholar. Studies were selected based on relevance to MR safety classifications, device design considerations, regulatory labeling, and monitoring requirements.

Results The literature demonstrated that MR compatible devices are engineered and tested to meet regulatory safety standards and approved for use under specific scanning …

Application Of Lean Six Sigma Strategies To Improve Diagnostic Imaging Departmental Performance Metrics: A Literature Review, Obinna Newman Osuji

Radiologic Sciences

Purpose To systematically evaluate the effectiveness of Lean and Six Sigma quality improvement approaches in enhancing diagnostic imaging workflows and departmental financial performance.

Method Literature for this review was retrieved from Scopus, CINAHIL Plus, PubMed, and Healthcare Administration Database in February and March 2026. Empirical studies and literature reviews were included if they addressed the utilization of Lean Six Sigma, Lean, or Six Sigma as a method of quality improvement within a diagnostic imaging departmental setting.

Results Database searches generated 1,624 articles, and 17 were deemed suitable for inclusion in the study. There were four studies that directly measured patient …

Assault Vs. Assistance: Radiologic Technologist Decision-Making When Fall-Risk Patients Decline Assistance, Pamela O'Dowd

Radiologic Sciences

Purpose To explore how radiologic technologists experience and respond to situations involving fall-risk patients who decline assistance during imaging procedures.

Method A cross-sectional survey design was used to collect data from practicing radiologic technologists recruited through the American Society of Radiologic Technologists. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS to summarize participant responses, and a thematic analysis was conducted on open-ended responses.

Results A total of 87 respondents completed the survey. Results indicated that encounters with fall-risk patients who refuse assistance are common in clinical imaging practice. Sixty-three (72.4%) technologists reported having experienced situations in which a …

Deep Learning Reconstruction In Pediatric Ct Imaging, Cody Wyatt

Radiologic Sciences

Purpose To synthesize current evidence on dose optimization using deep learning reconstruction (DLR) with emphasis on computed tomography (CT), pediatrics, contrast to noise ratio (CNR), signal to noise ratio (SNR), and radiation dosage.

Method The methodology was a systematic literature review, synthesizing peer-reviewed literature on the use of DLR in pediatric CT. Databases searched included Scopus, IEEE Xplore, and Web of Science. Keywords include combinations of deep learning reconstruction, DLR, CT, pediatric, dose, and optimization. Boolean operators were used to refine search results.

Results Three themes emerged: dosage reduction, noise reduction, and improved spatial resolution with the use of DLR …

National Pacs And Electronic Health Records: Considerations, Challenges, And Implications For Radiomics, Darchelle Scott

Radiologic Sciences

Purpose To examine the considerations, challenges, and implications of implementing a national picture archiving and communication system (PACS) integrated with electronic health records (EHRs), with particular emphasis on interoperability, radiomics, and patient-centered data sharing.

Method A systematic literature review was conducted using books, peer-reviewed articles, original research studies, and government publications addressing radiomics, TEFCA, blockchain technology, PACS, and EHR integration. Literature was analyzed to evaluate national health information exchange, radiomics applications, and implementation challenges associated with a connected healthcare infrastructure.

Results Three primary themes emerged: (a) interoperable national PACS and EHR systems have the potential to improve continuity of care …

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger

Walden Dissertations and Doctoral Studies

Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …